How Does Life Get So Bad That You Kill Robin Williams?

Getty Images taken from http://screencrush.com/good-will-hunting-then-and-now/

I was riding home with a good friend when I got a text that read, "Robin Williams killed himself." "You were the first person I thought of when I found out," many of them said. "You're weirdly calm right now," my friend whom I was with said, "I expect you to freak out any minute."

At 11:30pm I laid down to go to sleep, and I haven't stopped tossing and turning. This wasn't a man I had ever met, and yet he has been a part of my life for as long as I can remember. I idolized him, the way he made people laugh, his impressions, and as a little girl I used to imitate him to make my friends laugh. Like so many people my age, I grew up with his characters. I grew up memorizing the lines to his movies. His talent for comedy inspired me, and his dramatic roles mesmerized me. I have been able to appreciate his work as both a child and as an adult, and even share my affinity for him with both my father and grandfather.

But you can pick anyone my age to talk to about Robin Williams, and chances are you would hear a similar story. So why was I the first person my friends thought of when they heard the news? Maybe it was because they know that I can't go a day without making a "Mrs. Doubtfire" reference. However, while not quite as advertised as my love for Euviginia Doubtfire, I shared something with the actor: depression. The deep, dense fog that clouds our minds, numbs our senses, and devours our will to stay engaged in life itself. That much we had in common.

Depression is not a feeling, it is a disease. It is an illness. It doesn't care if you are well-off, loved, surrounded by friends and family, successful; in fact, many of us with depression are those things, which makes it nearly impossible to find validation for how we are feeling. It isn't normal to have a good life and still wish that you didn't have to wake up the next morning. And yet, for those of us who have felt the deadening weight of depression, we know too well how that reality is possible.

Depression is not logical, nor is it reasonable. Depression takes wonderful, amazing people, and turns them into bullies, hate mongers, and killers. We bully ourselves, we talk to ourselves worse than we would talk to our enemies, and for some the pain is so great that they resort to killing themselves. One reason that this death has shaken so many people is because we are confronted by the reality of how depression takes over someone's life, someone good, someone funny and beloved. We are equally horrified at the reality of his death and the manner in which it was met. How could this man we all loved take a life? How could he take the life of a beloved, generous, kind man? How did his depression get so great that he had to kill Robin Williams? 

I can't get that thought out of my head. The thought that a man I so loved was struggling so deeply, that he felt killing himself was his only way to end the pain. We all know what it is like to feel pain, some of us greater than others. When we stop and think about how much he was suffering, how can we not break down? 

I am so sorry that you suffered. I am so sorry that no other treatment helped, or showed you a different way to peace. Even as I write this, my Genie doll, still in the box, looks at me with a goofy smile on his face, ready to sing a song, or do a quick Groucho Marx impression. That's who you were to so many. That's who you were to me. You will never stop being an inspiration in my life. 

Disney's Aladdin

Can you Know if a Broken Mind is Healed? Thoughts on Mental Health Care Parity

"President Obama’s latest effort to divert public attention ignores a fundamental problem: it’s much easier to know when a broken bone has healed than a broken mind.  That ambiguity opens the door to overtreatment and fraud." - Forbes.com, "New Mental Health Mandate Will Make Obamacare More Expensive, Increase Fraud And Canceled Policies"

Image courtesy of Ambro / FreeDigitalPhotos.net

Before you assume that all of us therapists are out there for your time and money, please take a deep breath and consider the benefits of mental health parity.

Now, I am usually all for a more conservative approach to treatment, both medical and psychological. A good counselor will know when a client no longer needs treatment. A great counselor will actively work with a client to ensure that they are not in treatment longer than is absolutely necessary for his or her health. 

Having an academic and professional background in counseling, I am trained to assess, conceptualize, and put together treatment plans for my clients. Sometimes symptoms warrant a diagnosis, but when diagnosing can be avoided I am of the camp that believe that it should. It stands then to reason that many would find it suspect that one's treatment can be ever finished; if the problem has no name, how can there be a treatment? If there is no standardized treatment, how can you know what a successful outcome would be? And if you can't measure the outcome, how can you ever truly be finished?

