The Importance of Self-Advocacy

It can be easy to forget that we dictate the terms by which others treat us. What we tolerate, we invite, and when we are willing to settle for less than we need, we give others permission to disregard us. We feel its effects at work, while shopping, at school, at the doctor’s office…anywhere we rely on another person’s cooperation, or minimally, their consideration.

When I was younger, I didn’t speak up for myself. I took people at their word, regardless of the number of times that word may have been broken. I let myself be pushed around by others simply because they were in positions of authority. I missed opportunities to take better care of myself because I thought I must accept what was given. But, I know better now.

My lesson in self-advocacy came from the most difficult and painful time of my life.

I’ve suffered from depression and anxiety my whole adult life, and have a history of alcoholism on both sides of my family. When we lost our child to suicide, those pre-existing vulnerabilities left me not only grieving, but struggling with PTSD, and on the downward spiral of chemical dependency.

When I sought treatment, not a single caregiver at my psychiatrist’s office suggested I receive therapy for bereavement or PTSD. Not one. After my first round of outpatient, my drinking worsened. During my second round of treatment, another patient repeatedly triggered me with talk of guns and violence and death. It got so bad I couldn’t be in the same room with him. So, I didn’t complete the program but asked to be treated some other way. It took them several weeks to coordinate my registration into another program. I consumed a liter of gin every day for almost a month. I was either asleep, passed out, or angry drunk, 24 hours a day. I didn’t dress, I rarely bathed. If I didn’t turn things around soon, the booze was going to kill me.

Only when I started my third round of outpatient, a women’s-only dual diagnosis group (a program that recognizes a pre-existing psychological condition which impacts and is impacted by alcoholism) did I get better. That’s when I realized I should’ve spoken up sooner, that I’d endured a lot of unnecessary pain and setbacks because I didn’t assert myself. While there was failure on the part of my clinic to properly assess and treat me, there was failure on my part to demand what I needed.

So, last year when I needed to work through some personal challenges, I had to start with a new therapist. My clinic set me up with a psychologist, and by the end of our intake, I knew it was a poor fit. Not only was she uncomfortable with aspects of my private life that I wanted to discuss, she was also incapable of working with me on my terms. Her treatment protocol didn’t allow for it.

This time, I wasn’t willing to accept what I was given. It was not good enough. Her two Ph.Ds. and years of experience were of no value to me, so I moved on. Quickly.

The second therapist they assigned still wasn’t right. I requested someone else. And now, I have a therapist who’s willing to be available when I need assistance. She’s not fazed by my alternative lifestyle. She doesn’t require me to see her on a regular basis, nor does she want to teach me skills I already know. Her approach is consistent with my expectations of treatment as a responsible, intelligent adult, and it respects my right as the patient to determine the course of my care.

Self-advocacy doesn’t require us to be boisterous or bullying. When it comes right down to it, it’s about saying, “no”, “this isn’t what I asked for”, or “that is not what I need”. Sometimes we have to repeat ourselves. But it’s worth it, because we’re worth it.


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