Be validating of their thoughts and feelings rather than offering empty reassurance. Saying “oh it will all be fine” and “don’t worry, you won’t get this virus” rarely helps and even thought that may be what the anxious person is pulling for you to say, resist the urge and instead focus on their feelings and say things like “it makes sense that you are feeling that way! That is a painful way to way feel,” or whatever feels genuine and from the heart.
As a part of my series about the the things we can do to remain hopeful and support each other during anxious times, I had the pleasure of interviewing Carlene MacMillan, M.D.
Carlene MacMillan, M.D. is the CEO and Founder of Brooklyn Minds. A Harvard-trained psychiatrist, she completed her adult psychiatry residency and child/adolescent psychiatry fellowship at Mass General Hospital and McLean Hospital. She held faculty positions at Harvard Medical School and NYU School of Medicine. Her practice Brooklyn Minds offers outpatient mental health services, including telemental health services.
Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?
Ifirst became interested in psychiatry in high school while I was working on a paper on Sigmund Freud’s first visit to the United States, to Worcester, MA specifically, where I was going to school at the time. I was fascinated by the many layers of the mind and of personalities and followed this thread through college and medical school. Child and adolescent psychiatry resonated the most with me because intervening early offers the most hope of changing outcomes for the better.
Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?
The book Measure What Matters by John Doerr stands out for me from a business perspective. It opened my mind to the concept of Objectives and Key Results (OKRs). Used by many of the most successful companies, OKRs help everyone in every role in a company feel like they are a part of something that matters and gives them a clear direction on where they are headed. As a psychiatrist, I have also introduced this concept to some of my patients and families. Most recently we came up with an OKR plan for an adolescent who was not attending class or doing homework and it resulted in dramatic improvements. As a CEO and as a clinician, I like when the business world and the mental health world intersect in unexpected ways and OKRs are a great example of that.
Ok, thank you for all that. Now let’s move to the main focus of our interview. Many people have become anxious from the dramatic jolts of the news cycle. The fears related to the coronavirus pandemic have heightened a sense of uncertainty, fear, and loneliness. From your perspective can you help our readers to see the “Light at the End of the Tunnel”? Can you share your “5 Reasons To Be Hopeful During this Corona Crisis”? If you can, please share a story or example for each.
- The forced virtual experiment we are undergoing opens opportunities for unexpected connections. On a personal level, I was able to participate in a newly formed Zoom dance class with my favorite dance teacher from Boston (where I lived five years ago). We are hearing of these types of opportunities from patients and colleagues. We think many of these connections will persist long after the pandemic.
- We have some of the best data scientists and epidemiologists analyzing data from what happens with COVID-19 in other countries and we know that there is a cycle to this illness, a cycle that can be modified with the deployment of behavioral measures to flatten the curve. The knowledge is there to learn from, so long as we embrace it and take decisive action to implement it.
- This experience is showing us that drastic changes to human habits are possible if the motivation is strong enough. We all know behavioral change is hard and when we look at escalating concerns about the environment and global warning there has often been an attitude that humans are not able or willing to change their behavior enough to make a difference, but we can.
- As a physician I am a member of several newly formed Facebook groups of healthcare workers involved in fighting this pandemic. It is inspiring to see the passion and spirit of innovation amongst clinicians who are working together to find ways to fight this virus. It takes true collaboration across different medical disciplines, hospital systems, government and other industries and that is what we are seeing start to happen in small and large ways.
- As humans facing adversity, we are more resilient than we often realize and while we would prefer of course to not face this type of adversity it does bring about many opportunities to model for others, such as our children or our patients. We can show them how to face uncertainty with as much grace and strength as possible. There is grief and hardship in all our lives, pandemic or no pandemic, and ultimately humans get to the point where they can make meaning for themselves out of any situation. We are seeing that happen in many ways. A lot of people are turning to creative endeavors. So many of my patients and colleagues have started writing or drawing or singing since this pandemic started and this is an age-old way to make meaning of all the complicated thoughts and feelings we are experiencing.
From your experience or research what are five steps that each of us can take to effectively offer support to those around us who are feeling anxious? Can you explain?
