I have worked with clients in therapy for 25 years. Each person you meet in therapy is, of course, a world unto his or her own. Yet over time, certain patterns emerge, common hazards and blind spots in myriad paths taken. What follows is a list of common mental health "blunders" that, in my experience, often work to undermine one's psychological well-being.
1. Mistaking thoughts for facts.
“If you dream of a muffin,” goes the saying, “you have a dream, not a muffin.” Yet we often forget this, and we confuse what we think with what is actually "there." Thoughts are mental events, not world events. Our thoughts about the world often contain scenarios absent from—or even impossible in—the world itself. Thus, while we may appreciate, or at times dread, the seductive lure of our thoughts, we should still maintain a posture of skepticism about them, seek evidence of their veracity and usefulness, and only heed the ones for which such evidence exists.
2. Equating strong emotion with deep truth.
“Flowers are restful to look at,” said Freud. “They have neither emotions nor conflicts.” We, alas, have both. People are often unclear about the function of emotion. Once you remove the fluff—the Hollywood-style rainbows and butterflies—emotions are merely one of many sources of data that help us manage our movement in the world. Emotions are neither our only source of data, nor inherently the best one. Emotions are a part of our overall experience, not the sum of it.
As data, emotions are often mishandled in one of two ways. Either we dismiss, deny, and ignore them, or we sanctify and follow them blindly. Ignoring or denying emotions may deprive us of important information. It also disowns an authentic part of our experience. On the other hand, sanctifying and blindly obeying emotion means privileging this one data source over others—such as our values, goals, logic, or scientific evidence—that are often more reliable, comprehensive, and relevant in trying to solve the problems of living. Sound mental health requires that we accept our emotions, yet listen to input from other sources of information before deciding how to act.
3. Viewing discomfort as a sign of trouble.
Seeking comfort is a basic human tendency. Picture a frightened baby consoled inside a mother’s embrace. We associate comfort with home, with safety, with pleasure and success. Most of us dislike discomfort and seek to minimize it. Emotional discomfort, specifically, is often interpreted as a sign of trouble, a signal that something is wrong. I feel bad; therefore I am bad, or my situation is bad. In fact, emotional discomfort is often useful, a sign of incipient growth. The ability to manage and tolerate discomfort is a telltale sign of maturity and mental health. Moreover, discomfort in the service of a meaningful goal or a cherished value is just the price of doing human business, not a crisis or a defect. Life entails discomfort. “You think your pain and your heartbreak are unprecedented in the history of the world,” said James Baldwin, “but then you read.“
Discomfort, in other words, is not the end of the world; it is just the world, and more often it's a sign that you’re alive than a sign that you are broken. An attempt to get rid of all discomfort is akin to the attempt to have everyone like you. You won’t succeed, but your true failure is choosing a misguided goal, not your inability to achieve it. The only way to reside in complete, undisturbed comfort is death. And there’s no need to hurry there. We’ll get—and remain—there soon enough.
4. Using avoidance as a go-to solution.
Human beings are biologically prepared to learn how to avoid pain, harm, and loss. And this tendency can serve us well. It is best to avoid, rather than confront, a speeding train headed your way. When we face the possibility of experiencing pain, harm, or loss, avoidance provides quick, effective relief. However, avoidance in the realm of mental health is often a devious trap. For one, avoiding rather than solving a problem only eliminates our immediate contact with it. My decision to avoid the dirty basement does not clean it; when I return, it will be as dirty or dirtier than before. Moreover, avoidance perpetuates itself; it only teaches you to avoid more, and if the only way you know to deal with a problem is to avoid it, you will end up in a prison of your own pervasive avoidance.
In addition, life requires competence, and you can’t become competent at something by avoiding it. Nobody becomes an expert skier by not skiing. Finally, avoidance is paradoxical, like looking for the darkness with a flashlight. In my practice I see many clients who, for fear of being judged by others, rejected, and driven into isolation, decide to avoid social contact altogether. In this way, their chosen medicine is the disease itself. Sound mental health requires that facing our challenges, not running from them, become our default mode.
