5 Ways to Not Act Like a Mental Patient

I love this quote by Dr. Linehan. When I’ve posted it on Facebook and Twitter in the past, it’s gotten lots of “likes,” “favorites,” and comments.  It came to mind this morning, and it made me think: What does it mean to “act” like a mental patient, and how can we change such behaviors if we so desire?

The answers to these questions are going to look different for each person reading this, so I’ll give you my take on it.  Let me know what you can relate to and where you differ.

What does it mean to “act” like a mental patient?

When I picture someone being referred to as a “mental patient,” warm fuzzy thoughts do not come to mind, nor do images of a person simply sitting calmly and filling out forms in a waiting room. No. “Mental Patient” carries stigmatized, often frightening imagery, say, of someone being restrained in a straight jacket, as in the retro image below.  When someone uses the term, it’s not one of endearment. They are saying that the person is “crazy.” The person is probably outwardly acting in ways that seem abnormal or even frightening to others.


Here’s an example of when I acted like a mental patient:

Due to feeling highly triggered a few months ago, I ignored warning signs to take care of myself and was astounded by my out of character (and out of control) reaction to a very small conflict — over bread.  In the middle of a crowded grocery store, I yelled out, “F*&k you” and gave someone I cared about a very rude hand gesture.  People were looking. I felt enraged. Moments later, I felt frightened and highly embarrassed.  I broke down and cried.  

Did people think I was crazy? Probably.  I didn’t stay in control.  I lost my temper, which happened so quickly.  I didn’t resist the intense and sudden urge to say and do hurtful things.  I caused a scene in a public place. This is, for me, what acting like a mental patient has looked like in my life.

Here’s a situation where I refrained from acting like a mental patient:

Have you ever had one of those “off” days where you’re anxious and/or thinking that it’s written all over your face that you’re stressed and losing it?  I had that today.  I went into my new cell phone carrier’s store, and having brought in all the energy from therapy session into the store, I felt like just one look at me and the clerk would be see right through me. She’d think I was nuts. 

I walked in with some residual anger and hurt — but I knew this. I became conscious of it.  The clerk was kind, attentive, knowledgeable, and friendly.  If anything, she picked up that I was a little bit stressed because I dropped cues (facial expressions, deep breaths and sighs, a tense brow), and she was even kinder. I got lucky!

When I realized how worked up I really us, I had the opportunity to practice Opposite Action and engage with her in a kind way. (Being kind is actually an Opposite to Emotion Action for anger. It can help reduce it!)

To me this is an example of not acting like a mental patient. even though the perfect storm had brewed right before my visit to the store — I was vulnerable and triggered. 

How can we act less like the stereotyped mental patient, at least some of the time?

My 5 Ways to Not Act Like A Mental Patient

1. Be aware of my feelings and acknowledge them.  I find that denial and suppression can have huge consequences. The thing is, sometimes our mind and nervous system do this for us automatically and without our knowledge, and the pieces or fragments of the story come back to us at a later time.  This can be frightening and upsetting.  I’m learning to notice and experience the feelings when they surface without allowing them to overtake me. I am also quick to reach out for support from my therapist or psychiatrist when the pieces are too heavy to carry alone.

2. Decide how I want to behave and have a plan before I am next triggered. I made a decision to consciously redirect my energy when I notice anger due to triggers coming on.  I take deep breaths. I excuse myself if I need to and take a short time out.  I drink some water.  I then come back and willingly and intentionally extend kindness to whoever is in my company at the time.  It may sound bizarre, but there’s something about doing this that calms the nervous system.  We begin to feel the effects of our choice to take on a softer stance, speaking gently, and smiling. Our nervous system senses that we are not in danger – no need to be on the attack. We calm down.

3. Engage in LOTS of self-care.  We tend to act outwardly in inappropriate ways when our inner needs aren’t being met.  If I feel tired, vulnerable, and irritated, this can manifest in the ways I engage with others.  Taking the time to swaddle up in a blanket with my cats, sip on some decaf tea, and unwind with a good TV show, movie, or book, can help to take the stress level down a few notches.   Being aware of how I feel and engaging in self-care even when it’s the last thing I may instinctively think to do, really help. Basic self-care (eating, staying hydrated, and sleeping) are essential and first on the list, but then picking up a little treat for myself or taking a nap start making it on there as well.  Will buying a lipstick at the drugstore solve my problems? Of course not. Will it help me to feel a little better even for a little while? You bet. And, it’s a reasonably small investment.

4. Take care of my physical health. The DBT PLEASE skills are so important, because when we slack on our basic self-care, as mentioned in item 3, we become so much more vulnerable emotionally. I must push myself to eat, even when I don’t feel like it, drink plenty of water, and take my medication as prescribed.  Taking walks also help so much.  Our doctor in IOP today actually suggested that all of the patients in the group start walking regularly.  We have such natural ways to release stress and feel calmer available to us.

5. Love myself through feeling crazy, without judgment.  If I notice feelings of overwhelm and mental chaos coming on, I’ve also noticed judgment, both of myself and how I expected others to treat me.  The truth is, no one knows what’s going on inside of you unless you tell them or act out.  I intend to watch my feelings and to then extend compassion around the fact that I “feel crazy” in that moment.  I can acknowledge it, experience it, and let it go. I don’t have to act on it. I can engage in Opposite Action and Self-Soothing.  I can let the feeling pass and go and wait on interacting with others until it does, if possible.

I’m curious. What does acting like a mental patient look like to you?  How can you work on maintaining composure and shifting from Emotion Mind to Wise Mind enough so as to not “act” like a mental patient?

Thanks for reading.
More Soon.

4 replies
  1. Gasoline Rainbow
    Gasoline Rainbow says:

    I feel the same way, as if all my hurt and anger is written accross my face. I find it hard to go out sometimes because of this.
    I too will react in public to something someone has said, the 'fuck you", followed by a hand gesture is very familiar to me. Some days it feels like it's my calling card.
    I try so hard to not "act like a mental patient" … It's difficult.

  2. Anonymous
    Anonymous says:

    Definately can relate, specially on the "over the top" anger demonstrations. Sometimes with phone calls (late night), confrontation, yelling, throwing objects. To be honest I don't think those behavior are "mental patient"-like… because I think that anger is within all humans… but our society has teached us to repress our emotions. People crave to be "normal" but to be honest. I rather be honest. People prefer to avoid conflict, and I think conflicts helps us to develop, learn and grow. Ad I think most people apply other repressed methods of violence but in a quiet way, soy they seem normal. BUT the breaking point is when that honesty backfires… then is when I think is a good idea to control our emotions because that will affect our lifes. Sometimes honesty is not enough for people to understand, it just makes them think we are crazy.

  3. Healing From BPD
    Healing From BPD says:

    Hi Ms. Rainbow 🙂 We can get better with our boundaries, and part of that, I'm finding, is an awareness of how we are presenting ourselves to the outside world. It sounds like you are aware of this as well. Thank you for sharing that you can relate. I love your comments. ♥

  4. Healing From BPD
    Healing From BPD says:

    Hi Daniela. Thank you for sharing your experience. You are so right — it *is* an expression of anger. Unfortunately, "mental patient" has become a slang term to describe others' behavior when we don't quite understand it, think it's abnormal, or are afraid of it. Proud of you for these insights. ♥


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