Returning to Active Duty - from Laurie @ MHRP

Hi All!

I recently experienced some significant-yet-positive life changes, so there hasn't been much activity going on at the site.

In late August '08, I left the counseling field to take a job as a full-time Professor at a Community College in WNY, teaching future counselors, social workers, and human service professionals.

Altho this is best change I've made in my life (thus far), it was also a difficult one. Change is NEVER easy - adjustment is a big stressor, regardless of how positive it is.

So for the last 2 months, I've been focused on re-adjusting my mindset from counselor to teacher, as well as put together lesson plans, exams, syllabi, etc.

It's worth it, tho, because I now feel I'm TRULY helping those of us who have survived our mental health issues and continue to recover.

The reason I started MHRP was my disappointment with the current mental health system. Systems, themselves, are difficult to change since they are so deep-rooted in bureaucracy and status-quo attitudes.

Regardless, the people who work in those systems still have the ability to make them better. Despite the fact I was working in a pathology-focused, medical-modeled system, my personal attitude toward my clients was strengths-based and recovery-oriented.

Unfortunately, many of the other counselors and social workers did not adopt this kind of mindset. This is not solely their fault because much of their attitude is based on their educational training.

Until very recently, mental health professionals were trained to view mental health issues as "disorders" that need to be "fixed." In addition, they were also trained to believe that THEY "knew" what YOU needed.

As a result, when clients didn't "respond" like they "should," the clients were labeled negatively. For instance:

• If you don't take your medication, you're "treatment non-compliant."
• If you resist doing what your counselor tells you to do, you are difficult, "manipulative" and "resistant."
• If you have a crisis and don't know what to do about it, you are "attention-seeking."
• And if all these things go on around the same time, you have a "Personality Disorder" and/or a "Severe Mental Illness."

To be clear, there ARE such things as Personality Disorders and severe mental health difficulties. And medication IS a vital part of treatment for some mental health issues.

However, I found that many people labelled with these diagnoses were actually MIS-labelled. As a result, their self-concept was negative, which in turn hindered their recovery.

The good news is that in the last 10 years or so, this has been changing. Thanks to advocacy groups (such as New York's NYAPRS), a recovery-oriented attitude is starting to seep into the mental health system.

I say "seep" because it's slow-going. As I mentioned, it's hard to get a system to change. It's also hard to get people to change. I worked with several counselors, social workers and psychiatrists who took to the recovery-oriented mindset right away. These were usually the professionals who, themselves, had experienced mental health problems.

However, for many other professionals, the idea that clients are not "sick" or "disordered" is too difficult to grasp, either due to their educational training, their own personal issues, or both. Usually both.

This, hopefully, is where I can help. I've been working with my students to understand that they cannot enter the field with unresolved issues, such as the need to control others, or closed-mindedness.

You would think people entering the "helping professions" wouldn't be like this....but it's actually this type of mindset that LEADS people to the field.

Many people become professional "helpers" because, at an early age, they were forced to take on that role in their family. Thus, their whole self-concept is based on "fixing" other people's lives. This, in turn, can cause them to "control" their clients in ways that not only they don't realize, but that their clients don't realize either.

In other words, it's usually the overly-nice and overly-helpful professionals who are the most controlling. They take it upon themselves to fix YOUR life because, if they don't, they feel worthless. As a result, they take over.

So I try to help my students identify if this type of thing is going on inside of them, because it can be re-adjusted. At the same time, I also teach about mental health and substance-use issues in a recovery-oriented and de-stigmatizing way.

For instance, after teaching my General Psychology class about Schizophrenia, a couple of the students gave me feedback about how they viewed people with Schizophrenia differently.

Since I teach in a "Big City," there is no shortage of people walking around the streets, talking to themselves, and appearing "disorganized." The students told me they used to view these people as "crazy" and would often wonder why they weren't "locked up somewhere."

Now that they understand what's really going on, they say that their view of such people is now one of understanding and, to my pleasant surprise, empathy. Altho my students don't have Schizophrenia, based on my teaching, they say they can actually relate to the behaviors of people with Schizophrenia, now that they realize that behaviors are just behaviors...and we all act in ways people don't understand.

Of course, I'm aware I can't reach everybody. It took almost 40 years, but I think I've finally shed my God-Complex (99% of it, at least - heh-heh!) But if I can change a few mindsets, that's still a positive step. And with your recovery-based attitudes, you are doing the same.

Positivity breeds positivity, so together we CAN change the mental health system...one person at a time.

Hate Your Job but Can't Quit?

How to survive in a toxic work environment...until you can get out of it
by Laurie Berkshire, M.A.

The realization you work in a "toxic" environment is stressful enough. Add to that our shaky economic times, ad it can make things worse.