- We can look to Maslow’s Hierarchy of Needs. In that hierarchy, humans need to have their basic physiological and safety needs met before they can effectively address psychological and self-fulfillment needs. Before offering other types of emotional support, check in about those basic needs and see if anything can be done to address them. Grassroots and community efforts to help people get access to things like food is important. Also, governmental decisions like stopping evictions can go a long way to help with this type of anxiety.
- Do not assume you know how an anxious person feels or that you have all the answers. In the type of therapy that I specialize in, Mentalization Based Treatment, we work hard to cultivate a curious, non-judgmental, “not knowing” stance. Maybe they are not even feeling anxious! You won’t know unless you ask. Asking open-ended questions and really taking time to listen are the first steps to helping someone emotionally.
- Help those around you take control of what they can and let go of what they cannot. The classic serenity prayer about having the serenity to accept the things we cannot change, the courage to change the things we can, and the wisdom to know the difference is key. On a day-to-day level this could involve helping them make a schedule for each day that includes virtual social contact rather than endlessly scrolling through the latest news on social media or TV.
- Be validating of their thoughts and feelings rather than offering empty reassurance. Saying “oh it will all be fine” and “don’t worry, you won’t get this virus” rarely helps and even thought that may be what the anxious person is pulling for you to say, resist the urge and instead focus on their feelings and say things like “it makes sense that you are feeling that way! That is a painful way to way feel,” or whatever feels genuine and from the heart.
- Encourage people experiencing intense anxiety which is significantly impacting them to seek out professional support. Now is not the time to stop therapy or psychiatric medications and there are also resources cropping up such as free COVID-19 mental health hotlines for people to get more support. I have had several patients say they are not sure they want to continue therapy because “there is nothing to talk about now” as they are stuck at home. On the contrary, we know from the literature that quarantines and pandemics can worsen underlying psychiatric conditions and cause trauma even in individuals without a psychiatric history. Evidence based treatment exists and should not be overlooked.
What are the best resources you would suggest to a person who is feeling anxious?
- The hospital where I trained for my adult and child psychiatry residency, Massachusetts General Hospital, has curated a wonderful list of resources for managing emotions during this pandemic and it is freely accessible to all: https://drive.google.com/file/d/1P-EQwCqjTHr93fGBk4fqB1sM735390dg/view
- For Parents, the American Academy of Child and Adolescent Psychiatry has a resource center on Coronavirus including this list of tips for parents: https://www.aacap.org/App_Themes/AACAP/Docs/latest_news/2020/Coronavirus_COVID19__Children.pdf
- Dr. Russ Harris, author of The Happiness Trap, created an acronym called F.A.C.E. C.O.V.I.D. and it consists of practical steps to face this emotionally: https://www.youtube.com/watch?v=BmvNCdpHUYM
- Finally, our team at Brooklyn Minds, in collaboration with the podcast studio Western Sound, has started a “Pandemic Check-in” podcast where listeners can call in and get perspectives from mental health professionals. You can call 858–255–1770 to leave a message and you can listen to the podcast at https://podcasts.apple.com/us/podcast/pandemic-check-in/id1503107429
Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?
My husband, a psychiatrist and co-founder of Brooklyn Minds, Dr. Owen Muir, has one saying stitched into some of his suit jackets: “This too shall pass.” I don’t have any tattoos, but this is the saying I would choose if I did. It applies to so many situations and emotions and seems very much suited to our present circumstances.
You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
There is a lot of talk about “reducing stigma around mental illness.” While I agree with that I don’t want to stop there. I want visits to the psychiatrist or therapist to be as cool as going to the latest spinning class. I am quick to say that I go to my own therapy and a lot of our staff does as well. We are very vocal about that. There is not only “no shame” around doing so, there is pride in knowing you are doing something good for yourself and those around you by engaging in mental health care.
What is the best way our readers can follow you online?
Readers can go to our website www.brooklynminds.com to sign up for our newsletter, read our blog, and learn about our services. Brooklyn Minds is on all social media platforms as @BKLYNMinds. You can follow me personally at @carlenemacmillanMD on Instagram and @carlenemac on Twitter.
Thank you for these fantastic insights. We wish you only continued success in your great work!