Access to Mental Health Care or the Jackson Pollock of It All

by Monica A. Ross, LPC

Problem-solving.  Why would the ability to problem solve be a core component of resilience? My first thought on that one is that people who are struggling just to survive, for those who face steep obstacles in life, the ability to problem solve is critical in order to figure a way out of the crisis(es). 

Take a look at this clip, for instance, from the Center on the Developing Child at Harvard University “How Resilience is Built.”  It talks about the importance of relationships and the importance for the developing child of the ability to both monitor and problem solve. 

At the time of this posting, what comes up in a google search on “How to problem solve” is this method:

1.     Identify the issues.
2.     Understand everyone's interests.
3.     List the possible solutions (options)
4.     Evaluate the options.
5.     Select an option or options.
6.     Document the agreement(s).
7.     Agree on contingencies, monitoring, and evaluation.

This is of course geared towards problem-solving in the workplace. That sounds about right, but we also know that people who find themselves in crisis at work or at home can’t even begin to complete number 1 let alone move smoothly along to 2, 3, 4, etc.  The reason for this perhaps is because those living in crisis are living life from a scarcity mindset. 

Mullainathan and Shafir in their book Scarcity: Why having too little means so much explain that the focus on what we lack, or approaching life from a scarcity mindset forces a type of preoccupation in life.  When we are preoccupied we do not have the cognitive bandwidth to begin to address other problems.  Or at the very least, addressing other problems becomes a daunting task.

The scarcity mindset as the authors point out is not about lacking the capacity to process, but it is about lacking the mental resources. With the scarcity mindset we tend to do things like incorporate tunnel vision which is good when something deserves our sole focus and concentration, but towards how many singular things in life do we have the luxury of dedicating all of our attention? 

Scarcity also affects our executive control, making it hard to have self-control.

A lack of self-control can then interfere with problem-solving.  Lack of self-control more often than not can exacerbate a problem. It is these types of psychological biases affecting those living with a scarcity mindset that fuel sometimes poor choices despite the fact that the consequences of those choices can be extreme.

This lends itself to doing impulsive things despite the fact that the stakes are higher. Not only do those who are operating at the survival level (e.g. the poor) have less room to fail because they have fewer resources, but they also have a compromised ability to make good decisions. This, in turn, increases the likelihood of failure.

As clinicians, one of the modules we are typically called upon to utilize in working with clients and in conducting psychoeducation is the module on problem-solving. Why? Because people with severe mental health issues sometimes forget to take their medication and when that happens they may stop taking medication altogether. They may act on impulse and find themselves running up gambling debts or maxing out credit cards in an impulsive spree, or making hasty major life decisions like moving cross-country.

It’s important then both to gain some level of stability as a consumer or client either on or off medication and from there to work towards maintaining that stability. Stabilizing itself takes a certain amount of problem-solving ability and that problem-solving ability may never be reached if a person finds themselves in a constant state of making both impulsive and poor decisions.

Now let’s compound the issue for the person struggling with mental health issues by making access to help in and of itself confusing. If I were to describe the process of finding a psychotherapist from the consumer or clients’ side, well it’s a bit like this:

Some Issues for Consumers

To me the current marketplace is like…..my own artistic interpretation:

scribble

 

Or

Like a Pollock Painting

Pollock Painting

Or

Like my friend Yoon Lee’s paintings

Yoon Lee

It’s like a kindergartener took a piece of paper and did this:

kindergarten

To put it metaphorically….

It’s like a city wanted to build a new roadway system and they let everyone decide where they wanted to put the pavement, stoplights, lane markers, and highway signs.

Mullainathan, S., & Shafir, E. (2013). Scarcity: Why having too little means so much. London: Allen Lane.

The Trap of Perfectionism

IMG_0005.JPG

by Monica Ross

What did a recently published September 2017 article in the Journal of Personality reveal?  Perfectionism leads to suicide.  Yet why are we so perfectionistic? 

We’re perfectionistic because we think that by telling ourselves constantly to work harder, to strive to be and do better, to excel as a mother, as a spouse, as a manager—that all of this will serve as MOTIVATION.  But the cold, hard truth of the matter is that it does not.

Dr. Kristin Neff at The University of Texas at Austin has done a lot of research on this topic, as well, and that is what her research concludes.  The self-criticism that we inflict on ourselves only serves to make us feel worse, it does not motivate us to change our behaviors.

The inner dialogue of someone with perfectionistic tendencies might look something like this: 

“I should have called my mother back this weekend, this is the second time she has tried to reach out to me to hear about the new position. I'm the worst daughter ever.”

or

“I never got time to go to the grocery store this weekend with the baby shower and all the catching up I had to do with work, so great that means another week of eating out.  I have to do better that.  It’s just not acceptable.”

or

”With all the meetings I have scheduled this week and the trainings I have to do there is just no way that I’ll be able to break for the gym at lunch and I’ll never lose that extra 20 pounds. I hate myself.  How did I let myself gain so much weight?”

The above inner dialogue is hard to read and absorb because it sounds so harsh and yet these are the types of things that we tell ourselves sometimes on a minute by minute basis.  We are often more harsh and cruel to ourselves than we would be to someone we dislike. 

Perhaps we feel that we hold ourselves to a higher standard.  And because of that, it’s okay to be harder on ourselves.

After all, wasn’t it I who got first place on the debate team?  Didn’t I graduate top 5% of my class? Wasn’t I selected to be chair or co chair of this or that committee in college?  Didn’t I accept the leadership role at work?

Here are three things that Dr. Neff points out that are essential elements to break through some of this thinking.

1.    Accept that we are human. 

And that being human is a shared common experience.  In other words, the person next to me in line at the checkout counter knows all too well what it means to be human and living in today’s world just as much I do.  We collectively as humans know what it means to experience joy and suffering, happiness and disappointment.  In that way, we are no different from each other.

We have a lot in common and therefore we have the ability to relate to one another.  If we can hold onto that concept then we can shift from a place of “look how much I’m suffering” to “look how much we all at times suffer in life.”

So it’s less about me not measuring up and therefore hating myself for it, but look at how we all set these unreasonable expectations and then beat ourselves and each other up for not meeting them.  It’s about moving from a place of shared judgement to a place of shared understanding about the human condition.  This makes it easier to connect instead of isolate.

2.    Strive to stay present and aware.

Another way to say this is to be mindful.  Part of being mindful is staying focused on the present moment and accepting whatever feelings, thoughts, or bodily sensations and physical reactions come up in the moment with acceptance. 

At the same time we are not our thoughts as Eckhart Tolle points out.  How can we be?  There is some part of us, call it the spiritual part if you want or the soul part of us that is an essence. It is untouched by what we might be feeling or thinking in the moment.  It is a strong, stable, solid, force.  It’s the place we tap into in order to feel a sense of groundedness.

3.    Be kind to yourself.

So, if we know all of this to be true, that we share a common humanity and as such are imperfect fallible human beings and that every moment brings new thoughts, feelings, and sensations that are at times difficult or even unpleasant to experience, then at the very least let’s be kind to ourselves and by extension kind to other people.

Click this link to set up an appointment to discuss how to decrease the perfectionistic tendencies in you life.