How About a Bailout for Our Patients?

Clinical Psychiatry News - Volume 36, Issue 12, Page 15 (December 2008)

As I write this column, congressional committees have been holding hearings with chief executives of the Big Three automakers about the pros and cons of bailing out that ailing industry. At this point, the debate is whether a $25 billion bridge loan would be enough to keep the domestic auto industry from collapsing. Meanwhile, I'm hearing that GMAC, of which the General Motors Corp. owns 49%, has applied to become a bank holding company so that it can get a piece of the $700 billion federal bailout package.

I'm what some might call a car enthusiast. I certainly understand the importance of the auto industry to the U.S. economy, and I want it to survive. But as I wrote last month (“Economic Turmoil and Mental Health,” November 2008, p. 15), I am also concerned about the impact this economy is having on the mental health of our people—both those who are mentally healthy and those with mental illness.

How about a bailout for them?

After all, money has a lot of meaning in people's lives, and the loss of it can lead to emotional turmoil. Of course, it's difficult to determine just on how much money we humans need. But I've got an idea: What if each person who was at a certain level of economic distress got a $1,000 windfall? Based on the kinds of problems those of us who see patients in large urban areas might see, such an approach might work. After all, $1,000 goes a long way in most parts of the country.

If a million people received $1,000, that would come to $1 billion. I realize that we're only talking about one million people in this example, but still, such an approach would be a great addition to the billions that are being spent on variety of institutional bailout plans and schemes.

A retired stockbroker I spoke with recently offered another solution.

Instead of money, her thinking was that for a certain level of current need, why not give 3 months' worth of food stamps to some of the millions in need? That approach would free up money so that people could focus on other expenses.

Certainly, neither the retired stockbroker nor I will come up with ideas that would solve this economic disaster. The solutions will come from the politicians and the economists. But the idea of looking at each American household on a personal level seems absent in so many of these mega bailout plans. Those of us who treat people with mental illness or see stress and anxiety in so many others know that making people feel better about themselves and helping them realize that their country cares could help begin to bring back lost pride and decreased self-esteem.

As a psychiatrist, my best efforts can be placed on reducing stress and anxiety, and letting people know there are strategies that can bring about clearer thinking in the choice of priorities and the serious decision making we citizens face.

We can reduce emotional stress, and thereby, help lessen bodily stress with relaxation techniques. These techniques can give people greater clarity of thought, which can make them more open to cognitive challenges that may offer broader perspectives on current problems.

Years ago, I used the red balloon technique to treat patients with insomnia. But over time, I realized that the balloon also served as a great asset in stress reduction. It allows a person to move stress and anxiety into a different sphere and leaves a person more relaxed with greater mental clarity.

First, suggest a person sit comfortably in an easy chair, close her eyes, take a few deep breaths—relax—relax—relax—and imagine a great, great, great big red balloon. Suggest that she see this balloon in the brightest red possible.

Then, as she focuses on the balloon, get her to move her eyes downward and notice that the balloon is attached to a large wicker gondola. Because the gondola is so large, it can hold many things.

Get the patient to put some of her worst anxieties, fears, and worries into that large gondola. Start by putting one or two fears or worries in the gondola, and get the patient to realize that this gondola, full of her fears and worries, is starting to rise into a blue, blue, blue sky.

It goes higher and higher, getting smaller and smaller into that blue, blue, blue sky.

All this happens in the patient's imagination and while the patient is in a relaxed state, but she will feel refreshed and even more relaxed when she returns to her real world. With a more relaxed and refreshed mind, thinking is clearer and problem solving is improved—which in turn reduce stress and possibly coincidental physical problems, such as stress-induced heart problems or gastrointestinal disorders.

We psychiatrists must challenge all-or-nothing ideas, such as “I will never have a 401(k) again” or “I never will be able to recover from this job loss.”

With thinking that is clear, the patient has a better chance of seeing life in fewer absolutes in these tough economic times. When our minds are clearer, we can challenge absolute thinking and help patients see the reality without the drama of the all-or-nothing absolutes—such as thoughts and words like never or always.

With a clear mind, we begin to see greater probabilities, and the doom and gloom of what is possible decreases. (For example, anything is possible, but the probability of many things happening is nil.)

There is much mental health professionals can do to help guide people through these severe economic times, from teaching them relaxation techniques to educating them about how to reprocess distortions. We've got countless techniques in our toolbox.

The question is: How do we want to deliver these vital strategies?

I've been pleased to do community service for years. So, for my part, I've offered a series of talks focusing on relaxation techniques and exercises, to both professionals and nonprofessionals in the workplace. The hope is they will use these tools to relax and assist them in achieving clearer thinking as they negotiate their financial and life issues.

Pushing the panic button is not the way to go in the current economic situation. And any help mental health professionals can render should be offered just as infectious disease specialists or epidemiologists offer their services in critical situations when their expertise is needed. We're in the midst of a national crisis of stress and anxiety, and this is an opportunity for mental health professionals to serve their communities.

Let me know your thoughts about serving in this economic crisis, and I will try to pass them along to my readers.

PII: S0270-6644(08)70803-8

doi:10.1016/S0270-6644(08)70803-8