Trigger warning: vulnerability ahead
Let’s talk about mental illness, shall we? I’ll go first.
I have an eating disorder.
Did reading that make you uncomfortable? Trust me, I get it. Imagine how it felt to type it out. Plus, if you caught my previous blog post about what it’s like to work remotely, then you already know I’ve got depression and anxiety thrown into the mix, too.
The point in sharing all this is not to elicit shock or sympathy, or to rack up credit for being “brave.” Instead, what I’m trying to do is stand a bit more squarely in the center of my shame and take a little more responsibility for the impact that it has on my role as part of the MetaLab team. We design and build things that millions of people use every day but if I’m ashamed to advocate for what I, a person with mental illness, need from the products and services I use, then how can I responsibly design for others with challenges similar to mine?
By keeping these conversations to myself, I perpetuate the harmful cycle of bias and discrimination against those who need more representation and support. Even my silence, in and of itself, is indicative of the privilege I bring to the table, and the ways in which my socioeconomic, cultural, and racial backgrounds afford me all kinds of advantages (including the luxury to explore topics like these).
My hope is that by publicly experimenting with my own internalized stigma, it might inspire the design community to more closely examine its own—what role can (and should) product design play in reducing bias and discrimination towards mental illness and making mental health accessible to all?
Move fast, break...people?
This vulnerability exercise made me suddenly aware of, and unsettled by, the misalignment between the concept of product design—made for humans, by humans—and the iterative, MVP-laden, “move fast and break things” mantra. How can we justify moving fast and breaking things when the “things” in question are humans? Perhaps it’s simply a matter of taking Mr. Zuckerberg’s gospel too literally, but I couldn’t quite shake the feeling that the nuanced dimensionality and emotional complexity we all possess often get deprioritized for the sake of shinier, shot-worthy designs.
Take Google’s infamous cupcake example. In 2017, Google Maps introduced a feature that translated distance traveled into calories burned, complete with icons of the food equivalencies of your caloric output.
Short of having the cupcake wag its figurative fat-shaming finger at me, this was a UX nightmare for someone struggling with self-image. Considering the fact that at least 30 million people suffer from eating disorders in the U.S. alone (and over half of girls and one third of boys between the ages of 6 to 8 wish for thinner bodies), it’s hard to argue that the problematic “earn your food” approach made sense for anyone’s “happy path.”
Imagine how different things could have gone if someone like me had not only been part of this product team but had felt comfortable speaking up about the potential impact of the design choices being made. Imagine how much better our products—and processes—could be if we all felt safe to speak up about our first-hand experiences of what makes life hard.
This isn’t about getting it right for everyone; we’re designers, not magicians. Rather, it’s about taking steps to ensure that your design process holds you accountable to the human behind the “user” and forces you to pay a little closer attention to what you say, how you say it, and who you’re saying it to.
If we’re not explicitly talking about or designing for the hard, messy, complicated, life stuff, can we really claim to be designing holistic, human-centered experiences that matter?
Even when we stop to consider our design-minded language, words like “user” and “edge case” subtly remove the human from the equation of what’s important and dehumanize things from the start.
In working on a digital sobriety platform for people with alcohol dependencies, for example, it became abundantly clear to our team that the term "user" was not only dehumanizing but demoralizing and discouraging, too. Visually, we also needed to think about the impact of our design choices on the audience's mental states. Too many options, too many things to click on or look at, or too much going on could quickly cause spiral and overwhelm.
Can we design for inclusivity, accessibility, and an optimum experience for all if we’re still uncomfortable talking to each other about the differences we’d prefer to keep in the dark? How does our individual and collective shame contribute to oversight in the research and design processes? If we’re not explicitly talking about or designing for the hard, messy, complicated, life stuff, can we really claim to be designing holistic, human-centered experiences that matter?
We’ve far from solved it at MetaLab, but we’re working with an increasing number of clients to build products for those who fall outside of both the project scope and our society’s list of priorities, like those dealing with terminal cancer, substance abuse, and death. With each new project comes critical lessons and learning curves that challenge us to choose “support and empathy” over “surprise and delight” where it matters most.
Empathy is good for business
Whether you’re designing an app for food delivery or treatment of depression, the most powerful tool in our arsenal as human beings and designers is empathy. Designing with empathy is not new, and my intent is not to draw a false equivalency between serious mental health conditions and somebody having a bad day. In fact, design requirements and contingencies for apps specific to mental health are critical, like Marli Mesibov’s useful set of guidelines.