What is a toxic work environment?

Well, it varies from person to person. Here are some ways I determine if a work environment is toxic:

• Rules, protocols and job descriptions are not clearly defined, or frequently change.

When this happens, you're always trying to adjust, re-adjust, guess, and predict the future, keeping you in a constant state of confusion and doubt.

More importantly, it also interferes with your ability to problem-solve, which is a cornerstone of mental health. Knowing how to solve problems gives us a sense of mastery in our environment. However, not knowing the situational boundaries in which you can find solutions for a problem can impair this. Thus, it's difficult to feel calm and balanced when you feel like you have no control over what might happen.

• Your workplace interferes with your ability to meet basic human needs

As a human being, you have needs that must be met before you can do anything else. According to Maslow (1943)¹, these include:

- Breathing
- Drinking
- Eating
- Excretion
- Sex
- Personal security from crime
- Financial security
- Health and well-being
- Safety net against accidents/illness and the adverse impacts

Source [1]

So if a workplace prevents or impedes your ability to meet these needs, you're likely going to struggle with fatigue and ill-health, as well as feeling of agitation, anxiety, anger, and helplessness.

• Frequent employee turnover

I worked for 2 years in a place that was always short one staff member. They'd hire someone, then a couple weeks later someone else would quit. And worse, it took a long time to hire people because what the company offered it's employees (i.e. salary, benefits, work-hours, etc) was so lacking that no one was interested in the job.

Situations like this are almost-always a sign (no, a billboard) that you're working in a toxic environment.

• Passive, aggressive, or passive-aggressive leadership

* Having a "passive" boss who lets everyone do anything they want can have some advantages, but they're outweighed by the chaos that ensues when there's no managed control over the workplace.

* The problems associated with an "aggressive" boss are self-explanatory. Being bullied is never good.

* A "passive-aggressive boss" is likely the worse because it's the mix of both. You have the face-value impression that everything is ok, but behind your back the boss is bad-mouthing or sabotaging you - and you have no clue until it smacks you in the face (i.e. being fired, a written warning, a demotion, etc.)

So what do you do?

Well, when people are in abusive relationships, there's only one remedy to make things better....get out! Working in a toxic workplace is a similar situation. But when money's tight and jobs are scarce, that's not always an option. So here are ways to survive until you can make your escape:

• Look for the "good"

When you work in a toxic environment, the bad stuff it so evident you can't avoid noticing it. In addition, our brains are hard-wired to look for "threats," which is what's kept the species alive. After all, if our early ancestors took the time to admire a sunset when a lion lurking nearby, none of us would be here, surfing the internet.

So with a brain constantly scanning for bad things, it's easy to focus on what's wrong. You can short-wire this, though, by making an effort to look for good things throughout the day. This doesn't mean you should ignore the bad stuff, because it's good to maintain awareness of it and how it's affecting you.

However, constantly thinking about the bad will create "internal stress" (in the brain and body), which only adds to the external stress in the environment. So, if you can take time to notice what's good in the workplace, it'll help balance this out.

Now, you might be thinking that there's nothing good about where you work, but in life there are very few absolutes. There's got to be something good at the place, no matter how small.

Some "good-things" examples from my own experiences in toxic workplaces are: the nice smell of the soap in the bathroom, a beautiful tree outside the building, having a window in my office, a co-worker with a good sense of humor, and the fact no one noticed when I was 5-10 minutes late (thanks Passive Boss!)

• Avoid "gripe sessions"

When you work in a toxic environment, there's no shortage of gripe sessions among co-workers. Sure, venting and sharing misery is good for you...to a point. Eventually, this type of negative energy will impact your mood and attitude. So if you're involved in a gripe session and start to feel "down," quietly remove yourself because you've gone past the point where it's helping relieve the stress, and is now just adding more stress.

• Try to adopt a "non-judgemental stance"

Marsha Linehan (1993)² , the founder of Dialectical Behavior Therapy (DBT), adopted the idea that non-judgemental thinking can assist with mental health.

True, we need to make judgements in order to survive. Our brain is trained to make them (see sunset-lion example above.) . However, we often make them about things that are not true threats.

Thus, viewing something non-threatening from a "fact" perspective instead of an "opinion" can help calm your negative emotions. For example:

Opinion: This job sucks (which is perceived as nothing but negative energy in the brain.)

Fact: This job is not the greatest, but it's better than no job. Even though I don't make good money, unemployment benefits would be even less. Since I can't quit right now, it's better than nothing.

This type of fact-viewing can help calm you by balancing both negative and positive energies in the brain...and balance is yet another cornerstone of mental health.

