Podcast: Self-Help Cliches Have a Peculiar Value

 

Take the bull by the horns! Pick yourself up by your bootstraps! Are these cliches condescending for people with mental illness? Or is there a grain of truth to them? Today, Gabe and Lisa debate the pros and cons of the all too common “taking your life back” advice we all get from well-meaning people. Gabe shares his personal story of gaining back control of his life a day at a time while healing from depression.

When you struggle with mental illness, how much of your behavior, thoughts and emotions do you actually have control over? Is it helpful to feel in control of your life, even when it screws you over?

(Transcript Available Below)

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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 “Self-Help ClichesEpisode

Editor’s NotePlease 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 week’s episode of the Not Crazy podcast. I’m your host, Gabe Howard, and I am here, as always, with my favorite co-host, Lisa.

Lisa: Hey, everyone. So today’s quote is, you must take personal responsibility. You cannot change the circumstances, the seasons or the wind, but you can change yourself. And that is by Jim Rohn.

Gabe: I’m assuming that we’re going to be talking about personal responsibility when it comes to managing and living with mental illness. This dude said it better and considerably shorter than Gabe and Lisa say anything. So you want to wrap?

Lisa: Mr. Rohn, yeah.

Gabe: Like anything has a double edged sword, right? You must take personal responsibility. OK. I dig that. We can change ourselves. We can be in charge of ourselves. We can move forward. That’s a very empowering statement and one that, frankly, does speak to me. But it has an upper limit, right? If you’ve been incarcerated against your will, you’re a political prisoner in another country because of gender or race, like. And somebody is like, listen, you can’t expect these people to let you out of prison. You’ve got to take charge of your circumstances. That just seems like jerk advice.

Lisa: It’s extremely condescending from a certain point of view, yes.

Gabe: And I’m wondering, is it condescending to say to somebody with a severe and persistent mental illness, I mean, literally a disease? I have bipolar disorder. I have anxiety and psychosis, and I mean just. And you’re telling me, well, Gabe, you have to take personal responsibility.

Lisa: Right.

Gabe: Should I just cheer up? Like, would that help?

Lisa: You could eat less.

Gabe: Is it like that? Or is there still, is there still wisdom in it, even for folks like us?

Lisa: There is absolutely still wisdom in it, because even if things are unfair, it doesn’t matter, you can’t change it. Although this advice is in fact very condescending and you want to say to this guy, hey, that’s easy for you to say. And it’s not a coincidence that when he said this, he was, of course, a wealthy white man. But it’s also just practical. It doesn’t really matter how much you’ve been screwed over by life. You can’t change that. This is all you can change. Your own behavior is all that you have control over.

Gabe: One, I completely agree with that, except that in the case of mental illness, we often don’t have control over our own emotions, brains, minds. I mean, just, I can only imagine if when I thought demons were trying to kill you and I was standing sentry in our front yard, you would have said to me, Gabe, you can’t control the demons. You’re only in control of your own actions in life. So therefore, by the power of will and want, you will defeat psychosis. Just come in the house and watch television. Do you think that would have worked? Would you have given me that advice on the lawn?

Lisa: That’s why we can spend the next however many minutes talking about it, because it’s so deep. There’s so many levels.

Gabe: Oh, is it meta? I know you like things that are meta.

Lisa: I don’t think you understand what the word meta means. No, this is not remotely meta. No.

Gabe: When you said that boxes were mailed in boxes and that was meta,

Lisa: Right.

Gabe: I did laugh. But I have no idea what you’re saying.

Lisa: It’s a box of boxes. Whoa.

Gabe: I think what you’re getting at, Lisa, is we have to be active participants in our life. We can’t just sit back and wait for a magic medication or a magic treatment. If we don’t participate in our own recovery, recovery is unlikely to move forward. I understand that this advice does not work for people who are literally in the high end throes of mania or suicidal depression or suffering from psychosis or have such deep crippling anxiety that they can’t get out of their house. Mind over matter doesn’t always work. We’re discussing this from the point where we have gained back some of our faculties, where we have a little bit of control and we have the ability to make decisions and we’re trying to decide if we want to. That’s how it kind of was for me for a while. I didn’t know that I wanted to try. I’d failed so much. It was painful to try.

Lisa: You do have to be at a certain base level of functioning to even begin to take this advice. But as condescending as it sounds, it is practical.

Gabe: It’s so easy, Lisa, when I’m depressed to just really hate these quotes, because people are just throwing them at you, right. Constantly telling you you pick yourself up from your bootstraps, just cheer up, go for a walk. You know, stop and smell the roses. The sun will come out tomorrow. It is what it is. There’s just a million of them. But I do agree with it. So there’s a lot of nuance to all of this. And I just want to orient our listeners to the idea that what we’re saying is, if you have the ability, use it. And if you don’t have the ability, do whatever you can to get it. And then finally, this is going to be the crux of the show, right, Lisa? Try to figure out the difference.

Lisa: Well, maybe this would be a good time for you to tell the story that inspired today’s podcast.

Gabe: Nope, Lisa, you’re going to tell the story, because arguably this is your story. But I’ll give you a little bit of setup. Bipolar disorder took a lot. It was unfair. I didn’t deserve it. I don’t deserve it. I was fighting this illness, at, you know, what, twenty five years old? And all of my friends, they kept advancing in their careers, whereas I lost my job. I wanted to make sure that everybody within the sound of my voice knew that I was wronged. That I was a victim of this. That I was suffering from it. And that it was bullshit. Picture all of my anger, energy and loudness, proclaiming how I was a victim and how I was wrong. And I did it one too many times, and, eventually, Lisa snapped.

Lisa: I couldn’t take it anymore. And you would just go on and on and on about, oh, this isn’t fair, this isn’t my fault, this isn’t the way things should have turned out. All these terrible things have happened to me. Woe is me. And all those things were true. And what I finally said to you is, yes, I agree with you. You are completely 100% right. God f**ked you and nobody cares. You can go on and on and on about this for the rest of your life, but where’s that going to get you? You cannot pay your bills with this sad story. And I think what specifically I said is, well, then why don’t you just call up the bank and say, hey, look, I’m sorry, I can’t pay my bills this month. See, life was unfair and the universe turned on me and life screwed me over. Yeah. Why don’t you go ahead and do that and see how far it gets you.

Gabe: We fought about this for a while.

Lisa: We did.

Gabe: A nuclear argument ensued, lots of yelling. Like, she offended me so. That was really hurtful. That was probably the meanest thing. Yeah. Up until that point, that was probably the meanest thing anyone had ever said to me. And I was hurt. I was damaged by it because how dare you? I felt like she was taking the side of bipolar, I honestly, I thought.

Lisa: See, that makes no sense. Because I agreed with you.

Gabe: I thought that you were relishing in the idea that I deserved this. That’s my initial thought.

Lisa: Well, what’s up with that? Why did you think that?

Gabe: Because what you said was mean and it was meant to be mean and it was said in anger.

Lisa: Ok. All those things, yes. But I’d also like to say it finally got through to you, and it worked.

Gabe: And that’s the amazing part, isn’t it? This is probably my favorite story to tell in a speech for two reasons. One, I, always give the exact quote, so what, life screwed you, get over it. Are you going to spend the rest of your life bitching that life isn’t fair? Or are you going to do something about it? Because no one gives a shit about you and you sure as hell can’t pay your bills with your sad story. That’s the quote I start the speech with and then I end of the speech with, so, you know, I have just told you my story. I got hired to be here, which means I’m going to get paid to tell this story, which means finally, Lisa was wrong. I sure as hell can pay my bills with my sad story.

Lisa: Who saw that coming? I have to say, that does really annoy me. But I think my original point stands.

Gabe: Listen, here’s the point, I never would have been on that stage to take that cheap shot at you if you hadn’t erupted.

Lisa: Once again, you’re welcome.

Gabe: The part where Lisa and I are in a perpetual fight for the rest of our lives and now have a podcast for unexplainable reasons, just push that to the side. I couldn’t see it. If you would have asked me right before Lisa snapped if I was doing everything that I could to get better, I’ve have said yes. But then when you asked me the next day if I was doing everything that I could to get better, my answer was no. No, I wasn’t. I hate to say that the power of positive thinking is real, but it kind of is. I was thinking about everything pessimistically and all I wanted to do was wallow in my misery. And Lisa pointed that out. And had she never pointed it out, I wouldn’t be here. I wouldn’t have been able to move forward. I wasn’t taking a realistic stock of everything that I needed to do. I just wanted to wallow. And that was.

Lisa: Counterproductive? Self-destructive?

Gabe: In a way, it was allowing bipolar disorder to win because it had me right where it wanted me. It was attacking me and I was sitting around complaining about it. Once I attacked back, momentum started. Extraordinarily slowly, but I had a little bit. I am thankful for that, Lisa. Maybe you could have said it nicer?

Lisa: Well, maybe I could have done it in a different way. Hindsight. But also, maybe it wouldn’t have worked if I’d said it nicer.

Gabe: Maybe.

Lisa: But I want to make clear, I agreed with you. Life had screwed you over. You can have a lot of compassion and love and feel bad and feel sorry for someone that has had bad things happen to them. For someone who society has screwed over, who society has abandoned. Just on a practical basis, it doesn’t matter. What are you gonna do? You just gonna sit around and wait for life to turn out fair? For the cosmic scales to be balanced? Gonna sit around and wait for wealth inequality or racism or sexism or the structural problems with society to be fixed? You don’t have time for that. You’ll be dead by then. The only thing that you have control over is what you yourself do. And again, it’s condescending. And the more life has screwed you over, the more ridiculous this advice is. But, it does give you some agency and some control over your own life.

Gabe: When it comes to living with mental illness, one of the things that I think about is that point that you just brought up, Lisa. The trashed mental health safety net, the abuses in the psychiatry, people that have money get better care than people who have no money. Just on and on and on.

Lisa: Social inequality.

Gabe: I think about that, and that’s, I did not know this at the time, but if I had not gotten better, I could not have become an advocate. I want everybody listening to get well and lead their best life. Because being well and living their best life is a good enough reason. Like, you can just stop right there. But I’m a little bit selfish. As loud as I am, I can’t do this alone. I’m helping other people. People are helping me. And I want everybody listening to be advocates as well. And one of the best ways that you can be an advocate, of course, is to live well in spite of mental health issues and mental illness. So, when you get there, you can then become an advocate and we can turn around and try to fix all of these social problems and funding problems. And I don’t think Lisa is saying, I’m not trying to put words in your mouth. I don’t think Lisa is saying to ignore these issues. She’s just saying that everything has a time and place. You can’t fight all this social inequality if you can’t get out of bed. And that’s really where I was. I just wanted to lay in bed and talk about how it was unfair. That wasn’t doing anything to make it fair. I wasn’t helping myself and I sure as hell wasn’t helping anybody else. 

Lisa: I’m not normally a big self-help fan, and there certainly is a place to wallow because, hey, it feels good for a little while, but at a certain point, you’re not helping yourself. And letting your loved ones wallow, you’re not helping them either. You’re just enabling them. It’s not fair. Who cares? It’s like you always say, Gabe. It may not be our fault, but it is our responsibility.

Gabe: That’s a hard thing for people to understand. It’s a bitter pill, right? I have to be sick and I have to deal with the consequences of being sick? But I mean, yeah. Yeah, that’s how the world works.

Lisa: I just keep coming back to the practicality of it, that all this other stuff is kind of an esoteric argument. You’re trying to address all these social things, all these large-scale macro things, big picture. But you don’t have control over any of that. Advocacy can certainly help with all of those things, and you should definitely go down that route. But all you have control over is the little micro environment that you’re in. It’s just not practical to sit around and complain. The only thing that you can do is try to affect the immediate environment around you.

Gabe: I have to say, one of the things I keep thinking about is how often I wanted to talk about how unfair the world was. It wasn’t because I thought that I was making the world more fair. Me complaining wasn’t moving the needle in any way. It’s not like I was volunteering at a peer center or donating money or I wasn’t doing anything. 

Lisa: And the world was unfair. I want to be very clear on that point. It was unfair. Bad things did happen. But no one cares.

Gabe: But I wasn’t affected any change. I was using it as an excuse not to have to deal with my own shit. I mean, you were there, Lisa. Was my complaining making life better for people living with mental illness?

Lisa: No, and it was actually kind of weird. It’s like you thought that if you could convince enough people that life was unfair, it would somehow suddenly get better for you. No. No, it wouldn’t. As I say that, I think about well, I guess if you could convince enough people that the mental health safety net was in tatters, that you would, in fact, be able to make some change and that might make life better. 

Gabe: Well, let’s focus on that for a minute. You said that if I could convince somebody. That’s sort of my point, right? Would the angry mentally ill guy who isn’t speaking in coherent sentences, who’s probably not done a lot of really good research, who probably has word salad going on? I’m not sure that that individual is going to get a meeting with somebody who can affect real social change. But, hey, I’ve fallen into shit before, so let’s say that I do get a meeting with that person. Am I going to take advantage of that meeting? I have gotten those meetings now, and I come in prepared and with stats and with talking points, and I shake people’s hands and I say, hello, my name is Gabe Howard and I live with bipolar disorder. And the reason that I am standing in front of you now as a voter is because I was able to find care. And the only reason that I got access to care is because I have money and privilege. And a good family. And arguably a Lisa.

Lisa: We could spend days upon days upon days talking about all the problems, all the things. But what are you going to do right now? What are you going to do immediately? And I think there is a lot to be said for when you feel like you have some agency over your own life, no matter how small an amount of agency that is, it’s good for you, and it leads to positive things.

Gabe: One of the things that you said to me, Lisa, which I found very incredible, is I told you, that one of the reasons that I was struggling is because before I was diagnosed with bipolar disorder, before I was aware, I had 100% confidence. If I went in and applied for a job and I didn’t get the job, it’s because I didn’t get the job. No big deal. If I tried out for a sport and I didn’t get the sport, it’s because I wasn’t good enough, no big deal. But then afterward, like, my confidence was shattered, right? And I would not get a job, and I would think to myself, is it because they didn’t, they didn’t want a guy with bipolar disorder?

Lisa: What you’re talking about is privilege. Privilege is never having to wonder.

Gabe: Yeah, and my privilege evaporated immediately. But then also I started to wonder, like is the reason I didn’t get the job because I was symptomatic during the interview? That was a hard thing to struggle with as well. So, you know, I’d say, you know, I want to be a bricklayer. Let’s just go with bricklayer. And I feel that I’m a good bricklayer and I go apply for the job as a bricklayer. And they don’t hire me. Now, did they not hire me because secretly I’m a bad bricklayer? That’s a possibility. Did they not hire me because I have bipolar disorder? That’s a possibility. And.

Lisa: Is there a more qualified bricklayer who also applied for the job?

Gabe: Right. That’s certainly a possibility as well. But the thing that bothered me is if you’re not getting hired as a bricklayer, then you need to look internally and you need to think to yourself, OK, maybe the reason I’m not getting hired is because I’m not a good bricklayer. And what got in the way of that was two things. One, am I really a good bricklayer but nobody wants to work with a bipolar bricklayer? But put that aside. Maybe the reason I’m not getting these jobs is not because I’m not an excellent bricklayer, but because I’m always symptomatic during the interviews? Or I’m not well enough to work as a bricklayer right now? Or I have a panic attack right when the brick laying interview begins? So if I could get those symptoms under control, then I could get a job as a bricklayer. That’s like another element that I had to deal with. That was very difficult. Now there’s programs in, once again, here’s some luck, in big cities. Vocational programs that will help you work on that. They will work with you in your chosen professions to let you know. I did not go through one of those programs because I was not aware that they existed. The thing that I used to do for a living I was still qualified to do. I was very good at it. But I had to switch jobs because I had a high-pressure job. There was a lot of stress. And every time something would happen at work, that was a normal part of the job that I chose.

Lisa: You lost it. You couldn’t do it.

Gabe: Lisa, how many times did you have to pick me up?

Lisa: A lot, a lot.

Gabe: Somebody thought I was having a heart attack at a job once because the panic attack was just so.

Lisa: It was actually pretty amazing how often you kept getting new jobs. You apparently are amazing at job interviews because you would get hired. But then you couldn’t keep that up for more than a few weeks, maybe a couple of months.

Gabe: I couldn’t.

Lisa: The pressure would get to you and you’d quit. One time you came home and I said, what? Why are you not at work? And you said, well, it was an emergency. I had to quit. It was an emergency quitting? Yes, there was an emergency, and I had to quit. Huh.

Gabe: Yeah.

Lisa: Yeah. No, you had a panic attack and you couldn’t take it. You quit.

Gabe: That was the emergency. So, I had to take a long, hard look at what jobs I could do. It was very difficult because I didn’t want to leave that profession. I was good at that profession. Like Lisa said, I got hired a whole bunch. So,

Lisa: You got paid well too.

Gabe: Yeah. Clearly my resumé was good enough to keep getting these jobs, and I was good. But I, I had to switch gears. I had to find what else I was good at that worked with well, essentially my new reality. I worked it out with my therapist. I worked it out in groups and I wish I would have known about vocational training because that, man that would have made it easier. But I didn’t. But I, it’s one of the things that I worked on in therapy and we started with, OK, what are the things that you’re good at? What are the things you are bad at? What are the things that cause you panic? I started part time and I, I worked my way up. I’m very, very thankful to have been able to move all the way up. But I originally tried to go back to work as if nothing had ever left. I tried to do exactly what I was doing before. I tried to do exactly what I saw people my own age doing, because after all and this is the phrase that got me in more trouble, I wanted to be just like everybody else. I compared myself to others chronically, chronically. Gabe, why are you doing that? Because Joe did. Well, so? That’s how I know I have to have it. It’s like keeping up with the Joneses, except instead of stuff, it’s like, you know, job status or work status or.

Lisa: The point is that you were trying to go too far, too fast, too soon.

Gabe: Yeah, yeah.

Lisa: Baby steps were really where you needed to go here. And once again, if this is about taking back whatever amount of agency or control you can have, a small amount at least get you started down the road, and eventually you’ll get all of it. But for now, whatever you can claw back, take it.

Gabe: You know, I remember when I was really, really depressed like super super depression, and I couldn’t leave the house. A therapist recommended that I write on the mirror everything that I need to do. But like, don’t write, take shower. Because take a shower actually encompasses a lot of things. Right? Take a shower is, you know, washing your hair, washing your body, shaving, brushing your teeth. You know when people say, I have to take a shower, they tend to do all of that stuff. Right.

Lisa: She was basically saying that you needed to count the success where you could.

Gabe: Exactly. So, I wrote on the thing, all right, get undressed. All right. Got to do that. Brush teeth. Shave. Get in shower. Soap up body. Rinse off body. Dry off. Get dressed. And I kept all of those, like, single things.

Lisa: So, one day at a time, one step at a time kind of mentality. Just one foot in front of the other.

Gabe: Yeah, and don’t be bothered with how long it takes you she said. Don’t even worry about the time. Don’t say, well, I have a friend that can do all that in 10 minutes and certainly don’t say, well, I’ve done that before in 20. Just make that your goal for the day and cross them off as you get there. If you don’t get them all done, start over tomorrow. So, Gabe, these 10 things, which again, brush my teeth and turn shower on, turn shower off, were on the list. Celebrate that success. I loved that for depression. It helped me a lot. It helped me get moving. And eventually I didn’t need the list, and I started taking showers in 20 minutes again and getting dressed and leaving the house and no problem. I started applying that to my ability to work. So, a 10 hour a week job was a huge amount of success because I was no longer comparing it to a 40 hour a week job. And that really helped. You know, I’ve had some jobs that people would consider crummy, but I kind of liked them. One of the jobs was at a fast food restaurant where I got free food. Truthfully, I kind of miss that job. Free Diet Coke, all I could eat food. It didn’t pay well at all, and I had to work until like 2:00 in the morning. But, man, did I love that job. That was a good job. You remember that job, Lisa?

Lisa: Well, that ties back to the eating disorder episode, doesn’t it? You were unreasonably thrilled by that job.

Gabe: Yeah, yeah, I didn’t talk anything about the money or the benefits or the stability or that they were nice to me or that it was close to my house. Nope, just the free food.

Lisa: Perhaps not the best example. Anyway.

Gabe: But it did work for me and it got me to where I am today.

Lisa: It got you out of the house.

Gabe: Well, it got me out of the house. But what I wanted was what I have now. What I wanted was to go from nothing to what I have at this moment right now. And that was unreasonable.

Lisa: Yeah, you can’t do that.

Gabe: And, you know, I’ve since gone on to marry a woman with an MBA. It’s a master’s in business administration. She understands how businesses work. And when I started my business, I was like, well, this is the business I want, and she’s like, OK, what are the steps to get there? And I said, what are you talking about? This is the business that I want. She was thinking in the same way that I needed to think to get over depression or get back to work, which is the day you opened your business is not the business that you want. As much as we like to think that all of this thinking is abnormal and it’s just something that people with mental illness need to do. No Amazon, the most profitable and wealthy company in all of America, started out with a plan. Day one, register Amazon.com. Day two, build the Web site, expand the Web site, growth, build the warehouses. And now world domination. But

Lisa: The point is step by step. Not all at once, you can’t get there in one fell swoop.

Gabe: And the bigger point is, this isn’t some rule that only applies to people with mental health issues. This is how everything works. I got a billion examples of this, but maybe this is my favorite one. The day you join the workforce is not the day that you have all the shit your parents have because it took them 50 years to get it and you want it on day one. This is how the world works. And I needed a big reality check for that and I needed to realize it. I needed to apply those skills. But more importantly, I needed to recognize that I was in control. I had the ability to affect the outcome, and that gave me power. That power is why I work so hard, because that was infectious. I had missed that. I had missed having agency. I had missed having control. Do you remember, Lisa? I know we were divorced and I had worked so hard and I moved into a six hundred square foot apartment.

Lisa: You really loved that place.

Gabe: It was in a mediocre section of town. It’s not the bad section, but not, you know. Lisa and I, when we were married, we had dual income. Mostly Lisa income.

Lisa: We lived in the good section.

Gabe: We lived in a very upper middle class section, in a house. We had a house. And then I moved to this little six hundred square foot apartment. And everybody, everybody, including Lisa, was positive I was going to fail.

Lisa: I was. I did not have enough faith in you. What I said to you a year later, because you said, oh my God, I’m just so depressed, I’m so sad. This is not where I want to be. And I said, are you kidding? Do you remember a year ago? None of us thought you could do it. And there you did, throwing it right back in our faces.

Gabe: Your exact words were, you rubbed our faces in your success. And when I thought about it, I was like, yeah, I did.

Lisa: We didn’t think you could do it and you did.

Gabe: How you like me now?

Lisa: You were a good sport.

Gabe: I was. I was not a bad winner. Especially since I didn’t think that it was good enough and you had to remind me of it. And I fell into the same trap where I was comparing the apartment that I lived in to other people’s my age, houses and marriages and children and nicer cars and better vacations. And that’s what I was doing. I was comparing myself to others again. And when Lisa pointed out that literally everybody in my life was positive that I was going to need to be rescued. They were all making plans behind my back. All right, how are we saving Gabe as soon as he screws this up? Which again, they were doing because they loved me and because they’re a good support system. And when I started hearing the stories of how shocked they all were that I made it, how proud they were of me. A year later, same job, same car, all my bills paid, had built up a little nest egg. I just.

Lisa: Even started cleaning your place. It was amazing.

Gabe: I did have the magic hamper. Lisa still did my laundry. That was pretty cool.

Lisa: He got it at Ikea.

Gabe: I bought this hamper and I threw dirty clothes in it, and once a week the hamper would show up in my apartment with clean clothes in it while I was at work. It was pretty awesome. I, still to this day, don’t know how it works, but do you know how that worked, Lisa?

Lisa: And eventually he started trying to test it. How much could he put it that hamper? Just how far could you push that? Yeah.

Gabe: One day a week, my sheets would automatically change on my bed and it would be made.

Lisa: It was a magic apartment.

Gabe: Sincerely, though, even as I tell the story right, Lisa was still helping me out. I’m sort of making air quotes because she wasn’t helping me, like, manage my mental illness or anything. I mean, she was.

Lisa: You were helping me, too.

Gabe: Oh, yeah, we were trading. But,

Lisa: Yeah. We traded.

Gabe: You know, she was doing my laundry because she had a washer and dryer and I did not have a washer and dryer. And Lisa didn’t mind. I took care of her car because I didn’t mind taking care of her car. She’s about to list all this other stuff that she did for me. Suffice to say, she did a lot for me and I am very thankful, you don’t.

Lisa: I was actually going to list all the things that you did in return. That shows you where your negative thinking gets you. That’s when my shoulder had gotten so bad, and so you started coming over and mowing the lawn and all the other stuff that I couldn’t do.

Gabe: I did. I did. You couldn’t lift anything. Which really slowed down your ability to clean my apartment, I might add.

Lisa: Yeah, I know, I know. Almost as if that inspired you to start cleaning yourself.

Gabe: I mean, all six hundred square feet. You basically stood in the middle with like a Windex bottle, just spraying it. You covered every surface. I didn’t have a real vacuum cleaner. I just had a DustBuster and that was enough.

Lisa: What? Why does that even exist? No. We’ll be here for the rest of our lives talking about why DustBusters suck.

Gabe: 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.

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Gabe: And we’re back discussing the wisdom of self-help clichés.

Lisa: It can be very difficult to know where that line is. Because you want to have sympathy and love and compassion. But at what point does it cross into enabling? At a certain point you’re not doing this person any favors, you’re just allowing them to stay sick. And you’re thinking, well, but there’s such a limited amount that he can accomplish. There’s such a limited amount that this person can do. Well, yeah, but that ain’t zero. And you want to make sure they’re living up to that potential.

Gabe: And not for nothing, you don’t know.

Lisa: Well, that’s true, yeah. Your expectations could be completely wrong, and won’t you be surprised?

Gabe: Like you were, Lisa, when I just became this.

Lisa: That’s true. I didn’t think you could do it. I really didn’t. And I feel bad saying that now. And there have been times where I’ve tried to be like, oh no, I always had faith in you. I knew you could do it. Nah. No, I totally didn’t. It took me about a year to realize that you could. I might have told you I thought you were gonna make it, but, yeah, I didn’t really think so.

Gabe: No, you told me I was going to fail. In a way, I think that honesty helped because you weren’t enabling me. You let me try. I understand, Lisa, that our situation was a little different, right? I mean, I had to move out. We were getting a divorce. We couldn’t live together anymore. We were moving on with our lives and we needed to do stuff. But I know that you were angling very hard, that maybe I move a couple of states away near family or in with family because you did not want to be a caregiver. I insisted that you were never my caregiver, and that’s part of the reason that we are getting a divorce. Long and involved story, we don’t need to discuss it. But the point that I’m making, though, is that I believed that I could do it. Lisa did not believe that I could do it. But Lisa didn’t interfere.

Lisa: You did not believe you could do it. That is not true.

Gabe: I did believe that I could do it or I would’ve.

Lisa: Did you really?

Gabe: Yes. What I said was that.

Lisa: You didn’t say it at the time.

Gabe: You are wrong. I obviously thought I could do it or why would I have done it? Yeah, I could have moved in with my parents, I could’ve moved in with my grandparents, I could have moved in with my sister. I could have tried to apply for disability. I could have moved into a roommate situation. I could have. I had 100 other options. Why did I pick the one I thought I was gonna fail at? You’re thinking, no, no, it wasn’t perfect. You weren’t like [singing]. Yeah, you’re right. I had trepidations. I was nervous. I was scared. I cried the first night I was in my apartment. But no, I absolutely thought I could do it.

Lisa: Ok.

Gabe: That’s nonsense. That’s like saying that Debbie doesn’t think that she could be a mom because while she was pregnant, she was worried she’d be a bad mother. No, Debbie was confident she could be a good mom. She was just scared.

Lisa: Thinking back on it now, I don’t remember it that way, but there was a lot going on. So, I don’t know. 

Gabe: The point that I want to make to people is, you know, this is how we decide who is in our lives. Because I knew that Lisa was worried about me and didn’t think that I could do it. And I knew that my family was worried about me and had major reservations about whether or not I could hold down a job and live alone in an apartment. And everybody was very, very worried, but they still supported me. They did make their worries and concerns known, which I think made me better. I was able to talk to them about my worries and concerns, which got me help during the process. And even though Lisa thought that I was going to fail, she still did my laundry. That’s really nice, right? We’re a divorcing couple where she thinks that her mentally ill, soon to be ex-husband, is about to, like, get fired from a job and run out on a lease and become homeless.

Lisa: And implode.

Gabe: She’s still talked to me like an adult. She still helped me. We still worked it out. And all of that, it helped prove Lisa wrong and helped prove my family wrong and helped me, as Lisa put it, rub all their faces in it. Those are the people that we need to surround ourselves with. We need to talk to the people who are supporting us, helping us, or giving us a leg up and saying, look, if you don’t think I can make it and you are actively hindering my progress, I probably can’t make it. If you don’t think I can make it, and you refuse to help me, maybe I can’t make it. Because one of the reasons that I believed I could make it is because I did believe that I could count on the people around me. You know, Lisa, my family, my friends. I thought I had good support and they never turned on me.

Lisa: Do you remember what you said to me, you said, you know, I don’t understand why you think that I can’t do this. What were you working all this time for? If you thought it was hopeless, why did you bother up until now?

Gabe: It was curious. I don’t know why you started dating a severely mentally ill man, got him help, got him all the care that he needed. And then when he went out on his own with a job, said, you’re going to fail.

Lisa: You make me sound bad when I say it that way.

Gabe: You wanted a severely mentally ill man who didn’t get better.

Lisa: No.

Gabe: In your house forever?

Lisa: Now, when you do stuff and I say things like, oh my God, you’ve got to be kidding me, blah, blah, blah. Really? You went for a hike? You never would hike when we were together, would you? And you always say, why did you try so hard if you didn’t think that someday I would become this? Why did you even try to get me here in the first place? Why didn’t you just ditch me by the side of the road? And so, yeah, it turns out I was very prescient.

Gabe: A lot of us are younger when we’re going through these things. You know, I was young, twenty-five is young. Thirty is young. I talk to a lot of people that are in their early 20s. You know, they’re talking about their families, you know, their parents who have put up with a lot. And they ask me, they’re like, why should I tolerate my family treating me this way? And I was like, well, look, you’ve gotten yourself into this rut together. You know, stop pretending that it’s all your family’s fault. It’s not just, you know, mom, dad, brother, sister, best friend that have done it to you and you’re innocent. And this is the part about taking responsibility and control of our own agency. Lisa cares about me very much. She was there through the worst of it, she guided me. She is my best friend in the entire world. Her thinking that I was going to fail is not because she was mean. It’s because I had a history of failing. It’s because I had a history of emergency quitting jobs and having panic attacks. And I had a history of not being able to do it. So, I needed to understand that honestly, people thinking that I wasn’t going to be successful was probably not an unreasonable thought. They have that right to think that. Just make sure that they’re respectful and ask them directly how they can help. You know, we use the example of Lisa doing my laundry. It’s because I asked her, I said, hey, I don’t have a washer and dryer anymore. Can you help me with this? And Lisa said, absolutely. That’s how we did it. I hope we’re an inspiration to all.