Regardless, good product design demonstrates an awareness of the spectrum of human experience, with empathy being the universal vehicle through which connection grows. Designing with empathy is less about maximizing accommodation and more about minimizing alienation: what matters is not that you find a quick-fix to people’s struggles, but rather that you hold space for them to feel safe as they struggle through.
Today, blind spots, tights budgets, and bad habits continue to prevent empathy from making it onto the must-have list in most business’ board rooms. Still, designing with empathy is good for your karmic debt, and Gen Z’s buying power is proving it’s good for business, too.
The future has feelings, and the cultural shift towards embracing self-expression, supporting emotional and mental health, and promoting self-acceptance isn’t a passing trend. So while being scrappy and lean might appeal to business stakeholders in the short-term, it doesn’t adequately meet the needs of the hyperconnected, tech fluent “kids these days,” who will make up 40 percent of all consumers by 2020.
Designing with empathy is less about maximizing accommodation and more about minimizing alienation
When it comes to their health, this younger generation is more readily talking about, and embracing, historically stigmatized elements of the human condition and feel more comfortable advocating for what they need. Immediate, instant, and always-on is all that they’ve known but they’re also not afraid to turn off their devices in the name of self-care and self-preservation. They’re generally more self-aware, have more access to information and resources, are better equipped with vocabulary for their emotional needs, and are generally better supported than previous generations when it comes to emotional acknowledgment and self-expression.
Thus, authenticity is imperative for being taken seriously and gaining buying traction. They want you to listen. They want a seat at the table. They want acknowledgment that they’re human, and so are you. What’s important to them is not that you’re perfect, but that you’re demonstrating an investment in doing better and trying to meet them where they are.
Spoiler alert: the past had feelings too, but it’s been hard to talk about them until now. Businesses have been lacking in the empathy department for a long time, but it’s taken the social acceptability curve of Gen Z to coax older generations’ emotional needs out of the shadows and into the conversation. Dubbed the “loneliest generation,” millions of Baby Boomers in America are grappling with crippling social isolation that’s costing them their health and costing Medicare an estimated $6.7 billion annually. The economic and societal consequences of systemic emotional neglect are real and worth taking heed of.
Whether it’s providing a third, non-binary gender option, using reassuring language to help get people unstuck, or providing help and support at key moments, or merely addressing people by name, design is powerful. It can build bridges of understanding, of vulnerability, of shared experience, and can drive brand loyalty in meaningful, lasting ways. To design by paving inroads of understanding and extending opportunities for connection is to tap into our primal need for safety and belonging—what’s more powerful than that?
Answering the calls for authenticity, empathy, and moral obligation could put your product’s valuation and longevity in the marketplace at a critical, multipronged advantage.
If you’re not yet compelled by my personal and generational plugs for more vulnerability in the workplace and elsewhere, you don’t have to take my word for it. Instead, consider what Larry Fink posits as the new, nonnegotiable paradigm for modern businesses. Or subscribe to the gospel of many of today’s VCs, who believe that driving sustainable, long-term growth is now dependent on a business model built upon healthy emotional wellness and a greater social purpose.
What used to be a laser-focus on profitability, efficiency, and market share has expanded to include an emphasis on virtue, social responsibility, empathy, impact, diversity, and inclusion—things that serve the whole human first, and the business’ bottom line, second. Take examples like Butterfly IQ’s handheld ultrasound, which is revolutionizing global access to healthcare and lowering maternal and infant mortality rates, or Philip’s Ambient Experience MRIs, which are easing patient anxiety and dramatically reducing sedation rates.
These efforts exemplify how answering the calls for authenticity, empathy, and moral obligation could put your product’s valuation and longevity in the marketplace at a critical, multipronged advantage.
Small changes, big impact
The good news? We’re all born with the innate capacity to empathize, which means it’s a matter of learning how to flex that muscle. We aren't experts, nor do we have definitive answers on how to get it right, but we’re doing our best to work at it and get better every day.
Here are some ways we suggest trying to put empathy into practice:
Get back to design basics.
There is no way to innovate around or substitute for talking to people and getting a firsthand understanding of what they need and how they feel. Start and end with empathy, making exercises like empathy mapping and user (or, people) interviews table stakes for your design process. Ask not just what they’re thinking, feeling, and doing at each phase of an experience, but also ask what you might be missing and how you might put yourself in their shoes.
Tap the experts.
