A third of all people will be a caregiver at some point in their lives. Caregiving for people with schizophrenia presents challenges that many people are ill-prepared for. Host Rachel Star breaks down the principles of caregiving and creative ways to navigate schizophrenia. Dr. Sarah Kopelovich joins to share schizophrenia caregiver specific training.
About our GuestSarah Kopelovich, PhD is a forensically-trained licensed clinical psychologist in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. Dr. Kopelovich is an Assistant Professor in the department and holds the Professorship in Cognitive Behavioral Therapy for psychosis. Her current research is specifically oriented toward implementation and dissemination strategies for psychotherapeutic and psychosocial interventions for Schizophrenia Spectrum Disorders. She regularly conducts workshops, seminars, and professional consultation across the country for an array of mental health professionals and trainees in CBT for psychosis; Recovery-Oriented Cognitive Therapy; Individual Resiliency Training for First Episode Psychosis; Assertive Community Treatment; and diagnostic, suicide, and violence risk assessment. Back to Life, Back to Normality: Volume 2 -outlines many of the cognitive-behavioral techniques used in the Psychosis REACH training. (https://ift.tt/3m7X5Uy) Computer Generated Transcript of “Caregiving for Schizophrenia” EpisodeEditor’s Note: Please be mindful that this transcript has been computer-generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: Welcome to Inside Schizophrenia, a look in to better understanding and living well with schizophrenia. Hosted by renowned advocate and influencer Rachel Star Withers and featuring Gabe Howard. Sponsor: Listeners, could a change in your schizophrenia treatment plan make a difference? There are options out there you might not know about. Visit OnceMonthlyDifference.com to find out more about once monthly injections for adults with schizophrenia. Rachel Star Withers: Welcome to Inside Schizophrenia. I’m your host, Rachel Star, here with my wonderful co-host, Gabe Howard. Gabe, now it sounds at first like we have a very squishy, lovey-dovey topic. Caregiving, right. I could feel like just the title of it. It sounds like a nice Hallmark movie kind of thing going on. But we’re going to get into some kind of, I don’t want to say deep, but intense stuff with it. We’ve talked before, Gabe, we feel strongly about that word being used towards people with mental health problems. Gabe Howard: Caregiving is universally thought of only in the positive, but as folks are going to learn, even very positive things can have a flip side. Rachel Star Withers: And right off the bat, I don’t like the term caregiver because it automatically puts that person kind of over the other one. So if my mom is my caregiver, then obviously she has to take care of me for whatever reason. I’m not able to. I’m sick. I’m inferior. You know, there’s a problem somewhere, which is true in it, but it does, it just kind of that mentally puts it out there. And, you know, Gabe, I gush all the time about my parents. They’re absolutely wonderful. And I cannot live on my own. It’s hard for me to have to accept that on some level that they are my caregivers, because that means I’m a burden to them. And I know they would never describe it that way. But it makes me feel bad as a 35 year old grown woman that I do have to depend on somebody else. Gabe Howard: So here’s sort of the issue with caregiver, right? It becomes all encompassing. Let’s say that tomorrow you get in, we’re going to use car accident and for the purposes of this analogy, you’re going to recover. But in the car accident, you break both arms and both legs. Now, that’s like pretty high level caregiving. Nobody would argue that you need care and that the person doing it is your caregiver. But in that analogy, remember I said you’re going to make a full recovery. Eventually you start getting use of your body parts back. First your hands work and then your arms work and your family or your caregiver starts doing less and less and less and less and less. And in physical health, people acknowledge that. People acknowledge that you’re needing less assistance and less help. Over on mental health, it doesn’t matter if you are the worst of the worst, the sickest of the sick, or if you are Rachel Star and all you’re really doing is just living in your parents’ basement, hanging out. It’s talked about in exactly the same way, and I think therein lies the problem. Right? Because now when people say, oh, Rachel, your parents are your caregiver, they immediately assume that you are the worst of the worst and have no partnership, no control, no faculties. And you are not assisting in your own care. Rachel Star Withers: And I also think whoever they’re talking to, like this third party, they automatically feel sympathy, like you poor thing, you have to deal with this, you poor thing. And I don’t want to say, like as the person who has the issue, like, I get jealous, but it’s also like, OK, well, they’re not the ones who are hallucinating. Gabe Howard: We have more sympathy for the people next to the person with schizophrenia than we do for the actual person suffering from schizophrenia. And could you imagine if somebody said, oh, you know, Rachel has cancer, but the real people suffering are her family, like everybody would just be up in arms Rachel Star Withers: Oh, yeah. Gabe Howard: And not tolerate that. But if you say, well, you know, Rachel has schizophrenia, but the real people suffering are her family people immediately they’re like, well, but I mean, they’ve gone through a lot. It can’t be worse for them than it is for you, Rachel, Rachel Star Withers: Yeah, to make it clear for everybody, when we were saying caregiver today, we’re not talking about the doctors, nurses, that kind of thing, we’re talking about the kind of normal day to day stuff. So a caregiver, they could be paid but most caregivers are unpaid members that are related or in the social circle of the person who is needing care. Usually our caregivers don’t have any professional training. We have a wonderful guest today who’s actually going to talk to us more about caregiver training. The majority of caregivers are women. I think with a lot of women, you already have that kind of motherly role and they’ll usually be the first to step up to be the caregivers. Typical duties, this is all little things, OK? Daily activity stuff is what caregivers do. They manage medications, making sure that you’re taking your medications, you’re taking them correctly. They may talk to the doctor or nurse or whoever on your behalf. Rachel Star Withers: With schizophrenia, what we need might change. So caregivers, when it comes to schizophrenia, may or may not have to help with like cleanliness, that kind of thing, making meals, making sure that the person is eating healthy, not just eating Pop tarts nonstop. So right now, there’s around 50 million family caregivers nationwide in America. Fifty million people. That’s so many. And if you were to pay them, in theory, it would be around three hundred and six billion dollars. So these family care like you are worth a lot of money. To my people that are out there listening, it is a thankless, usually moneyless job. And a third of us, a third of all people will have to be a caregiver at some point in their lives. But you also have to take into account the person and you need to make sure that they are still feeling respect and dignity. No one wants someone telling them what they can eat, what they can’t eat. OK, this is what you’re going to do today. Like nobody wants their whole life controlled by somebody else. Gabe Howard: And nobody wants to be seen as less than. Oftentimes, people experiencing schizophrenia don’t have that level of respect to balance out the burden. We just have the burden. That’s a lot to overcome, to be seen by society as hurting our families in addition to managing schizophrenia. That’s, that’s big. That’s, that’s mighty big. We don’t want to hurt our family. We love our families. And we are incredibly thankful for everything that they’re doing for us. We just want to make sure that we’re not lost in that discussion. Rachel Star Withers: If you are a caregiver for someone who, like you said earlier, has a broken bone, if you’re a caregiver for someone who is elderly, you kind of know what to expect. But with schizophrenia, it’s not that predictable. The caregiver of someone who has schizophrenia, you have to be on the lookout for other things. One of the biggest is going to be medications and side effects. If the person that you are helping also has depression, you really need to kind of watch out for suicidal tendencies, kind of signs that this person might not need to be alone. This person might need to have their medication changed up. And the side effects I know, Gabe, and you’ve seen me do my little dance here, but I have tardive dyskinesia where I shake and there’s just a lot of side effects that can affect people with schizophrenia differently, it’s not predictable. With those medications, and we had a previous episode about this, it opens you up to being vulnerable for more diseases. So, for instance, diabetes is a huge risk if you have schizophrenia. If you’ve ever been on any antipsychotics, you do tend to put on weight very frustratingly quickly. So caregivers need to kind of watch that. And I’ll be honest, Gabe, I don’t like the idea of someone telling me what I can and can’t eat. Gabe Howard: Well, right, because you’re an adult and you need to make your own decisions and let’s take this at a base level like a human dignity level, if you are not choosing your own meals, your own food, if somebody else is making that basic decision for you, how much wellness do you actually have if you don’t even have the autonomy to choose what you put in your own mouth, what you eat for sustenance and meals? Rachel Star Withers: Another thing that changes with schizophrenia versus other types of disorders, diseases, et cetera, is the cognitive ability, disorganized thoughts. Sometimes, and it’s so hard to explain when people ask me about this, but sometimes, like, I’ll forget something very simple, like, how to zip up my jacket? It’s just like the piece is gone and you can have a full conversation with me, I’m fine. But then I’ll go to do something. And I’m like, oh, no, how do I do this random thing? And I’ll get confused. That’s what caregivers have to watch out for with schizophrenia. Like, I don’t need anyone to help me dress. I don’t need anyone to come over and pick my clothes out for me. But then some days I get confused and I can’t remember how to do something. And just throwing this out there, my way around that is that I lay out my clothing ahead of time and I always have a backup set with no fun things like zippers and things. Schizophrenia isn’t predictable. Gabe, a few weeks ago, I had a really bad psychotic episode and I haven’t had one this bad in way over a year, 99% of the time, I don’t need help. Rachel Star Withers: I hallucinate and I have little delusions and things, but I’m able to manage it myself. I usually don’t even tell anyone. But this was different. And when it happened, I became very scared. I knew I did not have a grasp on reality. I couldn’t get my phone to work. I was trying to text my mom who was upstairs, and I couldn’t seem to text. I couldn’t remember how to text. I was like fighting my phone. I don’t know if I was texting the right person couldn’t put words together and somehow I got in the kitchen. Eventually, my mom, she did get some of the text messages. She came out, got me and stayed with me the rest of the night. That was very scary. And I’m very lucky that she was there to step in. Again, this is once a year that she had to do that. But we don’t know when that once is. She may have had to, like, be up early for work or something the next morning. So taking care with schizophrenia, it’s very unpredictable. And it’s kind of like you’re on call, like you’re ready to help if the person needs help in this way. But most of the time they might be OK. Gabe Howard: And obviously, that can be frustrating for all involved, I mean, who wants to be on call? You’re going about your day, you’re doing what you’re supposed to do and then boom, right in the middle of it, this thing happens that you have to be 100% for your loved one and that you want to be 100% for your loved one. And hopefully your loved one realizes what you’re doing and they need help. And that’s why I think that it is extraordinarily important to make a plan when you’re well. You know, one of the things that that Rachel does well and that we’ve talked about in this whole podcast series is she doesn’t just talk about schizophrenia with her family when she’s in crisis or when she’s hallucinating, when she’s having a problem. This is a continuous conversation that they have even when she’s completely well. The analogy that I like to use is it’s like having a fire drill when the house is on fire. But the best time to install smoke detectors and the best time to have a fire drill is when your house is not on fire. It’s very much the same in schizophrenia. And I think a lot of caregivers miss this. And in fairness, a lot of people living with schizophrenia, they miss it, too. We want to believe when everything is fine that it’s going to stay fine. And we just want to focus on the here and now and not make a plan for what happens in the event that things go a different way. Rachel Star Withers: So many of these caregiver relationships, like my own, is parent, adult child and mothers out there, a lot of you just kind of don’t step in to caregiving. You just step into mothering, just taking over like you did when they were five. And that’s where a lot of the tension comes from. ‘Cause I’ve talked to so many mothers who are just overwhelmed with trying to help their adult child and don’t know what to do. And part of it is you’re trying to do too much. You need to acknowledge what the person with schizophrenia can and can’t do. Like, I would much rather just bring someone food and be like, eat it, then say, OK, well, let’s work out the plan. You’re going to cook this, not, you know, I get it. That’s like more work. It’s totally easier to just dominate over someone and make all the decisions. But you can’t. Gabe, so I have a friend around in his 30s, but he has schizophrenia and he lives with his parents and he’s on disability and they’re constantly fighting because his parents take all of his disability money and he doesn’t like that. He’s like, that’s my money. And I was like, well, if you were out on your own, you would still have to pay for rent, groceries, utilities, etc. So I do believe that they are entitled to some of that because you’re using those things. I don’t think they should take all of it. But when they do give him money, he immediately spends it on alcohol, gets drunk. I don’t know, Gabe. What are your suggestions? Because I know so many people that get caught in like, what do we do? We’re stuck in this circle and don’t know how to get out of it. Gabe Howard: In this scenario that you’re given, both sides are right, the family needs the money for the expenses that the person living with schizophrenia is generating. We can’t ignore that. But we also can’t ignore that the disability check is this person’s. It’s in their name and they feel like they’re not being given a choice. They feel like their money is being stolen. But then again, let’s go back to the other side. They feel like, well, when I give that person the money, they make dangerous choices. You know, buy alcohol, and especially in the case of, you know, the family dynamic, if this person uses alcohol, it interferes with the meds. They have a crisis. This crisis affects the whole family. So when taking a look at everything, these are very difficult things to resolve because the reality is, is both sides are right and both sides are wrong. This is where it’s really important to understand that. I call it negotiating in good faith. If you have this idea in your head that the other side is wrong and you’re right, you’re not negotiating in good faith. And I’m speaking both to the caregiver side and the side of people living with schizophrenia. Gabe Howard: And that also points to a larger problem, which those two sides are often at odds. They’re often looking at each other as heroes versus villains when in actuality you’re neither of those things. That’s very important. These things get resolved in any number of ways, whether it be by compromise, whether it be by walking a mile in the other person’s shoes, whether it’s understanding. So often, caregivers don’t think that they’re the ones that need to seek mental health help. They don’t think that family therapy is needed because after all, they’re this big, strong caregiver. It’s only the person living with schizophrenia that needs help. It’s vital that you understand that if something is contributing to the mental health decline of the household, it means that the entire household needs mental health help. And so often people think, oh, well, I’m not as sick as my loved one with schizophrenia, therefore I don’t need any help. Don’t think of it that way at all. Rachel Star Withers: And you have to know what you can and can’t do. Most people have to work full time. OK, so we get this. This is almost like a second job or maybe a third job for many on top of your life. And it becomes intense. Family members are awesome because they’re usually the main support system. Whenever you’re making that decision of should the person with schizophrenia live with you, there’s actually I like this. It’s a little chart, Gabe, I have here, but it says Gabe Howard: I love charts as well. Rachel Star Withers: I know, but it says, living with your family and you have schizophrenia works best if you are high functioning and you can still maintain friendships and activities outside of the home, meaning I’m still able to go to a part time job, volunteer work. I still have friends I talk to. It’s not just me and my parents and that’s it. Another is that the relationship around the family is relaxed. You know, if you always have a lot of tension with a certain family member, it’s going to be a lot worse when you add in schizophrenia and then living together. You want to make sure that there are other support systems. Again, you can’t do it all yourself. We’ve talked about NAMI and different things, support groups, at the doctor asking them. Make sure as the caregiver that you’re not all the person with schizophrenia has and make sure this last one here that the living situation is not negatively impacted, if there’s young children in the home, by the person with schizophrenia, children come first. Always make sure they’re protected and everything. I’d say for the most part, my family has, they fit all of those. Gabe Howard: Ok, Rachel, but along that same vein, what things are immediate disqualifiers? Like living with the family is not advised if what happens? Rachel Star Withers: Well, one, if the caregiver is single, ill or elderly, that’s going to be really hard. You know, someone in their 80s is going to have a very hard time helping out with someone with schizophrenia. That’s just the truth of it. If the schizophrenic is very low functioning, if they pretty much they need more help than you can give them. So when I say high functioning, low functioning, what I mean is I’m usually considered a high functioning schizophrenic, meaning that for the most part I’m good for, let’s say, two weeks I could live alone. But after that I get weird and I have, like, little spurts of times when I’m going to need a lot more help. But I’m high functioning. Low functioning would mean I need a lot more help, more supervision. I need someone kind of stepping in my life, helping me make important decisions, helping me with my money, etc. Gabe Howard: Makes sense. Understood. Rachel Star Withers: You shouldn’t be a caregiver for the person in your family if it’s causing stress on your marriage, if your life is in shambles, you can’t help anybody else. I can’t stress that enough. And you’re going to hate that person you’re trying to help because you’re like, oh, well, I’ve lost my marriage. I’ve lost my job because of this person. It’s going to impact you both negatively. You just have to accept that you cannot do everything. Gabe Howard: And I think that’s really the key. What we want to point out is that doing something about it doesn’t necessarily mean that you personally do it. It could be a matter of getting the person to the right care. For example, we’ll go back to the car crash scenario that I gave. I am not an EMT. I am not a trauma surgeon. I don’t know how to set a bone. So if that happens to my friend Rachel, the best thing that I can do for her, of course, is call 911 and get her the help. In mental health, we have this tendency to do just the opposite, to say, oh, I’m going to pick you up, Rachel, and we move her from the car accident, we start doing all kinds of damage because we’re unaware. Sincerely, ask other family members to pitch in, call friends, call the local charity, schedule an appointment with a therapist, find out what you can do. And honestly, by listening to this podcast, you’re already starting that process. You’re looking for hints and tips of how you can be better. Again, I really feel the need to be clear. Me calling 911 one for Rachel in the car accident analogy is me doing a hundred percent of what I can do and ensuring that Rachel has the best possible outcome. We need to start thinking that way in mental health rather than thinking, OK, well, I have to fix 100% of this because after all, I love my child, friend, family member, etc. Rachel Star Withers: So, Gabe, we’ve really been a downer up until this point, Gabe Howard: And we don’t mean to be Rachel Star Withers: We don’t mean to, but we have all these problems we discussed. How do we fix them? One of the best things you can do is set out rules or make it very clear as the caregiver what is expected of you and as the person receiving care, what is expected of them so that, you know, if you’re overstepping your bounds. Make sure that the person receiving care has to give something too. All right? It’s not just like take, take, take. Now, it could be little things. It could be. You know what, hey, if you’re able to vacuum, if you’re able to handle the groceries, but make it clear that this is a partnership, it’s not just one person completely depending on the other. You know, what you can and can’t do might change over time. For the most part in my family, I buy a lot of like the groceries and things like that. I like that I’m able to provide food, make food and things because it makes me feel that, hey, I am contributing to the household. It’s not just me living in the basement, creepily skulking around the house, taking everything and not giving back. Gabe Howard: I really like what you said about little things really matter, you know, I have a, I have a pseudo kid in my life. I have a granddaughter and they’re a young family. They’re in their early 20s. They have a two year old. They don’t have a lot of money. They’re just starting out in life. They just bought a house. Long story short, whenever we go anywhere, I pay 100% of the time. I buy dinner, I buy the putt-putt tickets, I put gas in the car because I can afford to do so. The other day, my daughter in law bought me a Diet Coke. She showed up at the house. She was running errands. She had to drop something off. And when she pulled in, she handed me a Diet Coke from my favorite place. Straw and all, exactly how I like it with the light ice. It cost her a dollar. That meant a lot to me, an incredible amount, and it meant a lot to her because she got to give back in some small way. And, you know, there was hugging. You have to understand that those things are very, very powerful, breaking that analogy into the caregiver relationship with somebody living with schizophrenia. Gabe Howard: Find out what that is. Because it empowers the person and it gives you that hope and positivity to move forward as the caregiver. So often we’d rather just sit and think, well, I pay for everything. Well, I do everything? Well, they don’t help at all. Find those, I’m going to call them little Diet Coke moments. If you have this idea that you’re always going to be the caregiver and that they’re always going to need help and that they’re never going to contribute, you create a self-fulfilling prophecy. Rachel Star Withers: And so many times when someone does have to move back home or need care, they’re recovering. They’re recovering from a very bad psychotic episode, or maybe they’ve just fully been diagnosed as having schizophrenia and they’re going through that. So make sure that you have goals of where do I want to be in a year? If your goal is to live on your own, and right now you can’t. If the caregiver is too overprotective and just taking over my life, I will never get to that point because I won’t know how to stand up on my own. You did it all for me. So make sure as you find objectives to help with that, as a caregiver, you know when to step back. As the caregiver, you need to watch out for some things in your own life. There’s actually something called caregiver syndrome, and that is when you’ve just kind of you’re burnt out. And you can get burned out on a job, lots of things in life, but you’re burnt out of caring for a person. And that manifests in exhaustion, anger, rage, depression, anxiety and even physical things. High blood pressure, diabetes. This is all stuff we talked about earlier. Gabe, this is like, you’re trying to help someone else with these exact same problems and now you have the problems. Gabe Howard: Yeah, you can’t pour from an empty cup. I know that it’s a cliche, but if you are not well, what support are you providing? Sincerely, Rachel, would you want help from a person who was sleepless, scattershot, angry, frustrated, confused, annoyed? Is that the person that you want to show up to provide you what, in some cases, could be life-saving care? Rachel Star Withers: I do not, Gabe. The stress there. Can you imagine now if I’m living with that person and it just never ends? You’re going to have to learn as a caregiver to step back, take a vacation, even if it’s just like little mini vacations during the day. Really cool. I actually was talking with this family and they had a young teenage son. He was diagnosed with childhood schizophrenia. And so he had been on antipsychotics for quite a while. And they’d definitely affected his weight. And the parents were just pretty much, they were at their wits end. You know, they’re doing so much trying to help their child. And now on top of that, they’re worrying about his weight gain. Rachel Star Withers: So what happened? The uncle stepped in. The uncle decided that he was going to start working out with the young man. And it was kind of cool. You know, you got the cool uncle. The pressure wasn’t there. They would go out, he’d pick them up, they’d go and they would do some physical activity every single week. For one, that gave the parents a chance to take a little break from having to worry about the son, but also gave the son a social outing. And it made him feel like this isn’t something I have to do. I’m getting to spend time with my fun, cool uncle. And I love that. And that’s something like if you’re able to incorporate that, look around. If there’s other family members, be like, listen, I’m already doing this, this and this. Is there any way that you could help with one of these things? If one of your family members likes to cook? Yo, like, maybe you could make a little more. Maybe you could come over and show, like, find ways to give yourself a break as a caregiver. You can also look into assisted living situations like that. You know, don’t think that you have to do everything. Get help when you need it. Gabe Howard: I think a lot of people are experiencing stress in the time of corona, so it’s very important to understand that no matter how hard your family dynamic tries, external factors out of your control can change things. And the whole point of this is this is why it has to be an ongoing conversation and an ongoing partnership between all the parties. Otherwise, you’re not going to be nimble enough to survive when things happen. Now, obviously, I don’t think anybody saw a worldwide pandemic coming, but nevertheless, people with schizophrenia are also managing a worldwide pandemic, as are the people who love them. Rachel Star Withers: And we’ll be right back after a message from our sponsor. Sponsor: It can sometimes feel like another schizophrenia episode is just around the corner. In fact, a study found that patients had an average of nine episodes in less than six years. However, there is a treatment plan option that can help delay another episode: a once monthly injection for adults with schizophrenia. If delaying another episode sounds like it could make a difference for you or your loved one, learn more about treating schizophrenia with once monthly injections at OnceMonthlyDifference.com. That’s OnceMonthlyDifference.com. Rachel Star Withers: And we’re back discussing schizophrenia and caregiving. Gabe Howard: Rachel, you got to spend time with Dr. Sarah Kopelovich, who is an assistant professor, and has done a lot of research on caregivers. She taught us things like compassion fatigue, and it was very, very cool. I loved hearing your interview. So let’s go ahead and play that now. Rachel Star Withers: We’re here speaking today with Dr. Sarah Kopelovich, who is a licensed clinical psychologist, and she’s also an assistant professor who has been doing a lot of very interesting research into schizophrenia spectrum disorders. And today we have been talking about caretakers and the role that they play in helping different people with schizophrenia. Doctor, tell us about your research and how it deals with caregiver training. Sarah Kopelovich, Ph.D.: Sure. So my primary area of expertise is in psychotherapeutic interventions for people with schizophrenia spectrum disorders and other forms of serious mental illness. I do a lot of work trying to increase access to these evidence based psychotherapies. And the kind of frontline intervention in that realm is cognitive behavioral therapy. In trying to increase access to cognitive behavioral therapy for psychosis, how do we leverage other members of the treatment team and the natural support team so that we can really take an all hands on deck approach to helping people get access to good quality skills that can help them cope better with the symptoms of psychosis? There is a model called Psychosis REACH, which was developed by Dr. Douglas Turkington, who also happens to be one of the co developers of Cognitive Behavioral Therapy for Psychosis that teaches family members cognitive behavioral therapy concepts and skills so that they can have more therapeutic interactions with their loved ones. We have now piloted an eight hour training in May of 2019 and it was a huge success. So we found that just through a one day training, we were able to improve the well-being, so in other words, depression and anxiety, scores of the family members who attended that one day training and there was no other intervention involved. It was just that one day in person training, correcting myths and misconceptions about psychosis, providing background, and how can cognitive behavioral therapy help improve your life and well-being and depression and anxiety? And then how can you use these skills and concepts to improve relationships with your loved ones? So we’re really excited about these preliminary findings and we’re continuing to provide this training to family members in the coming years. Now, virtually, of course. Rachel Star Withers: That’s really amazing. So it’s just a one day training as of right now? Sarah Kopelovich, Ph.D.: This is a one day training and it is outside of any mental health clinic. We know that our national schizophrenia treatment guidelines recommend that the care team is providing family intervention for psychosis, but unfortunately, that’s just not playing out in practice. Only about two percent of families in the United States who have a loved one with serious mental illness are receiving any kind of family intervention for psychosis. So our goal was to take this out of the clinic. And I was able to do that because I was very, very fortunate to receive philanthropic support. So we offered this training to anyone. We provided financial support for travel and lodging. We brought them all together in a beautiful space, catered and just really communicated to families you’re valued. We care about you and we want you to learn. We know you’re doing as well as you can. We want to help you do even better. Rachel Star Withers: So why is caregiver training important? Sarah Kopelovich, Ph.D.: Well, we know that for a long time now, families have been in the shadow of the mental health system in our country. I talked about how 98% of the time families are not brought into their loved one’s mental health treatment, and this is contrary to the overwhelming evidence. Research shows that if we can support families appropriately, we can save money, we can save relationships and we can save lives. We spend three hundred billion dollars annually on costs associated with serious mental illness. And much of that comes from hospitalization costs. Which it just so happens that family interventions like caregiver training, one of the strongest outcomes that we see for this intervention is reduced hospitalization rates and reduced number of days in the hospital. In terms of saving relationships, there’s this really interesting study about 10 years ago out of Delaware. They just asked people living in the community with a schizophrenia spectrum disorder, do you feel alone? And 90% of the people that returned a survey said yes. And yet it’s also true that 90% of individuals with psychosis are in close contact with at least one family member. Psychosis can be a terribly isolating experience. So you can be surrounded by people, and by very well intentioned people, and feel so utterly alone. And we can change that. We can help get the relationship back on track. We can improve quality of life. And then, of course, that brings me to that last point, which is that family interventions like caregiver training can save lives. So one third of people with schizophrenia will attempt suicide and one in 10 will die from suicide. When you ask about why caregiver training is important, it’s about saving families and saving lives. It’s about giving family members a very different message than they’re likely receiving, which is that they should expect recovery. That’s what the data supports, is that most people who experience a psychotic episode will experience wellness, will experience recovery, and families need to hear that. Rachel Star Withers: Very nice, I agree on that. When I know most people hear caregiver, we tend to think of someone taking care of like an older family member. When my grandfather and my grandmother both had Alzheimer’s, I remember we kind of had to do a little caregiver training, but it really had nothing to do with the mental. How is your type of caregiver training different than, let’s say, dealing with someone who’s in their 90s like we were? Sarah Kopelovich, Ph.D.: Yeah, well, so first I want to clarify that I’m using the term caregiver quite broadly to refer to anyone who identifies as a support person. So that could be a biological family member, a significant other, a friend. And in terms of how it differs from other kinds of caregiver training, I think the domains in terms of what it’s trying to accomplish are actually more similar than they are different. If you are the loved one or the support person of somebody who’s experiencing an episodic or potentially episodic condition, then there are some basics that we need to help you to do. One is to have accurate information about the diagnosis and to be realistic and also hopeful. And with schizophrenia and other forms of psychosis, there’s a lot to be hopeful about. Despite all the doom and gloom you might confront on the Internet or in even peer reviewed journal articles, there’s a lot of progress that is being made in the realm of psychosis, recovery and treatment. Family members need to hear that. Otherwise, they’re going to go do a Google search or they’re going to talk to a family member that has their own anecdotal experience, and it might not be positive. Right? But there’s a lot to be positive or hopeful about. Family members want and need connection with their professional care team, but also that connection with other caregivers. Sarah Kopelovich, Ph.D.: And that’s across conditions. And then finally, I think they want resources and skills training. How do I, how do I help? What helps? And what makes things worse? They want to know what can I manage at home and what will the professionals be doing to help my loved ones recover? And then on the flipside, what in the home environment might be counterproductive to my loved one’s recovery? And what kinds of treatments might be unhelpful? There are more similarities than there are differences. But when we get a little bit more granular, a little bit more detailed, that’s where we start to see differences within the Psychosis REACH training and other kinds of family interventions. We’re going to be giving psycho education, obviously, about psychosis. We’re going to be really defining some boundaries for a training so that when we teach you these skills, our goal is not for you to do psychotherapy with your loved one. Right? That is not indicated, nor is that within your skill set. It’s really about helping you to apply some of these skills to yourself in your own life so that you could be more effective with your loved one. Rachel Star Withers: When you’re doing these different trainings or you’re speaking with loved ones, support givers and whatnot, what are some of the common problems that they bring up to you? Sarah Kopelovich, Ph.D.: My colleague, Maria Monroe-DeVita, conducted focus groups before we started the Psychosis REACH training and these focus groups were across the state of Washington with families who had had a loved one hospitalized for a psychotic episode. And what these families disclosed can really be boiled down to two things. They wanted skills to manage their loved one’s illness. And they said that they wished that they had had someone, and they were referring to another family member, appear to tell them, this was my experience. This is what you can expect. Here’s what worked for us. There’s something incredibly powerful about connecting with other people who have walked that path before. And then they also wanted to know things like how do I respond when my loved one is experiencing a delusion? How do I help them when the voices get really intense or really degrading? They’re referring to things like coping skills, problem solving skills, communication skills. So that’s exactly what Psychosis REACH teaches them. How do you help? What do you do in those situations? And then also how do you know when to back up? Because we also need to make sure that we are meeting people where they’re at and kind of know when to tactfully withdraw from the situation. Rachel Star Withers: How can your loved ones know when they need to tactfully withdraw or maybe kind of step back from a situation? Sarah Kopelovich, Ph.D.: So it’s really important to know that we cannot progress from a place of conflict. Sometimes things can escalate quite quickly or unpredictably, and you find yourself in a situation where now people are yelling. And so that’s not a therapeutic interaction, right? That’s a situation where we need to actually withdraw. You know, this is a bad time. Let’s come back to this another time. Or shift topics, right? Hey, I’m wondering if you caught the game last night. I missed it. Can you fill me in? Falling back on the relationship, going to neutral topics, getting back on the same page with your loved one. Hey, I know it’s really important to both of us that you stay out of the hospital and I can see you’re feeling really unsafe right now. What can we do to help you feel safe in this moment? Rachel Star Withers: So many times, including my own situation, you have a support person or caregiver that’s a parent, and the person that they’re supporting is their own child, an adult child with a serious mental disorder. Not only do you have the stress of the parent child, but with that added schizophrenia and psychosis. Can you speak on that? Sarah Kopelovich, Ph.D.: Sure, it can be a really tricky balance, right? You have a parent who wants their child to be well and can feel quite helpless and might be concerned for their well-being, for their safety, for what’s happening with their school. Are they going to get so off track that they’re going to have implications for their future? And then you have a young adult who is appropriately going through this process of separating from the parent and individuating, really becoming their own person, independent of their parent’s aspirations, their parent’s thoughts and ideas. It can feel quite stifling for the young adult to now have a parent who is taking care of them, who’s asking them about their medications. Who’s asking them about whether they’ve gone to their therapy appointment. That’s part of what we try to do with the Psychosis REACH training is to create a different dynamic. How do we change that dynamic that has started to unfold with the diagnosis or with the onset of the disclosure of the symptoms so that we don’t have so much stress and tension in the home? And this is really coming from a key finding in the psychotherapy literature where we see that that therapeutic relationship is the key to positive outcomes in therapy. So we work with the family members to identify shared goals. What’s important to you and what’s important to your child? And the way to get to those goals might be different. And usually it is, right? Usually they can both be on the same page about the fact that they want to be healthy and to kind of get back to the things that matter to them. Sarah Kopelovich, Ph.D.: But the parent thinks that the way to do that is to take this set of medications and to throw themselves back into life as usual. And the child thinks, well, when I smoke marijuana, that’s what helps me, right? It’s not these other medications. But the goal is the same. How do we take that goal and work from there? How do we help them activate positive emotions by thinking about positive memories, by having other things that they connect about outside of just the illness. And so when we can redevelop that healthy relationship, then we can progress to other kinds of skills, like inquiring curiously. So asking and not assuming, asking good quality, curious, open ended questions about your child’s experience, about their perspective, about what they want. We can teach parents to not fear their child’s experience. A lot of that concern and that tension that’s happening is coming from a place of fear. If we can tell parents actually voice hearing is a really common experience. And there are a lot of voice hearers all over the world. And here’s what we know about what leads to distress in some and not in others. Then they feel a little bit calmer. They feel a little bit less anxious about what their child is going through. And then we can help them work on the higher level skills as well, like trying out different skills together and getting feedback. Rachel Star Withers: Very interesting. A large part of our audience is caregivers and the support people, family that are all around different people with schizophrenia. What do you have to say to all of those people? Sarah Kopelovich, Ph.D.: What I want to say is it’s not your fault. That if you feel like you’re not doing enough or you feel like your child or your loved one isn’t getting enough, that it’s not your fault. And psychosis is nobody’s fault. That needs to be the first message right out of the gate. Psychosis is nobody’s fault. We have a lot of wishes for behavioral health system transformation, and we know that the system isn’t doing as well as it could be to help meet their needs. So I have training in dialectical behavior therapy as well. And one of the principles of dialectical behavior therapy is this assumption that we’re doing the best we can and at the same time we can do better. That’s the message I tell myself every day. That’s the message that as a policy advocate, as a mental health professional, I communicate to mental health providers and administrators. And that’s what I share with family members as well. You’re doing the best you can. And when we know better, we can do better. Rachel Star Withers: It’s very interesting that you said that one of the main important things is that it’s not your fault. That was just kind of really struck me because in my own situation with my parents being my main support system, I do think it comes up a lot. And I would say that for other people with schizophrenia and their support system, that our family. Yeah, that’s a big thing is did I cause this? Did I give this to my child? Did something happen under my watch to my child to cause this? And I hear that a lot. As far as like, did something traumatic happen? This is very interesting. That’s one of your main points, you’ve got to accept right away that it’s not your fault. That just when you said that, it really struck me that was very powerful. Sarah Kopelovich, Ph.D.: Absolutely, the more we know about psychosis, the more complicated that picture becomes, because it’s really not this simplistic model of how you’ve got this set of genes, then you’re going to develop schizophrenia. There are a lot of contributors to psychosis. We used to see psychosis as this really uncommon, abnormal state. Psychosis is far more common than we used to know. And across cultures. There are the schizophrenia spectrum disorders are one kind of set of causes for psychotic experiences. But there are a lot of people who have psychotic or psychotic like experiences who don’t have a mental health diagnosis. There is not a clear formula for this, but what we do know is that it’s not any one thing. Rachel Star Withers: It’s a very powerful point that. Definitely helps a lot of different support people out there who are listening to hear that. So how can caregivers find training? Sarah Kopelovich, Ph.D.: In my mind, the place to start is the National Alliance on Mental Illness, NAMI is the largest mental health organization for families, been around since 1979, and it’s really become a leading voice on mental health. What NAMI provides is both a way to connect with other families and also they provide their own set of education and resources to family and caregivers. And because they are such a large organization, there’s a good chance that you’re going to have a local NAMI chapter in your region. I find their trainings are a really nice base for families who are just beginning their journey supporting a loved one with psychosis. A lot of their educational programs will teach you about some of the common terminology. They’ll talk about different treatment options for different disorders. And then a lot of families will find that they’ll benefit from more specialized training. For loved ones who struggle with a family member who doesn’t agree with their diagnosis, which sometimes gets referred to as poor diagnostic insight or something called anosognosia, for those families they might find a specialized training program is helpful. And the LEAP Foundation, which is directed by Dr. Xavier Amador, can be really informative and helpful. They have a number of offerings, a number of different trainings that they’re now offering virtually. Sarah Kopelovich, Ph.D.: It’s kind of the silver lining to the dark COVID cloud is that so many of these trainings are now being offered via distance learning. The LEAP program uses principles and techniques from motivational enhancement therapy or motivational interviewing to really target communication patterns and to improve relationships for family members who are looking to learn concrete coping and problem solving skills and to dive deeper into their understanding of psychosis. They can sign up for the Psychosis REACH training. We had our first training back in May 2019. We got a little off track because of COVID, but we are offering now our second training. It’ll be our first virtual Psychosis REACH training. We’re really excited because of the philanthropic support that we’ve received for this training, I’ve been able to get the leading expert on CBT for psychosis, a psychiatrist named Dr. Douglas Turkington, who co developed CBT for Psychosis and Psychosis REACH, and he’ll be leading the training. And then in May 2021, we have another training that will also be virtual that folks can pre register for. They can go to www.PsychosisREACH.org to learn more and to preregister. Rachel Star Withers: Sarah, and I understand you have some different books that you can recommend. Sarah Kopelovich, Ph.D.: Sure, Dr. Turkington and Dr. Spencer have written a book called Back to Life, Back to Normality: Volume 2, and this outlines many of the cognitive behavioral techniques that we’re teaching to families in the Psychosis REACH training. So I highly recommend that one. That’s been a big asset to the families who’ve gone through our Psychosis REACH training in Washington. And then I have a book chapter coming out next year in 2021. It’ll be in a book published by the American Psychiatric Association called Decoding Delusions Advanced Psychotherapy Practices for the Clinician. And I’ll have a chapter in there called Supporting Families Caring for Someone with a Delusion. I will also go through the Psychosis REACH training key points. Rachel Star Withers: Well, thank you so much for sharing all of that with us today. I know that you have definitely helped a lot of our listeners who are support family and caregivers. I know my mom, I’m definitely going to have her listen to this and check out the books and the REACH program that you spoke about. Thank you so much for joining us today on our show, Sarah. Sarah Kopelovich, Ph.D.: Thank you so much for having me. It was so nice to be here. Gabe Howard: Rachel, a great interview, as always. What was your main takeaway? Rachel Star Withers: It really kind of threw me during our interview when she said it’s not your fault. I don’t know, like why that struck a chord with me, but it just kind of maybe like, I guess, peacefulness almost. You know, caregivers, a lot of times it’s a family situation. You need to know that stuff going on, a lot of it’s out of your control. You didn’t cause it. And the same thing for people like me who have schizophrenia, you didn’t pick this. This is just something you got that you have to learn to deal with. But you didn’t do anything bad. You didn’t do anything wrong. And that’s not something that we tell ourselves very much, Gabe. I think it’s easier to blame yourself for everything, whether you’re on the caregiver or the receiver end of that. It’s easy to be like, well, you know, this is all happening because I can’t work anymore. This is all happening because this person’s lazy. But you know what? A lot of this stuff, it’s no one’s fault. We just got to figure out how to deal with it. That gave me peace. Gabe Howard: I can certainly understand why. When you start blaming people, you expect those people to fix it. If I say this is Rachel’s fault, well, then I can just sit back and do nothing except be angry that Rachel is not fixing it. And the reality is, is if it’s nobody’s fault, then that gives Gabe and Rachel an opportunity to work together to assess the situation, find the problem and fix it. And the fixing it is what we want. I’m angry because I’ve blamed Rachel and she’s not fixing it. That manifests itself as me being angry at Rachel, but in reality, I’m mad at the problem that’s not being fixed. And I’m placing the blame not on the problem, but on an individual. That spoke to me a lot. Rachel Star Withers: Absolutely right, Gabe, and a lot of this keeps coming back to one thing, communication. Make sure that whatever the situation is between the caregiver, the care receiver, talk, make a plan, define the roles, what is expected of each person and reexamine them depending on if I’m doing better, if I’m doing worse. If I don’t need you to help me get dressed, don’t do that. All right. However, I could be sick one day and I haven’t showered in a few days, and you might have to help me. So be up front, reexamine the roles, know what’s required of each person. That way you don’t have to, like, step on toes. And to my fellow schizophrenics, check in, let people know how you’re doing. I’m really bad at this, OK? I won’t tell people I’m having a hard time until it’s really, really bad. And I don’t need to do that. I need to speak up. But it’s awkward sometimes. Just to be like, oh, hey, just so you know, I’ve been hallucinating a lot. I don’t know, I’m bad about that. But we need to step up, you know, let the other people know when you need help or especially if there’s signs that you notice that you’re going into a psychotic episode. Give them a heads up. Hey, by the way, this has been happening a lot. If you could just kind of watch me a little bit closer. We all need caregiving in some way during our lives, you know, we need to take care of each other, whether you are a family member or a close friend or even a neighbor or let’s say you signed up for a program and this is a stranger and you’re stepping up. That’s awesome. But know that you’re appreciated and make sure to treat each other with dignity and respect. I’m Rachel Star. Thank you so much for listening to today’s episode. Like, share, subscribe, pass it around to all of your friends and we will see you next time here on Inside Schizophrenia. Announcer: Inside Schizophrenia is presented by PsychCentral.com, America’s largest and longest operating independent mental health website. Your host, Rachel Star Withers, can be found online at RachelStarLive.com. Co-host Gabe Howard can be found online at gabehoward.com. For questions, or to provide feedback, please e-mail [email protected]. The official website for Inside Schizophrenia is PsychCentral.com/IS. Thank you for listening, and please, share widely. The post Caregiving for Schizophrenia first appeared on World of Psychology. from https://ift.tt/31safnb Check out https://daniejadkins.wordpress.com/
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In today’s show, Gabe discusses what he could have done differently as a newly diagnosed bipolar patient that may have made his life a little easier. He and Lisa also discuss some common pitfalls a new patient may run into. For example, what’s the problem when patients are told they need to be med-compliant at all costs? Should you be open at work about your illness? Join us to hear Gabe’s experiences and learn from his rookie mistakes (which actually ended up working out in the end anyway).
