Protecting Mental Health

This is an extract from Dr Keith Gaynor’s book ‘Protecting Mental Health’. 

‘Hope’ is the thing with feathers –

That perches in the soul –

And sings the tune without the words –

And never stops –

at all 

Emily Dickinson

In the ten years I have been a psychologist, I have met hundreds of people in the course of my work. Many have struggled with extraordinary psychological and emotional difficulties. People have been racked with anxiety, have felt the darkest lows, have heard voices or been crippled by fear or paranoia. The truth, seldom articulated, is that most people get better. These things happen but we get through them.

The colleague in the room next to mine told me the other day that the most common sound she hears coming from my office is laughter, mine and my clients’. That might sound positive to you, but as a therapist it got me quite worried. Was I glossing over people’s difficulties? Was I avoiding the hard questions and the tough emotions? I mulled it over. Ultimately, I decided I was doing something, intuitively, which is vital in therapy. I was embodying a hopeful spirit and inviting the clients to do the same. People were finding tiny glimmers of light in their situations, however challenging.

The reason we laugh in sessions is because we constantly find little shafts of brightness and, in those moments, hope is born. Not everyone laughs – and plenty of people cry – but for each person, seeking out that genuine emotion allows them to connect to that most human part of themselves. All therapy begins in hope: in the hope of feeling better, in the hope of suffering less, in the hope of enjoying life. It mightn’t always be apparent. We sometimes have to work a little bit to find it but hope is always there, just beneath the surface.

Friends often ask me if being a psychologist is depressing and I can honestly say it isn’t. People start from a difficult place. No one comes to a psychologist because life is wonderful. But you get to sit with people as a minor miracle happens: they become happy. I’m able to laugh because it is a joy to be with someone in those moments but also because I know even if we are not there yet, most people will get there. I know the statistics and the recovery rates and I’ve seen it countless times with my own eyes. It is a myth that people don’t recover from mental health problems. People get better all the time. They go back to work and to their families and move on with their lives. I know this from my own family and friends. Students have a difficult couple of months in college but eventually get back on course. People return to their jobs and their lives. Couples have a difficult period in their marriage but twenty years later it seems like a blip. Therapy isn’t about developing coping skills or the capacity to merely muddle through. It is about complete recovery. It is about getting to the point where you are just content.

Yet significant changes are needed if we, as a community, are to achieve good mental health. To my mind, we need to understand three things if we want to achieve good mental health. These aren’t small things. In fact, if we were really to engage with them, they would be revolutionary.

As individuals, we need to understand how to be happy

As individuals, we need to understand how to reduce unhappiness

As a society, we need to understand how to create a happier country.

Dental and mental health

We treat our mental lives quite differently from how we treat our physical lives. How many times will you brush your teeth today? Twice? Three times? But what will you do to nurture your psychological well-being? If you are like most people, you probably won’t do much. We tend to wait until there is a crisis before we start doing anything to improve our mental health but we are far more proactive when it comes to our dental health. With our teeth, we take small positive steps every day to prevent decay. We know it is too late to start brushing when we already need dentures. We treat our mental health the same way our great-grandparents treated their teeth: to be ignored until they became overwhelmingly painful.

There is an extraordinary prejudice that nearly everyone in Ireland has. We believe mental health problems are different from physical health problems. It is perfectly acceptable to take the necessary treatment for high blood pressure, a migraine or high cholesterol. But a different attitude prevails when it comes to mental health. Many still believe that to feel overwhelmed is a sign of weakness – no matter how stressful our lives – or believe that we are to blame for feeling depressed. Even with the changes in society, it is still very common for people to believe that mental health is something shameful that needs to be hidden. We see our troubles as impossible battles that we have to struggle with forever.

Although attitudes are changing, we still have a long way to go. There’s nothing magical about mental health; it isn’t some unknown realm where witch doctors roam. Such attitudes came from a basic lack of knowledge about how the mind works. The last thirty years have seen an explosion in the number of publications on the subject of popular psychology and the bestsellers list has been brimming with titles that relay cutting-edge discoveries to the layperson.

They include Steven Pinker’s explanations of how important evolution is to our psychology; Antonio Damasio’s description of the neurological underpinnings of consciousness; and Daniel Kahneman’s revolutionary work on the two core processes of our brain. We have a radically improved understanding of how the mind works as a result. However, I visit my friends’ houses and, though they have all these books on their shelves, they haven’t necessarily deployed that knowledge in their day-to-day actions. It’s like reading a book about the gym – unless you put it into practice you won’t get fit.

Most people I see are already in crisis and their mental health has been declining for a while. Things have gone awry: partners may have left; they may be on long-term leave from work due to illness. These crises drive people towards mental health services. But our mental health is not unlike our dental health – if we wait for the crisis, then it is much harder to fix. We understand this intuitively about the rest of the body but we are still reluctant to embrace this reality when it comes to mental health.

We need to take responsibility for our own mental well-being. We watch our diet to reduce the risk of diabetes; we manage our fitness to reduce the risk of heart disease; we quit smoking to reduce the risk of lung disease. Over the last fifty years, our attitude to physical well-being has shifted from one of crisis intervention to preventative healthcare. Mental health is only catching up.

The pattern in most people’s lives over the last twenty years has been to work harder, put more demands on themselves and, as a result, become ever more stressed. Humans are excellent doers. In fact, we can be efficient from the moment we wake in the morning to the moment we fall asleep at night. But we have become terrible at just ‘being’: being calm, being quiet, reading books, listening to music, being in the garden, not trying, not focusing, not having a goal.

Think of the hours of your week. What percentage of those hours allow for happiness? What hours allow for calm? For how many hours do you get to be you? We all have responsibilities and we cannot be unoccupied all the time, but is there any possibility that the ratio of work to calm has been compromised? Happiness matters and if we don’t emphasise it in our lives, it disappears. It won’t turn up by accident. We have to seek it out.

Dr Keith Gaynor is a Senior Clinical Psychologist with St John of God Outpatient Psychological Services, Stillorgan (2771440).