It starts like this: “You’re in a mental hospital. Use the first 7 people on your chat list to fill in below…”
When this popped up in my Facebook feed recently, something in me snapped.
Why? The game asks you to assign 7 people on your chat list to be characters with you in a “mental hospital” skit, and to post the list of characters.
Assigning one friend to “lick the windows,” another to “run around naked,” and another to be “the person you went crazy with,” is neither humorous nor harmless. It exploits common, hurtful misconceptions about people receiving psychiatric care.
We know that psychiatric inpatient facilities take care of people and loved ones in some of the worst circumstances, when they are aching and terrified. Jokes and games trivialize their experiences of mental illness and psychiatric care in general.
Posted in a public space like Facebook, the shared laughter gives it even greater weight, and greater hurt.
Your Facebook posts can be repeated, and probably will be.
Even in a closed group, Facebook posts go in a permanent public record. Despite the lull of our privacy settings, a post can be shared by anyone who reads it, with anyone they know outside of a group. It can be copied and emailed to a friend, or copied onto another open forum.
Our words and pictures on social media can be read and repeated to pretty much anyone in the world.
If you engage in social media as a massage therapist, your role as a professional follows you wherever you post. (This is why Laura Allen implores MTs to cover up key body parts in their Facebook photos.)
Even if you don’t engage specifically as an MT, your friends and associates know what you do, so your posts reflect on the profession even when you don’t intend it that way. And the sting of a hurtful post gives it a particularly long shelf life.
A Professional Pact
With our words and actions, each of us individually represents massage therapy. By training, practicing, and licensing as a massage therapist, each of us enters into a pact with the profession.
That means you represent me. And I represent you. We don’t have to represent each other perfectly, or be serious all the time, or check our personalities at the door. But we do agree to be our best selves in public, and use words that reflect well on our work.
In my view, this agreement does not preclude personal information or lighthearted Facebook posts, or even occasional light profanity, but it does preclude ridicule of certain populations of people. Coming from someone with the word “therapist” in their job title, humor that dismisses someone else’s heartbreak is wildly out of place, especially in a public forum. There, a cheap laugh has a high price.
This particular joke has been propagated at the expense of real people, not just characters in a skit.
Just how many people are we laughing at here?
Around 13% of US adults report receiving some kind of treatment for a mental health problem (1).
We can safely say that massage therapists, massage clients, and Facebook users make up some of that percentage. It is likely that you are already working with clients with mental health histories, whether they tell you or not.
Of these conditions, anxiety and depression are notoriously common: 350 million people cope with depression worldwide (2). In the US alone, anxiety disorders affect 40 million adults (3). Again, assume more than a handful of those are on Facebook, reading your posts.
The numbers are staggering, but the real irony in the massage-therapists-poking-fun-at-mental-illness game? Some of the most well-documented benefits of massage are for people with anxiety and depression.
One summary of massage research findings is worth shouting from the mountaintops. It reports that, for people with anxiety and depression, a course of massage therapy is comparable in benefit to a course of psychotherapy (4). Indeed, you read that correctly. Look up this mind-blowing meta-analysis for yourself.
There we have it: our power to hurt with our words, or help with our hands. Turns out we’re supposed to be part of the solution, not the problem.
Now suppose I post the “mental hospital” joke on my timeline.
After seeing me make light of mental illness, how would a person with a mental health history feel safe on my table, telling me about their history? More importantly, even if they never saw the joke, why should they feel safe on my table at all? How does trivializing (or sensationalizing) someone’s pain earn their trust?
How does it earn the trust of that nurse or physician we’re trying to impress?
How does it serve us to make fun of health care consumers—real people in need—when we are hoping for massage therapy to have a real role in health care?
We all know how much stigma, trauma, and utter non-support exists for people with mental illness, without massage therapists adding their jokes to the fray. Patients and loved ones don’t need our questionable humor, they need our care and solidarity.
They need us to remember who they are. They need us to be professional and remember who we are.
Yes, remember who we are.
Propagating the “mental hospital” game is inconsistent with our signature compassion. This compassion comes so easily to us in other situations: Do we make similar sport of other people being treated in the hospital, such as cardiac inpatients? People with diabetes complications, trauma survivors in the ICU, or people with alcohol addiction or stroke histories, in rehab?
Is it funny to go around acting like them, or however we imagine them to be?
I’m guessing the answer is no. If those examples sound ridiculous, it’s because they are. As ridiculous as the joke that inspired this post.
Think before the Thumbs-up
If you are a friend or a colleague who has posted, commented upon, or liked the “mental hospital” skit, I hope you will consider deleting and unliking it. For a really deep cleaning, untag yourself from the thing and let your friends know why. And drop the outdated term, “mental hospital,” substituting “psychiatric hospital,” or “psychiatric unit/floor” instead.
If I sound offended all over the place, it’s because I am. Even though I rarely lose my temper, it went missing the 4th or 5th time I saw “mental hospital” in my feed.
With breathing, it came back. Getting curious about this humor also helped — understanding that we’re all trying to connect with each other on Facebook, and occasionally we miss the mark. If you’ve posted or supported this skit, I still value our connection and whatever else you’re posting about your life and work.
From your other posts, I assume you’re about as fallible, mistake-prone, and well-intentioned as I am, and—whether or not it matters—my respect for you is still alive and well.
In fact, I respect you enough to raise this concern in the first place.
I know how tempting it is to play along with a shared joke. I have been there. So I offer up a general guideline: Before breathing any more life into it, pause. Think.