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Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Lisa is the producer of the Psych Central podcast, Not Crazy. She is the recipient of The National Alliance on Mental Illness’s “Above and Beyond” award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has worked alongside Gabe in mental health advocacy for over a decade. She lives in Columbus, Ohio, with her husband; enjoys international travel; and orders 12 pairs of shoes online, picks the best one, and sends the other 11 back.
Computer Generated Transcript for “Newly Diagnosed” EpisodeEditor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Lisa: You’re listening to Not Crazy, a Psych Central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts. Gabe: Hey, all, my name is Gabe Howard and I am the host of the Not Crazy podcast, which you are listening to right now. And as always, I am here with Lisa Kiner. Lisa: Thank you, Gabe, and today’s quote, the two most powerful warriors are patience and time, and that is from War and Peace by Leo Tolstoy. Gabe: What happened to the pregnant quote? I kind of dug that one better. Lisa: Really? That was just for you, I didn’t mean that one for the show. Gabe: Well, what was it? I really do think that it illustrated an excellent point. Lisa: Ok, so Warren Buffett said no matter how great the talent or efforts, some things just take time. You can’t produce a baby in one month by getting nine women pregnant. Gabe: I like that one because I do think that it is a good analogy, and I, I get it, Leo Tolstoy versus Warren Buffett. I’d like to point out that they’re both old white men, so. Lisa: But it’s a slightly different feel, one you’ve got patience and time, not just time, and also it’s about the warring aspect of it and this is your strongest tool in the fight. Gabe: I think the point, though, is, is no matter how hard you try, how efficient you are, how much you want it, how hard you work, baby takes nine months. Lisa: No amount of extra effort gets it to be less than nine months. Gabe: Right, and in terms of mental illness recovery, no matter how hard you want it or how hard your family and friends want it for you, it takes as long as it takes. And I think this is often missed when people are diagnosed with severe and persistent mental illness. Which leads us to our show topic. Lisa: Yes, the topic today being things I wish I had known when I was diagnosed, the chief among them being just the sheer amount of time everything would take. Gabe: Wasn’t that like a shocker to you? Lisa: Yes, very much so. Gabe: It was a huge shock to me. I sincerely believed that I was going to leave the psychiatric hospital one hundred percent in recovery and perfectly well, I had no idea it was going to take four years. Lisa: Well, certainly, I didn’t think it was going to take four years, but really, you honestly thought it was going to take zero? Gabe: Of course. Lisa: Like the next day would be done? Gabe: Well, yeah. Consider this, every other time I had ever had a medical problem, I went to the doctor, they diagnosed me, they gave me the treatment, and within a few weeks, I was fine. Lisa: But that just goes to show how good your health had been up until that point. Gabe: Yeah, you asked me things that I wish I knew when I was diagnosed, that’s one of the major things that I wished I knew when I was diagnosed. And I got to tell you, the average age of diagnosis of a severe and persistent mental illness is 16 to 24. For the average group of people to have excellent physical health are people who are the ages of 16 to 24. That’s why they’re all the athletes, Lisa. It’s no surprise that all the athletes are young. It’s not Lisa: Well, but I’m just Gabe: A bunch of old people Lisa: I’m just, I’m trying, Gabe: Except now Mike is fighting and he’s like really old. Lisa: I’m trying to show Gabe: You know what I mean? Lisa: You Gabe: Like like like old people Lisa: You are such an ass Gabe: Are getting out there more, but still the best are the young people. Lisa: What I’m trying to say is that this isn’t unique to mental illness. This is true with all illnesses because we all watch too many medical dramas on TV. We all just expect that as soon as someone leaves the hospital, it’s over, it’s done. They don’t need long term care. Their problems are completely resolved. I had surgery yesterday, but today I’m ready to go back to normal life. In real life, healing just takes a really long time and that is not represented in media. Gabe: You’re right, young people, we believe that we’re invincible. I thought I was invincible. I thought that any problem that befell me could be resolved with, you know, drops or pills or, you know, an outpatient stay. Lisa: Well, because you only had acute problems, you never had a chronic problem, that was one going to take long term management or even that just takes a long time. Gabe: Right, Lisa: The kind of things that you’re Gabe: Yes. Lisa: Talking about are things like a sprain or needing stitches Gabe: Right. Lisa: Or something like that. Gabe: Yeah, that was my only understanding of medicine, but let’s move that back for just a little slight, tiny moment, even though that was my experience, you recognize that if I would have gone to the hospital for three days and had been diagnosed with breaking both of my legs, I would have recognized that that was long term. So when you say, well, everybody thinks this. Yeah, everybody thinks this about things that they understand. I didn’t understand mental illness. I didn’t understand it was going to take this long. Nobody taught me anything about it. Or perhaps, just perhaps, I would have been diagnosed before the age of 25, considering I had symptoms of this insidious disease at 15. Lisa: Well, and as we all heard of the last episode, though, it wouldn’t have been appropriate to diagnose you at 15. Gabe: It would have been at 20. Lisa: Yeah, it would have been. Yeah, you were definitely symptomatic by then. Yeah. Like I said, I didn’t recognize my own mental illness until I was in my 20s. And that was a long, long time of symptoms. Gabe: I like the point that you’re making, Lisa, where you say, look, one of the reasons that that we have such a hard time understanding and managing mental illness is because we’re young and we just we just don’t understand the process of our bodies and minds failing us. But I don’t like what you’re implying that, yeah, we’re stupid about everything and mental illness is just exactly the same. I do think there’s another level. Lisa: I do think there’s another level. Gabe: I did, in fact, have symptoms that nobody recognized. I do believe that my family would have recognized symptoms of other illnesses. The example that I always use is my mother took me to a dermatologist from the time that I was very young because she understood that her red head, translucent son burnt easy and had a lot of skin problems. Well, how did she learn that? My mom was not a doctor. Enough people came up and told her and said, hey, your son is a redhead and very fair skinned. You’re going to want to put a lot of sunblock on him and get him a dermatologist, like on call. Why did nobody teach them this about mental health just as a precautionary measure? Lisa: Well, but there’s got to be somewhere in the middle. The number one thing, when people tell me that they have a new diagnosis or a friend or family member has a new diagnosis, that I want to impress upon them is the amount of time this is going to take. And I had absolutely no concept of that. And I think things would have been a lot better, a lot different if I had, although I’m not sure I would have listened. If one of your doctors had sat us down and said, look, this is going to take four years. I don’t think we would have believed it. We would have thought that, oh, no, that’s ridiculous. We can knock this out in six months, tops. Gabe: Yeah, I mean, it’s going to take nine months to have a baby, but that’s ridiculous, we can knock this out in three months, tops. Lisa: All right, good point. Gabe: The reason that we know how stupid that sounds is because we openly talk about pregnancy. We’ve met people who were pregnant. We’ve seen people who were pregnant. We’re willing to discuss and learn about pregnancy and not for nothing. I recognize that nothing in pop culture is displayed accurately, but pregnancy is displayed fairly accurately. Never once have I seen a show where they said, oh, I will only be pregnant for one month and I won’t gain any weight and I’ll have a baby. No, they always show the baby bump. They always imply that it’s been nine months. The baby ages fast. ou know, the woman has way too much energy in most cases. I Lisa: Never gains any weight. Gabe: No, no, she does gain weight, but it’s that perfect little baby bump. Lisa: Yeah, her face is exactly the same. Gabe: Face exactly the same, arms exactly the same, and of course, she’s still walking around in high heels like it’s not a problem, I recognize that it’s not a perfect analogy, but never once have I watched a show where they said, hey, this woman is pregnant on Monday. She’s going to work really, really hard and be really, really efficient and give birth on Friday because everybody’d turn it off and call that stupid. Just go back to my personal experience and the personal experience of a lot of people. They don’t realize how long it takes. And that leads me into my next thing that I genuinely and honestly wish that I knew on the day that I was diagnosed. I wish I knew that the term be med compliant was bullshit. Lisa: Well, I don’t know that you can say that it’s bullshit, but I would say that I wish I had known that medication wasn’t the end of the story. Gabe: The reason that be med compliant is bullshit is because it’s not complete. First off, being med compliant doesn’t do anything. For example, let’s say that all you had to be was med compliant. Well, then every psychiatrist should just prescribe every single mental health patient, M&M’s, and say, listen, wake up and eat a bag of M&M’s and go to bed and eat a bag of M&M’s. And as long as that person does that, they will in fact, be med compliant. But we all know that that’s not going to help them with their mental illness. That’s complete nonsense. I don’t understand why the term isn’t being med compliant on the correct medications. I feel that it’s be med compliant only because that puts all of the pressure and responsibility on the patient while giving none of the pressure or responsibility to the doctor. The minute you add be med compliant on the correct medication, well, now you’ve got a combo deal. Now the doctor has to be right and the patient has to be right. I think that it is this little insidious thing that puts all of the pressure on the patient, because after all, if it’s not working, it’s because you weren’t med compliant. It’s not because the medicines didn’t work or were wrong or you were prescribed incorrectly or diagnosed wrong. No, no, no, no, no. It’s you weren’t med compliant. That’s why I hate that so much. And that’s why I say it’s bullshit. Lisa: That is a good point, I did not have a good understanding of how long it would take to find the right medication. Gabe: I remember, Lisa, when I was first diagnosed, you did a really good job of saying to me, listen, people with bipolar disorder, they have this habit. You understood this very well because, well, you had done it. You had done it with depression. You told me that under no circumstances was I to stop taking my medication, that I must be 100 percent med compliant. I needed to be perfect, you said. And that as long as I took my medicines as prescribed, you would stick with me, you would help me. I am so thankful that you gave me this message because I do believe it was a good one. But I would like to point out that even though I was perfect on my medication, it took four years. Lisa: Yeah, you were always perfect. Gabe: And this was a big shock to my system, because all I could think was, is I’m doing what I’m told, I’m listening. This hurt me a lot because I started to believe things like, oh, I must have treatment resistant bipolar. I must have such a severe case that it can’t be cured. And you’re thinking, why did you believe that, Gabe? Well, I did everything the doctors told me to do. I did everything that Lisa told me to do. I was obeying all the rules and I wasn’t getting better. And since I did not have any understanding that it could possibly be the doctor or the treatments’ fault, that only left me, it must be my fault. I must be bad. I must be wrong. That’s a lot to deal with on top of, of course, managing a chronic illness. Lisa: So what are you saying you wish you had known? Gabe: I wish that I would have had a better understanding that this needs to be a relationship between me and my doctor and that we need to work together to find the right treatment for me. I did not understand that. I thought that this was 100 percent on Gabe and that any failure was only my fault. Lisa: I do have to give you a lot of credit for that, you were in fact, 100 percent perfect. You were always compliant, unlike almost every other person diagnosed with bipolar disorder we’ve ever met. That’s just a common thing. Lots of people go on and off their meds. And you never did to the point where every once in a while, a doctor would doubt that you were actually taking it. They would say things like, well, are you sure you’re taking it? Well, but are you taking it every day? Are you taking all the pills? So it’s yeah, even doctors have this very condescending attitude sometimes about, well, it can’t possibly be the treatment. It must be you. Gabe: I know we’re going to talk about stigma later in the show, but this is one of those like hidden forms of stigma, right? It’s like systemic stigma. Lisa: Yeah. Gabe: I feel like there’s only two choices for people with mental illness. Either we are unwell and therefore failing, or we got our shit together. Lisa: Right, there’s no in between. Gabe: It’s always our fault. If the treatment works, oh, thank God for the treatment. Yeah, yeah, it worked. If the treatment fails, you must not be taking your meds. You’re not be going to therapy. You’re not using your coping skills. You don’t want it bad enough. You need to try harder. There’s not really a space for you beat it. You’re a survivor. You’re amazing. The two choices are you are sick or you got your shit together and you’re normal. Lisa: Yes, there is. There’s totally a space for that cheerleading, you did it, it’s over, you did it. Yay! What there’s not space for is the in-between time of treatment. And cancer doesn’t have this problem with cancer being our favorite disease analogy. You either don’t have cancer and you’re fine or alternatively, you’ve recovered from cancer, you’re in remission, but you can also be undergoing treatment. You can be in treatment. You can be getting chemotherapy right now. You can be getting radiation right now. We don’t have that. Either you don’t have mental illness or you’re successfully treated. You’re in recovery. Well, what about that in-between time where OK, I’ve been diagnosed, but I haven’t really found what’s working for me yet so that I can be in recovery and have that life that I’m looking for. What about that period? There’s no in treatment, not all the way there yet, period. Gabe: It just really seems like there’s only two levels for people with severe and persistent mental illness, either sick or well. And when we’re well, the credit is not given to us for being well. Lisa: You’re right. I think we’re making two separate but intertwined points where you’re saying that there’s no victory at the end Gabe: Exactly, that is what I am saying. Lisa: And I’m saying there’s only the two steady states. Gabe: There are only two options and you’re either well, in which case everybody gets the credit but you, it seems. You know, your mom worked so hard for you. The doctors got all the right medicines. Research is so great or you’re sick and then it’s your fault for not wanting to be better. It reminds me of all my photographer friends. If they take a bad picture, it’s because they suck as a photographer. But if they take a good picture, it’s because they have an amazing camera. Oh, Lisa: Yeah, Gabe: You must have an amazing camera Lisa: Yeah, and that’s why no one’s willing to pay the money that it takes for good photography. Gabe: Exactly. I think that’s very difficult because I want my moment in the sun, I feel that this, just I thought I would get it. I sincerely believed Lisa: You did? Gabe: That if I. Yeah, I thought that if I worked hard that I would be praised for beating bipolar disorder, for achieving recovery, that people would be like, that is amazing. Wow. You know, most people his age don’t have to deal with that. And Gabe did it. Lisa: Wow. Gabe: But when I got there, everybody’s like, what? You’re finally behaving, buddy. Lisa: This actually makes a lot more sense on some of your behavior during that time, leading us to another thing you wish you had known when you were diagnosed, the role that stigma was going to play. Gabe: But you know what? I can’t count this as one of the things that I wish I knew because I did know because you told me. You told me a hundred percent about Lisa: Yeah. Gabe: All of the stigma, the discrimination. And you pleaded with me to change my behavior. And I Lisa: Yep, Gabe: Thought you were wrong. So, Lisa: Yep. Gabe: Yeah, things I wish I knew now. This would go under the show, advice I wished I would have taken. Lisa: So the thing that you wish you knew was that Lisa was right. Gabe: Yeah, I just. Lisa: Which maintains a lesson you could use today. Gabe: You specifically described it about the stigma that I would experience at work, and you said to me, look, Gabe, if you tell people that you have bipolar disorder, that you have mental illness, they will treat you differently, they will behave erratically and it will hurt you and your career. I had known these people. I had worked at this place for, what, four years? I did not believe that based on an illness, coworkers who held me in high esteem and who I held in high esteem would immediately turn on me. But I got a death threat, I. Lisa: You wouldn’t shut up about it as soon as you were diagnosed, you put it on the Internet, Gabe: I did. Lisa: Because you were off for a couple of weeks after being the hospital. OK, where were you? Oh, well, I was at the mental hospital and now I’m back. And I had pleaded with you not to do that because, yeah, I knew that was going to turn out badly. I knew it was. I knew this would hurt you at work. And we desperately needed you to continue working. But to be fair, I did not anticipate how bad it would get and how deep the stigma in our society really ran. Gabe: I want to defend my reason for not listening to you. It’s just. Lisa: There’s never a reason for not listening to me. Gabe: I can think of many. It’s you told me that people that I respected were going to turn on me. Why would anybody believe this? I just obviously I want to be right. I want to be clear. I love winning arguments with Lisa. In fact, that’s pretty much my only hobby in the new COVID world, but. Lisa: That’s too bad you suck at it. Gabe: I mean, I think I’m holding my own, Lisa: I could do this all day. Gabe: I but, you know, Lisa, if I told you, hey, your parents are going to stab you in the back, you need to not do something. You wouldn’t believe me, right? You’d be like, no, my mom and dad aren’t going to do that now. Now, obviously, that’s your mom and dad. People are like, well, yeah, that’s her parents. I recognize that I should not have had this level of faith in my coworkers. But as you know, Lisa, I was a rock star there. I was the youngest person who was ever hired. I was well respected. I was on a management track. If I never got sick, I would probably still be there. Lisa: Yeah, doing quite well. Gabe: I was doing quite well when I hired and they only wanted to give me more. Why on earth would I think that that would suddenly change based on a diagnosis that was given to me by a doctor? Obviously, you were right. I know you were right. I give you full props, but I’m still struggling with why? How? This is absurd that you were right. It’s absurd. Lisa: At a certain point, dealing with the stigma and the reactions of other people for you actually did become more difficult than dealing with the illness itself. Yeah, it was terrible. I just. How did you not know this? How could you not have known that this was in our culture ahead of time? I mean, what was your own reaction to people with mental illness? Were you nothing but progressive and understood and had nothing but sympathy and compassion? Gabe: I did not really know anybody with mental illness, so I never had an opportunity to try this out, so. Lisa: There wasn’t anybody in your family who just couldn’t get their shit together? Gabe: Well, yeah, that’s not mental illness, that’s couldn’t get their shit together. My family didn’t recognize mental illness in me and I didn’t recognize mental illness in me. So I was that person. I couldn’t get my shit together. And we sure as hell didn’t think it was mental illness. Once it was diagnosed with mental illness. Let’s flip it and pretend that I’m the perfectly sane one and a family member is diagnosed with mental illness. I would not have threatened them or been mean to them or dismissive of them. But I am fairly confident that I probably would have done nothing. And silence implies consent. In my workplace, not every single member of my workplace attacked me. That’s nonsense. Only three or four people did the horrible stigmatizing things that I’m talking about. The other 30 just sat there and watched and did nothing. Lisa: Like management. Gabe: Like management, for example, so, yes, so you’re asking me, Gabe, do you live in the real world? I don’t think I would have ever been mean to somebody with mental illness, and I would have thought that doing nothing was neutral or helpful. But in actuality, doing nothing was very painful to me because the people who I thought were my friends and allies turned out not to be in this case. But yes, I would have accidentally stigmatized my mentally ill friends, family or coworkers. I would never, ever have threatened to kill them. I want to be very clear. Lisa: And I want to point out, you’re not kidding on the death threat thing, that is not an exaggeration. It sounds like it. Very few people believe you when you tell them. But, yeah, that actually happened. Gabe: It happened in writing, Lisa: Yeah, Gabe: In writing. Lisa: In e-mails. Yeah, we had the emails, printed them out, took them to management, took them to H.R. and still nothing was done to stop this behavior. Gabe: No, no. Something was done to stop. Lisa: Well that’s true. That’s true. You were fired. Gabe: Yes. Lisa: That definitely did stop that problem. Gabe: I was let go, they did handle it, they said that I was inviting the conflict, that Lisa: Yeah, Gabe: That was the solution. Lisa: Yeah, it is unbelievable, if I had not been there, I probably would not believe you. It was so extreme. Gabe: And that’s another thing that I wish I would have known, it does fit into stigma. I wish I knew that people would stop believing things that I said. Look how we’ve structured this conversation. We’ve made sure that I have brought proof that somebody threatened to kill me because they got angry with me at work and that I was the one let go. I’ve got Lisa here vouching for me. Why isn’t my word enough? And I’m constantly with my friends, my family members and even on panels where I say that things happened and people are like, well, did they? Are you sure? And this is particularly traumatizing for people with mental illness when they report abuse or misunderstandings from doctors, therapists, orderlies, hospital staff, because we say, hey, X happened and the other side says, no, it didn’t. And they’re like, well, you know, yeah, it didn’t. I mean, you’re the crazy one. So we don’t have to believe you. We’re not even going to investigate. I didn’t know that before I was diagnosed with bipolar disorder, Lisa. I commanded so much respect and people saw me as somebody with so much integrity that if I said it happened, that was the end of it. After I was diagnosed, I better bring along the smoking gun, proof and, you know, something notarized from God. It was, it was very, the contrast was incredibly stark for me. Lisa: You know, I’ve been stable for so long that that really doesn’t come up for me very much anymore, but every once in a while I’ll mention maybe offhand that, yeah, I take antidepressants, I’ve taken them for a long time, and someone will suddenly, after years of knowing me, start acting differently or say something or be like, huh? Really? Gabe: We’ll be back in a minute after these messages. Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Lisa: And we’re back, talking about things we wish we knew when we were diagnosed with mental illness. Gabe: Another thing that I wish I knew when I was diagnosed is that living publicly with bipolar disorder has this exceptionally high cost. I just thought that being who I was enough. Like that was enough. Like Gabe, why are you telling people you have bipolar disorder? Because I do. Lisa: Well, I think that you knew something was wrong, something was clearly wrong, you had this underlying wrongness. And so when you finally had a name to put to it, you were just so relieved. You felt that it justified a lot of your behavior and you were just so relieved to finally have an answer, to have a word, to have a way to express what was happening, that you wouldn’t shut up about it. You told everybody, which I advised against. Gabe: I didn’t expect telling people that I had bipolar disorder to absolve me of the responsibility. I thought that it provided a clear explanation of my behavior, which would lead to forgiveness or understanding or mending the relationships and. Lisa: Right, or a chance to explain further. Gabe: And in some cases, it did. My relationship with my parents got a lot better once they understood that, OK, Gabe isn’t a jackass, he’s sick and he’s working on it. It gave us a starting point to mend fences. They now understood why my behavior was erratic in a way that they did not before. And I understood why my behavior was erratic in a way that I didn’t understand before. That’s what I was excited about. That’s why I told everybody. I guess I don’t want people to think that it only had bad consequences. If I could do it over again, I would only tell my family and friends and I would not tell anybody at work. Lisa: That would also be what I would wish for you. This just gave you so much insight and understanding into yourself that you wanted to share it with others. You wanted them to also have this insight and understanding into you. It became an important thing to you that you wanted to tell other people about. We talk about that a lot about should you be open at work? Eh, good for the cause. Might not turn out so well for you. There’s a definite cost to that. And you paid it. Gabe: Ultimately, I’m happy with my decision, I get to be me. Lisa: But you would have liked to have done that on your own terms, I would say that you are not, in fact, happy with that particular decision. If you had it to do over again, you would not have told your work back then. Gabe: I would not have. Lisa: You might still have ended up in the same place or thought to yourself, hey, the very fact that I can’t tell these people means I need to go become a mental health advocate. But yeah, you would not do that over again. It was not worth it. Gabe: This is of course, one of those interesting lemonade out of lemons things. The reality is, is I do regret it. I regret it a lot. And at times I regretted it more than others. But in many ways, it sort of reminds me of the guy who applied to be the piano player at the brothel. Lisa: Ok, I’m not familiar with that story. Gabe: Oh, it’s it’s. Lisa: Oh, good a chance for you to share an anecdote. Gabe: You know, I love anecdotes, so this guy comes to town and he needs a job, so he walks into a brothel and he says, hey, are you hiring for anything? And they said, well, we’re hiring for a piano player. Can you play the piano? And he says, no, no, I can’t play the piano. And they said, well, that’s the only job we have. So he goes out and he tries to find a job and instead he starts a business. And 20 years later, he’s a multimillionaire. He’s on the world stage and everybody loves him. And he’s just really famous and he’s really rich. And his mother says to him, you know, don’t you wish that you would have taken piano lessons? Imagine what you could have been. And he thinks about it for a minute and he says, Huh, I guess I’d be a piano player in a brothel. The point is, is that you never know how things are going to interconnect or work out or go together. And in this case, him ignoring his mother’s wishes to play the piano made him a multimillionaire. But it can turn out many different ways. In my situation, if I hadn’t told anybody, yeah, I’d still be in that job. Maybe I’d be making lots Lisa: Maybe. Gabe: Of money. Maybe I wouldn’t. I don’t know. I am fairly certain that if all of these bad things hadn’t happened to me. I never would have become a mental health advocate because I became a mental health advocate so that nobody else had to go through this misery. I guess the misery, it was training to be an advocate. I’m just so sad that this misery exists. And that I had to go through it. Lisa: But you don’t know how it would have turned out, maybe on your way to that job, you would have gotten hit by a bus. Gabe: Yeah, you always say Lisa: It totally could have gone another way, Gabe: You always say stuff like that. Lisa: Because you always go with the best-case scenario. That’s not necessarily what could have happened. Anything could have happened. You might have ended up in the exact same place. Gabe: Yeah, we all get that. My only point is that I would not have become a mental health advocate if bad things didn’t happen to me, the only reason I was an advocate is because bad things happened hard stop. I went through hell and I saw other people going through hell and I became a mental health advocate to stop them from going through hell. Some people would argue that’s worth it. I don’t know that that’s worth it. I’m just saying that’s where I ended up. This is one of those things that people will debate until they’re blue in the face. Oh, well, if you’re happy now, it all turned out the way it was supposed to. I don’t know that I’m leading my best life, my worst life or just a life. The bottom line, though, is, is had I made different decisions, I’d end up in a different place. And people seem to like this show. So I guess the job that fired me for getting a death threat did all of our listeners a solid. Lisa: You’re welcome. Going back to the theme of the show, you do wish that you had known that this would happen, you wish that you had known how deep the stigma went so that you could have prepared for it differently. Gabe: Yeah, and then I never would have done it. Never would have done it. Never would have told them at work. Lisa: If you wanted to tell people at work now after so many years of stability or recovery, that’s a whole different thing than right at the beginning when it’s still new to you and you’re still adjusting and you’re still coming to terms with it. Gabe: And I wish I knew that conversations like this had to take place where I would be sitting at home with my wife and saying, OK, somebody asked me why I was out for six weeks. Now when Jenny was out for six weeks, she said it’s because she had a baby. And when Jimmy was out for six weeks, he said it’s because he broke his hip in a jet ski accident. Now, I was out for six weeks being treated by a doctor in a hospital. But you’re saying that I should lie. Like that’s, that feels bad to me. You know, Jimmy and Jenny, they got casseroles and cards and letters and there was a potluck when they came back, they decorated their desk. When I came back, there was nothing. There was nothing. Lisa: No casseroles, not a casserole illness. Gabe: Nothing, nothing. Lisa: And at the next job, we told absolutely no one. Gabe: Yeah, and it did turn out better in terms of none of the stigma, none of the discrimination, but I had a very difficult time making meaningful connections with my coworkers because I felt like I was always on guard and always hiding. And that juxtaposition, the openness was bad. The being closed was bad, made me pick the lesser of two evils, which I decided to go ahead and be open, knowing full well that I was inviting stigma, discrimination and chaos into my life. It was a very difficult decision and frankly, it sucked that I had to make one. I do wish that I would have understood that. And you know what else? I wish I would have understood the seething anger that accompanied this discrimination and this diagnosis and the way that it impacted my, my. Lisa, I was I was angry. Lisa: You know what I’m going to say, this is what white male privilege is, because you’d never had this experience before, Gabe: That is true. Lisa: Because there’s been plenty of times that something has happened to me and I think to myself, is this because I’m a woman? Is he not taking me seriously because I’m female? I’m not sure. Maybe he’s just a jerk who doesn’t take people seriously. But I wonder. You never had to wonder these things. Gabe: I never did. Lisa: That’s what privilege is. Never wondering about it. So now you started thinking to yourself, huh? Is my boss giving me this problem because he knows that I’m going to be out for a psychiatric reason? Or is he just not a very good boss? You never had to think about how you were portrayed to other people. You could just relax and be yourself. You didn’t have to constantly be on guard. That was very difficult for you. You just didn’t have any experience with it. Gabe: None, none whatsoever. I could just be who I was, and if I didn’t get the job, it’s because I didn’t get the job. I didn’t have to wonder if I didn’t get the job because I had bipolar disorder. This has been explained to me in so many different ways and so many times. And it’s fascinating to me because you’re right, this set me up higher to fall further. And in that way it’s a negative. But on the other hand, cry me a river. You had all of this free birth right stuff because of your race and gender. I struggle with this a lot because I don’t want to come off as arrogant. But that was difficult for me. Lisa: It was. It was surprisingly difficult for you. Gabe: I didn’t have any training or experience at this, you know, my father is a white male, too. He didn’t teach me any of this, probably because he didn’t know it existed. Nobody prepared me for this. And it made it harder suddenly wondering if people liked me based on something I couldn’t control. Lisa: This lack of confidence was very difficult for you. It was surprising to me at how difficult that was for you. Gabe: And this manifested as rage, just literally rage, I was angry all the time, and to try to get ahead of this, I would just explain to people why I was pissed off and why I had been wronged and how the universe had screwed me. And remember what you said there, little Kiner? Lisa: Yeah. I said to you, yeah, God f**ked you and nobody cares, you can’t pay the bills with your sad story. Gabe: I would like to point out you were wrong Lisa: Yeah, yeah, yeah. Gabe: About the second part. Lisa: Now you’re paying the bills with the story, yes, yes, yes, anyway. Gabe: But you were right. No, I was only alienating the few people that I had left, but I didn’t realize at the time. And truthfully, I don’t think you realized at the time either how much of this anger was symptomatic. Lisa: Yeah, all the time. Gabe: I think that we saw bipolar disorder as the depression and the mania and the grandiose thinking. I don’t think that we considered that anger was part of bipolar disorder. And I say that because in the early years, we never reported that level of hostility or anger to my therapist or my doctor. It wasn’t a symptom that we were on the lookout for, which is one of the reasons that it makes the list of things that I wished I knew when I was diagnosed, because I wish that I could have told my therapist, my doctors how much anger I was actually having. Lisa: And gotten some help. Gabe: Yeah, I could have gotten some help for it. Once we understood it, remember? I went to anger management. We started talking to my therapist about anger. And you were the start of that because I realized that I had to do something about anger. And when I started talking about it openly, that’s when I found out that there was this intersectionality or connection or symptom. And I was like, well, all stuff that would have been good to know yesterday. Lisa: I feel that a little bit with my own diagnosis, with depression, when I first started getting treatment for depression, in my mind, depression was sadness. So the doctor said, how are you doing? Well, I’m not sad. There you go. It didn’t occur to me that there were other symptoms, the fatigue or the lack of motivation. I didn’t associate these things with depression. So when it came time to tell a medical practitioner how I was doing, I was leaving out huge swaths of the story, which no doubt led to me getting worse care than I would have otherwise. To