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Mental Health Awareness: the evolution – and devolution – of the dialogue

Mental Health Awareness: the evolution – and devolution – of the dialogue

The recent mass shootings in America have spawned a new discussion around mental health. Unfortunately, it is a dialogue that is tearing down much of the progress we’ve recently made to raise awareness and destigmatize the topic.

In response to the tragedies in Texas and Ohio, our president has referred to the shooters as “mentally ill monsters,” suggesting that the mentally ill should be “involuntarily confined” to prevent such things from happening again. His myopic statement that “mental illness pulls the trigger” stands to perpetuate the idea that all people who have a mental illness are dangerous, when in fact, most are non-violent.

Much research has been done on the topic, and the findings show that only three to five percent of all violent acts are perpetrated by someone with a mental illness.

However, mental health experts are speaking out in opposition to this statement. They offer instead that people who suffer from mental illness are ten times more likely to be victims of violence rather than the other way around.

The truth about violent behavior and mental health

Statistically, only one percent of all gun violence in the United States is perpetrated by individuals who have a mental illness. In reality, the most significant predictor of violent behavior is a history of violent behavior.

Experts believe that the rhetoric that the president is currently dishing out on the topic may further stigmatize people living with mental illness, and possibly discourage them from seeking help.

In 2006, a national survey revealed that 60 percent of Americans thought that someone with schizophrenia would act violently towards another person. A further 32 percent thought that people with major depressive disorder would be violent.

Scientific research reveals, however, that only a tiny percentage of mental health sufferers are violent. Perhaps more significantly, the majority of mental health patients who do commit violent acts also have co-occurring substance abuse issues or other factors that contribute to the behavior.

The history of mental health awareness: progress and regression

Mental health has long been stigmatized. It has only been in the last fifty years or so that we have made some progress in this regard. As psychiatry and understanding of the nature of mental illness have progressed, the way we approach it has changed considerably, but the echoes of past persecution still linger.

The movement to deinstitutionalize began in the 1950s, changing an “asylum-based” system to care that is more community-minded, providing patients with a better quality of life. By the 1960s, health standards were passed to ensure that only people who posed a serious risk to themselves or others could be committed.

In the past decade, we have made significant strides toward gaining a better understanding of mental illness, in all its forms. The discussion sought to reveal the truth about mental illness and to refute the stereotypes that ultimately lead to the neglect of people who suffer from psychiatric illness.

Making the connection

We have gained a lot of ground in the effort to educate the public, and a lot of positive things have come from it, not the least of which is knocking down the idea that people with mental illness can’t hold a job, maintain an apartment, be a contributing part of the community, or build a long-term relationship of any kind. Without these basic needs being met, mental health will suffer – even for those of us who are sound of mind and body.

One in four people will require professional help for a mental health problem at some point in their life. However, this doesn’t mean they will seek out the support they need, largely because they fear what might happen or what people will think.

In recent years, many programs have evolved to address the issue. Celebrities, actors, and musicians have spoken out about their own struggles with mental health, encouraging people to seek help when they need it and calling for a more open, transparent, and nonjudgmental discussion.

How far have we come?

Based on the building awareness, the progress we have made towards reducing the stigma attached to mental health is significant. With a growing number of children and young adults affected by anxiety and depression, it is more important than ever to ensure they know they can have a safe discussion around what’s happening to them.

Statistically, anxiety disorders are affecting 25 percent of teens between the ages of 13 and 18, impacting their ability to enjoy life and thrive in their social groups. Medical science continues to advance in this area, but sadly, 75 percent of that group will never seek out or receive adequate care.

Changing the conversation

There is plenty of research to prove that talking about mental health improves health outcomes, boosts self-esteem, lends hope, and tells us we are not alone.

All over the world, mental health awareness has become a mainstream topic, with the entire month of May dedicated to changing the conversation. Green ribbons, and the hashtag #breakthestigma have entered our collective consciousness, clearing a pathway to wellness that has historically been a very rocky one.

School programs, mass media, film, television, and popular music have joined forces to destigmatize and create change where mental health is concerned – and it’s been working incredibly well. Tough issues, like body image, substance abuse, chronic pain, and depression were brought forward, and solutions, support, and understanding were applied. Finally, after decades of living in the dark, we were starting to make some headway.

Until August 2019, when one of the world’s most powerful men drew a line between a horrific and tragic crime and mental health.

Is it a public health crisis?

The National Council for Behavioral Health recently published a report that summed up their research into mass shootings.