Lisa: It’s not just that someone is enabling you, you are allowing them to. Again, it doesn’t matter how little control you have, it’s more than zero. And the more you can take, the more you can get.

Gabe: Lisa, I want to switch gears a little bit and talk about, we lived together.

Lisa: Yeah, well, we were married.

Gabe: Well, yes, but and I know this isn’t completely analogous to a lot of our listeners who aren’t married or maybe live with roommates or friends that are causing them problems or live with family members who are.

Lisa: Ok.

Gabe: But I think that a question that I want to know is how I was able to manage you? The scenario that I’m setting up, is let’s say that you’re a person living with mental illness, mental health issues, and you’re living, you know, in your sister’s basement or you’re still a younger person or just whatever. You’re living with somebody who you now are thinking they might be enabling me.

Lisa: Ok, OK.

Gabe: They’re not trying to help me get a job. They’re not trying to push me out the door. They’re OK paying the bills and let me play video games all day. But you’re right. I do want more out of life than playing video games all day. And people are thinking to themselves, if they’re reasonable. Well, as soon as I tell them that I want to get a full-time job, they’re going to tell me I’m going to fail. Like you did, Lisa, with the apartment and everything. And they’re like, well, man, this guy seems to have a good relationship with this lady and she didn’t believe in him. What are the odds that my friends and family are going to believe in me? Maybe they have failed a lot, like I did. I’m trying to project my story onto them because the question that I have is, how did I convince you to help me even though you didn’t believe in it?

Lisa: I’m uncomfortable with you saying I didn’t believe in you, although that is accurate. Maybe I’m just uncomfortable in being portrayed in a way that I feel is negative.

Gabe: I know that you don’t like the truth, but, you know, this is a no bullshit thing and you did not believe in me.

Lisa: I did not.

Gabe: You were positive that you were going to have to bail me out of some sort of trouble.

Lisa: I was.

Gabe: No doubt with time, energy and money and pick up the pieces of whatever I destroyed.

Lisa: Yes. Yes, I was positive of it.

Gabe: And I told you, in no uncertain terms that I would be fine and that you were wrong.

Lisa: I don’t think that’s accurate, you actually did not have that much confidence, at least not that you were expressing to me.

Gabe: I had enough confidence that I did it.

Lisa: That’s true, but it’s not like you were saying, I am a winner. You know what I mean? It’s not like you had this mindset.

Gabe: Who cares? My actions projected confidence. You told me that I would fail. Nobody told me that I would succeed. And I did it anyway. 

Lisa: Yes, you did. 

Gabe: You understand the question that I’m asking. Why did you decide to support me? What is it that I said that made you think, well, I need to support this guy, even though I think that he is wrong?

Lisa: I don’t think there is anything that you said. It’s just what’s the other option? How do I not support you? Just say no? No, screw you, you’re on your own. Don’t call me if bad things happen. I mean, how do you? What would I have had to do to not support you?

Gabe: We fought about this. We fought about this a lot. This was not a touching moment. This was not the part of the Hallmark movie where we came to terms and hugged each other. This is the part of the Hallmark movie where we yelled at each other and doors were slamming so that when we finally did hug each other at the end of the Hallmark movie, it was so much more meaningful, because we came together. How did we come together? What did that path look like? Stop pretending that you were just like, oh, I think he’s wrong. I’ll just be okay because there’s no other option. The option is to constantly tell me I’m going to fail and try to talk me out of it.

Lisa: Did I do that?

Gabe: Yes. What made you stop?

Lisa: You know, I don’t know that I remember. I guess the obvious reason of what made me stop telling you that you were going to fail was probably when you succeeded. Why would I keep saying to you, you are not going to be successful in doing this when you were right in front of my eyes being successful? Once you moved into the POD, did I ever say at that point you were going to mess this up and I’m going to have to bail your ass out? Did I ever say that at that point?

Gabe: Side note, POD stands for Pretty Okay Domicile.

Lisa: It was nice.

Gabe: Because my high school bedroom was pit of despair, which I also called a POD. I was trying to be trying to use my coping skills and.

Lisa: You were reframing.

Gabe: Yeah, I was reframing. I like that.

Lisa: Yeah.

Gabe: That is a good point. You’re right. You remained critical until the die was cast. You did not believe in me. And I kept moving forward. And finally, I moved forward enough that you really had no choice but to follow along. 

Lisa: Well, right. Yeah.

Gabe: And I think that’s a powerful message, right? For people listening, like how can I get my family on board to support me? You might have to take the first several steps of the journey.

Lisa: On your own.

Gabe: While listening to them criticize you and tell you that you’re wrong. You’re right. You were not on board until I was, until I was already down the path. Do you think that’s the message? You’ve got to take the first several steps by yourself? That you probably won’t get buy in.

Lisa: Maybe.

Gabe: Until after you’ve stuck to your guns for a while?

Lisa: But let’s look at the reason why you’re not getting buy in. And again, I acknowledge that it sounds mean, etc. But the reason why I did not think you were going to be successful, you did not have a track record of success.  Not having faith in you was, frankly, the safe bet. I feel like that was reasonable at that point.  How much blind faith versus pragmatism should we have here? I mean, how do you find that balance?

Gabe: I’m not saying that you were wrong for not believing in me. I’m just saying that I think there’s a lot of people that believe that the people in their lives have given up on them.

Lisa: Maybe they have.

Gabe: I’m just trying to get your side of the story out. Why did you not believe in me? And you’re like, 

Lisa: Because you had not succeeded up until then, you continued to have a track record of failure. How much was I supposed to invest in this potential future where you said, no, no, no, I’m gonna do it this time? I mean, how many times had I been burned before?

Gabe: See, that’s what really struck me looking backwards for me. First, I thought, well, she’s just being mean and she doesn’t support me. I couldn’t see the forest through the trees. Right? I didn’t see all the times that you supported me, and then, of course, I let you down or it didn’t work out or failed.

Lisa: Right.

Gabe: I was looking at it in this one little window. This whole thing reminds me of the basketball coach who cut Michael Jordan. And everybody’s like, oh, my God, that guy’s an idiot. He cut the greatest basketball player ever. What a moron. Except that he was right to cut him, he wasn’t good yet. He needed to be cut because he wasn’t prepared. He wasn’t ready. He needed to learn more fundamentals. He learned to practice. And one could argue that, in fact, that coach is not an idiot, but the father of the greatest career in basketball history.

Lisa: Right, because this failure gave him inspiration. Or his coach’s lack of faith in him is the extra push for him to practice, etc.

Gabe: Sure, all of those things. Whatever it is, and I think that sometimes we don’t give that credit. We take the easy route, which is a ha-ha that coach was a moron for cutting the great Michael Jordan.

Lisa: But he wasn’t the great yet.

Gabe: Right. The actual thing that happened, Lisa, is it’s not that you were a moron that didn’t believe in the great podcaster Gabe Howard. No. The guy to you didn’t believe in wasn’t great at anything.

Lisa: Yeah.

Gabe: I had failed at everything. You looked at the facts and said, yeah, this isn’t gonna happen. And because you were honest, and because you told me what I sucked at, I had the opportunity to fix it. I’m just going to pretend that in the Michael Jordan analogy that the coach was like, dude, you can’t make it because you suck at free throws and you can’t dribble. And Michael Jordan was like, aha, I will practice that. And then ta-da, we get Michael Jordan, or in this case, Lisa, we get Gabe. So, this guy unleashed Michael Jordan on the world, sorry LeBron James fans. And you unleashed Gabe on the world, sorry fans of quiet and peace.

Lisa: Sorry world.

Gabe: Yeah. I think that a lot. But it’s easy. It’s easy when you’re that guy to just look around and be like nobody believes in me. And I just think that I want the people who are listening that might be in this situation to think it’s not that my family and friends are morons. It’s that I haven’t given them anything to believe in yet. And that’s taking back the power. Right? Remember your quote, that’s you taking back the power and giving them something to rally around. Like, give your family something to believe in. I feel like an 80’s song is coming up. Don’t stop believing. But do you agree with that? Like at what point were you like, now I can rally behind Gabe.

Lisa: Maybe you want to look at it from the other person’s point of view. How much of what you perceive of your family and friends not supporting you is actually them trying to protect themselves emotionally? It is exhausting to be let down over and over and over again. How many times are you supposed to get your hopes up only to have them dashed? What’s a reasonable amount?

Gabe: It’s interesting, this idea of it’s not all about us. Like that’s kind of a new concept.

Lisa: Yeah, almost like you’re not the focus of the universe.

Gabe: But it’s easy, though, right? It didn’t occur to me that.

Lisa: Is that actually true? It honestly didn’t occur?

Gabe: No, of course not. I was only thinking about myself

Lisa: Like, you honestly didn’t think about that?

Gabe: No, I was busy only thinking about myself. Why would I?

Lisa: Well, that makes a lot more sense.

Gabe: And I think that if you thought about it, it wouldn’t occur to you that I would have thought about anybody other than myself. I was very wrapped up in everything that was going on in my life.

Lisa: Right. Well, that’s what mental illness is. You’re trapped in your own sphere, in your own mind.

Gabe: Yeah, exactly, but forget about mental illness. I think it’s just very common when you feel like somebody has done something that’s mean to you. I felt that it was mean that I wasn’t being supported. So, I don’t know that it’s natural to put yourself in the shoes of the person who’s being mean to you. I’m not saying it’s not a good idea. It’s an incredibly good idea. And it would have paid dividends all the way back then. Because if I could have seen things from your point of view, maybe we could have …  Anybody listening, put yourself in your family and friends’ point of view. Is it that you’re too anxious to leave the house? Or is it that you blew them off eight times and they’ve bought food and made dinner and counted on you to come over? Like, how are they seeing what’s going on? You, Lisa, were seeing it as, oh, my God. If he does this, I’m going to have to save him.

Lisa: Again.

Gabe: I’m gonna have to worry. Time, energy, money. 

Lisa: Money.

Gabe: This is emotionally devastating when he fails. I must prevent this and protect myself.

Lisa: Right. You have to look at your own individual situation. How long has this been going on? How much is your family and friends been doing for you? What are the risks? What are they putting on the line? How many times have they had to rescue you already, and maybe they just don’t want to do it anymore?

Gabe: All very fair questions. I guess the thing that I want people to understand from listening to both of us, from the perspective of the person who is upset that nobody believed in him and the person who was exhausted at believing in me and being let down is that both of our journeys are valid. I didn’t mean to let you down, Lisa. I wasn’t malicious. I wasn’t trying to hurt you. But that doesn’t.

Lisa: Yeah, but you also weren’t focused on not

Gabe: Yeah, probably.

Lisa: It’s not like you were going out of your way to not hurt my feelings.

Gabe: I think that’s part of a larger conversations. I mean, I was desperately trying to get well and if I could have succeeded in getting well, that would have not hurt you. So in that way, I was trying to be who I needed to be. But even if you don’t believe that, I certainly wasn’t trying to end up divorced. That was not my goal.

Lisa: Well, maybe this goes back to your point of you should start with baby steps,

Gabe: Yeah, it does.

Lisa: Because the more steps, the more complicated, the bigger your plan, the less buy in you’re going to get. Because statistically, just playing the odds here, the less likely that you’re going to succeed. You were talking about how do I get buy in right away or is it even reasonable? Well, maybe if you start with small goals and then accomplish them, maybe that will help you get buy in as well. Rather than saying, I’m going to go get a job. Eh, I don’t know that I’m going to help you with that. I’m not going to do this. Help you buy a new outfit and spruce up your resume. I’m not gonna go through all this crap again. I’ve already done this eight times. You’re on your own, buddy. Maybe if instead you said, hey, I’m gonna go volunteer. Someone would be like, oh, okay. Yeah, sure. I’ll drive you,

Gabe: Hey, at some point, you’ve got to make the leap. I think it’s a leap. I think it is a leap for folks to believe that their loved ones can do it.

Lisa: You’re acting like this is the first time anyone’s ever asked them to do that. They’ve already taken that leap several times and fallen. So, you’re saying, hey, take a leap of faith, but if you’ve already leaped multiple times and fallen to the bottom of the canyon, at what point are you just an idiot for leaping again?

Gabe: I hear ya. But just do we want the message to be don’t believe in your loved ones, don’t believe that they can ever get better? I mean, how many times is it reasonable.

Lisa: Exactly, maybe the in-between message is if you feel that the goal they’ve set is unreasonable or you think, Ugh, no, not again. Maybe that’s the takeaway, that you should try to work towards something that you both believe is a thing. What are some options? I think many people do have in-between options, but they don’t want to take it because it’s depressing. No one really ever wants to set manageable goals. Right? Everybody’s always like, I’m going to lose 50 pounds. Yeah. People say that all the time, but no one ever says, you know, I’m going to go for a walk right now. No one ever does that. It’s more fun, it’s more satisfying to have these large, bigger goals, but it’s also less likely to be successful.

Gabe: I hear what you’re saying and it goes back to the discussion we were having earlier about baby steps. Don’t just say, hey, I want to get ready and leave the house, say that I want to get undressed, I want to turn the shower on. You can do more than you think you can. It’s going to be a lot of work. And if people don’t believe you, try anyway. But be reasonable and get rid of toxic people. But maybe consider that their toxicity is on you. 

Lisa: Yeah.

Gabe: And it’s not 100% their fault. So be willing to forgive them when you succeed and finally, set manageable goals. There’s no reason to say you’re going to lose 50 pounds when you’re not even willing to put on sweat pants and walk around the block with your dog because, and I quote, it’s hot.

Lisa: It’s easier said than done, but try to step outside of yourself and see it from someone else’s perspective.

Gabe: That is a difficult concept for people. 

Lisa: Well, obviously, yeah.

Gabe: And again, it’s not a mental illness thing, right, Lisa? 

Lisa: Yeah. That’s everybody, yeah.

Gabe: People have a hard time seeing things from other people’s perspectives.

Lisa: Yes, obviously. Otherwise, we the world, would be so much different.

Gabe: Yeah, it would be. I only bring that up because, again, as a guy who lives with bipolar disorder, I think these things are only happening to me. We love all of your comments, everyone. In fact, our favorite comment was where somebody said, I love listening to your show. Do you and Lisa have kids? No, we do not have kids, but we do have a podcast, and that’s like a kid. We certainly fight about the podcast as much as other people fight about their children.

Lisa: Gabe, the only reason we’re fighting is because you’re just always way too hard on the podcast.

Gabe: Well, he’s got to learn.

Lisa: He needs your love.

Gabe: I want the podcast to get into a good college and not be spoiled like my other podcast.

Lisa: You know, sometimes you just need to sit around and play a game. It doesn’t always have to be high stakes. My advice is good.

Gabe: I love our podcast parenting style. Listen up, everybody. Thank you. Thank you. Thank you. Thank you for tolerating us and for listening. And if you loved the show, please subscribe on your favorite podcast player. Please rate, rank and review. Share us on social media. Use your words and tell people why they should listen in. 

Lisa: Don’t forget about the outtake, 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 show@psychcentral.com for details. 

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Key Strategies to Help Your Child Transition Back to School During a Pandemic

Change is hard for all of us. Since the onset of COVID-19 in the spring, we have been in a constant state of flux. Families went from routines and always being on the go to sheltering-in-place in their homes.

Overnight, work and education went from outside in, shifting from offices and schools to our kitchen tables. Therapy sessions moved home and telehealth became the new normal. We did kitchen kindergarten and remote therapy for a while before transitioning to summer. Now, as the days grow shorter and the aisles at Target are filled with bright yellow Crayola boxes, it’s time to think about school again.

Transitions can mean challenges, especially when they are sprung upon us. As adults, we can work through them in our minds and approach them rationally. For children, it can be more difficult. They are not able to pivot as easily, and it can cause unrest or frustration. As you prepare to transition back to school in the time of COVID-19, here are some strategies to make the shift smoother.

Communication is Key

Even if your child is too young to understand what is going on with COVID, it is important to communicate what you can. Help them understand what will stay the same and what will be different as they approach the school year. Will they participate in in-person learning or will their classes be conducted remotely? Will masks be required? Address these questions and concerns well in advance of school starting to allow time for them to feel comfortable. A great way to help your child understand is through role playing. Having your child play the part of the adult and the parents play as the child is a great way to help your child understand and identify effective behaviors connected to different situations as you are modeling appropriate behaviors.

If your child has sensory issues or a disability that will prevent them from wearing a mask, communicate with their school or Individualized Educational Plan (IEP) team before starting school. Engage your therapy team in the process. Lean on your team to help troubleshoot any concerns about additional safety precautions.

Normalize Masks

Many school districts plan to wear masks in the fall. If your child will wear a mask to school, let them be a part of the process of picking out some fun masks so they feel included. Normalize masks by wearing them together around the house or on errands so they get used to the feeling of a mask on their face.

Children may have a harder time recognizing people in masks. According to a recent NY Times article, children do not start recognize a person as a whole until they are six-years-old, which may cause them trouble recognizing faces when they are partially covered. To help with comfort, put on your masks and take them off a few times so that your child recognizes that you are still mom or dad, mask or not.

Many children prepare for school by buying new school supplies and even outfits. Make your child’s mask part of this by having them pick out a new mask for the first day of school. This will motivate them to wear it and show it off to their friends (example: a child loves Mickey Mouse so they may pick out a mask with a Mickey Mouse nose).

Stay Connected

It is tough to stay connected when we are social distancing. It is time to get creative! Find ways to stay connected to friends, family, and your child’s school while you are at home. Follow your local health department’s guidelines. Consider some of these options to keep close from afar.

  • Have a Skype Date: this is great for parents and kids alike to feel connected. Grab a few friends and hop online for a Skype or Zoom call. Everyone can call in from the privacy of their own home with no risk of germs. In the weeks leading up to school have a virtual session with a few of your child’s classmates and maybe even their teacher.
  • Socially Distanced Playtime: if you are comfortable, you can host a socially distanced playtime with one of your child’s friends. Get together somewhere outdoors and “share” a snack. Each child can bring a blanket to sit on and a snack to enjoy while they catch up.
  • Get a pen pal: since we have been separated by COVID, communication has changed. People are writing more letters and emails to stay connected. Help your child draw a card for their new teacher or a classmate, letting them know how excited they are about the new school year.

Review, Prep & Plan

If your child has an IEP, starting the school year can mean even more prep. Review your child’s existing IEP so you can address any concerns about how their needs will be met in school with any COVID procedures in place. Make sure that you are all on the same page before the school year begins.

Celebrate the End of Summer

While it may look different, it does not have to be less fun. Celebrate the end of summer and the start of the new school year with a staycation or a family party. In our house, the kids love a party, and any occasion calls for balloons and a sweet treat. A celebration can show your child that the start of a new school year is something to be excited about, not feared.

Adjust Bed Times

In preparation of transitioning back to school, have your child begin to go to bed earlier and wake up earlier in the morning. Two weeks prior to the start of school, start having your child go to bed earlier and earlier each night, until reaching the desired bedtime three nights before school begins. With summer and the three months prior having had a very relaxed and different type of schedule, getting back to a routine could be beneficial for your child in transitioning back to school. 

Remember, we are all in this together. These changes are impacting everyone, as we transition again, we will do it as a team.

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Got Bored? A Mindfulness-Based Relapse Prevention Plan

All we have to decide is what to do with the time that is given us.  – J.R.R. Tolkien

I question. I question my clients. “What’s been coming up for you?” or “How are you experiencing life these days?” 

For many clients in addiction recovery, the experience of boredom will surface. Boredom, if not taken seriously, is a fast track to relapse. 

When we remove elements of our life that we no longer have interest in (i.e. drugs, alcohol, people, places, and things) we are left with “empty space” — and many of us, not skillful with the use of our time, will call that empty space boredom

A larger truth, is that the empty space is a luxury — it’s a gift — and if we can start to see it this way, our lives have potential to dramatically change. 

Once we let go of x, y, and z (elements of disinterest), we can find ourselves with more time on our hands, not knowing what to do with it. We haven’t yet developed new areas of interest and this can feel uncomfortable. It feels like no man’s land, unknown, uncharted. We can’t see our way in or through this empty space. 

The discomfort of not knowing how we should fill our newfound time and space can lead to feeling restless, antsy, and can lead to relapse. If there is nothing new, we can easily revert back to old habits and patterns. 

Let’s consider that the empty space is good. If we find ourselves without new things or habits to fill our time and space, it means we’ve made great progress. It means we have already let go of old habits and patterns — the old is no longer filling our time. This can be congratulated. 

The discomfort of none — of nothing — to be without negative experiences — is good. 

This is what I introduce to clients as “human minimalism.” In much the same way as we learn to declutter our physical space, we are sometimes left with empty space. As Marie Kondo would say, “If it doesn’t spark joy, let it go.” 

The challenge is just that: If I let “it” go, and I have nothing that sparks joy, then I am left with nothing. If I let something go that continues to fail me or not support my happiness, then I also take the chance to be without something. I am choosing to be without pain. I am choosing to not be unhappy, but happiness hasn’t found me yet.  

To be without pain can feel like nothing. Nothing is happening. But nothing is better than pain. Ask yourself if what you are calling boredom is actually better than addictive behaviors and consequences. 

I heard a teacher once explain the paradox of wanting true peace, in that many of us, when we actually experience true peace, won’t want it — because nothing is happening. 

Peace is calm. Peace is the still water. No waves, no ripples. Not much happening. 

To be without interesting, engaging new habits is like having a blank slate, a blank canvas, and I urge you to be very careful and patient about what you start creating for yourself. That blank canvas is a gift. That empty space of time is a luxury. That empty space is freedom. That thing we call boredom is a gift. A gift of time. Time is the gift of life. That empty space is opportunity. 

Why is it a luxury? You are lucky enough to not have any demands imposed upon you. Life is not demanding anything from you within that empty space. This is a luxury. 

How is it freedom? You are free to choose what you do and how you use that time (i.e. your life). For recovery, this is a huge deal. It means you are now in the choosing seat, as opposed to the object of addiction. To choose wisely is to set yourself up for sustainable relapse prevention. You are learning to break the boredom-addiction connection. 

Why a gift? That empty space is the gift of your life back. Congratulations

Why an opportunity? 

  1. Empty time and space is an opportunity to be with yourself. To be with your thoughts and feelings. We are quick to change our “state of mind,” which leads to addiction patterns, instead of learning to be with our current state of mind. It’s an opportunity to learn to observe your mind, even in states of discomfort, and learn to take care of and support your state of mind in healthier ways.
  2. Do nothing. It’s an opportunity to learn that doing nothing is sometimes the better choice. That which we call boredom is a chance to learn the truth of this experience. One of my favorite meditation quotes is: Don’t just do something, sit there.
  3. Interestingly, as someone who meditates, we call doing nothing “meditating” as oppose to boredom. People who formally meditate, choose, to do nothing — just sit there, in observation of breathing, thinking, feeling. Call it boring? Not so much. Amazing things can happen in self-observation.
  4. Do something worthwhile. Depending on the stage of recovery, this extra time can be used to manage the life in front of you — kids, cleaning, cooking, better health, finances, errands, and the domestics of daily life. It’s an opportunity to engage (or re-engage) in the fundamentals that make life move forward. 

Lastly, and not an easy feat, I ask clients to consider filling in the empty space with what they find valuable, meaningful, and important. For many clients, this is the first time in their life that they are presented with the opportunity to start creating a life of meaning and importance. It’s a powerful moment. A powerful gift. 

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Podcast: Is Life Coaching the Same as Therapy?

Would you benefit from a therapist or a life coach? What’s the difference? Today, we welcome Dr. Jen Friedman, a consultant and coach with a doctoral degree in psychology, who helps explain the distinction between therapy and coaching. She breaks down the purpose and benefits of each and details which practice could help you the most.

Are you hoping to change negative patterns or habits? Or are you looking to build on your strengths and develop a vision? Join us on today’s Psych Central Podcast.

SUBSCRIBE & REVIEW

Guest information for ‘Jen Friedman- Life Coaching Therapy’ Podcast Episode

Dr. Jen Friedman is the founder of JENerate Consulting. She is a consultant and coach who capitalizes on her doctoral degree in psychology and over 20 years of experience in non-profit leadership, mental health, and education to focus on her passions of enabling personal growth, developing leadership, building cohesive teams, and creating effective systems to enhance culture. Jen works with organizations as well as individuals, both locally and across the country. She speaks widely about topics such as growth mindset, brain-based leadership, and emotional intelligence. You can contact her directly at jen@JENerateConsulting.com or check out her websiteTwitter or LinkedIn.

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 ‘Jen Friedman- Life Coaching Therapy’ Episode

Editor’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. Calling into the show today, we have Dr. Jen Friedman, who is the founder of JENerate Consulting. Dr. Friedman is a consultant and coach who capitalizes on her doctoral degree in psychology and over 20 years of experience to help people and organizations develop leadership, build cohesive teams and create effective systems to enhance lives and organizational culture. Jen, welcome to the show.

Dr. Jen Friedman: Thanks for having me, Gabe.

Gabe Howard: I am very excited to have you here because in general, therapy is understood. But life coaching, leadership coaching, just any type of coaching in general is significantly less understood. And in fact, most polls show that people believe that coaching is is just kind of a scam so that untrained, unqualified people can provide therapy. And it’s something that the medical community, the doctors, the therapists, the PhDs, they don’t race to debunk that. Which is why I wanted to have you on the show, because you’re the rare combination of PhD and coach.

Dr. Jen Friedman: Yes, it is misunderstood and I’m happy to provide more clarity for it.

Gabe Howard: Let’s just talk about the differences right out of the bag. What is the difference between traditional therapy and coaching?

Dr. Jen Friedman: So therapy really is focused on helping people heal. People go into therapy because they’re experiencing significant symptoms and significant issues that are interfering with their lives in some way. It might be interfering with their social lives. It might be interfering with their work life, their home life. And they want to fix that. They might have anxiety, depression, which manifests in fears or cognitive distortions. That’s what they want to do in therapy, is fix those things. Whereas in coaching, most people are coming from a point of functional. And they want to transform and become even better and even more productive, even more successful. And they want to be transformed and inspired and focus on that. So they’re not necessarily looking to fix anything. But as a coach, I’m going to meet them where they are and take them even further.

Gabe Howard: Thank you so much for that, Jen. Let’s talk about their similarities because I usually don’t get to ask anybody this question because I’m usually talking to just a therapist or just a coach. So you’re really in a unique position because you provide both to tell us what they have in common, what coaching and therapy really share.

Dr. Jen Friedman: So one of the things that is most obvious is that people will gain insight into themselves in both situations if they’re in therapy. They’re going to gain insight into what kinds of things are really interfering. What kinds of maladaptive coping strategies they’re using? What kinds of issues that are just repetitive bad habits are getting in their way? So they’re developing that insight. And in coaching, people are developing that insight as well into what their strengths are, what their next course of action is to elevate themselves further. And so there’s this unique and common thread of self awareness and self insight. Also, in both of those situations, people are developing connections with their coach or their therapist. Any good therapist, any good coach is developing a real solid partnership with their client. And that is really the basis of any successful experience, is rapport. If you can build good rapport with someone, you’re going to get much farther. Where things are different is that we are really as a coach, again, not looking to fix a person, but meet them where they are and take them to the next level of success and growth in whichever realm they’re looking for. Usually it’s multiple realms like personal and professional.

Gabe Howard: Therapy has a sort of a governing body. There’s licensing, there’s insurance, there’s educational requirements. You can’t just open up a Web page and call yourself a therapist. But over on the coaching side, it really does seem like anybody can just decide, hey, I’m a coach today and boom. Is there training? Is there licensure? How does the general public know that they’re getting a good, honest and safe, we’ll go with safe, coach?

Dr. Jen Friedman: That’s a great question. And there are some collectives that are organizations that have specific rules, regulations, ethics tied to them, the International Coaching Federation ICF is one of those. And people can go through a coaching program and become a certified coach or a master coach. And it will be governed by that body. And then they are responsible for adhering to those specific standards that that organization set forward. Not everybody has to be a certified coach, correct? I think the word coach, because it’s used in so many different ways, you can be a basketball coach,

Gabe Howard: Right.

Dr. Jen Friedman: Very motivating, develop great partnerships with the people you’re coaching, whether it’s kids or professionals. You can be a life coach. You can be a career coach and guide people towards their next career. And so I think the term coach itself, because it’s so widely applied, is really what is confusing to people. And people who are certified by a specific coaching organization don’t necessarily make it to the level of expert coach. So just like any therapist who even though they’re governed by a regulatory body, they may not be a good fit for a person or they may not be a great therapist. They just got the education required in order to meet the criteria of the governing body.

Gabe Howard: Now, from your vantage point, you are qualified, trained and licensed as a therapist and you’re qualified, trained and excelling as a coach, which makes me wonder, why did you choose coaching over therapy?

Dr. Jen Friedman: So I have been working in lots of different arenas for the last 20 years, so I’ve been working in education, in nonprofit leadership, and I’ve been working in different organizations where mindset has been a very compelling theory and applied practice. And I’ve studied Carol Dweck’s work and applied it both to kids and adults. And I find it so compelling. It really aligns more with the coaching model where it’s the ultimate growth mindset. Coaching really focuses on becoming the most powerful use of the term yet where you’re growing into what you will become. You just haven’t gotten there yet. But the hopeful position that you will get there, it’s really focused on empowerment and creating a vision toward the future. I’m really passionate about focusing on people’s strengths. I really believe that everyone operates with underlying assumptions and that their strengths, everyone has them. It’s so important to draw those out of people. Therapy doesn’t always focus on strength, but again, looks to fix different things that people are dealing with and that are getting in their way. Choosing the coaching field really helps me focus more on growth, mindset and people’s strength. Though it’s similar to therapy and you’re empowering people and helping people reframe how they’re doing things, it’s really looking at optimism and positivity more than looking at fixing and maybe what’s broken in a person, because I don’t believe people are always broken. And the majority of the time I don’t think they’re broken. I think we’re not focusing enough on people’s strengths and how much talent they bring to the table. And perhaps if we focused more on how much talent they’re bringing and how many gifts they really have, they’d feel like they were less broken to.

