“Dear Man”

In an earlier post, ‘DBT: The Skills’, DEAR MAN is used in objectiveness effectiveness as part of interpersonal effectiveness. Interpersonal effectiveness is described as the ability to increase the changes that will help you reach the outcome you are looking for in a specific situation, while not hurting the relationship you have with others or losing self-respect.

DEAR MAN is useful in situations in which you are asking for what you want or refusing a request from someone else. It is also useful for those with depression or mental illness because it is an effective way to communicate your emotions, your wishes and desires and allow you to negotiate a possibly tenuous situation.

DEAR MAN stands for:

Describe

Express

Assert

Reinforce

 

Mindful

Appear confident

Negotiate

Describe the current situation. Tell the person exactly what you are reacting to and stick to the facts. By doing this, you are making clear your perception of the situation but you aren’t coloring it with your feelings, but sticking only to the facts.

Express your feelings and opinions about the situation. Assume that others cannot read your mind and know how you feel. Don’t expect others to know how hard it is for you to ask directly for what you want or to refuse. Use ‘I want’ or ‘I don’t want’ statements instead of ‘I need’, or ‘you should’.

Assert yourself. Ask for what you want or say no clearly. Assume that others will not figure out what you want unless you ask. Don’t assume that others can read minds. And don’t expect others to know how hard it is for you to ask directly for what you want.

Reinforce the person ahead of time by explaining the consequences or the reward. Tell the person the positive effects of getting what you want or need. Also tell the person, if necessary, the negative effects of getting what you want or need. Help the person feel good ahead of time for doing or accepting what you want.

Mindfully keep your focus on your objectives. Maintain your position and don’t be distracted. Keep asking, or keep saying no, if necessary, express your opinion over and over, rewording but staying on point. Ignore the person if they attack, threaten, or try to change the subject and ignore any attempt to divert you from your goal. Don’t respond to attacks and just keep making your point!

Appear confident by using a confident tone and physical manner; make good eye contact. Appear effective and confident. Don’t stammer, whisper, stare at the floor, retreat or say things like ‘I’m not sure’ etc.

Negotiate by being willing to give to get. Maintain your point, but offer and ask for alternative solutions to the problem and ask what the other person is willing to do to fix the problem. Stick to simple things and make your goals realistic. Focus on what will work. What am I willing to ‘settle for’ or ‘give up’ in order to gain what I want in the situation?

Sometimes it helps to write out DEAR MAN for specific situations so you know what to say and how to say it. A more simplified version of DEAR MAN is: “I feel ______ when you ________. I want _______.”

Using ‘I feel’ and ‘I want’ can be difficult, but by phrasing your requests in this manner, you are refraining from accusations which can make people feel attacked.

I have also attached a form that can help you use DEAR MAN in real life situations.

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2015 Mental Health Awareness Month Speech

I would first like to begin by giving a trigger warning. I will be talking about mental health and depression and I realize that this may be triggering for some people. If that is the case, I would advise you to leave for the duration of my speech. Also, please note that the pastors and I will be available to talk about this subject after church (event).

Before I get started, I would like for all of you to imagine your worst day ever. Your alarm didn’t go off, so you barely have time to get ready. You struggle to get the kids ready for school. Your car won’t start and you’re late to work. At work, or if you’re in school maybe someone starts digging at you about a project, they’re making fun of you or yelling at you. You start thinking about all of the things you have to do, at work, at home and everything in-between. Do you remember how that felt? (Ask for opinions from audience.)You felt anger, sad, frustrated, lost, lonely, down, stressed, overwhelmed.  That is essentially how someone suffering from depression feels on a normal day.

How would I know? My name is Talia Malon and I know that I seem like your normal, average 20-something year old. I look healthy, however I am clinically diagnosed with depression and anxiety. I also have avoidant personality disorder tendencies. I have been in therapy for over 4 years and I was only recently discharged from an outpatient treatment program for mental health.  I’m here to talk to you about depression because May is Mental Health Awareness month (mental awareness is important) and I want you to understand mental illnesses. I want you to understand that I wake up fighting a battle everyday whether I am at work, at home or out with friends. Each day may be a battle where I am under siege for every waking hour but I am determined to win this war, because there is only one other alternative.

