Sunday, December 16, 2012

Mass Murder & Mental Illness

As the roar of reaction begins to quiet following the horror in Newtown, many media comments I have read express a demand for better "access to mental health services."

I'm not sure what that means in this case.

The biggest gap in mental health care in our country, as I have come to know it, is in in-patient hospital care. After Congress passed laws in the 1980's that down-sized state hospitals, hundreds of people were released from care. States and communities were expected to provide needed services, but in many places, such care never materialized. The numbers of homeless, mentally ill and/or addicted persons swelled, and state and federal dollars for the seriously and/or persistently mentally ill dwindled and has stayed low.

We have now have a chronic shortage of psychiatric hospital beds, and an even more critical shortage of child and adolescent psychiatrists. The cost of in-patient care is close to $1000 a day in some cities like Minneapolis. We have a shortage of psychiatrists because our medical system is controlled by the third party payer system of insurance companies, and they don't pay psychiatrists commensurate to their 10 year + post-college medical training. Fewer medical students want a job with longer training and lower pay.

If the shooter in Connecticut wanted mental health care, there are plenty of master and doctorate level out-patient counselor/therapists in Fairfield County. Family physicians are often the first level of care for mental health, and would have been able to offer referrals for counselors and medication if needed. If anyone feared for his life or someone else, state laws around the country commonly allow for persons to be held in a locked hospital ward for up to 72 hours for evaluation.

But that is all for those whose mental health is clearly disturbed and dangerous. We'd like to believe that we can see the most dangerous among us coming from a mile away. The plain truth is that we often can't.

Contemporary research into the minds of mass killers in America has shown that the majority are men who have had difficult lives and blame their pain on everyone else. They don't have a sense of their own responsibility for their lives, and when pressed even harder by some large stressor like the loss of a job or an important relationship, plan a sweet revenge upon their oppressors. These are usually men with personality disorders, people whose characters have little concern for the well-being of others. These folks make up about 10% of the population and don't seek mental health care. Or when they do, can fake their way through and get released without any improvement.

Stalin. Hitler. Mussolini. Pol Pot. Idi Amin. These men are mass murderers too. Do you think more mental health care would have solved the problem of human evil in them? No. We will always need to build a world that takes human sin seriously. That does what it can to control for access to weapons that kill quickly. That knows that evil doesn't come at us through normal channels. That remembers that evil seeks power, and that power can overtake governments, too.

We weep with those whose lives have been shattered by evil in the form of a silent 20 year old killer. For their young lives lost. But also for all who, throughout human history, have died at the hands of evil persons. Evil does exist, and it exists not outside of us, in some kind of satanic underworld of the devil. Every evil I know of is born of a bent human mind, and the continuous will to wreck vengeance, power and control of others.

We can't medicate, hospitalize, or counsel our way around human evil. Looking for relief from the mental health system is looking in the wrong direction.

Friday, November 23, 2012

ProBiotics Could Help Your Brain

I know that eating helpful gut bacteria (acidophilus, for example, found in active yogurt cultures) helps our digestion work at its best, and can improve our immune function, but little did I know that scientists are studying the effect of healthy gut bacteria on emotional resilience and mood. It turns out that good gut bacteria seem to work with the function of the Vagas Nerve, the nerve that links the brain to the digestive tract, to stimulate positive emotional function. (Check out a brief intro to this amazing nervous system giant here: Vagas Nerve.) 

In mice, this connection made mice more resilient in the face of stress and able to persist in difficult circumstances far beyond their "normal" peers. There is more than some suggestion that human emotions and mental health could be lifted by additions of pro-biotics into the daily diet. Jamie Lee Curtis (Activia!) may be absolutely right: adding yogurt or other pro-biotic supplements can make you a happier, healthier person overall.

If you struggle with mood, energy, and lethargy, it may be worth your while to give daily yogurt or a pro-biotic supplement a try.

If you'd like to hear more about this research, listen to this episode of the science radio program, RadioLab,  entitled, "Guts."  (The research about the mice is around the halfway mark if you'd like to cut to the chase.) The whole program is amazing.

 

Monday, November 12, 2012

I Need Help NOW

Several of my clients are suffering with destructive moods, relationships, jobs or unemployment at the moment.


I understand what that vortex feels like: overwhelming physical tension, unclear thinking, rushed or confused decision making, hair-trigger temper, uneasy sleep. During times like this in life, it's very hard to trust that you can find a way to hang on. The present is so unpleasant it seems endless.