For more info and exercises for non-judgemental stance, visit: dbtselfhelp.com

Source [2]

• Take as much control as you possibly can

* Use your "delay-button" and watch what you say when you're at work. Count to 10, bite your tongue, sit on your hands...do whatever you have to do to keep your opinions, anger and negative comments to yourself. In a toxic workplace, seemingly-benign statements can come back to bite you. But also, find someone on "the outside" to vent to, even if you have to pay for it (i.e. counseling.)

* Always keep your eye out for new jobs while also keeping in mind that this is often a long process in a weak economy. In other words, if you look at the want-ads with the I'll-never-find-anything attitude, you're again adding to your own inner-stress. Instead, remind yourself that you're at least trying to do something to change your situation.

* Only accept responsibility for your feelings and needs. The only think you owe a company, your boss, and your co-workers is adequate job performance. If you're not required to work overtime or do extra work (i.e. you won't get fired,) then don't do it. You are not responsible for making sure other people's work gets done. It's not your problem if people quit, call-in sick, or slack-off. That's a responsibility for bosses, which is why they make the big bucks.

* Upgrade your skills, or develop new ones. You might be having a hard time finding another job because you've been at this one for so long, your skills are a bit outdated. For example, you might be a great forklift driver, but you haven't learned how to use the more specialized machines in the shop. Or, just because you have a bachelor's degree in social work doesn't mean you can't follow your dream to be a computer programmer. Take a class, ask for more training, or even go back to school. This will help you see a "future" instead of feeling stuck in your present -misery.

Advice on advice

Advice is best-taken buffet-style because you don't usually eat every single food available. In other words, everything listed here won't work for everyone, but you won't know until you try it. Also, if you've tried it before and it didn't work, then it's probably not worth trying again. And most importantly, if you try everything all at the same time, you'll feel bloated.

Remember...
"A journey of a thousand miles begins with a single step..." (Lao-tzu, Chinese philosopher, 604 BC - 531 BC)

Sources:
[1] Maslow's Hierarchy of Needs - Wikipedia
[2] Behavioral Tech, LLC

Psychiatry's Role in Recovery (inspired by Steve)

Warning: This is a pretty long blog, but I think it paints an excellent picture of recovery. So please hang with me...

The following comments were made by my friend Steve on the MHRP website:

• "It's funny how some of the people in these Myspace mental health groups like to play doctor and diagnose a person as manic or whatever."
• "I know a lot of people who accused me of being manic when I started disagreeing with psychiatry...The idea that people who don't believe they're mentally ill is an indication that their judgment is impaired is bullshit."
• Dr. GlenMullen, M.D. (states that) scientists haven't proved a chemical imbalance exists in a mentally ill person's brain, and that they don't know how medication works.
• "Medication can be helpful sometimes, but I'm getting the sense that it's tremendously overprescribed."

I was inspired by these comments and felt compelled to write about them. Why?

Because Steve is the picture of Recovery!!

Being a mental health counselor, I wish more of my clients thought this way. But before you agree or disagree, I'd like to break down some of Steve's comments to explain my thought-process...

• "...people in these Myspace mental health groups like to play doctor and diagnose..."
• "The idea that people who don't believe they're mentally ill is an indication that their judgment is impaired is bullshit."

I've been guilty of this. As soon as I became "educated" on mental health issues, I was eager to start using it. I couldn't have a brief conversation with a store cashier without thinking: "She's depressed." And I'm still trying to figure out what kind of personality disorder my ex-husband has (heh-heh!)

I don't think this is unusual. As soon as we learn something new, we want to use it. Why learn how to cook then continue to hit the McDonald's drive-thru? But after awhile, I had to force myself to stop diagnosing people, including my clients.

Labelling people creates negative energy, and by holding mental pictures of a person's pathology not only brought my own mood down, but also prevented me from hearing what my clients were really saying.

I'm not perfect - I still slip into "diagnosis mode." This is why I like Steve's comments because he understands that the "people in these mental health groups" are not necessarily right. True recovery involves standing up for yourself, even when "The Experts" tell you you're wrong.

• "...(people) accused me of being manic when I started disagreeing with psychiatry."

It is human nature to try to understand what you don't understand. In other words, people with mental health issues are "different," and mainstream society hates that. People who deviate from the norm are threats - not necessarily to society as a whole, but to our own psyche. If the seemingly-put-together woman who has "everything" suddenly loses it and ends up in therapy and on medication, we get scared. Could that happen to me? And then, How can I prevent that from happening to me?

That's how psychiatry was born - as a way to "fix" the "different" people so they don't intimidate our own insecurities. But human behavior is so complex and unique that it can't possibly be explained with blanket-theories and treated with one-size-fits-all medications.

