Recently, I spoke at an event in Boston about my life with schizophrenia. It wasn’t just a speech; it was an invitation to look beyond the diagnosis and see the person beneath it. The journey started with some hesitation, my voice shaking slightly, as I navigated the weight of sharing something so personal with an audience. But as I continued, my confidence grew, and I was able to speak candidly about both the highs and lows of my journey. The experience was transformative, yet it also left me with mixed emotions about how mental health professionals respond to raw, unscripted vulnerability.
After the talk, several people approached me, moved by what I had shared. They thanked me for my honesty, seeing me not as a label, but as a person with complex, relatable emotions. Yet, some of the doctors in the audience reacted differently. One psychiatrist noted that I seemed “more emotional” than they’d seen me before and asked, “Are you OK?” What may have been intended as a kind check-in felt like a spotlight on my perceived “otherness.” My genuine expression of vulnerability, rather than being seen as a testament to my humanity, registered to some as a sign of clinical instability.
This moment illustrated a tension that many of us with lived experiences in mental health face: the question “Are you OK?” can feel loaded. It’s meant to be supportive, but in a clinical context, it can also feel like surveillance, a reminder of the invisible line we’re not supposed to cross. This is especially true for people living with conditions like schizophrenia, where expressions of emotion can be misconstrued as symptomatic rather than seen as natural responses to life.
The Double-Edged Sword of “Are You OK?”
“Are you OK?” is often a well-intentioned question. It’s designed to show care, to offer support. But when directed at someone with a mental health condition, it can sometimes feel like an evaluation rather than empathy. This isn’t a new experience for me, nor is it unique among people with mental health diagnoses. On Mental Health Affairs, other contributors have described this phenomenon in their own words. Ethan Miller, for example, wrote in his piece “The Thin Line Between Empathy and Pity” about his experience sharing his life with major depressive disorder. He describes how well-meaning professionals often responded with concern that bordered on pity, leaving him feeling diminished rather than understood.
In mental health advocacy, the “Are you OK?” question can be both comforting and triggering. It signals concern, yet it can sometimes undermine our attempts to simply be seen as people experiencing complex realities. When the psychiatrist asked if I was OK, it was as though my emotional expression had crossed an invisible line. My rawness, instead of being recognized as genuine, appeared to activate the mental health professionals’ instinct to assess rather than empathize.
The Challenge of Authenticity vs. Clinical Curiosity
When I shared my story in Boston, I wanted to be authentic and real, not clinical or guarded. I wanted to speak about the full range of my life with schizophrenia, not a polished version. My emotions were natural responses to my journey, not symptoms to be examined. And yet, in that moment, my vulnerability seemed to raise more concern than the experiences I was describing. The question—“Are you OK?”—signaled that my display of feeling had transitioned from my truth to something they needed to “watch.”
This isn’t about faulting individual providers. Clinical training emphasizes vigilance, and mental health professionals are trained to identify signs of distress. But an unintended consequence of this approach is that people like me, who strive to share openly, may feel policed or invalidated by the very system designed to support us. This dynamic isn’t unique to me—other stories on Mental Health Affairs have shared similar challenges. In Lila Brooks’s piece, “Living in My Fullness,” she describes how sharing her journey with PTSD often led to professionals “watching for signs” rather than simply listening.
Empathy Isn’t Just Checking In—It’s Seeing the Whole Person
The mental health field has made strides toward more compassionate, holistic approaches, yet a gap remains when it comes to accepting the full range of human emotion without judgment. As someone with schizophrenia, I don’t want to be seen as an “outlier” when I’m moved to tears or when I’m passionately sharing my story. True empathy in mental health shouldn’t only be about checking if someone’s “OK”; it should be about honoring that person’s reality without filtering it through clinical concerns.
At Mental Health Affairs, we’ve highlighted pieces that reinforce this idea. Sarah Jung’s essay, “Finding Safe Spaces for Authenticity,” discusses her experience with schizoaffective disorder and the boundaries she set with friends who constantly wanted to “check in.” Her story resonates with my own, underscoring that support shouldn’t mean stripping our experiences of their intensity or relegating our emotions to clinical symptoms.
Creating Spaces for Unfiltered Humanity
Sharing my story in Boston was a reminder that lived experience brings unique insight to mental health advocacy. For those of us living with conditions like schizophrenia, vulnerability is not a “symptom” but an essential part of our humanity. Professionals, peers, and advocates alike must make room for these moments of genuine emotion, even when they’re intense. The lived experience of mental health is often raw and layered with emotions that defy neat categorization.
Instead of asking, “Are you OK?” in a way that suggests monitoring, let’s cultivate a culture where people can say, “I’m here. I’m experiencing this. And that’s OK.” Empathy shouldn’t only appear in moments of crisis but should be present in all expressions of the human experience, particularly in the mental health field. Ethan Miller wrote something that has stayed with me: “Pity is a passive act. Empathy is active. It requires us to sit with discomfort without seeking resolution.” His words remind us that empathy in mental health spaces must go beyond checking in—it must mean embracing the entirety of our shared humanity.
Embracing the Full Spectrum of Lived Experience
The talk in Boston underscored the importance of sharing lived experiences with all their messiness and intensity. For those of us who live with schizophrenia, vulnerability is not a “symptom” to be managed; it’s a testament to our resilience. Emotional expression isn’t about crossing lines; it’s about bridging gaps and reshaping perceptions. Instead of feeling “assessed” when we’re moved to tears or passion, we should feel validated as people with voices and stories that matter.
In the end, I am “OK” — but not because my emotions have been managed or analyzed. I’m OK because I am allowed to feel them, speak them, and own them without having to justify or downplay their significance. At Mental Health Affairs, our mission is to continue creating space for stories like these—to amplify voices that show the depth, complexity, and strength of those navigating the mental health journey.
Author Info:
Max E. Guttman
Max E. Guttman is the owner of Mindful Living LCSW, PLLC, a private mental health practice in Yonkers, New York.
