It’s All in the Mind

13# My name is Nazir Hussain, i have recently completed a Ph.D. researching on mental health problems of asian immigrants in U.K. I have noticed alot of misconceptions about mental health. Dr. Sohail has informed/encouraged me to participate in this forum. It`s important to develop distinction between appropriate and inappropriate negative emotions. According to Ellis(1987)People can hold rational and irrational beliefs at the same time. They can easily escalate their desires into demands. Thus I may rationally believe, ``I want you to love me``, and simultaneously believe that, ``Since i want you to love me, you must do so.`` Thus, it is important for psychotherapists to discriminate between their clients` rational and irrational beliefs. When such distinctions are made, it is easier to distinguish between appropriate and inappropraite emotions. Appropriate negative emotions are deemed to be associated with rational beliefs and inappropriate emotions with irrational beliefs. In the following, the appropriate negative emotion is listed first.
#1. Concern vs. Anxiety: Conern is an emotion that is accociated with the Belief, ``I hope that this threat does not happen, but if it does, it would be unfortunate,`` whereas anxiety occurs when the person believes, ``This threat must not happen and it would be awful if it does.``
#2. Sadness vs. Depression: Sadness is deemed to occur when the person believes, ``It is very unfortunate that i have experienced this loss but there is no reason why it should not have happened.`` Depression, on the other hand, is associated withe the Belief, ``This loss should not have occurred and it is terrible that it did.`` Here, when the person feels responsible for the loss, he or she will tend to damn himself: ``I am no good,`` whereas if the loss is outside the person`s control he or she will tend to damn the world/life conditions.
#3. Regret vs. Guilt: Feelings of regret or remorse occur when a person acknowledges that he has done something bad in public or private but accepts himself as a fallible human being for doing so. The person feels badly about the act or deed but not about himself because he holds the Belief, ``I prefer not to act badly, but if I do, too bad!`` Guilt occurs when the person damns himself as bad, wicked, or rotten for acting badly. Hee, the person feels badly both about the act and his ``self`` because he holds the Belief, ``I must not act badly and if i do it`s awfful and i am a rotten person!``
#4. Disappointment vs. Shame/Embarrassment. Feeligns of disappointment occur when a person acts ``stupidly`` in in public, acknowledges the stupid act, but accepts herself in the process. The person feels disappointed about her action but not with herself because she prefers but does not demand that she act well. Shame and embarrassment occur when the person again recognizes that she has acted ``stupidly`` in public and then condemns herself for acting in a way that she should not have done. People who experience shame and embarrassment often predict that the watching audience wil think badly of them, in which case they tend to agree with these perceived judgments. Thus, they often belive that they absolutely need the approval of these others. Shame can sometimes be distinguished from embarrassment in that the public ``pratfall`` is regarded by the person as more serious in same. However, both emotions involve self-denigration.
#5. Annoyance vs. Anger. Annoyance occurs when another person disregards an individual`s rule of living. The annoyed person does not like what the other had done but does not damn him or her for doint it. Such a person tends to believe, ``I wish the other person did not do that and i don`t like what he/she did, but it does not follow that he/she must not break my rule.`` In anger, however, the person does believe that the other absolutely must not break the rule and thus damns the other for doing so.

It should be noted that honest psychotherapists do not generally target appropriate negative emotion for change during therapy since they are deemed to be Consequences of rational thinking, but inappropraite negative emotions require psychotherapeutic interventions.

Dear Zahraj, thanks for the appreciation. The model that I use in mental health can also be used in other disciplines. I chose these examples so that readers can read the words of people who use the model in their relationships.
I have extended the concept to other aspects of life and written a series of three books so far
The Art of Living / Loving / Working in your Green Zone
These days I am working on the books Creating Green Zone Families and Schools.
sincerely sohail

Very Interesting. Your nomenclature is also shared by the business world to identify potential risks. The concept of red, yellow and green is picked from the colors of the traffic signal. Hopefully, the examples will be beneficial to those who may be headed toward the yellow zone or have forgotten to come out of their red zone. The article is quite refreshing, but I am a little surprised on the selection of both examples. Probably, there is a purpose in presenting the two specific examples. Thank you for an involving read!