The study highlights several characteristics of mass shooters:

  • They are men
  • They have anger or issues that relate to work, money, or close relationships
  • They are ambivalent about life
  • They feel that they are victims
  • They sympathize with others they see as being like them
  • They have a history of violence, domestic or otherwise

According to psychiatrists, these characteristics are representative of individuals in mental distress – which is very different from mental illness. This means that they are motivated by a life event or stressor that causes them to act out.

Because most of us can’t imagine a person in their “right mind” committing such acts, some assume that the person must be mentally ill.

If we are willing to accept that the reason for such violent acts is mental illness, it may well follow that we will see certain restrictions put in place that will restrict the movements and freedoms of people who have been diagnosed with a mental health disorder. It will then follow that anybody who suffers from mental health issues will likely not seek treatment because of it.

The domino effect from this would be deadly, but not from violence perpetrated against others. It will be self-harm, suicide, and unnecessary mental anguish – all of which could have been prevented.

Words have so much weight: They can heal, and they can also be weaponized. Which will you choose to wield in this next, all-important chapter in mental health awareness?

If you or a loved one is struggling with mental illness, we are here to help. Reach out today to get started.

Trauma: Big T and Little T

Trauma: Big T and Little T

The word “trauma” is used widely today to refer to an experience that is damaging to a person’s psychological health, and as we’ve mentioned in previous articles, the magnitude of this experience is completely dependent on the individual. What most people outside of the behavioral health profession don’t know is that trauma can be categorized into two classifications: what are known as “Big T” and “Little T.”

BIG T TRAUMA

In general, the Big T variation of trauma refers to a single, traumatic event that can leave a survivor of the event with symptoms associated with Post Traumatic Stress Disorder, or PTSD. Experiences like sexual assault, serious injuries, violent attacks, and near-death experiences all fall under this category, and it’s now widely understood what kind of impact Big T trauma can have on a person’s life. People coping with the effects of a traumatic event, and may be suffering from PTSD, experience various symptoms including:

Re-experiencing
  • Flashbacks
  • Bad dreams
  • Frightening thoughts
Avoidance
  • Staying away from places, events, or objects that are reminders of the experience
  • Avoiding thoughts or feelings related to the traumatic event
Arousal and reactivity
  • Being easily startled
  • Feeling tense or “on edge”
  • Having difficulty sleeping, and/or having angry outbursts
Cognition and mood
  • Trouble remembering key features of the traumatic event
  • Negative thoughts about oneself or the world
  • Distorted feelings like guilt or blame
  • Loss of interest in enjoyable activities

Adapted from National Institute of Mental Health (NIMH)

POST TRAUMATIC STRESS DISORDER (PTSD)

Given the general public knowledge of trauma, you might find it surprising that it wasn’t until 1980 that the American Psychiatric Association recognized PTSD as a clinical diagnosis, when they added it to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). According to the U.S. Department of Veterans Affairs, the diagnosis was both controversial and groundbreaking as it suggested for the first time that the cause, “was outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis)”. The introduction, research and development of the PTSD diagnosis has paved the way for more trauma-informed and trauma-focused care. You can read the latest criteria for diagnosing PTSD in the DSM-V below.

LITTLE T TRAUMA

Little T trauma is a very different thing though, because it includes virtually every other adverse life experience — each hardship and struggle that people deal with throughout life — that doesn’t fall under the Big T umbrella. Whether it’s a case of bullying, loss of friends or family members, or an emotionally abusive relationship, Little T trauma tends to be the tough situations that many people deal with on a daily basis that don’t necessarily result in a clear diagnosis of a lasting effect. Because trauma is subjective and depends entirely on a person’s resilience and perception, adverse life experiences include anything that could potentially result in trauma; not only the presence of a negative experience, but also the absence of a positive one.

Trauma is anything short of love.

-Unknown

Everyone handles trauma (in either variety) in different ways, and there is now a fairly prevalent belief — and the scientific backing to prove — that dealing with repeated Little T trauma can be just as significant as a single occurrence of its Big T counterpart. Much like experiencing a traumatic life event such as a natural disaster or surviving a serious car crash, experiencing repeated events that engage the body’s stress response system can alter the neural network, especially when these experiences take place in early childhood.

ADVERSE CHILDHOOD EXPERIENCES (ACE) STUDY

Thanks to a study conducted by the CDC and Kaiser Permanente Health in the late 90s, we now know the impact the Adverse Childhood Experiences, or ACEs, have on a person’s neurodevelopment and social-emotional-cognitive development, and as a result, their later in life health outcomes. In the ACE Study, seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned.

