“I can’t do it any longer,” the raspy, defeated and tired voice uttered through the phone. “I want to die.”
While such sentiment is something I hear on a nearly daily basis, the seriousness of what is being communicated never loses its impact.
I glanced at the clock and it read 9:17 p.m.
“I’m on my way to the office,” I responded. “I trust I’ll see you there in 20 minutes?”
“Yeah,” was the simple reply.
It might not seem like much, but I understood the courageousness of the word under the circumstances.
For the next 90 minutes we talked, we cried and we even shared a laugh or two.
A person who, a couple hours earlier, had all but given up on life had generated enough hope to make it through another day.
People ask how I do it. Truth is, I don’t have a good answer. It’s a part of my being, I suppose. This is what I do for a living. I meet people when they are at their lowest points. And I love it. It’s a tremendous privilege.
The more compelling question to me is how they do it, as I have always seen the patients I work with as the true heros of the therapeutic narrative.
While my graduate training certainly provided many forms of useful information and technique, I have found that simply being human in crisis situations often pays enormous dividends.
I cannot get into the specific details of the person in the story above for reasons of patient confidentiality, but what I can tell you is that the story was about a young adult male who was battling a diagnosable anxiety disorder.
What some folks might find interesting is that many days you wouldn’t even notice he was struggling with any kind of anxiety. He was an expert at hiding this from the outside world. In fact, the expectations for a man in Western culture all but demand it.
In his outside interactions with others, he would often put on a facade of toughness and insolence. In our work together, he allowed me the honor of seeing what was behind this. What I found was a well-intentioned young man who was often overcome by “anxiety” with no road map for where to go or what to do.
For anyone who has not experienced anxiety, it can be challenging to understand. However, it’s something I’ve worked with for a decade.
While I have never met Houston Rockets’ rookie Royce White, I have at least a basic idea of what he’s likely going through thanks to the countless journeys that patients of mine have allowed me to accompany them on. What makes White’s battle even more difficult is the fact that he is battling anxiety on a national stage.
Reading the reaction from many fans and some media members is disappointing, but unfortunately not surprising. What follows are just a few of the tweets that White has received in recent weeks, and these are just the ones fit (to a certain degree, anyway) for public consumption:
“are you sure you got the right diagnosis because you sound like a schizo…”
“the rockets and fans all hate you”
“Stop tweeting, we get it, you’re a boy in a men’s league. #attentionwhore”
“stop crying. Man up.”
I see this kind of reaction from family members of people I work with all too frequently. This notion of “pick yourself up” or “get over it” is still extremely prevalent. This sort of notion is only intensified when the patient is a male, and even more so when he exists in the hypermasculinized world of professional sports.
Now, I’m not going to try and even pretend to know White’s personal story. What I can say, at a very basic level, is that hearing through the media that he is “struggling with an anxiety disorder” is woefully insufficient information from which to generalize. Also, to assume that the only issue he is struggling with is “fear of flying” because that is what has been reported through the media is one heck of a dangerous leap.
For some perspective (through the use of a crude analogy), it is sort of like if someone asked you what you drive and you responded by saying a vehicle. Are we then to assume that a Hummer is the same in its physical makeup, maintenance requirements and gas mileage as a Mini Cooper?
Put differently, Generalized Anxiety Disorder is a much different presentation than a specific phobia, which is a much different presentation than Panic Disorder. All three of these (and many others) fall under the broad category of Anxiety Disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR).
Moreover, many people operate under the mistaken impression that there is one “correct” diagnosis for every person. If only people were so simple and my job so easy. It is not uncommon for people to present with comorbidity, or have more than one diagnosis simultaneously. Also, sometimes people struggle with very real anxiety that is negatively impacting their lives, but do not fit all the criteria for any single diagnosis.
In short, the science of diagnosing “mental illness” exists in an imperfect and complicated system.
As if it were not already complicated enough, we also exist in a world where stigma is still a major factor in dissuading people from seeking mental health treatment. Add to that the fact that many employers are reactionary in their approach to dealing with the mental health of employees, and you have a recipe for disaster.
Many folks have criticized the Houston Rockets for not truly understanding or being prepared to deal with major mental health issues present in one of its players. While this might be true, it certainly doesn’t make the Rockets unique.
Could you imagine for a moment if a professional sports organization did not have a team physician to deal with physical health problems in the year 2012? Impossible to comprehend, right? In fact, organizations have an entire team of physicians, surgeons, etc.
However, how many professional sports organizations have a team of mental health professionals on staff who work with all of the players on a daily basis? I’m willing to bet you can count the number on one hand. However, they have strength and conditioning coaches, trainers, nutritionists and any number of other available resources.
With regard to mental health, what most organizations do is wait until there is a problem and then send the player to a psychologist that has worked with members of that organization in the past. A reactionary approach is favored over a proactive one.
Mental health treatment is not like taking a car in for an oil change. A person doesn’t see a mental health professional, get fixed and walk away good as new. Achieving optimal mental health is a lifestyle that requires lifelong attention and maintenance.
Teams often bring in gimmicky “team building” or “communication specialists” to do trainings a couple of times a year, but these do absolutely nothing to address mental illness.
All of the blame doesn’t necessarily fall on the teams, either. The NBA and other professional sports leagues could be more proactive and require that a team of mental health professionals be on staff at all times to work with players or other employees in the organization for that matter.
Let’s not forget, we are talking about White because he has chosen to make his struggles public. This is something the vast majority of professional athletes choose not to do. There are players on every team who could benefit from treatment for issues that fans and media simply aren’t aware of.
For example, consider the case of just retired former NBA player Keyon Dooling. He courageously told his story of childhood sexual abuse and has become an advocate for the kind of treatment he recently received. Imagine if all of the six teams he played for during his 12-year NBA career had a team of proactive mental health professionals on staff who worked exclusively for the teams. Perhaps Dooling would have gotten the treatment he has now benefited from much earlier in his life, and before it became so acute that he had to be hospitalized.
Let’s call it like it is: Professional sports leagues and franchises are in the business of making money. Truly caring about the people who work in the organization is not necessarily a requirement. Fact is, a lot of these players are left to fend for themselves after they leave a team that all too often has no long-term investment in each player’s well being.
Take the NFL, for example. The league only started instituting the concussion protocols that are now in place after the evidence of long-term effects became overwhelming and widely available to the general public. The data were in place to take such measures years before the league actually acted. Just because the media isn’t aware of the data and hasn’t written some kind of exposé doesn’t mean the data do not exist.
Think about the numerous suicides of retired professional athletes we have heard about in the last several years. While the data are leaving little doubt that head trauma played a major role in some of these suicides, think about how the outcome may have been different if the players had years of quality mental health care during their career that also had continuity with the care they received after retirement.
Suicide is, of course, the absolute worst outcome. Many other current and retired players struggle with mental illness in tortured silence. It is truly a shame that we only take notice once the most drastic of action is taken. What if we would have intervened before it got to that level, or at the very least, the players knew whom to turn to when it did?
People have been writing and talking about how White better be careful or his NBA window will close. The problem starts with that very backward assertion. We shouldn’t be concerned about White’s professional career. Instead, we should be concerned about Royce White the person. If that takes place then his professional career, along with the rest of his life, will begin to fall into place in due time.
Believe me, I have the great privilege of seeing it happen everyday.
Dr. Travis Heath is a psychologist in private practice, assistant professor of psychology at MSU Denver and former team consultant in the NBA. He also co-hosts a show on Mile High Sports Radio weeknights from 6-8 p.m. You can follow him on Twitter @DrTravisHeath.