contemporary psychology

Are Creative People Prone to Mental Illness?

2011-09-01T15:55:00.000-07:00

Charlie Parker. Jim Morrison. Vincent Van Gogh. Ernest Hemmingway. Marilyn Monroe. Kurt Cobain. Sylvia Plath. Jimi Hendrix. Heath Ledger. The list goes on and is seemingly endless. They were all wonderfully creative. They also all died from self-destructive behavior often associated with mental illness, such as depression.

The untimely deaths of actors, writers, musicians, and other creative types seems to have become so commonplace that the general public seems to almost expect it, if not accept it as a hazard of the workplace in which artists toil. But what causes this self-destructive behavior? Could it be linked to creativity? Are artists really more susceptible to mental illness, such as addiction and depression, or do they just get more publicity when it occurs?

Quite a few studies suggest that the link between artistic people and mental illness goes beyond the stereotype and publicity. In fact, numerous studies have indicated that creative persons are more at risk for serious mental illness such as depression and bipolar disorder. While these studies do not offer definitive proof of the connection between creative people and increased risk for mental illness, the associations are strong enough to call mental health professionals to action to try to better understand this phenomenon. The reasons this connection may exist are not fully understood and need to be explored in order to help the creative person.

The Artist’s Search for Fame

Not all creative people are artists, and not all artists are all that creative. While fame and creativity seem inextricably linked, thousands of actors, writers, painters, and musicians are drawn to Los Angeles every year in search for fame and for reasons that have nothing to do with creating innovative work. Here in L.A., understanding the link between creativity and mental illness is difficult to distinguish from how the search for fame may be connected to mental illness.

Of course, choosing a life in the arts is not pathological in and of itself; however, some people may be attracted to working in the arts for reasons that have nothing to do with creativity and are not altogether healthy.

For example, many artists long for unconditional acceptance and love from complete strangers. They may dream of being “discovered” from a life of rejection or neglect. Only the applause of an anonymous audience might make the artist feel alive and his life has meaning. What may cause this need in the artist, while others are perfectly content to attain the love and affection of a few family members and friends?

The answer may lie in the possibility that the artist who craves adoration from strangers may not have received enough love and acceptance from his primary caregiver(s) as a child. It is no coincidence that many psychologists theorize that mental illnesses, such as depression, are also a result of not being adequately emotionally attuned to by one’s parents.

Creativity and Regulating Emotions

Depression is often described as an overwhelming feeling of sadness. However, clinical depression sometimes manifests differently. People who suffer from depression frequently describe a feeling of emptiness, not sadness. Their emotions become flattened, not deepened. In other words, people who suffer from depression sometimes describe not only the inability to feel happy or excited, but also the inability to feel anything, including sadness.

From this perspective, depression is the brain’s way (albeit unhealthy way) of protecting itself from overwhelming emotions. Depression may be viewed as the brain’s (pathological) strategy to regulate overwhelming or intense emotions.

Similarly, artists may use their craft to deal with their overwhelming or intense emotions. Artists frequently talk about “getting it all out” in their work. Songstress, Anna Nalick, captures the artist’s quintessential relationship to her emotions when she sings, “If I get it all down on paper, it’s no longer inside of me threatening the life it belongs to.”

Along these lines, psychologists often view artistic work as a healthy sublimation (conversion) of intense feelings, such as anger, sadness, and pain. While the conversion of intense emotions into artistic work has created some of the world’s masterpieces, this process may not work one hundred percent of the time for the creative person. When it fails, the artist may find herself unable to regulate her intense emotions.

Unfortunately, the most common way most people, including artists, try to deal with overwhelming emotions is through self-medication using alcohol and drugs. While the use of substances may provide temporary relief from these feelings, it is also a fast track to addiction and depression – the two most commonly associated mental illnesses to self-destructive behavior. Perhaps it is no coincidence that artists frequently find themselves in the cycle of using drugs and alcohol and getting more and more depressed.

Creativity and Destruction

The writer is sitting there staring at his blank computer screen. He's got a burning cigarette in one hand and a bottle of scotch on the other. If he had a third hand, he’d bang himself over the head with a hammer while he tries to write.

This little dramatization might be over the top, but it captures the feeling that exists in many artists when they're trying to create -- many artists ascribe to the myth that in order to retain their creative powers, they must behave self-destructively. In fact, this type of thinking seems to be endemic in the artistic communities -- one must sacrifice himself to the creativity gods in order to be endowed with the gift of originality. Of course, this makes seeking mental health treatment seem threatening to the artist. “If I get well, I’ll lose my source of creativity,” an artist might think.

