We need to nurture our psychological health as we would our physical health, to overcome problems and build a sense of joy, writes Dr Keith Gaynor
In the 10 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.
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. 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. 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.
Mental lives
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.
Attitudes
Although attitudes are changing, we still have a long way to go, and 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.
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.
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.
Depression
I work in a clinic for anxiety disorders and depression. At the moment, using a specialist cognitive behavioural therapy (CBT) approach we have an average recovery rate for those in therapy of 80%. Those are people who are not just managing, not just coping or getting by, but who are as content and active as anyone else in the population.
One of the privileges of being a psychologist is that patients come to talk about their lives. I’ve learned something amazing from those experiences. It is really hard to lose your job, break your leg, be bullied in work, or have deadlines that are impossible to meet. It is very difficult to be the mother of a newborn or be a mother of a toddler and a newborn; it’s difficult to be old in Ireland or be young in Ireland. It can be difficult to simple ‘be’. Any of these situations can make us stressed and unhappy.
Yet there are lots of quick, effective treatments that will help you with those stresses but we have to seek them out and we have to use them. The pharmacist doesn’t ring round the house on spec to see if you have a cold. We have to approach them.
The simple fact is that if people have access to evidence-based treatments, the treatments work. The major problem in mental health today isn’t that there aren’t treatments that work. It is that people either don’t have access to them or they don’t receive treatment quickly enough.
There’s nothing magical about interacting with a psychologist. It is good, solid treatment that could have been availed of months or years before.
Change
Because we are so used to going to the doctor, getting a prescription and getting better, we are surprised that the key to change is us. Maybe psychological approaches aren’t really like medicine. They are more like physiotherapy. When we go to the physiotherapist, we are given the tools needed to improve. They can show us where our bodies are struggling, where and why we are feeling pain. Then we can begin to strengthen areas that are hurt and build our bodies back up in order to engage and enjoy the world around us. When we go to the psychologist, we are given the space and guidance needed to recover. But the work comes from us.
Our ability to change is intrinsic to our human nature. This is why we should never lose hope. We are built to change. I am in the privileged position of seeing that people can and do change, every day. Therapy is the process through which the seed of hope, which is in every person, is nurtured and allowed to grow. These powers of change, adaption and growth may not be easy to channel. However, by taking up the challenge we can begin to understand the nature of what it is to be human.
*Dr Keith Gaynor is a senior clinical psychologist at St John of God Hospital, Stillorgan, Dublin. This extract was taken from his new book Protecting Mental Health, published by Veritas.