Laura Goorin: So, themyth that all neat freaks have OCD is a common one.
Most people who are clean just actually care about being clean, and that's totallydifferent than having OCD.
Also, there are no five stages of loss.
It's just a myth.
Narrator: That's Laura Goorin, one of three psychologistswe brought into our studios to debunk some of the mostcommon mental-health myths.
Goorin: So, the myth thatmost people with schizophrenia have multiple personalities, that was a very old waythat it was understood, and it's been proven to not be true.
So, with schizophrenia, it'snot another personality.
What it is, though, isa break with reality and a part of ourselves, maybe, for instance, that believes that someoneis out to get them.
OK, so that's a really commonone with schizophrenia.
So the myth that all “neatfreaks” have OCD is a common one.
It seems like it's almosta popular cultural thing that people say to eachother, “You have OCD, ” when somebody is, like, organizing their bag.
And, in reality, OCD itself, the illness has different components.
And one of the subsets is the keeping things organized and clean.
But it has to be at an obsessive level, where people are thinkingabout it all the time.
And so that itself is really uncommon.
Most people who are clean just actually care about being clean.
And that's totallydifferent than having OCD.
Jillian Stile: Bipolar disorderis not simply mood swings.
It's a very high elevationof maybe a positive mood and a very low, negative mood.
Everybody has mood swings.
But with bipolar disorder, it's not just that.
It's severe forms of elevatedmood or depressed mood, and they cycle through that.
And so sometimes it could be shown as symptoms of, like, a manic episode, might be somebody, like, hypersexuality or not sleeping at all and things like that.
It's not simply feeling good.
Goorin: This is a common myth, and I hear people throwthis one around a lot too.
Anxiety itself is thinking, thinking, thinking.
And just imagine yourself going into the worrythoughts of “what if.
” What if, what if thishappens, what if that happens.
And it's unremitting, and it goes on for hours for some people.
Sometimes it's more passing for others.
But being stressed out about something, as humans, we're wiredto handle stressors, and we've been dealing withan onslaught of stressors since the beginning of time.
You know, going towork, taking the subway, coming in contact withother people.
You know, that can be stressful.
Thatcan be stress-inducing.
Unless you have anactual, like, panic attack while you're taking the subway, that would be more of an anxiety reaction, whereas the stress of taking the subway is more stress-based.
Stile: You know, everybodyfeels anxious, let's say, before a presentation or before an exam.
But an anxiety disorder isthe extreme form of that where it becomes, you know, it interferes withsomebody's daily functioning.
Goorin: This is actuallya really important myth.
Sadness is an ephemeralreaction to something.
It's an emotion and, bydefinition, lasts a few seconds.
It can last, like, 10minutes, but on average, we have an emotion, it passes, and then we have another emotion.
The thing that tends to bring us from sadness to depression is rumination, which means thinking andthinking and thinking about the thing overand over and over again.
And that's how we then gofrom sadness to depression, but it's not an immediate thing.
We all have moments of sadness, and we just allow them and let them pass.
We tend to be OK.
But if we get caught upin getting ruminating and thinking about allthe reasons why we're sad, that's when we tend to go into depression.
So, to the myth that depressionis not a real illness, it is a real illness, and, in fact, it can beincredibly debilitating.
In order to classify as having depression, we have to have some kind ofa lethargic kind of behavior where we have trouble getting out of bed.
I mean, there are differentways of depression, but one of the primary ones has this, what they're calledneurovegetative symptoms, like, where we can'tsleep, where we can't eat.
There's also a kind ofdepression which is dysthymia, which has an anhedonia component into it, which means less pleasure inthings that we used to enjoy, which is another kind of depression.
And a lot of people will describe, like, “Oh, I used to love pottery, and now I can't even look at pots.
” You know? Like, somethingjust totally changes for them when they're deeply inthis state of depression.
Neil Altman: Talking about painful things that you've learned how to sort cover over can initially be more painful but in the interest of working out things that if not dealt with straightforwardly are gonna come back to bite them.
I'll say another thing about that is that sometimes patients wonder, “What's the therapist gonnafeel if I say thus and so?” Like, “Can the therapist handle the level of despairthat I sometimes feel?” And on those occasions, when the patient has thestrength to put it out there and see how the therapist responds, the fact that the therapist can handle it is a big step toward the patient then being able to handle it.
There are reasons, andthey may change over time.
But I think the thing thatI would want to debunk in that respect is the idea that there's a single reason.
So that if you handle that, then you're gonna be freed of that.
And there's not.
In most cases, there's not.
You've got to discover thereasons, in the plural, that you're depressed and whatyou can do something about.
And what you can't.
Stile: The myth thatonly women get depressed couldn't be further from the truth.