Gabe Howard: I really like everything you said there, and I’m going to kind of ask you the exact same question except from a completely different perspective. Let’s say that you’re an individual and you’ve decided that there is something that you wish to change. Whether you see it as a deficit, whether you see it as just a strength that you can improve on, there is something in your life that you want. So you’re now sitting in front of the Internet and you’re trying to decide if you want a therapist or a coach. How would a person make that decision? Because I imagine that there’s some probably excellent examples of things that coaching is not appropriate for. How can they help tease out when seeking a coach is appropriate versus when seeking a therapist is appropriate?

Dr. Jen Friedman: People have habits and people have routines when they are looking to better themselves, if they really feel like they want to change some habits that perhaps are maladaptive and are again getting in their way, then they may want to look at therapy to change those patterns. We talk in therapy about people repeating and repeating the same patterns until they resolve that. And finally, can break out of those habits and move forward. So if you’re feeling like you have, I don’t know, some monkey on your back and it just keeps getting in the way, you may want to go into therapy to change some of those cognitive distortions, build some different habits and build adaptive coping strategies so that you can be at this neutral, positive point in your life to then benefit perhaps from coaching. But if you’re really ready to imagine the future, to focus on transforming yourself into the person, you want to be calm and you feel like you have the basic skills to be functional and the wherewithal to be hopeful and optimistic, even if you need a partner to help you, and even if you need motivation and inspiration and encouragement and someone to guide you, you’re still operating from that neutral to positive position. That’s when you would choose coaching because you want to make sure that you’re not allowing other things to get in the way of setting the vision for an ideal state as opposed to focusing on the things getting in your way.

Gabe Howard: We’ll be right back after these messages.

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 discussing the differences between coaching and therapy with Dr. Jen Friedman. One of the things that we hear so often is that some of the coaching is centered around severe and persistent mental illness, like we’ll have a psychosis coach or a bipolar coach or a schizophrenia coach. And these are all coaches that believe that they can help guide you past the symptoms of severe and persistent mental illness like bipolar disorder, psychosis or suicidality, etc. And I know that a lot of our listeners, that’s what really scares them, especially for their loved ones who are, you know, maybe desperate or who are suffering the ill effects of a serious mental illness. And I sort of want to put up an asterisk that everything can be abused. I don’t want anybody to throw out the baby with the bathwater. I just, I don’t want to ignore the fact that we do see some of these things, you know, suffering from depression, hire a get over depression coach to go for a walk in the woods. Can you discuss that whole mentality for a moment?

Dr. Jen Friedman: Yes. Because I think that is scary when you’re dealing with severe and persistent mental illness. You really have to have a trained person who understands the neurophysiology of that illness. You have to have an education about the effective and research based treatments that work best for people with those specific illnesses. You know, there has been research on schizophrenia for decades speaking to how social systems and dealing with those systems and with the thought distortions, those things have to be addressed. You can’t just coach someone out of hallucinations and delusions unless the person you’re working with is highly skilled and trained in that specific disorder. You can’t just coach a person out. Those aren’t habits. It’s not like somebody chose to be a certain way or decided they were going to have a hallucination or, you know, not be able to get to work the next day because they were so severely depressed. These things come from genetics and an issue in our bodies and in our brains. That’s not our fault. And that, again, a skilled person has to know the most effective strategies to use in order to get that client over the hump and to be more functional. So whether it’s cognitive behavioral therapy or even psychodynamic therapy, any implementation has to be based in research. And the research in psychology and mental illness has been going on for 100 years. We have to be educated and use that to help that person be as successful as possible.

Gabe Howard: I really appreciate all of that and thank you for saying that, I just, I know that in times of desperation, it’s easy to seek out what appears to be a simple answer, and unfortunately, especially when it comes to serious and persistent mental illness, it’s not simple. I understand how enticing it can be. You know, when I see some of those ads on the Internet, they just always make me shake my head. So thank you for addressing that.

Dr. Jen Friedman: Of course, and also, you know, psychopharmaceuticals have come such a long way. And psychologists and other therapists are trained in the effects of those and can work closely with a psychiatrist to give the person that multiple benefit of those two professionals who know what they’re doing. And a coach that isn’t trained and that can’t do the same.

Gabe Howard: I completely agree with that. Now, let’s switch gears a little bit. One of the things that does excite me personally about coaching and something that I thought was a great idea even when I first heard about coaching 10 years ago, was organizational coaching, because obviously you can’t move your organization into therapy. It doesn’t quite work that way. But I know that things like organizational understanding, leadership, understanding, roles of employees versus management. And just a general understanding of workplace culture. These are things that coaching has really excelled in addressing, especially for small to mid-sized businesses. I’m really excited about how coaching impacts, I’m using businesses, but really any organization with multitudes of people.

Dr. Jen Friedman: Yes. And it excites me as well. And that’s part of the reason that I did switch into coaching because I love working with organizations and with the place where people gather and organizations are made of people. So when you have all of these people in one place, they go to work every day. Usually at least eight hours a day. You’re talking about a micro chasm of the world in one place where people spend much and most of their time that isn’t spent with their family and friends. You get to see how people relate to one another, how they operate under pressure, how they basically can bring out the best in themselves, or sometimes how the worst can come out of different people. And the magic is in helping people become as self-aware as possible, use tools to relate to one another as best as possible, and to really take the sum of the parts and make a greater whole. That’s the goal with organizations. And when you have people that feel good about themselves, are self-aware, are working towards their ideal state, then they’re interacting with other people who are in that same mindset. They are working better together. Everyone is feeling more satisfied and motivated. Thereby they are more productive. The organization then gets better results and at its finest will have as much innovation as possible because people are in their frontal cortex, is operating in a space with creative freedom and positivity and lots of positive energy. And that’s when you can really get a business from good to great and you can really optimize everybody’s experience plus the outcome and results of the organization.

Gabe Howard: One of the things that you said during the pre interview for this show is that no matter how great you are, you can always be better. And there is a part of me, when I first heard that, it was like, oh, that’s just a sales pitch. I mean, you know, if some is good, more is better. But you actually convinced me a little bit in your writing that, wow. Thinking that you are perfect at something and that you don’t need help is really pretty arrogant. I know that there are people that are thinking, well, I don’t need coaching. I’m excelling in my field. But you feel very strongly that everybody can benefit from coaching.

Dr. Jen Friedman: Absolutely. And again, this links back to my alignment with growth mindset that we are always growing. And really, if we’re not growing, we’re dying just like a plant. A plant has to always be getting its nutrients, getting its sunlight, getting water. The minute one of those things isn’t present, the plant starts to die. There is no homeostasis. And I believe that with people as well, when people are growing, they’re encouraged. They’re feeling good about it. Even when you’re at the top of your leadership game, even the most successful CEOs and leaders in our world know that there is more learning to be done. You can hone your skills to an even greater level and you can take what you’ve learned and your exceptional qualities and then inspire others. So you’re growing by helping others grow. My vision is of people who are positively engaged with others in this life cycle of inspiration, where everyone is constantly growing and becoming better and better versions of themselves. That, I believe is our sole purpose on this earth is to constantly be doing better, becoming better people and engaging others in betterment to make this world a better place.

Gabe Howard: I could not agree more. Jen, thank you so much for being here. I really appreciate everything that you’ve discussed and that we’ve talked about. I really think that you have enlightened me and our listeners on the difference between therapy and coaching and how they both coexist in the world together. Thank you again.

Dr. Jen Friedman: Thank you, Gabe. It’s been a pleasure talking with you.

Gabe Howard: Jan, it’s been a pleasure talking to you as well. Where can folks find you?

Dr. Jen Friedman: You can go to my Web site at JENerateConsulting.com. I am also on Twitter @DrJenFriedman and on LinkedIn at Jennifer Lerner Friedman, PhD.

Gabe Howard: Listen up, everybody, here’s what we need you to do wherever you have found this podcast. Please go ahead and subscribe. That way you don’t miss any great episodes and go ahead and review us. Use your words. Give us as many stars as possible. And when you share us on social media, tell people why they should listen, and remember, you can get one week of free, convenient, affordable, private online counseling anytime, 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 show@psychcentral.com. 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.

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Small Ways You May Be Undermining Each Other as Parents 

Being a parent is a tough job under the best of circumstances. Even strong parenting partnerships can struggle when things get difficult. Unfortunately, there is no manual or black and white solution for many situations. Of course, there are plenty of people who love to tell other people what to do and how to do it according to their own logic. There is, however, one huge parenting no-no that couples regularly and often unknowingly commit, and that’s when one parent undermines the other in front of the kids.

As big of a blessing and joy as children can be, they often have a way of testing the patience and resolve of their parents and their parent’s relationships. As individuals we don’t always agree with one another and when there are disagreements about children and parenting decisions we can sometimes make big mistakes. Sadly, those mistakes can have a detrimental affect on children and on children’s relationships with their parents. 

What Undermining Looks Like

Most parents when asked will tell you they never undermine the other parent. They will also probably tell you, however, that they themselves have been undermined by their partner at some point. So, it really does beg the question — what does undermining look like?

Undermining one another can happen in a variety of ways. Some are intentional and some aren’t, but that really doesn’t matter when it comes to the overall effect. If you are wondering if you have been guilty of it ask yourself the following questions:

  • Do you ever disagree about repercussions for bad behavior in front of your child?
  • Have you ever encouraged your child not to tell the other parent about something?
  • Use the other parent as the ultimate threat (i.e., “Just wait until your mom/dad finds out?” or “Your Mom/Dad is going to be so mad when they get home.”)
  • Conversely, do you offer to conspire with phrases like, “You can do or have xyz, just don’t tell your mom/dad” or “Remember, this is our little secret”? 
  • Do you complain about the other parent in front of your kids?
  • Do you change or reduce a punishment that was doled out by the other parent?
  • Routinely sleep in the room with your child, instead of with your partner? 
  • Say things like, “You know what he can be like?” or “She’s really in a mood today”?
  • Make excuses or cover for your child to the other parent when they’ve misbehaved?
  • Say things like, “It’s no big deal” or “Calm down, they’re just kids” when your child has done something wrong?

These are all examples of common and somewhat inconspicuous ways that parents can undermine each other. Many of these are innocent in that one parent really isn’t trying to damage or hurt the other, or their relationship with the child. Unfortunately, this behavior can become deliberate and extreme when the relationship between parents is tense, or if there’s a separation or divorce in the works. In these cases, there may need to be counseling or parenting classes needed on how to effectively co-parent.

Effects Undermining the Other Parent Has on Your Children

You may be reading this and thinking, “I do one or two of those, how bad can they really be?” Well, the answer to that can vary, but generally these behaviors act like water flowing over a rock. The more often you do them, the more of the relationship erodes. And the impact is multiplied when your relationship with the other parent is already strained.

Remember, children learn more from what they see than what they’re told. Undermining the other parent sends the message that a positive and honest relationship really isn’t that important. It can also teach them manipulation is an acceptable way to get what they want. Most kids will try at some point to play parents off one another. If you have regularly undermined each other over the years they will not only see pitting you against each other as acceptable, they will also know quite well how to do it themselves because you will have taught them.

As a consequence of this you may find that your child doesn’t take either one of you seriously when you set boundaries, make rules, or issue consequences. 

How to Stop

Learning not to undermine each other requires conscious effort. So many of the little ways it can happen can sneak in over time despite your best intentions. In the heat of the moment it’s very easy to get emotional and forget that a united front is the most effective means of parenting. 

Having regular discussions regarding parenting issues when things are calm can be a good way to keep things on the right track. And communicating with each other regarding any behaviors or comments that feel like you are being undermined. These conversations, however, should be done away from the children.

If you find that you have done things that may undermined your partner parent, then you can still work together to fix things. It may require a conversation with your child to explain that despite what they may have seen or heard, you have come to agreement on whatever the issue is and present a united front. This will serve the dual purpose of not only reinforcing your message, but also showing them that two people who love and respect each other can come to agreement even if they didn’t see eye-to-eye at one point. Effective conflict resolution is a difficult skill to learn and should be modeled to our children whenever possible. 

Most parents have accidentally undermined the other at one point or another. Children can bring out the best and worst in us, and also inspire a lot of strong emotions. Working to be a better parent and a better parenting team is a never-ending process. So, if you’ve stumbled and made mistakes, the good news is that you get to try again.

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Podcast: Life with Binge Eating Disorder

 

At one point, Gabe weighed more than 550 pounds. Today, he and Lisa remember and discuss the extreme pain and slow healing process of living with binge-eating disorder. Gabe shares his shame in being so overweight, his intense relationship with food, the story of his gastric bypass and the difficult process of learning new coping mechanisms.

How did Gabe’s bipolar and panic attacks tie in with his binge eating? And, importantly, how is he managing the illness today? Join us for an open and honest discussion on living with an eating disorder.

(Transcript Available Below)

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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 “Binge Eating DisorderEpisode

Editor’s NotePlease 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: Welcome, everyone, to this episode of Not Crazy. My name is Gabe Howard, and I am here with my ever present co-host, Lisa.

Lisa: Hey, everyone, and today’s quote is Food is love, food is life by Edwina O’Connor.

Gabe: Ok. There’s so much to say about this. But food is life. It’s life. Oxygen is life. Oh, that’s so deep, you should put this.

Lisa: It’s profound.

Gabe: Like this is like live, laugh, love.

Lisa: Right

Gabe: You need food to survive. So we all get that you have to eat to live. But food has sort of taken on a little bit extra, right? If I give you a cupcake, it means I love you. If it’s your birthday and I don’t get you a birthday cake. You don’t need a birthday cake to live. We do these things to express love, right?

Lisa: So it works both directions, giving people food is love and accepting their food says I love you back.

Gabe: Woo! And that’s where we really sort of get into, I’m gonna go with crux of our discussion today, which is binge eating disorder. Many people don’t know, I used to weigh 550 pounds. I’m six foot three. My top weight was five hundred and fifty pounds.

Lisa: You realize your top weight was a lot closer to six hundred and fifty pounds.

Gabe: That’s not true. I never weighed over 600.

Lisa: I’m willing to bet that you weighed over six hundred.

Gabe: I did not. I know for a fact.

Lisa: The day you had gastric bypass, you weighed 554 pounds, but you’d been on a diet for several weeks and you’ve been fasting for several days. I’m willing to bet you lost 20 or 30 pounds at least.

Gabe: There is one thing that fat people know more than anything else, especially fat people who have lost a lot of weight, they know their top weights.

Lisa: Ok, well, never mind. Go back, unpause.

Gabe: No, we don’t need to pause at all. I think you should leave this in there. I want people to see how often Lisa pauses to correct me. 

Lisa: You’re welcome.

Gabe: Do you think that there is a difference from a storytelling perspective between weighing five hundred and fifty pounds and weighing six hundred pounds? I mean, just I guess I maybe I qualified for This 600-lb Life.

Lisa: Yeah, see, there you go. I didn’t set the limit. Somebody else did.

Gabe: Well, I’m not going to retroactively go back and try to be on a fat-sploitation show. But just the thing that I want the audience to know is that I weighed over five hundred and fifty pounds. Now, the weight that I weigh today, which according to the BMI chart is in fact obese, is 260 pounds. I’m six foot three and I’m a big guy. I’m broad shouldered. I’m not a small person. But 260 pounds is is less than half of 550. I lost a person. I lost a person and change.

Lisa: Yeah, it’s very impressive. This was a long time back. You had gastric bypass in 2003 and you’ve kept it off all these years. 

Gabe: Let’s move past how I lost the weight and let’s talk about life as a five hundred and fifty pound man. Because I thought that I just ate a lot. Like, I thought that I needed to go on a diet. And when you first met me. I don’t know. You know, the more we tell our story, Lisa,

Lisa: The crazier I sound?

Gabe: Yeah.

Lisa: Yeah, I’ve noticed that.

Gabe: You met a man that weighed five hundred and fifty pounds with untreated bipolar disorder. And you were like, yeah.

Lisa: You were very engaging. You Gabe magicked me.

Gabe: Gonna get me some of that.

Lisa: Yeah. You carried it well. What can I say?

Gabe: Oh, really? I just I dressed so well? You know, you get the right tailor, you can hide anything with clothing.

Lisa: It’s amazing. Yeah.

Gabe: But back to our point, I thought that I just ate a lot. I thought I was just overweight, like so many Americans and I.

Lisa: You’re remembering the story a little bit different. By the time I met you, you had already been diagnosed with binge eating disorder.

Gabe: That’s not true. That is completely untrue.

Lisa: That is true.

Gabe: That’s not true. Nope.

Lisa: That is true.

Gabe: No. 

Lisa: That is true. I don’t know what to tell you.

Gabe: No, it is not true. 

Lisa: I never thought that you were just, just fat. You know what I mean?

Gabe: You had me join Weight Watchers.

Lisa: Although Weight Watchers is obviously not designed for people with serious eating disorders, it is a mechanism to keep track of what you eat.

Gabe: Yes, an umbrella is a mechanism to not get wet. But would you hand it to a hurricane?

Lisa: I’m not saying that it was the best choice for you.

Gabe: Is this what you recommended, like for Katrina? 

Lisa: But what were the options?

Gabe: Like medical intervention?

Lisa: You were doing that too.

Gabe: I wasn’t doing any of that. We can fight about the timeline until we’re blue in the face. But here’s what we know, I weighed five hundred and fifty pounds and I wasn’t doing much about it. Why do you keep

Lisa: I disagree.

Gabe: Why do you keep shaking your head? I love how you’re shaking your head.

Lisa: You told me not to talk. So I shake my head. By the time we started dating, you were already trying to get a gastric bypass.

Gabe: Here’s the thing, though, that I think you’re not considering. You’re tying together Gabe trying to get gastric bypass with Gabe understanding that he had binge eating disorder and those two things are not in any way related.

Lisa: You don’t think so?

Gabe: I didn’t know any of this stuff. I did want gastric bypass because I was 24 years old and I weighed five hundred and fifty pounds. I saw gastric bypass as a quick fix, which we’ll get into that later in the show. But let’s focus on binge eating disorder. Have we established that Gabe was overweight and had issues with food?

Lisa: You were very overweight and you definitely had clear issues with food. As I might have said to you at one point, you were, in fact, circus freak fat. 

Gabe: You did.

Lisa: Sorry about that, that was rude.

Gabe: I don’t know how our relationship made it.

Lisa: Yeah, yeah.

Gabe: I think that the divorce was probably inevitable.

Lisa: I’m pretty sure I said that after you lost the weight, but I’m not positive.

Gabe: Let’s talk about our language for a moment. You and I weren’t, we’re not big language police. We kind of think that the goal should be communication and context, not so much the words. But I got called fat a lot. You, Lisa, saying that I was fat, it does not offend me. It does not bother me. But other people doing it, it did. As you can imagine, weighing five hundred and fifty pounds. I got a lot of sideways glances, stares, giggles, comments, and it hurt my feelings a lot. And the other reason I kind of bring this up is because why are we so cavalier about it? I know how damaging body image can be, because, again, even though I weighed five hundred and fifty pounds, even though I couldn’t walk from my car to my office desk without taking a break, the only thing I cared about was how I looked. I didn’t care that I would lose my breath standing up. I cared that I wasn’t pretty enough and that maybe I couldn’t find a girlfriend.

Lisa: Really?

Gabe: Yeah.

Lisa: You weren’t worried about the health?

Gabe: No.

Lisa: Not necessarily worried about the health consequences, but it wasn’t things like you had trouble getting upstairs? You weren’t concerned about stuff like that?

Gabe: I wasn’t. You know, I was 22, 23, 24, I was invincible. I cared that I couldn’t find clothes that fit me. I cared that I was ugly. I cared that women wouldn’t want to sleep with me. I’m not trying to make Lisa out to be a bad person. But Lisa and I were not exclusive because Lisa gave me a fake name when we first met.

Lisa: Well, I wasn’t going to give you my real name.

Gabe: That’s fair. I was circus freak fat, apparently. I’m just saying that these are kind of the things that went through my mind. But what I was really surprised to learn and tying it all the way back to you thinking that I was diagnosed with binge eating disorder when we met because I was trying to get gastric bypass, is my entire motivation for getting gastric bypass was wanting to look better. I did not know that I had binge eating disorder until I was in the steps of gastric bypass. One of the things that I had to go through was a psychological examination where they started talking to me about why I ate. And I ate because it made me feel better.

Lisa: Everything surrounding gastric bypass was a lot different back then. Insurance companies were paying for it in a different way. The surgery was still relatively new. It was kind of a halcyon days for gastric bypass. And there were still stand alone surgery centers that specialized in this. You just don’t see those types of programs anymore. You don’t see the ads on TV anymore. And every surgeon was doing it. Every hospital had a program. You specifically went out of your way. Well, at the time, I thought you had gone out of your way to find this really good program with really high success rates. And one of the reasons they had such a high success rate was because they were so comprehensive. They had all this psychological counseling and nutritional counseling and this really long waiting period and on and on and on. And at the time, I thought, oh, there’s a health care consumer. He has made the best choice for him. Good job. But I found out later, no, he just knew this lady who went there. So he was like, sure.

Gabe: You’re half right and half wrong. When I looked at the other places they kind of scared me a little bit. I know this is a stupid thing to say, but one of the reasons that I felt comfortable at the bariatric treatment centers was because they had wide chairs.

Lisa: I remember that.

Gabe: When I walked in, they had these wide chairs that I fit in.

Lisa: They were like benches.

Gabe: When I went to the other place, it was just in a regular, it was a well-known hospital. I don’t know. I had to pay more money to go where I went. So in theory, I could have picked the cheaper place. So.

Lisa: Through a variety of good decision making and luck, you ended up at a place with an excellent program that was very intensive in the pre surgical period. They had a lot of psychological and nutritional counseling, which most programs did not have then or now.

Gabe: So here I am, I walk in and they’re like, why do you want to have this? And I say, because I’m ugly and I don’t want to be ugly. And they say, OK, that’s what we get. Like, what are some things that you would do if you weren’t this size? And, you know, I said I wouldn’t sit in the handicapped seats at hockey games, for example. I would sit in booths instead of tables. I would ride roller coasters again. But in the back of my mind, what I was thinking is I would get laid more. I felt so bad because I felt so ugly and I tied that directly to my weight. Now, I didn’t know that I had bipolar disorder at this time. I did not know that I was untreated. There was obviously a lot going on, but those were my initial reasons. That’s why I wanted to do it. And through that process, I ended up at an eating disorder clinic and I remember my very first appointments. Were you around for that appointment or had I already gone to it and told you about it?

Lisa: You know, I don’t remember if that was your first appointment. Very early, I remember going to the eating disorder clinic. Yeah, it was just like a whole other world. It was so odd to go there because obviously most people getting treated for eating disorders are anorexics because those are the people who are most likely to die of their eating disorder. So they’re the people most likely to get treatment. And most of the binge eaters were quite large. So it was this bizarre mix of very, very small, mostly young women, just painfully thin young women and extremely overweight, you know, 20 some, 30 some year olds. And I went to one of their family support groups and the majority of the people there, their family members, family or friends, were anorexic. And they had the exact same behaviors, the exact same attitudes, the exact same everything. Even though their problem was that they didn’t eat enough. And your problem was that you ate too much. That really went to show that eating disorders were not about the food. It was about the psychological thing.

Gabe: Well, that’s interesting because while it was psychological, it was also about the food. For example, if I was feeling sad, I needed birthday cake. Because birthday cake was tied to happy memories. You couldn’t just give me 20,000 thousand calories in.

Lisa: Veggies? Salad?

Gabe: Man, that’s be a lot of salad and veggies, but

Lisa: Well.

Gabe: I needed like the foods that I grew up with. I guess a better way to say it is it was about the psychological connection to the food.

Lisa: Yeah. So I looked up the definition of binge eating disorder, because how do you know when you’re binge eating and how do you know when you’re just over eating? Binge eating disorder is characterized by recurrent episodes of eating large quantities of food very quickly and often to the point of discomfort and a feeling of loss of control during the binge, experiencing shame, distress or guilt afterwards and then not regularly using unhealthy compensatory measures such as purging, because that’s a whole other eating disorder. And this was interesting, I actually didn’t know this until today. The binge eating occurs on average at least once a week for three months. And this is how you can get diagnosed with binge eating disorder, which was not its own separate mental illness until 2013 with the new DSM.

Gabe: You know, all the eating disorders have things in common, right? And the thing that it has in common is this unhealthy relationship with food. A healthy relationship with food is that you eat to survive. You start to get into a gray area when you eat to survive but you also enjoy what you eat.

Lisa: Oh, I don’t think that’s fair. You can eat to survive and enjoy what you eat. You probably get into a gray area once you get overweight. And I am overweight.

Gabe: The goal of food is not enjoyment. The goal of food is sustenance. The reason that we get in a gray area is because who’s ever eaten that extra bite? Because it tastes so good. That’s a gray area. You do not need that extra bite. But also, why do we have foods that go with holidays or occasions? That’s a gray area, right? There is no reason on Earth that we need to celebrate our occasions with food.

Lisa: But that’s an evolutionary thing. What encourages the animal to eat? Because it’s enjoyable. It’s pleasant. Otherwise we wouldn’t eat. We’d all starve to death. So it goes together. Humans throughout time would not survive if they did not find enjoyment in food because then they wouldn’t eat and they’d all die.

Gabe: Well, I disagree with that. Why can’t it work the other way? We don’t eat, so we feel pain. We feel hunger.

Lisa: It’s both.

Gabe: I suppose alleviating that hunger provides joy. I don’t know why we fell down the rabbit hole on it’s a gray area. But I do I think that it’s important to establish that sometimes our relationship with food, while healthy, is a gray area. There is absolutely no reason that we have to have cake on our birthday. But I would venture to guess that anybody who didn’t get a birthday cake or some sort of special dessert on their birthday would feel that they were left out or that they missed something.

Lisa: Well, that could be its own separate show about the emotional relationship to food and American’s relationship with food, because we just have this ridiculous eating pattern that nobody else has. Nobody in history has had previously.  

Gabe: So would you say that that’s a gray area?

Lisa: Ok, fine gray area. 

Gabe: Lisa, the point that I am making, when I was sad, I ate. That is what I learned by going to a nutritionist and examining my relationship with food. And I think that everybody in America has sort of a messed up relationship with food to a certain extent. What I called the gray area, but it was just so extreme. 

Lisa: When you were sad, you ate to comfort yourself. When you were happy, you ate to celebrate. When you were angry, you ate to calm down. When you were fill in an emotion, you responded to it with food and to a lesser extent, so do I. Which once again is why I’m overweight. But it was very extreme, and still is extreme for you.

Gabe: But I don’t think it’s fair to call it extreme anymore.

Lisa: Why?

Gabe: It was extreme before I got help. I don’t think it’s extreme anymore. I do think it’s outside of the normal lines.

Lisa: Ok. Well, that’s just a semantic argument, it’s much more than for the average person. How about that?

Gabe: Well, I’m just saying, if my relationship with food is extreme now, how would you classify it before I got help? When I weighed five hundred fifty pounds, what word would you use there?

Lisa: Even worse.

Gabe: Well, but we need a word here. We’re using extreme for my relationship with food now.

Lisa: Horrifying. I would call it horrifying. I think you have lost track of how far outside of the norm you still are. You are much better than used to be, obviously. But I think you’ve normalized in your mind a lot of your behavior, and it is not. This is not the way the average person, even the average American, reacts to food.

Gabe: It’s the way you react to food.

Lisa: Well, yes, but that’s not a good measure because I am also overweight. But it’s worse with you. It’s a lot worse.

Gabe: Give some examples.

Lisa: Whenever we go out, there has to be food. It’s not fun for you if there’s not food. All activities have a food that goes with it, a food that must go with it. You can’t go to a movie and not have popcorn or snacks. There’s no enjoyment in the movie if you don’t do it. You can’t go to a Blue Jackets game and not get concessions. You know, a lot of people say, oh, well, I like to have a beer while I watch the game. No, it’s a whole different level for you. You would rather not go at all than go and not eat.

Gabe: You think that’s out? Popcorn at a movie theater? Me wanting popcorn and a movie theater?

Lisa: No.

Gabe: You’ve decided that is extreme and outside the norm? So I’m the only one? 

Lisa: The level at which you want popcorn at the movie theater and the level of distress you go through, if for some reason, you can’t have it. If I told you in advance, hey, the popcorn machine is broken at the movie theater. You wouldn’t go. Even if it was Star Wars on opening night. You would not go.

Gabe: I think that is untrue. 

Lisa: One of the things Gabe and I don’t know if you remember this, that I think really showed the emotional relationship you had with food is a few weeks after you had gastric bypass. We were in the parking lot of your apartment building. And I don’t remember, we had argued about something. And you got so upset that you started crying and you actually said, I just feel so bad and now I don’t even have food. I don’t know what to do. I don’t even have food.

Gabe: I remember.

Lisa: The idea being that was what you were going to turn to make yourself feel better. And this was so soon after surgery that you couldn’t and you were devastated at that. You were so distraught because you just couldn’t come up with anything else to soothe those emotions. 

Gabe: My mom and grandma were staying with me. I asked them to come and take care of me. You know, I was single.

Lisa: Well, you needed someone, major surgery.

Gabe: But, you know, fish and house guests smell after three days. And they had been there for a week. And I was ready to get my privacy back. And I had asked you to stay to kind of be a buffer. And you said that you were ready to go home. You’d been there for a while

Lisa: Oh,

Gabe: And I walked you out to your car. So we didn’t really argue. I had pleaded with you to stay.

Lisa: I don’t remember that part.

Gabe: Just, you know, come on, come on, come on. And, you know, you were like, no, I gotta get going. I’ve got to go back to work. So I had walked you out to your car and you asked me what was wrong. And I just, I just started crying. And then, of course, I had trouble standing because I just had surgery and I fell down next to your car.

Lisa: Yeah.

Gabe: And I was going through so many emotions. And my coping mechanism at that point was eating. And I didn’t have it. I had not learned new coping mechanisms yet.

Lisa: Just how emotional you were at this loss. Almost as if your best friend had died.

Gabe: Yeah.

Lisa: And it was one of the things that really drove home to me how much your emotions were tied up with food. That there was this thing you had always been able to turn to and now you couldn’t and you didn’t know what to do or how to behave. And it was heartbreaking. 

Gabe: You know, on one hand that a devastatingly sad story.

Lisa: It was.

Gabe: But the reason I’m snickering is because do you remember my neighbors walking by? And one of them said hi to you 

Lisa: Right.

Gabe: But of course, as they rounded, they see this 550 pound guy hunched over in his bathrobe on the

Lisa: On the ground.