Depression is defined by the Mayo Clinic as, “a mood disorder that causes a persistent feeling of sadness and loss of interest…. It affects how you feel, think and believe and can lead to a variety of emotional and physical problems.” While this definition works for the health institutions around the world, I find that there is an easier and more forthright definition. “Mental illnesses are diseases. Depression is a disease.” It is a disease of the mind and it’s not easy to physically see unlike cancer but nonetheless, it is a disease. “This disease affects approximately one in four adults” (NAMI). You can die from it. People have died from depression. The most recently notable, would be Robin Williams. The coroner’s report may say suicide, but honestly he died from depression. “Suicide is the 10th leading cause of death in the US and more than 90% of those who die by suicide had a mental disorder” (NAMI).

Trying to explain depression is like trying to teach physics to preschoolers; it’s virtually impossible because depression affects everyone differently which makes it so hard to describe. It’s hard to explain the numbness you feel, the uncaring, sadness, frustration, loneliness, worthlessness, etc. But what I can tell you is that depression lies. It’s like a bully, but it is able to reach into the darkest places of your mind and use it against you. .It magnifies every negative thought I’ve ever had about myself.  And it does so continuously. I won’t just ‘get better’ one day. It’s a continuous struggle between me and my brain. My therapist at Linden Oaks calls it a committee. This committee is my depression. It’s sitting in the back of my mind constantly, so I have to be careful because I know that there is something self destructive in me. Martha Manning, clinical psychologist and writer says, “Depression is such a cruel punishment. There are no fevers, no rashes, no blood tests to send people scurrying in concern, just the slow erosion of self, as insidious as cancer. And like cancer, it is essentially a solitary experience; a room in hell with only your name on the door.”

Mental illnesses are also invisible diseases. You can’t tell by looking at someone whether they have these diseases or not. Often times, we make split second decisions about a person without speaking a word to them, without knowing them at all. We don’t know if they are suffering from bipolar disorder, anxiety, depression or any other illnesses or issues, but we have already judged them based on their looks, their behaviors and their actions. I feel that this is an issue, because honestly, people with mental illnesses can’t help the way they think. As an individual with depression, there is something chemically wrong in my brain that affects my thinking and I cannot fix that on my own. As Trisha Goddard, a British actress and TV personality said, “Cancer is not the worst thing I’ve faced – that was depression. With depression, nobody brings you flowers, and the doctors can’t operate and tell you, you’ll be free of the disease within weeks.” (and she would know, she has suffered from both)

So what can you do? You can be part of a support group for someone with mental illness. You can help them and be there for them. Ask them how they are doing and really mean it. Sometimes there is nothing that will make them feel better. Sometimes there are only  things that will make it worse. You can not ‘fix’ them or cure them of their mental illness anymore than you can cure a person of leukemia. I feel that it is best understood in the words of one of my supporters. “I support Sara fully, no matter what. Even though I have feelings similar to hers, I still have trouble remembering that her thoughts of worst case scenario are not by choice.  I get frustrated talking with her. I get angry sometimes and just want to explode. But I take a moment to remember how I’ve felt and how she must feel; a million times worse. I take solace in knowing that I can be there for her. No matter what. If you know someone with depression, take the time to educate yourself. Listen to them, no matter how frustrating it can be, and give them a shoulder to cry on.  Don’t bother asking them what’s wrong because they probably don’t know. Just let them talk. Be their supporter. You could be the only motivation they have to do anything.”

Coming here to speak to you today is the first small step towards my ultimate goal.  These are the first steps as I try to start a non-profit organization for education, awareness and tolerance on mental illnesses.  I have named this foundation ADAPT; Advocates for Depression Awareness, Progress and Tolerance. I felt that this name was fitting because when you make the decision to be the supporter of somebody suffering from a mental illness, you have to adapt. Depressives also have to adapt as they try to cope with their illness. Both sides have to adapt their viewpoint and adapt how they interact with others.  Educating yourself and becoming an active supporter of someone with a mental illness may save a life.

In closing, I would also like to encourage you to take care of your mental health. It is just as important as your physical health and it can be anything from taking a break from life and going for a walk outside to talking out a troubling situation with a friend to getting therapy for even a couple of sessions. I encourage those with depression to keep holding on. You are not alone and this may be the hardest fight of your life, but it is also one of the most important. We are here for you. Please visit my blog for more information on depression, how you can help and how you can find help. Thank you.

