Why is there a stigma around dealing with mental health? As Dr. Bira explains, when we break a limb no one is shocked by the need to get treatment, yet when we are dealing with mental health issues people aren't allowed to receive a similar sort of direct care... Dr. Lindsay Bira shares why she thinks the stigma exists and what she is doing to get rid of it.
This blog post covers part of my conversation with American clinical health psychologist, therapist and coach Dr. Lindsay Bira. This is the first part to our interview. Dr. Bira was a TEDx speaker in San Antonio and speaks often about health, mindfulness, the brain, and stress. She has been featured on public radio, Women's Health Magazine, and more media outlets for her work.
Zach: So let's start off with your TEDx talk The Counterintuitive Life, which was wonderful to watch. I think it's a very simple message, but a lot of people ignore it or don't want to hear it. Please tell us more about it, along with how and why you ended up on the TEDx stage?
I value the role of translating the science to the general public. I found myself, as a clinical psychologist, behind a door with one person, and the rest of the world seemed to have questions about the field of psychology as well as what people do in therapy.
I started to realize that people didn't know what I did. A common question was: “so you simply talk to them and they get better?” (if you want to know more about what therapy is like, click here). So, I thought, there's a big disconnect here. What I care about is helping people being the best versions of themselves, but I also recognized that due to misunderstanding of the process, there's a lot of stigma around talking about mental health issues or acknowledging certain struggles.
I discuss the brain and mental health in very concrete terms. If we hurt our elbow then we go get physical therapy or we get a cast or whatever is needed. You determine if the injury is bone, tendon, or muscle, and then you apply the appropriate treatment. Nobody looks at that sideways. When it comes to our brain, it's harder to measure what's going on inside of it, but we can measure the output, which is emotion, cognition and behavior. That’s how we, as mental health professionals, apply treatment and research supports this. Everybody has a brain that might begin to have issues. Therefore, appropriate treatment makes sense.
So I did the TEDx talk to help the public understand a little on how the brain functions and there are specific things that we can do to help it function better.
These techniques and exercises have been shown in extensive research to alleviate symptoms in brief periods of time, sometimes better than medication for certain issues. Cognitive behavioral therapy and mindfulness-based approaches are a couple of approaches that help people grow, make new connections in the brain and get better control over symptoms. I’ve found that mindfulness is an avenue by which I can access a lot of people. Since it is brain exercise anyone can do, in any setting, people are interested in learning about it, and I view it as the groundwork for more focused mental health treatment. Beginning to learn about the brain and how to help it takes away the stigma around mental health struggles. My TEDx talk came down to that: taking back control through going against your own brain grain
Any time we go against our own grain, we're exercising different pathways in the brain. One neuron has 15,000 connections to neurons around it. So if we’re helping cells fire differently, they are making new connections, and we're laying the ground for better behavior, healthier emotions, and more helpful ways of thinking -- they all connect.
That's why I've been doing the public speaking side of things: to help people understand, “What tricky thing is the brain doing? Why am I struggling?” I want people to peel off the thought “I am weak” and understand that it may be just a sneaky behavioral pattern that the brain started, which reinforces unwanted emotions. They can break that by doing things that are counterintuitive to give the brain feedback that may help that cycle stop."
Zach: And do you think the stigma exists in the first place largely because these are things that the average person can't really grasp with their senses? For example, if you have a broken elbow most people could see that and appreciate and sympathize with it. But if something is going on within us, that's harder for other people to appreciate.
Definitely it's more abstract. It's not as tangible, concrete, or easy to define. So part of my message is that I can't draw your blood and run an assay (a test done in labs) to tell you what's wrong, but I can measure your behaviors. I can look at behavioral patterns and how you're thinking, as well as what emotion is sticking around despite the things you’re doing. That is where I can map out tricky loops that develop. Very often, issues arise due to behavioral conditioning. I use the following example a lot:
You teach your dog to sit by having a treat and saying the same word over and over, until the brain learns to automatically sit whenever it hears the word. Our human brains are very similar. We're a lot more complex of course but we often respond to things automatically and then the brain learns to repeat that response, even if it isn’t helpful. Awareness allows us to catch these responses and then practice a different response, which can lead to positive change and brain growth.
Zach: Is it fair to say that you speak publicly more as a method of de-stigmatizing mental health issues than actually trying to directly help people? I ask this because you can't really do that with such a general talk. Therapy and mental care is a very personal process, correct?
Exactly. I shared my personal story of the man who broke into my bedroom in college and my subsequent symptoms of post-traumatic stress (for another therapist's moving story click here). I explained what I put into place for me, with the training that I had related to what I knew worked in terms of treating a hypervigilant nervous system response. I knew that if I left my door unlocked (and I was in a locked building, it wasn't a bad area of town, so I was relatively safe) there probably wouldn’t be a problem and it would help retrain my brain’s automatic response of fear. I didn’t tell everybody to leave their door unlocked if they are overly worried -- I don't know where they live, I don't know if they actually have someone stalking them or what their level of safety is.
I shared my story as an example and not a rule. I wanted people to know there's research around how we respond to certain things and why the brain may struggle. Specific suggestions must be saved for one-on-one therapy. However, my global message at the end was to have everyone think about themselves and their struggles. Asking, what is it that you just can't shake? And what is one thing that you can put into place that helps you go against your grain? Practice stopping that automatic behavior, doing the opposite, and repeatedly doing that brain exercise to break personal patterns that may be keeping things stuck.
What I wanted to illustrate with my talk is that I went against my own grain. I taught my brain something different by allowing myself to face that fear in the way that felt like the worst way to do it. It was tough, but my brain learned, and my symptoms went down. I see this same process happen as a psychologist treating many issues in others, and think there is a lot of benefit in people having a greater understanding of mental health and therapy.
Dr. Lindsay Bira and I also spoke about the three main approaches for dealing with PTSD, and the importance of responding versus reacting to the world around you. Follow our blog to hear more from Dr. Lindsay Bira on these and other topics.
To consult with Dr. Lindsay Bira in-person or remotely from her San Antonio office, contact her directly through her profile.
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