Gabe: On the ground. They’re just like, OK. I, yeah.

Lisa: When a really large person hits the ground, people, people react.

Gabe: Yeah. Yeah. Yeah.

Lisa: And then your mom thought that you had just fallen

Gabe: Yep.

Lisa: Because she didn’t know that you’re upset and you didn’t want her to know how upset you were.

Gabe: Pandemonium.

Lisa: So she started getting all upset because she thought, well, we’re not going to be able to pick him up. He’s fallen down and we can’t lift him back up. So there was humor in it. Sort of. Looking back.

Gabe: You know, hindsight,

Lisa: Mm hmm.

Gabe: Hindsight is always funny-funny.

Lisa: Fun times. Fun times.

Gabe: Yeah.

Lisa: We’ll be right back after these messages.

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Gabe: We’re back discussing binge eating disorder.

Lisa: In order to have the diagnosis of binge eating disorder, you need to have three or more of the following: eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not physically hungry, eating alone because of feeling embarrassed or by how much you’re eating, and feeling disgusted with oneself, depressed or very guilty afterward. And when I read that, the thing that really struck me is eating much more rapidly than normal. It was amazing how fast you could eat. Like you could be a competitive eater.

Gabe: One of the things that really struck me is the things that I used to do to hide how much I was eating. Like, I would order pizza and I would say, you know, hey, I need two large pizzas. And they’re like, OK, do anything else? Well, hang on. Hang on, guys, you think two large pizzas is enough? Hang on, hang on. You got like a special for three. Go, go ahead and. There was just me. There was literally just me. I wasn’t even married. I was just. I was.

Lisa: So, you were pretending there were other people on the phone to the pizza place because you didn’t want them to know you were ordering for yourself?

Gabe: Yeah, and I would go through drive-throughs and I would order multiple value meals. Same level of, you know, I’d like a number two and number three, both with Diet Cokes. All right, what sauce do you want? You know, my girlfriend likes your barbecue. So let’s go ahead and grab that. And on that other one, I think my buddy said he wanted no ketchup. Yeah, these were all for me.

Lisa: Right. And you knew that.

Gabe: Oh, yeah. It was important to me that nobody thought that I was eating all of that food. Also, if I had, like, appointments. I was going out to lunch or something for work or business, I would eat before I went.

Lisa: You remember that night with the pizza? 

Gabe: Yep.

Lisa: And I ate more pizza than him. And I thought, huh? I’m a giant cow person and I need to eat less pizza. But no, it turned out that you had ordered two and eaten a whole one before I got there. And now were pretending that this pizza had just arrived and we were now sitting down together for the first time. When you had, in fact, already consumed an entire pizza.

Gabe: Yeah, and I hid the box.

Lisa: Yeah, you would hide the box or the wrappers.

Gabe: It wasn’t even like I said that I ate. I didn’t want you to think that I was a giant fat ass. That was important to me.

Lisa: One of the things that was interesting when we went to the eating disorder clinic is you did try to hide how much you would eat, but you didn’t have a problem with eating in front of me. One of your doctors told me that was a little bit unusual, that most people literally do not want to be seen chewing in front of other people. But you never seemed to have that particular problem.

Gabe: Well, I didn’t have that problem in front of you.

Lisa: Ok, that’s fair. You want to tell the story?

Gabe: I don’t want to tell the story, but I think now you’re going to have to. The people just heard you give the punchline away.

Lisa: You go. 

Gabe: We were at a pizza buffet, all you can eat pizza buffet, and I was eating and I looked up and you were looking at me and.

Lisa: I had stopped eating by this time and was just watching you. 

Gabe: And I said, what? And you said, wow, you can really put it away. And I was like, that’s so mean. I’m just trying to eat my lunch. And you’re just like, I don’t know what to say. 

Lisa: I remember that day because we were eating and then eventually I’m not eating and I’m just watching this because it was like watching. Oh, I don’t know, a snake swallowing its food or something. It was like watching some sort of extreme physical feat. It was amazing. Like, ignoring that it’s pizza, I would not have thought the human body could chew and swallow that rapidly, that a human being could do that. And you couldn’t look away. I do recognize, especially looking back, that was really mean. But I kind of feel almost justified in it. This thing I was watching in front of me was just so stunning and so extreme. How could I not stop and stare and comment on it? It was just incredible in a really, really horrifying way. Yeah.

Gabe: Yeah.

Lisa: It was disturbing.

Gabe: When I got to the eating disorder clinic, you know, they put me through a lot of paces and I started to realize that my relationship with food was not good. I mean, my weight, you know, over 550 pounds, my girlfriend looking at me in disbelief as I ate, the side glances, the comments, not being able to fit into things like roller coasters or booths or I had to sit in the handicapped section. I needed the seatbelt extender for my mid-sized car. It’s not like I was in a tiny car. I had a Ford Taurus. A family car. And I needed a seatbelt extender.

Lisa: By the way, you’re welcome.

Gabe: Yeah, that was all Lisa. I just didn’t wear a seatbelt before.

Lisa: Because I don’t let anyone ride in my car without a seat belt and I thought, what kind of fool doesn’t wear a seat belt? And then, lo and behold, you didn’t wear a seatbelt because it didn’t fit, because he couldn’t wear a seat belt.

Gabe: Remember when I said it doesn’t fit? And you said, bullshit? Show me. You didn’t believe me.

Gabe: You’ve seen how far those things stretch out.

Gabe: Didn’t fit. 

Lisa: So, yeah, that was really shocking. And just within a couple of days, we had seatbelt extenders for all the cars of everybody we knew.

Gabe: Yeah. Thank you. That.

Lisa: They will give them to you for free if you ask.

Gabe: Just call the dealership or call the manufacturer and they will mail them to you. Also side note, if you’re on an airplane, just ask the flight attendant when you get on. Just whisper I need a seatbelt extender and they will bring you one or hand you one. Highly recommend doing that as well. Very, very important. But here I am at the eating disorder clinic. I finally got a surgery date. And what was it like a month and a half before I finally got gastric bypass after like two years of fighting for it is when I went to the psychiatric hospital.

Lisa: Yeah, like two months before. But you already had the date scheduled

Gabe: Yeah. And so as I’m losing the weight, I’m also getting treated for bipolar disorder.

Lisa: Right. That’s what comorbidity is. You had a lot of things going on at one time. This is one of the reasons it’s so difficult to treat mental illness and binge eating disorder because there’s all these factors coming together. And how do you tease out what’s what?

Gabe: I guess I don’t remember the specific day that I was diagnosed with binge eating disorder. I do remember my aha! moment. I had to do a few things and one of the things that I did is meet with a nutritionist. And she had flash cards and she held up the flash cards. And she was like, what has more calories? And the only one that I remember was she held up a donut, cream filled, icing, and she held up a muffin. She said, Which one has more calories? And I said, the donut. I know this one. Muffins are a diet food. And she said, no, the muffin has more calories. And I said, how is that possible? Muffins are healthy. Muffins have less fat. But they have way more sugar. But I thought a muffin had less calories. It didn’t.

Lisa: Lots of people don’t understand the specifics of nutrition or aren’t quite sure what the right foods are to choose, etc. That’s why they have eat this, not that. What does that have to do with binge eating disorder? Why was that your aha! moment?

Gabe: Because up until that moment, I thought I completely understood what was going into my body, why I was eating it. And that was the first thing that let me know that, no, you’re just wrong. You’re just wrong. I did not understand how any of this worked, but I thought I did. That’s the part I’m getting at. If I can be so wrong about what constitutes a healthy meal, then what else am I wrong about? And she helped me understand that I don’t know what’s going on. I clearly do not have a good understanding of my relationship with food, food in general, nothing. And that opened my mind.

Lisa: So your lack of understanding of nutrition made you feel like, hey, maybe I don’t understand a lot of things about eating and how I eat, and therefore maybe I should consider that these people are telling me something of value rather than something I can dismiss?

Gabe: Sure. That’s a fancy-schmancy way of putting it. But what I actually thought in the moment is, holy shit. I don’t know what I’m eating. I do not understand food. I am putting food in my mouth and I think I am making healthy choices. You know what I used to eat and I thought it was a health food? A Snickers bar. Because the advertising was packed with peanuts, Snickers really satisfies. I was hungry and I needed a snack to get to the next meal. So clearly peanuts. I was eating a candy bar with peanuts, but I thought I was eating a nutrition bar. I thought I was eating something healthy because the advertising got to me. I did not understand what I was putting in my mouth, but I’m supposed to believe that I understand the psychology behind my desire to eat? No. That’s when I started to become much more malleable. That’s when I started listening. That’s when I wanted to understand why I was making the choices that I was making.

Lisa: Well, what did you think before, though? What did you think your relationship with food was up until then?

Gabe: I thought that I overate, like everybody, but I also thought that it wasn’t my fault because after all, I didn’t get a good metabolism.

Lisa: Oh, metabolism.

Gabe: I believed in that. Aww, my metabolism that’s broken. I don’t have good genes. It’s not that the people who weigh less or are a healthier weight or are healthier in general are making better food choices. No, no, no. They won the genetic lottery.

Lisa: It was not something that you could control. It was just this swirl around you that was impacting you.

Gabe: Right. Yeah. I didn’t believe it was my fault at all. It was bad luck. Everybody else was eating just as much as Gabe. But because of their bodies, their metabolism. Oh, well, she just has a good metabolism, and that’s why she’s not overweight. I have a bad metabolism and that. It’s not my fault. It’s just I didn’t even realize I had any control. I.

Lisa: So stuff just kind of happened to you. You weren’t directing the action.

Gabe: Yeah, I was the victim. I very much felt that I was a victim. That my body had somehow failed me. That it wasn’t in my control or my fault.

Lisa: Well, did that matter though? I’ve been cursed with a bad body, which means that I must now make different choices than other people.

Gabe: Yes. And one of those choices that I thought I needed to make was to have surgery to correct it.

Lisa: Oh, ok.

Gabe: See, I thought that surgery was the magic cure. People have said to me, you know, surgery is the easy way out. It’s not. I don’t know who believes that or why they say it. I don’t know why there is a moral value in what method you use if you are super morbidly obese like I was. But I gotta tell you, spending four days in the hospital, being cut from the top of my chest to below my belly button, opened up, having my insides rearranged, the six week recovery time, the vomiting on your mother, the crying in the parking lot, all of the problems going through two years of therapy and nutrition appointments and re learning everything, with the aid of the therapy, over the next year and a half to finally lose all of the weight and then having to have a secondary surgery to remove the massive amounts of excess skin and male breasts that I had then developed. I had a full mastectomy. So, attention, listeners, I don’t have nipples.

Lisa: He likes to get that into every conversation.

Gabe: It’s you know, it’s a fun fact. I just. Then people look at me and they’re like, Oh, you had surgery? You did it the easy way.

Lisa: Well, I think that people what they don’t understand is that the surgery is not magic in that you can still eat. You’re not somehow prevented from chewing. You can still eat. You just react differently to it. And as evidence of surgery is not the easy way out, the failure rate is really high. And what is the definition of success, you ask?  Someone has had a successful gastric bypass if they have kept off 50% of their excess weight over the course of five years.

Gabe: Well, I’m successful.

Lisa: You’re very successful.

Gabe: To be fair, I went from five hundred fifty pounds all the way down to two hundred and thirty at my lowest weight. Now, my average walking around weight is about 260

Lisa: The failure rate for gastric bypass, depending on the numbers you look, is up to 70%. So after five years, 70%. It’s now been 18 years for you. So even if you gain all the weight back tomorrow, even if you weigh 700 pounds tomorrow, you have had a successful gastric bypass. And then also let’s do some approximate numbers here. Say that you had 300 pounds to lose. Right. And you lost 280 of them. You realize that you could gain, right now, 130 pounds and still be successful. You could right now weigh over 400 pounds. And when it came time to count up all the gastric bypass numbers, you would be in the success category. So when some people say, oh, Gabe had a successful gastric bypass. No, you didn’t just have a successful gastric bypass, you had the A plus, gold standard, amazing of gastric bypasses. Because you could weigh substantially more than you do now and still be a success. You have plenty of people in your life now who never knew you then. People don’t realize how much weight you have lost and this backstory that you have. They just look at you and you look normal

Gabe: Yeah.

Lisa: And they think, oh, there’s Gabe.

Gabe: Yeah.

Lisa: No one’s gonna describe you as thin, but you’re perfectly normal. You’re perfectly normal weight. Nobody stares at you in public. And that makes people think that you’re done, that you no longer have this messed up relationship with food, that you’re no longer struggling. And that’s not true. I don’t think you get enough credit for that. You are actively struggling with your weight and with your eating disorder on a daily basis. And it just doesn’t show anymore because you’re not so fat. People look at you and they think it went away. It didn’t go away.

Gabe: I still want to give you a little push back on, is it OK that we’re using the word fat so cavalierly?

Lisa: Seriously, that’s what you’re going to get out all this?

Gabe: No, I, mean, thank you for all of the kind words. 

Lisa: We’re both still fat.

Gabe: I kind of wonder if I was listening to the show and we just kept saying, fat, fat, fat, fat, fat.

Lisa: Well, but you’re adding the pejorative. What does fat mean?

Gabe: Overweight, I guess.

Lisa: Overweight or heavy or excess weight or more weight or something like that. Why are you adding extra words? It’s like when people say, oh, no, you’re not just bipolar. Yeah, I know. Why are you adding in words? I’m saying to you, hi, I’m bipolar. That’s not all you are. You’re also blah, blah, blah, blah, blah. Yeah, I know. You’re the one who added all the baggage to the word. I was just fine with the descriptive phrase, fat.

Gabe: Are we taking it back?

Lisa: Not even that necessarily. Just why are you adding in this pejorative of fat is inherently bad and we shouldn’t throw it around so cavalierly? You were heavy. You were big.

Gabe: It’s true.

Lisa: The word for that is fat. And I would like to point out, for the record, that both of us are currently fat.

Gabe: I guess that is my question. As much as I love you, Lisa, you are not the same size as you were when you were 23.

Lisa: Yeah, even then, I was not thin.

Gabe: So are you, are you fat now or would you prefer that I say nothing because I’m not dumb?

Lisa: Well, don’t get me wrong, usually I do not care for it when people tell me I’m fat because they mean it as a pejorative. But as a simple description, am I overweight? Am I heavier than those charts and everything? Or even heavier than I personally would like to be? Would I like to be smaller than I currently am? Yes, I am fat. Accept that. I’m also blond and relatively short. Accept it. Yeah, I’ve got a big nose and I’m fat. There you go.

Gabe: Your nose is gigantic.

Lisa: I know. I hadn’t noticed how huge it was until we started doing this so much and with the video and all. I knew it was big, but, oh, my God. Like a toucan. This is the part where you say something nice, like it’s very attractive or, or, you know.

Gabe: If I had that ability, we would not be divorced.

Lisa: Fair, fair. So anyway, we could talk for a long time about all the high points of amazing stories surrounding Gabe and his extremely disordered eating and the struggles of gastric bypass. And to hit a few, when he said the whole thing about struggling after surgery and throwing up on your mom. He didn’t mean his mom, OK? He threw up on my mom. He didn’t vomit on his own mother, although you actually did that as well. He vomited on my mother. That’s the story he’s telling.

Gabe: In a fancy restaurant.

Lisa: Yeah, yeah. And the reason why it makes me, people are like, oh, why are you angry about that? The poor little dear, he got sick. I told him not to eat that. I told him it was gonna make him throw up. He ate it anyway, and then he threw up on my mother. That’s all I’m saying. That’s OK. We’ll get that over now. Are there any high point stories you’d like to hit? Do you remember how you’d written that list of things that you wanted to do once you lost the weight?

Gabe: Yeah.

Lisa: And one of them was buy clothing in a normal store.

Gabe: Yeah,

Lisa: Sit in a booth at a restaurant

Gabe: Yeah.

Lisa: And ride a roller coaster.

Gabe: The roller coaster.

Lisa: And we went out. We were at the mall. He went off to go shop. I’m looking at clothes. And then he comes over to me and goes, Well, I asked them for the largest size they had and it didn’t fit me. And I thought, aww. And I said, well, honey, it’s okay. It will. You’re still losing. It’s okay. And then he goes, and that’s why I got the size three down,

Gabe: It was.

Lisa: Because it turned out that he had gone below the largest size they had in the store. He was so excited.

Gabe: It was. It was a good day. The booth. Do you remember one year

Lisa: I remember.

Gabe: For Christmas. You got me a gift card to every restaurant that I couldn’t go to because they only had booths.

Lisa: Yep. There had been a lot of places that he couldn’t go because they didn’t have tables. They only had those fixed booths and there’s nothing you can do. And yeah, occasionally he would try because someone would ask him to go to that restaurant. He’d try to squeeze himself in. And, oh, God, it was so painful to watch. You would say things like, oh, no, I can fit in that chair. Dude, you cannot fit into that chair. Please don’t make all of us uncomfortable by trying. Please stop.

Gabe: Yeah.

Lisa: Just, it was terrible on so many levels. Yeah. I got you that for Christmas one year. I did like a ten dollar gift card to all these restaurants you hadn’t been able to go to. And you insisted, even as we were walking in the door, that you would not fit. And I thought, yeah, you’re, dude, you’re going to fit. And then you crawled into the booth and started like wiggling around to show how much extra space there was. And of course, listeners can’t see this, but the look on your face right now and how much you’re smiling like it’s just the greatest thing you could ever remember. It’s, that’s so sweet.

Gabe: Do you remember when we went to the amusement park?

Lisa: Uh-huh.

Gabe: Because, remember, roller coaster is on there. And again, I was worried. You said that I was at the right weight and we went up to the first roller coaster and I said, will I fit? And the gentleman said.

Lisa: The ride attendant.

Gabe: Yeah, the ride attendant said, I’m not sure, but we have a seat here. 

Lisa: And you know, these lines can be very long. You might be in line for an hour or more. So they have one of the roller coaster cars sitting at the front of the line, so you can test it. Because no one wants to wait in line for an hour, only to be told, hey, you don’t fit in this seat. Get out of line. 

Gabe: So the roller coaster attendant was super nice. I sat down in it and as he was pulling the thing down, and he said, we just have to make sure that it will latch over your shoulders because of your height. And I said, you’re testing this because I’m tall? Of course, he’s just this kid. He just looked at me like I was a crazy person. I was like, oh, my God, I just, no, I was asking because I’m fat. 

Lisa: Yeah.

Gabe: And for real, I just wanted to, like, hug him. 

Lisa: When you walked up to him and said, hey, I’m worried that I might not fit, he thought you were saying I might not fit because you were tall.

Gabe: Yup.

Lisa: It never occurred to him that you were saying because you were fat.

Gabe: I cried. This poor kid. He’s like 19 years old and he’s like, Why is this man crying? 

Lisa: You turned to him, you said, oh, my God, you said that because I’m tall. And he was like, Yeah? He was so confused. And you spent the next forty five minutes repeating that. Oh, my God, he thinks I’m too tall. Oh my God, he said that because I’m tall. Yeah you did. You started to cry a little bit. You were so excited.

Gabe: That was a good day. Lisa, you touched on comorbidity a little bit. I believe very strongly that I, of course, do have binge eating disorder, but I also believe that it was driven by the excess of untreated bipolar disorder.

Lisa: Yeah.

Gabe: I was doing pretty much anything that I could to manage the emotional overload of depression and grandiosity and mania and suicidality. And anything that could provide me even a moment of joy, whether it was drugs, alcohol, food, sex, spending money, I would do. What do you think the intersection of all of this Is?

Lisa: Well, obviously, having gastric bypass was an amazing choice for you, and it worked out great. And who knows what would have happened if you hadn’t had it done? But I actually recommended at the time that maybe you not do it because you had just been diagnosed with bipolar disorder and everything was changing so fast. And I thought, well, hey, maybe his eating disorder isn’t actually the thing. Maybe this has always just been an almost symptom of bipolar disorder. And once he has that under better control, he’ll just be able to control his eating and he won’t need to go through the surgery, etc. And of course, you have a gastric bypass, you were losing a pound a day. Think of how delicate that balance of all your different medications are and then think about how you get that balance when your body is changing so rapidly. 

Gabe: One of the things that I think about in terms of comorbidity, is mistaking feelings, and the big one is that it took a long time to be diagnosed with anxiety and panic disorder because I honestly thought that panic attacks were hunger pains.

Lisa: Yeah, you would say that all the time.

Gabe: Every time that I would have a panic attack, I would think that I was hungry. Which, of course, created a Pavlov’s dog effect where a panic attack was very much associated with food. And in fact, more importantly, the cure for the panic attack was associated with food. So every time I have a panic attack, I would have to eat.

Lisa: We’d be standing in line or something, and I recognize now that you would start having a panic attack, but what you’d say, you’d turn to me and say, I’m hungry and, oh, I’m so hungry, my blood sugar, ack. I actually thought back then, I thought, well, I mean, he is really heavy. So, I mean, I don’t know what that does to your body chemistry and stuff. Maybe he really is feeling hunger this often? And looking back on it, yeah, those were panic attacks. And you had them a lot.

Gabe: I did. I really did. 

Lisa: Well, what happened? When did you figure out that it was actually not hunger? I mean, what do you do now? One of the things you told me years ago is that when you had the urge to binge that you didn’t even try to stop the urge anymore. That was impossible. It never worked. Just forget it. That what you did instead was try to substitute different foods. So instead of bingeing on chips or pizza, you were now bingeing on strawberries or yogurt.

Gabe: So, a few things, you are right, making healthier choices does help to try to put those feelings or emotions at bay in a healthier way. Some of the things that I do now when I have a panic attack is one, I understand that it is a panic attack. So sometimes I can stop them just because I am aware of what they are. And I have all kinds of other coping skills, you know, sit down for a moment, count to 10, remove myself from whatever is causing the panic attack if I can see the cause. Splash water on my face.

Lisa: All the thousand and one coping things that you have for panic attacks.

Gabe: I mean, yeah, there’s just so many coping skills. You know, salty snacks help. Once again is probably in the gray area, it’s not the healthiest choice. But, you know, sometimes, like eating saltines, eating crackers, eating pretzels.

Lisa: Pretzels, so many pretzels.

Gabe: I try to find a healthy choice. You know, sometimes sitting, drinking a diet soda, eating some pretzels, counting to ten, taking a 20 minute break. These things help. But remember, before, all of this would happen, I would go eat a large pizza. I would go eat two, three, four, five, six thousand calories in order to get rid of that panic attack. And because I didn’t know it was a panic attack, I was having multiple of these a day. This would happen once or twice a day on top of all of my regular eating.

Lisa: I tried to look at it now as kind of a harm reduction thing. It is not the greatest for you to sit down and drink that much Diet Coke or to consume that many pretzels. But in comparison to the things that you were doing to deal with this before, this is much better. In a perfect world, you wouldn’t do any of this stuff. You wouldn’t have panic attacks to start with. You wouldn’t need the coping mechanism to begin with. But since you do, this is a much better choice than what you were using before.

Gabe: I’m certainly in more control today than I ever have been in my entire life. But it’s not perfect. I still binge to this very day.

Lisa: Well, that’s a question, how often would you say you binge these days? Because it used to be daily. What is it now?

Gabe: Maybe once a month.

Lisa: Really? 

Gabe: I would say that I start to binge maybe once a week. But that’s an advanced skill, right? I put all of the food on the plate. Like I’m ready. I am ready to just binge. And I realize before I get too many calories, oh, this is bad. And I’m willing to get rid of the food. I’m willing to wrap it up and put in the refrigerator or push it down the garbage disposal or just not eat and I never would have done that before, because, after all, that would be wasteful. So I’m proud of myself for being able to stop. I still order too much. I have an unrealistic view of what a serving is. One time I had four people coming over, so I ordered three pizzas. Three large pizzas, and it was you. And you said, why did you order so many? I’m like, well, there’s 

Lisa: There’s four of us.

Gabe: There’s four of us. And you said, you realize that if you ordered two pizzas, that would be half a large pizza per person and you ordered more. And you have chips. I was like, huh?

Lisa: He does that all the time. You always have way too big of servings. It doesn’t matter what size pie you have. It’s a little tiny pie, or if you get, like the giant pie at Sam’s Club, you will count how many people are in the room and cut the pie into that many pieces regardless of pie size.

Gabe: I want to make sure that everybody gets enough pie. I am learning. I am learning to let people cut their own pie and to ask other people to cut for me. I also had to accept along the way that I can have seconds before I thought that I had to take all the food that I wanted now.

Lisa: So obviously food is love, mixed up with all this emotion. A lot of it, you can tell is very clearly rooted in your childhood. Have you figured out the origin story or the backstory on this? Why did this hit you? Where does this come from? Your brother and sister don’t have this problem. They’re normal weight, maybe even thin. Nobody else is at the level that you were.

Gabe: Nobody else is bipolar in my family either. There’s

Lisa: That’s fair.

Gabe: You know, I’m a foot taller than every member of my family. I’m the only redhead. For those paying attention, that does, in fact, make me a red headed stepchild. I’m the only one with severe and persistent mental illness. I don’t know. I had to find a lot of coping skills. You know, some of the questions that I asked myself is, you know, why did I gravitate toward food and sex? Why didn’t I gravitate toward

Lisa: Right. Yes.

Gabe: Toward alcohol and drugs?

Lisa: Right.

Gabe: So I think that sometimes

Lisa: Or extreme sports or any other thing?

Gabe: Or whatever. I think that sometimes there’s just no answer. I don’t know why my brother and sister don’t have this problem. Of course, they both have kids and I don’t. Why did that happen? I mean, just it just did. And on and on and on.

Lisa: You don’t really think it’s a worthwhile problem to even contemplate, then. You just feel like, hey, these things happen and. Because on TV, people can always pinpoint it to like one specific experience. Oh, it was the day that I was so sad and my great grandmother gave me cake, you know? But you’re saying in real life, no, you don’t have anything like that.

Gabe: I think that there is that. When I was sad, my grandmother did give me cake and my mother gave me cake and my mother would make the foods that we wanted on our birthday. And food is love. As you said, food is love. My family loved me a lot. I don’t know what you want. We celebrated every single success with food. We licked our wounds with food. We went to the buffets all the time. Buffets were huge, huge things when I was growing up. What do you want? Name something and I will tell you how food is involved.

Lisa: Well, yeah. But almost everyone can say that.

Gabe: Yeah.

Lisa: Why did it hit you different than anybody else?

Gabe: I have no idea. Why does your brother ride a bike 100 miles a day and you don’t?

Lisa: Yeah, that’s fair.

Gabe: I have no idea and I don’t think you do either. Lisa’s brother, like for real.

Lisa: He’s an athlete.

Gabe: If you Google super athletic bro dude, I’m pretty sure Lisa’s brother comes up. And if you Google refuses to go out in the sun, hates to walk, Lisa comes up.

Lisa: Look at me, for God’s sakes. You think the sun is safe? The sun is not safe. I could burst into flames.

Gabe: You have the same parents, were raised in the same small town, raised in the exact same way, grew up on the same foods.

Lisa: That’s fair.

Gabe: How come he likes to ride a bike a thousand miles uphill for no apparent reason?

Lisa: That’s true.

Gabe: And you don’t like to talk about bikes?

Lisa: Ok, that’s fair.

Gabe: Remember when your husband bought you a bike and you just started laughing at him uncontrollably?

Lisa: What were we going to do with that? Oh, we can go for bike rides. That’s just stupid. Anyway.

Gabe: Lisa hates that bike so much, she won’t even use it as a clothing rack.

Lisa: That’s true. That is true. It’s in the garage now. We’re probably gonna get rid of that the next time we move.

Gabe: I think that reality television is really skewed people to believe that mental disorders, mental illnesses and issues have to have some triggering event.

Lisa: An easily found one.

Gabe: Whether it’s substance use disorder, whether it’s hoarding, whether it’s. The reality is, you don’t need any of this stuff. Does smoking cause lung cancer? Absolutely. But there are people who do, in fact, get lung cancer that never smoked a day in their life. Yeah. There’s not always a clear and present cause for these things. Sometimes there are. Sometimes the thing that we think is a clear and present cause isn’t. We’ve just assigned it to that.

Lisa: That’s fair.

Gabe: I work with families all the time and they’re like, oh, my God, the mental illness started when he lost his job. OK, well, let’s talk about what he was like before he lost his job. And they would tell me all of these things that are clearly symptoms of mental illness. But in their minds, it was the job loss that triggered the mental illness, even though there was a decade’s worth that they ignored. And I think we do that to ourselves, too. Lisa, what are the takeaways? I mean, binge eating disorder, it’s played a major role in my life.

Lisa: Yes it has.

Gabe: And I know that it’s played a major role in other people’s lives. And I think largely that a lot of eating disorders don’t really get the respect that they deserve. They’re dangerous and people die from them and.

Lisa: The death rate is a lot higher than you think.

Gabe: Why do we as a society not take eating disorders seriously?

Lisa: I don’t know, maybe because we live in a time of abundant food? Which has not always been the case for humanity, isn’t the case everywhere in the world. Maybe because you can’t see it?

Gabe: We take substance abuse disorder seriously.

Lisa: Probably because you can’t have an all in. Right. Oh, you’re an alcoholic? Never have another drop. That’s it, problem solved. You have to eat. That was always, because a lot of the treatment things that you did were focused on this food as addiction model or 12 steps, et cetera. When complete abstinence is not an option, how do you manage an addiction? I did not notice until after you had gastric bypass, every other commercial is for food and the food looks so good. And it’s always for food that’s bad for you. No one ever has a commercial for carrots, you know. No, it’s a commercial for fast food or pizza. And it’s so desirable looking.

Gabe: And cheap.

Lisa: Yeah, and cheap.

Gabe: And cheap.

Lisa: There’s a reason why marketing is everywhere, it works. 

Gabe: One of the things I think about is the fast food restaurant that advertises fourth meal. Fourth meal is not a thing. They’re advertising it as if it’s real. Don’t forget fourth meal. And now second breakfast is a thing. The marketing is literally tell you to eat when you do not need to eat. And we’re proud of this, you know, fourth meal, second breakfast. It’s exciting.

Lisa: Well, and if you’re the average person, no problem. It’s like alcohol ads. The alcohol ads are telling you that, hey, when you’re having a good time, you got a beer in your hand. All celebrations go with alcohol. And for most people, hey, that’s fine. No problem. That’s the ad. But if you’re an alcoholic, that’s a real problem. How do you get over that? Most people look at the fast food and are like, oh, yeah, I might stop there for lunch, but for you, it’s a whole thing.

