The Systems Thinking of Mental Health

My personal mental health system, built through lots and lots of therapy.

can’t remember the first one, but they eventually started happening so often that I could no longer ignore the pattern. They had always taken place every few months but it wasn’t until just after my 27th birthday that the condition evolved from a minor inconvenience to a profound crisis.

It started subtly. Panic Attack seemed like too strong of a term. Mental images of inconsolable patients and theatrical breakdowns came to mind from TV. Though my episodes of irrational stress were intense and inescapable, typically things came to pass quickly, and I had learned to cope.

Weathering the storm was typically the best method. It didn’t solve the underlying issues, but over the years I became resilient enough to survive to fight the next battle. I could handle panic attacks on first dates, which were preexisting spikes of discomfort. I survived in public, stuck on a sweltering Q train in the middle of the Manhattan Bridge. I could even glide through barrages of tough questions in my startup’s #marketing Slack channel on Sunday nights (often the choice context of the most critical scrutiny).

Inevitably, the competence I had established fell as the storm progressed from a monthly episode into a daily swirling tempest. A stressful new job coupled with an emotional breakup and the ever-persistent New York winter resulted in spending more time on my computer indoors and less time interacting with friends and loved ones than ever before. As each comfort zone dwindled, anxiety crept in and took its place.

The familiar view out the window of my Park Slope bedroom as panic attacks dramatically increased in the winter of 2018.

The first brutally cold days of 2019 could be measured in chewed nails as I struggled to deal with this new equilibrium. Riding out the storm is not a feasible strategy if the storm itself never actually passes. As every experience became impossibly stressful, disconnecting became the only solace. Numbness made it possible to get through intact, but it sapped the enjoyment from everything that made life worthwhile. Friday nights no longer had the same open-ended allure. Hobbies I’d long enjoyed fell by the wayside as life became a diametric spectacle of work versus mental survival. Every former interest became a chore with the opportunity cost of having one-too-many IPAs on my couch.

It became all too clear that my solution was not working. Desperate to improve, it was time to ask for help. It was only through therapy that I was able to uncover the source of my anxiety and build systems of thinking that ultimately resulted in a complete shift in the way I react to the world. There is no one-size-fits-all solution for mental health, but I wanted to lay out the system that I found most helpful in the hopes that it might encourage others to pursue finding their own solutions.

Observation

After endless hours spent pasting email templates in Psychology Today’s Index, I finally found a therapist with flexible enough hours to fit my hectic work schedule. Everyone has a different experience with therapy, but I largely attribute my success to going in with the clear overall objectives of a) addressing my anxious thoughts in the short term, while b) reducing their inflow in the long term.

Right from the beginning, simply having someone else validate your thoughts and feelings can provide a significant amount of catharsis. I found voicing my thoughts aloud to be half the battle, with every syllable rolling off the tongue like a massive weight removed from an overloaded mental squat rack. Like a muscle, the ability and willingness to step back and analyze my thinking patterns grew with every session.

Suddenly I understood the value of mindfulness, a concept I had long dismissed after too many arbitrary mentions in Williamsburg yoga classes. Through simply observing my thinking process rather than judging it, I quickly realized that what I had always considered personal failures and inabilities were rooted in unhealthy and irrational patterns of thinking that were preventing me from succeeding in the first place.

The first step, as with any problem, was observing the issue. This provided the basis of improvement from then onward.

Assessment

With each therapy session I emerged feeling either validated that my concerns were reasonable, or relieved to let go of those that were not. Though I had a massive quantity of anxious thoughts, culling them down was still possible through a systematic approach of gauging their validity and only allowing those that passed the test. In order to scale this strategy outside of sessions and into my daily life, I worked with my therapist to develop a system that could be applied at any time and in any situation.

Is this thought valid?

The first question is designed to weed out irrational concerns. In order to gauge whether a thought is rational, we determined two primary criteria:

  • Realistic Outcomes: If a concern is not based in an outcome that could realistically come to fruition, it is likely not worth stressing about. For example, like many other Millennials I have long had a case of Imposter Syndrome, which is characterized by the irrational fear that those around you will suddenly realize you don’t actually know what you’re doing (does anybody really?) In my entire career, never once have I walked into work to have this be the case. Thus, the data shows that this is an unlikely outcome, and not worth wasting mental energy over. It is not nearly as simple as shutting off the thought, but through repetition I have been able to greatly decrease the volume and intensity of these worries.
  • Reasonable Standards: Holding yourself to high standards can be a good practice, but doing so to unrealistic ones can result in a false sense of self-esteem and ultimately a skewed view of reality. Comparing against a high-performing peer is a useful litmus test. Would I hold [insert peer here] to this same standard? The more I have asked this question, the more I realized that I was expecting way more from myself than I would from others. Even if I was falling short of the same standard, it was still more productive to view the reality of the situation rather than my own diluted interpretation. Re-framing this was immensely helpful to filter out thoughts that were based on unreasonable expectations.

