By Mike McMahan, LPC
 
What if LOST had really gone out with a bang?
 
According to this recent article, the producers of LOST wanted to include the eruption of a volcano in the series finale of the show. The final season tends to be heavily criticized, but I am a LOST fanboy and think they did the best they could considering it was, in all likelihood, made up as the series went along. To me, this was apparent while viewing it, and there was no ending that was going to tie up all of the loose ends. The volcano would have been better than the golden light (which was kinda hokey, truthfully).
 
What fascinated me about this LOST revelation was that the producers and writers had hinted about the possibility of the volcano playing a role and were forced to abandon it due to budget constraints. Generally when writing fiction, the developments in the story should pull towards the ending. Otherwise, the creator runs the risk of having a deus ex machina moment and annoying readers/viewers.
 
To get existential for a moment, all of our lives have the same literal ending. No one lives forever. But that’s not what we’re talking about here. If we view our lives as a series of interlocking stories, inevitably new pieces will begin and others will end. It’s the natural ebb and flow of living 70+ years.
 
But how the story of our lives and events in our lives end is something else entirely. Frequently when I meet with a client for the first time, they may feel that they have hit a dead end. “I can’t solve this problem because this and this and that happened, so I’m stuck with this situation.” As a therapist and creative person, I totally understand this line of thinking. Many of us group things that happen in our life into stories, and if you notice things (like hints of a volcano, say) it’s no surprise that you expect a volcano at the end. But are events and outcomes in our life inevitable? I don’t think they are.
 
My first thought upon hearing that someone feels that a certain outcome is predetermined is to ask “what would you like to see happen?” Inevitably, the client is going to say something different than whatever they feel is the predetermined outcome. Helping a client set this goal is the job of a therapist. It’s funny… we may sit around our house thinking that we want something to be different but not sure what it is or how to make it happen. Then you get in a room with a therapist and you’re able to articulate a goal. Like magic!
 
And it is a bit like magic… but not really. That “someone I don’t know” is a big part of the reason that therapy works. When you’re talking to a mental health professional in an office or clinic, it’s totally different than talking to a friend or family member. You don’t have to ask yourself “why is this person giving me this advice?” because a therapist is not involved in your life personally and you recognize that they have no personal stake in the outcome. This is, of course, the value of therapeutic services being very private. It’s a literal sanctuary. A place where the ending is not predetermined and where you can collaborate to work on the steps to get to that all-new better ending.
 
Unless… 4 8 15 16 23 42 means something to you. In which case, maybe it is all predetermined.
 
 
Mike McMahan, LPC is a psychotherapist based in San Antonio, Tx.
 
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By Mike McMahan, LPC
 
On Sunday night, CBS’s 60 Minutes featured an introduction to Julia, a new character on the long-running Sesame Street series. But Julia is unlike any other character ever introduced on the show, as she has a diagnosis of Autism Spectrum Disorder.
 
The report itself is interesting and worth a read or watch as it contains a brief look at how Sesame Street has demonstrably achieved its goal of educating kids. But my favorite moment comes from puppeteer Stacy Gordon, who is herself the mother of a child with an autism diagnosis: “It means that our kids are important enough to be seen in society,” she says. And she adds that she values “Having Julia on the show and seeing all of the characters treat her with compassion…“
 
This is, indeed, an important aspect. While children certainly don’t learn everything from TV and entertainment (or shouldn’t anyway), it is undeniable that what they see in media influences their perceptions of the world. And, according to the CDC, they are going to be seeing a lot of children with autism, as the prevalence of the diagnosis is on the rise. Whether this is due to the disorder being diagnosed more frequently or actually occurring more often is currently a subject of debate.
 
It will be interesting to see how Sesame Street develops this character, as the producers recognize that autism is a very individualized disorder, with very few children exhibiting all of the behaviors associated with the diagnosis. This fact likely plays into the diagnosis rate. In fact, the specificity of the diagnosis will likely change in the future, as many researchers believe that autism is likely a family of disorders. Given that the number of cases is increasing, a lot of money will be spent on this matter so mental health professionals and families effected by autism will likely know more in the future.
 
How Sesame Street will (or won’t) help kids and families remains to be seen. However, it is undeniable that this move will create a sense of possibility for families with autism. Caring for a child with autism can be incredibly challenging, and Sesame Street is allowing families everywhere to dream and imagine that their children can be better understood by others, and thus, have a better shot at finding their place as contributing members of our complex world.
 
 
Mike McMahan, LPC, is a psychotherapist based in San Antonio, Tx.
 
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​By Mike McMahan, LPC
 
When TV gets something mental-health related right, it is worth celebrating. And, last week, This Is Us got it right.
 
Part of being in any profession that is ever depicted on television or in movies is cringing at the inaccuracy of what is being shown. Entertainment is generally not about education; even documentaries tend to show clips and feature conversation that fits the narrative the filmmakers are shaping or the message they are trying to impart, any broader truth be damned. This often creates a situation in which professions are portrayed in a very broad or even inaccurate manner. Whatever the characters need to do to advance the story is what writers and directors do. Who cares if a scientist would never remotely act the way he or she is depicted.
 