Then ask yourself if the joke comes at someone’s expense. Does it exploit sensitive topics such as someone’s illness, addiction, or history of psychiatric care? How about a person’s body type, dress, race or ethnicity, religion, gender or gender identity, age, or sexuality? Any of the other generally accepted human tender points?
Is it possible that person could be a client one day?
Are they already hurting?
If yes, take a pass and take a stand. Delete it and let it die.
It’s not worth the laugh.
*****
References
1. National Institute of Mental Health. Use of Mental Health Services and Treatment among Adults. Retrieved June 14, 2013, from http://www.nimh.nih.gov/statistics/3USE_MT_ADULT.shtml
2. The World Health Organization. Depression. ( Fact Sheet N*369.) Retrieved June 13, 2013, from
http://www.who.int/mediacentre/factsheets/fs369/en/index.html
3. National Institute of Mental Health. Anxiety Disorders. Retrieved June 14, 2013, from http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.
4. Moyer CA, Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull 2004 Jan; 130(1): 3-18. Click here for abstract.
Tracy, very well stated! I completely agree with you.
I whole-heartedly agree. I am a massage therapist and RN. I worked with mentally ill children in a locked psychiatric facility for 9 years. These children were horribly abused. Thank you for drawing attention to this.
Brilliant! When I received the original posting I immediately deleted it. I did not find any humor in it either. Thank you for going the next step.
Hi Tracy. Just to let you know, when I put in my website it wouldn’t accept it.
Cherie, thanks for your words and heads-up! And I edited it to put your site in.
Thank you for writing about this and helping people to be aware. You really explain very well, why this sort of this is just so wrong. Thank you
Thank you Tracy, this is a touchy subject and you were able to address it brilliantly.
Very well said. I agree completely.
Thank you for the ethics FB update Tracy! It would be like using a diabetic client and selecting people from chat to: be the most likely to eat at McDonald’s, lose a toe/foo/leg, be on dialysis, lose the ability to achieve an erection, most likely to have neuropathy, and sickenly on and on…no humor about it whatsoever!
I will definitely share this with my class tonight!
Sherry, this analogy works! I will quote you! Thanks…
Yes, yes indeed! As usual, Tracy, you say forthrightly what can be hard for some. I stay sensitive to a version of this around pregnant women’s body image and feelings. While most predominantly embrace and have a normal weight gain, jokes about their elephant legs or looking like a beached whale are particularly painful to those struggling with negativity about their larger bodies.
PS Similar problem as Cherie about the website entry.
Carole, this is a useful perspective indeed! And I did not edit your website back in like I did with Cherie’s, in order that my my web person can look at one of each and fix it. Carole Osborne’s site is http://www.bodytherapyassociates.com/.
After reading your post I looked on the Internet Archive WayBack Machine. We have had a website since May of 2000 — before the advent of MySpace, Facebook, Twitter, Pinterest, et al. With the years of invested time and money creating our website and now social media presence we would not think of comprising that image or our integrity. My personal FB page is public. There is nothing on my page or any of my business pages that I am not honored to share and to have shared.
Eloquent as usual while hitting the proverbial nail on the head, Tracy! I think I only showed up in one of these posts on a friend’s page and I was the “doctor”. Incidentally, the “person” most likely to lick windows in that round was actually a dog who happens to have a FB page (and he has been known to lick windows!). I was mortified that I was in the post nonetheless. Always appreciative of you, your compassion, your insight, and your writing skills, Jen <3
Jenifer, Mark, Janet, Elisa, Ellie, Sherry, Jill! Thank you for your support.I hope it helps the “pause and think” button. And, for some of you: Pleased to meet you!
Excellent food for thought. I must admit, I have Liked and Shared some things that are questionable. #Liveandlearn
Yes, yes, yes. Thank you for calling this to our attention, Tracy, with vigor, righteous anger (appropriate) and excellent prose. Makes me think carefully, and re-consider, how I present myself in social media. As Benjamin, above, I am truly #Liveandlearn
Thank you.
I think you already know how much I love this post. Thank you for writing it. To have an ethics instructor of your caliber clearly address this issue gives it some serious weight.
Facebook ethics aren’t just about not posting bikini pics. It’s about being mindful of your behavior and interactions, too. You just never know what could be seen by others.
Benjamin, Kristen, Yvonne, Allissa. Thank you for your comments, and I appreciate (and have lived) the humility we feel when we re-examine what we’ve posted.
I’m afraid I will be the contrarian here, and say I think this joke is harmless, and any sensible person would never associate a laugh at this with desensitizing mental illness or those who suffer from it. This is the kind of false solemnity which does nothing but make people more uptight and politically correct. I am certainly horrified at what some people post on Facebook, but this wouldn’t be one of those things. Sorry…
Hi there, Seth: Contrarians are some of my favorite people. It’s true a single joke will offend some people and not others, and others have agreed with you. I know many people for whom it HAS been hurtful, however, and it certainly has horrified some of the massage therapists seeing it. We can write them off as not being sensible people. However, knowing that the joke has a track record of being hurtful to people, I would think we would not want to alienate potential clients (or potential referral sources) right off the bat. Many of us (not all) want greater acceptance as health professionals, and some softness around stigma and charged issues seems more likely than jokes to serve us in that goal. Negative attitudes toward mental illness can pose barriers to care. I learned a lot from this CDC report about attitudes. http://www.cdc.gov/hrqol/mental_health_reports/pdf/brfss_full-report.pdf.
Comedy……always a thin line.
I think I only showed up in one of these posts on a friend’s page and I was the “doctor”. Incidentally, the “person” most likely to lick windows in that round was actually a dog who happens to have a FB page:see more at:http://www.lunanaturally.com/remedial-massage-therapy/