Guillermo Miatello: "Mental health is more necessary today than ever".

We interviewed psychologist Guillermo Miatello, director of the psychology portal Tescuchamos.com.

Today, in the midst of the pandemic, with many people suffering from stress, anxiety and loneliness (among other symptoms caused by confinement) we realize something that psychologists and psychiatrists have always been announcing: the fundamental importance of mental health in people's lives.

During these days when our realities have been disrupted, when our routines have been altered and everything seems to have fallen apart, it is when we are most forced to confront ourselves, to look "inward".

Therein lie our strengths and weaknesses, our fears and our virtues... and therein also lies our tolerance, our resilience and the ever-human capacity to move forward in the face of adversity. Who knows, maybe with a little bit of good will, this bad experience (as hard as it is) will be an opportunity to stop, prioritize our mental health and build a better future for all of us.

In Madrid there is a group of specialized psychologists who have been working hard since COVID-19 began to provide support and professional accompaniment to people in need. Today we interview Guillermo MiatelloPsychoanalytic Psychologist, Director of the portal Tescuchamos.com.

Interview with Guillermo Miatello: the importance of mental health during the pandemic.

Guillermo Miatello is a Psychologist, Magister in Psychoanalysis, and has been dedicated for more than ten years to provide face-to-face and online care to people with various emotional difficulties. In the middle of the pandemic, he opened the Mental Health portal Tescuchamos.com, which has grown at a dizzying pace in recent months. In this interview, Miatello tells us what, according to his perspective, are the causes of this phenomenon, while describing the situation of Psychology in general and, in particular, from the world drama experienced by the coronavirus.

What is understood by mental health and what is its value?

To put it briefly, mental health defines the way in which a person relates to him/herself. People are permanently in the company of others: family, friends, colleagues, etc. However, if there is someone with whom we have to deal permanently, it is with ourselves. Well, if we are not comfortable with who we are, with what we do, with how we live, discomfort, anguish and frustration are inevitable.

On the contrary, if we build a friendly way of relating with our dreams, projects, with the bonds we choose and with our life in general, surely we will not avoid having problems like everyone else, but we will feel more alive, more in control of our life.... In this sense, the value of mental health is fundamental.

Do you think that sometimes people do not give it due importance?

Sometimes people overestimate the importance of "functioning" because of comfort, inertia or not wanting to know (resistance). Let me explain what I mean: sometimes we care that "things work" at any cost, without paying too much attention to how they work. And there are many times when things work, as we psychologists say, "dysfunctionally", in a pathological or unhealthy way, that is to say, with a great deal of suffering for some of the agents.

The fact that the suffering of the singular agents is silenced by the dynamics of the bonds themselves does not mean that it is not there, and we therapists, who are the ones who listen to the subject and his or her pain, know this very well. In many families or couple relationships, for example, conflict or dissent tends to get a bad press, so the usual way out is to "pretend that everything is fine" and that everything remains as it is.

And what is the role of therapy in these cases?

Therapy represents the opportunity to build a limit to this. From therapy, a person can consider that although there are things in his/her life that work, maybe they do not work the way he/she wants them to. So, that someone can say and tell this to him/herself is a very important step, because it will allow him/her to build healthier bonds with those who are part of his/her environment and to make room for a life more in line with his/her wishes.

How do you think the pandemic has affected mental health crises?

Like any extreme situation, the pandemic has functioned as a kind of magnifying lens, magnifying pre-existing deficits, shortcomings and virtues. This is what has happened, in my opinion, with the economy, the organization and the health system of the various countries: those who have suffered most from the pandemic have been those countries that were structurally unprepared for such a shock.

Is it possible to prepare for the trauma?

A city is never fully prepared for a natural disaster such as a tsunami or an earthquake. However, the intensity of the damage will depend on how the houses are built and how they are engineered from the ground up.

It is the same with human relationships and mental health: in couples that were "wired" together, confinement has triggered conflicts and ended up dissolving them; in people who sustained their emotional stability through frenetic activity or work addiction, the sudden and forced interruption of their work has plunged them into uncertainty and today they are experiencing depressive symptoms for the first time. In fact, the volume of psychological consultations has increased by almost 50% during these months.

