Lloyd I. Sederer - Improving mental health: four secrets in plain sight

This book is a must read for those who experience or have a family member with a psychiatric condition. Dr. Sederer gives moving descriptions of patients and their suffering and sage advice about interventions. His deep experience in working with those afflicted with mental illness comes ringing through, page after page.

Maria Oquendo, M.D., Ph.D., President, American Psychiatric Association, and Professor of Psychiatry, Columbia University Medical Center

Lloyd Sederer has written this book to help laypeople and practitioners see whats right before their eyes, but often unnoticed. He explores four secretsthat behaviors have meaning, that attachment is central to health (and recovery), that doing more often means doing more harm, and that chronic stress may be the most debilitating condition of life.... This is well worth reading, digesting, and using as a foundation for interactions between clinicians and the people they aim to serve.

Paul Gionfriddo, President and CEO, Mental Health America

There are secrets hiding in plain sight, so writes Dr. Lloyd Sederer in his new (10th!) book, which can make a real difference in the lives of people with mental and addictive disorders and their families. He is not only right; he reveals these secrets using stories, anecdotes, science, and history. This is a must and wonderful read for clinicians and for those affected by these all so common conditions.

Linda Rosenberg, MSW, President and CEO, National Council for Behavioral Health

Weve been honored to have Dr. Lloyd Sederer as a regular on my SiriusXM show to discuss his writings on mental health and addictions, as well as his film and book reviews. His expertise extends to every aspect of the human struggle with mental problems, from science to history, from popular culture to the drug war, as this Secrets book reveals. He is an uncommonly compassionate medical professional and public servantand hes a terrific writer too.

John Fugelsang, SiriusXM radio host

Lloyd I. Sederer, M.D.

Medical Editor for Mental Health of the Huffington Post and Chief Medical Officer of the New York State Office of Mental Health, New York, New York

Note: The author has worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family.

Books published by American Psychiatric Association Publishing represent the findings, conclusions, and views of the individual authors and do not necessarily represent the policies and opinions of American Psychiatric Association Publishing or the American Psychiatric Association.

The author has indicated no competing interests to disclose during the year preceding manuscript submission.

If you wish to buy 50 or more copies of the same title, please go to www.appi.org/specialdiscounts for more information.

Copyright 2017 American Psychiatric Association
ALL RIGHTS RESERVED

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Library of Congress Cataloging-in-Publication Data

Names: Sederer, Lloyd I., author. | American Psychiatric Association Publishing, publisher.

Title: Improving mental health : four secrets in plain sight / Lloyd I. Sederer.

Description: First edition. | Arlington, VA : American Psychiatric Association Publishing, [2017] | Includes bibliographical references.

Identifiers: LCCN 2016035449 (print) | LCCN 2016036324 (ebook) | ISBN 9781615370825 (hc : alk. paper) | ISBN 9781615371204 (eb)

Subjects: | MESH: Mental Health | Mental Disorders--prevention & control | Stress, Psychological

Classification: LCC RC454 (print) | LCC RC454 (ebook) | NLM WM 101 | DDC 616.89--dc23

LC record available at https://lccn.loc.gov/2016035449

British Library Cataloguing in Publication Data
A CIP record is available from the British Library.

For pilgrims and problem solvers around the world.

In the pages that follow, Lloyd I. Sederer, M.D., has distilled the lessons he has learned after more than 40 years of helping people with mental illness and addictions return to lives of love and contribution. As the Chief Medical Officer of the New York State Office of Mental Health, the nations largest state mental health system, he has invaluable insights to share with the next generation of professionals and the patients and families they serve.

At the heart of his message is a fundamental recognition of the dignity and worth of each personboth practitioner and patient. As Dr. Sederer acknowledges, no one chooses to have a mental illness or addiction; we are all wired for human connection, to love and be accepted. Knowing the biological basis for these illnesses is only the first step in treating them, and the traditional medical response is only one leg of the stool. Any comprehensive treatment must include a strong psychosocial component.

Dr. Sederer effectively underscores that chronic stresswhether from childhood trauma, military service, or other sourcescreates the conditions for brain illness. As a nation, we spend a great deal of time discussing the failures of our educational system, without understanding that adverse childhood experiences, or ACEs, such as living with an addicted or depressed parent or lacking basic necessities like food and housing, do serious damage to the developing brains of our countrys children.

We must focus more attention on evidence-based interventions that can counter these early childhood experiences, promote brain fitness, support social and emotional development, and improve academic performance. Dr. Sederer is right to encourage mental health professionals to join with others to press for public policies that root out poverty, violence, discrimination, and other conditions that undermine the well-being of people at every stage of life.

Over the next decade, we will experience incredible breakthroughs in diagnosing and treating brain diseases. The future holds tremendous promise for learning more about genetic predispositions to behavioral health conditions, developing new, effective treatments with fewer side effects, and improving our ability to select the treatment that is most likely to work for a particular patient, among many innovations.