5. Confusing scary and dangerous.
Our fear system has evolved as a defense, an alarm mechanism that alerts and prepares us to deal with danger. In the time of our evolutionary ancestors, perception of danger mapped well onto real danger, which was prevalent. A high spot was likely a cliff’s edge, not the third floor of an office building. But times have changed. If you’re high above the ground, you’re probably looking down from a third floor window, not a cliff’s edge, yet your ancient alarm system might still kick in. This is one reason we often mistake our fear for the presence of danger. In reality, it is a mistake to judge how dangerous something is by how much fear it generates, and vice versa. Sound mental health requires us to remain aware of this quirk of mental engineering.
6. Over-reliance on past experience.
Experience can teach us important things. Experiential knowledge is, in some regard, the deepest knowledge. If you’ve never experienced war, you don’t know war like someone who has. But experience has a dark side. For one, it can only teach us what it knows. Our experience is, by definition, limited, because we are. Learning from your own experience is slow, inefficient, and haphazard. Moreover, certain things don’t lend themselves to trial-and-error experiential learning—how to throw a hand grenade, for example. And if I only trust my past experience, I can never transcend it, and true growth often resides in transcendence. Finally, experience can be a prison. If you've experienced 20 years of bad sex with your partner, that experience teaches you that sex is bad, when in fact it isn’t—it’s your experience that’s bad. Sound mental health demands the ability to make a leap of faith into others’ experience, to escape the tyranny of our own.
7. Taking the short- over long-term view.
Human beings tend to privilege immediate gratification over delayed reward. Moreover, a temptation that is right in front of us is all the more tempting if the harsh consequences of succumbing to it are far off. In the battle between French fries and heart attack, the fries win because they are here right now, steaming hot and salty, and the heart attack is 40 years away. Our brain is biased toward the short term. Life, however, is long-term. And as a long-term proposition, it tends to reward long-term strategies. Thus, spending money you don’t have and drinking to forget your troubles feel better than saving money and dealing with your troubles. But saving and dealing will usually benefit your health in the long term.
8. Prizing content over process.
We spend so much of our energy on deciphering and choosing content—what to say, what to buy, what to do. It’s understandable: Content is usually visible; it’s what’s on sale, and what's on TV. However, a system’s overall health often depends more on its underlying processes. A shredder’s effectiveness isn’t measured by what’s written on the paper being shredded. Thus, while the decision often gets top billing, it’s the decision-making process that determines success or failure in the long run. In this way, what you are feeling is less important than how you handle feelings. What you drink is less important than how you manage alcohol. Your specific partner is less important than how you handle relationships.
Mental health itself is, at the end of the day, a process of negotiating our commerce with the world. It’s not a thing you have or don’t have, but how you go about having and not having things. Clinicians often get more information about a client by tuning in to how the client talks rather than what the individual says. The same sentence (“I love him”) can be uttered lovingly, passionately, flatly, desperately, cynically, or bitterly. The meaning of the words (content) will be decided by the tone in which they were uttered (process). Sound mental health requires that we mind our processes.
9. Neglecting attentional focus.
The quality of your experience and judgment is largely shaped by where you lay your mind. Right now many stimuli impinge on your senses; many things exist around you—are going on around you—that will not register unless you turn your attention to them. How we experience and remember an event depends on which part of it we attend to. Our attentional focus is like a circle of light projected from a flashlight in the darkness: It illuminates a part of the environment while helping to obscure other parts. Thus, your success in navigating the environment crucially depends on where you point your light.
This quirk of our basic mental architecture can’t be eliminated, but it can be managed with awareness, and even turned into strength. You can filter away distractions by choosing to focus intently on what’s meaningful and important to you. This is the notion behind the phrase, “Keep your eyes on the prize.” You can also change your experience in a situation by focusing on different aspects of it. While you drive, deciding to focus on the road will reduce the odds of an accident. During sex, shifting focus from your anxious thoughts (“Am I better than her ex?”) to arousal cues (“Her smooth skin is so soft to the touch”) will improve performance and satisfaction.