Again, We-The-Experts have studied this stuff for a long time (and have the student loan payments to prove it - heh-heh!) We're convinced we "understand" people's "problems," sometimes more-so than the people themselves. So when someone disagrees with our "knowledge," we don't like that.

Is this ego? Sure, everyone has an ego. But also, most people who work in the mental health field are good people - i.e., they care. I've personally witnessed clients in crisis, and it wasn't pretty.

When you've seen people with rope-burns on their neck or charcoal on their lips after having their stomach pumped, you want to make sure that never happens again. But when you become a zealot about it, you tend to shoot-down people like Steve who are just sharing theirs opinions.

Calling someone "manic" just because he says something is bad practice. Now, if he robbed a bank and spent all the money on gumballs and hair gel...well, then yeah, he's manic.

• "Dr. GlenMullen, M.D. (states) that scientists haven't proved a chemical imbalance exists...and that they don't know how medication works."
• "Medication can be helpful sometimes, but I'm getting the sense that it's tremendously overprescribed."

So what do you do with the manic gumball-and-hair-gel-lovin' bank robber? You give him medication. I don't dispute that for a single minute. Steve is right - scientists don't know how medication works, but it does work. Which leads to Steve's second point about over-prescribed meds.

Psych meds are a complex issue with many players involved. First, human beings don't like to feel crappy, so when they find something that helps them feel better, they use it (coffee, anyone?)

As a result, some people rely solely on meds to solve their problems. In fact, I once had a client ask me if the doctor could prescribe an "anger pill." Translation: I don't want the natural emotion of anger and I don't want to take Anger Management classes.

Drug companies confuse the issue. I can't watch a T.V. commercial for an anti-depressant without rolling my eyes. They paint this wonderful picture that if you take a med, you'll be transformed from a depressed lump to an active, happy camper.

And why wouldn't they? A single pill only costs a couple cents to manufacture, but can be sold for a couple bucks apiece. Now that's a helluva profit! So if they can run a commercial to convince you it'll work (cuz it likely will), it's a win-win: they get rich, you feel better.

This puts psychiatrists in a tough bind. They know meds work. And if someone with a history of aggressive behavior asks for an "anger pill," it can be hard to say no. After all, if this client ends up shooting 10 people in a Burger King, eventually someone will ask the psychiatrist why he/she didn't help.

Again, this can lead to zealousness. When you know something is helpful, it's hard not to make it available. Dr. Peter D. Kramer's book Listening to Prozac does a good job at explaining why some psychiatrists get happy with the prescription pad.

On the other hand, I've worked with psychiatrists who refused to give meds based on a client's random symptoms and requests. Instead, they suggest other methods (therapy, self-help, stress-management, lifestyle changes, etc.) Unfortunately, they'll tell you that most clients don't want to hear this...but some do. Steve is part of these "some." His comments show that he is willing to try more than just meds...and that's the attitude you need to recover.

In short, Steve's comments are an example of someone working a recovery plan. Recovery is about finding what works for you, then being willing to do the work. This requires:

• A sense of personal responsibility. Take what's yours and own it. If you have a pet, it's your responsibility to take care of it. And if you have a mental health issue, it's your responsibility to take care of it. In both cases, if you don't take care of your responsibilities, someone else will step in and take care of it for you. Don't give your power away.
• An open-mind. Be willing to try something to see if it works before completely rejecting it. If you try something a couple times and get no benefit from it, then you'll be able to move on to something else. This type of effort sends a message to "The Experts" that you're in control, which will get them off your back.
• An ability to look in the "gray area" between pro-psychiatry and anti-psychiatry. If you embrace psychiatry completely, you'll be at the mercy of the mental health system. If you reject psychiatry completely, you'll be eating all your gumballs in a hospital gown.
• Self-respect. You have to love yourself enough to do what you need to do to take care of yourself, and reject what's hurting you.
• A positive mind-set. A lot of people think this means "thinking happy," which it isn't. Instead, it means favorably viewing yourself, others, and the world. If you think you're a loser, that "The Experts" are against you, and the world is a horrible place, you're not going to recover.
• Balance. Be aware that everything and everybody has good and bad points. Embrace your strengths, understand that "The Experts" are mainly good people, and that there's more kindness in the world than hate.

  Yes, it's good to know the "bad" so you can avoid it. But make sure to give equal attention to the "good," because it's out there.

  Your behavior responds to your thoughts. Awareness of BOTH good and bad will help you feel more balanced...and balance is the cornerstone of recovery.

Recovery...it's YOUR responsibility

Unfortunately, due to that necessary evil called "managed health care," getting treatment for mental health issues basically goes like this:

"You've got a disease. Take your pills. Stop thinking like that. Pay the receptionist on your way out. Who's next?"

