Hi Friends,
One of my key motivations in starting this Substack was to puzzle through a mystery: We know more about mental health and wellness than at any other point in history. Rather than having less psychological suffering, however, we seem to be experiencing increasingly more.
Despite what some will tell you, there’s no single-cause explanation for this - e.g., digital technology and social media have not single-handedly destroyed our mental health. At the same time, I’ve come to believe that a broader and more fundamental problem has contributed to our suffering. It’s what I call the problem of ‘too much’ in the pursuit of mental health.
Today’s post is an argument for this perspective and thoughts on what we can do about it.
Warmest wishes,
Tracy
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Enough is enough
I’ve been a psychologist for almost a quarter century. I started my career in the aftermath of 9/11. Back then, I told myself a very simple story about how I could help make the future better: My fellow mental health researchers and I would make scientific discoveries. We would use those discoveries to develop more and better treatments to relieve psychological suffering. Those treatments would help people heal and become happier and more resilient.
Almost none of what I predicted came true. In 2024, mental health is an official public health emergency. Rates of mental illness are higher than in decades. We’re less happy, more stressed, anxious, and depressed, and upwards of 20% of youth self-harm before they turn 18. Leaving the stats aside, and perhaps as importantly, the vibes are off. A huge number of us find it hard to know how to live and how to feel at home in our own skin.
Yet one part of my simple story did come true. We have more and better treatments for psychological suffering than ever, not to mention a massive array of wellbeing and self-help resources at our fingertips.
Which leads us to an overwhelming question: Why isn’t all this enough?
I believe one of the answers to that question is simple.
It’s not that we don’t have enough knowledge and resources to support our mental health. It’s that we have too much.
This sentence needs unpacking. Let’s start doing so with a brief visit back in time to Medieval Europe, where we see the roots of mental healthcare.
The No-Solution Solution
In 14th-century Europe, life for most people was, as Thomas Hobbes wrote in Leviathan, nasty, brutish, and short. More so if you were mentally ill. The church-sanctioned explanation for mental illness was demon possession, so treatments ranged from neglect, to ritualistic placebos, to outright torture. In 1349, however, an oasis emerged in a small town in Belgium called Geel. There, a stunning cathedral honoring St. Dymphna, the patron saint of the mentally ill, had just been completed. Miraculous cures were quickly reported, and soon, tiny Geel drew not just hundreds of pilgrims, but thousands. To accommodate the influx of people seeking divine intervention, townspeople and farmers from Geel and the surrounding areas took the pilgrims into their own homes. It was not uncommon at any given time for more than 2,000 pilgrims to live with locals, helping with daily tasks and chores to earn their keep as they sought divine intervention.
A number of them stayed on, even after their religious duties were completed, and were referred to as ‘boarders’ because they continued to live with the families who housed them - sometimes for months, but oftentimes for years. Perhaps they stayed because of the beauty of the place. Perhaps they wished to continuously pray for St. Dymphna’s intercession, for a miracle to occur. Whatever the reason, their prayers were often answered, because the boarders who continued to live with families in Geel got a lot better. Not just once, but repeatedly, over hundreds of years. In Geel, they lived independent lives, contributed to the community, formed relationships, married, and had children.
The tradition of family fostering for those struggling with mental illness became a point of pride among the families of Geel, and in the coming centuries, many opened their homes. The intent of fostering never wavered: Invite people to simply live as part of a household. Don’t try to “fix” them. Treat them as part of the community, but never as a patient.
Pilgrims, on a journey in the bewildering and frightening landscape of madness, perhaps felt, in Geel, at home in the world again.
Now, in the 21st century, life is much less nasty, brutish, and short. A fewer number of us believe in divine intervention for mental distress. So, we’ve taken a different path and put our trust in the power of the new healers of the soul, psychologists and psychiatrists.
But modern-day miracles seem thin on the ground. We don’t feel at home in the world. The healers themselves despair. They don’t know how to help. In his book, Healing, Dr. Tom Insel lamented that in the 13 years he ran the National Institute of Mental Health, “Nothing my colleagues and I were doing addressed the ever-increasing urgency or magnitude of the suffering millions of Americans were living through — and dying from.”
The psychologist Henck P. J. G. van Bilsen argues that the success of Geel, compared to the relative failure of today’s mental healthcare, shows our dire need for a “...style of recovery ‘par excellence.’ Not recovery that demands but recovery that accepts what is and invites the patient to find their own and perhaps very slow path to better health.” Or as Patricia Deegan writes, “The goal of recovery is not to become normal. The goal is to embrace the human vocation of becoming more deeply, more fully human.”
This way of speaking about mental health rings strange to our ears: Not become normal? Be more fully human? Yet, the enduring story of Geel whispers to us that perhaps the best solution is sometimes no solution at all.
An Epiphany Waiting to Happen
A no-solution solution, a less-is-more approach to mental health - nothing could be less 21st century. We inhabit an information landscape driven by the ideas industry, where the logic of he marketplace makes ‘too much’ inevitable: there are too many self-help books, too much information, too many experts, too many tips and tactics, too many problems to solve, too many theories, and too many ways to be messed up. This state of affairs forces us to make dozens of decisions every day just to find the signal in the noise - the signal being how to feel okay in the world.
