Creating Our Mental Health

Ann Green, PMHNPHugh Polk, MD
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Welcome to a conversation between two social therapists who meet regularly to share and advance our therapeutic work. We hope these dialogues can support and stimulate others who are integrating developmental conversations into their therapeutic practices and personal growth. See the first post in the series for a brief explanation of what social therapy is and the perspectives we’re coming from in our dialogues.

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Hugh: Ann, I’ve been leading a series of workshops having to do with issues of ‘mental health’ and ‘mental illness’ at UX, a community organization that offers free classes and workshops. We’ve titled this series “Creating Our Mental Health,” and I’ve been looking forward to talking with you about how it’s going… and what I’ve been learning and trying out.

Ann: Great! I’m so glad to see you volunteering and leading therapeutic workshops. It’s a great way to show, in practice, that we can build therapeutic environments and have therapeutic conversations outside the therapy office. How is that going?

Hugh: Well, as you know, there’s so much stigma attached to mental health issues that it’s really hard for people to talk about them openly, even with professionals, much less with friends or family. What makes it even harder is that so many people, particularly poor and working class people, have had bad experiences with helping professionals and the mental health system which is focused on testing, diagnosing, labeling and medicating them rather than empowering them to grow. I’ve been co-leading the workshops with Rachel Mickenberg, a licensed social worker and social therapist, and Jan Wootten, an East Side Institute faculty member. We wanted to create environments in which people can have new kinds of conversations that would help change their relationship to mental health — to help them come to see mental health not as something that happens to them but as something they can participate in creating. I’ve been moved at how open and honest people have been. They’re hungry for these kinds of dialogues.

Ann: Relating to people as active creators of their mental health, rather than suffering from a “mental illness,” is in-and-of-itself therapeutic. Not an easy task! It’s so ingrained in our culture and I struggle with it in my practice. People come into therapy wanting to fix their brains, their chemistry, their broken emotions. And that’s how they talk about themselves and how they talk with others. It’s hard to have people change their relationship to their mental health and how they talk about it.

Hugh: Yes, that’s exactly why Rachel and I came up with the idea of a three-session series of workshops that would bring together these two things that aren’t usually thought of as having much of a connection — creativity and mental health.

Ann: So what did that look like?

Hugh: Rachel and I started the series by calling attention to the weirdness of the title. We explained that we wanted to challenge the conventional assumption that mental health is a static condition or attribute — like having long legs or big ears — by suggesting that it’s more useful to think of it as an activity that people do together, rather than a thing that individuals have or don’t have. If we’re interested in growing, this distinction matters because we can change what we do — what we are, not so much. That started things off with a bang. The workshop participants were a very diverse bunch, ethnically and otherwise, which helped make for some rich conversations — including conversations about how we were talking.

Ann: “We can change what we do — what we are, not so much.” Hugh, that’s a pretty provocative statement! What do you mean?

Hugh: It’s like what you said earlier. People think there’s something wrong with them and that they have to get fixed, so they work on changing themselves. We help people focus on their activity — how they talk, how they respond, how they live their lives — because they can change their activity, and by doing so, they grow, develop and change.

Ann: Yes, that’s another complex therapeutic struggle. People often think they have to be fixed before they can change what they do. But as you say, and I agree, it’s the other way around.

Hugh: Yes. So in this workshop Rachel and I said that we wanted to explore different ways of talking. Often the way we talk can produce loneliness rather than an experience of being connected to others. At our first workshop we did a performance exercise called “Amazing Silence,” which we discovered in a wonderful book called Performance Breakthrough: a Radical Approach to Success at Work by Cathy Salit, the CEO of Performance of a Lifetime, which has several performance exercises that we found helpful.

Ann: How did the exercise go?

Hugh: We asked participants to pair up and face each other. The pairs were instructed to look directly into each other’s eyes for ten seconds. Then one person in each pair was asked to tell the other person something that was important or meaningful to them — something that they might not normally talk about — in just one or two sentences, while the two maintained direct eye contact. Before the other person responded, both were instructed to be silent for ten seconds, still looking into each other’s eyes. Then the second person was asked to respond to what the first had said without saying anything about what they themselves thought or felt about it, without identifying with it or criticizing it or changing the subject.