However, women are twice aslikely to experience depression.
So, the reason why oftentimes people think women have a higher rateof depression than men is because of maybe hormonal changes, life circumstances, and stress.
The other thing that I like to think about is that women might express their feelings in a different way than men do.
So, sometimes men might, youknow, act out behaviorally, whereas women might focus ontheir internal experience.
And so they might be more likely to see a therapist if that's the case.
Goorin: When peoplehave gone down the road of eventually decidingto go on medications for antidepressants, they don't change your personality; they change the symptoms of depression.
They can also work for anxiety.
So, typically, if you have just typical symptoms ofdepression and anxiety, we'll be given an antidepressant is what it's called, an SSRI.
And that will help usregulate the symptoms of our, just, up and down of moods.
And the way I describe it to people is it's like going back to your baseline you when it's the right medication.
But it doesn't change your personality.
Your personality, you're you.
So, in terms of the myththat we'll always be cured from depression by antidepressants, the research shows that themost effective thing right now for depression is actually therapy.
And then for people whoneed antidepressants, therapy and antidepressants together are another effective form.
And not everybody has to take it.
So even with people whoare taking antidepressants, it's important to still be in therapy.
Altman: The myth that badparenting causes mental illness I think is a trap.
Because parents are all too ready to take responsibility and to feel guilty about all sorts of problemsthat their children have.
So there's no point in reinforcing that and harming and damaging themental health of parents.
If you think that your parentscaused your mental illness, you're gonna end up endlesslycomplaining about your parent.
What can you do aboutthe way you were raised? You can do something aboutwhat it's left you with in the present.
Goorin: Around LGBT adults and youth, there's so many mythsassociated with mental health.
And a big part of it I think is, unfortunately, becausethe profession that I'm in had a really dirty historyalong these lines in the DSM, which is our DiagnosticStatistic Manual, until 1973, homosexuality was actuallylisted as a disorder.
And after a lot of pushback and studies and LGBTQ rights beingintegrated into theory, we realized that that was really outdated.
And since then, inDSM-3, it stopped being, unless somebody has specificanxiety related to being gay, then they're not diagnosed ever with a mental-health-relateddisorder associated with it.
The same is true forbeing trans, actually.
That it's only if somebodyhas what's called dysphoria, where they don't like their body, that they then have a diagnosis.
But just being trans in and of itself isn't a disorder anymore.
You know, to the question about what role mental health plays in theattacks of gun violence, unfortunately, that'sbeen a mischaracterization of people who have severe mental illness, is that they're more likely tocommit crimes and with guns.
It's not that people with mental illness are more likely to be aggressive.
It's the people who commit thesecrimes have access to guns, and they tend to be really self-loathing.
Like, that's kind of the primary thing that makes people have a lack of empathy.
That seems to be the things that make them be moreviolent and aggressive.
Those are better predictors than any type of a mental health disorder.
People talk about a wholetown, like, on the news, “A whole town wastraumatized by the shooting, ” for instance.
Right? And it doesn't work thatway, and that's actually one of the most commonmental-health disorders that I've seen mischaracterized in that particular way, is PTSD.
People seem to think that byvirtue of having the experience to a potentially traumatic event, that you'll have theseparticular realm of symptoms that include hypervigilance, there's impulsivity.
There's so many different realms of what comes up for people after trauma, and I've heard people say, you know, “Because I was traumatized, because I was there at9/11, ” for instance.
Well, a whole city was there, and we have really good numbers about the number of peoplewho ended up having PTSD, and they're actually really small.
When something like this happens, a major tragedy like agun shooting or a 9/11 or any other type of tragedy like that, people tend to be resilient.
There's a big myth, actually, even within the mental-health field saying that there are prototypical ways to respond to grief and loss.
And that's in pop culture as well, that people have these ideas that there's one way to grieve and if we're not devastatedand deeply traumatized that somehow we're in denial or unfeeling.
And that's not true.
In fact, since the beginning of time, we've been dealing with death.
We have different ways of dealing with it.
And sometimes we're relievedthat the person dies because we didn't have a verygood relationship with them.
Or even if the person, if we love them and we feel really connectedto them but they were sick, we're relieved that they're dead because we don't wantthem to suffer anymore.
People tend to feel really guilty about being relieved after a death, which is a very common reaction to death.
There are no five stagesof loss; it's just a myth.
And it's one of the mostpopular myths out there.
And it's one of those things where people who aren'tvery psychologically minded will come in and say, “Oh, my gosh, I must be inthe denial phase of loss, ” or, “I must be in this phase because I'm not dealing with it yet.
” In reality, I just thinkit's one of those things that makes us feel safe.