Remember, I'm a therapist, so I see this first hand. It happens because mental health issues are considered an "illness" whose only form of "legitimate" treatment is in a "medical-based" system.

The "pros" to this is that we can receive treatment and get it paid by insurance. The "cons" is that treatment focuses on symptoms, not strengths.

When you go to your doctor with flu-like symptoms, he/she gives you a prescription and sends you on your way. Doctors don't discuss your lifestyle, trying to figure out what you do right so they can encourage you to keep doing those things to prevent getting the flu again.

They can't, cuz insurance companies pay "decreased rates" (that the insurance co. decides, not the Doc.) So in order to make any money at all, Doctors need to see as many patients as possible, which leaves little time for you.

Now mental health therapy is the same way since insurance also covers it. So you probably won't be encouraged to focus on strengths in your therapy sessions cuz your therapist NEEDS to address your symptoms.

Why? Cuz if therapists don't do this and you end up in crisis, it's their job on the line (i.e. more money to malpractice insurance companies and lawyers, and less for the people who have devoted their lives to helping people - or so they thought).

In short, the system sucks, which was my reason for starting MHRP.

If you truly want to recover from your mental health issues, you are the one who's going to have to do the work. In other words, you can't rely on your Dr., therapist, or a pill to make you feel better.

And you're already doing it. By visiting this site, you're proving you're attracted to the word "recovery." You're thinking it and believing it. And you're willing to try to get better, despite the limited care you receive from the system.

For that, I am truly grateful.

The Blame Game

I'll be the first to admit...I'm guilty of this myself. I tend to either blame others, or myself, for my problems. But even tho you properly place the blame where it belongs, seriously, where does that get you?

My point? Well, to begin with, there's always someone to blame for screwing our lives up. Here, I'll give you a list of the likely suspects:

- Ourselves
- Parents
- Siblings
- Spouse
- Significant Other
- So-called friends
- Co-workers
- The boss
- Neighbors
- Therapists
- Doctors
- The extremely-slow cashier at the supermarket
- The asshole who doesn't know how to drive in the car ahead of us
- That jerk-off who mows his lawn at 7am
- Dr. Phil (yep, couldn't resist)

So that about covers it for most of us. These people have, and will continue to "wrong" us for as long as we live. And yes, you have the right to be angry. But anger does nothing but immobilize you. It makes you sit there with your fists clenched and stress-hormones pumping.

In other words, anger is a slow-death and doesn't solve anything. And problems are meant to be solved.

Here's a couple examples. I told my boyfriend this morning: "I eat too much, I smoke too much, and I sleep too much." Who's to blame? Well, me, of course. But if I was to sit around, blaming myself for being an over-indulgent loser, then I would feel even more shitty...and eat, drink and sleep some more.

Instead, I found this self-revelation to be a starting point for change. Yeah, A.A. is right when they say that admitting you have a problem is an important step toward recovery. You can't solve it if you don't know it's there. So after saying the first part to my boyfriend, I added: "I guess I need to make some changes."

Here's another example. I was verbally and quite maliciously attacked by a co-worker recently at the start of the workday. My response? Well, I cried my eyes out for an hour, threatened to quit, and only calmed down after I smoked a half-pack of cigarettes and ate 3 donuts. Even then, I was so wiped-out that I went home after lunch.

So could we say she ruin my day?? No!
Did I let her ruin my day? Well, yeah.
Who's to blame? No one.

Again, I used it as a good learning-lesson. True, I analyzed and obsessed about the incident for days (and yes, slept too much, ate too much, and smoked too much...gotta love unhealthy coping skills.)

But in the end, I realized my errors (which, in this case, was to try to reason with someone in an irrational mood - which rarely works.) So now I know what I can try to do the next time this happens (because it will happen again...maybe not with this person, but definitely with another person. There's no shortage of people in irrational moods.)

In both these examples, I could have held on to my anger toward myself and my co-worker. But I didn't. I looked at each situation as a problem to solve, then started doing things to solve it. And as I did this, my anger toward both myself and my co-worker melted away. Seriously, it just melted...

You can never, ever, ever, ever change another person.

But you can change yourself.

In short...
Don't let the blame-game ruin your recovery!!!!

To Dr. Phil or not to Dr. Phil -- that’s not really the question

When I first started as a counselor, I hated Dr. Phil....HATED him. However, now that I've been in the business for 5 years, I've learned to really appreciate him and, uh, even love him a little.

See, I work with people who have been labeled with a "Severe and Persistent Mental Illness" (SPMI). I say "labeled" because the reason they're labeled as such is due to their "diagnosis" which is usually Schizophrenia, Bipolar, or Depressive Disorder.