Ann: That sounds so uncomfortable, both looking into each other’s eyes and waiting ten seconds to respond. Did people say they felt awkward, looking into a stranger’s eyes?

Hugh: Yes, very. But everyone was willing to try, awkward and uncomfortable as it was. Rachel and I encouraged the listeners to let what the first person had said “wash over” them, to think about it, to be curious about it, to ask questions — and in doing so to get to know that other person. And again, before the first person responded, both were asked to sit silently as they continued to look into each other’s eyes. They did this, back and forth, for about three minutes. Then we had them reverse roles, the second person becoming the speaker and the first person the listener. And after that we all got back together as a group and talked about what they’d experienced.

Ann: What did they say?

Hugh: Several people said they found the experience “intense.” Some said they had felt vulnerable. A few were “nervous” while they were looking so intently into their partner’s eyes for what seemed a long time. Others agreed that it had made them nervous but had also helped them feel closer to the other person. One woman said it made her realize how “speedy” conversations normally are, and that she loved the experience of slowing things down… it helped her to hear what the other person was saying. A woman who described herself as “shy” said she hardly ever talks about herself, but this exercise had forced her to do so — and she found that she enjoyed it.

Ann: How did you feel, leading this exercise? Certainly not in the repertoire of psychiatric practice.

Hugh: You know, it felt really good to break out of my role and do something playful with people — so it was therapeutic for me too. I love doing these workshops. Rachel and I spent the next two sessions with participants examining what we did and how we did it. “Do try this at home” was our prescription.

Ann: Do you have a plan for expanding and growing “Creating Our Mental Health?”

Hugh: We’re reaching out to everyone who attended to ask for their help in bringing these workshops into their faith communities, their senior centers, their neighborhood clinics — anywhere and everywhere that they can. We believe that ordinary people can lead these kinds of conversations and we want to train people to lead these workshops in their communities.

9 COMMENTS

  1. As someone who has studied and practiced Neuro Linguistic Programming (NLP = how language programs the mind) the idea that we create our own mental wellbeing is well established. NLP provides techniques for doing so based on the principles of neuroplasticity. We can understand how the brain perceives and codes information and we can learn to manage that practically with specific outcomes in mind.

    The core techniques are really simple – in essence, by asking yourself different questions you prompt the brain to create new pathways. Doing so deliberately quickly becomes a habit. By focusing on what you can change or engineer/create, you can easily change your relationship with self to create better experiences and with the world to create better outcomes. And vice versa – achieving better outcomes reinforces a better relationship with the world through our social reward systems.

    You will notice I didn’t mention illness once – NLP is a wellness model that works for everybody.

    To create new experiences, you simply find a point in an unhealthy routine, program or experience that you can easily spot to create a point at which you interrupt it – a point from which you ask yourself “How can I change my response? What is it that I am trying to achieve?” This brings a ‘program’ or habitual response into the mind in an aware way to prompt you to replace it with a more deliberate choice. Interrupt/replace is a very simple and powerful technique for creating new experiences.

    Similarly, in thinking about what we are trying to achieve (which usually is something we do with others), it helps to spend a little time defining what it is we are trying to achieve by asking the basic sensory questions – “What will it look, feel and sound like?” And the reward or appreciation questions – “What will it do for me and others?” This clarifies what it is that we are trying to achieve, IN THE BRAIN, placing information that becomes a part of positive pathways. Then ask “What do I need to have in place?” to clarify the conditions for success and “What do I need to do to…?” to get the brain working on identifying actions to get there.

    There is your short course in NLP – those two techniques can make a huge difference. Doing so quite literally creates pathways in the brain that shape and create the futures and experiences that you desire.

    We are of course social mammals and we crave social reward or appreciation. We create more interesting experiences and outcomes with others and rewards are therefore most powerful when the appreciation is from and with others (shared appreciation) – which is where social therapy obviously has a great strength in connecting healing and reward/appreciation systems in the brain.

    Hope you are well Ann and Hugh, I am missing our interactions on the wellness scene in NYC.