Gabe: It is, and it is very difficult. I’m so glad that I lost the weight. And when people look at me now, like you said earlier, Lisa, they don’t see it. I have deeply entrenched issues with food, things that I struggle with every day. And because I’m a normal body weight, we’ll just go with that, nobody realizes this is a problem and it makes it difficult to seek out community. I remember when I went to my first binge eating group, I was really large and the other members of the group were also very large. And in walked this man who was thin. He was thinner than I am now, and I consider myself to be a normal size. And he was lanky and he just talked about his struggle and how he ate a whole gallon of ice cream on the way there. And we were mean to him. We did not pay attention to him. We did not offer him any help. We as a group were not kind to him. And now I kind of feel like I’m that guy.

Gabe: I don’t want to go to the binge eating support group because I’m afraid that they’re going to look at me and say, you know what? You’re thin. I’d kill to look like you. And I understand. I understand why they would want to have the success that I’ve had over the last 18 years. So I don’t know where to get support or. I’m very fortunate that I can afford traditional therapy and that I have a therapist and I have good supports. And of course, the online communities are really, really helpful. And I’ve advanced to a stage where I don’t need as much support as I used to. But I do remember. I remember what an asshole I was. I don’t think I said anything, but I certainly didn’t put any effort into trying to help him because in my mind, he didn’t need it. And that’s an important lesson I want to get out there. Binge eating disorder is not dependent on your looks. It’s not dependent on your weight. It’s not dependent on your size. It’s dependent on your unhealthy relationship with food.

Lisa: And the important thing is that you’re so much better now. The struggle isn’t over. You’re still struggling with it. But it’s night and day. You are so much better.

Gabe: I love it when we have microphones. You’re so much nicer to me when we have microphones. I’m just going to carry around.

Lisa: You know I think you’re better.

Gabe: A podcast kit and just every time you get, like, mean to me, I’m just gonna, like, thrust a microphone in your face and be like podcast time.

Lisa: To think we’ve been arguing all these years for free. How wasteful,

Gabe: Ok. Listen up, everybody. Thank you so much for tuning in. Obviously, the whole world believes that food is love, but you know what else is love? Subscribing to our podcast, sharing our podcast, rating our podcast, telling everybody that you can about our show. The official link for this show is PsychCentral.com/NotCrazy. Share it everywhere and subscribe on your favorite podcast player.

Lisa: Don’t forget, there are outtakes 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 show@psychcentral.com for details. 

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5 Ways to Manage Your ADHD When You Work from Home

Can’t focus? Here’s how to cope with ADHD when you’re stuck at home.

Living with ADHD can be a daily struggle. Put social distancing, working from home, and staying inside much of the time in the mix, and you probably feel like most or all of your systems, strategies, and self-care practices have been ripped away.

You may feel like there’s no real certainty of when you will be able to reincorporate these necessities back in your life.

Well, as a therapist who is also living with ADHD, I feel your pain.

There are some tips that might make life easier as you move through this time of uncertainty.

I have never been one to do well working from home. Having nowhere to go, no real reason to get dressed, no consistent structure, or pending deadlines can send me down a rabbit hole of feeling depressed.

For me, it feels like a constant pushing, moving from one task to the other. Even the littlest thing like brushing my teeth ends with me asking, “Why bother?” If there’s no immediate reason, then there’s no point.

I struggle with activation. Getting started is always hard for me.

I can’t wake up and just get going. I need some coffee, a television show that doesn’t last longer than an hour, and my stimulant medication before I can get going.

If I have to be somewhere, I wake up at a time that allows me to have my morning activation routine. But with nowhere to go, that hour can turn into four hours. Then half of my day is gone, and I have put off yet again something I wanted to finish.

This is where my negative self-talk comes creeping in and further down the depression rabbit hole I go.

Anxiety will set in when I can’t separate work time from my responsibilities at home. Like cleaning the house, making appointments for kids, animals, medication refills, meal planning, etc,. because it is all in one space.

If you struggle with inattentiveness like me, then you know that as your brain is scanning your environment, it can’t filter out what isn’t important. So everything is of equal importance and equal urgency.

As my brain sees everything, my body responds with physical anxiety responses. I immediately feel overwhelmed, become paralyzed, and shut down. I don’t know where to start. So I procrastinate, which makes me feel even more anxious.

Well, you know how your brain works. That’s why you had all of those systems, strategies, and practices of self-care in place.

Here are 5 ways you can cope with ADHD on an uncertain schedule and still be productive.

1. Learn How to Adapt to Change.

A good book on this topic is Who Moved My Cheese? by Spensor Johnson, MD.

This is a short book about change. I think Dr. Johnson does a wonderful job of creating funny scenarios of what can happen, depending on how you respond or don’t respond to change.

Intellectually understanding and emotionally understanding don’t always go hand in hand. Especially when you don’t choose the change!

So much is out of your control right now. And honestly, many things always have been and always will be out of your hands.

Still, you always have choices. Learning how you react in these scenarios and how you can learn to react will be helpful at giving you a sense of power in your life.

This book can provide some insight and space for you to think about how you want to reset yourself in your own time and in your own way.

Common But Often Overlooked Symptoms of ADHD in Adults

2. Use the “Pomodoro Method” for Productivity.

This technique makes productivity feel much more doable. It works by focusing on 25- to 30-minute blocks of working time separated by five-minute breaks.

You pick a task and just focus on that one task during the working session. It’s much easier to activate you brain if you think of working for 25 or 30 minutes segments with breaks, than if you think about the work by itself.

By breaking your necessary projects up, you’ll get more done. You can decide for yourself what time increments work best for you.

Just keep in mind the transitions. If you are working for 30 minutes, maybe set your timer for 27 minutes to allow for the transition.

Transitions can be one of the more difficult things to manage with ADHD.

3. Work with Your Own Natural Flow of Energy.

If it feels better to go straight into working from your comfy bed before you brush your teeth, then do it. You can find another time in the morning to brush your teeth. Maybe in one of your five-minute breaks.

If your body and mind want to rest, then rest. This could be the opportunity to take a real lunch break and watch a show on Netflix. Just be mindful of not getting caught in a time suck and watching a whole series.

If continuing to watch gives you the stimulation you need while cleaning the kitchen or doing laundry, go for it. But if the television becomes a distraction, then you’ll need to use something else to help you focus.

You know, all the things that require “not thought,” but are the hardest to do because they aren’t interesting?

The Struggles Only People With ADHD Understand

4. Get Creative With Your Exercise.

There are some great free workout videos on YouTube or OnDemand. They also have some that are just 10 to 15 minutes. This is a great way to see if you would even like them.

Listen to your body. If your body just wants to take a walk, then walk. If you feel like yoga, then do yoga. You don’t need to force yourself to come up with the same intense workouts you may be used to at the gym.

Exercise is so important for the ADHD brain, but it’s also supposed to be fun. If it isn’t, you’re more likely to not do it.

Even a person without ADHD or focusing problems would struggle to follow through an exercise routine that sounds miserable.

5. Practice Self-Compassion.

I think this is the most important tip. What’s happening in the world is hard for everyone, but it can be especially difficult or those with ADHD who are still trying to work from home, distance, and be responsible while cooped up in the house. Maybe not all, but many.

The idea behind practicing self-compassion is intentionally acknowledging to yourself that life is hard right now, without judgment, criticizing yourself, or over-identifying with how you feel.

Because you aren’t how you feel. And you aren’t alone in how you feel — ever!

Be kind to yourself every day. Focus on your strengths and what is really important to you. As with all things, this too shall pass.

This guest article was first published on YourTango.com: 5 Strategies To Cope With ADHD When Working From Home.

Photo: Viktor Hanacek on picjumbo.

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Podcast: Do Cell Phones Cause Anxiety?

Do you constantly refresh your social media feed? Are you checking your notifications more often than you’d like to admit?  In today’s Psych Central Podcast, Gabe and psychologist Robert Duff have an enlightening discussion on how the information age has affected our mental health — but only if we let it. Dr. Duff explains how the overuse of social media is often driven by a fear of missing out and even a false sense of productivity.

So how can we work with the modern world rather than be controlled by it? Join us to hear specific tips on how to make social media the servant, not the master, of your reality.

SUBSCRIBE & REVIEW

Guest information for ‘Robert Duff- Social Media Anxiety’ Podcast Episode

Robert Duff is a licensed clinical psychologist from Southern California. He is the author of the popular Hardcore Self Help book series and his most recent book, Does My Mom Have Dementia?. He also hosts a weekly podcast where he answers listener mental health questions and interviews interesting guests. When he’s not working as a neuropsychologist in private practice or creating content for his “Duff the Psych” persona, Robert can usually be found sharing a few glasses of wine with his wife or playing video games.

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 Duff- Social Media Anxiety’ Episode

Editor’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: Welcome to this week’s episode of The Psych Central Podcast. Calling into the show today, we have Dr. Robert Duff. Robert is a licensed clinical psychologist and is the author of the popular Hardcore Self Help book series. He’s also a fellow podcast, hosting the Hard Core Self Help Podcast, a weekly show where he answers listeners’ mental health questions and interviews interesting guests. Dr. Duff, welcome to the show.

Dr. Robert Duff: Thank you so much for having me.

Gabe Howard: Today, we’re going to discuss anxiety and the modern age and more specifically, how things like technology and social media impact our anxiety and stress levels. I think that most people don’t realize that our modern world is causing us stress in other ways than just work, relationships and children.

Dr. Robert Duff: Yeah, I think at the very least, it’s different. I wouldn’t say better or worse, but certainly the Internet and definitely social media, I think, are kind of some of the biggest changes to society and the way that we interact since the industrial revolution or the printing press or something like that. So absolutely, it’s different.

Gabe Howard: It seems like if you read back through history, every new thing was going to be the end of the world. And I remember reading about the printing press and how the printing press was going to destroy the world as we know it. And it was fascinating to read because, of course, we all love the printing press. We think that the printing press is one of the greatest revolutions in the world. And yet at the time, it was very much maligned as being a bad thing. Which leads me to my question. Is that this. Are people just saying, oh, no, social media and technology is the downfall of the world and it’s sort of, you know, the sky is falling syndrome.

Dr. Robert Duff: I think that people can fall on either side of it. Sometimes people think that it’s a very, very, very negative thing. For me, I’m like, well, it doesn’t matter either way, it is what it is. And it’s sort of growing up in this period of time. I think that one of our major, for lack of a better term, developmental tasks is to figure out how to manage all this stuff, because there’s just a lot. The jump up from the printing press gives you access to information that you never had before. And this is that like times a gazillion. So there’s just a lot in knowing what to do with that, how to manage that. I think it’s a really, really, really important thing.

Gabe Howard: Social media is just the, it gets blamed for everything, it seems nowadays. What role does social media play in anxiety in 2020?

Dr. Robert Duff: There’s good and bad and neutral, you know, it is what it is. I think that one of the good things about it is that you have unprecedented access to connecting with people and finding resources. If you’re to go on Twitter say, and say, hey, I’m having extreme anxiety. Can somebody help me out? And a bunch of people are going to come and they’re going to send you resources. That’s how a lot of people find my books and stuff like that, for instance. So there’s, it’s a great way to connect with people. It’s a great way to find resources. It also, though, feeds into sort of the compulsive nature of anxiety. Anxiety, you tend to get this sense of unease like you want to know the answer. Whether that’s is the situation dangerous or what’s going on in the world or how does this person feel about me? You really, really, really want to know the answer to that. And social media gives you a way to either get those answers or at least fulfill some of that compulsive desire to do that. So, when you want to know what’s going on in the world, all you have to do is refresh your social feed. And you see the news there these days. A lot of people, myself included, don’t even turn on the TV or go to CNN.com when we want to get news.

Dr. Robert Duff: I just go to Twitter and see what’s trending. And that’s going to help me understand in the immediate right now sense what’s going on, which is a good thing and a bad thing. I always tell people your knowledge of what’s happening in this moment, especially if it’s something like a natural disaster, a shooting, a political event, things like that. Your knowledge of it does not change the fact that it’s happening at all. But there’s this, with how much information is available, there’s just this weird guilt that sort of sets in where if you don’t know what’s happening in that exact moment, you feel bad about that or disconnected somehow. And so, you know, by refreshing your feed, by checking those things, it relieves some of that. They release some of that tension, which is going to lead you to do that more and more and more. So it can become a thing that’s just so absent minded. You’re constantly either checking notifications, which is a whole different story, or just refreshing social feeds, trying to see what’s going on. And that can certainly play into anxiety, especially if it’s an issue that you already have.

Gabe Howard: It’s fascinating that you talked about refreshing the social feed to learn what’s going on, to release anxiety on one hand. I completely agree with you. I have done it. I have sat there on my phone when something a big event has happened. And I’ve just hit refresh, refresh, refresh, you know, going through like four different Web sites going on, like you said, Twitter or Facebook to see what other people are saying or what other people are posting. And in that moment, I feel less anxious because after all, I’m up to date.

Dr. Robert Duff: Right. Right.

Gabe Howard: But then again, I’m completely enmeshed in it.

Dr. Robert Duff: Right.

Gabe Howard: I’m not doing anything else. I’m not focused on anything else. I’m letting other things like work, family, friendships, joy go, because I’m just, I’m so engrossed in this story. And then I often learn, whether it be days, weeks or months later that some of the information I got was just false. There’s so much pressure to have the scoop that people say the police questioned Gabe Howard. He’s a suspect. And in the meantime, Gabe Howard was the Jimmy John’s delivery guy. And now the whole world believes that the poor Jimmy John’s delivery guy is involved. Which I imagine creates even more anxiety.

Dr. Robert Duff: Yeah.

Gabe Howard: How does that all flow together?

Dr. Robert Duff: The other thing to think about with this is how it doesn’t allow you to turn off with anxiety. A lot of people. Their brain is already going to be searching for signs of danger. Answers to things. It’s going to be sort of always on. And it’s an active effort to try to get that to slow down, to rest, to recuperate. Sustained anxiety over time is really exhausting. And then you integrate something like this where you’re getting the immediate information that’s constantly changing. So you have to keep up with it. I can recall just recently, somewhat recently, I live in the area of California that has all the wildfires, these really big fires that have happened. And one of them that was closest to us happened while my wife was asleep. But I was still awake and I had to really make the choice of, OK, do I wake her up and let her know what’s happening? Just because she needs to know with the knowledge that that’s going to keep her up all night because she’s going to be doing that refresh and continuing

Gabe Howard: Right.

Dr. Robert Duff: To look, continuing to get that. Or do I wait till there’s a need to know part of the information? Because really, for all practical purposes, it wasn’t affecting us yet at that point and the information was only going to be more solid later on. But you really, really, really, really want to know. And the anxiety is going to fuel that because it’s going to say, hey, I’m trying to keep you safe. The best thing you can do here is gather all this information, try to figure out every aspect of it, and then also avoid things that would actually make a difference or maybe make you involved somehow. So it definitely plays into it. But at the very least, I think we need to pay attention to how it affects us. And one of my biggest sort of takeaways for people is that you need to start building some self awareness about how social media plays out for you, for different people, it’s going to have a different level of impact. For me, it may not be quite as big as somebody like. Like I said, my wife, she’s somebody that openly struggles with anxiety. It has a big effect on her. And so knowing when to invite that in, when to not invite that in, I think that’s a skill that we all sort of need to build at this point.

Gabe Howard: I’m thinking of my own social media use, and I got sucked in by everything, I had the notifications on, so when something happened, there was a ding. I had the emails that came in. And this is the thing that I’m most ashamed of. I wanted to earn all of the badges. Social media does a really good job of telling you that you’re a top poster, you’re a top fan. You’ve made one

Dr. Robert Duff: Verified.

Gabe Howard: Update a day every day for 100 days or. Yeah. Verified is a big one. I wanted to earn, and I’m using that word earn. I wanted to earn them all. But I’ve since learned, as comes with, you know, maturity and age and better understanding that I wasn’t earning anything. It was a false reward. I think many people are stuck in this trap where they think they’re accomplishing something. But in reality, you’re not accomplishing anything.

Dr. Robert Duff: Yeah, definitely. And the checking nature of social media with anxiety, you’re taking away that unease of not knowing what’s going on. But then on top of that, there’s also positive reinforcement. You’re getting hearts. You’re getting likes. You’re getting badges, you’re getting these things. And they are just quick little hits of essentially dopamine that are reinforcing you for that behavior. And it’s built that way. That’s why Facebook is such a huge monster that can charge so much for ads and make so much money because everything is just built on that. It’s like Vegas. You know, you have this positive reinforcement. You have the light, you have the ding, you have the money payout. You have all these things that kind of keep you going and keep you going. And so I think that’s definitely important to recognize that it’s designed to make you compulsive. That doesn’t mean it’s a terrible thing in and of itself. But just like when you walk into a store, you see all the ads and promotions and things like that, you’ve got to at least know that they’re trying to sell you and that’s going to at least help you take things with a grain of salt.

Gabe Howard: I do think that people understand that the stores, the televisions are trying to sell you. Do you think that people understand that Facebook and other social media sites are trying to sell you? Do you think that people understand that they are are consumer of these products? And do you think that that understanding or lack of understanding contributes to anxiety?

Dr. Robert Duff: That’s an interesting question. I think that one thing that Facebook and the social media platforms do really well as they get to know you, you give them permission to give them a lot of your information. And so things start to become very tailored to you. You know, you hear the stories about, oh, I was talking over dinner about getting a new vacuum. Suddenly I see ads for new vacuums. So, I mean, I think that people do know that they’re being sold to. However, it is worked in a very sort of contextual way where sometimes you don’t even notice it. But I have kind of mixed feelings about, I’m getting a little bit off topic with this. But the idea of sort of your social media feed becoming a bit of a bubble, that’s very tailored toward you. It depends on what you’re using it for. But for some people, maybe social media plays a great role in broadening your perspective for other people. I think there’s nothing necessarily wrong with controlling what you see there for ads or for different types of posts. You can block. You can say, I don’t want to see this type of content. You can sort of curate your social media feed to be something that works for you instead of against you. Somebody who has, say, depression. They might want to intentionally remove some of the things that are maybe a little bit more pessimistic. They may want to bring in things that are a lot more that’s sort of positive content. That’s going to help them at least have a tiny boost throughout their day that will inspire them. And I don’t think that there’s necessarily anything wrong with that. I think a lot of people feel like there is. So they feel like, oh, well, I can’t just, like, make myself in my own little bubble because then I’m not seeing what’s going on on the other side. It’s a tool. It’s a tool that you can use however you want to. But it’s something that you do have some degree of control over.

Gabe Howard: I know that you talk a lot about fake productivity or false productivity. It’s this idea where you think you’re accomplishing something but you’re not. Can you explain what fake productivity is?

Dr. Robert Duff: So for me, the way that I see this the most is with not necessarily social media, but like apps. There are gazillions of apps out there and they’re all trying to be the perfect tool for this thing, whether it’s a to do list or a calendar app or tracking your period or exercise, whatever it is. There’s a million options for each of those things. And one thing that a lot of people do is fall down this rabbit hole of searching for the perfect tool. Oh, this one doesn’t have this feature. OK. Let’s keep looking. OK. This one has a lot of great features, but not quite. This one was too expensive. And you keep going. Keep going, keep going. Keep going. And at the end of the day, whatever the tool is supposed to help you with, you did nothing related to that thing. You don’t have your to do list made. Your calendar isn’t updated. So you kind of spent a bunch of time going down this rabbit hole of trying to be sold on the perfect tool and didn’t actually do anything with it. And for people who have anxiety. So with anxiety, the thing I would say is that avoidance is the fuel of anxiety. Anxiety tells you to avoid something so that it can keep you safe. And then when you do avoid that thing, it gets bigger and more present. So you avoid more and more and more and then suddenly you’re having a really hard time. And I think that one sort of insidious thing that can happen is that we turn this search for the perfect tool into a form of avoidance. If you’re just planning and looking for the right thing and doing all this top level stuff, you don’t actually have to take action because action is scary. And so you can use that as a form of avoidance and just kind of keep doing this over and over again.

Gabe Howard: But you’re not actually achieving anything. And at some point you realize this. It really does seem like this self-fulfilling prophecy. I’m anxious because I’m productive. Now I’m anxious because I’m realizing I’m not productive. But I can be productive by doing what is effectively nothing. But if I don’t do it, I become anxious. But if I do do it, I become anxious. I just I’m having, like, a really hard time getting out of the feedback loop of what do I do so that I am productive, well-informed. And I don’t have this sudden fear that I don’t fit into society and that I’m just one of these curmudgeonly people on my porch saying social media is going to kill us all. This whole conversation is making me anxious because I honestly don’t know what to do.

Dr. Robert Duff: Yeah, I mean, that’s anxiety itself, though, right? Whether it’s social media or anything else, I think that the thing that the Internet does and social media does is provide like a big sort of magnifying glass or megaphone for those things that are already tendencies you have. The answer is really trying to build self-awareness of your patterns. Right. And especially understanding the way that your patterns interact with these new tools that are available. The best way I think to do that is talking with people, trusted loved ones, your therapist, whoever. Also journaling. That’s like a form of self therapy and sort of self monitoring. OK. Write down at the end of the day, what did I do today and how did it affect me? I spent six hours diving down this rabbit hole of trying to find the perfect tools and all my apps are set up pretty and all these things, but I haven’t done anything. And now I feel bad about that. And I feel anxious that I wasted time and I have less time tomorrow to do all these things, write those things out so you can at least understand your patterns and use that information to adjust your approach. I’m a big fan of using both online and offline things open in front of my face right now. I have an Evernote document with some notes from when you asked me questions beforehand for this interview, I’ll also have my Google Keep, which has like my whole to do list. But I’ve also got a stupid little index card in front of me. If I think of something and I don’t have time to get to the to do list, I’m just going to write it down there.

Gabe Howard: We’ll be right back after these messages.

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Gabe Howard: And we’re back discussing anxiety in the digital age with Dr. Robert Duff. I certainly don’t think that the solution here is to cancel all of your social media, never read the news, never get on email, never prepare. Like you talked about the extremes. How does one make sure that they’re staying in the middle? Because I imagine that that moderation, that middle, that average is where the least amount of anxiety comes in.

Dr. Robert Duff: Yeah, I think a lot of it is about sort of setting limits for yourself and having some boundaries with yourself at this point. I think it’s really unrealistic to tell people to say, OK, you’re only allowed to do these actions at this time, like you’re only allowed to engage with social media at this time. That’s kind of pushing against a really strong beast, unless social media isn’t even a big thing for you. There’s plenty people out there with like, oh, well, I don’t have a Facebook it’s not a big deal, but insert whatever it is, checking email, checking the news, what have you. It’s easier, though, to block out times that are sacred, times that you’re not doing that. Actively disconnecting from the world. And I think that’s really important in terms of like especially things like sleep, being able to sleep and turn off for the night. Massively important when you’re dealing with mental health issues, both in terms of memory and learning the skills that you’re trying to work on and build and just giving enough energy to get back out there and fight a little bit of the uphill battle that you’ve been fighting. So I’m a big fan of sort of book ending the day is what I call it. So the beginning of the day, first half hour or so, last hour of the day, disconnecting from the world, putting the phone away. And I really am a big fan of not even having your phone in the bedroom because so many people, last thing they see before they close their eyes is their phone, email or social media feed.

Dr. Robert Duff: Then they close their eyes. If they wake up in the middle of the night, drink water, they’re going to be checking their social media feed again or their email. They wake up in the morning. What’s the first thing they see? They pull that out again. And really, I think that there are very, very, very few instances where that’s going to be a great thing. It could be neutral. It could not affect you very much. And there’s a pretty significant chance that it’s going to derail you. If you’re gonna see something that pisses you off, something that scares you, something that you forgot about for work or whatever, you know, the last thing you need is to wake up in the middle of the night and see a work email. OK, bye bye sleep. So I’m a big fan of in the morning, kind of taking some time before you even pull out your phone. Make yourself some coffee. Take a few deep breaths. Write some thoughts down if you have them. Do whatever you want to do with that and then pull that out. And at the end of the night, focus inward, do some journaling. Like I said, you can do some stretching or foam rolling or deep breathing or just enjoy an off line activity like we used to do in the olden days and try to come down a little bit and disconnect from the world so that you can drift off into restorative sleep, not having your brain running a million miles per hour.

Gabe Howard: When I am in a hotel, when I travel, I keep my phone next to me because it’s my alarm clock and every single time I get up to go to the bathroom, because that phone is sitting next to my bed, I check it. Now, fortunately, 90% of the time, there’s nothing on there. But 10% of the time there’s something, there’s something. And I’m up the rest of the night. And I think that people need to realize this. Now, what do you say to the people who are going to immediately fire back, well, I have to. I have to keep the phone next to my bed because I have teenage children who are out or my spouse works nights and might need to call. I am the emergency contact for my mother or of course, my personal favorite, it’s my alarm clock and there’s just no way around that.

Dr. Robert Duff: Yeah, those are all very anxious responses, right? You know, oh, my God, what if this what if that. There are ways around that. They still make alarm clocks. 

Gabe Howard: Yeah.

Dr. Robert Duff: I have one. It’s really annoying. I have to put it on the other side of the room. So actually physically get up and walk over there. Otherwise, I’ll just turn over and hit it with my hand. So, you know.

Gabe Howard: We may be soulmates. I’ve just, yes, I do the exact same thing.

Dr. Robert Duff: I’ve always had to because my brain will create a scenario where there’s like a nuclear launch happening and I have to hit this button to stop it. And that’s the alarm clock. And so my brain will troll me and it just won’t work. So I have to actually physically get up. But, yeah, they make real alarm clocks, you know, and then in terms of the other concerns about what if there’s an emergency, et cetera, there’s a variety of ways around that. There are things like maybe you have your Apple Watch in the room if you have Apple products, but not your phone. Or you keep it outside the room, but you keep it on do not disturb and you can sort of have your specifications. So if somebody calls you, it’ll ring loudly. I mean, that’s outside the room, but you’ll still be able to hear it. There’s a variety of ways to do it. If you have teenage kids that are out for the night, maybe that’s the night you make an exception and you try to be responsible with it. As responsible as you can, not keep it right next to the bed. But that’s your kind of exception for the week and the rest of the week, you’re not going to have it in there. So you could do a lot with it. And those are usually just sort of knee-jerk reactions. I get that sort of knee-jerk reaction from people a lot, too, when I’m talking about setting limits on social media, even taking breaks from social media, things like this, they say, well, it’s my job. I need to be on it. There’s definitely usually a little more wiggle room than you think there as well.

Gabe Howard: I really feel like this all does boil down to making healthy choices and sticking to them and I really think this is a good analogy that people who say that they don’t have time to exercise and the people that say that they have to be on social media. But, of course, one of the things that you can do to exercise is park at the back of the parking lot and walk forward. You can take the steps instead of the elevator so you can turn off social media during dinner. 

Dr. Robert Duff: Right.

Gabe Howard: Do you believe that finding those tiny little things? Because in the grand scheme, those are small things. But it sounds like you’re saying those will pay big dividends when it comes to lessening our anxiety.

Dr. Robert Duff: I feel like just exercising control over it is a good practice, right? Intentionally putting it away sometimes, intentionally having it out sometimes. If you’re feeling that discomfort, much like if you walk out the door and you realize your phone Psych in your pocket, you get this sense of discomfort these days like, oh, God, something’s wrong. A lot of people feel that way. If they’re not able to immediately check their phone at dinner and they’re feeling a buzz in their pocket or whatever you have, that that sense of discomfort. So learning how to sort of modulate that and do it intentionally, you know, I’m going to put my phone away or I’m going to log off or not check these things for this period of time, at least gives you the flexibility to say, OK, sometimes I’m on, sometimes I’m off. And that’s a practice I think, that people need to need to do. You know, we have all these coping skills, mindfulness, you know, all these different things that that we use in the mental health field. I think that this is just simply another one of those things, sort of like technological flexibility or something. The ability to just decide when you’re on and when you’re off. And that’s a hard thing to do when the structure is designed to make you on all the time. But you need to wrest some control back from that. Otherwise you’re gonna be worn out.

Gabe Howard: I hear a lot of what you’re saying, and I completely agree with it, and I know that making more intentional decisions about our social media and about our use of technology will make us feel better. But do you think that there is a role in that when we’re staring at our phones? There’s often people in the room and those people are our friends, our families, our loved ones. And they maybe don’t feel so good about it. And they’re probably giving us pushback, whether straight up, put your phone down or passive aggressive, well, I’m not going to tell you. You care more about your phone or whatever. Do you think that keeping them happy also lowers your anxiety? And I know keeping them happy is kind of a weird way to say it, but in the beginning, I got a lot of negative pushback from my friends and family, which also made me more anxious. And when I got better control over my phone and social media use, a lot of that went away. Which, of course, made me less anxious.

Dr. Robert Duff: Yeah, I think so. I mean, and also you’re making the assumption that the other person isn’t also on their phone. 

Gabe Howard: Sure.

Dr. Robert Duff: And then suddenly you are just both disconnected, sort of doing parallel life next to each other. Communication is something that is still really important, you know, and you could be communicating with people online. I think that’s valid. But you also need to communicate with people in person. And when couples are having trouble in my clinical practice, a lot of things sometimes I ask, do you guys eat dinner together? Like, do you sit across each other and eat dinner? And often the answer is no. We sit side by side or on our phones, whatever the case may be. And it’s like, OK, well, then you’re robbing yourself of the chance to practice communicating with one another and getting that support from one another. And yeah, I think that definitely accessing the supports that you have and then treating them well is it’s really important. That it’s a whole piece of the puzzle, along with all the other things you might do to help relieve your anxiety. So I definitely agree with you there.

Gabe Howard: I could talk to you about this all day because people seem to be more anxious than ever, people seem to be more disconnected than ever at a time that we should be more connected than ever. But the specific question that I want to ask you really involves a story with my grandfather. One morning, my grandfather comes downstairs, he is staying at my house, and he sees my wife and I sitting at the breakfast table and we’re both on our phones and and he says, oh, this is the problem with your generation. You’re staring at your phones. You’re not talking to one another. You know, in my day, we didn’t have this. We actually talked to each other. And for the rest of that day, I felt a little bad. I was like, oh, my God, this is my wife. I love her. And he’s right. I’m ignoring her. And then the next morning, I come downstairs and my grandmother and grandfather are sitting at the table and my grandfather’s reading the paper.

Dr. Robert Duff: Yep.

Gabe Howard: Yeah. And my grandmother is doing the crossword puzzle, completely ignoring each other.

Dr. Robert Duff: Yeah, yeah.

