Group Therapy USA

John J. Miller, MD

FROM THE EDITOR

November is an important benchmark month, and here it is upon us. In New England, it marks the end of fall, with most of the leaves long past their brilliant colorful displays and now resting comfortably on the ground waiting to be raked and relocated. The sun sets much too early, and layers of clothes are a must. Not uncommonly, a snowstorm will remind us of what is to come, including the cold and dark months that separate us from the warmth, sunshine, and renewal of life of April.

For many of us in New England, and throughout the United States, November is also a month of excitement and reconnecting. The significant bookends of the month are election day (the first Tuesday) and Thanksgiving (the last Thursday)—2 of the most important days of the year. The past 4 years have fueled an increasingly angry and hostile partisan divide, while simultaneously forcing us to embrace longstanding and deep-rooted cultural issues that need to be addressed.

Drawing on our psychiatric understanding of personality development, might it be time for us in psychiatry to sharpen our clinical sword and apply that understanding nationally to facilitate the collective emotional growth of our great country toward the healthier virtues of tolerance, compassion, kindness, self-reflection, and the acceptance of our imperfection with a willingness to continue to mature? After all, the United States is only 244 years old, quite young relative to the age of many of our allies around the world.

Arguably, our country is in its adolescence, which developmentally has many strengths, but lacks the experience and wisdom that only time can provide. A primary milestone in psychotherapy is when our patient moves beyond a black-and-white engagement with the world and is able to find comfort and understanding in the greys, where the truth usually resides. Opinions are just that, and often the healthiest resolution in a disagreement is the willingness to agree to disagree. Of course, some issues cross the line and require decisive action, and these are self-evident.

A notable and comforting quality of our great nation is the eventual coming together to assemble our collective strength in times of crisis. We are in a time of crisis. When united, our instincts act as one nation, and the numerous differences of opinion become fodder for another day. When united, we naturally move into the grey zone, and differences of opinions and beliefs are set aside for the greater unity and survival of our country. Our challenge this month, maybe more so than any other time since the Civil War, is to reunite as citizens of the United States of America, embrace our common ground, and restore our well-earned leadership in the world.

On November 26th, Thanksgiving Day, our great challenge will be to celebrate with our friends, family, and fellow citizens through the lens of grey, mindfully being thankful for all that is good in our life, in our country, and on our planet. On November 27th, let us commit to beginning a national group therapy by working together as citizens of the United States and fostering the maturity and wisdom that our collective nation deserves.

Dr Miller is Medical Director, Brain Health, Exeter, NH; Editor in Chief, Psychiatric Times^TM; Staff Psychiatrist, Seacoast Mental Health Center, Exeter, NH; Consulting Psychiatrist, Exeter Hospital, Exeter, NH; Consulting Psychiatrist, Insight Meditation Society, Barre, MA. Dr Miller notes he serves as a speaker/consultant for Sunovion and Otsuka/Lundbeck, and on the speaker’s bureau for Sunovion, Otsuka/Lundbeck, Allergen, Teva, Neurocrine, and Janssen. He is also on an advisory board for Janssen and has consulted for Align2Action. ❒