However, this label is extremely misleading because everyone with such a diagnosis is not "SPMI." What makes someone SPMI is an inability to fully function in the community. This is much more than shopping, eating, showering and paying your bills, because most people with SPMI can do these things.

Instead, to "fully function in the community," you need social skills - the ability to listen, compromise, and understand that sometimes you just can't get your own way. If you have this ability, you can work, go to school, and have healthy relationships with friends, family, and lovers. There are many, many people with Schizophrenia, Bipolar and Depressive Disorder who can do these things. As a result, they are not labeled SPMI.

However, there are people stuck in limbo. They haven't been labeled SPMI because they ARE able to work, go to school, form relationships, etc. However, they don't have the ability to "get along with people." These are the people Dr. Phil has on his show. So in essence, Dr. Phil and I also works with same type of people - those who lack social skills.

This brings me back to my original point. At first, I hated Dr. Phil for the sole reason that he was too confrontational and challenging. It really didn't bother me that he was an arrogant know-it-all. Since he's the Rock Star of Therapy, he's bound to think this way. Also, I've worked in hospitals, and this is a common mindset among doctors - and it should be (to some extent.) After all, I'm not sure I want some wishy-washy, insecure doctor deciding if i need surgery or not.

So I was able to get past Dr. Phil's personality, but not his therapeutic style. This is due to the fact that my own style, when I started in the business, was supportive, friendly, and validating. I did not like to challenge and confront people. I didn't like to point out another person's bad behaviors. As a result, I was a very, very ineffective counselor for the first year or two.

See, my original style did nothing but REINFORCE a clients lack of social skills. For example, if clients were perpetually mean and condescending to me, I didn't help by being supportive and friendly to them. All I did was teach them that it's okay to treat people like that.

So if I was to help clients at all, I had to start confronting and challenging their hurtful behaviors. Of course, I try to do this in a supportive, friendly, and validating way. But I'll admit, sometimes I don't. Like anything, my therapeutic style is a work in progress.

That said, whether we like Dr. Phil or not has nothing to do with him, and EVERYTHING to do with us. Yes, Dr. Phil makes mistakes. And yes, Dr. Phil thinks he knows everything about everything. But this aside, Dr. Phil's main point is ALWAYS right - that if people don't change their behaviors, they're going to continue being miserable.

Dr. Phil didn't invent this. It was Albert Einstein who said "Insanity is doing the same thing over and over again and expecting different results." Makes sense, right? But if it doesn't, that's the root - the root of our problems, and by extension, the root of our distaste for Dr. Phil and anyone else who tries to tell us this (our therapist, family, friends, spouse, boss, etc.)

So in short, the way you feel toward Dr. Phil is not really the central issue. The real issue here is WHAT makes you feel that way. Answer that question, and you'll have all the answers you need.

How to Survive and Thrive in the Mental Health System

First, I'll give you my story. I was 32 when I first considered counseling. I asked around and got the name of a woman who had a long-standing private practice. I trusted the people I asked, so I called to make an appointment. She said she could see me in a week.

Her office was in her home, which was located in "the sticks" (i.e. outside of the city limits, where there's trees and stuff.) The view from her office window was breathtaking and serene. The counseling session was not. I immediately had doubt as I sat in her long, narrow office. She sat at her desk on one side of the room....I sat way over on the other side where the proverbial client couch was located.

This gave me an opportunity to see every inch of the space between us...and I was reminded of my doctor's office - sterile, scrubbed, and devoid of everything except furniture, Kleenex, and a couple diplomas on the wall. The counselor's demeanor was also similar to my doctor's - willing to listen, but all-business and no smile. After that first session, I didn't go back.

By now, all of the "important" people in my life got wind of what I was up to...and they weren't happy. As a result, I started to hear messages from these people that I didn't "need" counseling, and that there was nothing "wrong" with me. You know how it is, if I would just relax, pull myself up by my bootstraps, and live the way they tell me to, I'll be okay. My response: Uh, alright, makes sense, I'll try it.

So for 6 more months, I pushed on, struggling to get better without any help. Yeah, it didn't work. So I decided to try again and I found another private practice in the phone book. A couple weeks later, I had my first appointment.

When I got to her office, I found it was in an old, Victorian-style house...next to a cemetery. A really big cemetery. Dead people as far as the eye can see. Hmm...okay. I wondered if it was some existential message: you have two choices - come into the house, or go lay down next to the dead people and wait for your headstone. I opted for the house.

The waiting room had mis-matched chairs, worn-out oriental rugs, toys all over the floor (they counseled all ages) and haphazardly-filled cases of books and magazines. When I got into the actual office, it was much of the same, but more tidy (except for the paperwork-littered desk in the corner.) The counselor gave me a big smile as she led me into her office, and sat in the chair right next to mine. I've been seeing her for 7 years now.

