Everyone’s Crazy, But No One’s Mentally Ill: 7 Things You Need to Know About the Mental Health Revolution

I still remember my first training sessions as a budding psychotherapist. It was 1965 and I had just dropped out of medical school at U.C. San Francisco and transferred to U.C. Berkeley. I had wanted to help people ever since my father was committed to a mental hospital when I was five years old. I wondered what happened to my father and whether it would happen to me. I thought if I were well-trained I could avoid “mental illness” and the fate that my father faced when he had his emotional breakdown.

My first student placement was at Napa State Hospital and social work and psychology students had an opportunity to observe a well-respected psychiatrist work with patients. We attended sessions every week for a year and watched this expert through a one-way mirror as he worked with various patients. After the session we could join the psychiatrist and ask questions.

Right from the beginning there were a number of things about this expert’s way of doing therapy that I questioned. First, he never touched the patient. When the patient reached out to shake his hand in thanks at the end of the session, he didn’t extend his hand. When questioned he asserted that it would interfere with the transference where-in the patient would project the issues he had in his life on the “blank screen” of the therapist and then the therapist would interpret his feelings. I told him, I thought that human contact was important. He explained that I would learn the value of therapeutic distance as I became better trained.

Second, he would never advocate for the patient if there was a problem on the ward. On numerous occasions he patient couldn’t come to a session because of a mistake getting him released. The doctor said, that the therapy session had to be insulated from the rest of the patient’s life if it were to be most effective. I disagreed.

Third, it seemed that there was no relationship between the diagnosis that a patient was given and what went on in the therapy sessions. One patient may be diagnosed as being manic-depressive, another with an anxiety disorder, and a third as having a character disorder. But he interacted in the same way. When I asked he said diagnosis was very important, but it seemed a far cry from diagnosing someone with pneumonia, diabetes, or some physical illness. [Read more…]

Could Depression Be A Healthy Response to a Dysfunctional World?

More and more people are taking anti-depressants these days and more and more doctors are treating us for serious mental disorder.  I’m beginning to wonder if all these people really have a brain disease or is depression and other “mental illnesses,” really a healthy response to living in a dysfunctional world.

We know people become depressed following a divorce or the death of a loved one. When we suffer a loss, we may become sad. We may cry or mope around with little energy. The things that once gave us joy seem uninteresting. We may sleep too much or not be able to sleep at all. We overeat or may have no appetite for food.

Most of us don’t take medications to deal with this kind of depression. We recognize it as a healthy reaction to a traumatic life experience. We don’t try to make the feelings go away. We let ourselves grieve and eventually we come back and regain the joy we once had. We may have to learn new skills or develop new relationships after the loss of a loved one, but we don’t see ourselves as sick or mentally ill.

I remember when I was in medical school many years ago. I had just graduated from college at U.C. Santa Barbara and had gotten a four year, full-tuition fellowship at U.C. San Francisco Medical School. I was excited to be embarking on a career in medicine where I could help people. But during the time I was in medical school I became increasingly anxious and depressed. I wasn’t prepared for the long hours, lack of sleep, demanding, often bullying, staff.

I thought there must be something the matter with me that I couldn’t handle the demands of what was reported to be one of the best medical schools in the world. I eventually dropped out and for years I felt like a failure for not being able to do what it takes to become a doctor. It never occurred to me at the time that become anxious and depressed might have been a healthy response to a dysfunctional learning environment of medical school.

I never realized how pervasive the problem was or how it impacted the lives of the medical profession and all those who see a doctor for help until I learned about the work of Dr. Pamela Wible. In her powerfully moving book, Physician Suicide Letters, Dr. Wible, herself a family physician, exposes the pervasive and largely hidden medical culture of bullying, hazing, and abuse that is a regular part of medical school training throughout the U.S. and around the world.

The result is that more and more medical professionals are breaking down under the weight of a dysfunctional system. “Each year more than one million Americans lose their doctors to suicide,” says Dr. Wible, “and nobody ever tells the patients the truth. Nobody talks about our doctors jumping from hospital rooftops, overdosing in call rooms, hanging themselves in hospital chapels. It’s medicine’s dirty secret—and it’s covered up by our hospitals, clinics, and medical schools.”