add to the things you wish you knew the day you were diagnosed, just more about bipolar disorder, more about the symptoms, the symptomology, what was going to happen in the course of the illness. It would have been nice to just know more. Gabe: And that leads me to another thing that I wish that somebody would have told me when I was diagnosed, that support groups are not bullshit. Lisa: Yeah. Gabe: They just they sounded so I had seen 12 step programs portrayed on TV with everybody in the basement and all of the who’s going to share. And I just I mocked them. Lisa: Me too Gabe: Just listen to me. Lisa: I was shocked. Gabe: I made fun of support groups and then we got so desperate, Lisa, you made me go because we had just run out of options. Lisa: Yeah, there was just nothing else to do. Gabe: We had zero, zero hope that this would be effective and it turned out to be one of the most influential things in my recovery. Lisa: It made a big deal at the time, for me too. Gabe: And to go from openly mocking something and saying that it was stupid and wouldn’t work and it was dumb and only weak people go, that’s the other thing. I mocked the participants. I just, I feel so incredibly guilty for being such an asshole. People were doing something that was providing value to their life. And I was mocking them like, how arrogant is that? When you made me go, Lisa, as you know, we live in a big city and I was able to find a lot of support groups. And the one that I went to was called Bipolar Bears because I was scared to go. And frankly, that name, that name sounded Lisa: Comforting. Gabe: Comforting to me. I went to the very first one, and this didn’t happen immediately. I was in there Lisa: Yeah, you had to go to for a few before you started feeling there was value. Gabe: Yeah, I was in there with a few people and I didn’t kind of know what I thought about it, but we had agreed that I would try to, I forget how many I would agree to? I Would go to a few. Lisa: It was like three or four. Gabe: Yeah, then the magical moment for me was when I was sitting in that room and a woman was just talking about her day. That’s it. There was nothing mind blowing or mind shattering. And she said something about cleaning the house and working with her husband and getting the kids ready. And I just looked at her and she looked so normal. She was a wife and a mother and a homeowner. Now, I have no idea this woman’s name. I know nothing about her. I would not recognize her if I passed her on the street to this day. But I immediately realized that she was a woman living with bipolar disorder, leading the kind of life that I wanted, which meant that I could do it. It’s doable. It’s so much easier to do something after you see somebody else do it first. That was probably the biggest moment in support groups. I’m a huge fan of them. As you know, Lisa, I went on to become a support group facilitator. That’s how much I believe in these. I was a volunteer for years. I meet a lot of people, especially men, especially men, that the minute you bring up support group, they roll their eyes and they think all the same things that I did the day that I was diagnosed. I wish someone would have gotten through to me and said, you’re an idiot. Go. They are amazing. There’s lots of different types. There’s lots of different options. There’s, there’s 12 steps. There’s discussion. There’s I’m not even naming them all. They’re led by peers. They’re led by therapists. There’s, there is one that will work for you where you are if you put a little elbow grease and Googling into finding them. Lisa: That’s the thing to emphasize, that there are so many options, especially for us in a large city, if one of them isn’t working for you, the structure, the folks, whatever, there are other choices out there. You aren’t constrained by just this one model. Gabe: And you age out, you know, I don’t go to the Bipolar Bears anymore, I went for a long time and then I stopped. I went to the Depression Bipolar Support Alliance for a while. I went to the Connections group for a while. There was a 12-step program, Emotions Anonymous, I went to for a while. And you’re thinking, well, if they’re all good, why did you switch around? Because I was in different points in my recovery. Also, you know, sometimes just groups’ dynamics change. You know, you might like a group for a while and then decide, well, you know, I’m not digging this group anymore, go away for a year and then come back. Well, there’s probably going to be all different people. That’s OK. I didn’t understand any of this and I can only imagine how helpful it would have been if I would have gone immediately after diagnosis rather than waiting, what, a year? 18 months? I guess what I wish I would have known, Lisa, is to keep an open mind. Lisa: Well, you know, the silver lining of COVID is that a lot of support groups are online now. Gabe: Yes. Lisa: If you are in a rural area, you don’t have a lot of options where you live, there’s a lot of options online. Gabe: Very, very true. Google it and check it out. Lisa: I went to one of the family support groups, and you’re saying that the thing that did it for you was seeing what a vision of the future could look like, that this was a possibility. The thing that did it for me was seeing that I wasn’t alone. It was actually the very first meeting when some gentleman was talking about his girlfriend and it could have been you. And I was just amazed that even though these people, you know, they were different ages, they had different jobs, different genders, but they were having such similar problems. That was very powerful. That I wasn’t alone on this out on my own. This wasn’t completely unique, that no one else had ever dealt with before. That was very valuable to me. And luckily, that support group was free because another thing I wish I had known on the day that you were diagnosed is just more information about health care and how the health care system works and how health insurance works. That was just a whole other problem. You’re not just dealing with the illness. You’re dealing with how to access care for the illness. Gabe: There were two fascinating things that happened for me in regards to the mental health care system, one, it was just how messed up it really was. And I had money. I had health insurance. I had a support group and resources and lived in a big city. And two, your reaction to it, because you had been battling insurance companies for a physical health problem for a long-time and. Lisa: You were frankly lucky to have me. Gabe: I was very lucky to have you. Lisa: Because I had a lot more experience than the average. Gabe: Yes, the thing that you kept saying is, oh, my God, I thought that physical health care was messed up. This is so much worse. And I just, I thought that you got sick. You used your insurance to get help. That’s how I understood it. You were smarter than that. But you thought you jump through all the hoops and you got care. But there were so many extra hoops. Lisa: Yeah, I was shocked and I didn’t expect it to be a good system or to be easy. I thought it was going to be complicated. It was so much more than I thought. And the part where everything is separated that there’s this divide between mental and physical health just creates its own problems. Gabe: I have this, this really good memory of you saying, OK, Gabe, we’ve got you approved to see the doctor for three visits. And I said, well, what if I’m not better in three visits? And you said, I don’t know. They said that you have to be better in three visits. And I said, is this typical? And you said, no, no, it doesn’t work this way in any other illness. You get cancer. They’re not like, OK, well, you can see an oncologist three times and hopefully you’re cured. But in mental health, they’re like, oh, we’ve approved three visits. We’ve approved six visits. The insurance company is like, what? Magic eight ball? Bipolar disorder will be cured for Gabe in oh, looks like three visits. Where are they getting this number? And listen, I had health insurance. This was the Mercedes plan. Lisa: You did, you had amazing insurance. Gabe: Don’t even get me started if you have Medicaid or Medicare or crappy health insurance. Like I said, I was cruising along in the Mercedes and I thought it was shit. Oh, some people, they don’t even have a car. It’s so bad. Lisa: Well, not to mention the shortages and the wait times, every place you called would be like, oh, five months, six months. It was like, really? Really? Gabe: I’m sick now, I’m sick right now. Lisa: Apparently, America needs a lot more psychiatric practitioners. I just couldn’t understand why the market wasn’t satisfying this. If there’s so much demand for psychiatrists and people are willing to pay for it, why aren’t there more psychiatrists? Gabe: Because people can’t afford to pay for it, it’s one of the lowest paying specialties in all of the medical field. Lisa: Ok, fair enough. Gabe: You need just as much training and it costs just as much money to be a psychiatrist as it does any other specialty. Yet here you are not only making less money, but every single psychiatrist that I’ve ever talked to is like we’re just looked at like we’re evil. You know, Lisa, we did that anti-psychiatry episode. And remember, they’re the target of this. Not only do they have to spend hundreds of thousands of dollars to get this job, they are also paid less and they have an entire movement of people calling them murderers. I’m surprised we have any. We don’t have enough doctors. I don’t know how we’re going to get more. Lisa: Gabe, out of curiosity, is that something you wish you’d known when you were diagnosed? Gabe: Oh. Lisa: Would that have helped? Gabe: Oh, that’s I, you know, I’ve never really thought about it before, I just on one hand saying, no, I’m glad I didn’t know that. I’m glad that I thought the world was fair and that everybody loved me. Seems Lisa: Yeah. Gabe: Like I’m burying my head in the sand. Right. But that would have just been so overwhelming. Could you imagine if the day that I was diagnosed, somebody would have told me all of this, all the stuff that I’ve learned. I think it’s better that I did not know. But you recognize that a lot of people who are newly diagnosed know this is a problem because it’s preventing them from getting care. I’m saying that I think for my care, it’s better that I didn’t know, fully recognizing that the people who know the day they’re diagnosed are the most vulnerable people there are. Lisa: I’ve been thinking about this as we’re talking about this, I do wish I had known these things on the day I was diagnosed or the day you were diagnosed, but I don’t think I would have been super receptive to some of them. I think if someone had tried to tell me any of these things, I would have dismissed it or not believed it or thought it didn’t matter. Gabe: So, wait, you mean to tell me that if somebody would have warned you about this system, that you wouldn’t have believed them? Kind of like how when somebody warned me about stigma, I didn’t believe them? So you’re saying that you would have made a Gabe type decision because it just sounds so incredulous? Interesting. Lisa: I don’t think that’s interesting at all. Gabe: But just for the record, I agree with you, I don’t know that I would have understood this concept, I. Lisa: I don’t know how you would even begin to explain it. Gabe: Yeah. Lisa: What are you going to put some of this in a pamphlet? Although I do feel like the medical practitioners around us had some non-zero responsibility, because that’s what informed consent is, to tell us some of this stuff, especially the big one for me is the time aspect of it. I had no understanding of it just wouldn’t be a linear process, there wouldn’t be a clear path forward, and how long it was going to take for you to get better. I had no concept of that. And the people around us knew. Your doctors knew. They all knew. They had to know that our expectations were completely unreasonable and no one ever said, hey, that’s completely unreasonable. I don’t know that I would have believed them, but I feel like they had an obligation to let us know that. And then we could have done what we wanted with the information. Chosen to believe it or not. Gabe: Obviously from this vantage point, we now know all of the things that we wish we knew when we were diagnosed. But I’m very interested in that thing that you said where somebody should have told you, because it’s their responsibility to tell you. But as we’ve just illustrated, somebody did tell me one of these things and you admitted that if somebody had told you, you wouldn’t have believed them. How do we wrap our arms around this idea that simply telling people isn’t enough? We’ve both admitted on this show that either we didn’t use the information, Gabe, or that we wouldn’t have believed the information even if we had it. Lisa. How do we get this information to people when the two people on this podcast having this discussion have admitted that we wouldn’t have accepted the information and/or didn’t accept the information? Lisa: Wow, that is a really good question, I, I don’t even know how to react to that. I don’t know. I’m not sure. But I am angry. I am upset that nobody told me this, especially your doctors, your therapists, et cetera. You’re not unique, this process of how long it takes and the fits and starts and the frustrations, that is not unique. That is pretty much universal. So they knew. They knew that this was the path before you and it wasn’t even hinted at. I don’t think that’s right. I think that information should be shared with us. But, yeah, I don’t know what I would have done with it. So I don’t have a good answer to this problem. Gabe: I’m still hung up on this idea, Lisa, that you believe that doctors should tell us, I don’t think we would have listened to doctors. I didn’t listen to you. You already admitted that if somebody had explained to you that this is the way that it worked, you wouldn’t have believed them because it’s just so utterly ridiculous. Your brain would have rejected it outright. And there’s a shortage of doctors. Do you really think that doctors should sit down and try to explain all of this to us? Lisa: They could put it in a pamphlet. Gabe: Could they? Could they put it in a pamphlet? And if it was that easy, why has nobody done it? But actually, it’s on the Internet. You know that it’s on the Internet, right? Hell, it’s in this podcast. Is the problem solved? Clearly, we are not reaching the people. Why are we not reaching the people with this information? That’s my question to you. The information is out there. Why do people not either A, consume it or B, believe it? Lisa: Because they don’t want to. Gabe: Now, that seems like a cop out. Lisa: Because it’s sad and you don’t want to believe it. Gabe: It is sad. Lisa: The same reason everyone who gets a cancer diagnosis decides that they’re going to be in the percentage that makes it. Gabe: But that’s, that’s a life or death thing that’s, that’s Lisa: And this isn’t? Gabe: I know, I mean, like I understand what you’re saying and I’m, but you’re confusing the issue in a way that I don’t think is serving this discussion. What I’m saying is, is I trusted you. You know that I trusted you. I did 99% of the things that you told me to do. And I followed you blindly. But you told me not to tell the people at work, to keep this on the down low or that discrimination would follow. And I did not believe you. Clearly, there’s nothing more that you could have done. If I didn’t believe you, I certainly wouldn’t believe a pamphlet. I certainly wouldn’t have believed a doctor. And as you just illustrated, if somebody had explained this to you, you wouldn’t have believed them. If somebody would have told you this is how the mental health system works. You, Lisa Kiner, would not have believed it. So no, no, it’s not because people don’t want to or because they’re stupid. And if they are, why didn’t we believe it? Because Gabe and Lisa are stupid and it’s sad and we don’t want to? Because we didn’t do it. So whatever reason you come up with as to why people don’t understand this applies to Gabe and Lisa. So be very careful with your next words because you’re describing us. Lisa: I have no words, I’m going to have to think about this, I don’t know. Gabe: It’s stunningly, surprisingly complicated. Lisa: It is surprisingly complicated, yeah, it seemed much more straightforward when we started. Gabe: I love that I was able to stump you. Lisa: Eh, I wouldn’t say stump, just consider more deeply. Gabe: You had unlimited time to answer this question and you couldn’t, and we’ve been mental health advocates for a decade, and if we knew the answer to this question, we’d do it. Lisa: Does anybody have the answer? Gabe: I don’t think people have the answer. I think that people have some answers. Peer support, support groups sharing information. This podcast, I think that does get the information out there. But does it get it out there in a meaningful way for people who are unaware that they need it? What are the odds that somebody is going to get diagnosed on Monday and find our podcast on Tuesday? And more specifically, Lisa: Believe it. Gabe: Believe it or connect? You know, maybe if they find a middle-aged guy who gets diagnosed with bipolar disorder and he’s like, hey, I talk a lot, too. And I hang out with my ex-wife and I’m from Ohio. You know, I trust this guy. But it’s also possible the person listening to this podcast is of a different race or socioeconomic status or gender or lives in California and thinks these two are idiots. Our information is correct. But how do we get people to connect with it, to relate to it, to understand it, and most importantly, remember it when they need it the most? Lisa: Is this something we can outsource to the comment section? Gabe: Listen, if you have the answer hit up [email protected] and tell us about it. We would love to hear from you. Wherever you download this podcast, please, please, please subscribe. And as I tell you every week, I am the author of Mental Illness Is an Asshole, which you can absolutely get on Amazon. But if you want to be one of the lucky people to get Not Crazy podcast stickers, go to gabehoward.com, buy it there. I’ll sign the book, and I’ll send you those stickers absolutely free. Lisa: And we’ll see you all back next Tuesday. Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person? Not Crazy travels well. Have us record an episode live at your next event. E-mail [email protected] for details.
The post Dear Newly Diagnosed: What We Wish We Knew first appeared on World of Psychology. from https://ift.tt/37mjnNZ Check out https://daniejadkins.wordpress.com/ Let’s discuss the nuances of dysfunctional parenting. In today’s Not Crazy podcast, Gabe recalls the relationship he had with his parents when he was young. As a teen, he thought his parents were being overly harsh, but now he sees they were trying to punish symptoms of his undiagnosed bipolar disorder — and were doing the best they could. Join us for a great discussion on how the parent-child dynamic can go wrong when undiagnosed mental illness is involved.
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Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Lisa is the producer of the Psych Central podcast, Not Crazy. She is the recipient of The National Alliance on Mental Illness’s “Above and Beyond” award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has worked alongside Gabe in mental health advocacy for over a decade. She lives in Columbus, Ohio, with her husband; enjoys international travel; and orders 12 pairs of shoes online, picks the best one, and sends the other 11 back.
Computer Generated Transcript for “Dysfunctional Childhood” EpisodeEditor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Lisa: You’re listening to Not Crazy, a Psych Central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts. Gabe: Hey, everyone, and welcome to this episode of the Not Crazy podcast, I’m your host Gabe Howard. And with me, as always, is the sparkling Lisa Kiner. Lisa: Thank you, Gabe. Hey, all, today’s quote is by C.S. Lewis, you can’t go back and change the beginning, but you can start where you are and change the ending. Gabe: But is that true? Lisa: Yeah, of course that’s true, it’s never too late until you’re dead. Gabe: That goes along with my quote, It’s never too late to have a happy childhood. Lisa: No, that’s not similar at all. Gabe: Are you sure? Because I think that memory is one of those weird things. The way that we remember things changes dramatically as additional information pops into our brain and now it should be no surprise that we’re going to be talking about Gabe’s childhood, specifically how toxic my parents were. Lisa: Ok, but, yes, your memories are constantly being re-evaluated by your brain, but the actual truth of what happened is not. If you had a video camera that wouldn’t change, you could just go back and watch the video. What actually happened is the same. It’s just how you interpret it or feel about it has changed. Gabe: But that’s a very esoteric concept and have you ever watched. Lisa: You don’t use the word esoteric correctly. No, it’s not an esoteric concept. You mean to say nebulous, Gabe: Fine, it’s a nebulous concept, I Lisa: Ok? Gabe: Think it’s esoteric, you think it’s nebulous, let’s call the whole thing off. The Lisa: No, the words have actual meaning. Gabe: Do they? Lisa: Yes, that is the purpose of words. Gabe: Do they? Lisa: Oh, for God’s sakes. Ok. Gabe: The point that I’m making is, is that the way that we see things change as additional information becomes available, for example, the whole world, literally, the whole world believes that there is a line in the movie Casablanca that says, play it again, Sam, that Lisa: Yeah. Gabe: Line doesn’t exist. And we all remember it. We all believe that it’s true. Now applying this to our own lives, I very much remember my childhood in a certain way, but it evolves as I put myself in the shoes of my parents. For example, when I was 15, my parents were idiot morons that were just trying to keep me from living my best life. And when I was 25, they were horrible abusers that were trying to kill me. And now that I’m 43, they’re boring and they just bicker a lot. But I’m remembering the same. Lisa: We need to go back to that twenty-five-year-old thing, oh, my God, really? Gabe: Well, I knew you at twenty-five, that’s. Lisa: And that convinced you that your parents had been trying to kill you? Gabe: Somebody had to be trying to kill me. It was either that. Lisa: What? Gabe: Or made up stuff. If it wasn’t them, who was it? Lisa: Whoa, whoa, whoa, whoa, whoa, back up. You thought your parents were trying to kill you when you were 25? Gabe: So. Lisa: Like, wait, wait, wait. Were they trying to kill you when you were 25? Or looking back on it, you thought to yourself, gee, they were trying to kill me 10 years ago? Gabe: I, probably all of it. Remember back then, I thought that demons were hiding under my bed, I was paranoid. I thought that something was trying to kill me and I very much blamed them for all of my problems because I had to blame somebody and my world was very small. In fairness, I also blamed my ex-wife, society and probably several celebrities. It was a hectic time. But remember, those who are closest to you take the brunt of the blame. It’s no surprise that when you and I got married, it transitioned over to you. Lisa: There is so much there. Gabe: There is. There’s an incredible amount there. Lisa: And all of this is coming up because we received an email with a question and the question is, Gabe, how old were you when your bipolar symptoms appeared and when were you diagnosed? Did you have a relationship with your immediate family members then? And how did they help or hurt your recovery? Gabe: Obviously, we’re going to discuss this a lot more because, you know, we need to fill a longer show, but the speed round answers were the symptoms were kind of always with me. Nobody just recognized them. Right? I thought about suicide as far back as I can remember. Like literally from birth. Yeah. It was just always part of me. I showed symptoms of bipolar disorder in my teen years. Yeah, it was always there. I was 25 when I was finally diagnosed and my relationship with my immediate family was strained when I was diagnosed, I. Lisa: Before the diagnosis or because of the diagnosis? Gabe: Oh, no, before. It was strained because of the Lisa: So at the time of diagnosis, your relationship was strained? Gabe: Yeah, it was strained, it was, it was problematic, I don’t want to say bad because we were still in touch. I consider bad like I haven’t talked to my mom for five years. Like, that’s bad or like extreme abuse. Like your family is stealing from you or, Lisa: Ok. Gabe: You know, I don’t know that. Lisa: So, it wasn’t as good as it is now. So, strained. Gabe: Oh, no, no, no, now, now it’s fine. Lisa: Now, do you think that was strained because of your behavior and your symptoms? Gabe: Oh, yes, yes, without a doubt, my behavior was very problematic, both in the way that I treated them and in the way that I perceived they treated me, that’s like the real bitch about bipolar disorder, right? It sort of warps what you see. And that’s very hard to get over. Even after treatment, it took years to reflect back and realize, oh, what a weird reason to be angry. Lisa: You say that you had symptoms of bipolar disorder in your teens. What types of symptoms are we talking about? Gabe: When I was diagnosed with bipolar disorder, my mother said to me, after she learned what bipolar disorder was, she said, oh my God, I always described you as my Dr. Jekyll and Mr. Hyde child. And I said, Mom, that’s literally what bipolar disorder is. How did you not think that something was wrong? And she was like, well, I just I thought it was hormones. I thought it was boys will be boys. I thought it was the teenage years. I. In my parents’ defense, I’m the oldest. This was their first teenager. They didn’t know what the hell was going on. And teenage boys are ridiculous. We’re. Watch any coming of age movie, and I don’t know that my behavior was all that atypical. If you get your mental health education from pop culture, they just thought that I just needed direction. Lisa: I’ve often thought that, especially about parents of teenagers, you know, like if you have a kid who’s crippled by anxiety. Well, the point of a parent is to say, no, no, no, you can do it. Go out there, try the thing. Well, at a certain point, they can’t. Your parents specifically, like you said, you’re the oldest. Teenagers are moody. You were moody. Teenagers are dramatic. You were dramatic. Gabe: See, here’s where I think it’s a good idea to talk about the hidden symptom of bipolar disorder, and I’m trying to be like, really dramatic, like dun dun dunn. See, everybody thinks of bipolar disorder as the two poles, right? Suicidal depression and God-like mania. And those are absolutely symptoms of bipolar disorder. But what people get wrong is that it’s a spectrum illness, meaning suicidal depression is the lowest you can hit and God-like mania is the highest that you can hit. But you’re going back and forth on this spectrum. That’s what gets me to my quote unquote, hidden symptom. It is reasonable and probable and likely and possible that through doing nothing, you will end up in the middle. You will end up quote unquote, normal, just fine. And in my teenage years, that’s when I would excel in my after-school activities. That’s when I would excel in school. That’s when I would be the charismatic, intelligent, charming Gabe that my parents were trying to raise. And when that middle ground fell in the vicinity of a punishment, we now know that that was just luck. That was just random. But at the time, my parents were like, well, Gabe acted up. We grounded him. And now look. Now look, he’s doing great. He joined a club. Look at all his friends. He’s mowing the lawn like we asked. That was just luck. I was just asymptomatic, but I wasn’t actually asymptomatic. I was just in the middle of that spectrum. Lisa: That is asymptomatic. Gabe: Well, sure, but this further drove home to my parents that what they were doing was working, but it was actually just the disease process randomly linking up in the vicinity of my parents’ discipline. Lisa: I’m confused. You keep calling it a hidden symptom, but that’s not a symptom, that’s a period of normality. You’re saying that at times you had a normal mood state because you were in between the two extremes. That’s actually the lack of symptoms. That’s not a hidden symptom. That is a period of normal mood state. That’s not a symptom. Gabe: I understand what you’re saying, and I don’t mean to be confusing, but the reason that I call it a hidden symptom is because it still has negative consequences. So, you’re describing it as being symptom free, but you’re still on the bipolar spectrum. It’s not like because I am asymptomatic, I am not having symptoms. Lisa: Yes, actually, that’s what the word asymptomatic means. Gabe: Ok, you’re right. Let me, let me, let me clarify further, I’m trying to spin an analogy, and it’s clearly not working well. Let’s take an example. So, I get suspended from school because I’m dancing in the front of the room and I’m being the class clown because that’s what mania looks like. Right? So, I get suspended from school. I come home, mom and dad sit me down and they say, OK, Gabe, OK, well, we have to curb this behavior. This is bad behavior. So, my parents ground me, they ground me. And for the three days that I’m suspended, I have to work in the garden. And then I go back to school a week later and suddenly I’m good, I’m perfect. I’m respectful to my parents. Everything is fine. In my parents’ mind, the punishment worked, grounding me worked. That is a reasonable thing to think. But in reality, had my parents done absolutely nothing, the next week when I went back to school, I wouldn’t have been manic. The disease process would have shifted and I would have been perfectly fine. Gabe: But they didn’t realize that. And here’s why that’s a problem, because the next time that I was the class clown, they thought, OK, no problem, we’ll ground him for a week and we’ll make him work in the garden. But that didn’t work the next time and that only gave them the option to be like, OK, we have to push harder. We have to ground him for two weeks and make him work in the neighbor’s garden. I don’t know. And they thought I was being obstinate. Lisa: What you’re saying is that your mood would cycle in and out of a period of normalcy, as is the way with bipolar disorder, but your parents would attribute it to something they did Gabe: Correct, yes. Lisa: Like he was acting all out of control. We grounded him. He stopped doing it. Therefore, the grounding worked. Therefore, next time he acts all out of control, we will ground him again. And if that doesn’t work, we’ll just escalate and escalate and escalate. Gabe: Right. Lisa: But in reality, this was just the ups and downs of bipolar disorder. It actually wasn’t related. Gabe: Yes, exactly, but there’s another little insidious piece there, and that’s what I really want people to focus on, my parents believed that I could do it. You’re asking why would they try to ground the symptoms of an illness out of their child? How sick is that? Could you imagine if I came home with a broken arm and they’re like, well, you’re grounded until your arm is not broken? We’d call Children’s Services. That’s sadistic. You grounded your son for having a broken arm? But remove broken arm and put in mania, depression, rage. That’s what they tried to do. They literally tried to punish the symptoms out of me. And you’re asking why on earth would they do that? Because it worked. At least they thought they saw it work. They knew that I could be good. They’ve seen it. It’s like an intermittent problem with their son. It’s like when you take the car to the mechanic. What’s that saying? Lisa: Oh, every time you take the car to the mechanic, the problem is gone. Gabe: Yeah, their son just happened to have an intermittent problem, so every time they took me to the mechanic, I ran fine. Lisa: Their thinking was that because there were times where you did behave normally, where you were asymptomatic, they thought, OK, clearly, he can control it. If he’s capable of doing it sometimes, he’s capable of doing it all the time. Gabe: Exactly, exactly. But here’s the thing that sucks. I thought that, too. I wanted to be a good kid. I think that’s important to understand. My parents pictured me as intentionally malicious, intentionally acting up. That’s what they saw. I was not trying to do that. Well, I thought that my parents were boring and, well, stupid. And I didn’t want their life in any way because of the aforementioned boring and stupid thing. I did respect my parents. They worked hard. They paid their bills. They were active in their community. And make no mistake, even in my angriest moments, if I got in trouble, I called them. There was never a time, never a time, that I got in trouble that I thought, well, I can’t call my parents. I always knew that I could call them. But yeah, yeah, I yeah, I don’t even know what to say. I just I. I felt. Lisa: I always knew I could count on them. Gabe: So to summarize, did I have a relationship with my immediate family members? Yes, but it was incredibly strained because of, well, all the things that we just talked about. Lisa: We’re talking about did you have a relationship with your immediate family at the time of diagnosis, that was when you were 25. You must have left home at 18 or 19. What happened in those intervening years? Gabe: I moved out when I was 18 and still in high school because I just had to get away from them, I just, I couldn’t stand them. Lisa: But you moved in with your grandparents, right? Gabe: Yeah, I could stand them, I like them. Lisa: It’s not like you moved out on your own, you just went to stay with other family. Gabe: Yeah, I was willing to go out on my own, I, I just. Lisa: But your parents thought that was a terrible idea. Gabe: This is where memories change, right? Here’s what 18-year-old Gabe thought happened. My parents were assholes. I can’t take them anymore. I’m not dealing with this shit. I’m out of here. Grandma saved me. Right? That’s what Gabe thought was happening. Here’s what actually happened. Gabe was ready to run away from home and do whatever it took to be away from them. And my parents called my grandparents and said, OK, we need to work together to make sure that he graduates high school and save him from himself because he’s getting ready to run face first into fire. And he’s too stupid to realize it. And they all work together for the next two years to make sure that I got a high school diploma, to make sure that I matured, to make sure that I made friends, that I was in mock trial, that I had something to fall back, that I learned computers. My parents still paid all my bills, even though, you know, under my breath, I called them assholes all the time and they knew that I call them assholes. They’re not stupid, but I ran away from them. That’s what actually happened. That’s a really big difference. So, it’s hard to be mad at them now that I see the full picture. But I was so mad at them when I left, Lisa. So mad. Lisa: But why were you so mad, what were they doing wrong? Gabe: They were punishing the symptoms of bipolar disorder. Lisa: But none of you knew that. You thought it was bad behavior and so did they. Why would you be angry about that? Gabe: Because I just felt so strongly that I was trying and that they didn’t recognize it. I don’t think my parents realized how desperate I was to make them happy. Who wants to be a bad kid? I did want my parents’ respect. Hell, I still want my parents’ respect. I never thought my parents were bad people. I thought they were boring. I’m not trying to rewrite history to where I suddenly thought might, no. I thought my, hell, I still think they’re boring. If I have to hear about one more episode of Ice Road Truckers, I may scream, but who cares? Lisa: Your father has regaled me with many stories of the cinematic masterpiece that is Ice Road Truckers. Yeah. Gabe: Oh, that’s awesome. Lisa: It never gets more interesting. Never. But your parents weren’t completely oblivious that there was more than normal teenage angst going on here, because they did take you to a psychologist. Gabe: That’s true. Lisa: This would have been in the early 90s, the idea of how you treated children and mental illness in children was just completely different. It would have been extremely unusual to take your kid to a child psychologist. Gabe: You’re right, in the early 90s, it was completely unusual to take your kid to any sort of therapy. But wait, there’s more. My father is a truck driver. He’s blue collar. He believes that all problems can be resolved by rubbing mud on it. And he took his child to a child psychologist. In the early 90s there were white collar professionals with MBAs that wouldn’t take their kids to child psychologists. My parents were actually just so ahead of the curve. My parents admitted that they weren’t able to handle this and took me to a therapist. We got family counseling. Are you kidding me? There are families that struggle with that in 2020. They were progressive. Lisa: Well, it couldn’t have been easy, there weren’t very many child psychologists running around, it was probably quite a lot of effort to even find someone. Gabe: I have no idea how they found my child psychologist, but yes, we went to family counseling. Lisa: What made them decide to do this, what was the breaking point? Gabe: I honestly don’t know what the breaking point was, but, yeah, like what a question that would be, you know what I mean? I’m. Lisa: We should call your mother and ask. That might be the next episode. Gabe: Maybe I don’t want the answer. Lisa: Well, I want the answer. Gabe: It just when it comes to like rewriting history or retconning, as the kids like to say today. My parents did not fit the mold of people that utilized psychological services, therapy, child psychologists, we were very stereotypically blue collar. My father drives the 18-wheeler semi, honks the horn for kids. He says things like, we’re going back to the house. He couldn’t be more of a stereotype if they tried. My mom, a housewife with a part time job when the kids got older. I mean, it’s like Americana. You just want to vomit. It’s so stereotypical. We eat dinner together as a family, just like. Lisa: It’s Leave it to Beaver without the white-collar income. Gabe: Yeah, basically, how on earth did these people be so progressive that they admitted that they needed help with their kid? Like, is that how messed up I was that I was able to break that mold? Like, that’s messed up, right? Lisa: Was your dad gone for long periods of time as a truck driver? Gabe: No, no, no. Not long periods of time, he left one day and came back the next day. So, he would be gone like every other night. Lisa: So, he was gone every other night, he was absent from home quite a bit. Gabe: Yeah, yeah, three nights a week he was not home. He had a very varying schedule, especially when I was younger and he was newer. Lisa: Yeah, not high up in the union yet. Meaning that it was even more of a burden for him to go to the therapy appointment. Gabe: Yeah, yes. Lisa: Because it’s not like he could just send you with your mom, you all had to go. Gabe: Huh, you’re kind of blowing my mind because I didn’t even think of that. Lisa: Well, yeah, it couldn’t have been easy to schedule around him. Gabe: I. Do you want me to give them a medal? I just look, when I was diagnosed at 25, I was positive that they screwed me up. Lisa: Because you thought that bipolar disorder was the fault of poor parenting? Gabe: Yes, I also thought that I could have been violent at any moment and that I was going to die and that I needed to live in a group home, remember. . . Lisa: So we’re doing myths of bipolar here. Gabe: But they weren’t myths at the time, but. Lisa: Well, they were always myths you just didn’t know that. Gabe: Ok, yes, yes, but perception becomes reality. Lisa: Right. Gabe: When I was in the psychiatric hospital, I was locked behind the doors. I was staring at a doctor. They diagnosed with bipolar disorder. And all I could think of was, thank God I didn’t kill my family and I need to live in a group home and I’m going to die soon because everybody with bipolar disorder was violent, lived in a group home and eventually killed themselves. That’s all I understood. And then, of course, I learned more and more and more and my memories changed. Things shifted. Lisa: Gabe, you’re skipping back and forth a lot, it’s kind of confusing. Gabe: What do you need clarified? This is just my life, it’s all jumbled in my brain as Lisa: Well, let’s go back to the part where your parents are taking you to the child psychologist, so clearly, they’ve discovered something is wrong. This is more than just being a normal teenager. We can’t handle this. We need to reach outside for professional help. What happened? Did it work? Gabe: I don’t know. Lisa: Did you get better? Gabe: I don’t know. Lisa: Didn’t you go there for, like, years? I mean, it’s not like they took you once and stopped. Gabe: I honestly don’t know if it helped me understand them, but in some ways, I think that it helped my parents understand me. My family believes in paddling. My dad had a paddle, it had a handle and he whacked me on the butt with it. And I was terrified of this thing and it was demeaning and degrading. And plus, it’s violence. I see it very much as violence. And I, I said all of the things that I just said in the therapist’s office, and he said, you know, Gabe’s really old. Why are you still threatening him with violence? And my dad’s like, well, it’s just paddling. And he’s like, well, but, but it’s violence. You’re saying that the way to work out problems, if you don’t like how your son is behaving, is not to talk to him, but to threaten him with violence. And this made my parents get rid of not only the actual paddle, but the threats of it. And it forced them, whenever there was behavior that they didn’t like, to discuss it with me. There’s this little piece of me that still pissed off that I had to endure this shit for 13, 14 years. But my brother and sister, who are younger, it disappeared immediately for them, too. So, you’re welcome. Lisa: Hang on, we’ll be right back after these messages. Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Gabe: And we’re back, talking about my teenage years. Lisa: Your parents had a specific way of disciplining their kids that they probably learned from their own parents and this is what they did because this is what they knew. But what you’re saying is that as soon as someone else, a professional, a child psychologist, said to them, yeah, that’s a terrible idea, don’t do that, they stopped immediately. They didn’t argue. They didn’t try to equivocate. They were like, huh? All right. Well, now that we have better information, we’re going to not do that anymore. Gabe: I don’t think that it had ever occurred to them how it looked from my perspective, because from my perspective, what you were saying is I’m not interested in your ridiculous little opinion. Do as I say. Do as I say. And the therapist was able to point out, your son is a few years from being out in the world and he’s not going to be able to threaten people with violence when he doesn’t get his way. And if he is unable to articulate his needs, wants, desires and unable to argue with people, then you are stunting his development. I don’t think my parents realized that. I think they were taking the path of least resistance. We told you to do it. You said no, we’re going to threaten to whack you on the ass and now problem solved. But it never occurred to my parents that this debate had value. They only saw the debate as disrespect. And the therapist was able to say, look, discussing something with your children is not back talking and it’s not them being disrespectful. It’s them learning to use their voice and articulate their wants and needs. I think that was a big game changer for my dad. Again, I’m sure that their experiences are going to be much different from mine. But I really felt like in those sessions was the first time that my parents actually heard me, heard my words, rather than just saw it as a behavioral problem, that I had the audacity to question them. Lisa: You’ve told me in the past that your parents’ style of parenting changed dramatically once they took you to a child psychologist Gabe: Yeah, yes. Lisa: In part because the psychologist gave them all sorts of new advice and, frankly, told them that a lot of what they were doing was either wrong or at least not working. That they started taking parenting classes, that they just made these huge changes in how they treated you and your siblings once they had this information. Gabe: One of the things that my parents learned, and it’s really one of the only examples that I have that my mom told me when I was an actual teenager because she told everybody that she could find. It was don’t trick your kids, the don’t set your kids up to fail concept. And the example that she always used is if you know that your child didn’t go to Molly’s house, even though they said to go to Molly’s house, when they come home, don’t say where have you been and set them up to lie. When they come home, say, I know you didn’t go to Molly’s house, get it right out of the way, and that this setting up your children to lie is just exacerbating the problem. Your kids are going to mess up. They’ve already messed up. You’ve already got a problem. Just address the problem that you have. Don’t create new ones. This made a profound impact on my mother. So much so that she just told everybody that she could find. And again, I learned that when I was a teenager, that’s how big of a deal it made to her, that she talked about it openly in front of her kid. Lisa: Because most of the things that changed for them, they did not discuss with you until many, many years later when you were an adult. There was a lot going on behind the scenes that you didn’t know about. Gabe: Yes, one of the things that I learned as an adult is that my parents actually asked the therapist if they were bad parents. I was not in the room, obviously. It was, for those who have not been to family counseling, they talk to the child alone. They talk to the parents alone. Then they talk to you all together. And one of the things that my parents just flat out asked is, are we bad parents? And do you know what kind of humility? Lisa: Yeah, that must have been difficult for them. Gabe: It takes to be able to sit in a room with a doctor or a therapist and ask honestly, are we bad parents? And then sit quietly and wait for the answer? If you would have asked me at 15 if my parents had any doubt that they were awesome, I would have been like, no, they’re awful. They don’t give a shit. But they actually had this self-doubt, this care and concern. I did not know at the time that they were capable of that because after all, I just saw them as this overarching force that got to make all the rules and had all the power. When in actuality they were struggling. Lisa: And they did not let you know how much they were struggling and how much they changed in response to this, Gabe: Yeah, yeah, I had no idea. Lisa: When you’ve talked to me about this in the past, you’ve always described things as getting a lot a lot better after you started going to family therapy. But of course, things certainly were not perfect and it didn’t really work in that you continued to struggle. You continued to be extremely symptomatic and got in all sorts of trouble, dropped out of high school, just on and on and on. Does that mean it didn’t work or does that mean that just, hey, you were still bipolar? Gabe: This is where my dad is very angry, my dad believes very strongly that the child psychologist should have realized that I had bipolar disorder and diagnosed me with it and got me help before I really got into a lot of trouble. We have spent a lot of time, my family and I, my father and I, debating and discussing this point. For what it’s worth, I understand why my dad wishes that I would have gotten help sooner. He’s not wrong. And I understand his frustration because he’s like, look, I did everything I could. Lisa: Right, what more was I supposed to do? Gabe: Right, but 15-year olds just weren’t diagnosed with bipolar disorder back then, they’re not really diagnosed with bipolar disorder now. I don’t blame the child psychologist for not diagnosing me. I’ve thought about this a lot. I’ve gone back and forth a lot. And I am 100% confident that diagnosing me with the information that he had with what he heard from my parents and what he saw would have been wholly irresponsible and would lead to way more false positives than it would actual positives. So, I want to say that very, very clearly. But yeah, my dad is still frankly, he’s pissed about it. It comes up pretty much once a holiday. Lisa: Well, but again, that just isn’t how it was done at the time. Gabe: Yes. But to your question, yes, things got a lot better. But of course, the underlying issue of bipolar disorder was not actually resolved. The grandiose thinking, the demons under the bed, the anger, the mania, the depression. My parents started doing things better and having more patience and more understanding and moving forward in a much healthier way. But ultimately, if you don’t rectify the core problem, you’re sort of handcuffed on how much better you can do. Lisa: So things got better, but obviously were not fixed or completely cured because certainly your parents’ behavior towards you might have made things worse, but you weren’t behaving like this because of their parenting, you were behaving like this because you were bipolar. Gabe: Yeah, I was still an untreated bipolar. That’s probably an oversimplification, but it’s more correct than it’s incorrect. Lisa: But at the time, you were very angry with your parents and thought that they were doing a terrible job, and you continued to think that for a long, long time, right? When did that stop? Gabe: When I reached recovery with bipolar disorder, I started to see life very differently and I started to see the world very differently. And when I was on my second divorce, Lisa, which was ours, the world looked really differently, too. Like it was it was much more difficult to be an egotistical, arrogant person facing my second divorce and facing rebuilding my life from the bipolar diagnosis. And I had messed up so many things that some of the arrogance of, oh, I’m better than you went away. I realized that a lot of what happened to my parents wasn’t an example of them being idiots. It was an example of circumstance and them being idiots. I, I. Lisa: There were mitigating circumstances. Gabe: I did not see any of those mitigating circumstances when I was a kid. Some of the things that really gave me a great amount of pause was spending more time with young children. You know, young children are difficult. I’m going to go with difficult. I started mentoring a teenager. And the stuff that would come out of his mouth in the four or five hours that we would spend together were frankly, just like, what is wrong with you? What are you? What? And then I would reflect back on me doing the exact same thing to my parents. And then the more I understood about my illness and it occurred to me once I reached recovery that my perspective was skewed by symptomology, my perspective was skewed by bipolar disorder. The way that I was remembering the story is incorrect. I would always say me and my dad got in an argument, but in reality, that’s not what happened. What happened was, is my dad got in an argument with a person with untreated bipolar disorder experiencing grandiose thinking, bipolar rage, who was actively delusional. That’s a very different memory. And what, of course, was even worse is that neither one of us knew. I thought that I was perfectly fine and had 100% complete control of my faculties. And my dad thought that he was in an argument with his teenage son who was being a brat. The situation that we thought that it was was not the situation that it actually was. That changes things, changes things dramatically. Lisa: In the spirit of the original question, though, that’s how you felt once you were in recovery or that’s how you feel now. How did you feel at the time you were diagnosed? Gabe: That they did it, it was their fault. Lisa: Ok, so you had a lot of anger still Gabe: Yes, Lisa: By the time you were diagnosed Gabe: Yes. Lisa: And it was this process of reaching recovery that helped you get rid of a lot of that. Gabe: And here’s the sick part, right? I was so angry at them. I was so angry at them for letting me languish and not getting me help, they’re my parents. It’s their job. But I called them five times a day from the hospital. Lisa: Yeah. Gabe: I still wanted my mommy. That’s all I can say. I, it was both my mother’s fault and I wanted her so desperately. And my parents, as you know, they came later after I got out of the hospital and they helped me move. There was a lot going on in my life, etc. And they like swooped in and solved all of these problems for me while I largely sat in the corner crying. And I was still pissed at them as I was watching them carry my stuff. Lisa: As they were fixing your life, you were still angry. Gabe: Yeah, because they messed me up. Lisa: And at this point you were an adult with your own home, etc. Gabe: I was twenty-five. Yeah, I was going through my first divorce. Isn’t it great that we can, you know, chop up Gabe’s life into wives? Lisa: Yeah, yeah. Gabe: Like those were during the Megan years. Those were during the Lisa years. Now we’re in the Kendall years. Lisa: But those are the years that will never end. Gabe: I know. I mean, I know. Lisa: So, your parents at the time you were diagnosed, they’re falling over themselves to help you, you needed a lot of help because you were a wreck, but you were still extremely angry and your relationship was difficult. Gabe: It was, but there was. There was some moments and I didn’t realize how amazing they were at the time. Lisa: Even adult children are selfish when it comes to their parents. You just feel like they kind of owe you. Gabe: I was a jackass, I was moving out of the house, it was the house that my first wife and I lived in and I was moving into an apartment. That has a whole long back story. But let’s just describe it as a shithole. Lisa: It wasn’t that bad. Gabe: It was pretty bad, especially moving out of a real nice house. Lisa: It was a nice house, Gabe: Come on. Lisa: It was a very nice house. Gabe: And they had got me all moved in and I was at the corner of the apartment building just kind of trying to stand out of the way and hide. Lisa: As they did all the manual labor. Gabe: As they did all the manual labor, while I did nothing. I should probably point out, you know, at this point, my dad is like 60, and my grandfather, who was like 70 at the time. Lisa: So the healthy 25-year-old stands off to the side so that he can watch his elderly relatives assist him with manual labor. Gabe: I think they would both object to being called elderly, but, yes, that is that is correct. But there’s, there’s moments in this mess. One, nobody ever yelled at me for this. They just did it. So, I just want to put you in the mindset of my father, who has literally worked all day on this stuff. And I’m standing at the corner of the apartment building because I you know, I don’t want them to see me cry or be upset. I don’t even know why I was hiding. And my dad comes over and asked me if I’m OK. And I’m like, you know, yeah, I’m fine. And, you know, he’s kind of standing there. It’s kind of awkward. And I said, you know, I don’t, I don’t like it here. It’s not nice. And my dad looks at me and he said, Well, but this is just a footnote in your story. It’s not the end. You’ll be out of here before you know it. And then he just walked away. Lisa: He’s just dropping wisdom and then leaves you in the dust. Gabe: Yeah, like, literally, and I just, he, it was kind of a powerful moment because all I could think of was this is where I’m stuck. This is where I’m stuck. And my dad’s point was, no, this is just where you are. That’s a big difference. I do remember little things like this, but I didn’t know them at the time. I don’t want anybody to think that my life got dramatically better after my father said that or I didn’t spend the next, you know, four years fighting mental illness and I didn’t suffer a great deal. Or I still thought, you know, my parents are idiots, and they did this to me on and off. And we still struggled and had problems. But looking back now, they knew damn well I was pissed at them. They knew damn well that their son was an idiot. They knew and they were scared of bipolar disorder because it’s a terrifying illness. They didn’t know what to do and they had to drive 700 miles with old people to carry my shit. And yet here they are. Here they are. And I didn’t carry anything. I carried nothing. Lisa: Well, also, they both had responsibilities at home, they both still had jobs, your mother was caring for grandchildren and they dropped everything and drove to another state Gabe: They did. Lisa: To try to rescue you. Gabe: I mean, when you say it that way. Lisa: Yeah, well, to be fair, I did not see it that way at the time either. At that point, every story you’d ever told about your childhood was more horrifying than the last. Gabe: Yeah. Lisa: It was just constant horrifying. You told me this horrible story about how your mother actually knocked you unconscious once. Gabe: Ah, the softball story. Lisa: The way I heard this story is, Gabe was a teenager and was being difficult, as teenagers are wont to do, when his mother couldn’t take it anymore and threw a softball at his face, knocking him unconscious. And then you’re like, oh, Lisa, meet my mom. What? Oh, this will be great. Gabe: You know what a fish story is. Lisa: Ok, fair, fair. Gabe: A fish story, of course, is true in that the person was fishing and the person did catch a fish, but the six-inch fish becomes a two-foot-long fish. The story is true. My mother did, in fact, throw a softball. And it did hit me and it knocked me down. Don’t I didn’t lose consciousness. I don’t and I don’t remember saying that, to be honest. I think that might have been inferred. But it doesn’t matter. Lisa: You told me that you got fuzzy and that you had a terrible headache for the next couple of days, and I thought to myself, well, that’s a concussion. Gabe: That’s, that could be true. But the devil’s in the details, right? Let’s get a little more of the scene. At this point, I would have been almost 17 years old. I weighed 400 pounds. I was six foot three. And I was screaming at my mother. I was just screaming at her, yelling every word that I could think of because, frankly, I was enraged. Now, remember, not only am I twice as big as my mother, a foot taller, I am also an untreated bipolar who is clearly symptomatic. And upon the yelling back and forth, my mother picked up a softball and threw it over my head. I want to be clear. I knew she threw it over my head at the time because I didn’t even duck. Lisa: So she wasn’t throwing it at you. Gabe: No, she wasn’t throwing it at me at all, of course not, but it hit the wall behind me and bounced off and hit me in the back of the head and it knocked me over. And at that point, I became even angrier and just left. I just got in the car and drove off. Lisa: What did your mom do? Gabe: I don’t remember. I don’t think she did anything at that point. Obviously, when you tell the story, hey, mom and son got in an argument. Mom lost her temper, threw softball. Yeah, my mom comes off really bad in that story. And I come off looking like the innocent child. When you tell the story, giant enraged man screams at woman. Woman defends herself by throwing softball above head that happens to make contact. Well, that starts to move the needle a little bit on culpability. I’m not defending my mother. She never should have thrown the softball. She doesn’t think she should have thrown the softball. Nobody thinks that she should have thrown the softball. What my mother should have done was walk away. And we know that now. But it’s a little bit unfair to hold my mom 100% accountable for the aftermath of dealing with somebody with untreated bipolar disorder. It’s a chaotic scene. Again, do not throw anything at your mentally ill loved ones. My mother was 100% wrong. Lisa: Or any of your loved ones. Gabe: Yeah, that’s, that’s a good point. Lisa. Lisa: Wow. Gabe: I am not advocating for throwing softballs at your children, but I am saying that. Lisa: Or anyone outside the context of a softball game. I can’t believe I need to clarify this for you. Gabe: Also, good advice. Can I make my point now? Lisa: I just, whoa. Gabe: Yes, this was obviously not my family’s finest moment, it was not my mother’s finest moment. But when you start to dig into the details a little bit, it’s a little more tragic from my mother’s perspective than I realized. I don’t know what she was thinking. I don’t know why she did it. I don’t know why she lost her temper. I don’t know what was going through her head. It’s really easy to Monday morning quarterback now and say that that was a mistake, but Lisa: Well, it was a mistake, Gabe: It was. Lisa: It’s just. Gabe: But in the moment, hell, maybe that was her only move. It did, in fact, end the issue. I left. So, who knows? Maybe if she hadn’t thrown that thing. I can’t even speculate. I’m just. You know, sometimes things just happen that don’t turn out the best. And it’s not because your parents are bad. It’s because of a momentary lapse of reason or a mistake. I mean, Lisa, you got in a car accident. You don’t consider yourself a driver that needs to turn in your license or you would not drive for fear of killing yourself or others. Lisa: I had heard this story about your mother. I heard it before I met her, and it definitely shaped my impression of your mother for a very long time. And it does not leave a positive impression of your mother. And it actually wasn’t until we were discussing this show last night and you started giving all of these other details, all of this further information, that I started thinking, huh, maybe that isn’t quite the situation I had initially thought, especially as you started saying, look, she was dealing with an untreated bipolar who was much bigger than her in a full on rage. Do you think she was scared? I mean, was she physically scared of you? Was she afraid that you would become violent? Gabe: No, I don’t think so. I don’t think my mom thought that way at all. I do think that there was an element of her losing her temper. I think there was an element of her wanting to shake things up. I think there was an element of her wanting to break my thought pattern. You know, I was, I was just in this cycle. You’ve argued with me when I’ve been in this, it’s everything leads back to the same thing. No matter what you say, it’s Lisa: You get on a loop and you can’t break out of it. Gabe: And she broke that loop by throwing the softball. Lisa: So you’re thinking that she just got so desperate and also who knows how long this had been going on? Gabe: Yeah. Lisa: That she just thought, oh, God, we got to do something here? Gabe: And of course, in the moment, I was extraordinarily symptomatic, I was enraged. I was a person with untreated bipolar disorder. So, you’re asking me what happened? But the only memories that I have are heavily influenced by untreated bipolar disorder. So, you know, there’s got to be so much more that we are not taking into account here. But you’re right. When I was angry at my mother, I spun the story. Lisa: But you didn’t realize you were doing it. Gabe: I didn’t. I spun the story even for myself so that I could maintain my anger at my mother. Lisa: There were a lot of extenuating circumstances to the problems you had when you were a teenager and looking back on it now, especially from a position of recovery, you’re willing to give your parents a lot more slack than you were when you were a teenager or even when you were diagnosed. Gabe: A watershed moment for me, Lisa, was when I was in a support group and I started complaining about my parents and a couple of the people in the support group started talking about theirs. Their families had abandoned them, like literally one woman talked about how she hadn’t talked to her father in a decade and her mother was not allowed to talk to her, but opened up a private email account so that they could email a little bit. But her mother made it perfectly clear that your father is not on board with this and I will never meet you in public and I will not provide any help for you in any way. And other people talked about just horrific abandonment and name calling and. Lisa: And abuse. Gabe: Yeah, and I’m sitting there thinking, oh, I’m mad at my parents because they didn’t move me into my new place fast enough and of course, my parents made a ton of mistakes. And I want everybody to listening to this to know, ton of mistakes. I could write a book on all the mistakes that my parents made. But you know how you make mistakes. You’re there. You’ve got to be there. These other people, their parents made one mistake. They abandoned their kids. That’s it. That’s all they had. They abandoned their kids. Whereas my parents, they just kept trying shit. And the stuff that they tried was awful because they didn’t have, you know, guidance or understanding. And they thought that the myths of mental illness were real and on and on and on and on and on and on and on. But you have to be there in order to screw up. It never even occurred to me that my parents would leave. I like, I didn’t know that was possible, Lisa. I just, I did not know it was possible. I just. And you know what’s messed up about that? My biological father abandoned me when I was a baby, and it still didn’t occur to me that my mom and dad could abandon me. Like, what’s up with that? Lisa: If you haven’t listened to other episodes or know Gabe’s back story, your mother got pregnant with you in high school, she and your biological father had a shotgun wedding, Gabe: Yeah, Lisa: And within a year Gabe: Yeah. Lisa: Of your birth, he’d taken off never to be heard from again. Gabe: Yeah. Lisa: And eventually she met and married your father Gabe: Who adopted me, Lisa: Who adopted you. Gabe: She met and married another man who adopted me as his own and is the only person I’ve ever known as Dad. But he is not my biological father, he’s just the man who raised me as if I were his own, which is hilarious because I’m six foot three, giant and have bright red hair and he’s like five foot three, tiny and has black hair. So, yeah, anybody that thinks that he’s my biological father is a moron. Lisa: Your dad has some fun with that, too, Gabe: He does. Lisa: Because people will ask you all the time, where did you get that red hair? And he’ll go, Oh, he got it from his dad. Gabe: My dad’s a dick. Lisa: He just stares at them. Like, what? Gabe: It is funny, it is funny to think about, but but yeah, it didn’t occur to me that people could lose their parents. I just, I thought that I was abandoning my parents because they were bad and I was punishing them. But I always knew that as soon as I forgave them, they’d come back. Like, you recognize that I keep saying that my parents did all of these things so horribly wrong, but the foundation that they built was that I knew that I could count on them 100%. Lisa: To come and do the wrong things. Gabe: Well, right, yes, yes, Lisa: Right. Gabe: I would judge them implicitly. This is why mental illness is so messed up. My parents are good people. I want to be very, very clear. But they believed all of the myths of mental illness. That really is the take away here. They believed the pop culture representation of mental illness. Mentally ill people aren’t smart. Mentally ill people don’t own houses. Mentally ill people don’t get married. Mentally ill people have bad parents, specifically bad mothers. It was a moral value. And why wouldn’t they? That’s all they were taught. That’s what they were taught growing up in their lives. That’s what I believed. That’s what pop culture, television shows, movies, that’s what it all showed. Mentally ill people were in a corner, rocking back and forth, drooling and violent and came from broken homes. I’m not mad at them anymore for not realizing that I was sick because society kind of set them up to fail in this way. It’s one of the reasons I became an advocate because I thought, you know, my parents love me. They desperately tried to do the right thing at every single turn and they missed this glaring thing. Lisa: Well, everybody missed it, including the professionals they took you to. Gabe: Right, I want to talk to all of the people with mental health issues and mental illnesses who are mad at their families. Listen, I don’t know your families. There’s certainly toxic families. There are certain families that have done unforgivable things and on and on and on. I’m not pretending that every single family is my family. That is complete and utter nonsense. But I am saying that I realized along the way that my family was in the same impossible situation that I was in. So, it’s, I want people to forgive me for the things that I did when I was symptomatic. Why would I not forgive the people around me for the things that they did while I was symptomatic? I should be extending the same forgiveness to them that I want society and my family to extend to me. And I think that’s a very powerful message. Your circumstances pending. But then there’s sort of a shit or get off the pot mentality here. Look, you got to decide. If you’re not going to forgive your family, then cut them off and never talk to them again. Call it a day. Just, just don’t torture yourself. And if you want your family in your life, constantly reminding them of all the mistakes that they made five, 10, 15, 20 years ago is not the way to build a positive relationship moving forward. And that all ties back to your perfect quote, Lisa. Lisa: You can’t go back and change the beginning, but you can start where you are and change the ending? Gabe: Exactly, so with your family, you can’t go back and change the beginning, you can’t fix all of the things that your parents, brothers and sisters, aunts, uncles, grandparents have done. But if you make the decision right now to forgive them, radical acceptance, radical forgiveness, you can change the end. The reality is, is that my parents messed up. That’s fine. I messed up. That’s fine. I’d much rather talk about what we’re doing this Christmas than worry about what they did 20 Christmases ago. Lisa: Well, and speaking of apologies or messing up, your parents have apologized to you. Gabe: Oh, yeah, yeah, yeah, on video. Lisa: Yeah, good point, your father especially was like, well, yeah, we just tried to punish the symptoms of bipolar disorder out of him and he feels very badly about that now, even though he couldn’t possibly have known. Gabe: Yeah, and we did not get there overnight, my family and I didn’t have some Hallmark movie moment where music played and it started to snow and we all hugged each other and the camera panned away, showing the half a million-dollar house that we can afford on the kindergarten teacher’s salary. No, it didn’t work that way. We just started building new memories and that’s what we did. And as we started building new memories, the older memories sort of either faded away or became more in focus. Lisa: But, Gabe, you do have happy memories from childhood. Gabe: Aat the time that I first met you, Lisa, the answer to that question would have been no. I would have said no. I have no happy memories of childhood. But now, yes, because once I started looking at the entire picture, I realized that my parents can both have made a lot of mistakes and have done a lot of things right. I was very much in black and white thinking. Either my parents have to be all good or my parents have to be all bad. And at the time I met you all bad, all bad, 100% bad. They sucked. Lisa: Yeah, it made it difficult. You have a much better relationship with your family and your parents now than you ever did when we were together, and it’s made a big difference for you. It’s brought you a lot of happiness. Gabe: True that. Lisa: And here you are changing the ending. Gabe: Hey, next week, we should do you and your family. Lisa: Oh, I would like that. I have a lot to say, and they’ll love it, too. So everybody wins. Gabe: Yay! Thank you, everybody, for listening to this episode of the Not Crazy podcast. My name is Gabe Howard and I wrote the book, Mental Illness Is an Asshole, available on Amazon. But if you head over to gabehoward.com and buy the book there, not only will I sign it, but we’ll send you a bunch of Not Crazy podcast stickers. And that’s really awesome. You can put them on your car, your laptop, give them to your friends. And remember, wherever you downloaded this podcast, please subscribe. Also, use your words and rate it. Write a review, give us as many stars as possible and tell all your friends. Lisa: Don’t forget the outtake after the credits and we’ll be back next Tuesday. Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person? Not Crazy travels well. Have us record an episode live at your next event. E-mail [email protected] for details.
The post Understanding a Dysfunctional Childhood first appeared on World of Psychology. from https://ift.tt/3lGPa0e Check out https://daniejadkins.wordpress.com/ In today’s show, Gabe talks with Robert Kolker, author of the New York Times bestselling — and Oprah’s book club pick — book Hidden Valley Road. This non-fiction biography is the true story of a mid-century American family besieged by schizophrenia. Of their 12 children, 6 struggled with the severe mental disorder. Join us for the incredible story of the family who became science’s greatest hope in the quest to understand schizophrenia.
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Guest information for ‘Robert Kolker- Large Family Schizophrenia’ Podcast Episode
Robert Kolker is the author of Hidden Valley Road (2020), an instant #1 New York Times best-seller and Oprah’s Book Club selection; and Lost Girls (2013), also a New York Times best-seller and Times Notable Book, as well as one of Publisher’s Weekly’s Top Ten Books of the year and Slate’s best non-fiction books of the last 25 years. He is a National Magazine Award finalist whose journalism has appeared in New York magazine, Bloomberg Businessweek, Wired, and The New York Times Magazine.