So what does this all say? Well, I'll tell you what is doesn't say. It doesn't say that the first counselor was bad. Remember, several people I knew had sought therapy from her and thought she was wonderful. Do I think these people were delusional? Nope. Not at all. If there's a large mass of people who are satisfied with a certain service provider, then that says a lot...but not everything.

This brings me to what I'm really saying here: only YOU can determine who is the right counselor for you. And on that note, only YOU can decide if you really need help at all. For many people, it's involves a two-part process that isn't linear. In other words, you don't do one part, move on to the second part, then arrive. Instead, each part needs to work together.

The first part of the process involves research and trial-and-error. Marsha Linehan, PhD. encourages clients to be "scientists" of life. Formal scientific research exists to make things "better." But in order to find a something truly "better," scientists can't take their first new idea and run with it. They need to research it and test it out before deciding it's a truly "better way." It takes awhile...and tt requires work.

I won't lie. If you use this approach with your mental health care, it can be frustrating. When we're in pain, we want quick relief. The mere thought of having to consider options and then test them out can be can quite discouraging. It's not easy to use every bit of energy to make a decision, only to find out you've made the wrong one. After all, if you try it again, who's to say that the next decision will be right?

Who's to say? YOU do.

This is where the second part of the process can be helpful. Believe it or not, you already have an endless source of information that is almost always right...your gut. No, not that thing you look down at once in a while and think: Gee, I need to do some sit-ups. Instead, it's that feeling you get every now-and-then that says you aren't comfortable with what's going on.

But it can be difficult to listen to this feeling. After all, it tends to have very bad timing. I mean, unless you're independently wealthy, you really don't need your pesky gut telling you that your job sucks. To immediately act on this gut feeling would leave you, well, homeless and hungry. Also, if your already emotionally stressed-out, the last thing you need is your gut shouting-out the obvious, so you find ways to stop listening.

What's helpful here is to view your gut as just another resource in your fact-finding mission. Listen to what it says, and add it to your research. Just like the other research you gather from outside sources, your "inner source" will eventually prove itself to be right or wrong (but most likely right.)

Use my story as an example of how this process works. My fact-finding produced the following information:

External sources

• Where to find counselors (the phone book, advice from friends.)
• I didn't need counseling (all those "important people" who, incidentally, aren't around here anymore.)

Internal source (my gut)

• I needed counseling.
• I wasn't comfortable with the first counselor.
• My second counselor's office being next to a bunch of dead people was slightly creepy.
• I'm comfortable with sloppy waiting rooms, a messy desks, and counselors who sit next to me and freely offer warm smiles.

In short, it was my gut that made the decision here. It was my gut who said: This is the kind of person I am, and this is the place I will go to for help. And since the process worked so well for me in the beginning, I've continued to use it in the following way:

• I've made good money on eBay selling the self-help books that I stopped reading halfway-through because what they said made me feel worse.
• I've increased, decreased, started, stopped and continued medications because I not only listened to my doctor, but also to how each medication really made me feel.
• And I have stuck with a counselor who gives me the choice at the end of each session to either schedule another appointment, or call when I'm ready.

I mention this because finding something that works isn't usually the end of it. As you grow and change, all of your systems will have to grow and change with you - including your use of the mental health system. For example:

• Your controlling family members probably won't be happy with your new-found assertiveness, and won't be afraid to let you know.
• You'll hear several mixed messages from the media, your doctor, family, friends, and your own body about the medications you're taking.
• Your co-workers might be put-off when you stop working overtime, or won't do all the mundane tasks they don't want to do either (which is why they pushed them on to you.)
• And possibly the hardest one of all - your counselor or doctor might not believe you're truly doing better, and are reluctant to let you go on without them.

This last one can be hard to understand. As a result, some tend to think it has to do with money and job security, which isn't usually the case (usually). Remember, if you continually sought help from these people, it's because you ultimately decided they were both trustworthy and effective. You established a relationship with them, and they are now a part of your life.

Also, these people are just that - people. They're bound to worry. After all, they met you when you weren't doing so well. And even if you've been seeing them an hour a week for 5 years, they still haven't had the chance to see how well you do the other 6 days and 23 hours of your life. They care about you. And to be honest, they also care about themselves because it's their entire career on the line if something goes wrong and your family sues them. It can be difficult, but if they've encouraged you to have a good life, try to respect that they want their own lives to be good as well.

So whether you're searching for mental health or want to maintain it, use your 2-part process...and use it, and use it. Listen to what others say, but don't necessarily believe it until your gut has a chance to weigh in. Sound decisions aren't usually made on the spot. Sometimes you get lucky and find the right therapist, medication, or self-help group on your first try. And sometimes you win the lottery. But in both money and mental health, these "lucky" people are very few in numbers. The rest of us have to keep working to get what we need.