Like, if we can imaginethese stages are ahead of us, then we can feel betterabout where we are, and so I think that's why it's so popular.
However, I've seen the flip side, which is why it can be damaging, when people have losses andthey're judging themselves for not having thisprototypical series of stages, and they're not based onreality or evidence or anything.
OK, so, people are gonnahate me for saying this, but, and this is so common in the dating world.
Like, if you ever lookon people's profiles on dating profiles, they alwayssay, like, “I am an NYFB, ” or, I don't even know what they say.
But it's always about how they're these certain, you know, Myers-Briggs score.
And it's really popularthese days, Myers-Briggs.
And, in fact, a lot oforganizations use it and really base a lotof their testing on it.
Again, there's no validationaround any of these studies.
And so while it might resonate for people, and that is something that, you know, just like when we talk about, you know, “I'm a Gemini because I do this, ” you know, it resonates for you, the idea of being a Gemini, and you might act in ways that remind you of this description ofwhat it is to be a Gemini, but there are no empirical tests to say that you are such this thing.
There are personality tests, but Myers-Briggs isn't one of them.
Altman: The myth that therapy is gonna be exclusively about the past or predominantly about the past and not help you in your current life or not give you a form for talking about what'shappening today and yesterday, there's a reason why peoplehold on to that myth.
And the reason is that there was an earlyversion of psychoanalysis that held to the idea thatpeople's personalities were formed in their first five years and that the past was stronglyformative of the present.
It sometimes can be helpful to say that there was a patternthat was established in relation to people in the past.
And that can give you some perspective on what's happening in the present.
So making reference to the past is not necessarily a bad thing, but it should never bebecause this happened, therefore you're having this problem now.
It's not an explanation.
It's only a way of gettingperspective on the present.
Stile: I think oftentimespeople might say, “Oh, why not go speak with afriend who's a good friend, and they can keep things confidential?” But therapists are trainedto work in a particular way to help people deal withspecific problems they're facing.
Therapists are different than friends because even though yourfriends might be willing to, for example, hold a secret, therapists really treat things in a very confidential manner.
And they're willing to explore things that maybe a friend wouldbe uncomfortable exploring.
Altman: Actually, thefact is that most people who come to therapy areamong the stronger people.
And the reason is becausethey have the courage and the strength to look at themselves, which is not an easy thingto do in various ways.
I think it's because thepeople who come to me are people who've alreadydecided to work on themselves.
Good therapists don't force their patients to talk about something theydon't want to talk about.
To the contrary, I think that even encouraging a person to talk about something that they're not ready to talkabout is counterproductive.
The problem with hittingpain points right on the head is privacy, for one thing.
People are entitled to their privacy.
Therapy isn't just anopportunity to spill.
So I think having people's privacy, when their privacy is respected, that makes them more confidentto open up, actually.
But the other problem for that is that the therapist needs to be thinking that there's a limit tothe tolerance of everybody, including the therapist, for how much pain they cantolerate at any given time.
And so respect for people'sanxiety about getting into some of the more difficultthings in their lives is also part of the process.
Goorin: Psychiatrists are the only ones who are able in this countryto prescribe medication.
They do what's called apsychopharmacological consult, where they will go throughall of your history.
And that's somethingthey do if you want that.
And I say if you want that because it's really important.
As a psychologist, for instance, we always try therapy first.
It's the treatment ofpreference for all clinicians.
In fact, they've done all thesestudies that have shown that therapy first for several months before you then eventhink about a medication is the best course oftreatment for people.
Because that way you canreally see what is what.
And if you then stillwant to do medications, it's certainly somethingyou can talk about.
But you don't have to do medications.
It's up to you and your therapist if it feels like thatwould be beneficial to you.
Altman: I would not saythat most therapists consider that therapyhas to go on forever.
But I think when you'reinterviewing somebody and considering them to be your therapist, that's one thing to ask about.
How do you think about howlong this should go on, and when do you start to think that maybe it's time to end it? How do you break up with your therapist? Do not break up with your therapist in an email or a text or a phone message.
You've got to be direct.
You've got to say, “I've been thinking that maybeit's time for us to stop.
” But then that can't be the end of it.
If you haven't already said it, hopefully you have alreadysaid it in one way or another in the preceding sessions.
“What I've been looking for is this, and I see how it's beenhappening in my life.
” And maybe give an example or two.
But it's not like you feel you have to convince the therapist.
I want to be sure to let people know that there are lots of ways of getting good psychotherapyat a reduced fee.
So, there are institutes where people get advancedtraining beyond their doctorate.
And all those instituteshave training clinics where people are treated at a low fee.
And some people might thinkthat the higher the fee, the more skilled the practitioner, which is not necessarily the case.
But certainly in that case it's not true.