 If you are seeing any professional counselor, you have the right to know what treatment modality your therapist is using, and you should ask him or her. All licensed therapists are required to use only empirically supported treatments that are appropriate for your unique situation, and have been shown to be effective. Similar to doctors who have taken the Hippocratic oath, counselors too are ethically bound to do no harm to clients and provide only treatment that is efficacious and appropriate. That is not to say that there aren't swindlers out there, but to view the profession as fraudulent is grossly untrue.

Regarding length of treatment, if you, the client, never left therapy, it would mean that our work together isn't really working, and that would make me, the therapist, a failure. And trust me, therapists do not want to fail their clients. Long gone are the days of psychoanalysis which took years to finally uncover the unconscious. Today, most providers utilize brief and concise empirically supported treatment modalities that are specifically designed to achieve symptom relief quicker and more efficiently. 

Treatment outcomes are not vague, in fact, they should be specific and discussed from the initial session. So if you are concerned that you will be stuck forever in treatment, make sure you know what it is you hope to accomplish...For some the goal is less frequent arguing with a spouse. For others it is being able to go from a 6 on a scale of sadness (1-10) to a 3. There are measurable goals in therapy, and if you are working with a good therapist they are attainable.

In previous posts I address the stigma of mental illness and the difficulty many have in getting treatment. Sometimes the difficulty lies in treatment being not affordable, or simply not covered by insurance. Is it possible that some people in this country take advantage of benefits? Yes. However, with 1 in 4 of us experiencing clinical depression in our lifetimes, to ignore the necessity and validity of therapy would be unethical. And yes, it is true also that there are professionals and paraprofessionals out there who would gladly take advantage of you and keep you coming as long as they could. But then again, don't we see that with nearly every other profession, too? 

There is a fine balance between appropriate treatment and over treatment in both mental and medical healthcare. However, there are far more serious and sincere medical and psychological cases that need attention. As long as health care professionals are held accountable for the efficacy and necessity of their treatment, mental health parity should help our neighbors get back to living and loving the life they have.

In response to Fort Hood: Are Counselors Doing Their Job?

Image courtesy of Gualberto107 / FreeDigitalPhotos.net

After the news of the Fort Hood shooting perpetrated by Spc. Ivan Lopez, who was being treated for anxiety, depression and evaluated for post-traumatic stress disorder, many have speculated about the quality and efficacy of care being given to our veterans. To the lay person, it seems that the mental health system failed not only Lopez, but his victims and their families. How could someone in treatment commit such heinous crimes? Certainly the counselor must have missed some major red flags, or perhaps therapy just doesn't work at all.

As a counselor who has worked directly with individuals struggling with anxiety, depression, and post-traumatic stress disorder, I can assure you that therapy does work. Can it work miracles? Can it work for everyone in every situation? Perhaps not. But study after study, year after year, support the efficacy of mental health counseling overall. In fact, with roughly 25% of the country meeting diagnostic criteria for a mental illness at any given point, therapy is a vital part of the healthcare system and integral in helping individuals, couples, and families live productive lives.

The real issue is not whether or not counseling in and of itself works; the bigger issue is whether or not the counseling at Fort Hood works. Recall that Fort Hood had previously experienced a massive shooting in November of 2009, ironically perpetrated by a psychiatrist. In an article from WDN by Chelsea Schilling, an independent news network, the limitations and barriers to quality mental health care are discussed in detail. Shockingly, Fort Hood has been using free tests found on the internet to evaluate the psychological health of soldiers. Not only is this unethical, as these free tests may not have been designed for such purposes, but this is preposterous. Psychological tests are created by seasoned researchers, and take years and several trials before being widely used as measures for a given diagnosis. They are statistically proven to be both valid and reliable, and cost money in part due to the extensive research that goes into their development. While I am not saying that Fort Hood is using any old test found online, it is troubling that their mental health department is not utilizing, perhaps due to budgetary confinements, proven methods of psychological testing. If we ourselves needed medical attention, we would not want our diagnosis or condition to be evaluated by methods that have not been proven effective or valid. Why would we ever think it is okay to use potentially ineffective tools to treat mental health issues?