What do you think are the symptoms or signs that a person needs therapy?

A person needs therapy when he or she feels that there is some excess of any kind in his or her life that is recurring, that is hurting him or her and that the person cannot handle. This excess can be expressed in different orders of his life: nervousness, anxiety, food, drink, shopping, a drug, work or a relationship, to cite just a few examples.

In general, it is very difficult for a person to notice his excesses on his own, since they constitute what in psychoanalysis we call "his symptom". On the one hand, the person somehow benefits from his excesses and, on the other hand, these symptoms constitute deep-rooted modes of being that, so to speak, define or sustain him. Now, there is a hinge point that happens to many people, at which this "gets out of hand". At that point, the person realizes that the damage of his or her symptom has a disproportionate magnitude, and that is when distress occurs.

At that point, a person needs to initiate therapy and confront, however hard it may be, that unknown dimension of himself that is expressing itself in his pathology. Therapy represents the place where a person can open the way to this question.

What can psychology do for a person?

What psychology can do is to "shore up" the patient's desire to heal and accompany him/her in the journey of asking himself/herself why what is happening to him/her happens, why he/she repeats what he/she repeats, why he/she suffers as he/she suffers and, fundamentally, what he/she is willing to do to deal with these questions and do something about them.

When a person asks himself these questions, he often discovers that much of what he suffers from has to do with things he has chosen to ignore, though perhaps not consciously.

At that point, an unexplored universe opens up for the person in relation to certain long-delayed questions: What do I want? How do I want to live my life? Asking these questions does not imply a panacea or the promise of a fortunate future, but they represent something closer to the possibility of having a life.

What do you mean by "having a life"?

Sometimes we think that to live is to subsist, to feed, to breathe. Of course these things are necessary, but they are not enough to build a life. Nor does having access to material goods (money, cars, houses) or cultural goods (prestige, fame) guarantee us to have a life. Life is a metaphor that shows how a person takes charge of his own dreams, his projects, his desire, his present and his future. So in summary and in answer to your question: psychology can do no more and no less than make a person feel that he or she has a life, and not a mere existence.

How do current issues affect children?

Children feel and realize absolutely everything. Situations of parental distress and anxiety have a direct impact on them for several reasons: first, they are more sensitive to periods of uncertainty such as those posed by a pandemic. Secondly, they are at the mercy of and fully dependent on adults and, thirdly, their psychic constitution is still in process, so that traumas often have much more lasting consequences for them than for adults, for whom the "structure" of their emotional edifice is, so to speak, already built.

At the same time, it should be taken into account that children have lost access to indispensable places such as squares, parks and schools. There they usually find play, recreation and interaction with peers, they build their social skills and "breathe" an air different from the emotional density that very often floods their homes. Having been deprived of these spaces promotes alternative escape routes that are not entirely recommendable, such as those provided by video games or mobile devices.

How can we help them from our position?

The only way we adults can help children is by taking care of our own mental health. This is, in my opinion, the fundamental fact. No one can do for another what he is not willing to do for himself. Freud said that identification is the most primitive and effective mode of love. Children copy what they observe in their parents. If parents are overwhelmed, overwhelmed, frustrated, it doesn't matter what they preach or teach their children. If the parents are firm, no matter how hard the onslaught, the children will find the emotional resources to cope.

Do you think we can get anything positive out of this whole situation?

I think so. Many times it is noticed in the clinic that a psychosomatic illness, a couple, professional or academic crisis ends up being the occasion for a person to stop, listen to himself and ask himself what is his place in his family, in the couple, in society. At the beginning of treatment we often find that all these questions were silenced or on hold for the person: after all, we all know what we "have to" do to be a woman, a man, a father, a mother...but asking ourselves what is good for us and limiting what harms us can be, paradoxically, the most difficult.

At the social level, something similar is happening. Perhaps this pandemic represents the "monster" that we have to face today in order to learn that, as Nietzsche said, "we are farther from no one than ourselves". Perhaps this adversity is a good opportunity to know where we stand in our lives and with ourselves. It is a distressing time and, for that reason, mental health is more necessary today than ever. It is the commitment of each of us to address this need and take care of it, for our sake and for the sake of those around us.