Gabe Howard: And I said, oh, this is the problem with your generation, completely ignoring each other for newsprint. It seems like it’s very much the same thing. We’ve seen couples sit at the breakfast table ignoring each other since the beginning of time, but it does seem like technology is way more intrusive than the morning newspaper routine. Can you talk about that for moment? Because again, I think it’s one of those excuses. Oh, I’m on my phone, but my grandfather was on his newspaper.

Dr. Robert Duff: Yeah, people have always found ways to sort of disconnect and go into their own world, and I don’t want to place a value judgment on any of this. If they’re happy. These things are only a problem when they’re a problem. Right? If you’re realizing that these things are creating a sense of disconnection in your relationship or creating a sense of anxiety or messing with your sleep, that’s what you need to do something about it. If not, and if you’re satisfied and happy, that’s fine. You know, certainly there are times where what my wife wants to do is sit next to me and be on her phone, not talk to me, because she wants me my presence. But she’s super introverted and just doesn’t want to people right then, you know?

Gabe Howard: I like that.

Dr. Robert Duff: And that’s OK. That’s OK. But when it crosses into interfering with things, that’s, I think, where you need to pay attention. And so this is just the next platform for that and things that you need to consider related to this platform. I do think that the intensity is higher. Right? You’re right. There’s a big difference between having a book or a crossword or newspaper, then having this endless stream of information. And the default is to have all these notifications on, which I don’t think you should have. Where it is just constantly pulling your attention out of the present moment. And I think that in addition to the relationship part, the sort of regular life part, I think that we need to reclaim our ability to do deep work and focus on something without being distracted by all these other things. And so that’s another part where I think that training, that skill of being a turn on and off really matters when you’re having a conversation with someone or when you’re writing a paper or when you’re working on some sort of brainstorming project, you should be able to start that and put the work in without having to be pulled away constantly by these other things. If you can’t do that and it’s kind of messing with your productivity or your relationship, that’s where you need to maybe take a close look at how these things are affecting you and what you can do about that.

Gabe Howard: Robert, thank you so very much. How do people find you, what’s your Web site? Where can they get your podcast? Where are your books? Let our listeners know exactly how to track you down.

Dr. Robert Duff: Sure. So my sort of online persona is it’s called Duff the Psych. So if, a good place to start is DuffthePsych.com/StartHere. That has sort of like my greatest hits. So it has, you know, information about my books, which are called The Hardcore Self Help books. I’ve one about anxiety, one about depression. It has some of my most popular podcast episodes, A TED talk that I did. All sorts of things like that. That’s sort of like a great starting place. And then if you want to reach out to me or connect on social media, I’m on basically all platforms @DuffthePsych.

Gabe Howard: Robert, thank you so much again for being here.

Dr. Robert Duff: Totally my pleasure. Thank you.

Gabe Howard: And listen up, listeners, here’s what I need you to do. Wherever you found this podcast, please subscribe and review it and use your words. Tell people why you like us. Share us on social media. And if you are a fan of social media, we have a super secret Facebook group that you can join. Just go to PsychCentral.com/FBShow. And remember, you can get one week of free, convenient, affordable, private online counseling anytime, anywhere, simply by visiting BetterHelp.com/PsychCentral. We’ll 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 show@psychcentral.com. 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.

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Inside Schizophrenia: Impact of Schizophrenia in Minority Communities

Rates of psychosis are more strongly influenced by ethnicity and socioeconomic status than any other mental health condition. In this episode of Inside Schizophrenia host Rachel Star Withers, a diagnosed schizophrenic, and co-host Gabe Howard discuss the impact of schizophrenia in minority communities. Guest Sakinah “The Muslim Hippie” joins to share her experiences in mental health care.

Highlights of “Impact of Schizophrenia in Minority Communities

[01:00] The realization

[02:08] Sociology definition of the word minority

[04:30] The stats of mental health and minorities

[09:00] Diagnosing differences

[12:00] Is the medical community racially bias?

[14:00] Two people, same symptoms but different diagnosis

[15:40] The privilege of not having to worry

[16:30] Two people, same diagnosis but different treatment

[21:50] Guest Interview with Sakinah “The Muslim Hippie” Karen Michelle

[32:00] Police intervention in the minority mental health community

[39:35] What to do for someone who is suicidal

[51:00] So what is the answer?

About Our Guest

Karen MichelleSakinah “The Muslim Hippie” – Karen Michelle

Mental Health Advocate, Crisis Counselor, Speaker

Sakinah (Karen) Kaiser, also known as The Muslim Hippie lives in Baltimore, MD where she is currently a writer and mental health advocate. She hopes to go back to a school for a degree in social work with a concentration in substance use disorders.

www.Twitter.com/TheMuslimHippie

www.Facebook.com/Sakinah.Karen

 

Computer Generated Transcript of “Impact of Schizophrenia in Minority Communities” Episode

Editor’s NotePlease 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, a Psych Central podcast. I’m Rachel Star Withers here with my co-host Gabe Howard. Today’s episode, we’re going to be discussing schizophrenia and how it relates to minorities and also the treatment that minorities receive.

Gabe Howard: I think this is a very timely episode because I really believed before all this started that everybody received the same level of care and that things like gender or race or nationality or religion really didn’t play a role in it. I just thought this was just basic science. So, I was surprised to learn during the research that, yeah, things like gender, race, nationality, religion play a huge role in the treatment options that are offered, that are available. It was stunning to learn.

Rachel Star Withers: And I think with me, when we’re looking at the idea of minorities, you always immediately think discrimination, but so much is things that might just be like these subtle biases that we don’t even realize that we’re doing, whether it’s other people or even to ourselves. In the U.S., whenever I hear minority, most of us usually think it has to do with race. But of course, we have religion differences, gender, sexual orientation, age, lifestyles. So, this episode, we’re going to be looking all across that and explore kind of how those differences affect other stuff around us.

Gabe Howard: Rachel, let’s establish some guidelines so we don’t get off track. So, this episode is called Schizophrenia and Minorities. What is the exact definition that we’re using for this show?

Rachel Star Withers: So, Gabe, I had to look it up because I wasn’t 100% sure. Like I said, I, in the U.S., here, we kind of just think race. But

Gabe Howard: That’s all we think.

Rachel Star Withers: Yeah. Yeah.

Gabe Howard: We don’t kind of think, that’s what we think 100% of the time.

Rachel Star Withers: According to sociology, a minority group refers to a category or people who experience relative disadvantage as compared to members of the dominant social group.

Gabe Howard: So, Rachel, in sociology terms, a minority is not just a few of something, but also it puts you in a disadvantaged class because of it. Now, wouldn’t somebody living with schizophrenia then fall under this definition?

Rachel Star Withers: Yes, and disabilities also can put you into a minority group. So, we’re talking about mental health. We’re talking about physical anything that sets you apart that might hinder you compared to everybody else.

Gabe Howard: And then even in this subset of people living with schizophrenia, there’s a minority group of people inside the minority group. This is where it gets complicated. The general principle that we’re trying to establish here is that, let’s just call it out, white people with schizophrenia often have better access and get better care than African-Americans with schizophrenia. It’s the exact same illness, even in some cases the exact same socioeconomic class. Different outcomes based on race.

Rachel Star Withers: Yes. And here in the U.S., that’s very correct. But you also look that across different countries, different areas, that changes depending on what the dominant race may be.

Gabe Howard: And the reason that we’re pushing this so far into the ground is because it’s not so easy to say that, oh, well, if you’re a minority and you have schizophrenia, people don’t care about you. It’s just racism. It’s not that simple. It’s these cultural and societal biases that we’re completely unaware of. And hopefully this show will shed some light on that because it really is unfair what is happening. And we’d like to think that in some small way Inside Schizophrenia can help maybe educate people on that. Let’s talk about what we found out, because we found out a lot of just straight up facts. This isn’t Rachel and Gabe’s opinion. We’re going to hit you with some straight up Internet knowledge.

Rachel Star Withers: And you’re also probably wondering why does all of this matter? OK. Rates of psychosis are more strongly influenced by ethnicity and socio-economic status than any other mental health conditions. So not just schizophrenia, psychosis, which can, of course, extend into other mental disorders. I found that very interesting. If you were to ask me, Rachel, what do you think your ethnicity and, you know, economically where you fall, what that would affect the most mental health? I would assume depression. That’s what I would assume. Like, well, if you’re poorer, you’re probably going to be more depressed. So, the fact that it’s tied to psychosis really is eye opening. It’s just not what I, at least, would expect.

Gabe Howard: Now, we found an interesting study while we did this because, again, we just don’t want our flapping gums, because let’s be honest here, a couple of white people talking about minority mental health has its own challenges and issues. We just happened to be the hosts. Later on in the episode, we’re going to talk to Karen who bills herself as the Muslim Hippie. She is a very cool mental health advocate, and she taught us all kinds of things. That’s coming up later in the episode. But back to the study and it was done in the United Kingdom.  You know, I want to do a little aside here, the reason we’re using a study from the United Kingdom is because in America, we’re not actually doing a lot of studies on how these biases are impacting the minority community, and that’s very telling in and of itself. It sort of appears, from my perspective, that we don’t care.

Rachel Star Withers: I did find some studies and I was like, yes, finally. OK. And then I went to read through them and the words were very dated, for instance, describing race. And I was like, oh, and I’d have to like, oh, OK. I see. This was done in the 60’s. A lot has changed. But I immediately, like once I realized that, I’d have to start checking the dates and there are very few concrete studies, I would say, that have been done in the past few years, especially with minorities and schizophrenia. It was easier to find for like mental health in general. But definitely the schizophrenia community, almost, almost nothing.

Gabe Howard: Rachel, I think it’s important to remind our audience that there is no definitive test for schizophrenia. Schizophrenia is diagnosed observationally. A professional observes the patient and comes up with a diagnosis that way. And in the United States, black people are four times more likely to be diagnosed with schizophrenia than white people and Hispanic people more than three times. Now, that doesn’t sound right to me. Again, I am not a researcher. But schizophrenia doesn’t. It doesn’t discriminate against race or gender or religion. So, the fact that it’s four times and three times more likely to be diagnosed, shows me that there’s a flaw in the way that we diagnose. What did you find?

Rachel Star Withers: So in the U.K., they found that rates for psychotic disorders, again, not just schizophrenia, but psychosis in general, were five times higher in the minority group of people of black Caribbean heritage. Very, very specific. Black Caribbean, five times higher. That’s a lot. And I feel that if I were one those researchers, I’d be like, wow, there clearly is a genetic link. Right? But there’s actually no pattern found if you go to Caribbean countries that suggests this. So, it’s just found when the Caribbean black people there in the U.K. are a minority. That’s interesting, Gabe. It definitely makes you look at, you know, kind of that nature versus nurture situation.

Gabe Howard: Well, that’s certainly one possibility. Or it could be the trauma of living. There’s so many tangents that we could go off on here if we believed that there was no bias, that this is just the way that it was, then nature versus nurture could be an argument, like you said. But I don’t think that’s it. I don’t think that there is any nurture that causes schizophrenia. And the research holds up that you’re born with schizophrenia. So now we’re talking about diagnosis prevalence rates, not actual schizophrenia prevalence rates. And I think the disturbing thing is that there is a debate. Anybody listening to this should have grave concerns if they’re a member of the minority class. Are you feeling that you’re getting the best care when there’s all of this debate on how it’s diagnosed? It would be disturbing to me if I were an African-American living with schizophrenia. And I find out that it’s diagnosed four times more than in my white counterparts because I’m thinking that’s a lot of margin for error. Am I taking medications that I don’t need? Am I receiving treatments that I don’t need? Was I misdiagnosed? Now, Rachel, please, I imagine that it is very difficult living with schizophrenia, and I imagine that it would be even worse if there was a doubt. If there was an asterisk, if you were wondering to yourself, am I actually schizophrenic or am I a victim of a flawed system? I know that you’re a white woman, but what are your thoughts on that?

Rachel Star Withers: That can be really scary. You know, it takes so long to get a diagnosis and you kind of start to doubt yourself. It isn’t just America or the UK. They’ve done international studies and immigrant communities usually are assigned psychotic disorders way more frequently than the natives of that country who have the racial majority. This is like, OK, well, in America, it’s because they’re dealing with this. No, it’s across the world that if you’re different, they’re more willing to label you with a psychotic disorder.

Gabe Howard: Rachel, let’s do a little segue and talk about the individual patient doctor relationship. Let’s forget about all of the research, the bias and all of that. Let’s just talk about what many people with schizophrenia see for themselves, which is themselves sitting in front of a doctor. Do you think a lack of diversity among mental health professionals can lead to unequal health care?

Rachel Star Withers: Absolutely. For the most part, Gabe, I think me and you are very privileged. Most of the doctors I’ve been to have been white. So, all of the psychiatrists, specifically, have been white males. I’ve never walked in and thought, you know, I’ve never, I’ve never felt out of my element or, like, worried. That’s just, it hasn’t entered my mind. I’ve never looked at the person and thought, oh, you know, they don’t understand me. And that’s kind of interesting. And I was playing in my head being like, let’s say that I’ve never went to a white doctor. But let’s say they were always a different race than me. Would I second guess them? Would I be less willing to trust them almost if they were a different race?

Gabe Howard: It’s interesting because various studies have shown that people of color report more dissatisfaction with their care. And it was interesting when you were saying that all of your providers have been Caucasian, they’ve been white. I am shocked at this. And I didn’t even think about it before this very moment. One hundred percent of my doctors, mental health and physical health, have been white. And I don’t know how that has impacted my care. I don’t know how that has impacted my comfort level because they’ve always been white. A hundred percent of the time. It’s making me uncomfortable to think about. It’s stirring up feelings in me. And again, I’m a white male. Nobody should feel bad for me. But I’m thinking if I’m having this much trouble thinking about it in the abstract. This is a hypothetical. Gabe, how would you feel if all of your doctors were of a different race? And my brain is twisting. I can only imagine how it must feel if all of your doctors were of a different race in practice, not just in theory. But that then makes me ask, do you think that these are terrible psychiatrists, that just we’re intentionally providing bad care? By we I mean, the global we. Bad care to members of the minority class? I mean, is this deliberate? Are we filled with racism and hate? Like, it’s gotta be deeper than that. I don’t want to believe that the entire medical community is just filled with this. This. I don’t know. I just. Obviously, that makes me uncomfortable, too. I don’t want to believe that these are bad people because it does mean that Gabe and Rachel are getting care from bad people, too.

Rachel Star Withers: Of course, outright discrimination, that absolutely exists. But a lot of times it’s not that outright, it’s just more subtleness. And when you look at someone, you right away, you make all these kind of assumptions about them. When you hear someone, you make a lot of assumptions about them.

Gabe Howard: I’m always, of course, fascinated by people that say, well, I don’t see differences, I only see a fellow person in front of me and always think, well, if I went missing, what would you say? Would you say, oh, I’m looking for a tall white redhead? Well, but that means you noticed that I was tall, you noticed that I was white and you noticed that I had red hair. I mean, you certainly know how to identify me in a crowd. Like when you see me over there, you aren’t looking into a group of one hundred people and you’re like, well, I have no idea who is who. I don’t see anything. It’s just disingenuous to say that we don’t notice these things. And I’m wondering if all of this leads to creating criteria for diagnoses that while beneficial to the majority, are not beneficial to the minority.

Rachel Star Withers: Rutgers found that African-Americans with severe depression are actually more likely to be misdiagnosed with schizophrenia. So, you have two people who are coming in to the doctor saying the exact same thing. I’m having, let’s say, visual hallucinations. I’m having audio hallucinations, these different delusions. And they’re quicker to say the African-American person is a schizophrenic.

Gabe Howard: And you can see how devastating that could be, getting the incorrect diagnosis means that you’re getting the incorrect care. It means that you are not presented with options that are most beneficial to you. So therefore, you don’t have the opportunity to lead your best life. This is terrible. It’s terrible to consider. And speaking as a man who lives with bipolar disorder, I can only imagine that if in addition to managing bipolar disorder, which is devastatingly awful, I also had to wonder if I actually had bipolar disorder. Have you ever doubted your schizophrenia diagnosis, Rachel?

Rachel Star Withers: I haven’t doubted it in the past, you know, let’s say 10 years. In the very beginning, when I was first getting diagnosed, my early twenties? Yes. Mainly because the doctors kept, they were giving me different diagnoses. So, I was going, wait, which one of you should I believe? You know, one saying one thing, one saying another. However, I’ve never once thought it had to do anything with me. The psychologist was saying one thing. The psychiatrist was saying something else. I never said, oh, it’s probably because I’m a woman. That’s why this one thinks that. Oh, it might be because I’m white that one. That never occurred to me. I really just thought, you know, they’re different types of doctors. That’s why they maybe have different opinions. Never occurred to me that I in any way influence that. I was putting a lot of trust just in the doctors. And that goes back to what we’re saying earlier. That could very well be a privilege that I have, that it wouldn’t occur to me that I can’t trust this person.

Gabe Howard: I think it is an incredible privilege that you and I have. It’s wonderful not to have to wonder, because it just takes something off the table. There is a lot to manage with a severe and persistent mental illness. Schizophrenia is a scary illness. And also having to wonder if you are getting the best care based on the available research, based on your race or religion, socioeconomic status, etc. I just cannot imagine and I want to be very, very clear that there’s only so much understanding that Rachel and I can have, because it’s just not possible to walk a mile in these shoes. But one of the things that I’m wondering, Rachel, is we’ve talked about the bias in diagnosis. Now let’s pretend that it’s the correct diagnosis. Let get out of our mind that it might be incorrect. It’s 100% the right diagnosis. What about treatment? Are minorities with schizophrenia getting the best treatment?

Rachel Star Withers: And that’s what’s crazy. We go back to if we have two people walk in. Same symptoms walking into the same doctor. They found that all racial minorities. OK. So not just a specific race. All of them are less likely to be offered cognitive behavioral therapy than a white person. They’re more, it’s almost like they’re more willing, like, OK, like you have a lot of different options here. And then with minorities, let’s not give them as many options. And I don’t think it’s always, you know, an outright discriminatory thing. But, yeah, across the board, they’ve found that out. They’ve noticed that black patients are far less likely to be offered family therapy. I can see that definitely being a bias. Thinking the family’s less stronger in African-Americans, the family’s less stronger in Hispanics. Yeah. I easily see that being a bias with different doctors.

Gabe Howard: And that, of course, is, one, it’s just outright offensive. But let’s move that aside for a moment. I know that I would not be living as well as I am now if I didn’t have strong family support. And, Rachel, you’ve talked too. Your mom was on an episode of Inside Schizophrenia and talked about how much you two partner and work together to help you lead the best life possible. There is a tremendous amount of research that people living with schizophrenia do better if they have a strong support system. And listen, I always take this opportunity to point out that everybody does better.

Rachel Star Withers: Yes.

Gabe Howard: You don’t have to have a mental illness. No one is an island. So now this is being taken away from somebody based solely on the color of their skin. That, to me, is a tremendous loss.

Rachel Star Withers: Yes, and with Asian people, as far as being a minority, they are actually less likely to receive copies of care plans. Like isn’t that random? They’re less likely at the end of it to be given, OK, here is what we talked about today. This is our plan going forward. That’s worrisome because when I’m in the doctor’s, I have to take notes because the minute I walk out, I don’t remember anything. So, if me and that doctor are coming up with a care plan and then they don’t even like, let me walk away with it. You know, that’s odd to me. I’ve never had that situation. Like that would never occur to me that the doctors wouldn’t be wanting me to do this plan.

Gabe Howard: Rachel, along those same lines, what about the role of medication, is that at least the same for everybody in the treatment of schizophrenia?

Rachel Star Withers: No. Minorities have been found that they are prescribed typical antipsychotics over atypical antipsychotics. So, the typical ones tend to be the older ones. OK. The kinds we’ve been using since the 40’s. And if you’ve ever taken those type, like I have, the side effects are intense. They’re just so much worse than the newer drugs. Whenever you talk about movement disorders, that unfortunately are a side effect of many antipsychotics, the majority come from typical antipsychotics. So, if you have tremors, shaking that’s been brought on as a side effect, it’s going to be more of those older ones. So here we have minorities, they’re less likely to be offered therapy. They are less likely to be given a set plan and they’re more likely to be given medication without that support system. That can be very hard to deal with.

Gabe Howard: I’m really just speechless because, you know, I became a mental health advocate because I believe that people weren’t getting access to the care that they needed. And listen, this was largely from my own experience, seeing mostly middle-class white people. I thought that middle class white people weren’t getting the right care. And I still stand by that. And you’re saying that there is worse care based on gender, religion, the color of your skin. That’s just altogether frightening. In general, from what I’m seeing, from my perspective, from my eyes, from my vantage point, which I understand is only mine, I think that we need to do way, way better. And everything that we’re reading shows that it’s worse based on nothing more than who you are, where you were born or the color of your skin. And that’s, it’s a lot to take in, Rachel. It’s a lot to take in.

Rachel Star Withers: And we’ll be right back after this message from our sponsor.

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Rachel Star Withers: And we’re back to talking about schizophrenia in minorities.

Gabe Howard: Rachel, I think this is a good spot to introduce our guest, Sakinah, the Muslim Hippie, Karen Michelle. Clearly, we can only understand and process the world from our own vantage point, with our own eyes. The same with Sakinah. She is an incredible mental health advocate. She has done so much. And I’m so glad we had the opportunity to speak with her. So, go ahead and roll the interview.

Rachel Star Withers: So, we’re talking with our guest for this episode, Sakinah. And she’s also known as The Muslim Hippie.

Sakinah: Yes.

Rachel Star Withers: So, tell us a little bit about your background.

Sakinah: So I grew up in the D.C. area. That actually is why I call myself a Muslim hippie. When I started with my journey with mental health slash mental illness, one of the first hospitals that I went to was in Takoma Park. And Takoma Park has a really eclectic history to it. And I like it because when I was growing up, I was really attached to some schools in that area. And I kind of felt like since I got better, or started getting better, there, I wanted to remind myself of what I liked about that part of D.C. and I like being a hippie. So, I just called myself a Muslim hippie and it just stuck. And then people were like, Oh, that’s cool. What do you mean by that? I know that people have a negative association with the name Karen. But my dad named me Karen. So that’s kind of why I also stick to my given name, because he really wanted me to have that name and he liked the meaning of it, which is pure. So, I go by Sakinah because that’s my Muslim name. But I stick with Karen, too. So that’s me in a nutshell.

Rachel Star Withers: And you are a mental health advocate, crisis counselor, speaker and a mentor.

Sakinah: Yes.

Rachel Star Withers: Can you tell us a little bit about your mental health journey?

Sakinah: I did not intend to be a mental health advocate at all. I just dealt with mental health in one way or another since high school. And I kind of stumbled into all of this. And then when I started talking about my journey, I started blogging just because I like writing. And a few of my friends from elementary school, they read my stuff and they’re like, oh, you’re a really good writer. And a friend of mine, she’s a professional writer. She encouraged me to talk about what I was going through. And initially what I noticed was depression. So, I started talking about my depression issues. And then when I got online, which was mostly Twitter, I developed a following. And then it was kind of like I was healing and writing and like learning how to blog and do all that stuff all at the same time. So, then I learned about advocacy work. So, I used my journey online to kind of teach people about mental health. And as I was learning and healing, I decided, okay, why don’t I do this full time? So, then I started going to classes and things like that. And then I told people, OK. This is what I’m doing intentionally. So, let’s learn about mental health together. And then once I started going to the doctor and stuff, I actually told people, well, I didn’t know things and like maybe you don’t know either. And so that’s kind of how I got started. And there are so many mistakes that I made or that other people made. And rather than use my blogs to just say this didn’t work and hurt me, I used it to teach people about what I thought they should know about mental health.

Rachel Star Withers: So, our episode today is about minorities, and we were discussing that what a minority is, of course, changes depending on where you’re at.

Sakinah: Right.

Rachel Star Withers: And it can be, you know, a lot of different factors. A big one, though, however, usually is race. Can you tell us what race you are? Do you feel comfortable talking about that?

Sakinah: I’m actually African-American. My dad is black. My mom is black. They’re both American. My dad is from D.C. and my mom is from Georgia. The funny thing is people don’t know where I’m from because I cover with this scarf, this hijab, because I’m Muslim. So, when they see me, they assume actually, because I look racially ambiguous, they will assume that I am other, like Somali or Ethiopian or, you know, something. And my dad, they usually think he’s Egyptian or Moroccan. So, it’s hard for me when I identify. I’m kind of, I get stuck because when I was working in a hospital, I was a CNA for a while. And they would say things like, oh, you don’t have an accent. And it was hard for me to understand what they meant by that. Because I didn’t know if they meant I don’t have a D.C. accent? Or I don’t have a Maryland accent? Or if they meant I don’t have an American accent? I didn’t know what they meant. And then I realized they meant that I don’t have an accent for someone who they thought was Ethiopian or whatever. So, I’m African-American.

Rachel Star Withers: You should have said, well, my mother’s from Georgia, not me.

Sakinah: Yes.

Rachel Star Withers: For like a Southern accent. And they’d be like, oh, okay.

Sakinah: Yes. And what’s funny is I’ll actually, yeah. Well, funny enough where I was working was in northeast D.C. and I ended up saying things like, no, my dad’s from, and then I would say the street where he was from. That’s how I found out, because they just kind of look like what? And then even when I take the scarf off, people will say things like, are you mixed Black and Spanish? Are you mixed Black and White? So, it’s still kind of a thing where people don’t know where I am. So that mixes the race and ethnicity. So, I’m like, I’m black African-American. You know, I try to get both in because let me explain and clarify. And I shouldn’t have to do that. When it comes to mental health and the conversations that we have, if I’m talking about being a Muslim with mental health issues, being a black person and African-American. It actually does matter because when I go to the hospital, it depends on how they look at me, how they’ll treat me. Like, if they think that I speak English but they don’t care that I’m black, they’ll be really nice. But if they think that I am a Muslim who doesn’t have a good handle on English, then they’re really rude. That’s something that I’ve had to do.

Rachel Star Withers: Very interesting. So, you can tell right away, like how they’re interpreting you?

Sakinah: Yeah. Because you can see, especially because my name. I have not changed my name legally. My name is Karen Kaiser. I mean, that’s easy. But also, no one is expecting someone black when they hear it. Karen Kaiser, because it doesn’t sound black at all. And then they see me and always, oh, OK. And sometimes they’ll say, how did you get that last name? And I used to be like really rude. I’d say, slavery and then like

Rachel Star Withers: Oh.

Sakinah: Somebody said please don’t say slavery, but. You know, that isn’t a nice thing to say. But I don’t know what people want me to say because I don’t really know my whole lineage yet.

Rachel Star Withers: And they’re implying something else also.

Sakinah: Well, exactly. Exactly. And the thing is, though, when I go to the hospital or to the doctor, it depends on if the doctor is black or African-American. It depends on their background and how educated they are. And if they have a prejudice, how they’re going to treat me. So what I’ve noticed is sometimes I prefer to use my name, Karen Kaiser. I don’t want to deal with, oh, where are you from? And I had doctors that I grew up with, they knew me. But then when I put my scarf on, they didn’t recognize me and they were really mean to me. And then they’re like, wait

Rachel Star Withers: Oh.

Sakinah: A minute, we recognize this name. We just didn’t. And they did. We didn’t notice that something. Oh, so you’re saying that you’re going to be prejudiced against this until you know who I am. Sometimes you can see it right away and sometimes they won’t say anything. But it’s in how they will. And one time I went to the hospital and I was really very sick. I almost died. And I asked someone for Sprite and she, on purpose, brought me back apple juice because she thought that I wouldn’t understand the difference. And there is a black guy there who is also attending to my care. And he said, you heard her ask for such and such. Why did you do that? So, it’ll be little things like that. I don’t know how to tell the person you’re doing this because you think that I’m from someplace else. And by that time, it won’t matter if I take my scarf off. And then when I go to inpatient, it’s the same thing. So, I can hear things that people will say and they’re thinking, I don’t hear because I have the scarf on. So actually, when I was in Dallas, I had been able to explain it to them. Because I was in the hospital and they were doing things like making me take my scarf.

Sakinah: They would say that I can’t wear a scarf in the room because I’m going to harm myself with the scarf. And then they have bedsheets in there. So, there are things that like they will have cultural hang ups that they don’t realize. And I don’t know how to explain it to them easily. So that’s one thing that I’d like to work on with my advocacy is being able to clearly share with people how I can see their prejudices. And I’m not that eloquent sometimes in my speech, because if I’m unwell, if I’m in psychosis, I don’t have time to educate you. One time I was at a hospital and they said, well, there’s our patient line, you can tell us what we’re doing wrong and I shouldn’t have to do that when I’m not feeling well. So, it’s something that I want to work on when I’m like now when I’m passionate but not feeling hurt or upset, because I think that in the long run, it helps people to see how they can better help someone like me.

Rachel Star Withers: As far as, we’re talking about on the small scale of things right away, people seeing you. What about the larger scale as far as like diagnoses? How do you feel race or religion might have played a difference?

Sakinah: Well, so what I have noticed, this is just a small bit of research that I’ve done. What I noticed and what I’ve heard is that African-Americans, so we tend to be more easily diagnosed with bipolar and schizophrenia and definitely more psychotic disorders, whether that’s that or not. So, let’s say that you see me in a trauma setting. So, you might just put a label of bipolar or schizophrenia, and that might not be what it is. That’s easier because you just assume all of us, if I’m loud and I’m yelling and I’m assuming they think that is what the data supports, that it’s easier to put us with that label. Just how they would say, like with young black boys, they’ll get the label of ADHD. When it comes to psychotic disorders, black people will get the label of a psychotic disorder, and without getting much research. A lot of diagnoses are missed because we just get one thing slapped on us and then nothing else is looked into. And I think that is really so sad because we could get help. And also, there is a rush to overmedicate. Even if it is a psychotic disorder, I might be on a really high dosage or something when I could be on a lower dose just because it’s almost like criminalization of symptoms. Whereas someone else may just do with a lower dose because they’re not looking at her as a criminal. So that’s on a larger scale where it just is with African-Americans. It’s more of just you have that psychotic label and then we’re just going to medicate. Almost like a prison type thing within the medication.

Rachel Star Withers: Just asking, because this is obviously in the news a lot and it is a major issue and problem is African-American people specifically, but people of color being I don’t want to say harassed, but unfortunately, yeah, harassed in a lot of like legal situations, kind of police tend to jump where they’ll stand and might talk to a white person who’s, like waving a gun for hours and talk them down,

Sakinah: Yes. Yeah.

Rachel Star Withers: And they’ll tend to see a black person doing something like lighting a cigarette, thinking it’s a gun and overreacting. Mental health wise, how does that make you feel? You know, you’ve talked about being inpatient some. Are you scared to get help sometimes? That maybe things could escalate?