What the study found was that a person with a higher ACE score was at significantly higher risk for substance abuse, mental health issues, intimate partner violence, and a host of health issues. Before the study was conducted and accepted by the medical and behavioral health community, these experiences that know refer to as adverse life events, adverse childhood experiences or Little T trauma, had been considered a normal part of life. Much like combat veterans returning home from war and being shamed or dismissed as being weak are now being treated for PTSD, these seemingly common but potentially damaging experiences are starting to garner the attention, empathy, or treatment that a Big T survivor might receive.

WHY ARE THESE IMPORTANT?

As mentioned above and in previous articles, exposure to trauma — whether it be Little T or Big T — can cause psychological (and sometimes physical) pain that often leads to destructive coping mechanisms, behavioral adaptations and health-risk behaviors. As a means to escape or numb the pain endured during the trauma, and the recurring discomfort that follows, survivors often turn to self-medicating with controlled substances. As with many addictions, it then becomes a vicious cycle that is generally only broken through proper trauma-focused treatment.

In all likelihood, every person will deal with some type of Little T trauma in their lifetime, and many will be no worse for the wear. But now that it has become recognized as a legitimate cause of maladaptive behaviors that can lead to mental health and substance use disorders, it can finally be treated and viewed on an even playing field with its “bigger” sibling.

Resources:

https://www.ajpmonline.org/article/S0749-3797(98)00017-8/abstract

https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html

https://www.sciencedirect.com/science/article/pii/S2352289516300273

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml#pub3

https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.asp

 

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What is EMDR and How Does it Work?

What is EMDR and How Does it Work?

EMDR has received some notable attention recently thanks to its effectiveness in treating trauma. There is a lot of information available online and in academic literature of the therapy, so we put together this article as an overview of EMDR to help you understand what it is and how it works.


So what exactly is EMDR and how does it work? 

EMDR stands for Eye Movement Desensitization and Reprocessing, and it involves 8 phases including the use of eye movement, or bilateral stimulation, which appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. As we wrote about in past blogs, when a person experiences a traumatic event, their brain goes into defense mode and changes its function.

One of these functions includes the hippocampus, which usually works to store memories in a neat filing system that allows us to easily and accurately recall these memories. When faced with a threat, the hippocampus takes on the role of pumping cortisol throughout the body so that we don’t feel pain, and puts the memory storage on the back burner. So it’s no wonder it’s incredibly difficult to recall a traumatic event, or we recall it inaccurately by filling in the blanks later on.

EMDR allows us to go deep into the brain and file these memories with the appropriate meanings and emotions attached to them. According to the EMDR International Association, the goal of EMDR is to:

“Process completely the experiences that are causing problems, and to include new ones that are needed for full health… That means that what is useful to you from an experience will be learned, and stored with appropriate emotions in your brain, and be able to guide you in positive ways in the future. The inappropriate emotions, beliefs, and body sensations will be discarded… The goal of EMDR therapy is to leave you with the emotions, understanding, and perspectives that will lead to healthy and useful behaviors and interactions.”

One of the leading experts on developmental trauma and author of The Body Keeps the Score, Dr. Bessel van der Kolk recalls the experience he had using EMDR on a patient when he realized the power of the therapy. Watch below:


What are the 8 phases of EMDR?

Phase 1:  The first phase is a history-taking session(s). The therapist assesses the client’s readiness and develops a treatment plan.  Client and therapist identify possible targets for EMDR processing.

Phase 2:  During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress. The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.

Phases 3-6:  In phases three to six, a target is identified and processed using EMDR therapy procedures.  These involve the client identifying three things:

1.  The vivid visual image related to the memory
2.  A negative belief about self
3.  Related emotions and body sensations.

In addition, the client identifies a positive belief.  The therapist helps the client rate the positive belief as well as the intensity of the negative emotions.  After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation.  These sets may include eye movements, taps, or tones.

Phase 7:  In phase seven, closure, the therapist asks the client to keep a log during the week.  The log should document any related material that may arise.  It serves to remind the client of the self-calming activities that were mastered in phase two.

Phase 8:  The next session begins with phase eight.  Phase eight consists of examining the progress made thus far.  The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses.

From EMDR.com


Does it actually work?

At least 20 positive controlled outcome studies have been done on EMDR therapy. According to the EMDR Institute, which hosts a comprehensive list of EMDR-related research, some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six, 50-minute sessions.

EMDR International Association reports on the same topic, “Clients often report improvement in other associated symptoms such as anxiety. The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies. Research has also shown that EMDR can be an efficient and rapid treatment” (www.emdria.org).


Who does EMDR? 