response to no 17
Dear Dulla bhatti
Thank you for your comments. Being a psychotherapist I have realized that sharing one`s truth honestly and openly helps us grow and make new friends
After my book From Islam to Secular Humanism was published in Canada I met a number of people who shared their views with me about God and Religion that they were reluctant to share publicly. When my article Can we say goodbye to God was translated by Zirvi sahib in Punjabi and published I got more calls and letters as in that article I had discussed how sex is a taboo and because of social suppression and religious oppression we are unable to accept our sexuality and enjoy it. Unfortuantely sex is associated with sin rather than one of the gifts of nature and part of a loving relationships that we need to cherish and enjoy. I had also published a book HUR DAUR MAIN MASLOOB about gay and lesbian literature. It is the first book in Urdu on that topic. I hope one day we can talk about those issues openly and honestly to create a healthy community whaich is important for our mental health....thanks once again...sincerely sohail

#16 Our people are very ignorant about the mental health, sexual health, infirtility etc. Our media makes them even dumber in these areas by propagating more myths about these issues than spreading scientific facts. Other day I was watching this popular India TV serial where this virgin girl gets pregnant by ivf by mistake when she visited her doctor for some blood tests needed for college admissions in America. first they showed she going for blood tests but doctor puts her on bed and inserts embryos...which they repeatedly called ``samples`` or ``eggs``.....so this 19 yr old intelligent university student is shown not to know the differece between blood test and opening legs for insertion....then they showed this ivf lab which looked like college chemistry lab where lots of beakers, pippettes and furnaces heating exotic colored liquids....again many of them refered as ``samples`` of certain males. This would be funny if not idiotic that this kind of information keeps people ignorant about these issues.

Dr Sohail, thanks for the article. I have been browsing your website for few weeks now after finding out about it.
Someone is translating your biographical articles into Punjabi and has published some of them in gurmukhi meda. I must tell you that I have read them and liked them very much and so did many people I know. No one talks about the issues of religion, sexual health and other cultural issues related to these topics in desiland. We had very few writers like Mrs Kailash Puri (england), Dr Gill (not chowkwalla) etc who published in Punjabi wrote on such issues and I have been seeing people reading them albeit somewhat privately. Your articles, although translated, are quiet a good addition to that area.
thanks for the website and articles.

Dear Khurrum...you sound an enlightened human being. Those communities that are superstitious do not have a scientific attitude towards human sufferings whether physical or mental. I feel we need to educate people about their health so that they can understand their health problems and deal with them effectively. While i was studying in Khyber Medical College Peshawar I did house job in Gyne and Obstetrics before joining Psychiatry. I was shocked to find out that so many infertile women went to holy shrines to have children before they came to see us and get medically investigated for infertility.
I hope we can teach our children in schools and homes to develop a rational and logical approach to understand physical and mental health and learn to take care of themselves. We have a long way to go yet. But every effort counts. People like you help others to become more educated and enlightened. sincerely sohail

Dear Yin Yang
You are so honest about your thoughts, it is wonderful.
I do not know where you live but in Canada we are lucky to have a health care system where patients who need health care do not have to pay. So in my practice patients do not pay me.
In some cases friends can be of great help but in other cases people prefer to talk to strangers...but these strangers are trained professionals. I like for people to have choices.
Green Zone Philosophy is not only for patients it can help healthy people as well.
It helps us have a better awareness of our family relationships, our work and social systems and make wise choices.
If you are a happy and healthy person, you are lucky. I meet many people who are unhappy but do not know why they are unhappy and what they can do to be happy.
Green Zone Philosophy and books help people do their own assessment and take steps to improve the quality of life and then decide whether they need professional help or not.
I agree with you that no one can not be healthy, happy and peaceful all the time but we all try.
I try to live in my Green Zone but when I am in the Red Zone, I like to drive through it and not park there for a long time. I practice this philosophy myself while I recommend it to my patients.
It is just a Philosophy I discovered for myself and my practice and fortunately it helps my patients and I have a waiting list for one year. I am sure there are other philosophies that works for other people and professionals.
It is just MY TRUTH and not THE TRUTH and I humbly share with all of you. You are free to accept or reject it.
If you would like to know more and understand it and try it, you might be surprised. The proof is always in the pudding.
I am enjoying honest questions from Chowk readers.
I mentioned before this is my first time on Chowk and I am getting used to the honest dialogue.
sincerely sohail

Dr Sohail,

Excellent article!

I wonder if you have any experience dealing with people back in the East. Recently, I have been very surprised to learn about the prevalence of ``Jhar Phoonk`` among urban Pakistanis. People with obvious psychological issues blame their problems on `asr asraat` and black magic. An interesting thing I found was that some of their `healers` were rather selfless and had some limited effectiveness. However, in the long term , leaving the original issues unresolved eventually comes back to bite them. It`s interesting how easily people get offended if you suggest they have psychological issues but readily believe they are under some kind of `asr` .

psychotherapy is a way of making money. i would prefer to talk to a friend not a stranger about my problems. all the zones are blurred, coz normal ppl also have problems. you cannot be healthy happy peaceful at all times.

