Late word on Robin Williams, et al

Like most people. I really enjoyed watching Robin Williams.  He was the follow-up to Jonathan Winters and before that Oscar Levant, who were also terribly self- tortured but marvelously funny.  Robin also won the favor of a lot of us by playing a very good therapist in Good Will Hunting.  Most of the therapists in movies are played as pretty messed-up, (although Billy Crystal was OK in Analyse This).

It was well known that Robin Williams suffered from a bipolar type disorder.  He clearly had manic moments, although if they served to make a million people laugh I don't know if that gets classified as an illness or a talent.  It's the awful moments of despair and hopelessness that are the worst and most dangerous aspect of that condition. Writing a novel on the wall with lipstick, as one of my patients once attempted to do, is really disruptive, but not fatal.

There have been other high profile suicides, and now so many homicides, that call attention to the need for more mental health care, but then quickly fade, and not much changes.  There were many tributes to  Mr. Williams for a week or so, and I'm sure there will be some more, and a movie, but not much will change in the way we deal with people who are searching for a way out of despair, most of whom are just tortured and not famous.

Part of the problem is that just adding more mental health care doesn't always work.  This is a good example of that. I am sure that Mr. Williams probably was under someone's care at some points in his life, and probably had a therapist right up until he died.  I don't know if that was true, but he had access to the best care, from any and all kind of professionals, but that wasn't enough.

Mental health care is not that effective because the mind is just a part of the very complex creature we call humans.  Our thoughts and feelings are not under our direct control, they are the result of many complex forces.  Psychology and/or psychiatry really cannot be that effective in isolation.  Doing individual psychotherapy often feels like being one man in the water in front of an ocean liner, trying to steer it away from the rocks.  Not easily done.

What I have come to see more and more clearly, because of my long history as a therapist, and as a result of the explosion of information from other sciences, is that unless there is  a way to deal with the comprehensive nature of what creates human feelings and behaviors, the success rate in making positive changes occur will be severely limited.

The picture needs to include a person's genetic make-up, on many different levels, his or her family back ground, and the environment of their early years.  Also important are the sub-culture in which they live and it's values, and how well that sub-culture fits into the more general culture of their society.  Another major factor is a person's over-all physical health, past and present.

All of this is a big deal.  It is a very complex picture, with all of these forces causing chain-reactions upon each other.  But it is real.  Robin Williams was very complex.  Telling him that some of his thoughts and feelings were not accurate was not very helpful.  Medications probably made him feel worse.  I have seen both of those happen with many of my own patients.

Until we find better ways to coordinate all of our knowledge we will struggle with suicides, homicides, racial tensions, bad educational policies, and a great deal of added stress, tension and paranoia, much of which is really based on misunderstanding why people do the things they do. We are at the beginning of what could be an exciting time as more of the complexity of what makes up our lives becomes clearer.  But we all have to learn to talk to each other, combine our knowledge, respect each other's views, and find ways to work together.