 

What’s In A Name?

When you are first diagnosed with a mental illness, it can be very confusing regarding the number of people you are going to meet on your journey to better health. All of these people are here to help you, but what exactly are the psychologists, psychiatrists, and therapists doing to help you? Here is a short guide on the difference between all the medical professionals you will meet when you are diagnosed with a mental illness.

A psychotherapist is an umbrella term for any professional trained to treat people for their emotional issues. A psychotherapist can be a psychologist, social worker, counselor, or psychiatrist.

A psychologist is an expert in the field of psychology which is the “science of the mind or of mental states and process”. Psychologists have to attend graduate school and obtain their doctoral degree, a PhD or PsyD. The difference between a PhD and PsyD, is that PsyD psychologists are trained specifically for clinical work, while PhD often focus on research. Psychologists often have to complete years of internships to gain further training and experience. They also must be licensed by their state boards of psychology. Psychologists are not medical doctors and can not prescribe medication. Psychologists are licensed to do counseling, psychotherapy, and provide treatment for mental disorders.

A psychiatrist is a medical doctor that specializes in the diagnosis and treatment of mental illness via medication. A psychiatrist usually has 4 years of medical school, followed by an internship and residency. They have a M.D. A psychiatrist can write prescriptions for medication. Psychiatrists must be licensed as a medical doctor in their state of residency. They must also pass the American Board of Psychiatry and Neurology’s Psychiatry Certification Examination. Many psychiatrists have a special focus such as major depressive disorder, schizophrenia or bipolar disorder. They will often work together with a psychologist to provide treatment for mental illness.

A therapist is a person trained in psychological methods to help patients. Therapists can be psychoanalysts, marriage counselors, social workers and life coaches among others. A therapist provides support and guidance and helps patients make decisions and clarify feelings to solve problems. Selecting a therapist is a personal experience. You should always feel comfortable and welcomed by your therapist, but also consider their licensing and professional credentials. It may take time to find the right therapist for you, so feel free to shop around for the right fit.

A licensed mental health counselor has at least a master’s degree in psychology or counseling. They are focused solely on providing therapy to individuals, families or couples. The mental health counselor has to have 2 years of additional experience working with a mental health professional after graduate school in order to be licensed. They are qualified to evaluate and treat mental health problems, with much of the emphasis on working with problems of normal living rather than mental illness.

A clinical social worker has at least a master’s degree in social work and very specialized training. Social workers provide case management and hospital discharge planning. They can also act as an advocate for the patients. Some social workers also practice psychotherapy. There are many different types of licensure depending on the state in which they are licensed.

Psychiatric or mental health nurses have specialized training in providing mental health services. They often work with the doctors to form an individualized therapy and medication program for their patients. Some nurses can prescribe and monitor medications depending on the states where they practice.

Here is a quick cheat sheet for clarification:

Psychologist Therapists Psychiatrist
  • Advanced degree in psychology
  • Does research or therapy
  • Diagnose disorders or problems with patients
  • Determine appropriate treatments
  • Work in tandem with psychiatrist
  • Help patients make decisions & clarify feelings
  • Provide support & guidance
  • Includes psychologists, psychiatrists, counselors, life coaches & social workers
  • Any number of degrees or certifications
  • Help patients make decisions & clarify feelings
  • Provide support & guidance
  • Medical degree
  • Does research or therapy
  • Diagnose disorders or problems with patients
  • Determine appropriate treatments
  • Work in tandem with psychologist
  • Prescribes medication
  • Help patients make decisions & clarify feelings
  • Provide support & guidance

 

http://www.webmd.com/mental-health/features/psychology-vs-psychiatry-which-is-better

http://www.webmd.com/mental-health/guide-to-psychiatry-and-counseling

http://education-portal.com/articles/Psychologist_vs_Psychiatrist_Whats_the_Difference.html

http://www.allpsychologyschools.com/psychology-careers/article/differences-therapist-psychologist/

https://www.psychologytoday.com/blog/couch-meets-world/201107/psychiatrist-psychotherapist-whos-who-in-mental-health