Markham's Behavioral Health is moving to Substack. Join us there.

While Indonesia’s economic prospects seems promising, an essential factor of productivity needed to sustain growth is often overlooked: mental health.

How mental health affects the economy

People with moderate to high distress levels typically demonstrate reduced productivity and need higher levels of healthcare. This increases the societal economic burden.

The World Health Organization (WHO) found a 25% increase in the prevalence of anxiety and depression worldwide in 2020, the first year of the pandemic.

From the Public News Service

A bill in the New York state Legislature would implement new standards for Child Protective Services. The bill requires CPS workers to get a court order and inform parents and caregivers of their rights before searching homes.

The usual things that couples in their 40s and 50s are facing are:

Midlife crisis:  Many people experience a midlife crisis in their 40s, which can lead to feelings of uncertainty, anxiety, and depression. This can put a strain on relationships.

Empty nest syndrome: When children leave home, couples may experience a sense of loss and emptiness. This can lead to conflict and resentment.

Career changes: Many people make career changes in their 40s, which can add stress to relationships.

Health problems:  Health problems are more common in middle age, which can impact relationships.

People have a tendency to blame their partner or their relationship for their unhappiness rather than take responsibility for themselves. This stage of the marriage is what is sometimes called "the do your own thing stage of the marriage" because the individual needs to take responsibility for their own unhappiness and not expect other people to make them happy. They need to realize that they are not a victim but an agent in creating a life of satisfaction and fulfillment. 

Finding a way to do one's own thing and yet still stay connected takes patience, persistence, negotiation, assertiveness, and compassion which are qualities not always easy to develop without coaching and support.

Being able to give one's partner the space to do their own thing without jealousy and withdrawal takes a high degree of security, curiosity, and self sufficiency. It is what the people who apply Bowen theory call the "differentiation of self", DOS.

Finding an experienced mature therapist who can help the couple navigate this transformation in their relationship can be a challenge. The best way to find such a person is to ask friends who have seen counselors themselves.

Integral Philosophy, developed by Ken Wilber, outlines a model of human development that includes multiple stages of psychosocial growth. These stages are often referred to as "Integral Stages" and include:

1. The Archaic Stage: This is the stage of early childhood, where the child's focus is primarily on survival and basic needs such as food, warmth, and safety.

2. The Magic Stage: This stage is characterized by a child's growing imagination and the development of magical thinking. Children at this stage may believe in imaginary creatures and may have difficulty distinguishing between fantasy and reality.

3. The Mythic Stage: This stage is marked by the development of a sense of identity and an awareness of social norms and values. People at this stage may be strongly influenced by traditional cultural and religious beliefs.

4. The Rational Stage: This stage is characterized by the development of critical thinking skills and a focus on logic and reason. People at this stage may value scientific inquiry and evidence-based decision making.

5. The Pluralistic Stage: At this stage, individuals become more open to multiple perspectives and worldviews. They may be more tolerant of diversity and may place a greater emphasis on personal growth and self-expression.

6. The Integral Stage: This stage represents the integration of all previous stages and the ability to see the world from multiple perspectives. People at this stage may be more empathetic and compassionate, and may seek to make a positive impact on the world.

It is important to note that these stages are not necessarily linear and that individuals may move back and forth between stages throughout their lives. Additionally, not everyone may reach the Integral Stage, as it represents a high level of psychosocial development that requires significant personal growth and introspection.

Most MAGA voters are at the Magic and Mythic stages of development.

Narrative therapy is a form of therapy that assumes that people are separate from their problems and that they have the ability to change their stories. It is a non-blaming, non-pathological approach that aims to empower people to become the experts in their own lives.

The main ideas of narrative therapy are:

Problems are separate from people.

People have the ability to change their stories.

Narrative therapy is a non-blaming, non-pathological approach.

Narrative therapy aims to empower people to become the experts in their own lives. Narrative therapy is based on the idea that people's lives are made up of stories. These stories can be positive or negative, and they can shape how people see themselves and the world around them. Narrative therapy helps people to identify the stories that they are telling themselves and to explore whether they are helpful or unhelpful. It also helps people to develop new stories that are more positive and empowering.

Narrative therapy is a collaborative approach, and the therapist works with the client to co-create a new story. The therapist does not offer advice or solutions, but rather helps the client to explore their own resources and to find their own solutions.

