Moving Toward A Positive Psychiatry: The Zen Psychiatry Manifesto

There’s something wrong with the way we look at mental health these days.

Or rather, the problem is that we DON’T look at mental health, and instead focus on mental illness, trying to make people less “sick.” But rarely do we talk about making people “more well.”

In reality, most of us trying to make our way through the world aren’t sick, but we aren’t well, either. We’re burdened by fear, doubt or insecurity. We feel “off” – maybe slightly anxious or depressed (but not to the point of being “clinically diagnosed”) – and don’t know why.

Maybe we’re so busy running around doing all the things we’re supposed to that we don’t even realize something is wrong until we stop – maybe for a weekend off, a vacation, a trip, etc. – and in the silence and calm are flooded with an unsettled feeling that something in our life isn’t right.

I know this feeling because I’ve been there myself. I’ve felt that even though everything in my life looked good “on paper,” I wasn’t happy or satisfied. I’ve felt blocked from doing things I knew I should do, without understanding why. Sometimes I still feel this way!

I’ve discovered that the most meaningful change comes through not just effort, but insight. It’s not about putting your nose to the grindstone and forcing yourself to feel a certain way, but about learning about yourself, and through this process of self-discovery taking actions that align with your values.

Taking a positive perspective of psychiatry means that you:

1. Take responsibility for where you are

When I talk to someone who externalizes the cause of everything bad in their life to outside forces, I know positive changes won’t happen until they start to understand their own power to affect their life, in both positive and negative ways.

Sure, there are times when negative things happen that are outside of our control, but it’s more important to focus on the ways we can influence things. This means taking responsibility for the habits we’ve formed and feelings we’ve cultivated.

The power to reshape your life is in your hands – not in the hands of fate or any other person. You are the person who is responsible for changing your life.

2. Always learn about yourself

Before you can take meaningful action you need to have an honest view of your strengths and weaknesses. And this knowledge isn’t something you gain all at once, but something you seek out on a life-long basis. No matter how busy your life is you need to take time to reflect. And you need to be willing to see things about yourself that are both flattering and not so flattering.

By really knowing yourself, you can take the right kind of action to get where you want.

3. Take action to get where you want to be

I wish it were as simple as sitting around and introspecting until the answers come to you, but it’s not. You need to learn to take action and move forward, even when (especially when!) you are uncertain or afraid.

I know from my experience that excitement, motivation and joy all spring from these two key steps – reflecting and acting – taken again and again, one after the other.

When you learn to work through your fear, doubt, insecurity, anything is possible.

4. Cultivate wisdom and compassion

We can be really hard on ourselves. Our culture tends to emphasize values like achievement and monetary success over kindness. And when we think of kindness we mistakenly belive this means giving selflessly to others, whereas true compassion starts with how you treat yourself. In his book The Wise Heart, Buddhist psychologist Jack Kornfield writes (bolding mine):

“Compassion is not foolish. It doesn’t just go along with what others want so they don’t feel bad. There is a yes in compassion, and there is also a no, said with the some courage of heart. No to abuse, no to racism, no to violence, both personal and worldwide. This is said not out of hate but out of an unwavering care.”

With this type of compassion – wise compassion – you can develop an internal strength that allows you treat others in a compassionate way, without sacrificing your own needs.

5. Take care of your body as much as your mind

There is a powerful connection between the body and mind, so you can’t really take care of your mind without taking care of your body, too.

The opposite is true as well – sometimes psychological distress can manifest itself physically in the form of somatic complaints. You can see a bazillion primary care doctors and your physical pain will not go away until you address the psychological distress.

Taking care of your body means eating well, staying active, and using mind-altering substances in moderation (most things are okay in moderation). You can choose not to do these things (and I’ll be honest, I’m not always the best about keeping up healthy habits, especially with the demands of residency), but know that what goes in and out of your body can have a powerful effect on mood.

6. Use tools like medications and therapy wisely

We have a lot of powerful tools in psychiatry. We have therapeutic techniques like psychodynamic psychotherapy, cognitive behavioral therapy, dialectical behavioral therapy, etc. We also have medications such as antidepressants, antipsychotics and mood stabilizers. These are all extremely useful tools when used wisely – but it takes care to decide where and when they should be used.

I’ve noticed people tend to have extremely strong reactions to the use of medications in particular. Some people demand medications, thinking a pill will be the solution for their problem, while others want to avoid medications at all costs, saying they want to do things the “natural” way. On the more extreme end, some will vilify medications an inherently evil.

Like most things, the best approach is somewhere in the middle. I believe in using medications and will talk about them here, but they are only a part of the complex solutions that most people require.

7. Life is an adventure, so have fun with it!

Just in case I’ve started sounding to serious, I want to break things down to the most basic concept. Life is a gift, and our problems are rarely as serious as we think they are. If you take the perspective as life being an exciting journey rather than a destination you need to reach, you can see failures and mistakes in a greater context and as part of the path.

We’re on the brink of so many exciting discoveries in psychiatry these days.

In some ways the technology of psychiatry today is parallel to the field of surgery a hundred years ago – that is to say, operating without antibiotics, with ether for anesthesia, and with a limited understanding of the pathologies being cut out. In psychiatry we focus on symptoms because the underlying biological cause of many disorders is not fully understood.

But at the same time, the most important discoveries in the field of mental health are about to be made, or are happening right now. And the field is moving toward better integration of the both the scientific and spiritual side of the mind and brain. With these changes come exciting tools and strategies to make yourself healthier in mind, body and spirit.

At Zen Psychiatry I want to share with you these strategies for breaking through the barrier of mental mediocrity and having a more fulfilling, happy, and exciting life.

A positive view of psychiatry is about more than not being sick.

It’s about being well, taking care of your body and mind, cultivating the feelings and life you want to have and taking responsibility for where you are and where you want to be. It’s knowing that the power is inside you, not in the hands of anyone else, to reshape you life.

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Image by Esparta