What Getting Fired Taught Me About Mental Health

In medical school, I was trained to focus on what was physically wrong with a patient. I percussed lungs, pressed on abdomens, and palpated prostates, all the while looking for signs of anything abnormal. In psychiatry residency, I was trained to focus on what was mentally wrong, and then to “fix” — or, in medical parlance, “manage” — those symptoms. I knew which medications to prescribe and when. I knew when to hospitalize a patient and when to send that person home. I did everything I could to learn how to reduce someone’s misery. And after completing my training, I established a successful psychiatry practice in Manhattan, with healing as my mission. Then, one day, I got a wake-up call. Claire (not her real name), a patient who I thought was making progress, abruptly fired me after six months of treatment. “I hate coming to our weekly sessions,” she told me. “All we ever do is talk about what’s going wrong in my life. It makes me feel worse.” She got up and left. I was completely taken aback. I had been doing everything by the book. All my training had centered on minimizing symptoms and trying to undo problems. Relationship issues, job stress, depression, and anxiety were among the many problems I considered myself to be an expert at "fixing." But when I looked back at my notes about our sessions, I realized Claire was right. All I ever did was focus on what was going wrong in her life. It never occurred to me to focus on anything else. After Claire fired me, I began to recognize how important it is not just to dial down misery but to also cultivate mental strength. It became increasingly obvious that developing the skills to successfully navigate one’s way through daily ups and downs is as essential as treating symptoms. Not being depressed is one thing. Feeling strong in the face of stress is quite another. My research drew me to the flourishing field of positive psychology, which is the scientific study of cultivating happiness. In comparison with traditional psychiatry and psychology, which focus mainly on mental illness and pathology, positive psychology focuses on human strengths and well-being. Of course, I was skeptical when I first read about positive psychology, because it was the opposite of what I had learned in medical school and psychiatry residency. I had been taught to problem-solve — to fix something that was broken in a patient's mind or body. But, as Claire had so brusquely pointed out, something was lacking in my approach. By exclusively focusing on signs of an illness, I had failed to look for the wellness within a patient who was ill. By exclusively focusing on symptoms, I had failed to recognize my patient’s strengths. Martin Seligman, PhD, a leader in the field of positive psychology, describes it best: “Mental health is so much more than the mere absence of mental illness.”

Learning how to recover from big setbacks is essential, but what about learning how to deal with the little things — the daily hassles that can make or break a day? For the past 10 years, I have been studying how to cultivate everyday resilience — resilience with a lowercase “r.” How you respond to the daily hiccups — when your coffee spills all over your white shirt as you leave the house, when your dog pees on the rug, when the subway pulls away just as you arrive at the station, when your boss tells you she is disappointed in your project, when your partner picks a fight — is essential for mental and physical health. Research suggests, for example, that people who have more negative emotions (such as anger or feelings of worthlessness) in response to daily stressors (such as traffic or a scolding from a superior) are more likely to develop mental health issues over time. Too many of us underestimate our own capacity for wellness and our ability to weather these daily storms. We tend to see our own emotional state in absolute terms — depressed or buoyant, anxious or calm, good or bad, happy or sad. But mental health is not an all-or-nothing, zero-sum game, and it’s also something that needs to be tended to on a daily basis. Part of it depends on how you focus your attention. Let’s say you point a flashlight into a dark room. You can shine the light wherever you choose: toward the walls, to look for beautiful paintings or windows or maybe the light switch; or toward the floor and into the corners, looking for dust balls or, worse, cockroaches. No single element the beam falls on captures the essence of the room. In the same way, no single emotion, no matter how strong, defines your state of mind. But there are also a number of strategies that all of us can employ to boost mental health and to cultivate well-being. The following activities are data-driven, tried-and-true exercises to increase your resilience and keep you strong, even in times of stress: Cultivate gratitude. Write down five things you’re grateful for, three to five times a week. It can be anything: the beautiful weather, the barista who prepares your coffee in the morning, making it to the train on time, your children. The things you’re grateful for don’t have to be big; they’re yours, and sometimes that means they're small, personal, and private. The key is to recognize the positivity around you. Sounds cheesy, but research shows it actually makes a difference. Perform conscious acts of kindness. Do things for others: volunteer, help an elderly lady carry groceries, treat a loved one to an unexpected surprise. Even small gestures, like holding the door open for strangers, can reduce stress, according to one 2015 study. Meditate. Incense not required. Even those new to meditation can experience the benefits in as little as five days. Move more. Build activity into your day. It doesn’t have to be sweat-drenched indoor cycling or pumping iron. Walk to work, ride your bike, get up from your desk, and walk around the block. Spend time outside. It’s revitalizing and relieves tension. Both blue and green spaces have been shown to be helpful for managing stress. As the old saying goes, “Every day may not be good, but there’s something good in every day.” This isn’t just a cliché. Practically every moment of every day is a resilience-enhancing or -diminishing opportunity. Make the most of them. Samantha Boardman is a clinical instructor in Psychiatry and attending psychiatrist at Weill Cornell Medical College. She received her BA from Harvard University, her MD from Cornell University Medical College, and an MA in Applied Positive Psychology from the University of Pennsylvania. Her papers have been published in Translational Neuroscience, the American Journal of Psychiatry, and the Journal of Clinical Psychiatry. Dr. Boardman is a regular contributor to Psychology Today and the Huffington Post, and frequent guest on The Today Show. Through her website, www.PositivePrescription.com, Dr. Boardman shares scientifically backed insights that are life-enhancing and resilience-building.