Dr. Wible begins her book with these words: [Read more…]

Helping Men and the Families Who Love Them: Is Text Therapy the Next Best Thing?

On November 21, 1969 I welcomed my son, Jemal, into the world. I vowed I would be a different kind of father than my father could be for me and I would do my best to create a world that was supportive of men, women, and children. That was birth of MenAlive. But the roots of my desire to help men go back to 1948 following my father’s overdose of sleeping pills.

As a child of five, I wanted to understand what happened to my father, why his manic anger and his agitated depression, led to his being committed to Camarillo State Hospital north of Los Angeles. I wanted to understand why he was unable to make a living doing the work he loved and how his beliefs about manhood caused debilitating shame when he couldn’t find a job and my mother was forced to go out to work. And underneath it all, I wondered what would happen to me. Would I follow in my father’s footsteps and end up in the “nut house?”

For most of my 47 years as a therapist, I’ve seen people face-to-face in my office for regular psychotherapy lasting 50 minutes. However, when my book, Surviving Male Menopause, was published in 2000 and became an international best-seller, I began getting emails from people from all over the world asking if I could work with them. At first, I offered my standard answer, “Well, sure, if you want to fly out to California.”

Some did fly out, but most wanted to know if I could do counseling by phone. It never occurred to me that I could counsel people without seeing them. How would I be able to assess their feelings and develop closeness and rapport? But their need seemed so great and so few people were dealing with the issues I addressed—Male menopause, male type depression, irritable male syndrome, preventing mid-life divorce, and male anger issues—I agreed to talk with them by phone.

I soon found that talking by phone had some distinct advantages. It allowed many to work with me who were too far away. Many people, particularly men, liked the ease of talking by phone rather than coming into an office. They also liked the safety they felt talking by phone, without the intensity of eye-to-eye contact. Most of my clients now talk to me by phone and I’ve found I’ve gotten good at hearing the nuances of voice to tune into feelings. I still see people in my office, but “phone therapy” has become a large part of my practice.

Over the years, I’ve helped more than 25,000 men and their families. I still remember talking to a client in 2002 who told me, “Our sessions have been so helpful, I wish I could carry you with me and talk to you when needed.” We both laughed. “Yeah, you just need a little Jed Diamond that you could carry in your pocket.” [Read more…]

My Mental Illness: Coming Out as a Therapist

6339082427_87d8de1f5b_zWhen I found my father’s journals, I knew I had to stop running away from mental illness.  They were at the bottom of a box containing his unpublished plays and stories that revealed his struggles during the time I was growing up. By the time I read them I was a successful psychotherapist with a set of interlocking secrets: Mental illness ran in my family. My father was mentally ill. I suffered from depression and bipolar illness myself. I imagined I could run away from the reality of my own suffering by getting educated and treating others.

Then I opened the box and found the journals. I was alternately mesmerized, horrified, and transformed. Here is a small excerpt:

June 4th: 

               Your flesh crawls, your scalp wrinkles when you look around and see good writers, established writers, writers with credits a block long, unable to sell, unable to find work,  Yes, it’s enough to make anyone, blanch, turn pale and sicken.

   “August 15th:

              Faster, faster, faster, I walk.  I plug away looking for work, anything to support my family.  I try, try, try, try, try.  I always try and never stop.

“November 8th:

              A hundred failures, an endless number of failures, until now, my confidence, my hope, my belief in myself, has run completely out.  Middle aged, I stand and gaze ahead, numb, confused, and desperately worried.  All around me I see the young in spirit, the young in heart, with ten times my confidence, twice my youth, ten times my fervor, twice my education. 

             I see them all, a whole army of them, battering at the same doors I’m battering, trying in the same field I’m trying.  Yes, on a Sunday morning in early November, my hope and my life stream are both running desperately low, so low, so stagnant, that I hold my breath in fear, believing that the dark, blank curtain is about to descend.”

