With every assessment conducted, a seasoned mental health professional will conduct a Mental Status Exam (MSE) without your awareness. If not wholly obvious, he/she at times will involve you in the process by asking if you are suicidal, homicidal, or experiencing hallucinations. The mental status exam is a brief assessment of one’s current mental functioning. What mood is the individual in? How are they groomed? Is there anything notable in their speech? (for a full list of MSE questions, you may simply Google ‘Mental Status Exam’ and come up with dozens of other questions common to the assessment.
As part of this assessment, the clinician may note other observations. ‘Individual was malodorous’, ‘Individual appeared to be tired as evidenced by continued yawning and dark circles under eyes’, ‘Individual appeared older than stated age.’
Individual appeared older than stated age. Say it with me one more time…the more you say it, the more offensive it becomes to the average person…INDIVIDUAL. APPEARED. OLDER. THAN. STATED. AGE.
Appeared older than stated age. Appeared younger than stated age. Appeared stated age. These statements may indicate to the reader if an individual has had a ‘good life’ or a ‘rough life’. Whether they’ve had the pleasure of having a facelift, or the misfortune of being homeless, statements regarding an individual’s physical age in relation to their biological age can tell the assessor a great deal of information. This assists in the assessment process by allowing the clinician to ask further questions regarding lifestyle, housing, substance use, sleep habits, etc. I’ve written all these statements countless times in my own assessments, but never really actually thought about which statement best described me.
Until a recent experience, I probably classified myself in one of two categories: Individual appeared stated age or individual appeared younger than stated age. I’m not trying to brag, but being short in stature often wins you brownie points for appearing younger than you actually are. Pair that with a nasally, high-pitched voice and voila! You are instantly 10 years younger than printed on your driver’s license. (I will never complain about being ‘carded’)
In recent events, it seems my luck turned into misfortune when I was ‘let go’ by a client due to being seemingly ‘too old’ to ‘understand’ their life. *shaking my head*
If only they knew…that is what I told myself and attempted to ‘let go’ of the offense I had taken. But you know, I’ve had this subject as blog topic for at least two years- just never wrote it. This recent event really got me thinking it was go time!
It is a natural human response to categorize people the moment they see them. We all do this. It is autonomous and used to serve a function as a survival tool- those not like us are threatening and we must fight or fly. Because we’ve evolved greatly from caveman days, we no longer use this primitive tool for the same purposes, but it still serves a purpose; it allows us to quickly navigate our environment for things familiar and different so as to make quick decisions. As in the case of discrimination, we allow our brains to function autonomously without giving a situation or person a second thought. This is where quickly scanning the environment and categorizing becomes problematic. Racism, sexism, and ageism all stem from this lazy-brained processing. Rather than gathering further information about a person, we simply rely on our primitive and autonomous brain to categorize and move us toward or away from a person.
It is an unfortunate circumstance indeed. Life can be a lot more rich and rewarding when we allow ourselves to take a second look at a person, at a situation, and make decisions based on further evidence, rather than on appearance alone.
In the appeared older/younger than stated age argument, both are problematic in that they hold us back from learning more about a different generation.
Appearing younger implicates an individual is inexperienced; they are not yet wise, but yet they are more beautiful and exuberant than their older counterparts. There is something to be learned from youthful energy and a carefree spirit. Younger individuals can teach us to be brave, embrace change, and to try new experiences. Most of my friends are younger than I, and I live a lot of life through them vicariously- not that I did not live my own energetic and fly-by-the-seat of my-pants life. I did plenty of that, I assure you. My younger friends are more tech savvy than I, they understand how to navigate social media better (I mean, I’m still writing blogs for god’s sake), and above all they show me that age really can be just a number.
Appearing older implies bags under eyes, wrinkles, gray hair, and a perhaps a certain ‘wiseness’. It also implies a lack of fun, being set in one’s ways, and a persistent grumpiness toward ‘kids these days’. Older generations have a lot to offer the younger generations in terms of tried and true experience. Not that all of one’s experiences are like another’s, rather ‘older’ folk have learned a lot of ‘life’ by making (at times dumb) mistakes and now know what to do/what not to do. Again, generalizing here because things have changed so rapidly in the past 20 years. Regardless, younger generations can learn also learn vicariously through their older friends, co-workers, and family members. ‘Older’ individuals have a lot to offer younger folks in the way of communication skills. Technology has been a burden, at times, taking us away from intimate interaction with others. I cannot tell you how detrimental this is to human connectedness, an intrinsic need for Homo sapiens. We can see evidence for this in the younger generations in higher suicide rates, lack of social finesse, and an overall withdrawing from face-to-face communication.
The above being said, we must force our lazy brains to shut off the autonomous responding, or disregarding, of those who differ from us demographically. By doing so, we open ourselves to volumes of information about others- about life. I encourage you, whether you are older or younger to engage with others outside of your demographic (age, race/ethnicity, political stance, educational background, etc.). The richness of your life could increase triple-fold. And as for selecting an appropriate therapist…personally, I want one who has lived a full life. I want a therapist who has made life mistakes, learned from them, and can genuinely empathize with my pain and concerns because they have been there before.
If you have doubts whether Nellie has been there and done that, let me ease your mind. I sure have and despite it all, I have pushed through making a successful, content life for myself. Isn’t that what we all want? Success and contentment?
In closing, dear ‘young’ client, I hope you get the help you need and I hope your new ‘younger’ therapist encourages you to be less close-minded to the people and experiences that surround you, regardless of their differences. And dear ‘older’ clients please do not disregard the young, even if you have to pry their smart phones from their death grip!