Monday, January 24, 2011


In today’s New York Times there’s an article about the resurgence of electro-convulsive shock therapy as a treatment for severe depression. Last week, also in the Times, a psychiatrist, Dr. Friedman, wrote an article about insight not being enough to make for a happy life. These two articles illustrate the challenge and opportunity we have for dealing with our problems in a myriad of ways other than the extremes presented in these two articles.
             In one article we read that most therapists feel that insight is the cornerstone of healing psychological problems, and is the foundation of a happy life. Dr. Friedman does not agree. Though Dr. Friedman accepts that insight can be helpful, he points out that often insight is not enough, nor is it always necessary.
We know he’s right. Just because we know why we do something or react a certain way, does not mean we can change our behavior or our reactions, though it may make us feel better to know why we do certain things. With traumatic material, knowing what happened and being able to play it over again and again can actually make things worse.
Dr. Friedman shares that he feels good that he can use meds and some talk to alleviate suffering. Happiness, well, Dr. Friedman says, that’s another matter. Happiness, like self-esteem, you have to work for.
And I couldn’t agree with him more, but unlike Dr. Friedman, I feel that professionals can do a great deal to help clients live happier lives and improve their self-esteem. 
What can we offer that might help? Dr. Friedman points out a very well researched finding that most forms of therapy seem to do about as good a job as any other form.
What distinguishes good therapy from not-so-good therapy is not the therapy, but the therapist. It ‘s the quality of the relationship between the client and the therapist, coach, teacher, minister, or social worker that makes the difference. As professionals, we can offer a trained ear, and more importantly, a trained heart and mind. Most of us don’t listen very well, not even to ourselves. One of the most powerful things we can do is to learn how to ‘listen’ to ourselves better. I’ll talk more about this later.
            The other article offers that in difficult cases ECT can help with very severe depression. Though the treatment remains controversial, ECT can knock out a serious bout of depression and buy the client some time and breathing room while they try to address issues and make life changes and get on a track that does not once again lead to depression.
Clearly, ECT is for extreme cases, and no one is suggesting, otherwise, but we often take for granted the many things we can, and often must do to keep ourselves functional and happy throughout the ups and downs of life.
As Dr. Friedman said, for many of us, happiness takes work. So let’s not forget the basics.
If you want to be happy, start with your foundation: your body. Make sure you get enough exercise every day, especially if you’re prone to depression, anxiety, or moods.
Aerobic exercise may be a better antidepressant than anything you can buy. Make exercise part of your daily routine.
Watch what you put into your body and when. Do not run yourself down by not eating and then collapsing. Watch how much caffeine, sugar, and refined carbohydrates you eat. Notice what happens after meals, especially at midday.
Make sure you get enough sleep. Teenagers are prone to depression if they don’t sleep enough. It may be true for the rest of us.
Get outside, especially during the day when the sun is out. SAD, seasonal affective disorder, is real. Sunlight is the cure. 
Meditate every day for at least 15 minutes. There is a lot of research out there that supports the claim that sitting quietly every day for fifteen to forty five minutes, simply letting your mind be quiet, for example, observing your breath, can have many beneficial effects on mind, body, outlook, and mood.
Learn to pay attention to your body, noticing how you breathe, how you hold tension, how you collapse in certain situations. Meditation or mindfulness practice will help you become more aware of how your body is reacting to your life.
Watch what you think and say to yourself. Watch your ‘stinking thinking’.
Watch what you say to yourself as you face challenges. If one thing goes wrong, is everything wrong? If the weather is bad, does that mean the world is against you? Do you take temporary setbacks as evidence that you and/or the world are fatally flawed? If so, there are books, workshops, and practices that can help you change what you say to yourself and increase your happiness and wellbeing. This is powerful stuff and you need to do what you can to make sure that your mental machinery is not grinding you into the ground.
There are daily practices that can help you. Practice gratitude. Take note of and give thanks for the good things in your life. See where the glass is full, not where it’s empty.
Take healthy action in small incremental steps that move you where you want to go.
Help others. It’s a great way to help yourself.
Get out of your head, specifically, your left hemisphere, listen to great music and dance--scary for many of you guys out there, I know.
            Be mindful of your body. The philosopher Descartes said, “I think, therefore, I am.” Many of us fall into the trap of thinking, “I am my thinking.” That’s it. Period. We think thinking is all there is to us. We forget that we don’t simply have a body, but we are a body.
You are not separate from your body. If you were, why would magic mushrooms or prescription drugs radically alter your experience and how you feel? Why would sending electricity through your brain shake you out of depression? Why would exercise make you feel better?
Since you have and are this amazing being with body, mind, and possibly soul,
it makes perfect sense to use the zillions of cells and receptors and nerve endings and synapses to help you live your life.
But to do that you’ve got to slow down a bit and let yourself feel what your body is trying to tell you.
That’s not exactly right.
You’re not smart enough in this area.
Your body couldn’t tell you all that’s going on even if it wanted to. You wouldn’t get it all. Just imagine the overload you would experience if you had to consciously work every muscle and fire every nerve and control every gland necessary for you to successfully chew, swallow, and digest lunch. If you think about it, we’re morons in this area. And yet, when faced with emotional challenges, we deal with them primarily from the neck up, though emotions, by definition, involve motion within our bodies.
So, pay attention to your body when you’re going through difficult times. Notice your breathing, your areas of tightness and discomfort. Do not try to make them do anything, but let yourself feel and experience what is going on.
            Silently give a name to what you are experiencing, such as sadness, anger, anxiety, joy, anticipation, or whatever. Really let yourself feel the emotion, the movements and changes and sensations in your body. Pay attention and notice the change. Don’t try to change anything unless you feel it is really sucking you in and bringing you down. If so, then bring in resources that feed you. Breath more deeply. Imagine places and people you know and love that inspire you, make you feel alive, grounded, and present. Let yourself get to a place where you feel a little better. This should show up as a change in breathing or muscle tone. You might yawn or take a deep breath or relax a bit, whatever it is take note of it.
            Over time, as you do the work, like the star athlete you are, you will find that you get better and better at dealing with life’s challenges. So good, in fact, that you may find yourself feeling good, and feeling good paves the way for feeling happy.
            It’s great that we have meds available to us when we need them, and that in extreme cases things like ECT are available if we need them, but happiness is not to be found there. Happiness, for many of us, requires work, attention, commitment, insight, practice, tools, and good friends. The Dalai Lama said happiness is the purpose of life. That’s because life is tough and being happy throughout the ups and downs is a profound and radical act that takes work and a transformed human being. Maybe being happy is the most important work we can do.

I can be reached at or 805/680-5572

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