About The Psych Central Podcast Host Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from the author. To learn more about Gabe, please visit his website, gabehoward.com. Computer Generated Transcript for ‘Robert Kolker- Large Family Schizophrenia’ EpisodeEditor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: You’re listening to the Psych Central Podcast, where guest experts in the field of psychology and mental health share thought-provoking information using plain, everyday language. Here’s your host, Gabe Howard. Gabe Howard: Hello, everyone, and welcome to this week’s episode of The Psych Central Podcast, I’m your host Gabe Howard, and calling into our show today, we have Robert Kolker. Robert is the author of Hidden Valley Road, which was an instant number one New York Times best seller and Oprah’s Book Club selection. He is a National Magazine Awards finalist whose journalism has appeared in Wired and The New York Times Magazine. Bob, welcome to the show. Robert Kolker: Hi, Gabe, I’m really glad to talk to you today. Gabe Howard: Your book is nonfiction. It’s a true story. I’m going to read from Amazon right now the description, the heart rendering story of a mid-century American family with 12 children, six of them diagnosed with schizophrenia, that became science’s greatest hope in the quest to understand the disease. Let’s talk first about how you did the research for this book. You met the Galvin family. Robert Kolker: That’s right, my career really took shape at New York magazine, where I’ve written dozens of cover stories and feature stories about everyday people going through extraordinary situations. I really am drawn to the stories of people who manage crises and come through difficulties. I find it inspiring and I’m always looking for a deeper issue running at the bottom of it. And so when I met the Galvin family, I was amazed. This is a family that’s been through so much, so much misfortune and also so many challenges and so much scientific mystery. Medical mystery. I first met the two sisters they’re the youngest in the family. There were 12 children. They’re the only girls and they now are in their 50s. But when they were children, six of their 10 brothers had been diagnosed with schizophrenia. The family immediately became interesting to scientists and researchers who were trying to get to the genetic roots of the disease. But before that happened, there was a tremendous amount of denial, a lot of stigma that forced the family into the shadows. And so it became clear that by telling their story, maybe we could inspire the general public to sort of remove some of that stigma from mental illness, particularly acute mental illness like schizophrenia, which so many people still have difficulty talking about. Gabe Howard: And to anchor this in time, they were diagnosed in the 70s, this was I’m horribly bad at math, but they were diagnosed 50 years ago, so there was even more stigma, more discrimination, less understanding. It was harder to get diagnosed. Robert Kolker: Absolutely, and also more of a reason to hide, because so many people in the establishment were blaming the families themselves for the mental illness, blaming bad parenting, in particular, blaming bad mothering. And then, of course, the medical treatments, the pharmaceutical treatments were blunter and more extreme back then. And they were just coming out of the period of lobotomies and shock therapy, the insulin coma therapies, all sorts of drastic treatments which are now so questionable. Gabe Howard: Now, the parents are Don and Mimi Galvin, they’re mom and dad, did mom and dad have schizophrenia or any mental illness or was it just their children? Robert Kolker: They did not have schizophrenia and neither did anyone in their immediate families, and I think part of the mystery of this book is how does schizophrenia get inherited? Because we now are certain that there is a genetic component to schizophrenia, but we don’t know exactly how it is inherited. It’s not parent to child. It’s not recessive. It’s not like you need two people with schizophrenia to produce a child with schizophrenia. It kind of wanders and meanders through families in a very tricky way. And there was a lot of hope pinned on this family that they would help shed a little light on that mystery as well. Gabe Howard: What were some of the most surprising things that you learned about mental illness and what really schizophrenia from your time interviewing the Galvin’s? Robert Kolker: I was surprised by almost everything, but my biggest surprises were that my understanding of mental illness was that it was about brain chemistry and that great pharmaceutical drugs were coming online, that through trial and error and a lot of work perhaps would be able to correct your brain chemistry problem. And then whatever you had, whether it was anxiety or depression or even bipolar disorder, that it would be corrected and that you would become essentially cured, although cured is really the wrong kind of word for it. Gabe Howard: Being in like remission or recovery. Robert Kolker: Right, what I learned was that schizophrenia, this isn’t really true at all, that the drugs that they have, the antipsychotic drugs that are very popular, that are prescribed so much for schizophrenia, they are basically the same drugs that have been prescribed for 50 years. They may have different names, but they derive from the same classifications of typical neuroleptics or atypical neuroleptics, and that these drugs are essentially symptom suppressors. They might help a person control their hallucinations or delusions, or it might make a patient less erratic and more manageable as a patient in a health care setting. But it doesn’t turn back the clock. It doesn’t necessarily add the functionality. They really are just sort of good enough in terms of controlling the population, but not really the miracles that we look at when we talk about antidepressants, for instance. And that was a huge surprise. Gabe Howard: It sounds like that you didn’t know a lot about schizophrenia before you started working on this book, is that true? Robert Kolker: That’s right. I mean, I knew enough to know that it didn’t mean split personality and multiple personality, which is like the big misnomer that because of the way we use the word schizo, there’s a Latin root which refers to a split. But really, it was meant to mean a split between reality and one’s perception of reality. A person with schizophrenia tends to wall themselves off from what is commonly accepted as reality. First, a little bit and then a lot. And sometimes that means delusions. Sometimes that means hallucinations, and sometimes it means being catatonic. Sometimes it means being paranoid. And in fact, that was the other huge surprise for me for schizophrenia, which was that it isn’t really a disease at all. It is a classification. It is a syndrome. It’s a collection of symptoms that we have given a name. And I don’t mean to sound too nebulous or mystical in talking about there is such a thing as schizophrenia. It’s just that it may be several different things and that 40 years from now we might have removed the word schizophrenia from our lexicon and we might have decided that it’s really six different brain disorders with six discrete types of symptoms. And we have found ways to treat those six different conditions differently. That was another huge surprise to me. Gabe Howard: When doing your research for the book, obviously you spoke to the family. Did you also speak with medical doctors and schizophrenia researchers and people in the medical field? Robert Kolker: Yes, absolutely. My initial conversations were with the family themselves, who, after many years of difficulty, were ready to come forward and talk about everything that happened to their family in a very deep and profound way. But of course, in the back of my mind, I was thinking, well, how special is this family? For all I know, there might be a thousand families with lots of kids where half of them have schizophrenia. This might happen all the time. So I did an immediate round of checking, talking to major figures in scholarship of schizophrenia and the history of science, but also in the treatment of schizophrenia. And just to say, have you heard of this family? What would you say if I told you a family like this existed? How typical do you think it is? Do you know the doctors who have treated this family? Because I knew their names as well. Are those doctors on the level or are they quacks and everything really checked out that this is a family that is definitely unusual, extraordinarily so in terms of the numbers. They were an important family to study for their time, and they did help move the ball forward in a genuinely valid way and an inspiring way. So there’s a lot of hope in this story as well. Gabe Howard: Are there many families that have that many children with half of them being diagnosed with really any severe and persistent mental illness or even just schizophrenia? Robert Kolker: This is a big question that I pursue in the book itself, because Lynn DeLisi, one of the researchers who studied this family, was actually a collector of genetic material of what she called multiplex families, which is families with more than one, perhaps many instances of severe mental illness, not just among siblings, but maybe parents and aunts and uncles and grandparents. She made it her job in the 1980s and 90s was to collect data on as many multiplexed families as possible. So they’re out there. But even in that world, the Galvin family’s extreme. It’s hard for anyone to think of any other family with 12 children where six of them had this diagnosis. They are really, really unlikely. Then if you add on to that the complicating factor of such a family getting noticed by science and not being cast to the winds, not having people end up homeless or the family falling apart or everybody descending into addiction or suicide. Gabe Howard: I know that you went through a lot of records and you did a lot of research and you learned a lot, you just said that you knew the doctor’s names, who diagnosed the boys. What was that like? I mean, just I don’t know what medical records looked like in the 70s, but I know that medical records in 2020 aren’t exactly what we would call. I’m going to go with legible. Was this a difficult thing to get a hold of medical records 50 years old and try to decipher them? Robert Kolker: The ones that still survive mostly come from the state hospital in Colorado, where so many of the brothers cycled in and out, those all still existed and they are sitting there on paper in accordion folders. And those folders are all stacked up. And they were wheeled into a room where I and Lindsay Galvin Rauch, the youngest Galvin child, sat and waited. And there were two huge carts with folders spilling out. And we spent as much time as we could going through every page, scanning what we could, reading what we could. It was kind of a Raiders of the Lost Ark moment where you see at the end with all the warehouse filled with boxes, suddenly I saw there was this wealth of information. And yes, a lot of it is a little too clinical. But then there are things like the notes from the College Health Services Office where Donald Galvin was a regular back when he was in college in the mid-60s with written reports in handwriting saying that he ran into a bonfire and wasn’t sure why or got into an altercation with a cat and was bitten by a cat and wouldn’t say exactly what happened there. Lots of information that was really quite provocative and quite tantalizing and help tell a story really about a young man who was becoming a stranger to himself and not really knowing exactly what was happening to him and being afraid to talk with anyone about it. Gabe Howard: Hang on, we’ll be back after these messages. Sponsor Message: Gabe here and I wanted to tell you about Psych Central’s other podcast that I host, Not Crazy. It’s straight talk about the world of mental illness and it is hosted by me and my ex-wife. You should check it out at PsychCentral.com/NotCrazy or your favorite podcast player. Sponsor Message: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Gabe Howard: We’re back talking with the author of Hidden Valley Road, Robert Kolker. During your research, was there anything that struck you as incredible or interesting or provocative that didn’t make it into the book? I imagine that not every story or every tangent can fit into a book. Robert Kolker: This is first and foremost a family story. It’s an intra generational family saga where you get to know the parents and the life they were leading and the plans they had and the type of parents they were and the reasons why they had so many children. And then you see the children start to grow up and go through changes and then the worst happens and the illness strikes that by the time you’re done with the book, you’ve traveled with this family for many, many decades, the same way you would have if you read a book like one of the great family sagas like East of Eden or something. That was what I was aspiring to the science in there. I tried to weave in in the most seamless way possible so that it didn’t feel like eating your vegetables, it didn’t feel like homework. And so while there are some really provocative and interesting scientific passages in this book, there are elements of psychiatry that are not relevant to the Galvin’s that are definitely in the cutting room floor. Gabe Howard: Can you give us an example of that? Robert Kolker: Yeah, there’s the whole notion of anti-psychiatry, which I maybe put in a page, but during the 60s and 70s, it was especially popular. It was this notion that the people who are who most people would call insane, maybe the only sane people in the world, and that mental illness is actually a myth. It’s a construct and that psychiatrists are the new priests and psychiatry has replaced religion. And it’s about imposing social norms on nonconformists. I guess the most mainstream manifestation of anti-psychiatry is One Flew Over the Cuckoo’s Nest, which is essentially a metaphor for a repressive society trying to pound out an iconoclast. I only was able to flick at that. But there are several amazing books written on that subject and you can certainly really get very, very arcane talking about the nature of mental illness and how much society’s definition of it has really created it in our world. Gabe Howard: It’s fascinating because anti-psychiatry or psychiatric survivors, as they’ve sort of rebranded as, is still around today in different iterations. So it’s interesting to me that this was also a thing apparently in the 60s and 70s. It’s a variation of a theme. Right. This isn’t real, even though people are suffering from it. Robert Kolker: Right, and in anti-psychiatry, to me, the big thing that Star is the families like the Goblin’s was concerned was that it’s one thing to write a provocative book wondering about the nature of mental illness and whether we’ve created it. And it’s quite another thing to look at six sick boys in a family of 12 who are really in need of help right now and wonder, well, what do we do to help them? Regardless, they need to be helped. The practical aspect of it really is what I was drawn to. But I just want to say very quickly, I don’t want to be dismissive of anti-psychiatry in general. And certainly, there is a hearing voices movement now that is very helpful. And there is data to suggest that that delusional mental illness may not be something that is just exclusive to people who have schizophrenia, that that a large percentage of us have perhaps had an auditory or even a visual hallucination in our lives and more than one perhaps that this sort of thing exists on a spectrum and that you shouldn’t necessarily be stigmatizing anybody who’s going through it or even trying to brand them in any way. Gabe Howard: I’m often fascinated, especially as the host of this podcast, I get to talk to a lot of people. You know, some people believe that mental illness is absolutely 100 percent real. And everything that we understand about it is everything that there is to understand and will be. All there ever is to understand. And medical science is perfect in every way. And of course, other people go the other way and they say it’s a construct. It’s all made up. None of it’s real. It’s all in our heads. We should leave people be we’re just trying to be controlled. And what I have learned through, you know, research and talking to so many people is that the answer is really in the middle. Any medical establishment that says that they’re 100 percent perfect and we know what to do. As you’ve alluded to in the show, it’s not perfect. We don’t know what in 40 years, schizophrenia may be called. Something completely different, I believe, was your exact quote. And over on the other end, it’s absolutely real. As you said, just talking about the Galvin family, they suffered greatly, which, of course, caused their siblings to suffer and their family members to suffer. I can see why that would be an attractive thing and an attractive discussion to put in the book. I’m excited talking about it right now, but of course, it is a distraction from the Galvin family. And that sort of leads me to my next question. When I think of being distracted from the Galvin family, I am sort of rubbernecking and I’m fascinated by just the horrors that this family must have seen. But you really described the family as very hopeful. I believe your exact words are the family’s story has so many elements of hope. And I’m sitting here like I’m not seeing them. Can you explain that? Robert Kolker: I’m laughing because in the years that I was working on this book, my friends and acquaintances would say, so what are you working on? And I’d say, I’m working on a book about a family with 12 children and six of them had schizophrenia. And then they would turn white. And I would say, but there’s a lot of hope in the book that really is you got to believe me. But I can say in a couple of ways it’s hopeful. The first is that there were two teams of researchers that studied the Galvin family back in the 80s and took genetic material. And part of this book is the story of those two different teams, led by two different researchers and their various ups and downs, trying to find more meaning in the disease, trying to find patterns of heredity until finally the Human Genome Project throws them a curve ball and, in some ways, hurts and in some ways helps the effort until finally, we have some breakthroughs in 2015 and 2016. Each of those teams moves the ball forward in our understanding of the illness and potentially significant ways. So I knew that the story was going to have that kind of hopeful ending by the end. I was excited about that. Secondly, there’s a sense of how far we’ve come. When the first of the boys was getting sick back in the 60s, the family really had a choice. They could send their son in for treatment to a place that essentially was blaming the family for mental illness, saying bad mothering caused it. They called it the schizophrenia genic mother, and that was erroneous and has been disproven, but it really dominated psychotherapy for decades. The idea of the schizophrenia genic mother causing schizophrenia. Gabe Howard: And in fairness, it’s a myth that is still around today. It still comes up 50 years later. Robert Kolker: Yeah, for sure, and I think it’s because we have this nature nurture conversation about acute mental illness, we wonder is all of it inherited or are you just inheriting a vulnerability that then gets triggered by the environment? So maybe, maybe your bad mother did trigger your genetic vulnerability or maybe it was marijuana or maybe it was cat litter? Yeah, there are all sorts of theories about what might be environmental triggers be. So the family had this up against them and then the other way to go would be to institutionalize them, to send the son away and perhaps doom them to a future where they are medicated into a stupor or perhaps even lobotomized or definitely given various shock therapies. So these were horrible choices. Whereas today, if a teenage boy or girl is having early signs of acute mental illness, the hopeful thing about the story is we see how much has changed that if they’re lucky enough to have half decent health care coverage, there’s early intervention, there is family support. There are things that just didn’t exist before. So that part to me is hopeful as well. Gabe Howard: That all does sound very hopeful, and as somebody who is diagnosed with bipolar disorder, which I want to be clear, is not the same as schizophrenia, but it’s still a severe and persistent mental illness that needs understanding and research and has some commonalities. I like the idea that research has evolved so that when I needed care, it was there. Did it work? Do we understand schizophrenia better because of the Galvin family? Robert Kolker: There is one team in Colorado led by Dr. Robert Freedman, who is still there at the University of Colorado Hospital. He became the first researcher he and his team to identify a specific gene that was a player in schizophrenia called ceRNA-7. This is back in the late 1990s before the Human Genome Project came on board. And he’s been trying to find ways to manipulate and rectify the issues regarding that part of the brain and that gene interplays. He’s been working on that for years. He’s come up with a possible way to strengthen brain health in utero with a prenatal vitamin, with a substance called choline. Choline is a natural nontoxic substance that you can get at the vitamin shop or the GNC. His theory is that expectant mothers can strengthen the brain health of their children by taking choline. And not only that, if their child happens to have a genetic predisposition to perhaps developing schizophrenia or another acute mental illness, it’s very possible that choline will hit the brain receptor that he’s been targeting all this time and actually prevent some of those symptoms and perhaps prevent the condition entirely. Now, this is a theory and it’s being tested in a longitudinal study right now. It’s very promising. Robert Kolker: And it’s the Galvin family and his work with them back in the 80s that led to a long and winding road that led to this advancement. The other team is in Massachusetts, and this is a researcher named Lynn DeLisi, and she was with the National Institute of Mental Health in Washington. And now she’s in Massachusetts. And she teamed up with Amgen Pharmaceutical company to analyze the genome of the Galvin’s after years and years of doing her own work on the subject. And they identified another gene, this one called SHANK2. And they hope that by looking at what SHANK2 specifically does in the brain, that this might be a pathway that will help us understand exactly how schizophrenia takes shape in the brain. Gabe Howard: Let’s say that the Galvin boys became symptomatic in 2020, if the same thing happened to the family today, how would their story be different? What would play out differently in 2020 versus how it played out in the 60s and 70s? Robert Kolker: Some things would be completely opposite. Back then, they would blame the family and let’s say the 15-year-old Donald Galvin first displaying some problems, they would say, let’s separate him from the family and take him away so that we doctors can work on him. Today, the opposite would happen. They would say, how can we set up a situation where we can support the family at the same time as we’re supporting this kid and make sure that everyone is getting the help that they need? That’s one thing. The second thing is we understand now that early intervention is crucial, that with every psychotic break a person has, the harder it is for them to recover and the more likely it is they’ll have more in the future. Donald Galvin had his first signs of mental illness when he was about 15 or 16. And the psychotic break that brought him to the state hospital for the first time didn’t happen until he was twenty-five years old. So imagine nine or 10 years’ worth of psychotic episodes that could have been tempered or prevented if he had gotten early intervention. Gabe Howard: This entire story is incredible. How did you first become aware of this family? Robert Kolker: The youngest Galvin family child, Lindsay, went to high school with one of my oldest and dearest friends, who also was an editor of mine at New York magazine for many years, and my friend knew about the Galvin family story just over the years when he was in high school with Lindsay. He didn’t hear about it because Lindsay wasn’t going to be talking about her family with anybody. But then as he stayed friendly with her over the years, he started to hear more and more and sort of got the gist. And then one day, Lindsay and her older sister Margaret came to him. This is in like twenty sixteen and said we’ve been trying to find a way to help the world know about our family, and we’ve been trying to think about the best way to do it for years. We thought about a memoir, but as the youngest members of our family, we don’t have an immediate understanding of what our oldest siblings went through. We haven’t been able to look at the medical records yet. Telling the story is involves the perspectives of way too many people and there’s a lot of medical information. My friend thought of me immediately because I had written about families in crisis before. My first book is called Lost Girls, and it’s about the families of five women who are all victims related in the same unsolved murder case out here in New York City, the Long Island serial killer case. Robert Kolker: And it takes a close look at the families themselves and their difficulties. A very human story and I hope a very compassionate one. I seemed to be the right fit for this family. And that’s how I first contacted them. Now, my initial reaction was that it was going to be an impossible story to tell two parents, one of whom was deceased, 12 children, three of whom were deceased, weaving in all of their perspectives, writing about the mentally ill siblings as intimately as you possibly can so that they’re not monsters, understanding all the medical stuff that was going on, and most of all, making sure that there wasn’t going to be one family member who would stand up and say, I don’t want my medical information published in a book, which we all know there are HIPPA laws in this country where your medical privacy is yours. So I proceeded very slowly and I told the sisters that we all would know one way or another after a couple of months just how doable this would be. Robert Kolker: And after three or so months, everybody seemed ready to do it, that it had been so many decades since the most difficult things in the family had happened that people were ready, and also that the two sisters, as the youngest ones, had really been through so much and really have been on the receiving end of so many of the traumas in the family that the older siblings all sort of deferred to them and said, well, if they want to do this, I’m not going to stop them. To me, it was an amazing opportunity and I really didn’t look back. Once everyone was ready, I really hopped aboard and worked full time on it. Gabe Howard: Bob, without giving away the ending, where is the family now? Robert Kolker: Most of them are still in Colorado, and to me, that’s the most amazing thing. There was sexual abuse in this family. There was clergy abuse, there was a murder suicide. My question to the two sisters and to everyone in the family is, why are you still a family? Why didn’t you the second you went to college, just sort of leave and never come back, let go change your name. But these two sisters are back in Colorado and they were involved in the care of their family. One of them is the main caretaker for the surviving mentally ill sons who are still alive. They came back to their family on their own terms. And I wanted to tell that story as well about families and how they stay together. I think a lot of us can relate to a story like that. Gabe Howard: The name of the book is Hidden Valley Road. The author is Robert Kolker. Where can you find you and your book? Robert Kolker: My website is Robert Kolker.com, the book is everywhere. I’m thrilled, thanks to Oprah Winfrey, that it’s gotten immense visibility and helps people understand this family better. Gabe Howard: I highly recommend checking it out. Thank you, Bob, so much for being here. Robert Kolker: Thank you, Gabe, it’s a real pleasure. Gabe Howard: Thank you, everybody, for listening. My name is Gabe Howard and I am the author of Mental Illness Is an Asshole, which is available on Amazon, or you can get a signed copy, and hey, I include stickers with the podcast logo. Your laptop needs a sticker and it’s less money and I’ll even sign the book over at gabehoward.com. Remember, we have the super-secret Facebook page at PsychCentral.com/FBShow. Wherever you downloaded this podcast, please subscribe. Also, take a minute to write a review. Let people know why they should listen in. And remember, you can get one week of free, convenient, affordable, private online counseling any time anywhere, simply by visiting BetterHelp.com/PsychCentral. We will see everybody next week. Announcer: You’ve been listening to The Psych Central Podcast. Want your audience to be wowed at your next event? Feature an appearance and LIVE RECORDING of the Psych Central Podcast right from your stage! For more details, or to book an event, please email us at [email protected]. Previous episodes can be found at PsychCentral.com/Show or on your favorite podcast player. Psych Central is the internet’s oldest and largest independent mental health website run by mental health professionals. Overseen by Dr. John Grohol, Psych Central offers trusted resources and quizzes to help answer your questions about mental health, personality, psychotherapy, and more. Please visit us today at PsychCentral.com. To learn more about our host, Gabe Howard, please visit his website at gabehoward.com. Thank you for listening and please share with your friends, family, and followers.
The post Podcast: Large Family Beset by Schizophrenia first appeared on World of Psychology. from https://ift.tt/3jTeZcE Check out https://daniejadkins.wordpress.com/ Are you sad? Just be happy! Does this irritate you? In today’s show, Gabe and Lisa ponder whether happiness really is a choice — especially for people who struggle with mental illness. How do we measure happiness? And what is happiness inflation? Join us for an in-depth conversation on whether or not people can actually choose happiness.
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Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Lisa is the producer of the Psych Central podcast, Not Crazy. She is the recipient of The National Alliance on Mental Illness’s “Above and Beyond” award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has worked alongside Gabe in mental health advocacy for over a decade. She lives in Columbus, Ohio, with her husband; enjoys international travel; and orders 12 pairs of shoes online, picks the best one, and sends the other 11 back.