Sakinah: Now, that’s an interesting topic and how that plays out is it depends on your presentation, gender and how you look. Because as a Muslim, let’s say I’m five one and I’m light skinned. I might be Muslim and I am African-American and I cover. But if I’m not seen as a threat, well then no, I’m not scared. But then they won’t help me because they don’t see me as someone that they need to pay attention to. So, they’re not interested in getting me the help that I need. And since I’m not a criminal, they don’t want to pay me any attention. So let’s say that someone calls the police because I’m exhibiting psychotic symptoms. They usually will say, OK, she’s African-American, she’s dangerous. But then if they come out and I’m not dangerous, then they just walk away. So, they don’t give me any help. Do you see what I mean? So it is that criminalization of African Americans with any type of psychiatric symptoms. It’s automatically we have to harm this person. Then if they aren’t a danger to us, then we’re not going to help them. In order for me to get impatient, I have to take myself. Because when it comes to someone calling for me, nobody wants to deal with me because it’s almost like they’re like, OK, there, there. You know, we’re not dealing with you. Now, if it were my son, who is a darker skinned male who is bigger, yeah, I’d be afraid for him because the minute they see him, they’re thinking, is he a threat? OK, we’ll shoot him. So we talk about the privilege of being light skinned. If you have pretty privilege, that kind of thing, because certain people, they’re not looking for you. So they’re not going to do anything.

Rachel Star Withers: Now, as you just mentioned, you’re also a mother of teenagers.

Sakinah: Yes, two teenagers and a 20 year old.

Rachel Star Withers: What do you tell them? Do you warn your kids as far about, hey, when you go to the doctor, you might want to be careful about this? Do you ever worry?

Sakinah: I do, but I’m careful how I warn them because I don’t want to put in them this idea. This inferiority complex, like, OK, you do this so you don’t get hurt because then that raises someone with this idea that it’s OK for me to victim blame. At the same time, I don’t give them the idea that they can do whatever they want. It’s this tightrope, this walk that I have to do that. OK. And when it comes to psychiatric symptoms, if you need help, you have to know how to reach out. And then it’s a difficult thing. But I want them to know how to talk to me. I just have to let them know how to advocate for themselves. And I think that’s the best way to do it. But I do let them know they can look at my social media pages if they need to understand mental health and if they need to ask for help. I really try not to let me enter into it because I want young people to look at the adults in their lives to know how to get help. And that’s kind of the way that I’m steering my advocacy work.

Rachel Star Withers: Earlier in the episode, me and Gabe, we discussed that we’re both white and I have never been in a situation where I did not feel comfortable due to my race as far as like a medical setting. I’ve never thought when the doctor came in, they’re going to treat me differently. I’ve never worried about that. The nurse practitioners and other ones have been more diverse. But like the psychiatrists that I’ve seen, the vast of the doctors have all been white males, with the exception of two, and I’ve seen a lot. So that exception is under five percent. You know, at the end of the day, I can’t understand. What would you tell other people like me and Gabe?

Sakinah: Well, what I would say is that. See someone like me has also had a bit of a privileged experience when it comes to clinicians. So, I had to have that explained to me. And I didn’t know that because I grew up in the DMV area that which is the D.C., Maryland, Virginia area. I have had, I’d say about 98% really good experiences because those doctors are so well, not just well educated. These are the specialists of the specialists. So all of the really good hospitals, there are such good hospitals. And I’m not in a rural area. So if I had bad experiences, I can name them on one hand. And even if my friends had bad experiences, we are the anomaly. What I would say is for African-Americans, each person’s experience is going to be different. And then it’s going to depend on their life circumstances. Unfortunately, it depends on appearance. It depends on how well educated they are about their situation. And it also depends on money.

Rachel Star Withers: Yes.

Sakinah: For me, every single time I went to get diagnosed, it all lined up to what I have today, which is so rare. I’ve never had a different diagnosis. With all the times I’ve been to different hospitals, that’s unusual. Usually people say, oh, well, first they thought this and they never thought something different. And they hadn’t. They had no reason to say that. So I think I had one doctor who did something that was so unusual that it was racially based. It was abusive. But I can be mad at that one doctor. It might have been as bad as I should’ve sued the hospital. But again, I would say that as a patient who’s African-American. Like, I can’t even speak for all African-American patients, you know, with mental illness

Sakinah: Because my situation would be different, too, because of being Muslim. After 9/11, the difference is a lot of Muslims have trouble with trusting mental health professionals because some people are afraid of things like surveillance or afraid of stigma. And I never thought of that because my mom raised me to be so open with I’m going to the doctor that I didn’t think about it until people had told me, like, you’re so clueless. And so that’s, again, a privilege that I didn’t have bad experiences. And what I would tell to you guys is Gabe was probably the first advocate who came to me and said, OK, I don’t know about what you do and your experience. So how do I learn? I’m going to be honest, that’s unusual to me. You guys have been so open with me. And that was really helpful. If I talk about race and I talk about ignorance it is because some people, they just never were open. And what I like about when I meet advocates like you is that you asked me to tell you about my experience. So that helps me to see how I can teach you. So, I think that if each person shares their experience with one another, then we all can learn.

Rachel Star Withers: Oh, I like that. What the world needs more of is people willing to learn.

Sakinah: Yeah, yeah, I think so.

Rachel Star Withers: As you know, with mental health, depression and suicide comes up a lot. A few years ago, I’d given a response, we’re talking about as far as suicide. Pretty much, my rule is if your friend or loved one or whoever is talking about suicide, don’t treat it as a joke. If you think they’re going to hurt themselves or others, you need to call the police. And I had a lot of backlash because a lot of people said because you’re white, you think that means they’re going to get help. And yeah, unfortunately, a lot of times if the person isn’t white, they’re not going to get help. It’s going to be a very different response. And I know there is no correct answer. There is no. Well, this is what.

Sakinah: Right.

Rachel Star Withers: What advice, though, would you give me as far as dealing with those situations?

Sakinah: What I would say is a lot of areas now are starting to adopt warm lines. And like, I won’t say, a crisis text line. But there is a difference between the 911 number and a crisis line. But things like, in my area, they have either 211 or 311, which is the county services. And if you call them, which is a non-emergency number, they should have a mobile crisis. Now the problem with mobile crisis is that sometimes they will send the police. So unfortunately, in that sense, there’s nothing you can do. But I think by state, I think people are having these numbers for mobile crisis. Or you can ask for an ambulance when you call the cops. You can say maybe it’s not an emergency or when you call crisis text line. I also take crisis text line calls. What we can do on crisis text line is you can call on behalf of someone else and say, I think this person might need help and they can call someone for them. It doesn’t have to be the police. So, one of the things I want people to think about is if it is a person of color, African-American or somebody else, find somebody different to call besides the police. And if you’re not sure who, then you can look it up, because for whatever reason, there’s just such a stigma against us when it comes to law enforcement or they don’t know how to de-escalate. I’ve seen and retweeted videos of white Americans, they can walk at the police with all kinds of machetes and everything, and the police will just stand there like, oh, it’s OK. And then me, I can have nothing, and like, I’m like, I’m compliant, I’m on the ground and they’ll shoot us. And I don’t know why that is. Rather than figure that out, I would try to help by just call a different number. But I think until you get African-Americans to deal positively with law enforcement and share our experiences and teach, I don’t think that it will change that we’re getting hurt.

Rachel Star Withers: And something you said earlier. So Gabe’s a pretty big, big guy. You’ve met him in real life. He’s like six something, huge towering guy.

Sakinah: Yeah.

Rachel Star Withers: And let’s say there’s a situation and I feel that, yeah, he needs help. I wouldn’t think twice about calling the police. It would never occur to me that, like, oh, they’ll make it worse. And he’s huge.

Sakinah: Ok.

Rachel Star Withers: So, you should think that, hey, if anyone. Yeah, I would be worried that they might shoot him because he’s such a big dude, but that never entered my mind.

Sakinah: Right.

Rachel Star Withers: But that’s almost like that privilege that people don’t realize. I wouldn’t have thought about race having any effect.

Sakinah: Right.

Rachel Star Withers: Yeah.

Sakinah: And the thing with privilege, regardless of the scenario, you almost don’t realize it until someone lets you know where you have it. One time I was tweeting about something, about maybe going to the E.R. or why would you wait to get a doctor? And whatever I tweeted about, someone said, you know, you think that because you have privilege. You know where I am, even if you’re in crisis, if you call the doctor, they won’t see you for about a month. And I said, oh. And they were letting me know that your privilege is such that. Like, if I call my doctor, they’ll call me right back. Sometimes I have my doctor’s cell phone number. So I was sorta like, oh, I can just go to the E.R. right then and get evaluated by a psychiatric social worker so they’ll let me know if I need to go to inpatient. Like, why would you wait? And a couple things I said. And they’re like, you are in the D.C. area. Of course you have. And I was talking about like I just go and I just did this. And you don’t even understand how much privilege you have. We can’t go even in an emergency. And then I said, oh, OK, I get it. And I think we all have privilege. Even if you don’t realize this. So, sometimes someone has to tell you, oh, you didn’t realize. That was easy for you. That’s why you think that. So, yes, the same type of thing. And I think even for me, the way that my stature is with if you see cops, most of them, it’s obvious they are bigger than me and they have more like they have authority over me.

Sakinah: But when someone calls for me, there are six of them. Six of them came out and I’m just sitting there and they keep saying like, well, that your friend said that you were suicidal. And I said, I’m not. I just asked them out of it and like, OK, you can leave. But her son, they talked to him in such a way, it was obvious they wanted to harm him, you know, and they’re making fun of him and like, have you taken your medicine? And they weren’t really trying to de-escalate the situation. They didn’t do any of that to me. So, the way that they treat people like us is so different. And they weren’t interested in getting him out. They were just trying to, like, let her know that she had messed up by not giving him his meds. So that’s the kind of thing where if you don’t see that happen, you won’t really know. That’s how they deal with it. There were actually only three of them, and there were six for me. You know, there’s no need to. Like, they’re trying to strong arm us and let us know. None of that makes any sense.

Rachel Star Withers: And that goes whether you’re in a city or rural area, like how many? Obviously, you always hear where not everyone’s bad, which is correct. But when you look at like, the responses. Yeah. If you’re in an area that the police have more of a budget, they’ll probably send more. And it could probably escalate quicker than if you’re from where I’m from. And I don’t know, like five cops for like half of South Carolina. You know, the idea that a whole bunch coming out wouldn’t happen and be like, well, where are you going to find them? But yeah, usually, like, things change.

Sakinah: See, I didn’t even think of that. Yeah.

Rachel Star Withers: Mm hmm.

Sakinah: Yeah, because for me, I’m like, why are these six cops in a room? And like, they’re all like just trying to stand in front of a window where if I fell out, I’m not even going to die. And then I’m like, what are you even doing? It was really, really odd. And then I kept telling them, look why are you all around the windows? We don’t want you to jump out. Of this window? Yes. None of that makes sense. OK. Yeah. Then they had an actual budget. And then finally they’re like, all right, let’s just go, we’re wasting our time. I told you that. Yes.

Rachel Star Withers: So we’ve hit on a lot of different things, and I’ve loved talking with you. What overall advice do you have for people whenever they’re in a minority situation dealing with mental health, whether it’s a crisis or just worried about getting general help?

Sakinah: Ok, I’ll say two things. If you are a minority and you are concerned about your mental health, don’t be afraid to ask. What you don’t know, that is what can hurt you. And it is not a shame on you to say, hey, I’m dealing with this issue. And you won’t know what it is wrong with you unless you ask a professional. You cannot assume. Everything isn’t depression. Everything isn’t anxiety. You need to know and you deserve to feel well. And I have a friend who always told me that. So you should check into it. You should reach out. But especially if you are black or African-American, you need to take care of yourself because you need, you have to be strong in today’s society. But if you’re dealing with someone who’s black or African-American, same thing. Don’t assume that they know what’s going on with them and don’t look at them and think, oh, that person’s angry all the time. Or that person is whatever. They may be dealing with trauma and they don’t know how to get help. So, if you say something, let’s say online, you say, oh, reach out or take care of your mental health. They won’t know how to do that unless they’ve been taught. So, don’t assume that like one size fits all. Or if you’re an advocate or even a doctor, that they’ll know how to do that. And then you might be thinking, well, I said it. They won’t know. And so for us, you really almost are going to have to go into those communities and teach people and just be kind of patient because some people have such a stigma. Like in black communities, we have such a stigma. And you may need someone who looks like them or who they will take that information from. So, it’s OK if he will kind of push back. They’re not pushing back against you. They’re just a little bit scared sometimes. Just like no assumptions. No assumptions.

Rachel Star Withers: And how can our audience learn more about you?

Sakinah: The best way to learn about me, I would say, is through my social media, Twitter and Facebook is where I’m most active. My Twitter handle is @TheMuslimHippie. You can find me on Facebook /Sakinah.Karen. And both of those have all information on any other projects that I’m working on. You’ll find those. I’m working on the second book about substance use disorders. I want to write a book about Muslims dealing with substance use and how being in a marginalized community, if you don’t take care of your substance use disorder, you can die quicker. That’s kind of what that project is, but it’s going to be positive. And it’s a story of hope because I’m always looking forward. So, Twitter and Facebook is where you can find me.

Rachel Star Withers: Thank you so much for coming on here and teaching us and our audience. And I kind of hope we will all just continue to learn from each other.

Sakinah: Thank you for having me.

Rachel Star Withers: Thank you so much. Loved speaking with you today.

Gabe Howard: Rachel, that was incredible. I’m so glad that we have the opportunity to interview people on this podcast, not just Sakinah, but all of our guests have just been so incredible. What do you think?

Rachel Star Withers: I learned so much from her. Especially when we talk about, like religious wear. For the most part, when I walk into a doctor’s office, they’re not going to know what religion I am. It’s pretty hard to judge me off that, whereas they know right away with her, you know, and you make assumptions off that, whether you mean to or not.

Gabe Howard: One of the major takeaways that I learned from Sakinah was it’s not intentional. I think this is just such an important point to bring up. This debate is always tabled with you are a malicious racist or you’re perfectly fine. There’s like willful racism or nothing to improve upon. And the reality is, it’s so much more complex than that. I’m not saying that there’s not willful racists. There absolutely are. I don’t think Sakinah is denying that either. Her point was that some of the major issues that people of color, that minorities, have aren’t that willful racism. It’s the unexplored biases. It’s the misunderstandings that go unchecked that lead to people like her not getting the best care. That was a real aha moment for me because it would just be so much cleaner if it was, oh, you’re a racist and you’re evil. Oh, you’re not a racist and you’re wonderful. Like that would be so much easier, but it’s not that way. So, I’m really glad that she pointed that out and I can see where that would be very impactful on her care.

Rachel Star Withers: And sometimes you don’t have access, you know, where you’re living at. So how I dress, let’s say I walk in and the doctor, I’ll go, you know, a week without showering because I’m so depressed and I’m, like, mentally out of it. So imagine if I show up to a very first doctor’s appointment and they’re thinking, oh, wow, this girl looks rough. They make these assumptions that, oh, she probably has no support care system. Oh, wow. We need to, you know, up her meds right away. People look at you and they make assumptions based on the way you dress. There’s so many things that can affect our health care. And it, it’s scary, Gabe. I’m not gonna lie. It’s scary, especially for people with schizophrenia. And there is no like, OK, well, here’s the answer, guys. Like there isn’t. We have no answer for how do you deal with subtle biases? Because unfortunately, every single thing is going to be different and so much of it people don’t even realize they’re doing.

Gabe Howard: Our listeners probably aren’t aware of this, but Rachel is a stuntwoman and she’s also a model and quite accomplished at both. And I am just, I am lucky to have Rachel as a friend. And I bought a new wardrobe recently that Rachel helped me with. So, one, I just wanted to publicly thank you, because now I look stellar.

Rachel Star Withers: True.

Gabe Howard: But people are like, Gabe, you’re really stepping up your game. And I said, yeah, I have a friend who’s a model, Rachel, and she gave me all kinds of hints and tips because this is her experience. And that’s like, oh, that’s awesome. I wish I had a model friend. And the reason I’m telling this story is because recently one of my friends realized that my schizophrenic friend Rachel and my model friend Rachel were the same person. It never occurred to her that my model friend Rachel could live with schizophrenia. She very much considered them separate. Now, my friend is a very good person. She’s a very nice person. She’s not, she doesn’t have a mean bone in her body. This was not malicious, but she was unable to connect the two and she was quite surprised when she found out. That, in my mind, is an excellent example of just an internal bias that you miss. And obviously, the stakes aren’t very high on that. Health care is a matter of life and death. And that’s why we’ve got to do better.

Rachel Star Withers: Absolutely. This episode is a very hard one for me to kind of wrap up. I’m very upbeat. You’ve noticed that, I’m sure, throughout the episodes. So, I always want to leave on an upbeat note. And this is hard because as we’ve said multiple times, me and Gabe, in a lot of ways are very privileged. And we’ve never been outright discriminated against. We’ve never kind of been held back from health care due to being a minority. And I don’t wanna give upbeat words for something that I know nothing about. During this episode, we’ve talked about all different stats and acknowledged that so much goes into the way people perceive us and we perceive other people, how we subconsciously even connect to people. How you’re like, oh, hey, this person’s like me and the opposite there and that’s across the board. That’s something that’s scary to me, that there are people out there and they almost never feel like they connect with a doctor. And I do wish I could be like, oh, well just go find another one. As Sakinah pointed out, especially when you’re not in a city, there may only be one doctor. Depending on your financial status, you might not be able to go to anybody else. You might have to stick with a free clinic or something like that. So, there are no good answers that blanket everything. We all have blind spots. Some of them are self-imposed. Others are put on us. I think we all just kind of have to realize that we have these blind spots and try to do better.

Gabe Howard: Rachel, I could not agree more.

Rachel Star Withers: Thank you so much for listening to this episode of Inside Schizophrenia, a Psych Central podcast. Please, like, share, subscribe. Send it to all of your friends, any of your friends who are dealing with schizophrenia, caretakers, your medical friends, or just some really cool people you know.

Gabe Howard: See you all next time.

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 talkback@PsychCentral.com. The official website for Inside Schizophrenia is PsychCentral.com/IS. Thank you for listening, and please, share widely.

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Podcast: Debating ‘Anti-Psychiatry’ Advocacy

 

What is the “anti-psychiatry” movement? In today’s Not Crazy podcast, Gabe and Lisa get to the bottom of this mentality and debate the reasons and end-goals of people who are explicitly against medicalizing mental illness.

What is behind their passion? What is their end-game? Do they have a good point or are they heading down a dangerous pathway? Join us for an enlightening debate on this growing movement.

(Transcript Available Below)

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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 “Anti-PsychiatryEpisode

Editor’s NotePlease 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: Hello, everyone, and welcome to this episode of the Not Crazy Podcast. I’m your host, Gabe Howard, and with me, as always, is Lisa. Lisa, hey, what’s your quote today?

Lisa: Today’s quote is modern man has no more right to be a madman than medieval man had a right to be a heretic. And that is from the Encyclopedia of Theory and Practice in Psychotherapy and Counseling, the 2014 edition.

Gabe: I have a million questions, but what are you talking about?

Lisa: Ok. The quote goes on to say, because if once people agree that they have identified the one true God or good, it brings about that they have to guard members and nonmembers of the group from the temptation to worship false gods or goods.

Gabe: Listen, today we are talking about the anti psychiatry movement, the group of people that that seem to both recognize that mental illness is real. But they don’t believe that it’s a medical condition or that psychiatry should exist around it. I don’t like the anti psychiatry movement because psychiatry is literally the medical study of mental illness. Without psychiatry, Gabe would be dead. As everybody knows, you brought me to a hospital. You had me seen by a psychiatrist. I am on psychiatric medications. I go to a psychologist. All of this is psychiatry. I really struggle with the idea that anybody can be anti that. Because before I had psychiatry, I was this mess that needed you to save me. And now that I have psychiatry, I drive a Lexus. So I am not anti psychiatry in any way. Where I’m having trouble is, how does your quote tie into that?

Lisa: So the point is that medieval man, the heretic, was someone who thought differently or believed differently from the larger society around him. And people don’t like that. So the madman is thinking or believing differently from our larger society. And that makes us unhappy and uncomfortable.

Gabe: Ok. Am I the madman or am I the heretic?

Lisa: You’re both. That’s the point. Today’s madman is the 13th century’s heretic.

Gabe: But we don’t like heretics. Do we? What’s a heretic? Maybe I don’t understand the definition of heretic.

Lisa: A heretic is someone who spoke against the church.

Gabe: Oh. Well, but.

Lisa: It’s often used as a synonym for an atheist.

Gabe: Ok. But again, our society doesn’t like atheists. As we learned last week.

Lisa: Yeah.

Gabe: But where does the anti psychiatry movement fit in?

Lisa: Because what they’re saying is that you’re making people who are different, bad and ill, rather than just being different.

Gabe: Ok. All right. So the general gist of the anti psychiatry movement and again, we’re not members of it. We did a bunch of research. We read a lot of the prominent books and bloggers and outspoken members of this movement. But the general belief of this particular movement is that if you have psychosis, that is a gift. If you have bipolar disorder, that is a gift. If you have major depression, that is a gift. And you should learn to harness those gifts. And doctors do not need to enter into this. These are just personality traits that, while different, are not inherently bad.

Lisa: With the gift thing, in general, no, it’s not saying that this is a good thing. The point is that this is part of the human condition and does not need to be medicalized, looked down upon or altered.

Gabe: I don’t think that it should be looked down upon. But part of the human condition is having high blood pressure. But we believe that you should take high blood pressure medication and live forever. Part of the human condition used to be dying by 30, but because of advancement in medical science, people are living to be 70, 80, 90, 100. There’s nothing that is illness based that doesn’t fit into this. I’m having trouble understanding how somebody suffering, literally suffering from mental illness, that can just be, hey, this is part of it, you’ve got to let that person go. Because people are dying from this.

Lisa: But who are you to decide? Why do you get to decide who’s suffering and who’s not? It is not a coincidence that many of the prominent members of the anti psychiatry movement, and I should point out for clarity here, that they usually don’t use that particular term. But most members of the anti psychiatry movement are themselves people who have been diagnosed with psychiatric illnesses and have had really bad experiences. These are people who have been wronged by psychiatry.

Gabe: Lisa, you made a good point. While they’re often referred to as anti psychiatry, that’s not what they call themselves. What name do they give to their movement?

Lisa: Well, they use a lot of different names, but the one that you hear a lot is psychiatric survivor, or they’ll call themselves advocates who are against the medical model of mental illness.

Gabe: I agree that we have some serious problems with the medical model. We have some serious problems with how medication is prescribed and how mental illness is diagnosed. But they go all the way to the extreme, right? All the way to the extreme. It’s all bullshit. All psychiatrists fired. That’s their general stance. Correct?

Lisa: Sometimes, but I don’t think it serves anyone to just dismiss them outright as being this fringe group. I was about to say lunatic group. Hah, irony. But I don’t think it serves us to just dismiss everything they’re saying outright. They have a lot of really valid points. I will agree that many take it too far, but I’m totally on board with a lot of what they’re saying.

Gabe: That’s very interesting to me. First and foremost, when we did our research, we did prominent groups, groups with hundreds of thousands of followers. Huge web sites that get millions of hits. People who have written New York Times best sellers on the subject of anti psychiatry. This is, we’re not doing some mean thing, where we found some weirdo that lives in his parents’ basement and tweets about how this is stupid. And we’re not trying to hold up any group as the spokesperson for it all. But whenever you see hundreds of thousands of people following a movement, you can’t ignore the movement. I am surprised that you seem to believe that they have more positives than negatives, because that seems to be what you’re saying. I’m just. Anybody can have a point. A stopped clock is right twice a day. But you seem to think it’s more even. You seem to think these people are running like fifty-fifty, whereas I see them as a dangerous fringe group that are convincing people who need care to not get the care. Which raises the rate of suicide. Why do you look at them so sympathetically instead of seeing them as dangerous?

Lisa: I just think they have a lot of really valid points that concern me and that I myself struggled with quite a lot when I first started taking antidepressants, when I first started getting psychiatric care. And they may take it too far, but the main base premise is correct. We have over pathologized mental illness, and it’s hurting people.

Gabe: But I don’t think that’s their base premise. I think that’s how they create trauma bonding and gaslighting. I think that what they’re saying is, OK, what we want you to do is steal this guy’s car. Now, if we walk up to you and say, hey, will you steal his car? You’re gonna say, no, I’m not a car thief. That’s not gonna happen. So we start out very reasonably. Hey, man, do you own a car? No, I can’t afford a car. You know that guy? He’s got a $100,000 car. Can you believe that? Oh, that is a lot of car. Yeah. You know, I heard him the other day talk about how he dislikes people like you. Just look how he walks. Look at that strut. Yeah. That does annoy me. And before you know it, we all hate Carol Baskin. And why do we hate Carol Baskin? Because Carol Baskin was portrayed as an unsympathetic, elitist character in Tiger King. But in actuality, she’s committed no crimes and she’s done nothing wrong. And we should all have no reason to dislike her. I know I jumped my analogy there, so maybe I should start over. But no, I’m not starting over. I’m owning it. I could not get you to steal my neighbor’s car with one question, but if I set it up that my neighbor hated you, was hurting you and was injuring you and was mean and I convinced you and stroked you and taught you and brainwashed you into hating my neighbor, I bet I could get you to steal his car then. And you wouldn’t know why you’re doing it. But my base premise isn’t that I have a point. My neighbor is an elitist asshole because, you know, hey, maybe my neighbor is an elitist asshole. That’s not my point. My mission is stealing rich people’s cars are OK. Their mission is that psychiatry is bad and should be removed. All of these points that you’re bringing up are just the way that they convince people to join their cause. It’s disingenuous at best.

Lisa: What points that I’m bringing up? So far, all you’ve said is that you don’t like this your idea of their theoretical end goal. You haven’t discussed their points at all.

Gabe: I know a lot about their movement that I forgot that the audience probably doesn’t know. Lisa, let’s start talking about their points.

Lisa: Ok.

Gabe: And I’ll tell you why they’re wrong. I guess we’re doing that thing where you know who the killer is at the beginning of the movie. And then it goes flashback seven days ago and it goes all the way through the movie until it catches up to real time. I am not a fan of the anti psychiatry movement. We have figured that out. Now, back one week.

Lisa: The base premise being that all psychiatric diagnoses and therefore all psychiatric treatment is based on a subjective judgment. There isn’t any objective test that we can do here, and therefore there’s just no way to not bring in bias. Cultural bias, personal bias, and that can be extremely harmful.

Gabe: I completely agree with that, but I would like to point out, what we need to do is come up with a definitive medical test. The only way that we can come up with a medical test is to continue researching it, meaning psychiatry needs to advance. Which means that psychiatry needs to exist. So their base premise of being anti psychiatry and wanting to end it all and just accept this as the natural progression will never allow us to remove that bias or have a definitive test because they want it to go away, which means whatever we have today is all we will have forever. They want all psychiatrists to lose their license, be defunded and all medical terminology to go away surrounding this. They want all psychiatric facilities closed. They want all psychiatric medications taken off the market. You know, this is in their charter. The groups that we are talking about, you know damn well that they are not moderate. 

Lisa: Ok, slow your roll. I think you’re painting a very large group with much too broad of a brush. And you keep saying they want, they want, they want. We don’t know all the theys. I don’t think that’s fair. And again, how do you address the base point? This is about pathologizing normal human behaviors. How do you get around that? How do you get around the idea of subjective diagnoses, that are used to do stuff, turns out bad?

Gabe: Because I don’t consider hearing voices, seeing things, thinking that demons are under your bed, carving on your own body and essentially killing yourself as normal human behaviors. And those are all covered by psychiatry.

Lisa: Well, but so are a whole bunch of other behaviors. What about things like, you know, reactive attachment disorder or oppositional defiant disorder? You’re going to straight to the things that most people would not argue are a problem and saying, look, these aren’t a problem.

Gabe: But that’s my point. They are arguing it.

Lisa: Well, what about all the other things that are clearly a problem? Why don’t you say anything about that?

Gabe: Because that’s not what they’re focused on.

Lisa: Again, I’ve already acknowledged that many of these folks are going too far, right? I believe that psychiatric illnesses are real. I myself take psychiatric medication. I believe it has saved my life. I believe psychiatry is real. But there are a lot of abuses and a lot of the stuff psychiatrists say is not based on anything. These are all about social norms. This doesn’t have any biological basis. And there’s not any science, at least not yet, backing a lot of this stuff. So why aren’t you talking about that?

Gabe: I am talking about that. I in Gabe Howard’s advocacy work and on this show, we talk about that a lot. I’ve been doing this for 15 years. I have testified in front of the General Assembly that the way that we diagnose, treat and give people access to care is wrong. And in none of those speeches, over one and a half decades, over 15 years, have you ever heard me advocate to end medical help for the treatment of mental illness? I have heard these groups do that. And I’m sorry, I can’t take their conclusions seriously. I just can’t. It’s like when you like an actor and you love the actor and you love their comedy or their movie, and then they do something that is racist or sexist or they commit a really bad crime. And you’re just like, I can’t like them anymore. And then somebody says to you, well, but you have to admit that he was a really good comedian. Look, I don’t have to admit that at all. What he did was so far gone and so bad, it spoiled the whole pot. That bad apple spoiled the whole barrel for me. Sure. Fine. Bill Cosby is hilarious. What do you want? He’s a great comedian, but I’m sorry, I can’t watch him anymore. And I don’t think that’s unreasonable.

Lisa: So you’re saying that you aren’t going to listen or pay attention to the valid abuses these people are pointing out because basically you just don’t like them? And you don’t like where they go?

Gabe: No, that’s not what I said at all.

Lisa: Then talk to me about those abuses and how you’re gonna go around on them.

Gabe: Those abuses are very real. And as I said, they are causes that I myself personally have drawn attention to and taken up. And I feel that I have extraordinarily good odds, in a mountain of a climb, of seeing actual progress because I’m advocating for change that people will actually do. They’re advocating for forget it. It’s all over. It doesn’t exist anymore. Fire all the doctors. There’s only so much listening that politicians are going to do. And when I say something reasonable and then I have a reasonable solution and then they say something reasonable and have an unreasonable solution, they have wasted the time that is available. They have sucked the air out of the room and for whatever reason, because they’re so extreme, the media pays more attention to them. Like you always say, nobody wants to hear reasonable stuff on the news. A man saw a problem, man fixed problem, problem gone. That never makes the news. Man saw problem. Man overreacted, punched neighbor, neighbor burnt down other neighbor’s house. Nobody knows what the problem is anymore. Neighborhood on fire. Great. That’s what’s gonna make the news every time.