Narrative therapy has been shown to be effective in treating a variety of problems, including depression, anxiety, and substance abuse. It has also been shown to be helpful in improving relationships and increasing self-esteem.

The Narrative Therapy model as pioneered by Michael White and David Epston has been one of the maps I find helpful in serving people in psychotherapy.

There are parts of our selves that we hide because we are ashamed, we are fearful of exposure, and we are guilty and desire to avoid accountability. These motivations lead to estrangement not only from others but from our ego self which we put forward for other people to see. After a while we forget about the parts of ourselves which we have disowned but they have a way of leaking out from time to time much to our chagrin and horror.

In my psychotherapy sessions this is a common scenario:

Client describes the situation sometimes for 10, 15, 20 minutes.

I say, "What do you make of that?"

They say, "I don't know."

I say, "I know you don't think you know, because you have come here to talk about it to try to sort it out, but I think you do know."

There is a pause and then they tell me.

I think to myself, "You don't need a weatherman to know which way the wind blows."

 For Subterranean Homesick Blues by Bob Dylan Click here.

For more click here.

 Many studies show that talking to strangers is good for mental health and well being. Talking to strangers provides a sense of connection with others which is a skill in spiritual intelligence.

In psychotherapy self determination theory is an underlying understanding of what makes people tick. It helps the therapist and the client to understand what motivates the clients to engage in psychotherapy. Often the initial motivating factors are extrinsic, but as the client becomes engaged in the process hopefully the motivation becomes intrinsic.

 Cinema Therapy has a great video about movies about happy marriages.

This clip shows Julia Child sharing with her husband that she would like to find something to do that she loves. At first he tells her she should make hats, but then he asks, "What do you really like to do?" and she says, "Eat."

 The term "walking well" is often used to refer to individuals who do not have a serious mental health condition, but who seek mental health services for a variety of reasons such as stress, relationship issues, work-related problems, or personal growth. These individuals may be experiencing some distress or difficulty in their lives, but they are generally functioning well and able to carry out their daily activities.

Some people use the term "walking worried" or "worried well" to describe this population as well. The term "walking well" has been criticized by some mental health professionals because it can be seen as stigmatizing and dismissive of the real struggles that these individuals may be facing. It is important to remember that seeking mental health services is a sign of strength and self-awareness, and anyone who feels they could benefit from therapy should feel comfortable seeking it out regardless of their level of distress.

 "This Is Where I Leave You" is a 2014 American comedy-drama film directed by Shawn Levy and based on the novel of the same name by Jonathan Tropper.

The movie revolves around the Altman family, who reunite for their father's funeral and spend seven days sitting shiva (a Jewish mourning tradition) together in their childhood home. The family consists of four adult siblings: Judd (played by Jason Bateman), Wendy (played by Tina Fey), Paul (played by Corey Stoll), and Phillip (played by Adam Driver), as well as their mother Hillary (played by Jane Fonda).

During the seven-day shiva, old conflicts and secrets arise between family members as they deal with their grief and struggles in their personal lives. Judd, who has just discovered his wife is having an affair with his boss, is particularly struggling and is also dealing with the loss of his father. Wendy is dealing with her unhappy marriage and the stress of being a mother to two young children. Paul is struggling with the pressures of running his father's business, and Phillip is struggling with his own relationship issues.

Throughout the film, the characters confront their past, their relationships with each other, and the reality of their present lives. They all have to come to terms with their own issues and find a way to move forward, both as individuals and as a family.

The film is a poignant and often humorous exploration of family dynamics, grief, and the complexities of relationships. It features a talented ensemble cast, including some of the biggest names in comedy, and is both heartwarming and thought-provoking.

Families are messy and life is not easy. Grief in families sometimes leads to regression as family members revert back to old roles and rules whichl the key event, the death of a significant family member, throws the family system into disequilibrium which will eventually restabilize for better or worse after the loss.

What are the key losses in your family system over your life history and what have been the changes in family functioning since? Families can be reactive or they can be responsive to the loss. Reactivity often leads to a deterioration in functioning while responsiveness can contribute to enhanced functioning.

Families can reorganize as a new person steps in to play the leadership role or they can disorganize and die. The Altman family reorganizes in a positive way even with the significant changes that have occurred. They all eventually step forward to evolve their relationships to new and enhanced levels of functioning in spite of the multiple traumas.

For more click here.

This is Where I Leave You as of 03/11/23 is streaming on Netflix.