The tragic shootings at Sandy Hook Elementary School in Newtown, Conn., have multiplied the questions about the causes of mental illness and why people don’t have more access to treatment.
The book, The Heart of Psychology: Unraveling the Mysteries of the Mind, helps explain the essential elements of common emotional disorders, and suggests ways to fix our country’s mental health system.
This book began when Dr. Eduardo Chapunoff, prolific author and chief of cardiology at Doctors Medical Center in Miami, sought a prominent psychologist to answer his questions about the abnormal behaviors he encountered among his patients and in his personal life. He was introduced to Dr. Howard Paul, clinical psychologist and professor of psychiatry at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School.
From their email correspondences came this book, using the same question-and-answer format, with Chapunoff asking the questions and Paul supplying the answers.
In most of the book’s 28 chapters, Chapunoff asks Paul about a wide range of mental problems, such as obsessive-compulsive disorders, anorexia nervosa, narcissism, anxiety and suicidal thoughts.
Paul writes in the book and elaborated during a recent interview that the single environmental cause for a myriad of mental illnesses is outside expectations that individuals can’t achieve. Individuals become angry because they can’t achieve these goals, and so they lash out at others, or at themselves.
These expectations begin in early childhood, says Paul, who provides as an example common practices in a school. He says if kids are divided into groups according to their grades, our society teaches that the kids in the A-group are doing OK.
So the kids who can’t make it into the A-group believe that something is wrong with them. They become disenfranchised to varying degrees.
To remedy this, Paul says we need to cultivate a sense that people are important simply because they exist. Paul doesn’t deny that it’s exciting to come in first or win a prize: He’s not against achievement, but more fundamental than any achievements, he asserts, both prize winners and losers need to feel that they are equally valuable.
Cultivating unconditional worth also helps A-group members feel more secure, he adds. If their self-esteem is based on more solid ground, they won’t worry that someday they’ll lose the prize, and then lose the sense of their own self-importance.
In the chapters that focus on the mental health system, Chapunoff questions why more trained professionals aren’t available to deal with problems that lead to confrontations. For example, when he’s treating a patient for an acute heart attack, it’s rare for a psychotherapist to be in a hospital’s emergency room to assist with the patient’s psychological concerns.
Paul responds that one reason for the shortage is that universities need to develop more training programs. When he studied for his doctorate, 1,100 candidates applied for the mere eight seats in his program.
And upon graduating, psychotherapists need to be paid more. Paul says psychiatrists are among the lowest-paid physicians, and psychologists earn less than psychiatrists. Surgeons, he adds, can earn 50 to 100 times more than psychotherapists.
Because of these problems, plus the ongoing stigma of mental illness, and Congress’ tendency to save money by cutting mental health programs, social workers treat the majority of mental health consumers. Paul says even if competent, well-trained social workers are available, clients would benefit from the expertise of a specialist.
After Sandy Hook, and other recently reported violent incidents, Paul’s prediction at the end of the book seems on target. He says, “As long as mental health is on the bottom of the totem pole, I am fearful that the social ills of our country and the cost of remediable medical disorders that have psychosocial components will proceed unchecked.”