Although it may sound counter-intuitive, creating something is inherently a destructive process. E.E. Cummings captured this when he said, "To destory is always the first step in any creation." The truly creative person must take what has come before him or her and turn it on its head.

Think about Picasso’s cubist paintings. He literally took realism and destructed it. From that process, something original was born.

Kurt Cobain did the same thing to 80’s music.

Marlon Brando’s work in A Streetcar Named Desire shattered what was typically expected from an actor in that era. From that destructive act, he created something that had never been seen before.

Artists are encouraged to take creative risks, to do something different, to be original. But inherent in the message, “dare to be different” is the message that what exists isn’t good anymore. The status quo is devalued for the quest to be unconventional.

This mindset may make self-acceptance and self-value a tricky thing for the artist. It may exacerbate the feeling inside her that what she is isn’t good enough. The artist may even (perhaps unconsciously) feel that she must destroy herself, in order to be reborn into something original.

*This blog entry is in no way intended to be an exhaustive explanation of the link between creativity and mental illness. It is simply intended to be a conversation starter, a catalyst, a springboard to stimulate further thinking and exploration.

Thanks for reading,

Ryan Janis, Psy.D.
Beverly Hills Psychologist
http://www.drryanjanis.com/

The Dreamer's Guide to Dreaming

2011-04-02T10:10:00.000-07:00

Do you remember your dreams?
Do you ever think about your dreams?
Have you ever wondered what they're about?

Perhaps they're easy to dismiss as aimless wanderings of an unattended mind. Or, perhaps they're more than that; dreams can be deeply personal, accompanied by intense emotions, and are often distractingly bizzare. Many psychologists believe dreams to be important communications from the unconscious.

For centuries, mystics have tried to decode dreams by categorizing their symbolic meaning -- If you dream of water, it means this or that. If you dream you're flying, it means this. If you dream of such and such animal, it portends x, y, or z. I believe this way of thinking about dreams is reductionistic, and it falls short of understanding the personal meaning of a particular dream in the context of the dreamer's life.

I work under the assumption that dreams are the dreamer's attempt to process complex emotions. At night, when the so-called "defenses" are down, emotions come out to play. Feelings try to get worked-out, processed, synthesized, and ultimately understood. (The understanding of a dream typically comes later in conscious waking life. Unfortunately, this final part of the process often goes neglected as a dream fades from memory. More on that below.)

The most important aspect of any given dream is the emotion that accompanies it. I will go as far as to say that the content of the dream is rendered almost meaningless if we don't know how the dreamer felt about it in the dream. Trying to explore a dream without knowing the accompanying feeling is like the having the lyrics to a song without the music.

Dreams often reveal core emotions, basic anxieties and fears, and unfulfilled wishes. Understanding a dream is like understanding a part of you. The exploration of a dream is like unwrapping a gift from your unconscious.

Tips For Remembering Dreams:
   1) When you awake, don't move. Studies have shown that moving around disinigrates the memory of a dream. Instead, when you awake, lie still and review the dream in your head. Reviewing the dream immediately after you awake will put it into your conscious memory.
   2) If need be, write down a few words or a phrase that will help you recall the dream later. There is usually no need to write the entire dream down verbatim.

Thanks for reading,

Ryan Janis, Psy.D.
Beverly Hills Psychologist
http://www.drryanjanis.com/

Money, Sex, & Food

2011-02-26T08:12:00.000-08:00

I was talking with an old friend the other day, and he said glibly, "Everyone has got issues with either money, sex, or food." I smiled and gave a half-hearted chuckle. "It seems that way, doesn't it," I replied. Our conversation moved on, but I began to wonder why these three areas of life in particular seem to cause us so many problems. After all, money, sex, and food are three things we often we say we need. At least, we all want money, sex, and food from time to time. How come our pursuit of these basic wants and needs gets derailed for many of us? How come our level of satisfaction in one or all three of these essential aspects of life seems elusive? Well, maybe this phenomenon has something to do with how we express our wants and needs...

