Therapeutic Conversations: A Shameless Future for Mental Health

"Mental health" needs a new narrative -- a fresh, contemporary point of view about our daily lives and challenges.
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You've read it a hundred times: Mental health is the biggest modern maladie. Every year it affects more than 40 million Americans, kills more people than motor car accidents, and is responsible for more than $100 billion in indirect costs.

Why? Because most of those who need help (whether diagnosed or not) never receive any. And why don't we go get help? Reduced to two words, the answer is shame and dollars. The blame lies mostly with the stigma associated with "mental health" and with its high cost. Camus claimed that, "He who despairs of the human condition is a coward, but he who has hope for it is a fool" -- so perhaps this is all just part of being human?

I think differently. I believe this is a case in which we can't solve a problem using the same thinking that created it in the first place. "Mental health" needs a new narrative -- a fresh, contemporary point of view about our daily lives and challenges.

1. Every one of us is potentially a "mental health patient." The most successful human field is the science of misery. We all have issues, problems that we don't like to admit, challenges that make us feel less perfect, successful, or attractive, and threatens our perceived survival. All of this is perfectly normal and in many cases easily addressable. However, it is when our daily issues are categorized and labeled as "mental health symptoms" that we generally prefer to greet them with wall-to-wall denial.

2. The cultural stigma of "mental health" threatens us more than the actual issue we're dealing with. We prefer to bare our pain alone than to be tagged as suffering from "mental issues." Our egos resist it and compel us to want to feel beautiful/smart/successful, and of course, always "happy." We will go to extreme lengths and consume every form of cultural, prescribed or recreational drugs rather than be labeled and/or admit to ourselves (let alone others) that we're not as perfect as we would like to think of ourselves.

3. Mental health is the biggest unmet need of our health care system. Driven by immense good will, professionalism and empathy, our caretakers are perpetuating the situation by treating "diseases" and "clinical disorders," which evoke our shame instead of providing us with simple solutions that help maintain a healthy emotional lifestyle to begin with. Much like the venerable 1999 "cluetrain manifesto," the basic disposition and the language of this entire field needs to be reversed to reflect our lives and not psychiatry textbooks. This will alleviate much of the resistance that is driven by stigma. Consider this: We resist being labelled "depressed," but we will acknowledge that "food is a struggle for us" or that "our relationship has lost its spark."

4. It's all about getting help early. Like many other health issues, when conflicts and issues are ignored and not addressed, with time they may become clinical disorders. Many of the people that end up taking their own lives suffer for years before they succumb to their pain and fear. If we could find a way to overcome their initial shame and help them early on some may never get there.

5. Psychotherapy is key but is currently a luxury product that must be democratized. Although psychotherapy has been proved to be highly effective, it is prohibitively expensive and inaccessible; paying $150 for a session is a huge entry barrier that must be disrupted. Imagine a session for $15. Online therapy sites are similarly expensive and in most cases fail to understand what is needed to build scalable digital platforms: recreating the same traditional therapy session online is the equivalent of Skyping your travel agent instead of using tripadvisor.

6. Some professionals are simply not of this generation. They use irrelevant, distancing language. Websites prompt us to click and admit that we suffer from "depression," "eating disorders," or "PTSD." I already feel bad. Some professionals are threatened by and disconnected from social media and can't authentically engage with our ever-changing lifestyles. They should embrace the digital age and acknowledge that it creates exciting new ways for building relationships and connections. That's why we spend so much time there.

7. The technological, connected world is indeed part of of the problem. Social technology is a key driver in the rise of small-screen narcissism and in helping to create and amplify unattainable, shame inducing false images of perfect looks and lifestyles. Not sure? Have a look at Facebook, where everyone is happy and has hundred of "friends," Linkedin, where everyone is a Steve Jobs, or Instagram, where we're all so beautiful. At least Twitter is honest with its pure, unfiltered self-centeredness.

8. The connected world is also a major part of the solution. Social platforms are conversations, and social media is all about communication and relationships: two fundamental pillars of emotional wellbeing. Participatory culture is predicated on sharing as its main currency and is therefore a great potential fit for multiple forms of support and mainly for psychotherapy.

9. Conversations are critical for our emotional wellbeing and are the missing link that can dramatically improve early-stage mental health care. Online conversations around daily topics will allow people to share and learn from each other and from experts. Conversations are constructive social experiences that are proven to be therapeutic and help people empower and be empowered by others.

10. Therapeutic conversations in groups are the future and will be key in solving many of the barriers mentioned here. Groups are essentially communities, and just like with group therapy, they create a sense of belonging, of continuity, of mutual support -- of the safety of not feeling alone with our problems. Groups also allow modern participatory platforms to reduce the cost of the expert by splitting it between multiple users, and allow synchronous and asynchronous access -- anytime and anywhere.

In the near future, when millions of us log on to social networks that converse in groups about substantial, emotional topics, traditional, "clinical" mental health care will be much less busy.

Like numerous other industries, mental health is now opening up to disruptive, network-effect-based ideas that will transform it forever. After all, emotional wellbeing doesn't have to be an "all or nothing" lab-coat approach -- sometime it's as simple as talking with someone who cares.

Isn't that a form of happiness?

For more on mental health, click here.

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

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