Furthermore, inadequate funds are perhaps the least of the barriers to providing quality care for Fort Hood soldiers. Wait-lists upwards of a few months for treatment, an incredible 1 : 50,000 ratio of trained neuropsychologists to solders, and reported forced retirement of senior mental health professionals are among the short list of hurdles. This, in my humble opinion, is unacceptable. The men and women of our national services do not merely deserve respect, but they deserve to be treated for their psychological and emotional wounds with the same care and attention as they are treated for physical wounds.

As a nation, we need to be more aware of the conditions in which we welcome our veterans home, and we need to advocate for better care for them. We can start by being informed. Did the mental health system fail?I cannot say with any degree of certainty one way or another, as the details of his treatment remain confidential. However, it is clear to me that the mental health system was failed by larger systems, and has not been supported enough to provide the absolute best care to our returning soldiers.

Why Zero Tolerance Policies Don't Work

In an earlier post, I addressed the issues of one school's zero tolerance policy on being in the presence of alcohol. One girl made the decision to save her friend from potentially driving drunk herself, getting into the car with a drunk driver, or being taken advantage of at a party. In her attempt to save her friend by acting as a designated driver, her high school punished her for being in the presence of a party with alcohol. Not even the polices' statement that she had no involvement in the party could help her.

Today we have a new example of the unintended consequences of zero tolerance. East Lee County High School in Florida has a zero tolerance policy on fights; who started it or why it started is irrelevant. If you are involved in a fight in any way, shape, or form, you will be suspended. And so, Mark Betterson, who intervened on behalf of a student who was being bullied for his sexual orientation, is now facing a 10 day suspension.

Photo by Fox4

What is interesting is that Florida is notorious for their "stand your ground law" which protects the right to self defense. It is clear that his intentions were not to fight but actually to prevent harm to another individual, which relates to the Florida law that allows individuals to protect themselves from
others who are doing wrong. In this case, not only was Betterson acting in self defense (the bully swung at him first for stepping in), but he was doing so on behalf of a student who was also in danger.

Controversy of the stand your ground law aside, the zero tolerance policy of the school does not allow for the intricacies of human thought and behavior. When schools do not take into account the moral heroism Betterson illustrated in addressing his involvement in a fight, acts of compassion are less likely to occur. The message to Betterson and all others who would defend a fellow student is that you should not take any action yourself, even if it is to protect another person.

The school system in both Betterson's case and the young girl who acted to protect her drunk friend systematically punish everyone the same regardless of the circumstances or motives. Is this the way we want to teach our children right from wrong? The consequences for this type of punishment are immense. We need to encourage our children to realize that right and wrong are not black and white, and perhaps there is greater value in protecting another person rather than abiding by the school's rigid zero tolerance policy.

Unless, of course, we no longer value compassion for the suffering of others, and it is more important to do what you are told rather than what you believe is right.

A Challenge for Every Facebook User

By Michal Marcol, published on 07 February 2013

Stock Photo - image ID: 100138412

Do you think you could stand to tell the truth about your life on Facebook?

People have always been concerned with appearances, particularly when trying to make other people jealous or trying to fluff up their otherwise boring lives. The idea of lying or exaggerating one's life is nothing new. However, we're no longer just showing off to our neighbors; we're showing off to the world. 

 Sarah Emily Tuttle-Singer writes about "Fakebooking," and the pitfalls of lying about our lives on Facebook for the world to see. Facebook and other social media sites allow us to broadcast every detail of our lives to anyone willing to pay attention. We no longer have to wait to run into friends at the supermarket to brag about how our daughter is doing well in grad school, we can now update our "followers" the instant our son was kind enough to take the trash out-WITHOUT being told (such a good boy)! 

Not only do small and insignificant events become productions that make our children and spouses seem superhuman, but we are able to morph the realities of our mundane lives. More importantly though, we are now able to provide evidence for our lies. Pictures are only posted when we're smiling (and have our chins tilted just right so as to avoid the dreaded double chin), so we always look like we are thin and well dressed. We only update when something good happens, making it seem as though our lives are one wonderful event after another. We "check in" to cities, towns, shops, and landmarks, taking pictures of everything we do, to make it seem as though we are adventurous, always out of the house, and enjoying what life has to offer. We tag our friends in posts to make it seem as though we are so close with one another, and that we are thoughtful and caring friends.

