The idea of labelling people as attention-seeking is not unique to mental illness, but it’s certainly something that seems to come up an awful lot. The labellers might be friends and family, but unfortunately, they may also be health care providers. One of the labels that comes up regularly is “attention-seeking.”
Physical manifestations of mental distress
I work as a nurse at a mental health and addictions facility. One of the recent clients had borderline personality disorder and a history of significant trauma, and I heard staff frequently describe him as attention-seeking. He had a tendency to somatize mental distress, and this would often take the form of gastrointestinal discomfort, which many staff tended to dismiss out of hand. When staff dismissed his concerns, he tended to respond with very regressive behaviours, like crawling rather than walking.
I only work nights so I mostly just saw him at the beginning of my shifts. My experience, though, was that he almost always responded very well to heaps of validation. He didn’t necessarily need to be given what he’s asking for, and often what he was asking for wasn’t an effective way to meet his needs anyway, but validation of his distress settled him right down.
The problem with labelling
The attention-seeking label is thrown around a fair bit in mental health care.\ Where I work, a lot of the staff aren’t trained mental health professionals, and most of the regular nursing staff are pretty fresh out of school. I think both of these factors contribute to a tendency to quickly leap to the conclusion of attention-seeking. I’ve also noticed that the people who are most likely to apply the attention-seeking label have the least insight into the negative effects it has for the patient.
The way I see it, we all have needs that we try to get met. Sometimes we’re unable to meet our needs, and we reach out to others to help us. For the most part, that should be considered help-seeking behaviour, which is a good thing.
There are certainly times when people engage in problematic attention-seeking behaviour. Narcissistic and antisocial personality disorders are examples of this. For the most part, though, mental health professionals really shouldn’t have that much difficulty distinguishing this from legitimate help-seeking.
Factors that contribute to labelling
Someone reaching out for help may end up being labelled as attention-seeking for a few reasons:
- the genuine underlying need is not recognized
- the underlying need is seen but deemed to be not valid
- the person is viewed as not having made an effort or “enough” of an effort to meet their needs on their own
- the assistance that the “attention-seeking” individual is looking for would not be reasonably expected to actually fulfill the underlying need
- the “attention-seeking” individual expresses that the labeller’s recommended solution to the problem at hand seems inadequate or inappropriate
- on previous occasions, the labeller has not been able to provide any sort of meaningful help when the same reaching-out behaviour has occurred
- the labeller believes the person should just “suck it up” and deal with whatever the reported problem is
Consequences
This is similar to labelling people as “drug-seeking” or “medication-seeking” when otherwise compliance is what’s expected. There’s really no way for the patient to win when providers have a double standard.
It’s disappointing that for all that people are encouraged to reach out for help when they are having thoughts of suicide, people who actually do so are far too likely to be labelled as attention-seeking. It’s simple behavioural psychology that if you shoot people down for reaching out for help, they’re going to stop reaching. When it comes to suicidality, that can have deadly consequences.
I’m not sure what the solution is for this issue. I do know that it’s not okay.
Have you ever been labelled as attention-seeking by treatment providers?
My latest book, A Brief History of Stigma, looks at the nature of stigma, the contexts in which it occurs, and how to challenge it most effectively.
You can find it on Amazon and Google Play.
There’s more on stigma on Mental Health @ Home’s Stop the Stigma page.
Well let’s make this aswer about ME 😀 I worked in the MH-field and I couldn’t express what you are saying here. (that that client is expressing his/hers mental distress through certain actions and that we need to interpret them and maybe discuss them in a meeting with staff)I could say all those things but my co-workers were not impressed. That was one of biggest contributor to my burnout. Is that attention seeking? It’s a symptom of something that isn’t working for me. I always tried to interpret ‘weird’ of ‘different’ behavior and words in a different light. A light of meaning. I love to do that. But to answer your question: yes, I’ve heard those reactions too towards clients. And yes, I hear that I am ‘too soft’ for the profession. I can imagine people thinking it’s all a bit overreacted what I’m going through. And yes, people close to me accept the burnout part but not the depression. Although I have it on paper and they see the consequenses. I heard: ‘Why do you want to be depressed?’ So I believe they assume it’s a choice and therefore maybe attention-seeking. it hurts and I avoid speaking about it.
I can see why. Anyone who thinks depression is a choice needs to give their head a shake.
I also get told that I’m too soft, or that I should have handled a situation differently, even when my approach yielded a better outcome. It creates a really exhaustin work environment.
Even with better outcome? Sometimes I think we need to evidence-base every thought we have. Although these things have been studied. Exhausting it is for sure! I believe people (clients)who live in an enviroment where they have to strive for attention (mh-field) are also compelled to act a certain way. That won’t be true for everybody but for some people yes. I believe they can be more ‘sane’ in a more ‘normal’ environment where their needs are met. That is true for every body not only for people who struggle with mental health.
I completely agree.
I have been labelled as attention-seeking because (in my opinion), my providers were either not equipped with enough experience, overworked, impatient and/or having lack of compassion and passion about treating me or their other clients fairly. I am an Armed Forces vet and I’ve struggled tremendously with my mental health. When I realized something was wrong, the stigma to reach out for help was too great in the beginning. My career was on the line and if I didn’t have a career, I didn’t have a home or ability to care for myself or my family. This was very common when I was in the military. It’s more accepted now, but there are still struggles for servicepeople when getting help for their mental health. The labels are still prevalent.
It’s good that more people are starting to speak up about mental illness among servicepeople. There have certainly been far too many suicides, and things need to change.