Excess/Paucity
The specific ways that problems with money, sex, or food manifest themselves widely varies from one individual to another, but when problems arise with money, sex, or food, people usually fall into one of two categories: excess or paucity. The so-called "issues" that people have around these basic requirements are usually a matter of too much or too little. On the one side, even excessive amounts never seem to satisfy; like trying to fill a bottomless pit, a person tries to satiate him or herself, but the feeling of fulfillment is temporary and elusive. On the other side, living in scarcity or deprivation can be just as frustrating and unfulfilling

Internalized Expectations
I believe that the reason(s) that people have problems around these three areas of life are vast and multi-determined. Factors such as life circumstances, genetics, culture, religion, and modeling by caregivers (to name just a few) surely contribute to how an individual interacts with money, sex, and food. However, keeping in mind that I've been trying to keep my blog posts to just a few hundred words, please permit me to focus on just one of these factors and make a sweeping generalization: one of the main reasons people have difficulties around these three areas is because each of them is an expression of need. I believe that how we consider and express our needs and how we expect our needs to be met is an aspect of our personality that is molded and developed through our early childhood experiences. These childhood experiences create something I call internalized expectations.

Of course, we are all born with basic needs. How and if our parents meet these needs strongly impacts how we view and meet our own needs later in life. Simply put, problems arise when these needs are either ignored or over-indulged in childhood. A parent's responsiveness, or lackthereof, to a child's needs strongly impacts that child's expectation of how a need will be met later in life. I believe we carry these early childhood experiences inside us long after we become adults. (By the way, it's a tricky thing being a parent, isn't it? The line between meeting your child's needs and not over indulging him or her seems to be as narrow as a tightrope sometimes.)

Having one's needs met is supposed to be soothing; for example, eating a meal when you're feeling hungry is supposed to soothe the hungry feeling. However, if needs were either overindulged or never met at an early age, one can imagine the myriad of different ways an individuals expectations get severely off track.

So, there are many ways a child can internalize how to treat his or her own needs, but keep in mind that these learned attitudes from parents are often very subtle and even unspoken. How these internalized expectations get expressed later in adulthood can also be extremely subtle, and even unconscious.

While this topic was started by my friend's simple generalization, the explanation is extraordinarily complex and varies from one individual to another. If something in this brief blog entry resonates with you, it may deserve more exploration with me or another psychologist.

Thanks for Reading,

Ryan Janis, Psy.D.
Beverly Hills Psychologist
http://www.drryanjanis.com/

The Cost of Therapy

2011-01-07T16:45:00.000-08:00

If you're considering starting therapy, you're likely wondering, "How much is it going to cost me?" While this is a simple question, the answer is not. Here are some things to consider when estimating the monetary cost of therapy.

Average Cost Per Session
The average private practice therapist in Los Angeles charges $125 - $175 per hour. However, some therapists, like me, offer a sliding fee scale to patients who qualify. A sliding scale allows me to adjust the fee depending on your income.

Length of Treatment
One of the most common concerns when considering the cost of therapy is, "How many sessions will it take?" Frankly, there is no way of telling. Depending on what you want out of therapy, the length of treatment can be as brief as 10-12 sessions to see real results, or continue for months and even years. Many people find therapy so useful that they continue for longer than they had planned. Often, people come in with one specific issue that needs to be addressed, but in the process of therapy discover that there is much more to talk about. The mind is powerful and extremely complex, and no one can predict how quickly or slowly an individual will respond to therapy. However, this is not to say that treatment with me is open-ended. In my private practice, I like to set real world goals that will help us evaluate if the therapy is working and when to end treatment.

How Many Sessions Per Week
Many patients come in once-a-week for a session. However, I have found that increasing sessions to 2 or 3 times a week can actually shorten the total time spent in therapy greatly.

Health Insurance
Another consideration is how your health insurance may offset the fee. How much your health insurance covers is an entirely different issue -- Some health insurance companies only pay for a small number of sessions per year, some have a high deductible, some require a high co-pay from you, some only allow you to see their doctors, and almost all insurance companies require a diagnosis from the therapist in order to cover the cost. I am an out-of-network provider for all insurance companies. This means that I will require you to pay me directly, but I will work with you to get reimbursed from your insurance company. Through my experience working with many different insurance companies, I can guide you through the different options that may be available to you to ensure that you get the most allowable benefits from your particular insurance plan.

The Cost of NOT Coming to Therapy
While therapy can be expensive, I believe that the investment pays off many fold. For example, even moderate anxiety or depression can interfere with your ability to advance your career, keep you from having a satisfying relationship, may cause you to engage in self-destructive habits, and can be one of the main factors in many different physical health problems which may arise. Left ignored, problems such as these can ultimately cost you more than therapy ever will.