Instead of making potentially dangerous assumptions, go straight to the source (and ask for their participation and guidance from ideation through launch). Partner with industry experts, medical professionals, survivors, patients, and anyone who can offer invaluable (and direct) insight into the challenges they face.
Don’t cut corners.
This doesn’t mean you can’t move fast, it just means that you’re likely to do more good (and, more importantly, cause less harm) if you slow down where it counts. Focus on where your business needs and audience needs overlap and build out from there. By doing one thing well, first, instead of eking out an irresponsibly-designed MVP, you engineer thoughtfulness into a process where “failing fast” can have critical consequences.
Check for context, always.
Lovingly referred to as the “Tarot Cards of Tragedy,” this checklist is meant to help remind you that the people using your product are, on any given day, going through something that requires empathetic consideration. Checking yourself and your design choices against a list of potential circumstances can help to pressure test its score on the empathy scale.
Re-up your inclusivity standards.
The traditionally-held definition of accessibility is a good and important start, but more nuanced conditions need to be factored in as well. It’s not just about physical limitations or differences; there's a usability spectrum that spans physical, cognitive, sensory, and identity-based capabilities that are ever-changing to reflect shifts in circumstance and complexity.
Prepare to get it wrong.
PSA: we’ve all gotten it wrong, and you will, too. Probably more than once. Hell, even this post will be riddled with blind spots and missed opportunities. But when we stop to consider the options, can we really argue that it’s best not to try? When you make mistakes, miss the mark, or let people down, the best thing you can do is lead with authenticity and acknowledge the misstep. Vulnerability is the universal currency for connection and taking responsibility for your fallibility will pay dividends in the end.
Walk the walk.
As is true with most attempts at improvement, the key is to start small and to start from within. This could mean promoting inclusion, diversity, and tolerance with your company’s hiring and cultural practices, establishing consistent communication loops, or investing in constant learning. Don’t shy away from projects that are intimidating or foreign to your own personal experience. Raise topics that are hard to talk about, because if it’s hard to talk about, it’s probably pretty important. Get uncomfortable, and give yourself credit for baby steps, because every inch counts when it comes to moving the needle on mental and emotional wellbeing. If all that means, for now, is sharing this article with someone else or linking them to Brené’s TED talk, start there.
In the spirit of transparency (and the entire point of this article), the truth of the matter is that our secrets not only keep us sick, but they keep others sick, too. So when it comes to advocating for ourselves and our health, openness and honesty are the logical antidotes to the harmful impacts of silence and stigma.
And while good intentions are not enough and actions most definitely speak the loudest, opening the conversation and engaging in learning is a place to start. The human condition is inherently messy and complicated, and the sooner we can stop shaming ourselves—and each other—for moving through it as best we can, the better we might feel.
On Body Image
Finally, for those of you who struggle with your body and/or your relationships with food and exercise, here are a few more things to take with you:
There are no minimum requirements for suffering.
Just because you might not look or feel “sick enough” doesn’t mean the pain you experience doesn’t count. Your suffering is real, the mental, emotional, and physical tax is high, and there are ways to help yourself off the hamster wheel of self-loathing.
Change is hard.
And extricating yourself from the toxicity of diet culture can feel impossible. We live in a society established on the idea that you should always be striving for more, so the beliefs that you have enough, look good enough, and, ultimately, are enough, directly threaten the pillars that keep capitalism alive and well.
To choose the next right thing for yourself—and not necessarily for everyone around you—is nothing short of radical (and also not for the faint of heart). It’s exhausting and thankless, and I’m writing all this from the throes of my own circuitous road to recovery, so I bear very little in the way of hopeful assurances. What I can offer, however, is that there is relief in opening up about this stuff.
It’s slight at first, and feels far away at times, but it’s definitely powerful, and I’ve found it in my connections with other people who, like me, are tired of having it all together, managing it all on their own, and falsely hoping that they’re only five pounds away from silencing that cruel and insidious inner critic.
You don’t need to broadcast your personal struggles or be able to afford a therapist to find support.
I’ve been lucky enough to work with an eating disorder specialist and work at a company that’s given me this platform to share, but there are so many incredible (and free) resources available that invite you to consider ideas, voices, and new ways of relating to yourself in kinder, more compassionate ways. Some of my favorites include the NEDA website, Food Psych podcast, and Diet Culture Sucks and Colleen Reichmann on Instagram.
I’m a realist, so for me, loving my body is a tall order. Once I moved the goal post to tolerance instead of complete love and acceptance, I had an easier time choosing the next right thing. Start small and see what works for you.