People are scared of what they not know or can’t comprehend. It takes a great deal of compassion and mutual trust to work together on issues. I also believe we lack much knowledge of very traumatic events and the effects they may have on our bodies and minds. There is a lot of learning and healing to do. I hope you’re doing better now and wish you the best.
Thanks!
Well said – “attention seeking” behaviors are sometimes the only way people know how to communicate their needs, especially if you’ve had a history of being invalidated.
I agree it’s such a paradox that people always say, “If you’re struggling – speak up!” but that’s the most difficult thing for someone who’s been through a trauma so they try their best and get knocked down. They do speak up, just not in a language everyone else speaks.
I truly wish more people understood this!
Thanks for your insight and perspective <3
MB
Yeah saying speak up is great, but it does require one to listen, and not necessarily listen for what they expect.
Agreed – communication goes both ways!
What a weird thing… obviously when you go to a doctor you are “seeking attention.” When you go to get your car fixed, you are also seeking attention. When I go to a restaurant I hope to get some attention as well! Geez.
Seeking attention isn’t necessarily bad. Sometimes people should be doing more of it, instead of letting problems get worse.
I think we have a negative idea of it because we lump all annoying behavior in that category, such as trolling on the internet. That’s too bad.
Yes it is.
I think that opening this up to society as a whole, if there’s one thing social media has taught us, it is that the human animal is an attention seeking being. Whether it’s for simple recognition, validation, love, etc., it’s kind of startling the amount of people (with no sign of mental illness for the most part) who have prioritized needing likes and followers in their life. The pinnacle? Being able to be called an “influencer.” I don’t think we knew about this stuff in the pre-Facebook, Twitter, Snapchat years. I bet as a ratio of mentally ill people who seek attention to the “normies” there isn’t much of a variance.
That’s a very good point.
I just hate this word – attention-seeking! – It says a lot about the society that we even needed to coin it. In Polish there’s no word like that that would have such a negative context by default or maybe I’m having an eclipse and can’t think of any because I’m thinking in English. THis of course doesn’t mean that people aren’t dismissed in the same way by health care professionals here, but I guess at least the lack of a universal one-word label makes it look a tiny bit less obnoxious.
What makes me wonder is why people are so afraid, so desperate not to pay a little bit of attention to someone. So what if someone is “attention-seeking”? Everyone says humans are social beings, so we need attention, I guess? And even asocial beings (like cats) do sometimes, so why wouldn’t we? It seriously bugs me. I understand that health care professionals are very busy, have a lot of people often with very complex needs to care for, and then all the paperwork on top of it and probably some other things that I don’t realise, but would it seriously be such a problem if they devoted some of their very precious attention to such an “attention-seeker”? Even if it would just be simple validation, as you mentioned. Even if they will lose a bit of time and such person will turn out to really be an attention-seeker, after some closer attentive observation, and will be seriously manipulative or something, at least they made sure it’s not otherwise and they’ll have a clear conscience that they didn’t dismiss someone with a real problem. I understand that it’s really hard sometimes to pay a lot of attention to a person who has such an enormous need for it, for whatever reason. But I think sometimes it’s worth it to try and do it, even if we have to force ourselves to it.
Personally I have been there only once, that a mental health professional would openly point out that they thought I was wanting to get attention and because my brain tells me that pretty much every time someone is paying some more attention to me, whether I seek that attention consciously, voluntarily and actively or not so much, I did believe it and it confused me quite a bit, I still feel like an extreme manipulator when I reach out for support though it’s been worse, I think I’m doing really well now compared with how it used to be, I’m glad that I’m reaching out at all, and blogging and talking to my penfriends about my issues and being honest with people.
A lot of people with mental illness have great trouble reaching out without being labelled like that, and the attention-seeking label is just making it worse, and can make things so tragical if someone is suicidal.
I completely agree.
As a teenager with untreated bipolar, I use to think the girls that showed their cutting scars where attention seeking. I cut too but I hid it. But as I got older I realized, even if it’s considered attention seeking, there’s a reason they’re seeking the attention. It’s a call for help.
Absolutely.
I’m appauled after reading this… I con’t believe other nurses and/or health providers were refering to this patient as an attention seeker. That is so God awful! 😡
Yes it is.
We have to stop the negative energy and educate people. We have to hear in order to talk #Heartotalk
Well done. This piece made some very important points. A lot of people throw those words around without thinking – and it makes it harder for some people to come forward with their issues, for fear of being labeled as such. On the physical side I actually notice it sometimes too – physical symptoms and pain being written off as attention or drug-seeking behavior. Which I admit medical personnel need to be on the lookout for, but sometimes there really is an issue! One time I went in with horrible pain and a temperature I had had for a week. I think the doctor thought I just wanted pain meds, so he waved me off. Turns out I had a kidney stone!
Yikes! Yeah, definitely not god when people get so jaded they make snap judgments about everyone.
I so agree with you 💗 It’s not attention seeking. We just want help so sometimes ask for it in a different way but that’s okay too
Yes! 💕
Even if someone is seeking attention with their mental health problems, they’re probably crying out for help. People really need to stop being so judgemental and do their own research.
Absolutely.
Appalled. Glad you validated him. Glad you saw the need.
According to Marsha Linehan, founder of DBT and who had BPD herself, emotional invalidation, particularly in childhood and adolescence, may be one factor that leads to the development of BPD.
Growing up invalidated and then having their pain being dismissed as attention seeking which is further invalidation…ouch.
Absolutely
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