Six days after his November 8th entry, my father tried to kill himself. I was five years old. I never understood what happened to my father, but I was told he was in a hospital. Every Sunday for a year my uncle took me to visit him. I can still picture the line of trees as we neared Camarillo State Hospital after the two hour drive north from Los Angeles. [Read more…]

Why Bernie Will Win: We’ve All Been Screwed and We’re Sick and Tired of Being Sick and Tired

21581179719_571bb5a7ab_zWhen I first heard that Bernie Sanders was running for President, I didn’t know much about him or what he stands for. As I learned more I realized this is finally someone who believes in supporting the 99% of us (Republicans, Democrats, Independents, and others) and not the 1% or of those who have money and power in the U.S. Once I understood what he believes in and has practiced his whole life, I felt bad that he didn’t have any chance to win. It seemed to be Hillary’s time and having a woman President might be a positive change to the good-old boys network that has ruled the presidency since the beginning.

One of the people whose perspective I respect is Thom Hartmann a well-known radio commentator and author of such diverse books as The Edison Gene: ADHD and the Gift of the Hunter Child, Walking Your Blues Away: How to Heal the Mind and Create Emotional Well-Being (the most innovative books on treating ADHD, depression, and other mood disorders), and his most recent book, The Crash of 2016: The Plot to Destroy America–and What We Can Do to Stop It. In that book he surfaces what more and more people know to be true. Our country is in real trouble and we need real change if we’re going to come out of our downward death spiral. (On this point, Bernie Sanders and Donald Trump are in full agreement).

Here’s what Hartmann says in the Introduction to The Crash Of 2016, “The United States is more vulnerable today than ever before-including during the Great Depression and the Civil War-because the pillars of democracy that once supported a booming middle class have been corrupted, and without them, America teeters on the verge of the next Great Crash.” Here’s what he has to say about why he thinks Bernie will win.

If anyone has ever had to deal with a major chronic illness, we know that it’s hard to have energy for anything else when we’re in pain and our lives are overwhelmed just getting through the day. Looking honestly at the state of our country’s health, we have to conclude, as a people, we’re pretty sick. [Read more…]

Fear: 7 Simple Ways to Keep It From Killing You

Fear picThere seems to be a lot to fear in today’s world. According to recent Gallup poll here are some of the things most of us fear:

  • Having our credit card information stolen
  • Having our computer or smart phone hacked
  • Having our children harmed at school
  • Getting mugged
  • Being a victim of terrorism
  • Being a victim of a hate crime
  • Being sexually assaulted
  • Being murdered

We also fear larger issues in society including the following:

  • Government leadership, or lack thereof
  • Economic dislocations
  • Unemployment
  • Healthcare inadequacies
  • Immigration
  • Economic inequality
  • Global warming
  • Racism

We all have felt the effect of these kinds of fears. We worry more, become anxious, our stress levels rise, and we have difficulty sleeping. We become irritable, angry, and depressed. Dr. Lissa Rankin is the best-selling author of Mind Over Medicine: Scientific Proof That You Can Heal Yourself. In her forthcoming book The Fear Cure: Cultivating Courage as Medicine for the Body, Mind, and Soul, Rankin offers scientific proof that fear can make you sick. It can even kill you.

So how do we protect ourselves against the fears that can harm us? Here are some things I have found helpful: [Read more…]

It’s Good to Be Nice to Those Who Attack Us

Although my work is focused around men and stress, I also work with many women who are trying to get a better understanding of their man.  I get all kinds of letters and emails, most appreciate the work I do.  But this one was pretty hostile.  I considered writing back and telling her I wasn’t to blame for her husband leaving or just ignoring the letter.  Instead we had the following interchange.

She:  A friend suggested I get your book to help with my husband.  Yes; it is my husband who left me last Sunday. After 25 years of marriage.  What a waste your book was.  It is obviously written by a manipulative male stand point!!!!!! Thanks a lot! I can’t believe I bought this!

Me:  Thanks for writing to me. Of course you’re angry. The kind of abuse that men cause to others can be devastating. It takes a lot of courage on your part to want to understand what is going on.

She:  I am so sorry for my outburst…I went from the pathetic victim to the aggressor in a split of a second…split might be the perfect word. I really want to apologize. Your book is actually wonderful and very helpful (now that I read it all and calmed down).