Computer Generated Transcript for “Happiness a Choice” EpisodeEditor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Lisa: You’re listening to Not Crazy, a psych central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts. Gabe: Hey, everyone, and welcome to the Not Crazy podcast, I’m your host Gabe Howard, and with me, as always, is Lisa Kiner. Lisa, I’m inviting you to speak right now so that you know that it is your turn. This comes up more than you think when Lisa doesn’t know when she can talk. I do take some responsibility for this because, you know, I’m a talker, Lisa. Lisa: You’re going to have to redo that, because I won’t be able to edit that because you slurred it into your words. Gabe: I wanted you to, I wanted you to leave that there. Lisa: Why would I leave that there? Gabe: Because it’s funny. Lisa: Uh-huh, it’s not that funny. Gabe: I thought it was funny, plus I’m picking on you. I think it’s good. We’re supposed to fight more. Lisa: We’re supposed to fight. Wait a minute. What? I’m sorry, I didn’t listen the last part. Why are we supposed to fight more? Gabe: People like the debate, they like the acrimony, they like the frenemies, we’ve been accused of getting along too well. We haven’t created enough drama. Lisa: Really? Gabe: Yes. Lisa: Someone actually said that? Gabe: Multiple people have said this. Lisa: Whoa! Oh, my God, this is my dream. So, you’re telling me that the goal is to fight with you more? Gabe: The goal was always to be frenemies. Lisa: But to specifically fight with you more? Oh, my God, I’m going to be so good at this. Gabe: I know that’s why I picked you. Lisa: Oh, I’ve been training for this for years. Gabe: I thought you were uniquely qualified to not be a yes person. Lisa: Thank you. Gabe: I was very disturbed when people are like, yeah, the problem is, Lisa’s a yes person Lisa: I don’t think that’s true; you just usually say that the right stuff, just not always. When you’re wrong, you’re wrong by a lot, but usually you’re good. Otherwise, I wouldn’t hang out with you because it would annoy me too much. Gabe: Wow, I don’t know what that’s like. Lisa: OK, going back. You said welcome. All right. Hey, everyone, see, I’m pretending like that whole thing didn’t happen. I’m just going now because I’m a professional. Don’t give me that look. Hey, everyone. Today’s quote comes to us from Abraham Lincoln. And he said, Most folks are as happy as they make up their minds to be. And he was the 16th president. Gabe: You know, Lisa, I much preferred the quote, and I’m disappointed that you didn’t use it, which is I feel like I’m constantly worrying about the next part of my life without realizing that I’m right in the middle of what I used to look forward to. And that came from a Twitter user, Josie Vanco. Lisa: All right, that is an absolutely brilliant quote and describes you perfectly, but yeah, I feel like you’re not really understanding the essence of the quotes. I got the 16th president, the savior of our nation. And you found one of your Twitter followers who does, in fact, say something very smart. I just really feel like you need to up your quote game. Maybe I could get you a book or a website or something. I’m better at quotes than you. Gabe: You’re arguing with me for no reason. Lisa: You told me to do that. Gabe: The, it’s got to be good. Lisa: Well, this is a burden to me. Gabe: Let me start over. Lisa: Can’t just turn it on and off, Gabe. Gabe: Abraham Lincoln was obviously great, I mean, we learned about him in school and we clearly did not learn about Josie Vanco. Lisa: His birthday is the same day as my mom’s. Gabe: They’re about the same age. Lisa: Ha ha. Gabe: This quote spoke to me, like you said, it describes me to a T. Do you remember the show The Office? Remember the office? One of the quotes that one of the characters made is that the problem with it being the best years of your life is that you don’t know they’re the best years of your life when you’re living them. Lisa: Totally true. Gabe: I think all of us, you know, struggling with mental health issues, depression, sadness, loneliness, anxiety. We don’t know when it’s good when it’s happening. We know when we’re suffering. And then we reflect backwards and think, oh, why can’t I be like last summer when I was happy? But of course, here’s the thing. Last summer, we didn’t know we were happy. It’s only in retrospect. Lisa: But is that true? I don’t know that last summer you were happy, though. Why? Because you’ve decided that last summer is better than this summer Gabe: Sure. Lisa: If you weren’t happy in the moment, how do you define happiness? If you didn’t know you were happy, are you really happy? Gabe: It’s meta right? As you would say, it’s, ooohhh, so meta. Lisa: You do not understand the meaning of any phrases that I use. That is not what that means. Gabe: That’s because you use them all incorrectly. Lisa: No, that’s not why. Gabe: Is a box of boxes meta? Lisa: That is totally meta, get it? Gabe: But Lisa: Whoa. Yeah. Gabe: But thinking you’re happy when you’re unhappy, not meta? Lisa: Right, something that’s meta is self-referential. Gabe: So what if you’re happy, but then you don’t realize it until you have something to compare it to? Is that meta? Lisa: Yeah, maybe let’s go with for the purposes of this conversation, yes. Yes, it is. Gabe: My whole point is that last summer, I think pretty much the entire world, will say, was better. Lisa: Because we’re doing a COVID thing? Gabe: Well, I mean, it is, in fact related to the global pandemic, but you know Lisa: Right, right. Gabe: Last summer we went through the summer and it was just like, oh, we didn’t get the vacation that we wanted. The fair food wasn’t as good as we wanted it to be. You know, the concert series wasn’t good. Our sports team lost. It was a mediocre summer. And now we’re at this summer where everything’s canceled. The whole world’s going to hell and we’re starting to reflect back. And we’re like, you know, last summer wasn’t so bad. And in fact, it’s changed our perspective because a shitty fair is better than no fair. And a concert that is mediocre is better than no concert. So we’re starting to realize that last year was actually a pretty decent summer, but it’s only in retrospect. I think this is how happiness works for many people. Lisa: Well, that’s how happiness works for you, but that’s part of your problem, you’re constantly comparing things, you’re always comparing yourself to other people, you’re always comparing this situation to that situation, and it’s always coming up short. That’s one of the reasons you’re unhappy. Gabe: That’s because happiness has no definition, see, a dollar is a dollar. Gabe, do you have a dollar? I can look at my wallet and if there’s a dollar in there, the answer is yes. If there’s not a dollar in there, the answer is no. But then if somebody said, hey, Gabe, are you rich? Well, now what? How do we decide? Because I’m going to say, hey, I think having one hundred million dollars is rich, but you’re going to say, well, Bill Gates doesn’t. Bill Gates thinks that’s poverty. All right. Well, now what do we do? OK, so Bill Gates is rich, but, you know, the sultan of of who Lisa: Brunei. Gabe: Is the actual richest guy? The sultan of Brunei, he’s Lisa: I think it’s Jeff Bezos now. Gabe: Well, I don’t know. But there’s some Bill Gates is not the richest guy. So that person thinks that Bill Gates is poor. He doesn’t want to play on that level. And Jeff Bezos does, in fact, maybe have more money. But he’s not a sultan. He’s not royalty. He can’t make dictator laws. So I don’t know if Jeff Bezos has more money than the sultan of Brunei, but I do know for a fact that the sultan of Brunei has more power and influence than Jeff Bezos. Lisa: I don’t know that that’s true. Gabe: You know damn well that it’s true. Lisa: Not the point of the story, though. Gabe: Jeff Bezos does not have a military. He is not royalty. Jeff Bezos cannot go around and murder all of his people for fun. I don’t even know if the sultan of Brunei does that, but he’s allowed, whereas Jeff Bezos is not. Lisa: Yeah, so that’s not the point of the show. Bring us back around to the happiness. Gabe: This is my point. We can’t even determine who has more power, Jeff Bezos or the Sultan of Brunei? But you want me to determine happiness? How? Lisa: No, not for everyone, just for you. Gabe: Stop, stop right there, you just said, Gabe, I want you to try to determine happiness just for you, but you’ve also said do not compare yourself to other people, places or things. Lisa: Right, right. Gabe: How do I do it then? How do I know if I’m happy? Lisa: You do not have this problem when it comes to recovery, we’ve talked many times about how recovery is self-defined. Gabe: But OK, fine, so should I do happiness the way that I did recovery? Lisa: Yes. Gabe: Because the way that I determined that I was in recovery is that my life was better this year than it was last year. I literally compared myself not only to previous examples of Gabe, but I also compared myself to others. And you just said not to do that with happiness. Lisa: That’s how you decided you were in recovery? Gabe: Of course, Lisa: Seriously, that was your system? Gabe: Yes, 100 percent, and I don’t think that’s unreasonable. Lisa: Wait, wait, wait. So, for example, the summer of COVID, or if you have a massive car accident tomorrow or if your dog dies, then suddenly you’ll no longer be in recovery? Gabe: Well, potentially, what are my? What happens after that? And listen, when you said I got in a car accident, am I in physical pain? Lisa: Yes. Gabe: Yeah, I’m probably not my best self. Don’t you think that’s reasonable? Lisa: But does that mean you’re not in recovery from bipolar disorder? Gabe: Potentially. Lisa: So, you’re telling me that any single thing bad that happens in your life will automatically mean that you are no longer in recovery with Gabe: No, Lisa: Bipolar disorder? Gabe: No, I don’t know why are you adding the word automatically. No, of course not. That’s. Lisa: Because you just said that’s how you decide you decided. Today is better than the day previously. Also, doesn’t that give you, like, no wiggle room at all on a day to day basis? Are you trying to get every single day of your life better than the day before it? Because that sounds pretty hard. Gabe: I am simply saying that when it comes to recovery, I do compare this version of Gabe to previous version of Gabes to see how I’m doing, I need some measurement to know if I’m doing better. Otherwise I could just declare myself to be in recovery, determine it to be true, and you could be like, dude, you’re homeless, you’re not taking your medication. Your wife left you, you haven’t showered in six months. But according to you, all I have to do is decide I’m in recovery and it counts. That seems like nonsense. Lisa: So, you’re saying that the way you determine happiness is by comparing yourself to previous versions of you and deciding if you are happy? OK, I can work with this, then why aren’t you happy right now? This is the best you you’ve ever been. You’re the healthiest you’ve ever been. You’re in the best position with your recovery. You have the most money. You have the most stable relationship. You have the cutest dog. Why are you not happy right this second? Gabe: I can answer this question with needing ten thousand dollars, right? I need ten thousand dollars. Lisa: To be happy? Gabe: No, I just I need ten thousand dollars. It’s an analogy Lisa: OK Gabe: Follow along. The goal is ten thousand dollars. Everybody understand? Gabe needs ten thousand dollars. Now you say Gabe, oh, my God, you did it. You have eight thousand dollars. And I say, I know I’m, I don’t have the ten thousand dollars. Well, but this is the most money that you’ve had towards that goal ever. So therefore, you’ve reached the goal. No, the goal is ten thousand dollars. Having eight thousand dollars means I’m still not at goal. Oh my God. You know, when you started this, you had zero and you’ve gone all the way up to eight thousand dollars. This is, in fact, the most money that you’ve had toward the goal ever. You just can’t be at goal. Now, take out the word goal and put in happiness. And there’s the problem. Also, you still haven’t defined the word happiness for me. Ten thousand dollars. That’s an exact number, right? So happiness. I want to know what happiness is. Tell me what happiness is. Everybody looks at me and says, oh, you have to determine that for yourself. It’s internal. You have to decide. Even the sixteenth president, the guy who beat my guy for the quote said, well, most folks are as happy as they make up their mind to be. Well, I guess that is a nice philosophical point and it makes people all warm and fuzzy on the inside. It’s nonsense. It’s literal nonsense. Lisa: That is a problem. Gabe: And also, you know, while I’m on the subject, just just while I’m here, Lisa. Lisa: Yes, please tell me more, Gabe. Gabe: I just I feel the need to do so. What condescending tripe is that? Oh, you’re dying and you have no money and you have no health insurance and that dog is eating your gangrened leg. Well, just make up your mind to be happy. You’re only as happy as you want to be. Listen up, world. We don’t need to take care of this person dying on the side of the road because they’ve made up their mind to be happy. Wow, that’s fantastic. Lisa: You’ve got way too many things going at one time. Gabe: I’ll just sit back and let you respond. Lisa: Ok, well, it’s going to be a while because you’ve got many things going on here. Gabe: I’ll be patient. Lisa: First off, I love your analogies because they are very clearly illustrating everything wrong with your approach to happiness. And incidentally, the reason why you one, are not happy and two will never be happy. Ten thousand dollars represents happiness, right? That’s the analogy. Gabe: Right, yes. Lisa: Ok, ten thousand dollars represents happiness. What is your ten thousand dollars? What has to happen for you to reach happiness? Like you said, the ten thousand dollars, that’s clear. It’s exact. We know for sure. Either you have it or you don’t. Done. Do you have such an analogy for happiness? Can you tell me, well if blah blah blah blah then I will be happy? Do you have that? Gabe: I mean, I do, but Lisa: Ok, let’s hear it. Go. Gabe: You’re about to win the arguments, Lisa: Yes, I am, I know. That’s why I want to continue. Gabe: I know that I’m about to get checkmated because, of course, there’s been dozens of things. Lisa: Yes. Gabe: As soon as I get a job, I’ll be happy. As Lisa: Uh-huh. Gabe: Soon as I can be self-employed, I’ll be happy. As soon as I get in a relationship, I’ll be happy. As soon as I buy a house, I’ll be happy. As soon as I get divorced from the annoying Lisa, I’ll be happy. As soon as I get a new car, I’ll be happy. As soon as I go on vacation, I’ll be happy. Currently, it’s as soon as the pandemic is over, I’ll be happy. Lisa: It’s always something that isn’t here yet. Always. You always have one more thing that’s going to make you happy, and then when you achieve that thing, you’re like, well, yeah, I mean, I know I said last month that if I got to this goal, I would be happy. But now that I think about it. I can vividly remember the day you told me, this was before you had gastric bypass, that if you could just weigh 300 pounds, that would be it. You would never ask for anything else. That was all you wanted in life. You would be completely happy. That’s all you needed, was to weigh 300 pounds. Gabe: In my defense, I was not yet diagnosed with bipolar disorder, so maybe it’s not that I’m unreasonable, it’s that I get new data. Lisa: Ok, what new data have you gotten? Gabe: The ten thousand dollars isn’t enough, the reason I wanted ten thousand dollars is because that’s how much the thing that I wanted to buy cost. But in the time it took me to save up the ten thousand dollars. The price. Lisa: The price went up? Gabe: Yeah. Now it costs fifteen thousand dollars. I’m not the unreasonable one. Society keeps raising the price of things. Its inflation. Lisa: Oh, my God, Gabe: It’s happiness inflation. Lisa: My eyes are rolling so hard, I think I’m going to have permanent brain damage, Your problem is that society is constantly changing the definition of happiness? Gabe: They’re raising the happiness price, Lisa: Oh, Gabe: It’s inflation. Lisa: That’s. Gabe: Yes. Lisa: That is awesome. There are like no words to even respond to that. That’s how awesome the thing you’ve just said is. Gabe: So I win, right, I win. Lisa: No, no, no. Gabe: You don’t believe in inflation? Lisa: Happiness inflation, OK, so all right, fine, the happiness inflation has occurred. Now you need fifteen thousand dollars. Gabe: Yes. Lisa: What’s the current price then? You can’t tell what the price is going to be with inflation in a year, 10 years, 15 years. But you can tell me what the price is right now. So what is the price right now? Not what is it going to be when you get to the current price? What is it right this second? Gabe: I need the pandemic to end so I can get back to my job. I want to get back to work, Lisa: I’m writing that down. Gabe: I would also like the things with my job to clear up. You know, there’s a lot of transition right now that’s making me uncomfortable. Lisa: Right. Gabe: I’d like you to drop that tone. That would be helpful. Lisa: You all heard it here first, listeners. Gabe says that once the pandemic is over and the uncertainty with his job has cleared up and I start being nicer to him, perhaps an unrealistic goal, I’ll give you, he will achieve happiness. So that’s what it’s going to take. Gabe: Well, I mean, assuming that inflation doesn’t take over Lisa: Right, Gabe: I mean, Lisa: Right, right. Gabe: Inflation is a problem. Lisa: This is honestly, and I thought this about you for years, and it’s actually heartbreaking and really, really sad to watch. I was reading about how to choose happiness, right. And one of them was set goals. That people who set goals are happier. You do that part. You constantly set goals and they’re usually measurable and reasonably attainable, just as the advice column suggests. Right. But it doesn’t matter because you meet that goal and you’re still not happy. Then you immediately invent a new goal. I have, honestly, I really can’t think of any. Yeah, well, I’m going back through 20 years of knowing you. There are very few times when I felt like you were happy or content in the moment. Almost never. Gabe: Now, hang on, hang on, this is what makes me driven, could you imagine remember that Lisa: Really? Gabe: At the very first. Hang on, hang on. Just hear me out. I listened to you. I weighed 550 pounds, and I said that as soon as I weigh 300 pounds, I will be happy and content. Could you imagine if I’d just stopped there? I never would have got down to 220, right? Now, let’s go with some other goals as soon as I get a job. You recognize that, I remember that and that job that I wanted because I had been unemployed for a few years because I was struggling with bipolar disorder and I was. Lisa: You were underemployed, you were not unemployed. Gabe: The point is, is that I wanted to get back to working full time, and I did, but that job didn’t pay very well. It wasn’t a very good job and it didn’t pay very well at all. So according to you, I would have stayed there. Like, that’s not good. Like setting all of these goals is what got me to where I am today. So, you know, my next goal is, you know, to be on like satellite radio or to be on a big network or, I don’t know, to expand out my podcast hosting abilities or to launch a podcast network. And you’re saying that I should just be content with where I am, so I’ll just be the host of the Not Crazy podcast, the host of The Psych Central Podcast, and just call it a day. But you realize that if I would have done that, I never would have gotten the podcast. I’d still be all the way back at that crappy job I hated from 15 years ago, making no money with crappy health insurance. You’re holding me back. Lisa: Oh. OK, we’re just going to let that one go. I’m holding you back, I’m going to stab you in the face, OK? No, no, no, no. Gabe: She means metaphorically, she’s not actually going to stab me in the face because that would be wrong. Lisa: Kind of like how you mean that I’m metaphorically holding you back, which I’m not actually doing. You’ve got to be kidding me. Stop trying to derail the conversation, Gabe. You are trying to change the subject or distract me with off topic things, because, you know, I’m right. Gabe: I’m not doing that at all. You told me that the reason that I’m never happy is because I immediately set a new goal when I achieved the old goal. Well, but I think setting new goals is good. This is how you evolve as a person. It also creates happiness inflation. Lisa: You have reframed what is, quite frankly, a personality flaw as you being driven. I’m not impossible to satisfy, I just am motivated to succeed and move forward. No. OK, so you want to set a new goal once you get the previous goal? Great. Yay. Wonderful. But like, how soon after achieving the goal do You need to set the new goal? Because for you it’s within seconds. You can’t like, take a day. I mean, I’m not even asking for much. Right. I’m not even saying that you should be happy for weeks or months, just maybe like a day, maybe a few days. Maybe that would be nice. Maybe if you achieve the goal on a Friday, you could just be happy for like the weekend. And then on Monday you could get around to making this new unattainable goal. Gabe: Ok, first off, why do you keep calling them unattainable goals? Lisa: All right, let me rephrase. Gabe: This is the fascinating part about trying to establish, in my opinion, happiness, because I’m still very hung up on the time that I told you that I wanted to start a national advocacy movement and I wanted to be a national advocate on the same level as Julie Fast, as Natasha Tracy, as all the high level advocates that I have looked up to for years. And you told me, no, that hurt me a lot. Now, you don’t deny that that happened. Lisa: I did not tell you no, I told you to start with a more attainable goal. You said, Oh, I’m going to blah, blah, blah. And I said, OK, instead of being blah, blah, blah, why don’t you start with getting up off the couch? You’re like those people who are like, oh, my goal is to run a marathon. How about your goal is to walk out to the mailbox? How about that be your goal? I can’t help but notice that the goal you set is always very distant in the future, very difficult to attain, almost impossible to measure and can’t be done immediately. It requires some sort of thing to happen for it to come. Gabe: And herein lies the problem, you have now completely switched because you said Gabe makes good goals that are measurable and he follows the advice column. And now Lisa: No, no, no, no, no. Gabe: Here we are later. And you’re like all these nebulous goals and get Gabe, to, pie in the sky. Lisa: No. Gabe: A pie in the sky and nobody can reach them. Lisa: No, what I’m saying is, one you remember back incorrectly and the number two thing you are setting the goal that will lead to your happiness backwards. You just said that back in the day, I said that if I could be an advocate on a national stage, I would be happy. Gabe: I did say that. Lisa: Well, here you are. Gabe: Yeah. Lisa: Are you happy? Gabe: No. Lisa: Like anything? Were you happy for a minute? I’m not even saying you need to be happy long term. Just was there a period of happiness? Gabe: How long is a period? Lisa: More than one minute. Gabe: Yes. Lisa: Really, how long was that? An hour? Gabe: Maybe. That’s more than a minute. Lisa: Without exaggeration, I mean, we’re joking around here, but it wasn’t a day, it was not a whole day. Gabe: It might have been a day. Lisa: The first time you got one of those large contracts, you got booked at a big conference, you did not, in fact, have an entire day of happiness. You did not and you don’t now either. Remember how we had the whole conversation about self-talk and negative self-talk? Yeah, one time. This is a true story. We were on vacation. We were on a three-day vacation. We were on the evening of the second day and you started getting all depressed. I said, what’s wrong? We’re having a great time. And you said, yeah, but tomorrow we have to go home. Gabe: Well, that’s true, we do. Lisa: We’re on vacation, you can’t even enjoy the vacation because you’re talking about how soon this is going to end. Yeah, no kidding. You realize that that’s actually an analogy for life. All life ends, Gabe. Gabe: Well, how am I supposed to be happy when you’re telling me that I’m going to die? Lisa: Everyone dies. We were on vacation, we were actively on vacation, and you were going on about. No, no, no, I can’t have fun because after all, tomorrow the vacation ends. What, so you just can’t enjoy life at all? There’s no hope for you. There’s no hope. You can never be happy. Gabe: You know, I have a pronounced anxiety disorder, Lisa: Yeah, it was worse back then. Gabe: And it was worse back then, but you keep saying this like I have a choice. I know that when you reflect backwards, you think, why doesn’t Gabe choose to be happy? He got the thing that he wanted. He reached the goal. But you know what the definition of anxiety disorder is? I just Lisa: You think it’s anxiety? Not depression or bipolar? Gabe: I think it’s all of it, I think in the example that you used of the vacation, it’s anxiety because it’s going to end. I’m anxious about the travel the next day. I’m worried about, you know, back then I was still scared of airplanes. I was really pushing myself really hard. So, it was dread that factors in in no small way. And then you keep saying to me, choose happiness. Do you walk up to people in wheelchairs and say, choose walking? That’s just an asshole thing to do. And you would never behave that way because you understand that that’s real. Do you not think that anxiety disorder is real? Lisa: That is a good point, and that is a problem, it’s not clean. This whole idea of happiness is a choice, is a burden for the mentally ill. Well, it’s a burden for a lot of people, but we’re talking about the mentally ill. This is a burden for people with mental illness because it implies that you’re just not trying hard enough. Just cheer up. Just get better. So, yeah, it is not clean. You have a non-zero point there. Gabe: Oh, just, just a non-zero? Just a non-zero? Lisa: Yes, well, but here’s the problem with it, though, so are you saying that it’s completely unattainable? Yes, it is more difficult for us to choose happiness than it is for people who do not have mental illness. But is it impossible? No, it’s not impossible, especially when you have the resources to be treated and to be in recovery, which you do and which you are. So it is not an impossible thing for us to do. It may be harder than it is for the average, kind of like we always go back to the diabetes example. Yeah, it’s harder to live your life when you’re a diabetic. You’ve got to do more stuff. You’ve got a plan, but it’s not impossible. And you seem to think it’s impossible. It is not impossible for you to choose happiness. Gabe: I understand what you’re saying, and let’s go back to the wheelchair analogy, right Lisa: OK Gabe: That’s not clean either. I follow this incredible health advocate who recently had to have a part of her leg amputated and she is chronicling her journey. And one of the things that she keeps saying over and over again is I have to choose to walk again. The day that she came out of the surgery, you know, she had the picture and she’s like, I can’t be fitted for my prosthetic yet because it hasn’t healed. Now, this happened like a year ago. So, she’s now at the point where she’s doing the prosthetic and she keeps saying over and over again, of course, that she sees all of these people using prosthetics and they’re just walking normal. She, of course, brings up the marathon runners that are using them and she’s still walking with a cane. And sometimes she steps wrong. And she’s a very, very honest blogger. But you’re right, if she was sitting in the wheelchair, it would not be unreasonable for you to walk up and say, listen, you can walk if you want to. I just want you to understand that she wants to and she’s going through so much hell, she is working so hard. But you’re right, because she is choosing to walk, choosing to want to, choosing to do the work. There is some date in the future that she’s going to walk just fine. And when she wears a pair of jeans, people who just met her won’t even know that she’s got a prosthetic leg under there. I guess I understand what you’re saying, but I feel like people are cheering her on. I feel like when she falls down, people are like, get back up, you can do it. Whereas when I fall down, people are like, choose happiness, dumb ass. I don’t feel like I get the cheerleading that she gets. Lisa: You don’t, but so what? Gabe: I think that’s an excellent point. It’s hard enough being sick, but now I’ve got everybody yelling at me for being sick. Lisa: Ok, but let’s go back to the analogy you just gave about how she is doing some non-zero aspect of choosing, Gabe: She is, Lisa: Are you? Gabe: I am. Lisa: When you say that she had to make the choice to walk again, have you made that choice? Gabe: I feel like I have. Lisa: You have not. Gabe: I know. Lisa: And I’m not trying to be a bitch about it, but, yeah, you have not. She says to herself, hey, I know that I’m going to walk again. It will happen. I’m going to make it happen. You don’t say that to yourself. You’re never sitting around saying, you know, this is going to happen. You don’t even think it’s going to happen. And you’re definitely not choosing it. Gabe: As you know, I abhor the suffering Olympics, but I’m going to play them for a moment because it’s going to make my point. Lisa: OK Gabe: So for long time listeners, you don’t need to send me the hypocrite email, I’m already aware. She knows what it’s like to walk. She’s got a clear goal. When she can walk without assistance, she will know that she achieved it. I have never been happy. I don’t know what happiness looks like and nobody can define it for me because I’m supposed to choose it or define it for myself. So you say, have I chosen to be happy? Every time I set that goal and say that I’m going to be happy then, I think that I have. You think that I get there, I can walk and that I intentionally injure myself in some way so that I can’t walk anymore. Lisa: That’s not a good analogy. Gabe: It’s a poor analogy. My point is, is that I believe that that will make me happy. And then when I get there, I realize that I am not. Lisa: Do you honestly believe that? Gabe: Of course I do, I genuinely and honestly believe that these things will make me happy, I believed with all of my heart that just being a fully functioning adult that didn’t need supports from society or my family would make me happy. I thought that, you know, being a homeowner, being married, getting a dog, having money in the bank, I thought that these things would make me happy. And according to the research, those things were supposed to make me happy. There’s a research study that says, oh, all people need to be happy is an individual income of about seventy five thousand dollars a year, physical health, employment, experience of positive emotions, good social relationships, moral values and family, and basic access to safety and social equality. I have all of those things, so I thought I should be happy. But I’m not. I’m not happy. Lisa: That is not exactly what said study said. Said study said that people who define themselves as happy often share these traits. Gabe: Well, I have those traits and I don’t define myself as happy, nobody called me. I don’t think they called anybody with serious and persistent mental illness. I think they called a bunch of random people who, frankly, are living a great life. And they’re like, hey, Lisa: Yeah. Gabe: Do you like your job, your family? You have money, access to health care? Yeah, I have all those things. Are you happy? But I’m not. Doesn’t that just make me disordered? Lisa: Yeah, Gabe: Well, but. Lisa: Yeah, it does. Gabe: You don’t think it makes me disordered. You think that I am choosing not to be happy versus I am incapable of being happy. And therein lies the problem. You think this is a choice that I am not choosing. I maintain that it’s a disorder that I have that nobody is curing. Lisa: Ok, but what are you doing to cure it? What actions are you taking to get yourself this cure? Gabe: Ok, I go to therapy, I go to my doctor and take my medication, I speak honestly and openly about it. I’ve, of course, achieved all of those things in that research study that they said that people that are happy to share and I set measurable goals and attain them. And it still hasn’t worked. Lisa: Ok, you can always do more. Gabe: Yeah, that’s what I said, that’s why I set a new goal, that is the happiness inflation that I talked about. You’re right, I can always do more. And that’s why I set a new goal. And you said that was wrong. Lisa: No, what you said here are the things that I’m doing, and yet it has not succeeded in making me happy. Well, then clearly you’re doing the wrong things and or you need to add in more things. Gabe: That is why I keep setting goals, I am Lisa: No, no, no. Gabe: Adding in more things. Lisa: You’re adding the wrong things. Gabe: How do you know? Tell me what to add. Lisa: Ok, well, I got a couple of things. I’ve been doing Internet research. Gabe: This is going to turn out well, was it on YouTube? Lisa: No, because I could read faster than I can listen. Gabe: And you don’t like to listen. Lisa: But Oprah does have Gabe: Oh, Oprah. Lisa: This amazing video. Gabe: Is going to save us all, ladies and gentlemen, Lisa: Well, Gabe: I’m buckling in for this. What’s Oprah say to do? Tell me how the billionaire guru with no psychology background is going to fix the serious and persistently mentally ill Gabe Howard. Go. Lisa: Right, whatever. Don’t. Forget Oprah, although don’t forget Oprah because she’s amazing. Gabe: I agree with you, Oprah is amazing and I have a lot of respect for Oprah. Lisa: Oprah’s amazing. Gabe: I can’t help but notice that you said I did research on your severe and persistent mental illness by contacting a talk show host. Lisa: No, you said did you watch a video? I said, no, I did not watch a video, but if you do want to watch a video, Oprah’s got a great video. So if you’re video people watch Oprah. Anyway, stop trying to derail the thing I’m saying. Gabe: I’m sorry that I brought up that the celebrities can’t save us all and that we should stop valuing celebrities over actual doctors and researchers. Lisa: Red herring, Gabe, red herring. Gabe: I prefer a straw man argument Lisa: Oh, you’re right, that’s better. Yeah, take back the red herring thing. Gabe: So meta. Lisa: No, no, no, I’m a little impressed you used strawman correctly and. Gabe: I’m sad that every time I speak intelligently, you’re shocked. What do you think of me? Lisa: Really? We were married for years, you think I married a dumb guy? I hate it when you say that. You’re always like, oh, my God, you think I’m stupid. Really? Really. So I just deliberately chose to be around the stupid guy. It’s frankly insulting to my taste. Gabe: We had a healthy relationship, it’s much better now. Lisa: It is a lot better now, a lot better. You should all consider divorces, it works out great. Gabe: Remember when we were married and you specifically told me that fighting in public was wrong? Lisa: I know, right? That’s why this has changed my world. Gabe: So fighting in public is wrong, but fighting in public for money is OK. Lisa: I know. Like I said, I’ve been training for this job my whole life. Who knew you were actually giving me vocational training all those years? Gabe: Once again, you’re welcome. Lisa: We’ll be back in a minute after a word from our sponsors. Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Gabe: Now we’re back discussing, what are we talking about? Lisa: Gabe’s inability to feel happiness and joy and suck everybody else down. Gabe: All right, are you ready? Lisa: I feel like that’s an accurate summary. Gabe: And we’re back discussing my inability to experience happiness and joy. Lisa: It’s bleak but true. Gabe: Now explain to me again why it’s my fault that I’m not happy, even though I have chronicled an actual disorder and the celebrity that’s going to save me. Lisa: Stop trying to derail what I’m saying. I was looking up about choosing happiness, and I agree it is a very trite saying. I’m not a big one for self-help things. I’m in general not a snuggly, huggly, cuddly person. On the one hand, I feel a little bit icky saying choose happiness, because, yeah. I’m pretty sure rainbows or hearts are going to start coming in here pretty soon, and I really don’t like those things. Gabe: Space unicorn. Lisa: Well, OK, never mind, I take back. Space unicorns are great, also narwhals, they’re the unicorns of the sea Gabe: Narwhals, narwhals, swimming in the ocean Lisa: Narwhals, swimming in the ocean. Gabe: Anyways, continue. You’ve been trying to make a point now for about an hour and a half. Lisa: Gee, I wonder who’s distracting me from that. Gabe: Who? Lisa: Oh, for God’s sakes. All right, focus. When you say I’m doing the following things, I do recognize it’s kind of the marathon runner thing where people say, oh, my God, you’re so lazy. I just ran a marathon. Yeah, but did you run a triathlon? I mean, can’t you do better? So there’s always more. No matter what level you hit, there’s always more. So when you say I’m doing the following things, that’s wonderful. That’s great. But there’s always more. And here specifically, Gabe, are the more things that you could do, stop living in the past and more importantly, stop comparing yourself to others. You are constantly comparing yourself to other people and saying, look, I don’t have as much as those people, sad. Well, why are you picking those people? The majority of the world and the majority of humans throughout history are worse off than you are at this exact moment. So why aren’t you comparing yourself to those people? Because if all it takes and you’re the one who just told me that, that the reason you’re unhappy is because you’re comparing yourself to this person and that’s why you’re unhappy. Well, then compare yourself to a different person and poof, happiness. Gabe: Because the people who are worse off than me, I feel like it’s my job to help them be better. That’s what being a mental health advocate is. So, the fact that they are worse off than me is a representation of my failure and how much more work there is to do. Lisa: Wow, wow, Gabe: Yeah. Lisa: Wow, I don’t even Gabe: Yeah, I internalize a lot. Lisa: Whoa the ego on that. Wow. Gabe: I understand what you’re saying about ego, and probably is some of that there. I think that it is intermingled. But, you know, it bothers me. I have this guilt that I was able to get help. Whenever I hear stories of from family members who are talking about their loved ones who died by suicide. And I realized that they lived the same life as me. Their parents love them just as much as my parents loved me. Why was I the lucky one? That disturbs me. I can’t enjoy my recovery until everybody else has recovery, too. It pains me to know that there are people that could be living the exact same life as me if only they could get access to treatment and care. Because that is just so incredibly unfair. That keeps me up at night. The kids nowadays are calling that being an empath. It’s where you absorb other people’s emotions and claim them as your own, which is kind of an egotistical thing to do. And I don’t understand why it doesn’t work with happiness. I am traumatically affected by the suffering of other people who I consider a kindred spirit. And that is the basis of my advocacy. I understand that there is an element of ego in there, but it’s not because I think that I’m great or because I can fix it. A lot of people just don’t care. Lisa: Yeah, there is no answer to that, you are completely right and it’s horrifying. Gabe: Hey, I win, I win, I win, I win, I win, Lisa: No, because you’re Gabe: All I do is win, win, win and then I win, win, win. No, not too soon, Lisa: No, Gabe: Ok. Lisa: No, no, no. Also inaccurate, but again, sorry, I couldn’t resist. Gabe: I love how you get to be both my debate partner and you’re like the judge, you’re like inaccurate, no points awarded. I’m just like what happened here? I think I did win. I decide all points awarded. Lisa: Ok, so you decide, huh, but you’re not able to decide other things. Gabe: I can determine Lisa: Inconsistent. Gabe: I can determine things for other people, I Lisa: Exactly. Gabe: Can’t determine things for myself. Lisa: I’ve noticed that about you. Gabe: I know it’s, it’s a quirk. Lisa: That you’ve rebranded once again, reframed, as it were, as a virtue. Gabe: I learned it from watching you. You are the most critical person I know, and you say that being critical allows you to spot problems before they become bigger problems, Lisa: You’re welcome. Gabe: Right? You are correct, but you realize that you have rebranded being just this incredibly negative, spiteful, hateful person as no, no, no, I can spot problems before they become bigger problems, which I can’t deny. But most of the time you’re just complaining about a movie that everybody else enjoyed while we’re all trying to eat our dinner. Lisa: What I’m trying to say is you do it only in one direction, right? Like you look downwards of people who are not doing as well as you and say, well, look, I can’t be happy if I compare myself to those people. That’s not right. That’s morally wrong. Which, hey, you might have a point there. That’s not good. That’s not something that will enhance my happiness. OK, all fair points, all good. But you can look upwards at people who are doing arguably better than you and say, look, that’s the reason I’m unhappy. I can compare my happiness to those people and find it lacking. You consistently say I cannot use a downward measurement to do anything with my happiness. I can’t use that, but I can use an upward measurement. And that is definitive. That shows that I’m not happy and it shows that I’m completely reasonable in this belief. That does not make sense. You can’t have both. I think that you need to one, define happiness for yourself because you’ve never successfully done that. Gabe: Define happiness for you, Lisa. Lisa: I’ve got it. Gabe: Ok, you claim that you’re happy. Lisa: Yeah, I am happy. Gabe: What is Lisa Kiner’s definition of happiness? Lisa: Oh, don’t get me wrong, it’s a difficult thing to say. It’s kind of like that whole porn thing. I can’t really define it, but I know it when I see it, right? Yeah, I’m happy. Strangely, you don’t think I’m happy, but I am. I’m happy. Gabe: Define it then. Tell me the definition of Lisa Kiner’s happiness. Lisa: My mental illness is under excellent control. I haven’t been suicidal or hopeless in years, I admit it’s a low bar, but nonetheless it was one that I took a really long time to clear. So pretty excited about that. And overall, I’m mostly content and derive pleasure from things that I do in my day to day life. Gabe: All you do is eat Rice Krispies and sleep. Lisa: I find both of those things very pleasurable. Gabe: So I just need more sleep and more Rice Krispies, and I, too, can lead the Lisa Kiner life? Lisa: If those were the things that worked for you, yeah. You need to define the things that work for you in your own life, you get to define. Gabe: But a lot of people feel that you’re wasting your life. Lisa: So what? All of those habits that people who choose happiness have, that’s another one of them that you don’t have, you are defining yourself in comparison to others and you worry too much about what other people think. Gabe: But you worry about what other people think to this day, Lisa: Not like you do. Gabe: You are still upset that you don’t have a master’s degree. Lisa: Yeah, yeah, I am. Gabe: Well, but why? Lisa: Obviously, I’m not upset enough to go get one. Gabe: How will having a master’s degree help you sleep all day, podcast and eat Rice Krispies? Lisa: Which is why I don’t have one. Gabe: Then why are you upset that you don’t have one? You clearly don’t want it or need it. Lisa: Well, that’s my point. You remember how one time we were at Weight Watchers and the lady had an example of, oh, I saw a classical musician and he was amazing. And I thought, oh, my God, I would do anything to be able to play the piano like that. I would do anything. Would you? Would you practice six hours a day for eight years? Her analogy was, oh, I would do anything to be thin. Would you? Well, then will you go to the gym every day and follow this weight loss plan? Yeah, this is the same thing. When I say, gee, I’d really like a master’s degree. Well, apparently, I don’t in fact, want one. If I wanted it that badly, I’d have one. Gabe: But doesn’t it upset you that people that you’ve known a long time, the reason that a master’s degree is so important to Lisa is of course, because that’s all she wanted in high school. I believe you wanted a Ph.D.? Lisa: I did. Gabe: You wanted you wanted to go all the way and you just have a bachelor’s degree in physics. Just. Lisa: I was very academically successful when I was younger, when I was in high school, etc. But yeah, mental illness has a way of derailing some of your academic plans at that age. Gabe: But there’s a lot of friends and family that are disappointed in you for not Lisa: Yeah. Gabe: Having achieved it, and they say things like, oh, you’re so smart, why are you just a podcaster? Lisa: You had such potential, Gabe: Yes. Lisa: You had so many possibilities before you. Gabe: Doesn’t that bother you coming from people you love? Lisa: Yeah, it’s super annoying, totally bothers me. Gabe: Well, how come that doesn’t affect you? Lisa: How much are you going to let stuff like that bother you? Gabe: I, it bothers me a lot. Lisa: Exactly like I just said, that’s one of the habits you’re not choosing. You worry too much about what other people are thinking about you. And don’t get me wrong, I understand, as we talked about in a previous episode, this happens to be a little bit self protective. In general, people like you. People like you, they get along with you. People in general don’t like me and don’t get along with me and find my personality to be abrasive. If I cared too much about what other people think, I would just have to curl up and die. There’d be no solution because most people, in fact, do not like me. To say to myself, hey, I don’t care about what other people think. Well, isn’t that convenient, since most people don’t really care for you? Yeah. Yeah, it is. But nonetheless. Gabe: I like you just fine, Lisa, but it’s self-protective for me to listen to others because there was a point in my life where I didn’t listen to others when they said things like, Gabe, get off the roof, Gabe, don’t spend all that money. Gabe, you can’t behave this way. Gabe, you’re treating us poorly. Gabe, your behavior is problematic. Gabe, you need to get help. And I would like to point out that somebody once said, Gabe, being suicidal is not normal. You need to go to a hospital. And I did not listen to them. I was tricked. I was taken there under false pretenses, which was for my own good. So, once I realized that, oh, my God, I should have been listening to these people all along, I’ve now listened to them more. When did they switch from saying reasonable things to stupid shit? I don’t know. And how do I tell the difference? Lisa: That’s a problem, that is an absolute problem, and once again, it’s harder for people with mental illness, but it’s not impossible. So, yes, it is harder for you because how do you find that line? You couldn’t trust your own thoughts before. So what, you’re supposed to trust them now? That doesn’t make sense. It is more difficult for you, but it is not impossible. And you understand that in other areas of your life. There are plenty of people that tell you about various things you should do. The obvious answer would be politics or religion, right? There are plenty of people like, no, no, no, you should vote this way, Gabe. And you have no problem with saying no, you are wrong. That is incorrect. I should not vote that way. You don’t have any problem with that. That’s like a proof of concept. How do you find that of no, no. I am confident in my own beliefs on this subject. How do you find that for this? In your own self-worth or your own level of happiness? Gabe: Obviously, I understand what you’re saying, but let’s hang on to that political example that you gave for a moment. You know, Gabe and Lisa, we have pretty much the identical political leanings. I mean, Lisa: Pretty close. Gabe: So it would give me pause if one day you said Gabe X and I was like, no, Lisa, it’s Y. It’s always been Y. And you’re like, Yeah, but now it’s X. You’re saying that I should be 100 percent confident that I’m still right? No, that would give me great pause, great long. That would keep me up at night. Lisa: So, what you’re saying is that there are people whose opinions you respect who if they said something counter to what you believe, you would have to stop and consider it. Gabe: Like hard. Lisa: If you respect my opinion so greatly or you respect your long-term therapist or your doctors, et cetera, they’re telling you the same stuff. Gabe: Well, Lisa: Why aren’t you listening to it? Gabe: The role of a therapist or a doctor is not to tell you that you are happy. So, no, that is incorrect. Lisa: No, no, no, no, no, Gabe: But. Lisa: That’s not what I’m saying. They are telling you if you do the following things, it will be beneficial to you. Gabe: We’re not debating whether or not I have beneficial things in my life. Lisa: No, we’re debating whether or not you do the habits of happy people and you don’t. Gabe: Yes, I do. Lisa: No, you don’t. Gabe: Yes, I do. What habit of happy people do I not do? I don’t choose happiness? I don’t feel happy. I’m sorry I can’t choose it. And I think that’s ridiculous. It’s like choosing to have a headache or not to have a headache. You can’t choose it. It’s not a choice. That’s nonsense. Utter nonsense. Lisa: But you, you could choose to avoid your migraine triggers; you could choose to go to the neurologist and get a better treatment plan. Gabe: I do all those things, I absolutely do. Lisa: Oh, but see, that’s just it, you don’t. And once again, marathon triathlon, you could always do more. The thing you do not do is stop worrying about what other people think. Stop comparing yourself to other people and stop living in the past. Those three things are what is keeping you from having the ability, or from just generally choosing, happiness. Is it harder for you than the average? Sure. Life screwed you. But so what? Gabe: This is the happiest I’ve ever Lisa: Yup. Gabe: Been and this is also the most content that I’ve ever been. I recognize that I don’t feel like I should, but I do notice that when I reflect back, I do feel that I, we see this in our own marriage. When we got divorced, it was awful. We had a lot of problems. But now from this vantage point with our friendship, we actually have a lot of happy memories from the time that we were married and together, I think that our memories are constantly adjusting and shifting as new data becomes available. And that’s why the quote at the beginning, not the one you picked, not the crappy one from the president guy, but that’s why the quote really struck me so much when I saw it on Twitter, I feel like I’m constantly worrying about the next part of my life without realizing I’m right in the middle of what I used to look forward to. Lisa: Yes, and when you showed it to me, I thought, oh, my God, this person is brilliant and apparently is following you around to write down quotes, because this encapsulates your entire life and your entire mindset and not for nothing, it’s hard to watch. It’s difficult to see this in you all the time. It’s depressing and it makes me sad for you, which is messing with my happiness, Gabe. Gabe: I recognized myself in it, too, and actually, as you know, the first thing I thought about when I saw it is, oh my God, that’s what Lisa says about me. And I actually screenshot, Lisa is not on Twitter. I screenshot it and sent it to Lisa. But here’s the thing that I realized. That thing has been retweeted 36,400 times as of like four days ago. So I don’t even know what it’s up to now. And four days ago, it was liked 133,000 times. I am not alone. I am not the only person that thinks this way, feels this way or has this particular problem. And that’s what made me want to do a deep dive into it. Also, I love subjects where Lisa just gets to scream over and over again, you are so wrong. I still maintain that nobody is looking into happiness inflation, and it’s a real problem. But I also maintain, Lisa, you are correct. There is an element of control that I have and there is an element of control that the 133,000 people who liked this tweet have. We can steer our own destiny. I don’t know if I’m willing to say control it, but I think we can move the wheel back and forth and try to get a handle on it. Lisa: I also like subjects where I can tell you repeatedly that you’re wrong. We should definitely pick more of those subjects in the future, that will make us all happy. But your main problem is that you’ve never actually defined or determined what happiness does mean to you. Gabe: In the meantime, I will take solace in the fact that I am right in the middle of what I used to look forward to, which means retroactively, past Gabe would be very happy. Lisa: And you are certainly not alone. Gabe: All right, ladies and gentlemen, this is the point of the show where I plead with you, if you have any subjects that you want to hear Gabe and Lisa debate, argue about or cover, hit us up at [email protected] and tell us about it. Wherever you downloaded this podcast, please subscribe. Also, please rate, rank and review it and use your words and tell people why they should download and listen as well. And hey everybody, I wrote the book, Mental Illness Is an Asshole: And Other Observations. It’s three hundred and eighty pages of awesome. You can get it on Amazon, of course, but you can also go over to gabehoward.com and buy it from there and I will sign it. I’ll also throw in a bunch of free stuff, including stickers of the Not Crazy podcast. Lisa: Remember, there’s always an outtake after the credits, and we’ll see you next Tuesday. Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person? Not Crazy travels well. Have us record an episode live at your next event. E-mail [email protected] for details.