Dear Burpinder,
I admire your challenging spirit.
My Green Zone Philosophy is simple to understand and that is the key to its success. I am not suggesting that people with serious emotional problems may not need medications or other forms of therapy. I am focusing on helping patients and their families to get involved in education and self help. The Model I suggest is becoming popular because of its simplicity and effectiveness. I have met many people who had seen a number of psychiatrists and therapists before but had not benefitted. After I started working with them and they kept a record of their Emotional Zones within 3

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6 months their number of hours in the healthy, happy and peaceful Green Zone increased from 2 to 10 hours a day. They realized what they could do to improve their mental health.
I share with them a simple observation
Green Zone People ACT while Red Zone People REACT and many times REACT NEGATIVELY.
This Model is based on being more aware of one`s emotional state and the stressful factors in one`s life and finding a realistic way to deal with them.
In a small article it is hard to share the experience of 25 years. But I hope you can read some of the Green Zone Stories written by my patients on my website
www.greenzoneliving.ca
and if you are serious about the subject send me your postal address and I can send you my first book THE ART OF LIVING IN YOUR GREEN ZONE as a gift.
My goal is helping and educating people who suffer from emotional problems and decrease their suffering.
sincerely sohail

dear whichway,
thank you for your comments.
mental illness and emotional problems have remained a stigma
in the East as well as in the West. Media and films showing mentally ill people
as violent people has not helped.
Feel free to share your story. I would love to read. It is hard to give meaningful feedback without assessing people involved but still we can have a dialogue to highlight some points and share our views. It is one way of learning from each other.
sincerely sohail

``Most patients and their families I met did not feel satisfied with such treatment, as they did not understand the healing process. When psychiatrists tell the parents, ``Your daughter suffers from Depression because she has a biochemical imbalance in her brain and we would prescribe anti-depressants which would increase the levels of dopamine and serotonin in the synapses of her brain`` they are utterly confused, as they do not
understand the neurobiology of the brain. Many patients and families who see traditional psychiatrists for some minutes once a month feel helpless because they do not understand the treatment method and do not imbibe its essence.``

Yes, much better is our desi way, tell the relatives, ``Patient paagal hai`` and then sign him up for a lifetime of white-linen confinement and 230V injections.

So how exactly do you treat these patients of yours, doc? Green pills for the green zoners, red pills for the redzoners, that kind of thing?

Are you for a moment suggesting that mental illness is self-perpetuated? Cuz it sure looks that way from your theory that people can blithely hop skip and jump across zones as easily as they would resolve a few blimps in their marital relationships!

Sorry to bust into this lovefest you`ve got going here, but somebody had to say it.

dear dr,
an interesting article. would you be interested to hear about people who suffer from emotional stress, but are in a state of mind where they dont want to help themselves? in our part of the world, theres a negative connotation attached to psychiatric/ psychological help, especially among men. i have a specific case in mind and would be grateful for some advice if you`re interested.

dear doc
a great piece. i am circulating ut piece among friends. i didn`t expect such piece here. congrats chowk.
hiren

Dear farhanfaiz....
I admire your perceptiveness. Accepting does not mean we have to agree with it. Respecting other people`s truth is an acknowledgement that we are all unique and our life experiences are different.
In therpy it is amazing that when I accept my patients` truth then I can have a respectful dialogue and then we can share our TRUTHS and then we discover another TRUTH a joint truth.
I am of the opinion that we are all CONDITIONED by our family and culture. So our SELF has two parts
CONDITIONED SELF
ans
NATURAL SELF
To discover our NATURAL SELF we need to unlearn and transcend our conditioning. That is not easy. Some are lucky to do by introspection and genuine dialogue with friends, others need therapy. Discovering our Personal Truth is a lifelong struggle.
I admire those people who are aware that we are all in the process of learning and growing and becoming better human beings. When I meet people who claim they know THE TRUTH or ULTIMATE TRUTH or ABSOLUTE TRUTH, I wonder whether they have stopped growing.
Coming back to the original question you asked, acknowledging our and other people`s uniqueness and PERSONAL TRUTH is the beginning of a genuine dialogue and friendship in which we bring out the best in each other. sincerely sohail