When under stress, focusing on what you can change, rather than on what you can’t, will improve your ability to cope and be resilient. Attentional focus is a precious resource and a powerful tool we can wield in our effort to create and sustain health and wellness. Yet many of us never train ourselves to use it, and we allow our attention to be easily hijacked by environmental noise, or manipulated by outside actors for their own agendas. Sound mental health requires that we train our attentional focus to behave, wait patiently, and fetch, rather than letting it roam around munching on the furniture, peeing on the floor, and menacing the neighborhood children.
10. Seeking perfection over competence and mastery.
A clinician friend of mine who worked with perfectionists used to tell his clients, “Everything worth doing is worth doing half-assed.” This sentiment was not popular with his clients, yet he had a point: Perfectionism is seductive because it offers an internal and external alibi. We can tell ourselves, and our friends, that the reason we’re alone is because we are looking for the perfect partner; the reason we haven’t sent out our manuscript is because it’s still not quite "there," and the reason we haven’t moved on a decision is because we’re looking for the perfect time to do so.
In fact, perfectionism amounts to a black-or-white mental template that does not map well onto reality, which traffics in shades of gray. Since human efforts are never perfect, the perfection-or-bust system renders success impossible. Such a system betrays a harmful, if often unconscious, fear of success. Instead of seeking perfection, it’s better to seek competence and beyond that, mastery. True masters are often distinguished by their keen awareness of their own ignorance. This recognition, however, propels those who seek mastery into doing, rather than overwhelming them into paralysis, where perfectionists often dwell.
Upon receiving an honorary Oscar in 1990 for a lifetime of revolutionary film-making, Akira Kurosawa, widely considered one of the greatest directors of the 20th century, said, “I don’t feel that I understand cinema yet…but what I promise is that from now on I will work as hard as I can on making movies and maybe by following this path I will achieve an understanding of the true essence of cinema.”
11. Mistaking self-care for selfishness, and assertiveness for aggression.
Flight safety instructions always advise that, in case of emergency, you should put on your own oxygen mask before assisting others. That appears selfish. Should you not put the mask on your helpless child’s face first? People commonly confuse self-care with selfishness. The two, however, are not the same. Selfishness denotes a lack of concern for others. Self-care benefits others because it helps you remain intact and functional and thus useful in interactions with others. For you to not participate in caring for your elderly mother may be selfish, but for you to take a break from caring for your mom to rest and rejuvenate is self-care, and it stands to benefit your mom as well. You can’t light a candle from an unlit match. To spread your light, you must first protect it, vigilantly.
A related confusion is between aggression and assertiveness. For me to step on your head without permission is aggressive. For me to insist that you don’t step on my head without permission is assertive. Aggression involves usurping territory by violating boundaries. Assertiveness involves sharing territory by drawing clear and fair boundaries. Aggression seeks to take rights away. Assertiveness seeks equal rights. Our mental health thrives when we care for ourselves and are assertive with others.
12. Underestimating the importance of action.
Mention "sound mental health" and the image conjured up in most people’s mind is likely an image of an unscrambled mind. That, after all, is where mental phenomena reside. However, in a fundamental way that science is only beginning to understand, mind and body are one integrated system. Our internal psychic architecture is intimately linked with our embodied physical self, and the link is reciprocal. In the same way that language describes and creates our reality, action both manifests and shapes our mental state. Our attitudes affect what we do, but what we do also affects our attitudes. In fact, the best way to change how you feel is to change how you act. Thinking about how you feel every day without thinking about what you do every day is therefore misguided. To paraphrase da Vinci, sound mental health requires that we not just sit back and wait for things to happen to us, but that we go out and happen to things.