The post Podcast: Is Happiness a Choice? first appeared on World of Psychology. from https://ift.tt/2Sw7H2G Check out https://daniejadkins.wordpress.com/ Is anyone single on purpose? In today’s podcast, Gabe talks with Bella DePaulo, Ph.D, a prominent thinker and author on the single life, who shatters myths about being single. She shares how many people thrive as a single person and feel their most empowered living the single life. In fact, single people often hold prominent positions in their communities. If you assumed all single people were only single by default and are still looking for the “one,” tune in to hear a fresh new perspective.
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Guest information for ‘Bella DePaulo – Is Single Life Mentally Unhealthy’ Podcast Episode
Bella DePaulo, a Harvard PhD with more than 150 scholarly publications, has been described by the Atlantic magazine as “America’s foremost thinker and writer on the single experience.” Her TEDx talk, “What no one ever told you about people who are single,” has been viewed more than a million times. She is the author of Singled Out: How Singles Are Stereotyped, Stigmatized, and Ignored, and Still Live Happily Ever After, How We Live Now: Redefining Home and Family in the 21st Century, and other books. She has been writing the “Living Single” blog for Psychology Today since 2008 and she wrote the “Single at Heart” blog for Psych Central from 2011 to 2020. Professor DePaulo has also written for publications such as the New York Times, the Washington Post, the Atlantic magazine, New York magazine, Slate, Bustle, Forbes, Time magazine, the Guardian, the Chronicle of Higher Education, NBC, and CNN. Bella DePaulo has discussed single life on radio and television, including on NPR (many times) and CNN. Her work has been described in the New York Times, the Washington Post, the Wall Street Journal, USA Today, Cosmopolitan, Time magazine, the Atlantic, the Economist, the Week, the Nation, Business Week, AARP Magazine, Newsweek, and the TED Ideas Blog, among many others. She is currently an Academic Affiliate in the Department of Psychological and Brain Sciences, University of California at Santa Barbara. About The Psych Central Podcast Host Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from the author. To learn more about Gabe, please visit his website, gabehoward.com. Computer Generated Transcript for ‘Bella DePaulo – Is Single Life Mentally Unhealthy’ EpisodeEditor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: You’re listening to the Psych Central Podcast, where guest experts in the field of psychology and mental health share thought-provoking information using plain, everyday language. Here’s your host, Gabe Howard. Gabe Howard: Hello, everyone, and welcome to this week’s episode of The Psych Central Podcast, I’m your host Gabe Howard and calling into the show today, we have Dr. Bella DePaulo, a Harvard Ph.D. with more than 150 scholarly publications. She has been described by The Atlantic magazine as America’s foremost thinker and writer on the single experience. Dr. DePaulo is the author of numerous books, including Singled Out: How Singles Are Stereotyped, Stigmatized and Ignored and Still Live Happily Ever After and How We Live Now: Redefining Home and family in the 21st century. Dr. DePaulo, welcome to the show. Bella DePaulo, Ph.D.: Thank you for having me. Gabe Howard: Well, I’m very excited you’re here because I can’t recall a period of time in, definitely my adult life, but probably my entire life where I wasn’t either in a relationship or looking for a relationship. And honestly, that’s why your work intrigued me so much. You wrote an article called The Badass Personalities of People Who Like Being Alone. And it just it really changed my thinking about being single and of course, by extension, single people. Now you have a name for people who like to be single. Can you share? Bella DePaulo, Ph.D.: Yes, it’s single at heart, those are people who live their best lives by being single, their most authentic, fulfilling, meaningful lives, and for people who are single at heart, they’re not single because they were unlucky in love where they couldn’t find someone or they have issues or they were just stuck with it. It’s not a default. It’s a choice we embrace. I consider myself one of them and we embrace being single. Gabe Howard: I’m really looking at my own life because I really had two settings, either in a relationship or looking for a relationship, and from my vantage point, and I’m happily married, I want you to know that. But what’s so incredibly interesting is the people around me, they supported this idea that Gabe either needed to be in a relationship or looking for a relationship. People would be like, oh, Gabe’s single, oh, I have the perfect friend. Is this what life is like for everybody? Bella DePaulo, Ph.D.: Well, you know, that has been the assumption so often and so pervasively that everybody wants to get married, everybody wants to be in a romantic relationship. But just a few weeks ago, the Pew Research Center, they reported a survey that they did just before the pandemic started in which they asked solo single people who didn’t already have a partner. Do you want to have a committed romantic relationship? And then they asked another question, do you want to date? And half of the people, 50 percent, did not want a romantic relationship and they didn’t even want to date. And that’s just an astounding shattering of the kind of assumption that you just described. Gabe Howard: There is this strong social expectation that everyone desires to be married or at the very Bella DePaulo, Ph.D.: Right. Gabe Howard: Least coupled up in some manner, how Bella DePaulo, Ph.D.: Right. Gabe Howard: Do single people fight that societal pressure? Don’t they just end up there to quiet their friends, family and society at large? Bella DePaulo, Ph.D.: Well, sometimes they do, and that’s not a good thing, because if it’s not what they want, then obviously they’re not going to be happy. But it’s also not fair to the people they end up with when they’re partnering just because they think that’s what they should do. Would you want to be stuck with someone who was just doing it just with you out of social pressure? And I found some some really fascinating stories from people who meet the love of their life. And they’re in this relationship. Their partner makes their hearts pitter patter. And, you know, they’re crazy in love and their partner loves them back. And even though they have found this perfect person, they don’t want to be in a relationship. It’s just fascinating that this expectation has such a hold on us that it gets us into a relationship we don’t want. And most of those are the lucky ones who end up with someone that they do love. So, you know, at least there’s that. But, you know, a lot of people who really prefer being single, who live their best lives are single. People end up in relationships that aren’t that great. And then their partner keeps wondering, what’s wrong? What am I doing wrong? Well, maybe nothing. Gabe Howard: It really sounds like and then please, please correct me if I’m wrong, it really sounds like they’re remaining single intentionally on purpose. They’re planning on being single. And I really, genuinely believed that people ended up single because it just turned out that way. You’re saying that there are people making intentional choices to remain single. Bella DePaulo, Ph.D.: Yes, especially now that the idea that it’s legitimate, it’s fine, it’s a totally respectable way to live as that idea is getting out there, more people are making that decision. I think for a lot of people, they have had to go through the process of trying out romantic relationships and thinking to themselves, oh, what’s wrong with me? Why don’t I want this too? I have issues. I need to see a therapist and maybe some people do. But for people who are single at heart, they really do best on their own. And it’s not just, oh, well, they can settle for being on their own, but they have some very psychologically healthy profiles. For example, they tend to be more open minded. And in several studies, they are actually less neurotic than people who don’t like being alone or people who are afraid of being single. Gabe Howard: I watched your very popular TEDx talk, over a million views, it was called What no one ever told you about people who are single (sic). And in it you discuss research that shows that contrary to conventional wisdom, married people are not appreciably happier than single people. And divorced people are in a worse position. If research shows that marriage does not appreciably increase happiness. Why do we all think that it does? Bella DePaulo, Ph.D.: Well, first, the question is, if you get married, will you be happier? And we’re all led to believe, yes, yes, yes, yes, that’s the way to get happiness. And in fact, we use that almost as a synonym. Oh, Gabe deserves to be happy. He should find someone right? Gabe Howard: Yeah. Bella DePaulo, Ph.D.: And yet there are now dozens of studies that follow the same people over the course of their lives starting when they’re single. And then if they get married and when people get married, they don’t become any happier than they were when they were single. At best, they become a tiny bit happier around the time of the wedding. It’s all so exciting. And then they go back to being as happy or unhappy as they were when they were single. So, this idea that, oh, get married and that’s your magical route to happiness, tons of research shows it’s just not true. And yet, like you say, we believe that it’s such a hard myth to shatter. Not because the data aren’t there, but because people are really invested in believing that it’s true, because what marriage and long term romantic coupling is held out to offer isn’t just happiness, but a whole life that falls in place. You find that one special person and now you have your soulmate, your travel mate, your co-parent if you are a parent, your sexual partner, your confidante. And you will not just be happier, but you’ll be healthier and you’ll live longer and all of your wishes will come true. And of course, I mean, imagine that. That sounds like a magical snake oil that people used Gabe Howard: Right. Bella DePaulo, Ph.D.: To sell, but what a thing to grab on to. I mean, imagine that if you find a person and then that’s it, you’re set. So people are invested in believing that and it’s very hard to dissuade them from that very attractive belief. Gabe Howard: You are right, the concept of the one permeates our culture, but one of the things that you mentioned was there your sexual partner. Now, for many people, marriage and sexuality, they they go hand in hand. In fact, you cannot have one without the other. And that it makes me wonder, are people who choose to remain single, are they asexual? Are the two things related, unrelated? How does that fit together? Bella DePaulo, Ph.D.: People who are single at heart, are a little more likely to be asexual than people who aren’t. But the asexuals are still in the minority, even among the single at heart. And what they do for sexual gratification is some just don’t care. And then everybody else does what they want to. You know, there’s not the stigma anymore of having sex outside of marriage. So you don’t need to be married to have sexual partners or just people that you connect with for that reason. And different people have different ways of solving it. That’s really one of the main lessons about being single and especially single heart, is that it’s not a restrictive restricting thing to be. It’s expansive. So if you’re married, the expectation is that your partner is your sex partner and you have sex with them and you don’t have sex with anyone else. Whereas if you’re single, the whole wide world of alternatives is open to you. You can not have sex at all. Or you could gratify yourself or you could have sex with different people, or you could have sex with one person that you have some understanding with. There are just lots of possibilities and it’s a very personal individual matter. Gabe Howard: I like how you put that, that there’s an array of options that people don’t think about, because when it comes to sex, even though our culture is very sexualized, we also have this idea that you also have to find the one that must be your long-term sexual partner. And certainly we’re now seeing, you know, marriages that are non-monogamous. We’re seeing polyamory Bella DePaulo, Ph.D.: Yeah. Gabe Howard: And on and on and on. Bella DePaulo, Ph.D.: Consensual non monogamy, right? Yeah, Gabe Howard: Yes, consensual non monogamy. Yeah, but it is fascinating, this idea that we put so much on marriage and what you’re saying is that marriage isn’t actually solving as many problems as we thought that it was, and in fact, it’s creating some. And that doesn’t make marriage bad. It just doesn’t make single bad. And that’s really the message, if I understand correctly, that single is a choice. You can do what you want. Nobody’s hurting anybody. And. Bella DePaulo, Ph.D.: Oh, that’s too grudging, that is way too grudging. Single life can be an absolutely wonderful, empowering, amazing, fulfilling, meaningful life. Gabe Howard: It makes me wonder, though, and I’m heavily engrossed in this must be in a relationship, so I’m giving you full permission to smack me down, please school me here, but there’s this little piece of me that’s just sitting here like, well, but maybe they haven’t met the right person yet. They’re just, they’re just very picky. And as soon as the right one comes along, they’ll Bella DePaulo, Ph.D.: Right. Gabe Howard: Completely see things Gabe’s way. I hear how that sounds, even as I’m saying it. Bella DePaulo, Ph.D.: Yeah, it’s an important point because a lot of people will think that way, and that’s why I love these stories and I have a whole collection of them, of people who have met, the one, who have a partner they love, a partner who loves them back. And one person, for example, was telling me that she was trying to explain to her partner why she wants to be single. And she would say, now I have these adventures I want to do. And he said, well, we can do this together, but that’s not it. That’s not the life that she wants and envisions and cherishes and savors. So it’s not who we are. People who are single at heart, having a romantic partner at the center of our lives, it’s just not who we are. It’s like trying to tell somebody who’s not heterosexual to just keep trying to find a person that makes the heart pitter patter. It’s not going to happen. Gabe Howard: We’ll be right back after a word from our sponsors. Sponsor Message: Gabe here and I wanted to tell you about Psych Central’s other podcast that I host, Not Crazy. It’s straight talk about the world of mental illness and it is hosted by me and my ex-wife. You should check it out at PsychCentral.com/NotCrazy or your favorite podcast player. Sponsor Message: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Gabe Howard: We’re back with America’s foremost thinker and writer on the single experience, Dr. Bella DePaulo. So, what advice do you have for all of the probably well-meaning but yet incredibly nosy relatives and even strangers? How do single at heart people handle the Gabe Howard’s of the world that decide to, I’m making air quotes, correct them or help them when they don’t actually need help? Because I know how strong this messaging is, and I have to imagine that it’s stronger if you disagree with it. Bella DePaulo, Ph.D.: Yes, there are these amazing studies that looked at how people react to single people and they looked at two different kinds of single people, single people who really want to be couples, they don’t like being single and single people who chose to be single on their happily single. And guess which single people get treated most harshly? The single people who are happily single. Other people will say to them, oh, you’re not really happy, you just haven’t met the one. They even expressed anger at the single people who say that they’re happily single. And I think, again, it comes back to that mythical magical formula we’re offered that if you just find the right person, all the pieces of your life will fall in place and you’ll live happily ever after and you’ll be healthy and you’ll even be morally superior to what you wrote in your book. And so single people who are happily single threaten that myth, that promise that’s held out to people. And so they are rebuked and it’s difficult. So my advice is, to be honest. To say, I like being single. This is my best life, but know that you probably will not be treated kindly and people will second guess you as if they know your feelings better than you do. Oh, you don’t really feel that way. Oh, you just haven’t met someone. You’ll change your mind, you’ll outgrow it. One good thing now is that it’s easier than ever for people to find their tribes, especially online. So, for example, I started this online Facebook community called the Community of Single People. And it’s open to mostly everyone. But really, I started it for single people who love their single life and who want to be there for each other in supporting other people who also love being single and don’t want to have to feel defensive about all the time. And since I started that in 2015, we now have about four thousand seven hundred members from more than a hundred nations. Gabe Howard: And they’re just living their best life, minding their own business, they don’t need Bella DePaulo, Ph.D.: Yeah. Gabe Howard: Married people, coupled people telling them what to do, they’re just. Bella DePaulo, Ph.D.: Right, and so we talk about the things that people say to us and make fun of them. So it’s kind of a nice place. Gabe Howard: It’s interesting that you brought up that even though you’re single, you desire to have emotional relationships, they’re just not romantic relationships. Right? I really bought into these cultural messages that thinks, well, if you want to be single, it means that you’re antisocial. It means that you don’t Bella DePaulo, Ph.D.: Oh my gosh. Gabe Howard: Want to make connections. It means that you hate people. Bella DePaulo, Ph.D.: Oh, that’s so sad. Gabe Howard: I just I know I know how wrong that is, Bella DePaulo, Ph.D.: Yes. Gabe Howard: But it’s hard to get over. Bella DePaulo, Ph.D.: Yes, it’s actually exactly wrong because and again, there’s good research on this showing that when people get married, they become more insular, they pay less attention to their friends, they reach out to their parents less, and they become this little insular couple or family. Now, it doesn’t happen to all married couples, of course, but on the average, the married people who whose social worlds shrink and it’s the single people who have more friends who do more of the work of keeping up with their friends and neighbors, relatives, coworkers, they are more often the life of their towns and communities. And so, the actual data is exactly the opposite of what we are led to believe by these stereotypes and myths about single people. Gabe Howard: It really is. The myth is so pervasive, right, it’s just Bella DePaulo, Ph.D.: Yeah, yeah. Gabe Howard: The romantic comedies say it. I looked into a lot of like pop culture and there there isn’t a movie or a television show with a happily single person that doesn’t end with them finding the one. Even Bella DePaulo, Ph.D.: I know. Gabe Howard: When you find a single person in the group. You know, let’s take Phoebe in Friends. You know, she was predominantly single for a long time, but they found him. Bella DePaulo, Ph.D.: Or Sex and the City was supposed to be about four bold, sexy, empowered single women, and they all end up like cooing couples or are headed that way at the end. It was such a huge letdown. And that is really hard when there’s a whole entertainment industry that’s built on the assumption that everybody is going to get married. And, you know, it’s gotten to the point where it’s so overdone that it doesn’t work anymore to have a series that builds up to one wedding at the end. I mean, you have shows like Gray’s Anatomy that have episodes with multiple weddings in the same episode. I think it’s like we’ve grown so used to it that it takes more of this, what I call “matro-mania” to get through to us. Oh, one wedding? Big deal. We’ve got to try again. Make it another wedding. How about three weddings in this episode? Gabe Howard: My last question is for people who are, as you describe, single at heart, they want to be single. They’re struggling with pop culture, society, their friends, their families. What advice do you have for them? Bella DePaulo, Ph.D.: Yeah, find your tribe. If online support groups are your thing join the community of single people. I have a whole list of resources I can send that to you to post. And that includes blogs, podcasts, I’ll add this one now. Gabe Howard: Yeah, you’re the author of the Living Single blog over on Psychology Today. You’ve been writing that since 2008. Bella DePaulo, Ph.D.: Right, so that’s a good possibility, but I’ll send you a link to a whole list of resources for single people who are unapologetically and happily and joyfully single. Gabe Howard: And I invite everybody to check out her blog, Living Single over on Psychology Today. Also, we will put a list of other resources into the show notes that you can check them all out. Dr. DePaulo, thank you so much for being you and for being here and thank you so much for pointing out all of the ways that I was wrong. I really, really appreciate it. You’ve really taught me a lot. Bella DePaulo, Ph.D.: Thank you for inviting me. I enjoyed talking to you. Gabe Howard: And thank you, everybody, for listening, if you loved the show, please, please, please subscribe. Wherever you downloaded this podcast hit Subscribe, use your words, rate, rank, and review. Tell people why they should listen. Share us on social media. If you have any ideas for a show topic, hit us up at a Show@PsychCentral. My name is Gabe Howard and I’m the author of Mental Illness Is an Asshole, which is available on Amazon. Or you can get a signed copy for way less money at my personal website, gabehoward.com. And always remember, you can get one week of free, convenient, affordable, private online counseling any time anywhere simply by visiting BetterHelp.com/PsychCentral. We’ll see everyone next week. Announcer: You’ve been listening to The Psych Central Podcast. Want your audience to be wowed at your next event? Feature an appearance and LIVE RECORDING of the Psych Central Podcast right from your stage! For more details, or to book an event, please email us at [email protected]. Previous episodes can be found at PsychCentral.com/Show or on your favorite podcast player. Psych Central is the internet’s oldest and largest independent mental health website run by mental health professionals. Overseen by Dr. John Grohol, Psych Central offers trusted resources and quizzes to help answer your questions about mental health, personality, psychotherapy, and more. Please visit us today at PsychCentral.com. To learn more about our host, Gabe Howard, please visit his website at gabehoward.com. Thank you for listening and please share with your friends, family, and followers.
The post Is Single Life Mentally Unhealthy? first appeared on World of Psychology. from https://ift.tt/3kZPruP Check out https://daniejadkins.wordpress.com/ Who do you think understands more about bipolar disorder: a psychiatrist or a patient with the illness? In this Not Crazy podcast, we discuss whether a patient can be considered a mental health expert without all the credentials after their name. Today we invite writer and bipolar advocate Natasha Tracy — who also has bipolar disorder — to the show to give her opinion.
Would you seek advice from a patient? Join us for an in-depth discussion on mental health patients as experts. And Please Remember to Rate & Review Us!
Guest Information for ‘Natasha Tracy- Mental Patient Expert’ Podcast Episode Natasha Tracy is an award-winning writer, speaker and social media consultant from the Pacific Northwest. She works to bring high-quality, insightful and trusted information on bipolar disorder and related illnesses to the public while engaging with the mental health community. Natasha has written, literally, thousands of pages on mental health-related matters. She currently writes two award-winning blogs: Breaking Bipolar and Bipolar Burble, which has been named a top 10 health blog by Healthista, Health.com, Healthline, Medical News Today and others. Natasha has also been featured on the Huffington Post, BPHope, Healthline, PsychCentral, Sharecare and many others.
About The Not Crazy Podcast Hosts Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Lisa is the producer of the Psych Central podcast, Not Crazy. She is the recipient of The National Alliance on Mental Illness’s “Above and Beyond” award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has worked alongside Gabe in mental health advocacy for over a decade. She lives in Columbus, Ohio, with her husband; enjoys international travel; and orders 12 pairs of shoes online, picks the best one, and sends the other 11 back.