Me:  As I said, I know how difficult this can be. But you’ll also find the growth that will occur in your life will open to new possibilities.  Good luck with your future work and I hope your husband can rise to the challenge.

She:  Thank you so much for talking to me… I don’t mean to take up your time or get free counseling!  Sorry about my …I really don’t know what to call …my open neediness?  Thank you again.

Me:  Good luck with your journey. If you ever want to do counseling, I offer it by phone and counsel people from all over the world.

She:  What would be the number to call? And what are your rates? How does it work? Thank you!

Being supportive when someone is angry and blaming doesn’t always turn into new business.  Sometimes it just eases a bit of the burden and pain we all carry.  What’s been your experience responding supportively when someone is hostile and blaming?  How has it reduced your stress level?

Photo credit: http://www.flickr.com/photos/yourdon/2573762303/sizes/m/in/photostream/


Life, Liberty, and the Pursuit of Happiness: 7 Not So Simple Steps

As we reflect on those who have died in support of the American way of life, I think about what it takes to be truly happy.  Too often we live in fear or anger and it contributes to heart problems, relationship breakups, and conflict with other nations.

We all want to be happy and are looking for simple steps to getting there, yet scientific evidence makes it seem unlikely that you can change your level of happiness in any sustainable way.  Sad people don’t become lastingly happy and happy people don’t become lastingly sad.  But new research shows us all how to find lasting happiness.

In his book, Authentic Happiness:  Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment, Martin Seligman, the father of happiness research tells us, “The pursuit of happiness is enshrined in the Declaration of Independence as a right of all Americans, as well as on the self-improvement shelves of every American bookstore.”

But achieving lasting happiness isn’t easy.  Scientific evidence suggests that we each have a fixed range for happiness just as we do for weight. “New research into happiness,” says Seligman, “demonstrates that it can be lastingly increased.  And a new movement, Positive Psychology, shows how you can come to live in the upper reaches of your set range of happiness.”

How a Born Pessimist Learned to Be Happy

Martin Seligman is a world renowned author and psychologist who describes himself as a born pessimist.  In 1965 he stumbled on to field of study that would change his life and the life of all of us who suffer from things like irritability and depression.  In doing experiments with dogs he found something completely unexpected.  He gave dogs a mild shock paired with a tone (rather than pairing a tone with food as had been done in classical conditioning).

He expected that once the dog was conditioned, whenever the dog heard the tone he would associate it with the shock, feel fear, and run away.  Instead he found that the conditioned dogs just pathetically laid back and took the shocks.  Apparently, what the conditioned dog learned was that trying to escape from the shocks is futile. This dog learned to be helpless.

A new field of study was born, one perfectly fitted to a born pessimist.  The theory of learned helplessness was then extended to human behavior, providing a model for explaining depression, a state characterized by a lack of affect and feeling. Depressed people became that way, Seligman felt, because they learned to be helpless. Depressed people learned that whatever they did, it was futile. During the course of their lives, depressed people apparently learned that they have no control.

On a summer’s day in 1998 Seligman had another critical insight and his personal and professional life shifted once again.  “It took place in my garden while I was weeding with my five-year old daughter,” Seligman remembers.  “I am goal-oriented and time-urgent and when I’m weeding in the garden, I’m actually trying to get the weeding done. Nikki, however, was throwing weeds into the air and dancing around. I yelled at her. She walked away, came back, and said, ‘Daddy, I want to talk to you.’

‘Yes, Nikki?’

‘Daddy, do you remember before my fifth birthday? From the time I was three to the time I was five, I was a whiner. I whined every day. When I turned five, I decided not to whine anymore. That was the hardest thing I’ve ever done. And if I can stop whining, you can stop being such a grouch.’

“This was an epiphany for me. As for my own life, Nikki hit the nail right on the head. I was a grouch. I had spent fifty years mostly enduring wet weather in my soul, and the last ten years being a nimbus cloud in a household of sunshine. Any good fortune I had was probably not due to my grouchiness, but in spite of it. In that moment, I resolved to change.”