Only Masters-level or Doctoral-level professionals–therapists, nurses and doctors–who have gone through approved EMDR training can provide EMDR to people. Roots Through Recovery is proud to have two clinicians on our team that are trained and certified to provide EMDR. Clients who have undergone EMDR therapy for trauma have seen great improvement in their management of traumatic experiences, and how that plays a role in their addictions and mental health.

For a free assessment or to find out more, call us today at (562) 473-0827 or email us at info@roots-recovery.com


Related Articles from Roots:

The Direct Link Between Trauma and Addiction

How Childhood Trauma affects health across a lifetime

Resources & Further Reading:

EMDR International Association

EMDR Institute, Inc.

Dr. Bessel van der Kolk

Roots Through Recovery Announces the Start of its Evening IOP Program

Roots Through Recovery Announces the Start of its Evening IOP Program

Roots Through Recovery opened its doors in January 2017 and in the last four months, the program has grown to include daytime partial hospitalization and morning intensive outpatient to meet the various needs of our clients. There has been a lot of interest in recent weeks for an evening intensive outpatient program for the working professionals in Long Beach and the South Bay.

In response to this growing need, Roots Through Recovery is excited to announce the start of its evening IOP program beginning the week of May 15th!


CALL NOW (562) 473-0827


Much like our daytime programs, the evening IOP program will focus on addressing underlying trauma and mental health needs of community members who are coping with alcohol or drug addiction. Our compassionate and highly trained therapists provide trauma-informed care in small groups and individual therapy.

Group Room 2

Contact us today to find out about our promotional cash pay rate! Call Josh at 562-473-0827, chat with us or verify your insurance right now.

Doing these three things will make you a happier person… seriously

Doing these three things will make you a happier person… seriously

What if I told you that there were three (very simple) things you could start doing today that would make you a happier person?

Ex-Google engineer turned mindfulness expert, thought leader, author and philanthropist, Chade-Meng Tan, discovered there really are a couple of things every one of us can start doing each day that will bring joy into our lives, and as a result, make us happier. Meng, as he likes to be called, meditates for hours each day, which the majority of us cannot do… but thankfully, he offers the world the practical application of his education, practice and teaching.

I heard Meng speak on a few podcasts, which I highly recommend if you have the time to check them out: 10% Happier and Note to Self.

I began doing these things as soon as he suggested, because, well, who wouldn’t want to bring more joy, compassion and loving kindness into their daily lives? It works. Meng offers that in order to achieve the depth of cultivation of one’s mind, one must practice like anything else; however, if you have 15 seconds to spare right now, you can improve your outlook, your state of being, and your life.

So here they are, your keys to joy:

1. Bring attention to your breath. 

Sounds simple, right? For some people it is, and for others who find it difficult to sit and be present, this can be massive undertaking. Meng says, give yourself 15 seconds for this exercise, 5 seconds per breath.

First breath – Just bring attention to it, be aware of the breath in, and the breath out.

Second breath – Do the same, but this time relax your body, whatever that means for you.

Third breath – Now smile, while you breathe in and out with your body relaxed.

Now, try it. That smile should have brought a subtle sense of joy.

Taking a moment to breathe

2. Wish happiness to others.

This is the practice of raising the thought to your conscious mind when you see someone of wishing them to be happy. You can do this for people who walk by you on the street, or you can bring the thought of someone in your life and just think to yourself as you picture them, “I wish them happiness”.

You’ll notice that as you do this, being the giver of compassionate loving kindness to others makes you feel this loving kindness yourself.

Becoming aware of a tiny slice of joy

3. Raise your awareness of the tiny slices of joy already present in your life.

How often do we go our entire day, caught up in our routines and responsibilities, that we forget to appreciate the little things? Too often, is the answer I was looking for.

Our world is filled with what Meng calls “tiny slices of joy”–from taking the first sip of coffee in the morning, the feeling of the hot water from the shower hitting you, laying down in bed and feeling your head sink into the pillow–these wonderful, fleeting moments that we don’t take the time to acknowledge. His belief is that if we allowed ourselves to be present in these moments, we could experience this joy all day long.

Practicing these three simple things each day, experiencing joy and allowing yourself to be present in the moment will inevitably improve your well-being. On why the practice of mindfulness works, Meng says:

To worry you need to be in the future, to regret you need to be in the past. So if you take one breath of being in the present, then for that one breath you are free – you are free from worrying and regret.

And we agree.

***

Chade-Meng Tan (Meng) is a Google pioneer, award-winning engineer, international bestselling author, thought leader and philanthropist. He is Chairman of the Search Inside Yourself Leadership Institute, and Co-chair of One Billion Acts of Peace, which has been nominated eight times for the Nobel Peace Prize.