    • Shifting neural pathways is a matter of changing core beliefs and habits of thinking, aka deprogamming from double binding illusions and social progams, in order to experience our authentic truth, the truth of our heart and spirit. When we attune to that which makes us feel good and hopeful, rather than constantly dwelling on the shadow of life, then we are creating better feeling thoughts and beliefs which are not limiting, but instead, which honor our ability to self-heal and to embody our unlimited creativity. From this, our reality improves a great deal and we are in control of our experience, owning our power. That’s joyous freedom.

    • Thank you, Greg, for sharing NLP with us. The advances in the understanding of neuroplasticity are very exciting. I was struck by your statement in your last paragraph that “We are, of course, social mammals…” Yes, and thus neural programming is as social as everything else we humans do. Often people think of the brain as “inside” our heads as opposed to the world which is “outside” our heads. But there is no separation. Our heads and all that goes on in them are in the world. The beauty of that is that we can, with other people, choose how we perform our lives. We can collectively change how we live. Best regards, and I hope we meet soon again!

  2. Mental health is just a one point on the psychological map. If we want to forget about the important role of the rest of the psyche (pathology), we create apollonian ego (mental health) fundamentalism or maybe some kind of spiritual naive utopia ruled by theology. Because we also confuse theology with psychology.

    Without the real image of the psyche,we will have only pseudo scientific BS.

    We are not able to see the importance and the mechanism of human body or anything else, if we are talking about one finger all the time. This is psychiatry +theological hatred.Because this finger belongs to …satan.

    Without phenomenology of the psyche, we will have theological condemnation (psychiatry) and materialistic (apollonian ego fixation) hatred. We do not deserve it. People deserve to have more important role than being a religious or psychiatric slaves. Psychiatry is materialism. Psychiatric nominalism is capitalism.

    And Hillman writes about it, no one else ever did it. And we should be thankful for people like Hillman.
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    Because James Hillman has taught us how to think, not what to think.
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    Monotheistic culture have taught us how to condemn and hate each other.
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    Without real image of the psyche we will remain blind. We will remain abandoned, like children in the fog.
    Psyche is not a science, it is phenomenology. And we must notice the important role of pathology.This is the first step to homo psychologicus era. The important role of psychological pathology.

    And this is the antichrist. We are.People with psychological awarness. Church does not like psyche very much. XD

    O, and that “growth” model everywhere, we are not cabbage or mushrooms. Cancer is also a mode of growth.

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    https://www.thesunmagazine.org/issues/487/em-from-em-br-we-ve-had-a-hundred-years-of-psychotherapy-and-the-world-s-getting-worse
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  3. Hi Hugh and Ann,

    In public school teaching, we talk about wait time–letting kids think about questions before we expect them to respond, to the teacher, the whole class, or each other. Wait time is certainly not something we’re socialized to have in conversations with our friends, family, other loved ones, and, most noticeably to me, in the public sphere, especially at work.

    Your exercise sounds intense. As a member of one of Hugh’s Social Therapy groups, I wonder if that exercise is something we should try. I find it frustrating in our group when members don’t think about what is being discussed, but instead, respond with a story or just by passing on someone else’s words. It is as if the need to talk is stronger than the need to listen, to get close, to understand, or engage in a dialogue. I understand that. Some of us, myself included, have grown up responding immediately to people, as if response is a biological need, like breathing. If our therapeutic conversations were less about telling and more about engaged discussion, the learning might increase. I know this is not easy. I think people, again, myself included, come to therapy to talk, to talk about their lives, what troubles them. Talking, though, is not enough, or, ultimately, not as satisfying as discussing.

    What do you think?

    Garth

    • Garth,
      Thank you so much for your response. When you say, “people come to therapy to talk, to talk about their lives, what troubles them. Talking is not enough…” Yes, and that’s what people do in ordinary conversation everywhere. Endless hours are given to us learning to talk, to express ourselves, to talk “right.” Virtually no thought or attention, in school nor anywhere else, is paid to learning to LISTEN AND RESPOND TO THE OTHER. I think if we’re going to change the world, we need to help each other learn how, as you say, to have “engaged discussion…to listen, to get close, to understand, engage in a dialogue.” Let’s continue to work on this together.