Everyone is a Victim in Chardon, Ohio

untreated mental illness = a sick community

I just heard the news about the sentencing of this young man for killing three students in a lunch room at his high school. Sadly, in our violent culture, that did not catch my ear in the way it should as I'm desensitized in a way I wish I was not to gun violence.

What did was the incredible anger expressed in the sentencing by the convicted man--wearing a t-shirt with "KILLER" written on it, sticking his middle finger in the faces of those in the courtroom and other disturbing acts and statements I won't glorify here.

From my perspective he is just as much a victim as anyone else--this young man--barely a legal adult and certainly not one by any other standard is so mad. What happened to him? Why was in not caught earlier? How sad that the only thing we did with him was ignore him until he destroyed others, too late for all of them. 

this photo is property of the Associated Press

We have to get serious--very serious--about mental health in this country. What caused this man to take this lives? I don't know but I would have loved to have helped him when he was fifteen or sixteen. 

Depression and anxiety are spreading across the region because he was ignored. Witnesses, survivors, the family of those who died, his relatives, the entire community as well are all at risk to opportunistic mental illnesses such as depression and anxiety, if not more serious conditions. I was even effected by this and I am two-thousand miles away. 

Now I can't help him and neither can anyone else. 

Vicarious Trauma at Fort Hood?

(talk of trauma) + (talk of trauma) + (talk of trauma) = vicarious trauma

In the media's scramble to understand the "whys" behind the Fort Hood tragedy, a great deal of discussion is being paid to the fact that the apparent shooter was a Muslim. While I am unsure of how, if in any way, his faith played a role in what happened, my thoughts go in a different direction. I wonder about the vicarious trauma that he must have faced counseling at the largest military installation in the U. S.

While more people are aware of how trauma effects humans than ever before, most don't understand the communicable consequences of this kind of trauma. Vicarious trauma is, per the Headington Institute, "the negative changes that happen to humanitarian workers over time as they witness other people’s suffering and need." While there are a variety of benefits to providing therapy this can be one of the darker aspects of the work of helping others.

Sitting and listening to patients day in and day out, especially in the pressure cooker environment of a major military base, full of veterans from two wars, has to be overwhelming. Combine that with how under staffed and under budgeted the military is with regard to mental health services and the fact that most men are loathe to talk about their feelings due to the stigma--wow! I am feeling overwhelmed thinking about the challenges men and women in military mental health must face.

Just two weeks ago Defense Secretary Robert M. Gates said that many military personnel fear a stigma if they seek help for psychological injuries. He openly criticized a government and military bureaucracy that is “frustrating, adversarial and unnecessarily complex." When the top man is that candid about the problem, it must be quite profound.

There are a variety of ways that vicarious trauma can be avoided and I want to know if any of those systems were in place, and how efficiently they were implemented, at Fort Hood. According to an excellent article from The Journal of Counseling & Development (email me for a pdf if you are interested) by Trippany, White and Wilcoxon, there are a variety of way that trauma of this sort can be kept at a minimum. Among the recommendations are keeping caseloads at a manageable level and providing therapy for therapists via peer supervision.

As this conversation continues, it will be interesting to see how those systems worked, and to what degree they did not, at Fort Hood.

Headington Institute

Gates comments on stigma

Can Being an Individual Put You at Incresed Risk for Depression?

 (culture) + (biology) = (depression)?

I just read a fascinating article about the complicated role a person's culture plays in their likelihood to be depressed.

I can tell you as one who lives as an iconoclast that such a life comes at great expense. There is a great cost for not conforming to group rules, and it makes sense that when a person is ostracized that she would be more likely to be depressed, anxious, or both.

Take a look at the article and tell me what you think. 

Happy Wednesday!

What's the Number One Reason People Can't Make Changes Stick?

