How We Talk About Mental Health Matters

The practice of seeking support when we’re distressed is typically associated with emotional well-being. It makes sense: Most of us believe that having somebody—a friend, a parents, a therapist—who listens to all our travails will make us feel better.

But that may not be the case. In fact, endless discussions about our problems can inadvertently amplify distress.

A patient of mine who had a difficult relationship with her mother-in-law would spend hours rehashing the latest incident or insult with her best friend and speculating about what her “monster-in-law” might do next. Venting was her go-to conversation. Afterward, however, she would often feel even angrier and more agitated.

The reason is that individuals who ruminate, or dwell on negative feelings and distress, have a hard time letting go of what’s bothering them, which leads to a cycle of negative thinking. The more a person ruminates, the worse they feel, which then contributes to more rumination.

Co-rumination—when we ruminate with someone else—isn’t any better, even if it feels good in the moment. But excessively discussing personal problems without ever coming up with a solution can make you feel worse, sending you into an emotional sinkhole. A 2022 study found that co-ruminating about Covid-19 with friends and on social media was associated with heightened depression and anxiety symptoms.

The same is true for parents who, naturally, want to hear of all the difficult things their child is enduring. But there is evidence that turning any problem into a continuing centerpiece of conversation can ultimately undermine the development of coping skills. If your teenager is upset about something, asking her to recount every little detail to you and perhaps later to your partner—“Tell your dad exactly what happened today at school”—could make her feel even worse. You might be sending the unintentional message that the issue is more serious than it is, or that you believe your child can’t handle the situation.

An alternative approach

So, what should people do instead when dealing with a distressed friend or relative?

I may be a “feelings doctor,” but I worry about encouraging internal fixation and problem talk. A basic principle of every nonpharmaceutical treatment for depression and anxiety involves putting some distance between oneself and one’s emotions and acknowledging that feelings aren’t facts.

Psychodynamic therapy, mindfulness meditation and exercise, to name a few treatments, all create space between us and what is running through our head. Deep breathing, pretending to be a fly on a wall, imagining your thoughts are leaves on a stream floating, are well-recognized tools that dilute the power of feelings, provide some perspective, and promote self-regulation.

Cognitive behavioral therapy, one of the most widely studied interventions, teaches patients to identify and challenge faulty habitual thinking patterns known as cognitive distortions such as all-or-nothing thinking and emotional reasoning. Rather than rehashing problems, such therapy entails learning that thoughts aren’t always a reflection of reality and encourages reframing negative thoughts.

Focus on strengths

So if your child had an issue with Johnny today, don’t let the first question you ask after school tomorrow be, “Was Johnny mean to you again today?” If you don’t let it go, your child won’t either. When listening to loved ones, stay calm, express empathy, and encourage them to consider the situation from alternate perspectives. These are far more effective methods for working out problems, rather than to mine for pain and dwell on resentment.

Instead of only asking about what’s wrong, consider inquiring about what’s strong.
Focusing on a person’s strengths may be a more effective strategy for navigating challenges than fixating on the problems.

Similarly, if your best friend calls you to talk about something that is bothering her, avoid questions that encourage her to revisit every detail. “Start from the beginning. Tell me everything!” will only lead to a play-by-play of what took place and what she was feeling. Consider instead posing a question that might help your friend gain some distance from the situation. I often ask my patients, “If someone else were in this situation, what advice would you give them?” Rather than dwelling on the details of what happened, help the person to generate a plan of action and to capitalize on their strengths.

To paraphrase Nobel Prize-winning psychologist Daniel Kahneman, nothing in life is quite as important as you think it is while you’re thinking—or talking—about it. I don’t mean to imply that we shouldn’t talk to loved ones about what’s bothering us. All I am saying is that it shouldn’t be the only thing we talk about.