Lived Experience, Mental Health and the Things We Don’t Always See
Every October, World Mental Health Day gives us an opportunity to talk more openly about
mental health. This year’s theme, “Lived experiences heard: real voices, real change,” feels
particularly important because lived experience is not simply about telling a story.
It is also about the kind of understanding that comes from having felt something from the inside, often before there is language for it, before there is a framework, and before you
necessarily know how to explain what is happening.
I came to understand some things about trauma, attachment and relationships long before I had the professional language for them.
Training has since given me theory, frameworks and ways of understanding what I had already begun to recognise, and my work as a therapist has taught me an enormous amount through sitting alongside people whose experiences are very different from my own.
But lived experience can shape what we notice, the questions we ask, the assumptions we make and the things we are less likely to dismiss. That matters in mental health.
What we see is not always the whole story
A lot of mental health language describes what we can observe: anxiety, people-pleasing,
shutdown, low confidence, difficulty making decisions, hypervigilance and emotional
overwhelm.
Those words can be useful, but they do not always tell us where a response came from.
Someone who constantly scans the room may not simply be “an anxious person”.
Someone who avoids conflict may have learned that disagreement carries consequences.
Someone who struggles to make decisions may have had their judgement questioned.
Someone who shuts down may not be disengaged; they may be overwhelmed.
Someone who puts everyone else first may not simply need to learn better boundaries; they
may have learned that staying connected meant becoming highly attuned to what everyone else needed.
If we only focus on the visible response, it is easy to miss the context around it. Lived
experience often reminds us to ask a different question, not simply What is wrong? but
What has this response been trying to do?
Trauma can shape the way we relate to ourselves and other people
Trauma is often associated with a single catastrophic event, and sometimes that is exactly
what it is. But trauma can also be relational and can develop through repeated experiences
of uncertainty, fear, disconnection or having to adapt around another person.
Over time, our minds and bodies learn. We notice certain tones of voice, certain facial
expressions and changes in atmosphere. We anticipate, prepare, explain ourselves, become
quieter, keep the peace or perhaps hold tightly to connection because losing it feels unbearable.
These responses are not random. They often make sense when we understand the circumstances in which they developed.
That is where attachment becomes important too. Attachment is not simply about whether
someone is “anxious” or “avoidant”; it is about what happens when connection matters.
When a relationship feels uncertain or unsafe, some of us move closer, others move away,
and many of us do both. Understanding that can help us move away from judging responses and towards understanding them.
Why lived experience changes the questions we ask
One of the reasons lived experience matters is that it can challenge questions that sound
reasonable from the outside. Domestic abuse is one example.
People experiencing abusive or controlling relationships are often asked, Why did you stay?
From the outside, it may seem obvious: if someone is being hurt, why not leave? But
relationships rarely unfold in such a simple way.
The person causing harm may also be someone who is loved, someone a person shares
children with, someone they depend on financially, or someone who has also been kind,
reassuring or affectionate. There may be fear about what will happen if they leave, isolation,
hope that things will change, or a gradual shifting of what feels normal.
Something that once felt unacceptable becomes something you explain. Something
frightening becomes something you minimise. You start wondering whether perhaps you
are overreacting, whether you misunderstood, or whether the problem is actually you.
That is why a question like Why didn’t you leave? can miss so much.
A more useful question might be, What made leaving difficult or unsafe? or What were you trying to manage or protect at the time?
That small change in language matters because one question asks someone to defend themselves, while the other invites us to understand.
Mental health cannot always be separated from context
We can sometimes talk about mental health as though symptoms exist in isolation, but
distress does not happen in a vacuum. The environment someone has been living in
matters, the relationships around them matter, and the way they have been responded to
matters.
A person may be anxious because their nervous system has learned to expect
unpredictability. They may struggle with self-worth after years of criticism. They may doubt
their own judgement because their version of events has repeatedly been challenged, or
find closeness difficult because relationships have not always felt safe.
That does not mean every mental health difficulty is caused by trauma or relationships, but
it does mean context matters. Lived experience often brings that context into view and can help us understand why a response that looks confusing from the outside may make perfect
sense from within someone’s experience.
Being heard is more than being allowed to speak
This year’s World Mental Health Day theme is not simply about encouraging people to share
more. That is important, but being heard has to mean more than disclosure.
Being heard means that someone’s experience is taken seriously. It means not immediately
rewriting it through our own assumptions, resisting the urge to tell someone what they
should have done, and recognising that someone may have made choices that helped them survive circumstances we did not fully understand.
It also means remembering that people do not owe us every detail in order for their
experience to be valid. There can be enormous power in telling your story, but there can
also be power in deciding what remains private. Having a voice should not mean giving up
your boundaries.
The response matters too
If lived experience is going to create real change, then listening has to change what we do.
That includes the way friends, families, services and professionals respond, and it also
includes therapy.
Someone recovering from domestic abuse or coercive control may already have spent a
long time questioning their own perception, adapting around another person or feeling that
their judgement cannot be trusted. Therapeutic work needs to be careful not to recreate
that dynamic.
That means understanding that domestic abuse is not simply a relationship conflict where
both people carry equal responsibility. It means working in a trauma-informed, boundaried
and protective way when needed, while still respecting someone’s autonomy and choices. It
also means recognising that familiar therapeutic ideas such as compromise, increased
vulnerability or “seeing the other person’s side” may not be appropriate where coercion or
control is present.
Safe support needs to take account of power, fear, context and risk. It should help someone
become more connected to their own judgement rather than replacing it.
Why I am talking more about domestic abuse
Over the coming months, you may notice me writing more about domestic abuse, coercive
control and recovery. For me, this is not separate from my existing work around trauma,
attachment and relationships; it sits alongside it.
So much of this work is about what happens to our sense of safety, how we adapt in
relationships, what happens when we lose trust in ourselves, why leaving something does
not necessarily mean the impact ends, and what it can take to begin feeling more like ourselves again.
I want to contribute more to conversations about recognising coercive control, the barriers
to leaving, the psychological impact that can continue afterwards and how people can be
supported safely and respectfully. Not because every story is the same, but because too
many people are still met with questions that place the burden back on them.
Real voices, real change
For me, lived experience does not replace professional knowledge. We still need research,
specialist services, safeguarding and clinical understanding. But lived experience adds
something important because it shows us what something can feel like from the inside.
It reminds us that behaviour makes more sense when we understand context. It asks us to
be curious before we judge, and sometimes it reveals where our usual questions are not
good enough.
Perhaps real change begins with asking different ones.
Less Why didn’t you leave? and more What made leaving difficult?
Less Why can’t you just move on? and more What still needs safety or repair?
Less Why are you like this? and more What has this response helped you survive?
That is what this year’s World Mental Health Day theme means to me. Not simply giving
people space to speak, but being willing to let what we hear change the way we understand,
respond and support.
Because being heard should make a difference.
This is much closer to the style you were using earlier in the year: more like an actual article,
less like a sequence of captions.
Comments