Well the mental health parity laws are again in the news. Should insurance companies be required to give equal coverage for psychiatric illness as they do for physical illness? Here’s the rub, no one can agree on what a psychiatric illness is.

Most (but not all) will agree that a person with Schizophrenia has a psychiatric illness (a severe one at that) But what about Substance abuse? Is this a psychiatric illness or a behavioral problem?

In previous posts I spoke about defense  mechanisms in general, and  supression in  particular.  I also promised more.

Well here it is:  lets talk more about a fairly common defense mechanism:

Rationalization

 You know about rationalization, it what Archie Bunker does!  (And probably lots of other people you know, maybe you even do it yourself once in a while!) 

If you are feeling down, here is a quick way to feel better.

Laughter is truly good medicine. Research has shown it can

• improve your mood
• help to lower your blood pressure
• help you deal with stress
• boost  your immune system
• make you relax and feel good.
• release  endorphins
• improve breathing 
• reduce anxiety

If you havent read Norman Cousins Book Anatomy of an Illness, his account of using laughter to win a battle with a severe illness you should.

In the meantime laugh. Babies laughing is very contageous!

An article in today’s NY times about a doctor who offered to pray with a patient brought a variety of responses that covered the entire gamet from suggestions of taking his license away to nominating him for sainthood.

I thought about this because the use of prayer, religion or other spiritual practices has been a topic of many conversations by patients in my psychotherapy practice over the years. I usually say something like “if it helps you or brings you comfort its fine”. However, no one has ever asked me directly to pray with them. I can imagine this could happen especially during a crisis or emergency. As a matter of fact, it is a wonder I have avoided it so far. This article made me wonder what my answer would be to such a request.

   In previous blogs I talked about the use of  defense mechanisms  as a way of coping. I realized that I may have jumped the gun and not have  described clearly what coping is.  Coping  is a word we are all familiar with and use often, but do we know what the word really means? Coping is an almost automatic psychological regulation process that we all use when we feel a little off balance psychologically. Being off balance means experiencing feelings that may be unpleasant or just unwanted such as: anger, fear, embarrassment, and even closeness or intimacy for some (and lots of variations on these.) It occurs when our emotional security and comfort level begins to feel shaken in some way. During a crisis we all use our most familiar comfortable  coping / defense  mechanisms often unconsciously.

I felt compelled to respond to some of the misinformation in a NY Times book review this morning of A Brief History of Anxiety by Patricia Pearson.

• To start the reviewer calls Mrs Pearson a “neurotic”. This is very old term with no true meaning. It is not in use in modern psychiatry.

• Mrs Pearson is said to have anxiety. There are quite a few anxiety disorders on a continium that range from mild (generalized anxiety disorder) to very severe such as Obsessive compulsive disorder (OCD) and Phobias.

Take a look at this  NY Times story  on this crisis about  a third suicide by a teenager in the last year on Nantucket Island. It is a sad story. What struck me is the fact that the “experts” don’t agree and are not always helpful.

We need to realize that we have very few answers to this and many other Mental health questions.  We also are not paying much attention or doing much research in this area.  Mental health care often has sparce coverage by insurance companies. In this country our attention is often on other things:  money, possessions, power. Our educational system training “experts” is lacking to say the least.

Now that I have wetted your appetite for information on defense mechanisms lets talk about supression.

  Supression is a theoretical concept based on the work of Freud. It is a common way of coping with anxiety and crises for some people.  Scarlett OHara, the heroine of Gone with the Wind is a prime example of someone  who uses suppression as a defense mechanism. There are multiple examples of this throughout the movie, as she consciously  pushes away thoughts that cause psychological discomfort and anxiety.  As the movie shows this is a technique that sometimes works well, while at other times does not.  

I personally am fascinated with defense mechanisms and coping skills, however if its not your cup of tea I won’t be hurt if you click on.

In my last post I mentoned that defense mechanisms are methods of coping that we all use; they are necessary for our mental health. The purpose of defenses is to reduce anxiety in stressful situations so that we may continue to function and not be overwhelmed by the stressor.

Some common defense mechanisms are:

• Supression

• Denial 

• Rationalization

• Intellectualization

We All Have to Figure Out How to Cope With Stress in Life. 

Stressors, anxiety, crises and emergencies are a part of life none of us can avoid.  During such times, we all use psychological manuvers  called “defense mechanisms” to protect us against stress and the anxiety it causes.

The purpose of a defense mechanism  is to reduce anxiety so that we may continue to function and not be overwhelmed by the stressor. Defense mechanisms are the same as coping mechanisms.