(change) - (one step) = status quo

'Tis the season to change. People are back from the beach, out of Mai Tai mix and realizing that whatever was wrong pre-tan line is still there post-tan. Regardless of if it is needing a career change, wanting to lose that final 20 pounds or conquering depression, the fall is the time when people reach out to me for help.

Based on my own experience and the experiences of my clients, I have the number one reason short-term change fails to translate into long-term success.

Drum roll please.......

They don't fully engage. I work wtih them to understand their problem and help them design a plan to create significant, and real change in their lives. They are on board for 80 or 90% of it but one key aspect of the plan, many times THE key aspect, keeps them from success.

Let me give you an example. Years ago a client came to me complaining of anxiety, insomnia and of a boyfriend she was "addicted" to. No matter how hard she tried, she could not shake him out of her life. I spent a few weeks learning about friends (very few or none) and family relationships (she had cut them off because they were critical of HIM). She had inherited a significant amount of money from her father's estate so she did not work. It seemed that for the most part she had taken on Rodney (a pseudonym) as her full time job.

She and I created a plan that engaged her in community service with a few key causes she was passionate about. In that way she could begin to build friendships with people who shared her interests. We also implemented a three day a week exercise plan, mostly made up of classes, so she would have a schedule to keep and other opportunities for friendship. The most important part of the plan regarded Rodney--we agreed she would write and tell him they needed a full year apart to see who she was--and who he was too. I was convinced that the year clear of Rodney would allow her to see him for what he was as opposed to the man she imagined him to be.

Almost immediately we began weekly check-ins to see where she was on her three goals. She excelled in her non-profit work and lost seven pounds in her first month working out. She had also weened herself from her anti-anxiety meds, replacing them with the square breathing exercises I had taught her when she felt anxious. Her sleep had also gotten better in that she was physically and mentally active, making her more tired at day's end. Last of all, she had not spoken to Rodney, who she missed greatly.; she realized why the break was important and was committed to sticking to her plan. All tolled, she had a real success on her hands.

However, a few weeks later month two proved to be harder; the anxiety outbreaks began to reappear and her exercise tapered off from three to two days a week. A few sessions later she said something about what Rodney was doing. I asked how she knew and she confessed that she had been texting with him for about three weeks. She claimed she did not think texting "counted," so we discussed the implications of any contact with a man who "did not seem to be good for her" (her words, not mine).

"It is so hard," she said, "we meant so much to each other for so long." I asked her if she thought it was a coincidence that her exercise had gone down and anxiety had risen--threatening her plan. She said no, and told me she would try harder.

Eventually all of her forward motion was derailed by her inability to take a year off from Rodney. Was the goal hard? Yes, I acknowledged that it was. However, I would say, and she agreed, that no matter how hard it was it was not as hard as the life she lived under Rodney's control.

She had asked me to help her create a transition plan and we did, an effective one at least at the start. However, it was her inability to be consistent that kept her from moving forward and making her life a better one.

Do you see any of my former client in you? Creating real change is so very hard. One way to ensure success is accepting the entire plan and trying it out. After all, what do you have to lose?

Why Not Create a 12-Step Program for Depression?

I am in the process of starting a new group for people suffering from depression and anxiety. And two of the new members both e-mailed the same question the same day. Basically they wanted to know if our group "is going to be a 12 step group?"

I had to think about it for a moment and then I typed this reply:

No, this is nothing like that format in that 12 steps are typically effective with addictions or dependencies (alcohol, sex, gambling). Depression is neither; it is a disease that effects a large swath of our people. The group will help members learn cognitive solutions to their depression (and anxiety) that are proven to be clinically effective.

The question exposes one of the key misconceptions of depression--it does not happen by choice. And since one cannot choose to be "depressed," it follows one cannot choose to be out of depression either--right? Depression is a serious disease that eats up lives, ruins careers and destroys relationships. And there are things someone suffering from it can do to slowly, ever so slowly, turn the tide in the opposite direction.

Want to join us for a discussion on depression and anxiety? Just click here for our first FREE monthly meeting.