Thanks for reading,

Ryan Janis, Psy.D.
Beverly Hills Psychologist
http://www.drryanjanis.com/

How Does Therapy Work? (in 400 words or less)

2010-11-12T08:00:00.000-08:00

No matter what theory or school of thought your therapist uses, I believe the active ingredients of psychotherapy can be broken down into three general categories.

1) Thinking about how you think about things. Most of the time, the way we think and feel about things in our lives is automatic. Therapy will identify and often times challenge assumptions, automatic thoughts and feelings, patterns of behaving, preconceived notions, automatic reactions, schemas, and typical ways of interacting with others. The process of identifying these patterns can be jarring at times -- After all, we human beings like to stick to what we know. In a sense, therapy might take us out of our usual assumptions and help us begin to wonder about where those assumptions come from. Therapy may also address whether those assumptions or automatic behaviors work or don't work for us. Therapy often asks, "Why?" and involves some kind of insight about oneself.

2) Getting in touch with emotions. Effective therapy will often involve being able to freely discuss and express feelings. Often times, people have difficulty knowing what they're really feeling. Sometimes, the mind has ways of preventing us from knowing what we're really feeling. In addition, people often engage in an array of different behaviors, such as drinking, eating, gambling, shopping, procrastinating, etc. to avoid emotions. In a variety of different ways, therapy encourages the discussion and expression of previously unexpressed emotions.

3) The relationship between the patient and the therapist. It may sound simple, but a relationship built on trust, understanding, safety, authenticity, and consistency, can be quite healing in and of itself. The therapeutic relationship is different than the relationship between friends or family in that the focus will almost always be on you, the patient. The payment of a fee actually frees the therapist from demanding anything else of you. The therapist is free to focus on your happiness and life satisfaction with no hidden agenda or expectation that you reciprocate.

Thanks for reading,

Ryan Janis, Psy.D.
Beverly Hills Psychologist
http://www.drryanjanis.com/

Principles of a Satisfying Relationship

2010-10-02T08:05:00.000-07:00

Ever wonder why so many of us say that we want to be in a loving relationship, but so few of us get what we want? Understanding and applying these principles takes a lot of work and may require you to break free from your typical approach to your partner, but the reward of being in a more satisfying relationship awaits.

Above all else, a healthy relationship requires empathy and personal responsibility.

Empathy is about putting yourself in your partner’s shoes, especially during times of stress and conflict. Empathy is different from sympathy; sympathy is when you feel bad for someone. Empathy requires you to understand and feel what your partner is experiencing.

Personal Responsibility is about owning the fact that you are 100% responsible for 50% of this relationship. When you feel the urge to blame your partner or tell him/her what he/she is doing wrong, stop yourself! Instead, ask; what did I do to illicit that kind of response or behavior from my partner?

Build the intimacy muscle. Couples who regularly share their thoughts and feelings with one another report more satisfying relationships. Let your partner in on your decision making process -- your thoughts, fears, dreams, etc.. Strengthening the intimacy muscle doesn’t happen overnight or just because you share one or two times with your partner. Furthermore, increasing the capacity for intimacy doesn’t happen just because you want it to be so, just like strengthening a muscle doesn’t happen because you wish it to be stronger -- You must go to the gym, practice, and repeat dozens or even hundreds of times over months and years before you get results. Practice intimacy everyday. Over time, you will notice a difference.

Have sex. Couples are often under the false belief that every sexual interaction has to be spontaneous. Planned sex is necessary for any couple who has been together for awhile. Just keep in mind, men and women get turned on at a different pace. Women tend to need more time. Just because you planned it, doesn’t mean that sex is just another task on the list of things to do. Take your time!

When in the midst of conflict, remember that anger is an expression of hurt. When we perceive that our partner is not acknowledging us, not respecting what we’re saying, doesn’t care, or is not listening, we might act and feel angry, but deep inside, it hurts. This is so important to keep in mind during times of intense conflict. So, when your partner speaks in a raised voice, or threatens to leave, or turns red, you will know that he/she really feels very small inside. Your partner is behaving in an angry way because he/she feels hurt that you’re not hearing what he/she is trying to express. The quickest way to diffuse someone’s anger is to start actively listening.