The amount of information is overwhelming, but so is the tenor of the discourse. It’s bonkers. We’re told we need to upgrade our brains, design our lives, perfect our wellbeing, find our bliss, and control our beliefs, actions, and feelings. We’re inundated with aspirational paeans of perfection and brilliance, instructed through aphorisms, acronyms, and mnemonics to live Our Best Lives.
We shoulder the burden of having to separate out the steady stream of crap, sales pitches, and bad advice from the good so we can pay attention to the right information and make helpful choices. When I play the role of ‘tip-giver’ I immediately add noise to the system, making it harder to find the signal.
Struggling with this conundrum recently, my friend/book editor Bill encouragingly told me that my struggle was a sign that I was “getting down to the real” and that I was “an epiphany waiting to happen.”
Oh, if only it were so. But imagining that it could be true, it got me thinking - when we struggle, rather than trying to fix and optimize ourselves and our lives, what if we assumed we were just an epiphany waiting to happen? What would that look like?
Would we slow down? Would we do less and be open to what comes? Would we focus more on finding meaning? Would we devote more energy to getting down to the real and true? I think yes to all these. And these are good moves. But there’s something else we have to contend with to combat ‘too much.’
Contentment is for Cows
In my last post, I wrote about contentment - what it really is and why our misperceptions about it keep us stuck in the ‘too much’ approach to mental health. In brief, I described a friend I had in my early 20’s who I will call Jane. Jane was committed to self-improvement - she meditated, did yoga, attended self-help workshops, and studied books on spirituality and psychology. She also struggled. She worked hard, but wasn’t sure about her career. She was in a string of unsatisfying relationships, and suffered bouts of depression.
One day, she was talking with her mother about her struggles and hopes for the future, saying, “Mom, after all the work I’ve done to become a better person and to build a better life, I’ve realized that what I really want is to find peace. I just want to be content.” Her mother, without skipping a beat, answered, “Contentment is for cows.”
Thirty years later, this story still takes my breath away. Not only because her mom’s response was so cutting, but because it epitomizes the belief animating ‘too much’: Worthwhile people strive to be more. Contentment signals an end to striving, so it is a failure. Contentment is settling for less and giving up. You might as well live a life of standing in the field, chewing your cud, eating and eliminating, and feeling content because you don’t hope or expect anything more.
It didn’t matter that Jane was already ambitious, hard-working, and committed to bettering herself. If Jane were to use contentment as a north star, so her mother believed, she would get less out of life than she deserved. She wouldn’t get enough.
Why Too Much Backfires
Anchored in a state of ‘never enough,’ ‘too much’ almost always backfires because it distorts our natural and good instincts to better ourselves into what psychiatrist Adam Phillips calls an ‘orgy of improving.’ It looks something like this:
In the world of too much, we come to believe that chasing more, happier, healthier, and smarter is the only way to feel better. So, we chase a fix - a tip, tool, or a solution. This gives us relief for a time, but soon, submerged in the murky waters of too much, we get that sinking feeling of never enough and rejoin the struggle for better, chasing the next fix. With each turn of the cycle, the wheel gains momentum and speed. We feel worse and worse, we try more and more, wondering, why isn't all this enough? Around and around it goes. If this reminds you of addiction, you wouldn’t be far off.
The only way to stop this vicious cycle is to step off.
Stepping Off
That’s the thing about being an epiphany waiting to happen. It’s not so much what you do as whether you can stop and do less, to go deep instead of shallow. Stepping off the cycle of too much isn’t passive. Stepping off is a two-part process.
First, you have to strengthen your radar and call bullshit on the credo of too much - that chasing more, happier, healthier, and smarter is the only way to feel better and to get enough out of life. In essence, you have to tell the purveyors of ‘too much’ and ‘never enough’ to step off. When you see that advice about being less anxious for the 100th time, you can feel secure in the fact that you can and should walk away.
Second, you have to enact the alternative to never enough. That’s why the kind of stepping off I’m talking about is not passive. It’s not falling off the cycle. It’s actively springing yourself from the trap of too much. It’s a jailbreak, baby.
Saying no to the advice treadmill can feel scary. Will I cease to improve, you ask yourself? Maybe, but what usually happens instead is you gain clarity. You start to see what you really care about, what matters, and what makes sense for you to do - in other words, what feels like enough.
Thus girded with extra clarity - just pick one thing and do it. It’s best if it’s already at the tipping point, a thing you can ‘just do’ without too much re-engineering your life. This thing could be anything - a 15-minute exercise or meditation routine, making that therapy appointment, carving out more social time, volunteering, attending religious services, or picking up that one inspiring book you’ve been meaning to read. Note that ‘one thing’ could be as major as switching jobs or as minor as drinking matcha instead of coffee. It could be clearly psychological or not psychological at all.
Just pick one thing and do it.
You don’t have to chase ideas and tips because you know them already - or can get to them. We’re not facing a problem of knowledge scarcity. We’re facing an excess. It’s become fractal, spiraling and repeating itself, so that even the critics of “all the ‘how to be happy crap’ that’s been viewed forty million times on Instagram” are themselves shoveling out endless ‘how to stop worrying about all the ‘how to be happy crap’ crap.’ It’s like a house of mirrors.
Right now, by putting words to the page, I risk becoming part of the problem of ‘too much.’ Yet, I remain hopeful that these ideas might spark something for you, might prepare the ground for being an epiphany waiting to happen - or for you to see that you already are.
In my next post, I’ll write about another way to step off of the cycle of ‘too much’: Allow friction in your life.