Self-Help or Self-Hurt?

If I was to write a self-help book, it would go something like this:

You're fine. Stop thinking you're not. The end.

Now, I'm just guessing here, but I'm pretty sure this book wouldn't be a best-seller, or even sell at all. People buy self-help books because they think something is wrong with them. Telling them otherwise would conflict with their core belief that they're damaged, and they wouldn't believe it.

So many self-help books give readers what they want. This is the rub because people buy self-help books to find help. But they also want explanation and validation. They want to know the age-old question of "Why?" Why did this happen to me? Why am I like this? Why did my life turn out so horrible?

Thus, many self-help books follow a formula. They begin with "education" that explains the "why" behind symptoms and behaviors. They detail nature and nurture because everything we do has roots in our biology, environment and upbringing.

Take weight loss. Many of the current diet books will talk about how carbs just destroy you. You eat them, your blood sugar spikes, you get fat. So you read this, avoid carbs, and find out it's not easy (because your body needs carbs too). Eventually, you end up downing 5 donuts, remember how bad this is, then mentally beat yourself up. This opens the door for more emotional eating, and you seek out comfort foods which are, you guessed it, carbs. Carbs help balance your serotonin levels. Serotonin is the brain chemical that many anti-depressants target (eg. Prozac, Paxil, Zoloft). This is why we reach for cheesecake and mashed potatoes for comfort instead of just gnawing on a steak.

Then there's Schizophrenia. The main "education" given here is that it's a "brain disease." Translation: Sorry, but your brain, that thing in charge of everything you do, is messed-up. Good luck with that. (Oh, and don't forget to take your meds, no matter how crappy they make you feel.)

And trauma symptoms or PTSD (Post Traumatic Stress Disorder). People experiencing flashbacks and painful memories are "educated" on why events in their past are coming back to haunt them....and haunt them and haunt them. Then, there's explanation about how the brain has "trapped" these horrible memories and shoots them into awareness any time it senses a "trigger" (smells, sounds, sights, thoughts, feelings.) So if you were abused by someone with blonde hair, you could have a flashback every time you see someone with blonde hair. Have fun at the grocery store.

So the main problem here is that "education" can also reinforce the "you're-damaged" belief. After all, you can't change your biology, environment, or the past. And discovering this information might cause you to feel like a prisoner, stuck with something that isn't working for you, but also can't be changed.

So if it's so bad, why include the "education" piece at all? Because human beings want to know "why." This isn't a personality flaw - it's an innate tendency. This is why 3 year-olds spew an exhaustive list of "why" questions. As soon as we're old enough to navigate the world, we become naturally curious about what makes it tick. It's this curiosity that has kept the species alive. After all, if human beings never asked why crocodiles eat people, they'd never learn to stay away from them.

So am I saying you should stay away from self-help books? Only if you want to. But many self-help books do have valuable information, provided you're not so defeated by the "education" that you can keep reading far enough to the "help" section. So here are some tips to self-help. Like anything new, it's hard to adapt to a new way of thinking, but it can be done. While in the midst of self-help, try to continually remind yourself of this:

1) For every limitation you have, you also have a strength. Your brain is wired to compensate for weak areas. Blind people have a much better sense of smell and touch than a non-blind person. And someone who's survived abuse or war has extraordinary personal strength. You've heard the proverbial story of the little old lady whose husband did everything for her. When he died, she suddenly found herself 70 years old and learning how to balance a checkbook and having to shovel snow. The "easy life" is nice, but it doesn't help you develop problem-solving skills. And life is full of problems.

2) There comes a time when we have to stop with the self-improvement. In other words, you will never, ever, ever reach perfection. Instead, strive for "good enough" because that's all you can be. Think about the last time you got a flat tire. You didn't stand on the roadside, contemplating why the tire went flat and how the tire could be made better so it never, ever, ever goes flat again. If you did this, you'd still be standing on the side of the road while all the other cars passed you by, driven by people who were living their lives.

3) Remember that you're always doing the best you can. Human beings are hard-wired to do their best in each moment. If they didn't, they'd die. You might not be functioning the way you want to, but you're still trying. You're still searching. You're still surviving. You haven't given up yet. Give yourself credit for that.

Deep down, there's nothing horribly wrong with you. If you were completely damaged, you'd be dead (or really close to it). And if you were perfect, you'd be really bored (and people would hate you.) Constantly thinking you're "damaged goods" is going to make you feel weak, helpless and hopeless. And it will prevent you from fixing the things in life you can truly fix.