7 Steps for Becoming Happy

1.    Learn the Happiness Formula

Here is the happiness formula developed by Dr. Seligman:  H=S + C + V.

H is your enduring level of happiness.

S is your set range.

C is the circumstances of your life

V represents the factors under your voluntary control.

There are many things that will increase our momentary happiness:  Chocolate, a good movie, flowers, new clothes, sex.  But to achieve enduring happiness takes more work.

2.    Take the Happiness Test

The following scale was devised by Dr. Sonja Lyubominsky, one of the world’s leading happiness researchers.

For each of the following statements and/or questions, please circle the point on the scale that you feel is most appropriate in describing you.

A.    In general I consider myself:

1                  2                       3                     4               5                   6             7
Not a very                                                                                                      A very
Happy person                                                                                    Happy person

B.    Compared to most of my peers, I consider myself:

1                 2                       3                     4               5                    6              7
Less happy                                                                                            More happy

C.    Some people are generally happy no matter what is going on.  To what extent is this true for you?

1                2                       3                      4                5                  6               7
Not at all                                                                                               A great deal

D.  Some people are generally not very happy, never as happy as they might be.    To what extent is this true for you?

1                2                       3                      4                5                  6               7
Not at all                                                                                               A great deal

To score the test, total your answers for the questions and divide by 4.  The mean for adult Americans is 4.8.  Two-thirds of people score between 3.8 and 5.8.

3.    Imagine Your Parents Taking the Test.  How would they score?

Research shows that half of your score on the happiness test is accounted for by the score your biological parents would have gotten had they taken the test.  This may mean that we inherit a “steersman” who urges us toward a specific level of happiness or sadness.  This is our set range.

4.    Change the Circumstances in Your Life That Really Matter.

“The good news about circumstances,” says Seligman, “is that some do change happiness for the better.  The bad news is that changing these circumstances is usually impractical and expensive.”  Here are some of the circumstances that people believe will increase happiness:

  • Having more money.
  • Getting married.
  • Being healthy.
  • Good social life.
  • Avoiding negative events and emotions.
  • Getting a good education.
  • Live in a sunnier climate.
  • Engaging in religious practice.

Surprisingly money, health, education and living in a sunny climate had no effect on happiness.

Getting married and having a rich social network had a strong effect on happiness.  Avoiding negative events and emotions and engaging religious practice had a moderate effect.

5.    Don’t Dwell on the Negative.

Many people believe that in order to be happy they have to focus on all the negative things in their lives, find out what is causing them, and fix what is wrong.  In fact, research shows that the more we focus on what we don’t like in our lives, the more unhappy we will become.

Depressed men and women tend to ruminate and chew on all the things that are going wrong in their lives.  They believe that a bad events that happen to them are permanent and will persist.  Those people who are generally happy have a different view of the world.

6.    Focus on Gratitude and Forgiveness.

Those who would be happy ruminate on happiness.  They assume if something bad happens, it is temporary and will soon pass.  They focus their attention on feeling gratitude for what they have and look forward to more good things happening in the future.

I tell my clients that life has two windows. Look out one window and you will see all the negative things going on in the world:  Anger, violence, wars, poverty, death, suffering.  Look out the other window and you will see a different world:  Love, compassion, care, support, emotional richness, hope.  Both exist, both are real.

Happiness depends on which window you spend most of your time looking through.  When we look out one window we feel gratitude for all that we have.  When we look out the other window, we see all that we do not want.  Which window are you looking through?

Many of us carry old wounds from times we were hurt.  We also carry a lot of anger and blame within us.  We hold on to grudges for years.  Forgiveness is one of the most difficult, yet healing things we can do.  At some point in our lives we have to accept that the wounds inflicted on us were done by people who themselves were wounded.  At that point, we don’t forget, but we do forgive.

7.    Reach out today and let someone know that you care.

In our busy lives we often forget that a little recognition and appreciation can go a long way in making someone’s life a little more cheerful.  We can all use a little more love today as we reflect on those we have lost.  Make this a day that we show we care.

I value your comments.  What do you think about these 7 steps?  What are some things you do to be happier?

Photo Credit:  www.Freedigitalphotos.net