Lisa: You seem to be very angry about this. Why are you focusing all your anger on these folks rather than on the abuses psychiatry has committed? These folks would not exist if not for the abuses they are discussing.

Gabe: You’re kind of doing that thing where you’re like, Gabe, why are you fighting this man? That other man was worse. 

Lisa: Right. Yes.

Gabe: The show topic is anti psychiatry. Why do you want me to talk about people that aren’t on the topic? Would you like me to bring up other people I’m mad at?

Lisa: I think the topic is anti psychiatry has valid points. Some of the abuses of psychiatry are horrifying and we are part of that problem because we are normalizing this idea that you can pathologize human behavior. The diagnosis of mental illness is often a proxy for the designation of social dissidents. People we don’t like or behavior that we don’t like, we define as mental illness. And there’s a bazillion examples. The most obvious one being homosexuality was a mental illness until 1973 because nobody liked gay people. Rather than saying, hey, we don’t like this, we don’t like this behavior, those people are terrible, it was easy to say, oh, no, they’re sick. And then you were able to use that to justify imprisoning and often torturing these people.

Gabe: Yeah, this is where it gets really tough. I mean, you are right. I mean, think about the 50s when any husband could put their wife

Lisa: Right.

Gabe: In a psychiatric hospital with just their signature. You didn’t need anything at all.

Lisa: Psychiatry allows us to bypass legal procedures to establish guilt or innocence and incarcerate people based on we don’t like them.

Gabe: Yeah.

Lisa: So it’s very, very disturbing. We have a thousand examples of this is always done with people who have unconventional religious beliefs or have different sexual practices or it’s used for racial bigotry. It’s just on and on and on.

Gabe: You are correct, and as much as it pains me, because I just, in a way, I just want to win the argument. Right? I think that they have gone too far. And that’s my base premise. And I’m having trouble moving off that point. But if Gabe Howard was alive in 1950, I would be very inclined to start this group. I would be very inclined to say tear it all down because of things like crib beds and ECT and

Lisa: Lobotomies.

Gabe: Lobotomies, there you go. There’s a big one. You and I did a thing once where we talked about what would happen to Gabe if he was diagnosed with bipolar disorder, manic depressive, in 1950? And the answer was, I would have been put in a salt ice water bath until I entered a coma and I probably never would have left the psychiatric hospital ever again. The abuses of the psychiatric system are well-documented.

Lisa: So what you’re saying is, oh, no, all these abuses are in the past. We don’t do stuff like that anymore. Everything is good and happiness and rainbows. We should not be so arrogant to think that there’s not abuses going on right now. You don’t think in a hundred years we’re gonna be looking back on this and saying, oh, my God. Can you believe they did this?

Gabe: I’m not saying that at all. I’m saying that their base premise of we should just end it all and just let nature take its course is ridiculous. And I cannot get behind it. And I just I think that I’d be dead. And you’re asking where my emotion comes from? Death. I would be dead. You would be doing a podcast with my mom and dad who would be talking about how they didn’t know and how they wish that there was something they could do. And these anti psychiatry groups would be like, well, it’s OK that he’s dead because after all, he just couldn’t handle his illness. And that means he had to die because of what? Natural selection?

Lisa: You’re doing that thing where like, well, we never wore seat belts and we were all fine. Yeah, but the kids who died didn’t come to school. So you forgot about them. So what about all the people who died from the ECT or the induced comas or the lobotomies? So whatever the equivalent of that is, right now, those people aren’t here to tell us about it.

Gabe: This is very fair, but is the way to honor their memory, honestly, to let people like me die as well? Is that what we have to do? They died because of the abuse and now I die because I can’t get care? And suddenly it’s fair?

Lisa: I think part of the goal is that this is about giving individual people more autonomy. This is about letting individuals decide for themselves how they feel about this diagnosis and whether or not they want to undergo treatment. The reason they call themselves psychiatric survivors is not because one day they went and got themselves treatment and were like, oh, it turned out this wasn’t a good idea. No. These are people who were forced to do things to their detriment. You go to psychiatric hospitals, there’s an awful lot of people in there who don’t want to be there and have been forced there by the courts.

Gabe: As you know, I’m a moderate in this movement, and if this is the first time you’ve ever come across Gabe Howard or listened to me, you’re probably having trouble believing it right now. But I really do edge way closer to the middle than the average mental health advocate. I try to see all sides. I give people forums on our show, in blogs, everywhere, whom I disagree with. All the time. Being a moderate means that both sides hate you. And there’s been some very high profile advocacy points that have really dropped me out of mainstream advocacy. Assisted outpatient treatment being one of them. This idea that you can just declare that somebody psychiatric care or be forced on medications, who has broken no laws or done anything wrong, because the families have decided that it’s in their best interest. Now, I’m not saying that there is never a case for forced treatment. I’m not saying that at all. I don’t want to open up that can of worms.

Gabe: But what I specifically disliked about assisted outpatient treatment is it was very clear how to get somebody into the treatment, but it wasn’t clear how to get somebody out. There was all of these rules about how you could force somebody to do things against their will. But there was like no safety net to protect them from this. And there was no clear way out. And finally, study after study after study on AOT shows that it just does not work. As soon as the courts drop out, these people go back to where they started. And we’ve wasted a whole bunch of money and time and resources. And this has made me very unpopular with a lot of national mainstream charities. So I would have thought that would have given me some cred over on the psychiatric survivor side. It didn’t. The very fact that I say that medication is necessary, this is a medical disease, kills all my credibility over there, which meant my only choice was to start a podcast with my ex wife. Lisa, you are my only friend.

Lisa: It has been surprising how much people do not like those who are in the middle. If you’re not with us, you’re against us and you have to be with us all the way. You are either at 100 or you’re at zero and there’s no room for anybody else. That has been very surprising. And it has made it difficult for you specifically to find your place in all this as a more moderate person with more moderate beliefs. When you say these people, when the court system drops out, they just go back, but they don’t just go back. This thing happened to them. So they’re not going back to even. They’re not going back to where they were before. They’re in a worse position than when they started. Thanks a lot.

Gabe: Yeah, it’s very traumatizing.

Lisa: And they call it assisted outpatient treatment. Why don’t they call it forced outpatient treatment? Because that’s what it really is.

Gabe: That’s very true.

Lisa: We have personally met people who’ve been forced into treatment. And like you said, there’s no way out. It’s remarkable that no one considered how incredibly problematic this was, because who do you think is going to be forced into treatment? Vulnerable people, poor people, racial minorities. Just basically everybody society doesn’t like. This is not something that happens to upper class white folk.

Gabe: Clearly, these groups have some points, but I’m still gonna go back to the a broken clock is right twice a day. And Lisa, I got to tell you, some of it is based on their blatant misinterpretation of facts. The things like when they talk about the suicide rates. Again, this is a prominent group with hundreds of thousands of followers led by a New York Times best seller. This is not a small group. I want to read a study that is posted on their Web site. I’m not going to read the whole thing. But what I am reading is directly from their Web site. And the headline is it Could psychiatric care be causing suicides? And they write from 2,429 suicides and 50,323 controls, the researchers found that taking psychiatric medications during the previous year made a person 5.8 times more likely to have killed themselves. If a person had made contact with a psychiatric outpatient clinic, they were 8.2 times more likely to have killed themselves. Visiting a psychiatric emergency room was linked to a 27.9 times greater likelihood of committing suicide. And if someone had actually been admitted to a psychiatric hospital, they were 44.3 times more likely to have committed suicide within the year. It’s important to pause on those numbers. In a world of suicide prevention statistics, they are truly staggering. What other risk factor is associated with people being 44 times more likely to kill themselves? And then they finish up by writing, so we are left to speculate what might be causing these striking numbers. End quote from their Web site. Lisa, I know you are a trained scientist. You are a trained physicist. I want you to explain to the audience how offensively awful this is and how them passing this off as a fact that should make people change the way we treat mental illness in America, and using this as the driver is dangerous.

Lisa: Ok, I’m going to have to give you that one. It is hard to ally myself with these folks and their conclusions when they say stuff like this, because that’s just crazy. Putting this out there as a reason for why you should avoid psychiatric care is dangerous, and it represents a fundamental lack of understanding of science and statistics. Correlation does not equal causation. OK, let’s change some of this. Let’s switch it around. Did you know that if you had a heart catheterization in the last year, you are 50 times more likely to die of a heart attack? If you had, if you visited a cardiologist in the last year, you are 10 times more likely to die of a heart attack. Conclusion, do not visit cardiologists. They will give you heart attacks. No, that’s ridiculous. It’s so mind blowing that anyone even said this, right? It’s just ugh. Obviously, people who are extremely sick and who are at risk of killing themselves get psychiatric care. No kidding. So, yeah, this is, in fact, very dangerous.

Gabe: The word bullshit is not big enough. This is the literal equivalent of me saying that I looked at fifty thousand people who went to the hospital in the last year. And you were much more likely to die if you had a hospital admission. Now, I’m talking physical health now. Because I don’t know, sick people go to hospitals. They don’t seem to understand this. And they’re offering this up as if it’s a fact or meaningful in some way. These are sick people who sought out psychiatric care. No shit that they’re at higher risk of dying from a disease they were diagnosed with. They wrote exactly this, we are left to speculate what might be causing these striking numbers. This tells me, as a reasonable person, that we cannot trust them for anything. Because they’re left to speculate?

Lisa: Right.

Gabe: There is no speculation here. You know how in court, if you perjure yourself in one area, it is reasonable for the judge and jury to assume that all of your testimony is false? It is reasonable to assume they are lying if they lie about another material fact. They have just said we are left to speculate what might be causing these striking numbers. They have zero understanding of science.

Lisa: Yes, yes.

Gabe: Why should I listen to anything they say?

Lisa: You have an extremely good point there. Yes. If this is the level of misunderstanding you’re putting out there. Yeah, I’m pretty sure you don’t really understand anything. So I don’t necessarily want to listen to anything you have to say. Yeah, it’s just ridiculously stupid. It’s painfully stupid. It’s sad. But it’s that, it’s sad. This represents a profound lack of understanding. And these people are using that to make their own decisions, possibly to their detriment. And there’s a lot of pain and trauma involved in this. So it really just, more than anything, just makes me so sad for them that no one has ever sat them down and explained it. 

Gabe: I’ve sat them down and explained it. You don’t think that I’ve ever written a follow up article to something that they’ve written? 

Lisa: Oh, ok.

Gabe: You don’t think that I’ve ever sent them an e-mail? We’re doing this podcast right now where I am now pointing this out. I am a prominent mental health advocate with over 15 years of experience. I am partnered with one of the largest mental health Web sites and psychology Web sites on the Internet that’s been doing this for 25 years. You don’t think it’s never been pointed out to them? They are unwilling to change.

Lisa: All right. Yeah, I’m going to have to give you that. Excellent point, Gabe. It does seem to be deliberate ignorance.

Gabe: We’ll be right back after these messages.

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Lisa: And we’re back, talking about the points raised by the anti psychiatry movement.

Gabe: Now, you know what sucks? We’ve been talking about this psychiatric survivor movement, the anti psychiatry movement, these prominent movements that are pointing out a lot of the abuses, the actual abuses that exist and the problems with the psychiatric system. And, of course, this is resting largely on people who in some way identify with having these mental illnesses. And these are the things that they would like to see. You realize that we have no choice but in a few weeks to do the same amount of research and the same amount of in-depth reporting on groups that are run by psychiatrists. I’m thinking of two national groups that advocate on the Senate floor for laws like forced treatment, assisted outpatient treatment, who are just as extreme on the other side. And I have the same amount of hostility towards them for basically strangling data and numbers to match their bullshit that. I just, I am so angry that there’s no place to turn for me.

Lisa: That’s an excellent point that you’ve just made. I think this might actually be influencing my own thinking about this. When you’re talking about these prominent groups that are run by psychiatrists, etc., these are people with privilege. These are people that society looks to. These are people with money. These are people that bad stuff hasn’t happened to. When you look at these folks on the other side, they are wrong. They are just as wrong. But it comes from a different place. I don’t know, like their souls are purer? They have come to this through trauma and abuse and sadness. So I guess I just have a lot more. I guess I just have a lot more sympathy for their position and I want to take them more seriously. But you’re right, that’s dumb. You’re wrong, you’re wrong.

Gabe: It’s so difficult in mental health advocacy, Lisa, because I am often up against mothers whose children have literally died by suicide. They’re gone. And as you know, in my family, I watched my grandmother bury two children. They were my aunts and I loved them so much. And the trauma that it caused my grandmother and my grandfather and my mother and my uncle and me. And I watch these parents testify, and I want to give them everything that they ask for to make their pain go away. But it’s not backed by any research, by any data, by any study. And it will not work. And time and time again, it has been proven not to work. But by the time I take the podium, nobody cares anymore because they are so emotionally connected to that mother’s story. To that father’s story.

Lisa: You’re right.

Gabe: And.

Lisa: You’re right. I’m falling down the same hole. You’re right.

Gabe: We can’t pass laws and we can’t make rules that affect just an entire nation of people living with mental illness based on the trauma of any group. Of any group, not family members, not doctors, not people living with mental illness, not mental health advocates, not anybody. We need to look at hard data and science. And neither group is doing it. One group trots out that they were abused by psychiatrists, which they absolutely were. And another group trots out that their loved ones died by suicide because they couldn’t get help. And they absolutely did. This is not the way to make public policy. And I’m the bad guy for pointing it out. And it’s so incredibly difficult. I want to hug them all. But facts matter. Facts matter. We only seem to think that emotion matters. As I am all emotional, and I want you to listen to my emotional plea. It’s ridiculous.

Lisa: I’m sorry. Are you OK?

Gabe: I don’t think that my life is going to get better when we just have a suffering contest to who has suffered more? Family members, society, the medical establishment, law enforcement or the people living with the illness? First off, I want to be unequivocally clear, the people who have suffered the most are the people with the illness. You think it’s hard to be around somebody with severe and persistent mental illness? Yeah, we don’t get a break. We don’t get a break ever. I guess at least doctors get to go home. Honestly, Lisa, I don’t know what I’m saying, but you asked why I am so angry at these groups? Because we didn’t pick poorly funded groups. We picked groups with resources and money and following. And these are large, large groups that should know better. And if they would get their shit together and advocate for something that would work, where would we be? In the meantime there’s no moderate group out there. They can’t get funding to save their life. You either get money from the people who hate pharmaceutical companies or you get money from the pharmaceutical companies. Nobody wants to fund the people that like both sides.

Lisa: Or that don’t like both sides.

Gabe: I don’t have a problem with pharmaceutical companies, except for the list of things that I have a problem with, but I don’t think they’re all evil. The anti pharmaceutical lobbyists will not fund me because I don’t think the pharmaceutical companies are all bad. Pharmaceutical companies don’t want to fund me because I point out that they’ve done stuff wrong and that the way that they talk about people with mental illness is often sketchy. So they don’t want to give me a ton of money. I’m not 100% on their side. So in the meantime, we have two warring factions and neither side has a solution. They suck all the air out of the room and people like me suffer. That’s it. Mental health in America.

Lisa: Wow, that is so depressing.

Gabe: Am I wrong? Convince me that I’m wrong

Lisa: No, no.

Gabe: And then hug me. Like, hug me a lot.

Lisa: You’re right. I am being swayed by these emotional arguments and these incredibly heartbreaking stories. And, yeah, I’ve sat next to you. To the woman whose son died by suicide. And on the one hand, like you said, you want to hug her. But on the other hand, I want to strangle her because you’re not helping. You’re making it worse. This is not a good way to memorialize your lost loved one. So, yeah, you’re right. I have sat there. I’ve been annoyed. I’ve been angry. And I’m falling into that same trap just on the other side. I did not think of it that way. And now I am super depressed. Yeah.

Gabe: Every single member of the psychiatric survivor community or the anti psychiatry movement, they are welcome at my table. They are welcome in my house. They are welcome to email me at show@PsychCentral.com and tell me what I got wrong. I have not cut off ties. I want us to work together. I just want us to get focused on someplace where we can affect change, like real change. And I’m sorry, but completely tearing down the medical model and pretending that mental illness does not exist, is not it. One of the things that I think that we could work on is really deciphering what mental illness is because a severe psychosis and schizophrenia and bipolar disorder and is called mental illness. You know, in the exact same way that being nervous on Mondays is. We’ve taken this everything is mental health too far. It would be the literal example is if we called everything physical health. Oh, you have a headache? You have physical health. Oh, you have terminal cancer? You have physical health. And those are the same thing. They’re not. And we need more words for what’s going on. And I think that’s part of the problem. And that’s why I just think that the whole thing is just like baloney. And I just, I want to eat an elephant. The whole thing is just like, super sad, right?

Lisa: Oh, my gosh, it’s so incredibly sad. Ugh. But the fact that psychiatric illness is socially constructed, there’s no definitive test, there’s no biological basis that we’ve discovered. These are culturally constructed based on what we think, based on the cultural narrative that we have in the moment. 

Gabe: I struggle when you say that mental illness is culturally constructed. 

Lisa: It is.

Gabe: I don’t think that a bunch of people sat around and said, all right, let’s decide that everybody that wants to kill themselves is mentally ill. I think that people saw this behavior and were scared of it and terrified by it. And they saw that the people who were exhibiting this behavior did not look pleased or happy or, of course, they did not look alive. They were dead. And they thought that does not look normal. And then they studied it and found out that, you know, boom, boom, boom, boom, boom. And that’s why Gabe Howard is allowed to live a good life right now. But then other things like, for example, one of the things that they’re arguing about right now is whether or not gaming disorder is a mental illness. 

Lisa: That’s a thing?  

Gabe: That’s where you like to play video games too much. It’s being discussed right now. And, of course, the debates that we always hear about, like attention deficit hyperactivity disorder. When do you have a rambunctious child and when do you have a sick child? Actually, I’m going to use this example, Lisa. When is Gabe manic and when is Gabe loud?

Lisa: Right.

Gabe: You and I talk about this all the time.

Lisa: And that is the problem on a much larger scale, on a societal scale that these people are talking about. When is this God, that guy’s annoying or that guy is different or that guy’s weird? And when is it that guy is psychiatrically ill? That guy is mentally ill and he needs to be in a hospital even if he doesn’t want to go. And these anti psychiatry people are saying, where are these lines? We have drawn the lines in the wrong place.

Gabe: And if that was their argument.

Lisa: I know.

Gabe: First off, we know where the lines are. Interferes with the activities of daily living for more than two weeks. That’s the line. Now, that’s vague and it has all kinds of problems. But just because you don’t like the line or you think that the line is incomplete. This is why these groups frustrate me. There’s no line, they just make it up. That’s not true. There’s literally a book. You want to know where the line is? Read the DSM five. It’s written in the book.

Lisa: Well, but you realize the obvious example. I don’t mean to drive it into the ground, but homosexuality. It’s the perfect example for all the abuses of psychiatry.

Gabe: It is. But it’s also an example that’s old, that’s very old and that has been corrected.

Lisa: But again, that’s arrogance to think that, oh, those mistakes are all in the past. We aren’t doing anything like that today. No, we’re doing stuff like that today. We just don’t know yet.

Gabe: But I would like to point out that it happened decades ago and it was absolutely, unequivocally corrected and it wasn’t even like a pansy correction. Oh, we, no, it was like that was wrong. We were completely wrong. The part where husbands were allowed to lock up their wives. That was wrong. It was completely wrong. The literal abuses are

Lisa: Ok. But now we have mothers allowed to lock up their children. How is that any different?

Gabe: And that would be a good point to fight against. That would be a good thing to fight against. This is why I struggle, Lisa. Because you’re right. That would be a good part. But they don’t want to fight against it. They’re saying that because there is a disagreement in how to handle a situation, one group is evil and one group is the hero. And I hate that. I hate that. Why does it always have to be heroes versus villains? The anti psychiatry, psychiatric survivor group, they believe that they are the heroes and that everything that they want to do is correct, even though they say incredibly stupid shit and refuse to use any sort of science. Oh, what could possibly explain these higher numbers? I can think of a million explanations that you’re refusing to consider.

Lisa: You’re right. They are making the same logical fallacy that the other side of the argument is making. And that they are criticizing them for.

Gabe: It reminds me of couples that get in a fight where they’re both yelling, you never listen to me. And they’re both right. But, and you’re watching it from a distance because I don’t know, maybe they’re your parents. You grew up in that household. I don’t know. But you’re looking at them and you’re like, wow, Mom is not listening to Dad. Dad is not listening to Mom. Mom is very upset that she is not being heard. Dad is very upset that he is not being heard. They don’t realize it, but they are both completely and entirely right. And doing to the other what they are so offended by having done to them. Listen, if these groups find an advocacy point, they stick to the advocacy point, they stick to the facts, and they want to work together to change these things, I am on their side. But they don’t want me. They don’t want me because my end advocacy goal is to fix it. Their end advocacy goal is to burn it to the ground. And I think that having the ability to burn something to the ground and pretend that there’s no problem once it goes away is extraordinarily privileged and it will kill a lot of people, I believe far more people than it will save.

Lisa: Well, but they’re saying the opposite, that it’s killing far.

Gabe: But I have proof.

Lisa: No, you don’t.

Gabe: Yes, I do.

Lisa: No, you don’t.

Gabe: Yes, I do.

Lisa: You don’t have that proof. And neither do they.

Gabe: I feel that more people are helped by medical intervention for mental illness than are hurt by it.

Lisa: How do you know that? On what do you base this? Do you have stats or data or studies? What? Why do you say this?

Gabe: I’m going to use the stats by the National Institute of Mental Health, which, of course, they’re going to say is bullshit and you can’t count because they’re the government. I’m going to use stats by the APA, the American Psychological Association. But they’re going to say we can’t use them.

Lisa: But they don’t have them. What are you talking about? I’m willing to accept information from both of those groups. Show me this information of which you speak. They don’t have that data.

Gabe: What specific? How do you think the data is going to read, Lisa?

Lisa: Because it’s impossible to get in the first place. How are you going to decide that people have been helped by psychiatric intervention versus hurt by it? How are you ever going to decide that?

Gabe: Let me ask you this. If you saw somebody who is suffering from the effects or symptoms of bipolar disorder, would you say put them in your car and take them to the emergency room and have them committed?

Lisa: I did not have you committed. But yes.

Gabe: Oh, so you agree with me? You agree that the odds are greater that people would be helped by psychiatry than hurt by psychiatry. Or you never would have taken me to the hospital.

Lisa: But just because it worked out for you doesn’t mean it’s going to work out for everybody. And you’re also a white man. Do you think it’s going to work out the same way for everybody? That’s ridiculous.

Gabe: I don’t believe that they can prove it. I believe that I can prove it. But of course, here’s a problem. I don’t have any money. All right. I did not start an organization where I claimed to have proof of all of these abuses without actually offering up any proof. I want them to prove to me that more people are being hurt by psychiatry than helped. I understand that you’re saying that I can’t prove that more people are being helped. But I would like to point out that I have personally seen more people be helped.

Lisa: Well, that doesn’t mean anything.

Gabe: It doesn’t, but let me tell you what else I’ve seen. You are an odds player, Lisa. You have a scientific mind and you would not hesitate to take anybody to a psychiatric hospital. When you found me, I was symptomatic out of my mind.

Lisa: Right.

Gabe: You suspected that I was bipolar. You suspected that I was suicidal. Well, I. OK. You didn’t suspect, I told you that I was suicidal. And you did not hesitate to take me to the emergency room, by tricking me I might add. And then tricking me into signing myself in. It’s a semantic argument at this point whether or not I was committed against my will. You know damn well I didn’t know what I was signing.

Lisa: And I did it anyway.

Gabe: And you had no problem with that.

Lisa: That’s true. I had no problem with it, I still don’t.

Gabe: And you realize that the group that you’re defending thinks you’re the enemy. You literally tricked somebody into signing away their rights. They are no friend of yours. And you believe to this day that you did the right thing. And now be honest. Would you do it again?

Lisa: I absolutely would do it again. But you’re not considering that it isn’t just your situation out there.

Gabe: I am considering that. I’m considering there are abuses in everything. There is nothing in America, literally nothing that doesn’t. Everything’s the force. It has a light side and a dark side. So it does not surprise me that mental health and psychiatry would be the same way. You’re saying that it’s, that psychiatry in and of itself, the doctors, the system, the people working in it, are somehow malicious and evil and intentionally hurting people. So much so that they need to be stopped by outside forces. Whereas what I’m saying is that there are systemic issues that need to be worked on and advocated for. Because they’re underfunded, there’s not enough beds. We need more research. We need definitive testing.

Lisa: Where the hell do you get that that’s what I’m saying? That’s ridiculous. When did I ever say that? I personally get psychiatric care. Clearly, I believe it has value. I personally do it every day and pay money for it. But they do have some non-zero points. There are abuses out there. And just saying that, well, I’ve never had a problem, everybody I know is better off. That doesn’t mean anything. Everybody these people know isn’t better off. Plus, why did you go straight to people with bipolar disorder? Maybe everyone with bipolar disorder is better off? I don’t know. But maybe everybody with attention deficit disorder isn’t. Maybe they’re worse off. Maybe everybody with that gaming disorder thing you just talked about, maybe they’re worse off. We don’t know that.

Gabe: Because they specifically state anti psychiatry and mental illness, meaning they’re lumping everybody together.

Lisa: Exactly.

Gabe: Their point is the suicide rate is so high because of psychiatry. And they’re trying to prove that and offer it up as a point.

Lisa: Yeah, that’s dumb. There is no defense for that.

Gabe: This is not a point, and then you say to me, well, can you prove they’re wrong? I don’t have to prove a negative. It doesn’t work that way. They need to prove their point. They have not proven their point.

Lisa: They have definitely proven their point to me.

Gabe: No, they haven’t.

Lisa: Yeah, they have.

Gabe: They have not proven that more people are hurt by psychiatry than helped. They have not proven that.

Lisa: I don’t know that that’s their point.

Gabe: That is their point. That’s why they want to end it.

Lisa: They have multiple points. Why don’t we go with they have successfully proven to me that psychiatry has abuses and it’s very disturbing and it hurts vulnerable people.

Gabe: Yes, agreed.

Lisa: And it has the potential to hurt us, too.

Gabe: Agreed.

Lisa: And we as a society should really work on that, ’cause it’s creepy.

Gabe: I completely agree.

Lisa: And awful and horrible and depressing.

Gabe: I agree 100%.

Lisa: Ok. So there we go. So we’re agreeing.

Gabe: Well, yes, we are, and that’s part of their gaslighting until they get to the point where they asked me to steal the neighbor’s car and join the cult. Because they take it too far. They take reasonable points and they come up with unreasonable expectations and conclusions. You’re right, they do have reasonable points. Lisa, of course, they have reasonable points, but their solutions to those reasonable problems are so unreasonable that I have trouble looking them in the eyes when they talk. Once they came out and started promoting these conclusions and discouraging people from getting help when they are sick, I’m sorry. I don’t care that they made some good points. I feel that it’s kind of like a cult. You know, you’re walking by and a cult is like, hey, are you lonely? Do you lack purpose? You want volunteer gigs? All those things are very reasonable. I don’t want people to be lonely. I want people to have purpose. I think volunteerism is great. And that’s how the cult gets you in the door. And before you know it, they shave your head and they take all your money. And you’re just like, what? I just wanted to volunteer. They have some good points. Volunteerism is good. No, the cult is bad.

Lisa: You realize that comes back around to your point about the middle, because the other side isn’t offering anything either.

Gabe: I didn’t say they were, and I’m not on their side either. But you’re asking me why I’m not on the anti psychiatry side.

Lisa: But that’s the point. You’re in the middle. That’s how we tie it together. There is no middle. Where’s the middle? These people have good points. These people over here have good points also. Let’s all come to the middle.

Gabe: Do you feel that either side is making any attempt to come toward the middle?

Lisa: No, well. No, not really, no.

Gabe: I think the only way the sides are gonna come to the middle is if they stop looking at each other as the enemy. Both sides need to look at each other and say, you are not my enemy. We just have a disagreement. And both sides need to understand that disagreement does not equal disrespect. And then they need to start working together on the advocacy points that we all have in common, like actual abuses, specific examples, not examples from the 1950s. Not a book that was written wrong in 1980. Stuff that’s happening today. Not enough beds. The mental health safety net just being just ripped apart. Actual access to care where the person who is sick, one can participate in their own care and have reasonable guidelines for when they need to be treated against their will and how to escape that life. 

Lisa: That’s a fair point.

Gabe: Lisa, I appreciate you saying that you were taken in by emotion. I and any listener of, well, hell, this episode knows I’m an emotional guy and it’s easy to get sucked in. It’s just it’s incredibly easy to get sucked in. But this is not how we make national policy. And of course, they are very emotional about what has happened to them because of the abuses and mistakes of psychiatry. And they want to now make public policy based on that emotion. They don’t like that psychiatry isn’t using facts in their estimation, but they’re not using facts either. They’re just like we feel bad and we don’t want this done anymore. Two wrongs don’t make a right. And it is a shame, Lisa, because you’re right. Individual points here and there, I agree with. But I have to look at an organization based on their stated mission, their stated goals, and what they are encouraging people to do with their resources and their platform. I respect what they’ve gone through and I really do respect them as people. And, they are welcome to email us at show@PsychCentral.com and tell us why we’re wrong. But I’m sorry, as a platform, not only are they wrong, but I believe that their conclusions are ultimately dangerous and misguided. And that’s where I am.

Lisa: So, Gabe, do you think any of them will listen and send us that e-mail?

Gabe: I don’t know. They haven’t up until now, and I really have tried.

Lisa: Fair point. Good point.

Gabe: I do think that groups need to be diverse and they need to get people who disagree with them to join. I love to be surrounded by people who disagree with me. That is why I do a podcast with my ex-wife. 

Lisa: Aww.

Gabe: I mean, we don’t agree on nothing.

Lisa: Oh, you’re so sweet.

Gabe: I love how we don’t agree on nothing is like a term of endearment for us.

Lisa: Yeah. Aww. That’s why we’re divorced, dear.

Gabe: Listen up, everybody, I hope you enjoyed listening to the show. I hope that we made some good points and I hope that Lisa and I bickered just enough to be interesting. Check us out on PsychCentral.com‘s Facebook page. You can get over there by going to Facebook.com/PsychCentral. And of course, you can find Gabe and Lisa everywhere. The official Web site for the show, PsychCentral.com/NotCrazy. Subscribe on your favorite podcast player.

Lisa: And we’ll see everybody 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 show@psychcentral.com for details. 

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