We know our individual truths, though. We have our fat days, our bad hair days, and days where we don't get out of sweatpants. Good things don't happen that often, in fact we all have more stressful than inspirational thoughts on any given day. When we constantly upload pictures of what we're doing what we are really doing is preoccupying ourselves with technology rather than enjoying and living our lives. And most of us wish we were closer with our friends, but with lives so busy we probably haven't seen these friends in person for some time, if our Facebook friends are people we actually know in the real world.

It is my belief that when we focus on trying to make it seem that we are more successful and happy we miss out on enjoying our actual successes and happiness. When we are more concerned with posting pictures of our relationships looking perfect, we spend less time nurturing these relationships with genuine conversations and sharing. Let's start a movement. If you insist on using Facebook often (as I do), make a concerted effort to accurately reflect the life you live, and spend more time actually living the life you want.

Mental Health Databases: The New Executive Order?

In a September post, I addressed the Navy Yard Shooter's suspected mental illness and the consequences of this revelation. Recently, in the official report on the Newton Shootings, it was found that the shooter was diagnosed with Asperger's Syndrome, a mild form of Autism, in addition to Obsessive Compulsive Disorder and Anxiety. Study and study show that the link between mental illness and violence is NOT that clear; in fact, there confounding factors that are related to both that are more predictive of violence (socioeconomic status, history of being a victim of violence, history of incarceration, substance use and abuse, employment status, housing, etc). However, these factors are almost always overlooked in favor of a mental illness diagnosis.

By franky242, published on 03 January 2014 Stock Photo - image ID: 100225387

Executive Order 9066 signed by President Roosevelt during World War II created internment camps for Japanese Americans on the West Coast in order to prevent them from access to any military areas. The order was enacted in order to secure the safety of the American people and military, and to quell public hysteria that Japanese individuals were a threat to national security. Now we are facing a similar hysteria as the outcry for banning guns and restricting the rights of those with a mental illness grows louder. In fact, while some legislation has aimed at the severely mentally ill only, policies are in place in over twenty states that call for a Mental Health Database which contains the names of individuals who received mental health treatment.

By Ambro, published on 04 April 2011Stock Photo - image ID: 10036553

What is "mental health treatment"? It's counseling. It's talk therapy. It's going to a licensed professional when you are struggling with your spouse, your children, your job, or basically any aspect of your life. Counseling is offered at many jobs free of charge through employee assistance programs, and has been proven to be a beneficial resource. However, there is already a stigma for those who seek counseling, and with the added potential of risking one's confidentiality it is hard to image that people will be more inclined to seek help, if willing at all. 


Is a national database of mental health patients the new executive order leading to the marginalization of those who want to get help in a confidential way? Interestingly enough, the Newton shooter was engaged in counseling, and his therapist(s) found nothing alarming with him; they found no reasons to believe that he would have ever harmed anyone. What will happen when those who desperately need help, those who would commit heinous acts of violence, are so turned off by the idea of a mental health database that they do not even step foot into a doctor's office? Will we resort to even stricter rules of mandated treatment to ensure that the mentally ill are screened kept from society for our own safety? 
In order to protect the rights of ourselves and others, we must make sure we do not perpetuate stereotypes, or trust in the promise of safety without being shown how a law or policy has been researched and illustrated to be successful. We must be vigilant in doing our own research, and be comfortable questioning those who think they have the answers. 

Texting is Making us Dumber, Shallower, and Less Empathetic

Every generation thinks that new technology is going to lead to the downfall of our society. This time, though, they may be right.

By imagerymajestic, published on 16 July 2012

Stock Photo - image ID: 10092529 from Freedigitalphotos.net

A new study from the University of Winnipeg shows that "Those who text more than 100 times a day were 30% less likely to feel strongly that leading an ethical, principled life was important to them...Higher texting frequency was also consistently associated with higher levels of ethnic prejudice."

Although face paced social media such as Facebook and Twitter allow for increased connections with others, the connections are superficial at best. Replacing face to face or even voice contact with other people with short text based messages reduces the opportunities to reflect on what is being said, and allows room for tremendous misinterpretations. Without real human connection, teenagers and young adults are being less familiar with body language, reading facial emotions and social cues, and do not have patience to engage in thought provoking conversations. 

If we wish to be seen as more than the collectives of our social media projections then we must engage and cultivate that which makes us uniquely human, the ability to connect with one another beyond words.