It sometimes seems that this applies in a particularly strong fashion to the field of psychology. Perhaps it is the mystique that surrounds mental illness. Or perhaps I’m just biased. But the prevalence of, for example, “multiple personality disorder” (Dissociative Identity Disorder) has been totally blown out of proportion by its use as a plot device in movies and TV. And, hey, I get it. The disorder presents an opportunity for a huge twist moment and is shocking for most people to even consider. “What if I had a secret life and an entirely different personality that I don’t know about?” The thing is you don’t. And neither does anyone else you know, statistically speaking. This disorder is extraordinarily rare. Most clinicians will go their entire career and never encounter this illness. While schizophrenia is more common than DID, entertainment-driven stereotypes also confuse the issue of what schizophrenia actually is. People with schizophrenia are generally not violent or dangerous and they most definitely don’t have “multiple personalities.” They aren’t supervillains hatching sinister plots. Many of them have extraordinarily challenging lives and very sad stories.
 
Anxiety disorders are much more understandable than schizophrenia or dissociative identity disorder, and, of course, more common. I’ve never watched This Is Us, though it’s certainly been in entertainment headlines. Maybe I should, as I was struck to learn of this clip that showed a character, Randall, reacting to a call from his brother, Kevin, who was having a panic attack. These things are very scary, as Kevin’s reaction shows. When Randall leaves his performance to help Kevin, I found it pretty moving. Most people wouldn’t have done this, but Randall’s recognition and support was touching. Panic attacks are not something that you can just “get over” and people can’t just “relax.” In addition to the racing thoughts and feelings of imminent doom, panic attacks may be accompanied by physical symptoms such as accelerated heartbeat, sweating or shortness of breath. I’m aware of a psychologist who includes in her regimen of treatment for panic attacks at the VA an exercise in which she asks patients to drink 5+ shots of espresso. She then helps them learn how to work with their mind to help their body to control these physical symptoms of panic. If you’ve ever drank 5+ espresso shots, you can imagine the challenge. And if this doesn’t get your heart pumping, well, tolerance is a real thing and caffeine is a helluva drug!
 
If you experience these symptoms, by all means speak to a mental health professional, as treatments (including medication and/or therapy) are highly effective. And if you have a friend or loved one experiencing a panic attack, please don’t minimize it. They are terrifying.
 
 
Mike McMahan, LPC is a psychotherapist based in San Antonio, Tx.

By Mike McMahan, LPC

Evan Rachel Wood has been in the news quite a bit lately, due to her lead role on the fascinating new HBO series Westworld. The series deals with robots in a futuristic amusement park who endure all matter of violence in an Old West setting. The robots’ memories are then wiped and they repeat the experiences over and over. However, as the show opens, they have become sentient and begin to remember what has occurred in their pasts. The show itself provides plenty of food for thought on how we deal with trauma as well as providing a commentary on how the entertainment industry (and HBO, specifically) uses violence (especially sexual violence against women) as a plot device.

Wood gave a recent interview with Rolling Stone in which she dropped some serious knowledge bombs about bisexuality and psychiatric struggles; talked about her years ago relationship with aging shock rocker Marilyn Manson who is 17 (!) years her senior; and hinted at a history of sexual violence in her own life. While the matter is oblique in the actual interview, she clarified in a powerful statement on Twitter that she had, in fact, been raped twice. “I will not be ashamed ... I don't believe we live in a time where people can stay silent any longer. I certainly can't. Not given the world we live in with its blatant bigotry and sexism.”

Kudos to Wood for being brave enough to speak out on this matter. While certainly no one should be required to acknowledge such a matter publicly, each time someone does (especially someone who is famous), it chips away with the stigma associated with being sexually assaulted. There are many recent cases in the news in which young men have received light sentences or in which the judge has implied that the victim is somehow to blame: this reflects our so-called “rape culture.” The strength of someone like Wood may show that women (or men) who have been assaulted do not have to accept some sort of blame or suffer in silence for fear of persecution.

What impressed me the most about Wood, however, was not her bravery in speaking out but, instead, her acknowledgement that her role in the show was therapeutic for her. “Good God. I left so much in that first season and never looked back,” is a great attitude to have. When I have worked with sexual assault survivors, I talk about their path to recovery as a journey. Though I obviously wouldn’t wish trauma on anyone, people may come out on the other side of their recovery from the experience much stronger. In this case, Wood, who is magnificent in the show, is able to use past trauma to inform her performance and inhabit the character in a way that many other actresses would not have been able to. Given that one of the primary themes of the show is how we move on from trauma, it could be that the role itself will be key in her realizing new opportunities in her life. To be clear, I am not suggesting that survivors “get over it.” What I am suggesting is that one’s status as a survivor may allow mastery of new skills and that these survival skills may be applied successfully in other areas of one’s life.

If you have been assaulted and wish to speak to someone about the experience, consider your local Rape Crisis Center. You can also seek assistance via RAINN.

 
Mike McMahan, LPC is a psychotherapist based in San Antonio, Tx.