Is dwelling on this thought productive?

The second question is designed to ensure worrying only about matters that you actually have the capacity to improve. This was only feasible under the premise of not wanting to waste time on issues you have no control over, which took time to accept and internalize. Through repetition I have drifted further and further away from anxieties that at the end of the day do not accomplish anything.

  • Controlled Outcomes: The first criterion is particularly useful to weed out subjects that you cannot control, so mental energy can be reallocated to those that you can. When I worked on a large multi-faceted team at a prior job it often felt like I was being judged on others’ work, which sometimes received intense scrutiny. I noticed I would spend an enormous amount of energy being concerned about every detail, despite the fact that most of the work was explicitly not my responsibility. Freeing myself from the weight of others’ works allowed my mental energy to be reallocated into maximizing the quality of my own, and ultimately being happier with the results.
  • Utility of Dwelling: While the first criterion helps filter which thoughts to worry about, the second helps prioritize thoughts that are worth the energy. Even if an outcome is controllable, at a certain point the marginal utility of stressing about it is worth less than the cost of the energy spent. For example, over the years I have often found trouble getting to sleep with the next day’s tasks and priorities swirling around my brain. After filtering out the concerns I have no control over, gauging the utility of dwelling on each helps prioritize mental energy towards the greatest outcomes, while de-prioritizing those that would require a large amount of stress for little practical returns. At a certain point in the evening when I have gone through my top items, it becomes easier to shut off my brain and get to sleep, as the big tasks are addressed only the low-reward issues remain.

Improvement

This crucial final phase of the system is meant to create a self-reinforcing feedback loop to nip counterproductive thoughts in the bud, and ultimately decrease the amount of anxious thoughts that come up in the first place.

Applying the results of the assessment phase back to the origin of a thought builds thinking best practices. This way, as the same thought goes through the process multiple times, the brain starts to recognize in advance when a counterproductive thought comes up, and it’s able to shut it off before even considering in the future. This helps spot anxious thoughts a mile away, and builds the ability to quickly gauge value, sort accordingly, and save energy and time.

As I’ve dissected each strand of concern, revelations about the sources of my worries have been revealed, and through addressing those I have successfully decreased the overall volume of anxious thoughts.

The first two phases of my system have been immensely helpful in dealing with the symptoms of anxiety, but this one is the only real long-term solution to the underlying sources of the problems. Everyone is different in what works for them, but the most direct way I have found to address my anxiety and pull it out by the roots is through extensive talk therapy. As I’ve dissected each strand of concern, revelations about the sources of my worries have been revealed, and through addressing those I have successfully decreased the overall volume of anxious thoughts.

A visualization of the amount of time I spend thinking in various categories, pre vs. post-system.

Through repetition and discipline I have slowly been able to alter my thinking patterns for the better. I now focus less on concerns that are invalid or that I have no ability to impact, while the saved mental strength is reallocated to matters that actually warrant it. Panic attacks have ceased almost entirely, as the runaway train of anxiety is only allowed to progress through a self-reinforcing system of checks and balances.

Having a playbook to deal with life’s many stressors has been a major comfort in itself. As life optimization guru Ray Dalio describes in his systems thinking manifesto Principles, as you experience life through systems, each situation becomes “another one of those”, with an established precedent of learning and experience to inform each future decision. While every new problem becomes more familiar, the amount of anxiety with each decreases.

This framework has been very effective for me, but just as humans are infinitely diverse the solutions will be as well. With a deeper look inside the nuts and bolts of what therapy actually accomplished I hope that it has become easier to visualize what your own solution might look like. Regardless of what you’re dealing with, approaching your mental health with clear intentions and professional advice can result in a finite solution that can greatly improve your happiness and overall well-being.

Devin is a progressive data geek in Brooklyn, NY.

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