The goal is NOT to never fight. Conflict is a healthy part of a loving relationship. The repair is the important part. Healthy couples resolve their conflict through acts of empathy. Unhealthy couples engage in ongoing attacks, blame, criticism, or even worse – withdrawal.

Keep in mind; you’re in this relationship because you both want the same thing – a secure attachment and a loving bond.

Thanks for reading,

Ryan Janis, Psy.D.
Beverly Hills Psychologist
http://www.drryanjanis.com/

Psychologist Vs. Psychiatrist

2010-08-15T17:48:00.000-07:00

What's the difference between a psychologist and a psychiatrist? What about a psychotherapist and a psychoanalyst? How about a marriage and family therapist (MFT) and a licensed clinical social worker (LCSW)? These terms can be confusing, they often sound similar, and the people who label themselves with these titles usually purport to do the same thing -- help improve your mental well being. I'll do my best to briefly describe what the similarities are, what distinguishes one from the other, and perhaps most importantly, what you the consumer ought to know.

Psychiatrist -- These are physicians licensed by the Medical Board of California. A psychiatrist is a medical doctor (MD). Like any medical doctor, a psychiatrist can prescribe medication. Some psychiatrists provide their patients with ongoing talk therapy, but these days, many psychiatrists focus on prescribing medication. Psychiatrists will initially meet with their patients for a 60 to 90 minute assessment, during which time, they ask questions about possible symptoms. From the information gathered, a psychiatrist will often prescribe medication during that first visit. Subsequently, the psychiatrist will usually meet with the patient every 1-3 months so that the psychiatrist can monitor and evaluate how the medication is working. Their services normally are more expensive than those of psychologists.
Disclaimer: the preceding description is a generalization of how psychiatrists work, and it is intended to present a typical framework. Of course, many psychiatrists work differently; some provide more talk therapy, some require more meetings, and some may rarely even prescribe medication.

Psychologist -- A psychologist as a doctorate degree (either a Ph.D. or a Psy.D.) in psychology. Therefore, psychologists are frequently called "doctor" as well, but they are not medical doctors. A psychologist typically spends 4 to 6 years in graduate school to earn his or her degree, must perform thousands of supervised internship hours, and must pass a national and state licensing exam in order to call him/herself a psychologist. After completing these requirements, a psychologist is licensed by the Board of Psychology. A psychologist often provides talk therapy to his/her patients. These days, most psychologists see their patients once a week; however, many have found that more frequent sessions are beneficial. In some states, such as Louisiana and New Mexico, psychologists may also undergo additional training in order to provide medication to their patients, but psychologists in California have not yet been granted prescription privileges. Additionally, psychologists frequently provide assessment and testing for particular types of disorders. In California, with certain exceptions, only licensed psychologists may practice psychology independently.

Psychoanalyst -- A psychoanalyst is a person who has undergone extensive training in a particular type of talk therapy called psychoanalysis. Psychoanalysis originated with Sigmund Freud over 100 years ago, but since then it has experienced countless transformations, modifications, additions, rebellions, factions, elaborations, etc.. Psychoanalysts work in many different ways, but typically, a psychoanalyst aims to understand the human experience; symptoms have meaning, patterns of behavior are rooted in something, and the exploration of oneself is crucial. Keep in mind, while becoming a psychoanalyst requires advanced training, there is no prerequisite degree. This means you will often find psychiatrists, psychologists, as well as people with master's degrees who undergo psychoanalytic training.

Psychotherapist -- This is a catch-all phrase. Almost anyone in the mental health field may call him/herself a psychotherapist or therapist.

Marriage and Family Therapist (MFT) and Licensed Clinical Social Worker (LCSW) - These are professionals licensed by the Board of Behavioral Sciences. They must have at least master’s degrees, 3,200 hours of supervised experience, and pass the Board’s examinations. They can provide counseling regarding marriage, family and relationship issues. They cannot prescribe drugs and have limitations in doing psychological testing. Their services normally are less expensive than those of psychologists.

Shrink -- This is a slang term for a psychotherapist.

Life Coach -- This is a relatively new term that doesn't have many regulations behind it. Anyone may call him/herself a coach. Like the term sounds, coaches usually focus on one particular issue and coach their clients on how to think or behave.

*Some of these terms are particular to the State of California, and other states may have variations or different regulations on these terms.

Thanks for reading,

Ryan Janis, Psy.D.
Beverly Hills Psychologist
http://www.drryanjanis.com/