Dear Therapist:

I am an avid reader of this column and have found it very informative. I think it is interesting that so many of the questions are focused on disorders. People are asking what to do when they are struggling with a mental health issue. In general, I find that people do not think of "mental health" until something goes wrong. I imagine that just as with physical health there are things one can do to stay in shape and keep healthy to prevent illness, there must be much that we can do to support and maintain our mental health in the first place. This could prevent people from developing mental health problems. I do not see nearly as much of an emphasis placed on this. I wonder if you agree and what your go-to recommendations for maintaining optimal mental health would be?

Response:

Your question is very thoughtful. Exercises that can help to maintain good mental health should be foremost in everyone’s mind. After all, likely every facet of our lives is in some way affected by our moods and abilities to deal with our struggles.

It would seem to make sense that there are preventative measures that can be taken to avoid mental health issues. However, because the human mind is the most complex organism ever identified, there are innumerable emotional issues that can crop up. For each of these, there are innumerable causes, triggers, insecurities, impulses, needs, and other factors that contribute to its ever-evolving existence. This is part of the reason that the topic of preventative mental health can be vague. Therefore, I will address a general concept that often affects our ability to deal with our issues in a preemptive manner.

A big part of the reason that we are problem-solution focused can be simply chalked up to human nature. When things are going well, we tend to take this for granted. We assume that positive emotions and coping skills are normal. We don’t recognize the fact that these are not a given, and that changes in circumstances (whether logistical, cognitive, emotional, or otherwise) may cause an emotional problem to erupt. This is the reason that many parents will praise a good grade on an exam for a minute or two, but spend hours discussing a poor grade.

Additionally, our minds often utilize a defense (sometime conscious and sometimes unconscious) that prevents us from acknowledging potential issues until they are forced to the surface. A typical and relatable example often occurs within the marital relationship. While things are okay, both spouses are reluctant to bring up potential issues (why rock the boat?). It is only once these issues are front-and-center that they absolutely need to be addressed. Unfortunately, this is usually the wrong time to discuss them, as both parties’ hackles are up and it is more difficult to appropriately discuss the problem.

It is easy for us to connect to the above example because the avoidance defense is often conscious. However, we use similar defenses within ourselves, often on an unconscious level. There are issues that are painful for us to address, so we avoid them. When this happens unconsciously, we are by definition unaware of the process through which we are avoiding conflict. Therefore, very often the problem from which our unconscious mind is “defending” us is not anywhere near as problematic as the unconscious mind “thinks.” Basically, the unconscious mind is overreacting.

When the unconscious mind overreacts in this way, two things occur over time. Firstly, the unconscious mind’s instinctive reaction (avoidance in this case) is constantly reinforced. This begins in the particular area being avoided, but can then easily transfer to other—even less troublesome—areas. Secondly, the unconscious mind essentially “convinces” the conscious mind that these feelings are appropriate. This typically leads to emotions that are not in sync with the circumstances.

If we can identify cues that let us know that we are avoiding thoughts related to potential issues, we can make the conscious effort necessary to confront these. In many cases, doing so helps us to quickly recognize that our instinctive fear of considering the problem was overblown. Then it becomes much easier to deal with the problem, both emotionally and logistically.

There are some general practices that can help to support and maintain positive mental health. I will divide them into three categories: physical, social, and self. The physical category includes proper diet, regular exercise, zero to moderate drinking, taking breaks from stress-inducing activities or situations, and doing something (like a hobby) that you enjoy. Socially speaking, it is important to connect with others, ask for help, and to have someone with whom you can discuss things that bother you. As far as “self” is concerned, working on true intrinsically-based self-esteem may be the most important thing that we can do for our general sense of wellbeing. In past issues, I have written about this concept.

-Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Woodmere, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 516-218-4200

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