The Shame in Mental Illness

DSM5My recent posts got me to thinking about the term mental illness and how stigma-laden it remains to this day. As a society, we've come a long way from the bad old days when most people were too ashamed to admit going to a psychiatrist, when families kept those members with obvious psychological problems hidden from view. Back then, a moralistic aura surrounded mental illness, as if having one implied that you (as well as your family) were morally defective and therefore to blame for your emotional difficulties. This view of mental illness still prevails on the religious right -- as in the claim that homosexuality is a "lifestyle choice," for example, and that gays are obviously making the "wrong" one.

In society at large, the easing of stigma has a lot to do with the marketing of psychiatric medication to address "chemical imbalances" over the last few decades. Nowadays, you don't suffer from mental illness, you have a mood disorder, a result of faulty brain chemistry rather than a moral defect and of course, not your fault. While I strongly object to the widespread overuse of anti-depressants, I do believe that removing the shameful stigma surrounding depression and manic-depressive illness has been a good thing. It's difficult enough to struggle through depression without feeling you're a bad person to boot for being "abnormal."

Continue "The Shame in Mental Illness"

On Success and Having Arrived

Success
During a session on Thursday, one of my clients was talking about his feeling that he had "arrived" in his profession. In his mid-30s, he's well-established now in a competitive field, earning an excellent income and finding himself respected and sought-after as an expert. As I listened to him, I recognized that I had never felt that way, not fully. By just about any standard, I'm successful, leading a comfortable life; I'm valued by my clients and respected by my peers. I've written and self-published a book on psychological defense mechanisms that has sold far better than I expected. But I have not felt that I've truly arrived, not yet.

Arrival, to me, has always meant being accepted by the New York publishing world as a serious writer. As much as I love my work as a therapist, I've always thought of myself as a writer, first and foremost. For me, arrival would mean finding a first-rate literary agent and then securing a book contract with one of the Big Six. This is my definition of success and I've been trying very hard for a long time to achieve it. Despite what I wrote in my post about precocity and impatience, around the time I sold Why Do I Do That?, my contract with New Harbinger Publications didn't really give me that feeling of having arrived, not fully. New Harbinger is a small specialty house based in Oakland, California. And then, I had such an unhappy experience working with their editorial team, who tried to shove me into the cognitive-behavioral box, whatever satisfaction I felt didn't last.

I've mentioned here on the site that I've been working on a book about narcissism for a while now. In October, I sent my proposal out to A-list literary agents and actually got to choose between several very good ones who wanted to represent me. Together, my superb new agent Gillian MacKenzie and I worked hard to craft my first draft into the strongest proposal we could devise. I had some excellent and crucial assistance from my friend Emily Heckman, a freelance editor. As always, I had the weekly support and critical feedback of my writer's group: Laurel Goldman, Angela Davis-Gardner, Peter Filene, Christina Askounis and Peggy Payne. Earlier this month, Gillian finally sent out my book proposal to New York publishers. There was a lot of interest. Bids were due by noon yesterday -- the day following the session with my client who felt he had at last arrived. I wanted so much to feel the same way.

Continue "On Success and Having Arrived"

On Pessimism

Pessimism I haven't been posting much lately because I've been focused on my book about narcissism, plus I just completed another article for The Atlantic, which you can find here. It's about bullying as a kind of narcissistic behavior, linking the Richie Incognito story with the suicide of Rebecca Sedgwick and further thoughts on Lance Armstrong. Anyway, I've now emerged from my research-and-proposal-writing cocoon; it feels good returning to the "outside" world!

So in my practice, I've lately been thinking about pessimism as a character trait. Selena, the client I described in my post about the importance of joy in psychotherapy, tends to be very pessimistic about her future. She believes that she blew her opportunity to launch a career right after college and that nobody will want to hire her now because newly-minted college graduates will be applying for the same positions. Not long after she graduated, Selena was fired from a job that didn't particularly suit her, and she found the experience painfully humiliating. Most of us would feel the same way, but Selena has had a hard time recovering and moving on. She feels that getting fired has "tainted" her. Pessimism about her future keeps her immobilized.

Continue "On Pessimism"

Another Everyday Narcissist — Me

Painful WristA number of site visitors took issue with one of my recent posts, largely because of the way I used the word narcissist. Most people use it as a synonym for Narcissistic Personality Disorder, so it's understandable that those visitors heard me calling Ellen a bad name. But I use narcissistic in a descriptive sense to cover a wide range of behaviors, not all of them pathological; an Everyday Narcissist such as Ellen is in no way the same thing as a person who suffers from NPD.

In order to make this distinction clear, I'm going to describe another Everyday Narcisisist -- me. Shortly after my return to North Carolina, I went for my first piano lesson after the long summer break. I've been studying with my teacher Pei Fen for more than four years; my oldest son William studied with her for two years before that, so I've known her for six or seven years now. She's a friend as well as my teacher. In addition to the playing and instruction that goes on during our lessons, we also catch up and talk about our personal lives. I had a lot to tell her about my time in Colorado.

Continue "Another Everyday Narcissist — Me"

The Everyday Narcissist Revisited

JumperDuring the first year or so after I launched this site, my post about narcissistic behavior and the lost art of conversation was always a reader favorite. One of mine, too. I thought of it this past weekend when we were dining at a restaurant here in Colorado to celebrate a friend's 60th birthday. Passing by our table, the hostess overheard mention of North Carolina. A Raleigh native, she stopped by a few minutes later to introduce herself. Here is what I learned about this woman during our conversation, all without the prompting of a single question. Let's call her Ellen, a quite attractive blond who recently turned 40.

Ellen had married as a freshman in college and gave birth to three children during each of the following years. She and her husband separated when the youngest was three and Ellen subsequently reared those three kids alone, without his emotional or financial support. During all that time, she vowed that once the youngest had left home, she would leave North Carolina and make an entirely new life for herself somewhere out west. Two years ago when the third child finally went off to college, she packed up and moved to Colorado in order to start anew. Now she works as a hostess in a tony restaurant and gives riding lessons during the day.

Continue "The Everyday Narcissist Revisited"