When times like this come to us (and believe me, they will come to us all, at one time or another), I like to focus on two aspects of help: making the NOW better each day, and focusing o
n the small decisions we make so that we can create a more hopeful FUTURE.

The Now: There is a great deal we all can do every day to soothe our bodies and minds for optimum wellness even when in an emotional storm. They are aspects of daily self care, but few of us practice them with enough patience that they make a difference. Here are the basics I talk to all my clients about. What are you willing to work on each day to improve your own functioning?

1. Exercise. Absolutely, the most important addition to the self care tool box. The benefits of moving our bodies regularly, at a moderate level, for 30 minutes a day include lower blood pressure and blood sugar, a lowering of muscle tension, clearer thinking, better sleep. If ever there was a "magic potion" for wellness, daily exercise is it.

2. Nutrition. Along with exercise, what we eat has an immediate and lasting impact on our body's ability to get through the day with less stress. Less processed foods, less alcohol, and more real foods like vegetables, fruits, dairy, whole grains, lean meats, beans and fish will better nourish the body and brain.

3. Meditation/relaxation/guided imagery/breathing/prayer/ritual. A stressed mind and body needs to practice being relaxed. At times of high stress, the nervous system doesn't easily recover from tension. 20-30 minutes, every day, of quiet time that helps the mind quiet, slow, and focus will create a relaxation response in the body that promotes healing. Many people complain to me that they have tried meditation, breathing, or imagery and "it doesn't work." These are skills that take time to practice and learn. If you are patient, these skills can change your life.

4. Core relationships. When we are stressed by terrible strife at work, home or community, we can turn inward and neglect the other relationships that support us. We don't want to burden others with our struggles, yet it's exactly at this point we need the love and support of friends, extended family, pets, neighbors and healthy colleagues. Make time for these happier relationships, and don't spend every minute talking about yourself. Listen, laugh, relax with others. Relationships need to be balanced, even in stress.

Taking time to focus on what can be done TODAY will help lift the weight of life's struggles off your mind. Commit yourself to helping your body, mind and relationships be healthy, flexible and strong. It makes the now so much less destructive. In my next post, I'll talk about the mental skill of hopefulness that can draw us forward.

In the meantime, be well.

 
 

Saturday, October 6, 2012

We Can't Choose our Parents

It's true; we can't choose our parents.

Whatever skills or deficits they possess as people: their readiness or disinterest at caring for us, their physical and mental health, and their ability to meet basic needs for food, shelter and safety have an immediate and lasting effect on our own development. The human brain is shaped every day by the way we are cared for by those closest to us, and grows fastest during the first two years of life.

If a child is born to a parent who neglects their needs, is addicted, or who is violent, abusive or mentally ill, the effects are devastating. A human mind can be ruined if not helped and supported to develop in a healthier, more stable and flexible way.

It's also true that in America the first time a failing family may come into contact with an institution that could help it recover is with the justice system or the public schools.

In this wonderful episode of This American Life radio show, stories are told of educational and therapeutic systems that work to re-parent our cultures disordered parent-child relationships.  If you've ever wondered how schools cope, or how family and in-home therapy works, take a listen. It's great.

The American Life : Back To School, Episode 474

Sunday, September 16, 2012

Willing to Risk Again

Several times this week I have found myself talking to new couple clients about their relationships, and how hurt has caused them to feel withdrawn from their partners. Sometimes this distance has lasted for years, the human need for support, connection and understanding no longer expected from their spouse. 

One of the most important aspects of relationship repair is the willingness to risk being open to a partner who has been months or years at odds with our needs and hopes. Couple therapy at its best keeps both people focused on their individual efforts, while being confident, through actions and words in the therapy room and out, that the partner is doing the same hard work. 

It can feel like being open to injury. Like you are just asking for your partner to hurt you again. Many people resist, and for every right reason! But repairing such pain means turning toward your partner and feeling what you feel, expressing your hurt and disappointment, asking for what you need again, and being willing to see if your openness can be met with a similar effort of apology, repair, and affection by your partner. That's what a good couple therapist does every day with couples, with compassion, encouragement and patience. It's not a free-for-all in therapy sessions. If it is, run in the other direction. 

When deciding whether to go to couples therapy, this is one question you will need to answer: am I willing to be open again to this person, this one I once loved, and see what I feel, what they have to say, what they have experienced, and work together for new, common ground?