Ron Artest

I was watching the TV of the celebration after the LA Lakers won the National Basketball Association championship by defeating the Boston Celtics.. A TV reporter thrust the microphone in front of ebullient LA player Ron Artest and asked him how he felt. Among the words that the elated basketball player blurted out on national television was  that he would  like to thank his  psychiatrist! He went on to say ” There is so much commotion going on in the playoffs. She helped me relax.” Granted this was not an Academy Award acceptance speech but is seemed quite unusual and remarkable that we are now hearing such a public acknowledgment.

Ron Artest has had outbursts of temper in the past  and one time a few years ago he ran into the stands and pummeled a fan. However, it is not known if his psychiatric treatment involved psychotherapy, psychopharmacology or some type of relaxation therapy concerning this crucial series. It is significant that more celebrities  in recent years have been comfortable in talking about  their own mental health issues and their treatment with psychiatrists and other mental health professionals.

Brooke Shield

When the Boston Celtics started winning their championships in the 1960′s  such a public statement was nearly unheard of. In 1972 a vice presidential candidate was revealed to have had depression with ECT treatment and he had to resign from the  ticket. While I suspect that  that a modern day politician could still not survive such a public revelation today, there has been a steady flow of celebrities who choose to talk about the their mental problems and psychiatric treatment without any discernible harm to their careers.

Carrie Fisher

For example this list would include Richard Dreyfus, Uma Thurman, Ben Stiller , Jim Carey, George Michael, Adam Ant, Sinead O’Connor, Wionnal Ryder with some becoming spokespersons for mental health issues and even appearing at psychiatric meetings such as Mike Wallace, Brooke Shield and Carrie Fisher.

These public revelations demonstrate how far we have come in the fight against stigma in regard to mental illness. Even the fictional roles of therapists on televsion have evolved. In the 1970s there was a situation comedy  where comedian Bob Newhart played a therapist. It was good for a lot of laughs and lasted for seven years . Television’s depiction of therapy today is a much more realist one. For example In Treatment is an HBO drama   about a fictionalized psychotherapist 53-year-old Dr. Paul Weston  and his weekly sessions with patients. The program, which stars Gabriel Byrne  as Paul, debuted on January 28, 2008, as a five-night-a-week show and now is beginning it’s third year. The therapist certainly is shown with human flaws but as somebody who has genuinely helped his patients. Another somewhat more sensational type of TV production  is the reality TV show Celebrity Rehab and subsequent spinoffs  with Dr. Drew Pinsky who is an internist and addicition specialist who treats various celebrities on each show . The participants are obviously comfortable revealing their addiction problems and how they are trying to get help. When world famous golfer Tiger Woods had marital problems and sexual issues, he was shown going to some kind of a treatment facility.  Psychiatrists and other mental health professionals  have appeared as characters  on  television medical dramas such as ER as well as in some the popular police and crime dramas. They are   usually shown in a very positive light. The evolution of the depiction of psychiatry and mental illness  in the cinema is a fascinating and important story which  has greatly influenced the public’s attitude on these subjects. Two worthwhile books which discuss this subject are Psychiatry and the Cinema by Krin and Glen Gabbard and Reel Psychiatry by David Robinson.

The wide spread use of computers and the Internet has surely contributed also to the changes in the  attitude towards mental illness and therapy. Information about mental illness and treatment is available within a few clicks as is information about any physical condition. Blogs and web sites are easily found on any subject including those that deal with some aspect of mental health. Organizations which have traditionally tried to address the stigma of mental illness such as the Mental Health America ( MHA) ,  National Alliance On Mental Illness (NAMI), the American Psychiatric Association (APA) and many other reputable groups now have very popular web sites which are seen by millions of people. The social media on the Internet such as Facebook and Twitter are facilitating a freer communication which does brings into  the open  psychological concerns along with everything else. It seems to discourage people from allowing painful secrets to fester in a harmful manner. On this blog I recently wrote about a website called Postsecrets where people anonymously post their secrets in the form of an artistic postcard. When a San Francisco resident told of his or her discouragement about life and plan to jump off the Golden Gate Bridge more than 60,000 people responded in a supportive manner.

I am sure that we still have a long way to go before stigma about mental problems and receiving therapy is eliminated. However there are lots of indications that we are moving in the right direction. Most psychiatrists and other therapists are probably well adjusted enough that they don’t need to see their patients praising them on national TV as Ron Artest chose to do. However when someone wants to issue a public thank you it is great to realize that there is no reason to feel that they can’t do it.

In a recent blog I wrote about empathy and how we might try to teach medical students to be empathic physicians. Psychiatrists, other physicians and therapists try to put ourselves into our patient’s shoes (or skin) in order to understand how they are feeling in regard to the things which are troubling them. When we do psychotherapy we often approach this with an added dimension. We know that the patient will usually experience the therapist in a similar manner to how they experienced important people in their early life, most probably their parents and/or siblings. Freud has dubbed this situation as transference and for certain types of psychotherapy understanding the transference and using it in the therapy can be very helpful. In fact, for psychoanalytic and much of psychodynamic therapy, it becomes the essence of the treatment.

Social Empathy

I was recently made aware of another aspect of empathy which I never thought about before and which I would now label  “social empathy” . My consciousness to this form of empathy was raised when I read about a blog called Postsecrets which weekly displays anonymously mailed-in secrets on artistic postcards from across the country. It has been around for several years and has long been known for revealing suicidal secrets. It has set up a phone hotline in response since the blog began in 2004. Recently a postcard read, ” I have lived in San Francisco since I was young…I am illegal…I am not wanted here. I don’t belong anywhere. This summer I plan to jump off the Golden Gate Bridge.”  According to a blogger Kristi Oloffson .within 24 hours nealry 20,000 people had signed up for a Facebook group titled “Please Don’t Jump, which was later linked beneath the secret on the Postsecrets blog , linking in thousands of supportive comments. On the group’s page, sympathetic users posted comments ranging from simply “I want you here” to “If I knew when you’d be at the bridge, I’d drive all the way from Ohio to meet you there, and hold you until you changed your mind.”  A video about this phenomena has become the most viewed video on the Time Magazine web site.  ( For information about the issue of suicide from the Golden Gate Bridge please see two previous blogs I have written on this subject , Suicide Jumpers From the Golden Gate Bridge and  More on Jumpers, The Movie ).

I checked it out and sure enough and as of this writing there are more than 60,000 people  who have tuned in to this secret and obviously felt an empathic response which they posted on the Facebook site. It may have been that this group comes from a populations which were drawn to the  Please Don’t Jump Facebook page because  they themselves are in touch their own secrets and feel for someone who has this one.  Others without being aware of their own secret may also just want to reach out to someone else whose pain they can feel. It is also clear that people responding to the would be San Francsico jumper are not mainly other immigrants who are in a similar plight. They seem to come from all age groups, geographic areas and different backgrounds as best as I could tell scrolling through a sample of the now more than 60,000 responses.  I believe that it is the identification with loneliness  and isolation which  is the universal  piece that many people have felt at some time in their life which is connecting people with the San Francisco postcard sender.

Implications For Psychotherapy

I don’t believe that social medial will replace the role of psychotherapy. However, it does appear that there is a natural role that it is playing in the support of people who are feeling psychological pain. This new media is clearly interdigitating with other  forms of psychological support and there is no reason whey they can’t overlap. We should be asking patients if they have had  previous psychotherapy, whether they have been treated by any self help groups as well as including an an inquiry whether they  have been interacting with the social media in regard to their current or other problems.

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