Computer Generated Transcript for “Natasha Tracy- Mental Patient Expert” EpisodeEditor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Lisa: You’re listening to Not Crazy, a psych central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts. Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Lisa: You’re listening to Not Crazy, a Psych Central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts. Gabe: Hey, everyone, and welcome to the Not Crazy podcast, I’m your host Gabe Howard, and with me, as always, is Lisa Kiner. Lisa? Lisa: Hey, everyone, today’s quote is from Paul Kalanithi What patients seek is not scientific knowledge that doctors hide, but existential authenticity each person must find on her own. Gabe: Today, we’re going to be talking about patients as experts because it’s a controversial topic, those of us with lived experience being experts. But at the same time, I think that it’s very relevant, especially with the quote that you just read. Lisa, why did you choose this particular quote? Lisa: At first, I didn’t particularly like this quote, because it does kind of have that whole, oh, doctors all have the cure for cancer, they’re hiding it from us, you know, that kind of conspiracy vibe. But what it’s actually about is that when people seek out so-called patient experts, they’re not looking for medical information. They’re looking for reassurance. Gabe: That’s exactly how I heard it, Lisa. I didn’t think about any of this conspiracy stuff, I just thought about this idea that your doctor is sort of handcuffed. They can only give you the scientific information and scientific information is valuable and it’s important and we need it. And nobody is insulting that in any way on this show. But reassurance is also important. Understanding is also important. This idea that where we are going, somebody else has been is also important. And of course, it’s a scary place to be there. And I would kind of like to know what to expect maybe from somebody who’s already walked along that path. I still don’t understand why people can’t have two things. I’m always shocked that the debate is, do we need lived experience support or do we need doctor support or medical establishment supports? Why the hell can’t we have both? Why are they considered mutually exclusive? Lisa: You know, that’s a good question, and they really very much are. You can have one or the other. No one ever tries to combine them. Gabe: And I think you’re wrong if you try to have one or the other, you know, look, as a guy who’s living with bipolar disorder, if I get diagnosed with bipolar disorder, I tell my doctor to go F himself and I find a whole bunch of other people with serious and persistent mental illness and we all try to treat each other? That’s going to turn out poorly. But on the other hand, if I get diagnosed with bipolar disorder and I don’t get support for, my doctor can’t prescribe anything for the fact that I’m scared or the fact that people look at me differently or the stigma or the discrimination. I suppose we can discuss that in therapy if I bring it up and I have the words to bring it up. That’s really where I feel that the lived experience or patient experience or the patient expert is most valuable. They helped me put into words what I struggled to put into words. So, when I got that precious, you know, eight minutes with my doctor or 15 minutes with my doctor, I could say I’m concerned about X. And it was perfect. I knew exactly how to phrase it and what to ask for. And I think that made me a more efficient patient. Lisa: Well, and after all, efficiency is what we’re all striving for in health care. Gabe: It is. It is in America. I know that sounds funny, but it is. You know as well as I do that doctors will just not sit and talk you off a ledge. They don’t have time. This is managed care. Lisa: There is an emotional aspect to medical care and to healing that is not addressed, that is completely ignored, and I suppose that is the realm of the so-called patient voice or patient expert, probably the only realm where it’s appropriate. Gabe: You’ve thought about this a lot, Lisa. Lisa: I have. Gabe: You know exactly where you want it to be and you have grave concerns about the lived experience expert going anyplace else. Lisa: I do. I think often we see not only so-called experts trying to go somewhere else, but people wanting them to. You and I might be putting ourselves in the proper place, but the people who write into us or our customers, as it were, our, should I say, fans, Gabe: Yeah, Lisa: Listeners, Gabe: Why can’t they be our fans, our listeners? Lisa: Ok? Gabe: We could go with listeners, our friends, our dear supportive loved ones on the other side of the earbuds. Lisa: Yeah, those people are frequently putting us in the wrong place, and it makes me uncomfortable and I’m not sure what to do with that Gabe: Can you give me an example of this? You say they’re putting us in the wrong place. How? Lisa: All the time, whenever we have Facebook Live or something like that, people will ask questions that we are not qualified to answer. And the number one thing I always think is why are you asking someone on the Internet this? Why are you not asking a doctor this? You’re not even asking a doctor on the Internet. You’re asking two people who’ve already told you they have no medical training. And that happens all the time. We get more of those questions than we do questions that we can actually answer. Gabe: Now, of course, in fairness, we can answer those questions, the answer is you need have a conversation Lisa: Talk to a doctor. Gabe: With a doctor and here are some hints to get that conversation started. Lisa: That’s not what they’re looking for, though. Gabe: Well, one, you don’t know that. They keep coming back. Our show is very popular. We’ve never had anybody write in to us and say you’re not helpful. You didn’t diagnose me over your podcast, Facebook Live, public appearance, etc. You do that a lot where you decide that the people that are asking us the question are already wrong for asking us the question. And I’m curious Lisa: Yeah. Gabe: As to why. Why have you decided that their motivation is so either malicious or stupid? Lisa: Not malicious, mostly stupid, I never think it’s malicious. Gabe: But why? Lisa: I think part of it is that I would personally never do this. If I wanted medical information, I would not go listen to some random person on Facebook. Go to a doctor or at a minimum, go to a website run by doctors. It makes me uncomfortable that people are asking us these questions. And every single time, every single time, what I want to say is, I don’t know, ask a doctor. And you’ve actually said to me, look, you can’t answer every single question with, I don’t know, ask a doctor. That makes me uncomfortable because that is the right answer. Gabe: You say that it’s the right answer, but I’m curious is it the right answer because of your wealth, status, privilege and health insurance? Lisa: That’s true. Gabe: Are you saying that you don’t take this route because you have so many better ones? Is this the equivalent of you walking up to somebody and saying, oh, my God, why are you driving a 20-year-old car that Consumer Reports says is a jalopy? What is wrong with you? The correct answer is to buy a 2021 Toyota Corolla, the number one rated. It makes me uncomfortable that anybody would even drive that car. Is the assumption that every single person that’s asking us questions has the ability to, one see a doctor, two understands that that’s the path because we’re all taught good mental health care before we’re sick. Everybody, even people with no mental illness or no mental health issues whatsoever, completely understand what’s happening. So, the fact that they’re asking strangers on the Internet is because they’ve chosen to be stupid and ask incompetent people, not because they’re so new at this, that they just don’t understand what to do or they’ve already asked a doctor, didn’t understand the answer and the doctor pushed them along. And while you’re screaming, be a health care consumer and get a new doctor, they can’t because they’re on case management and that’s the only doctor they get. Is this what you’re saying? Lisa: But you’re doing the reverse, you’re assuming that all of these people don’t have other options, I don’t think that’s true. I think a large number of the people who are coming asking us these questions are just like us. They’re in a position of privilege. They’re middle class. They’re probably even in the Midwest. And they have the same options we do to go to doctors and get medical care from other sources. And they’re not using it because it makes them uncomfortable to do so. Gabe: Listen to what you just said, it makes them uncomfortable to do so. So they reach out to somebody to get better information. Lisa: It’s not better information. Gabe: Why not? They’re not using the information that they have. It doesn’t matter how good something is if you’re unwilling to use it. Their status right now is that they are not getting help. They don’t understand and they’re afraid to do so. So therefore, that information that they have is clearly not working for them. Lisa: But so what? Facts and figures and valid information is not working for me. Oh, well then. What am I supposed to do with that? Gabe: It’s interesting that you have this general attitude, because you believe in de-escalation. You believe in discussion. You believe that they should help you understand that it’s in your best interest, not just to say, hey, you made a bad decision and now you must bear the consequences. You believe this very strongly. Yet when somebody does that in the medical field, you’re just like doctors are deities. The doctor said it. You didn’t listen. You don’t deserve help. Lisa: No, absolutely not. No, you are completely mischaracterizing what I’m saying. No, I do not think that. Doctors are not deities. In fact, some of them are dicks. But anyway, when you say, oh, but you believe in de-escalation, etc., so that person’s role is to de-escalate. Doesn’t that mean that our role is to educate folks and to say to them, look, stop asking me, go ask someone else? Shouldn’t that then be our responsibility and our role to explain to people why it is they shouldn’t be talking to us? But you don’t think that. You’ve never once been OK with me giving that answer. Gabe: Well, no, that’s not true. That is a complete mischaracterization of me. First off, you said earlier that I said that you can’t answer every question with you need to see a doctor. That is true. I said that. But you’ve taken it wildly out of context. Lisa: OK. Gabe: Just wildly out of context. What I said is if somebody says I think I might have bipolar disorder, what should I do? I said that your answer can’t be you should go see a doctor because that’s not complete. What I said that you should say is, listen, you have to consider why you think that and then you have to consider what your options are. Your options are, talk to your general practitioner, to make an appointment with a psychologist, make an appointment with a psychiatrist. You can’t self-diagnose. But if you have a reason for thinking that you’re bipolar, for example, as you used in your question, you must follow up on it. And I want to reassure you that even if you are correct, treatment is available and it’s extraordinarily valuable. I didn’t say that you couldn’t weave in that you need to talk to a medical professional. I said to you specifically when somebody says, I think I might have bipolar disorder, what should I do? And you deadpan say, go to a doctor. That’s not helpful. They’re not going to listen. You think you’re the first person that told them that? Lisa: Maybe. We might be the first people who’ve told them that. If you needed medical information, why would your, why would any stop, be two random podcast hosts on the Internet? But aside from that, it seems to be many of these people’s first stop. I find that disturbing. Gabe: I disagree, the very fact that they think that they have bipolar disorder means that they’ve given this some thought, they’ve done some Googling. They’ve probably talked to somebody who realistically in our society was probably not encouraging. That is what I believe. I believe that when somebody gets to us, they’ve already talked to their circle. They’ve already talked to Lisa: Do you really think that? Gabe: Yes, I do. Because they found us. How did they find us? What did they Google? We are not so public that you just stumble upon us in the mall. You had to have key words to find us. We’re not Joe Rogan. You don’t just bump into us. It takes effort to find Gabe and Lisa. As much as I want to pretend that we’re worldwide famous. Yeah, yeah. I go in public and if I say Hi, I’m Gabe, the mental health podcaster, you know what I get? Laughed at. Because nobody’s heard of me. Lisa: That is a good point, I had not considered that. How did they find us in the first place? Gabe: I understand that you’re uncomfortable that we have a role to play. Lisa: Yes, I am uncomfortable with this role and I am uncomfortable with the role that other people keep trying to slot us into. Yes, and that’s the best word I can give. Uncomfortable. Gabe: I still maintain, Lisa, that it’s interesting that you feel that way in this area because you have no problem being a peer or lived experience expert when you hear somebody snoring. You don’t have any medical degree, but you tell pretty much everybody that you run into that they need a CPAP. And then when people say, wait, what’s a CPAP? You answer them, you tell them how it works. You tell them what they can expect from a doctor. You tell them about the sleep study. You tell them why it’s important. Well, that’s not your role. The minute you hear somebody snore, you should say you’re snoring. Go to a doctor. And if they say why, you should say I’m uncomfortable in this role, I will not answer any questions. And you should assume that that answer is complete and that that person will immediately go to a doctor for their snoring and end up with a CPAP. Lisa: That is an interesting analogy that you have given, I would say that the thing that makes it different is, one, I’m not handing out CPAPs, but neither are you. Gabe: Yeah, neither am I. I’m not handing out medicine, diagnosis, nothing. Lisa: No, you’re not, but so many of the people we come into contact, other so-called patient experts are. Gabe: Then say that, just like you said earlier, some doctors are jerks. Yes, you didn’t say all doctors are jerks. You didn’t say the medical field is filled with egomaniacs that misdiagnose you. But you did say that some did. And you did say that there’s bad therapists, there’s bad doctors, that you need to be a health care consumer. Say that. Why are you saying that all peer advocates or that all lived experience experts or that all patient experts are bad because you’ve ran into some bad ones? Lisa: I guess the thing that makes it for me is that I feel like it’s not aberrant in our, let’s call it field, the other so-called patient experts we talk with, more often than not, they are assuming the wrong role. When you say, oh, some doctors are jerks. Well, yeah, but they are, in fact, aberrant. That is not the majority of them. Most of them are OK. I don’t feel like with patient experts it’s that way. I think it’s almost the reverse, that most of them are not OK. And there’s only a few that are. Most of them are going way outside their scope of practice. And it makes me uncomfortable. It’s so common. It’s so prevalent that it’s basically the norm. So, I almost feel like it just needs to go away entirely. Gabe: I do agree with you that there are a lot of bad apples. There really are. And people like us, Lisa, we work really, really hard to expose them and get them out of our industry. Lisa: But our industry is full of them. There are more of them than there are of us. So, at what point do you just ditch the whole industry? Gabe: Never. Honestly never. I understand what you’re saying, Lisa, but ditching the whole thing I don’t think is the answer. For example, take American history. At one point in our history, there were more people who believed that women should not be allowed to vote. But the vocal minority worked really hard to establish that that was bullshit and they were right and they changed those people’s minds. That is what I feel being a mental health advocate is. Deciding who we are, where we belong, what we’re good at in educating the public on what to look for. Gabe: Lisa, you and I have different opinions on this, and for what it’s worth, I think that the conversation is good, but we need to just settle it. And I’m sort of having a fanboy moment here because we asked Natasha Tracy to be on the show. Now, Natasha Tracy is a bipolar advocate. She’s been around longer than I have and I’ve been around going on a decade now. She’s a patient expert. She is a subject matter expert. She is a bipolar advocate. She’s a mental health advocate. She’s written on the lived experience. She’s written about bipolar. She has done tons of work in the mental health field. She is a preeminent patient expert and we’re very excited to have her on the show. Natasha, welcome to the Not Crazy podcast. Natasha: Hi, Gabe. Hi, Lisa. Thanks for having me. Gabe: We are super excited to talk to you for a number of reasons, but the biggest one is because I want to hear your insights on a common problem that we have in mental health advocacy, and that is you and I. And Lisa, I always forget Lisa, but we want people to get information from experts. Natasha: Yes, absolutely. Gabe: Yes. And it’s easy to tell certain experts because they’re like doctors or licensed social workers and they have letters after their names or they have some governing body that watches over them. But, Natasha, you and I, we’re patient experts, which means nobody is watching over us. But I would bet that if I said, Natasha, you’re no expert, nobody should listen to you, that you’d come out swinging. Natasha: I guess I’m of two minds about that, right? I always tell people that everything I say should be double checked, everything I say should be discussed with a health care practitioner. So in that respect, yeah, no one should listen to me. On the other hand, I do know more about bipolar disorder than most people on the planet, including doctors. I’m an excellent resource when it comes to all things bipolar and depression. Gabe: You’re not kidding, your research on the topic is legendary, it’s excellent, and I could probably steal it, make up a fake doctor’s name, put it on there, make up a bunch of credentials, and nobody would be able to figure out that it was a fraud. Because if you compared it to something you’d read in a medical journal done by a Ph.D. or an M.D., it would stand up, but. Lisa: But that doesn’t have anything to do with Natasha’s own experience or illness, with her being bipolar or having depression, that would just be the same case with any devoted researcher. Natasha: I think, though, there is a really big difference. Lisa: OK Natasha: Between when I research a subject and when I write on a subject and when a standard Ph.D. or someone like that reads and writes about a subject, and that, of course, is experience. Right? I come from a place where I’ve experienced many of the things, if not all of the things, that I write about. And so when I put together information, it’s in a way that I know it’s going to be valuable to other people who are going through the same situation. And the thing about a doctor is they typically can’t do that because they can’t get inside the brain of a patient. I can’t get inside the brain of a doctor, to be honest, but I can get inside the head of other patients, which is why patients find the work so valuable, because it’s like I’m in their head. Gabe: Because you’re in your own brain, you know what we want to read about, because you are, in fact, us, Natasha: Exactly. Gabe: But for every Natasha Tracy, and even for every Gabe Howard, there’s a thousand people that are writing about living with bipolar disorder or depression or schizophrenia or psychosis or anxiety, and they get it completely wrong. But their articles, their work is trending, sometimes at the same level as yours. This makes me sad and usually angry. But we’ll just go with sad. How do you resolve that? Because for me, what I say is no, no, no, you shouldn’t listen to them because they’re patients. And then here we are, because I’ve just knocked myself out as well. Natasha: When people ask me what it is I do, I say I’m a subject matter expert in bipolar disorder. And yes, I live with it, which gives me additional insight. But that’s not actually what makes me an expert. It’s actually because I have spent 17 years researching the subject. So when you talk about the average patient’s perspective on any mental illness, they haven’t done that work. They may have even lived with it for 17 years. And it’s not the same thing. It’s not the same thing as actually researching an illness and knowing not just how you experience it, but how other people experience it, how doctors experience it, how therapists experience it. It’s about getting a broad range of knowledge and it’s about understanding that, while I do have this expertise, I also don’t have all the answers. The people who you should not listen to are the people who claim to have the answer, because those people are always wrong. Lisa: So how do you get that out there? How do you let people know that you have this background, you have this research, that you’re not just? Because, yeah, they’re a dime a dozen. There’s a thousand people online that have bipolar disorder and know the miracle cure. Natasha: Right. So I think that for me, there’s two really key things, the differentiation between my work and someone else’s work. And so one of them is simply my body of work. If you want to know about me, you can take a look at my blog, which has over five hundred articles on it. You can take a look at my blog on Healthy Place, which also has hundreds of articles on it. Now, between those two things, I have more than a thousand articles on bipolar disorder and you can make a determination from that how much I actually know and understand and whether you find me to be credible. That’s one thing. Another thing is about actually referencing my work. So, citing sources for my work. For example, when I say approximately 11% of people with bipolar disorder die of suicide, it’s not because I made up the number and it’s not because I read the number on some website. It’s because that’s the number that actually is used by medical professionals. 11 percent is what we believe to be the case at this time. That number may change tomorrow, but it’s what we believe right now. And I can cite a source for exactly where that number comes from. So, when you read my work, you see a body, yes, but you also see citations. So I encourage people to click on all of my links to see where does she get that information from? Because if I’m getting that information from some random source that isn’t really designed with any accuracy in mind, well, now you have your answer, right? How reliable am I if that’s a source that I choose to reference? Lisa: Oh, that’s good I like that point. Gabe: Natasha, what do you say to your detractors, to the people who say, well, she doesn’t know what she’s talking about, you should only listen to doctors, only doctors have the answers, to hell with patients? Because there’s a growing group of people that are understandably angry at the patient voice because there’s so many unchecked people. Natasha: It’s completely understandable. There are a lot of people spreading misinformation and a lot of those people are patients, I think that’s an understandable thing to feel and to be upset about. I think, though, that much like every doctor has credentials, some of the doctors are good and some of them are not so good, patients have credentials and some of them are good and some of them are not so good. I believe in doctors very strongly, which is why I tell people to talk to health care professionals, because I believe that everything should go through them. However, it doesn’t mean that every doctor out there is the best doctor out there. First of all, someone finished last in their medical school training. They did. Gabe: I always say that. Natasha: That’s the one thing. But another thing is as much as doctors are scientists and they’re trained to think scientifically, some of them don’t end up thinking that way in the long term. So you have people who have psychiatry degrees who are just as nutty as the people who claim that olive oil is a cure for something. They end up being just as irrational as those people. Now, this is not terribly common, but it certainly does happen. So whenever you look at someone, whether they are a person with letters after their last name or not, you do have to judge them on an individual basis. And much like not every person with bipolar disorder is the same, not every patient is the same, and not every voice is the same. Lisa: Can you tell us maybe a definitive Natasha Tracy answer, what do you think the role of the patient voice should be? Natasha: The role of the patient voice is very complex because it depends on the patient. So, the first role of the patient voice is to be heard in their health care relationship. Which, of course, is also the first job of the medical voice, which is to listen. That’s the first job and the really important one that patients absolutely must have, which is a voice in their own recovery, in their own treatment. They need to be heard and they need to be listened to. Those are really important things when it comes to the patient voice. Now, secondarily, patients who are advocates, people who are going out and doing something a little bit extra, that patient voice has the ability to start shaping things. That patient voice has the ability to start shaping how doctors speak to their patients in general. So, an individual patient can influence a single relationship, but someone who influences more people can influence relationships in general. So, I think that the patient voice can be used in a positive way to improve how companies interact with patients, to improve how doctors interact with patients, basically to improve the health care system in general, because they’re the ones with the most experience with it. Lisa: Now, you’ve been doing this for a long time, acting as the patient voice, do you see changes? Natasha: I do think things have changed. Patient voices are more heard today, certainly than they were 15 years ago. Part of my experience, of course, is colored by my own experience as a patient. I’m more heard today than I have ever been. But that’s also because I’m louder today than I’ve ever been. Natasha: So, I do think, especially younger, doctors are coming up being more familiar with patient voices and being more familiar with the fact that we have things to add to what to say on our treatment. And I think that patient voices like mine who are influencing other patients, we have made it so that patients almost demand that they be listened to more frequently. So, there has been a shift in what doctors expect and there’s been a shift in what patients expect. And I think also there’s been a shift in companies saying we’re going to do whatever we’re going to do and we don’t really need your input, thanks. I think there’s been a shift away from that to actually listening to the patient because they are the consumer and because the consumer does have power over large companies to say, we’re going to support you, we’re not going to support you. Companies actually do elicit more patient opinions today than they ever have before. Lisa: That’s interesting to hear that you do feel like there’s improvement. Gabe: There’s improvement, but. Lisa: Well, obviously, it’s not enough, there’s more work to be done. Gabe: You say it like it’s, well, there’s more work to be done and then the house will be perfect, but Lisa: Right, Gabe: It’s not like that. We’re Lisa: Because it’s unending, it’s never done. Gabe: Yeah, but that’s so sad. I don’t want it to be never done. But looking around at other causes. I just I can’t believe we’re fighting over this. Hi, we’re sick and we want health care. You know, I don’t know. We should discuss this. This just seems like such a stupid fight. I don’t get it. Do you understand it, Natasha? You’ve been doing this longer. Natasha: Your frustration is understandable, but I because I’ve been doing this so long, my frustration is like elapsed. Lisa: That’s a smart way to say it. Natasha: I understand why you’re frustrated, but I also understand that if you allow frustration to tint what you’re doing, I’m not sure that that’s the most effective way to get things done. It’s like people who want to reform the system versus people who want to throw out the system. There’s a big difference between those two people. I’m not saying one’s right and the other’s wrong, but my opinion is you work within the system to make incremental changes until you get to the place where you want to be rather than throwing everything out and starting again. I think that it’s a more reasonable thing to do. Throwing everything out and starting again sounds good. It’s just that in reality, it’s not. It’s too difficult and you will make too many mistakes along the way and you’ll end up in a place that you will need to change again. Lisa: That’s humorous because Gabe and I have that discussion constantly with almost the same words. Gabe: Yeah, yeah, you know, I have found that it’s better to make these small incremental changes around the margins that ripple inward and have huge effects. And I don’t know if it’s working or not. Sincerely, it’s very hard from our vantage point to see where we are. And some changes don’t come in until you get a guard change. Lisa: And we’ll be right back after these messages. Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Gabe: And we’re back discussing the validity of patient experts. Lisa: Well, you said earlier in the same way that doctors have credentials, patients also have credentials. What do you mean by that? What credentials? And then what are your credentials? Natasha: For me personally, it’s a matter of experience, what I’ve published and where I’ve published. So I’ve had everything from a coauthored scientific paper published to a book published to, as I said, over a decade’s worth of writing published. Those are my personal credentials. I also happen to have a Bachelor of Science if anyone cares. Gabe: I care. We care. Natasha: Yeah, I mean, if anyone cares, but I, but those are my credentials. Someone else’s credentials are different, but those are mine. You can take that into consideration and decide that those credentials don’t matter to you or you can decide that they do matter to you. And either way is really fine, because you know what? Lots of people who have followed me for many years consider me to be very reliable and a major expert in the field. And if you don’t agree, that’s OK. You’ll find someone else that you feel that way about. Gabe: Well, let’s talk about that for a moment. There’s a definite trend, at least in America, there’s a definite trend of here is my opinion, and I want it to be a fact. So, I will find somebody agrees with me and then I will make it a fact. And what you just said there is if somebody disagrees with you, they can go find somebody that they agree with. But a fact is a fact is a fact. I understand difference of opinion, but I’m really struggling with this idea that people can have a difference of fact. How do you handle that? Natasha: For me, when you come across someone who simply wants to deny facts or deny science, because certainly there are many commenters who want to deny psychiatry and science and those types of things. Gabe: Yeah, reality. Natasha: That happens. Yes, reality. That’s correct. So, if you come across a person like that, typically there is no speaking to them. You can talk to them all you want till you’re blue in the face, if that’s something you’re into. It’s not what I’m into. I’m into providing information to the people who are interested in having it. I am not interested in having a huge argument with someone who is never going to take my perspective, because they’re never going to understand science. They’re never going to believe in science. That’s never something that is going to work for them. So for me, I think that arguing with those people is time wasted and it’s time that I couldn’t spend on people that I’m actually helping. So to me, they’re not even overly relevant. Lisa: You know, we look through your blog and you see a lot of people making comments about how you’ve sold out, you’re just in the pocket of Big Pharma. You’re just one of them. You’ve become the man. What do you say to people who say things like that? Natasha: Well, first of all, if I sold out to Big Pharma, I’d have a much nicer apartment. Lisa: That is what I always think. Gabe: Yeah. Natasha: That, you know, that’s the first thing. No, I think that just because I agree with psychiatry in large part, just because I believe in science, does not necessarily mean that anyone is paying me to think that way. That’s an answer and a solution that I personally have come to and that I believe in because I’ve always believed in science. I have a bachelor of science. There’s a reason why I have that. And it’s because I’m a logical thinker and I believe in that kind of thing. In terms of people saying that I sold out, that’s certainly a perspective, if you want to take that. But in my experience with things, I’ve never personally cashed a check from a pharmaceutical company, for example. It’s never happened. So, it’s kind of hard to make that case that I have sold out because there’s no money to actually suggest that. Lisa: Ok, well, I don’t know that it’s so much about money as that they feel that you’ve been co-opted or that you have been corrupted in some way. You had your own original voice. You were thinking correctly previously, but now you’ve been exposed to too much science, too many doctors, etc. And you’ve now come to the wrong conclusions and are betraying your fellows. Natasha: Hmm, that’s an interesting idea. Lisa: You know how it is, you just see so much science, you just start to believe science, you know? Natasha: I guess that one of the things that I would say is that perspectives do evolve over time. I used to have it actually as part of my disclaimer, which is that when I write something, it is accurate at that moment. It reflects how I feel at that moment. It reflects what I think at that moment and it reflects the state of science at that moment. But five years from now, I may think differently. The science may think differently. There’s a lot of things that can change in five years. In terms of if you liked me five years ago and you don’t like me today, I understand. I’ve evolved as a human and you may not have liked the direction in which I’ve gone. And that’s actually totally fine with me. You know, I am not about bringing everyone on side to what I think. And this is not my job, OK? You know, I heard a writer once say something really brilliant, which is that you don’t write for the people who don’t read your book. What the person was trying to say is all those detractors that you have out there, you’re not writing for them. You’re not speaking for them. You’re not doing your job for them. You’re doing your job for the people who buy your book, for the people who read your work and for the people who want to have you speak at a conference. Those are the people that you’re actually doing the work for. So, the more time you spend on your detractors, the less time you have to spend with all the people that you’re truly helping. Lisa: Well, but isn’t that just another way of saying that you’re preaching to the choir? Natasha: I think that my work is exposed to many, many people, some of them are part of the choir and some of them aren’t. And it’s not to suggest that I’ve never changed anyone’s mind because I have. But those minds are open to begin with. Those minds are looking for solutions. They’re looking for answers. They’re looking for information. And they find me and it fits what they’re looking for. They weren’t the choir, but let’s say they became part of the choir once they read some of my work. That’s different than saying that you’re preaching to the same five people over and over again, which is not the case. Lisa: When you say that you have this large audience that you can influence, what type of influence do you think you’re having over them and are you comfortable with that? Natasha: Influence comes in many forms. For example, one of the things I don’t do is I don’t talk about my personal medication history. So I don’t say, you know, I went on this medication, it was the best thing in the world and its name is blah. I don’t do that. And that’s because I do have enough influence, and I do know that people will read that and go to their doctor and say, I want blah. It was really successful for someone online. And I know that I have that influence, which is exactly why I do not do it. I do not believe that that is how treatment decisions should be made. Thus I do not feed into that cycle. I do know that I have influence over people’s decision to get help. This is certainly something that has happened on many occasions through my career. People have credited me with saving their life. Now that’s a massive amount of influence on people. That also is not my job, but it’s certainly something that I’m cognizant of. I’m cognizant of the fact that someone will read my work and then say, OK, maybe that’s something I can look into. Maybe that’s a new perspective I can try. Maybe there is a doctor that can help me and so on and so forth. That’s something that I know happens because people actually write to me and tell me that’s what has happened for them. It’s a very powerful influence. Now, can I tell people what style of jeans to wear? No, I can not do that. Lisa: Are you trying to influence people in a specific way? Is there some ultimate goal that you have? Natasha: So I have always believed and believe to this day that my goal is to help one person. That’s my goal. As I have gotten more prominent, yes, I have an influence over a fairly decent number of people, but my goal is to help one person. For one person to read my work and say, that’s interesting. I never thought of that before. That’s my goal. It’s to be very authentic to the point where someone can read my work and say, yes, I respond to that because I see myself in it. That’s what I’m aiming to do, is to have one person actually see themselves in me. Influence is something that comes simply because so many people do respond to your work, right? It’s a byproduct, it’s not a goal. My goal has never been influence. My goal is to help one person. And if that happens, that’s enough for me. Lisa: So I’m assuming you get a lot of feedback, what kind of feedback do you get then? Is there any that you’re? Gabe: Yeah, what’s your favorite e-mail? Like, what’s, in your entire career, what is your favorite email that you’ve ever gotten? Natasha: I do get feedback from people who say things like they never responded to a single person online, they never responded to a single piece of writing. They never responded to anything until they met me. I think that’s my favorite piece of feedback, because what that speaks to is authenticity. And what that speaks to is, I like to think quality of work. I’m just going to say that I like to think my work is good. So that’s my favorite thing when people say that to me. Also, when people say that the book is the best book they’ve read on bipolar disorder, that’s a great piece of feedback, something that will certainly go in my ego file forever. Gabe: Yeah, and it should. Natasha: It’s a beautiful thing when you are not thought of as a person in a sea of work, but actually someone who stands out for whatever way. In terms of the most negative piece of feedback I ever got, it was someone saying that people like me should be killed and go to hell. That was the worst piece of feedback I ever got. And I have had more than one death threat. So more than one person certainly has thought that about me. And so it’s a little scary when someone feels so strongly about your work in such a negative way. That’s a scary thing. You don’t want those people to take it a step further. Most people are never going to take it a step further than writing you some nasty comments, but you never know when someone will. So those are scary comments, yeah. Gabe: This is where our criticism differs based on our gender. I remember Lisa: Mm-hmm. Gabe: I was sitting in a room with a bunch of, you know, influencers, writers, podcasters on the topic of living with mental illness. And I was young and naive. And I said, oh, yeah, I hate it when people tell me that I suck in email. And it was predominantly women. And they said, yeah, we hate it when they threaten to sexually assault us. And I was like, wait, what? And they’re like, oh, yeah. And they just the death threats, the sexual assaults. Suddenly I didn’t mind my email box so much. I’m assuming that this happens to you. Natasha: I try to ignore those things, to be honest with you. Some of them have stayed with me when they’ve been particularly nasty, and I certainly don’t like it when people make it really personal. And also, if they’re not sure what to say about what you’ve actually said, then certainly it’s easy to attack you personally. Lisa: It’s a way to derail. Natasha: It’s a way to derail. It’s a way to hurt you. That’s what they’re trying to do. So don’t let that happen. Don’t let that hurt you. I tell people who, quote-unquote, want to be me, and there are some people who do. They’re silly. But I say you have to grow a very thick skin because there are people out there who certainly are going to want to hurt you because of what you do, because of what you say, and possibly because of the fact that you’re female. Yeah. You need to grow a thick skin and you need to know it’s coming, because it’s coming. Lisa: Well, Natasha, thank you so much for being here with us. So before Gabe and I let you go, tell us about your upcoming master classes. Natasha: Yes, I’ve been doing master classes now for a few months because. I’ve been doing a variety of subjects in a line of what I call Get Real. It’s real talk about real subjects that real people care about. I don’t want fluffy stuff. I don’t want politically correct stuff. I want stuff that is actionable and I want stuff that is real. My two upcoming master classes are one of them has to do with treating treatment resistant depression. And this is one area that I really feel health care falls down in, which is the depression area for bipolar disorder, where treatments seem to be so inadequate so often and patients are left to languish and suffer. And I’m also holding a master class on how to have difficult mental health conversations. Specifically, if you are a person with a mental illness, how do you have conversations with other people about your mental illness? And if you do not have a mental illness, how do you talk to people with a mental illness about mental health challenges? That’s what we’re going to be talking about in that particular master class. And there will be more after. Lisa: Ok, if our listeners want to sign up for that master class or get more information about you, where can they find you? Natasha: You can find me at NatashaTracy.com and you can find my book Lost Marbles: Insights into My Life with Depression & Bipolar on Amazon. Gabe: Natasha, thank you so very much, really appreciated the conversation. Lisa: Yes, thank you. Natasha: Thank you, Gabe. Thank you, Lisa. Thank you for having me on. Gabe: So, Lisa, was I right? Was Natasha a badass? Lisa: Yes, she is pretty badass. She is. I’ve never actually met her, so that was nice. You see her name everywhere. Gabe: You do, and she’s one of the people that I found when I was looking for resources, so, you know, before I was an advocate, when I was just trying to get well, I read her writing. Lisa: I’ve seen her name since long back, I remember her from back then. Gabe: She’s timeless. That’s really what we’re going for. Lisa, did Natasha give you anything to think about? Did she change your mind? Did she give you pause at all? Lisa: I don’t know, I guess I would say she hasn’t changed my mind in part because I’m just not sure what my own mind is on this. I don’t really understand my own opinions on this. I haven’t worked it out in my own head yet. I don’t know why I’m having trouble doing so. Gabe: I love that you are a mental health advocate. I love that you have a podcast. I love that you answer people’s questions. I love that you’ve worked with me for a decade, and yet you’re still unsure of the role of the patient. You’ve Lisa: Yes. Gabe: You’ve put a lot of time, energy and effort to getting your voice heard, but you’re not sure that anybody should actually listen to it. That’s confusing to me. Lisa: I’m conflicted. I know it’s not sensible, I’m still uncomfortable with the entire concept, so why am I doing this? I have no idea. I can’t explain it. I don’t know why, but I’m just overly comforted by the idea of expertise. I like it when people have letters behind their name. It makes me feel, I don’t know, safe, secure, better. So when people who don’t start telling me things, I don’t like that. Gabe: I agree 100%. Nobody is denying that. Again, if you only listen to patient experts, you’re going to get in trouble. But, you know, my dad is not an artist. He’s not an interior designer. But he gives great ideas that I can then ask the expert about and incorporate into the final design. I would not let my dad paint my house. He sucks at it, but he is kind of decent at picking colors. But I got to tell you, he’s got like no art school behind his name. Should I start ignoring him? Lisa: I don’t know. I don’t know why I feel this way, because it’s not as if I’m all that conventional to start with. It makes me uncomfortable when people who I feel like do not have the necessary credentials start doing stuff. But why is that? The credentials themselves are quasi arbitrary. Gabe: I, too, am uncomfortable with the idea that we are devaluing education. Lisa: Exactly, yes, Gabe: And experts. Lisa: And it’s a cultural thing where we’re devaluing truth and science and expertise. Gabe: I am extraordinarily uncomfortable with that and I do not like it. Lisa: There’s this heavy strain of anti-intellectualism Gabe: Yeah. Lisa: In our culture, and I feel like this is almost an offshoot of that, because instead of going to the experts, the people who have studied this for years or even decades, you’re turning to us because it makes you feel good emotionally, not because it’s a good thing. So, yeah, I see that as part and parcel of all the problems we have now. It prioritizes feelings over facts and you could just look around to see all the damage that has done and is doing. Gabe: I agree that is disturbing and wrong on every level, but I have to say emotional support is not a bad thing. Study after study shows that patients do better, especially in the mental health field, if they have emotional support. And as you know, especially when it comes to severe and persistent mental illness, you have to be on board. You have to want it. You have to work hard. You have to self-report your symptoms. And if you don’t understand what’s going on, you’re not going to do that. Study after study after study shows that people who are involved in their own care and feel emotionally connected and cared for and, well frankly, feel good about their treatment do better. Are we going to deputize doctors that have never been through mental illness to follow us around? Do you think some of your discomfort is in society telling you that this is not your spot and that you can’t carve out your own niche because after all, it’s not your place? Lisa: Yes, yes, but I’m not convinced the society is wrong. I feel like it’s not our place. I don’t know what our place should be. Yeah. I don’t know why this is such a dissonance for me. Gabe: I suppose that’s a confusing thing to me, because I have been in the room, remember, Lisa and I used to be married, I have been in the room when Lisa Kiner, no medical training whatsoever, told a doctor that her diagnosis was wrong. You actually said to that doctor, you are wrong. I have sleep apnea. And the doctor said, I’m looking at the test and no, you don’t. And you said you are wrong and you got up and left. Now, how did you do that? Because if Lisa: I know. Gabe: I encourage another patient to do that, you would say that that’s not my role and that’s wrong. But you did it. Lisa: I know and I don’t have a problem with that, and I do think that’s a proper thing to do. I do not have a problem with this idea that the health care system is way messed up. It needs different things. It does not worry about your emotional health at all. But I’m not comfortable with this idea that we have a role to play. I’m not. Gabe: Do you think that it is OK to share your experiences so that other people know that they too can stand up to their doctors if they feel that the diagnosis is wrong or be a health care consumer. Lisa: Yeah, I do. Gabe: Don’t you see that as part of patient advocacy and being a patient expert, letting people know how to maneuver in the mental health system? Lisa: When I was uncomfortable doing the live shows where people asked the questions and answering the questions, that was the thing you said, that this was that kind of equivalent that you were just giving people kind of a moral support or a cheerleading. And that was the one thing you said that made me feel better about it. Gabe: Lisa, one of the most valuable things that you have ever done as a patient advocate, as a patient expert, as a mental health advocate, was teach me about a patient advocate in clinics, hospitals, doctors offices. I did not know this existed. Lisa: Well, it didn’t used to. Gabe: Well, I had a very bad experience, as you know. And you said you need to call the patient advocate immediately. And I said, what on earth is that? And I dial the number. I got a patient advocate and all of a sudden things started getting better. I Lisa: Yeah, Gabe: Have said this Lisa: It’s amazing. Gabe: A thousand times and I even gave this advice to my father, who was having a very bad experience with pain control after surgery. And it was amazing how quickly these problems were resolved. This just isn’t posted anywhere. And if it is, it’s posted in fine print. It’s very difficult to find, there’s a magazine rack in front of it. That alone, in my opinion, makes patient advocacy and patient experts valuable because doctors weren’t willing to tell us about this, but patients were. Lisa: Oh, that’s an interesting point. It’s a relatively new thing. I mean, you know, 20 years ago when I was having most of my interaction with health care, these things did not exist. Doctors never used to care about how you felt. They never used to have patient satisfaction surveys. That was never a thing. Things have changed a lot. And I do recognize that that is in large part because of advocates like Natasha and because of this whole movement of the patient voice. And that is 100% for sure, a positive thing. But yeah, I’m still not entirely comfortable with it and I’m not comfortable with our place in it. And I’m not even sure what our place should be. Gabe: I want to echo the words of Natasha Tracy when she said, look, I don’t care if you believe me or not, in fact, I want you not to believe me. Double check what I’m saying. Look it up, find other sources, read my studies, read my citations. You should not take Natasha Tracy at her word. And she is incredibly comfortable with that. And I want to say you shouldn’t take Lisa Kiner at her word either. You shouldn’t take Gabe Howard at his word. Frankly, you shouldn’t take anybody at their word, not even your own mom. You know, the number of medical things that my mother told me was true, that turned out to be false. My mother still believes that if you eat pizza and then go swimming, you will drown. She just believes this. This is the oldest medical advice that people have passed down forever. That is absolutely incorrect. So, yeah, I encourage you to disbelieve what patient advocates say and do your own research and find out if we know what we’re talking about. Lisa: Gabe, as you know, I’m uncomfortable with ambiguity, I want things to be black or white, I want things to be certain, I want to know for sure. Right. And the position of the patient and the patient voice is ambiguous. This has not been decided. It hasn’t been settled. Some people think the answer is that there’s no place for it. Some people think it belongs in a place much, much higher than it really does. Gabe: Lisa, I appreciate you being honest and to our listeners, I appreciate you being honest as well. Tell us what you think. Hit us up at a [email protected] and tell us your thoughts. We are always open. Do you have an idea for a show topic? Want to hear Gabe and Lisa debate? Do you have a guest that you want on the show? [email protected] is where you need to pitch all of those things. Thank you so much, everybody, for listening. My name is Gabe Howard and I am the author of Mental Illness Is an Asshole: And Other Observations. You can, of course, get it on Amazon, but if you head over to gabehoward.com/merchandise, you can buy it there for less money. And I will sign it and we will send you Not Crazy show stickers. Thanks, everybody, for listening in. Lisa: And we’ll see you next Tuesday. Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person? Not Crazy travels well. Have us record an episode live at your next event. E-mail [email protected] for details.
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SUBSCRIBE & REVIEW Tim Ward is co-owner of Intermedia Communications Training, Inc. Based in the Washington D.C. area, he works with global organizations helping them communicate better. He is a former print journalist, and the author of ten books. Tim is also publisher of Changemakers Books. He lives in Bethesda, Maryland, with his wife and business partner Teresa.
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