On today’s podcast we are continuing our season about mental health.
Our guest is Dr. Ari Graff, a psychologist at the Shirley Ryan AbilityLab, a nationally ranked rehabilitation research hospital based in Chicago. Patients come to Shirley Ryan to recover from severe illnesses and injuries. Dr. Graff’s job is to help patients mentally heal from the emotional trauma that comes along with being damaged physically.
The opinions in this podcast episode are solely those of Dr. Graff. They are not on behalf of the Shirley Ryan AbilityLab.
Noah introduces Dr. Ari Graff, who happens to be his older brother. Ari has been a practicing psychologist for the last 14 years. He has a private practice doing therapy mainly with adults, and he also has been working at the Shirley Ryan AbilityLab for 11 years. The Shirley Ryan AbilityLab is a rehabilitation center for people who have suffered severe illnesses and injuries such as strokes, brain injuries, spinal cord injuries, and amputees. (2:30)
Ari is the psychologist of Shirley Ryan AbilityLab’s outpatient clinic. Patients there are in the process of intense rehabilitation, often doing physical therapy, occupational therapy, and speech therapy. (4:00)
Ari says he sees around half of the roughly 150 patients who attend the clinic throughout the week, usually seeing patients only once for an hour. Sometimes patients request to a see a psychologist, but often they are referred to him by their rehab team or a physician. He says often he is the first mental health specialist patients have ever worked with. Generally they are not expecting to speak with a psychologist because they have been focusing all of their energy on their physical recovery. (5:20)
Ari says it surprised him at first how much impact just one hour-long session can have for patients. He says they get a chance to feel understood about what they are going through. They learn about what to expect from rehab. They also hopefully gain a better understanding of their own mental state. (6:40)
Ari says a common issue rehab patients have is that they don’t feel like they are in control. Becoming disabled is difficult for people to adjust to. One thing Ari tries to help them cope with is the uncertainty whether they will recover from their current disability.(9:00)
Ari says he tries to make people focus on the things they have control over rather than what they can’t control. He encourages people focus on their diet, sleep, and ability to manage stress. He encourages people to try to understand their condition and limitations. He also suggests to patients to communicate with their doctors and health providers to understand the recovery process and to advocate for themselves. (10:00)
Ari says it’s important for him to educate patients about what to expect during the rehabilitation process. He says after a stroke or injury to the brain, the brain needs time to recover. Research says this recovery usually happens in six months to a year, so it’s important for patients not to feel frustrated when they are not back to normal quickly. He says it’s important to give people hope as well as realistic expectations. (12:00)
Ari talks about the mental recovery for people who have been injured on the job. He says those people might have anxiety about going back to work. It’s important for them to process their feelings about how they were injured and process feelings of blame for coworkers, as well as blame for themselves. (14:00)
Ari talks about people he works with who are recovering from severe cases of COVID-19. Some people suffer the effects of being on ventilator for a month or two. Some people are weak or immobile after being in bed for a long time. Others suffer brain injuries if not enough oxygen gets to their brain. People also suffer psychological trauma from the illness, particularly if they were not able to see their loved ones while in the hospital. (15:00)
Noah asks Ari if he has advice for people whose coworkers are exhibiting mental health problems. Ari says some companies have employee assistance programs that provide some limited mental health support. He says it’s probably tricky for a coworker or boss to help another worker seek mental health support. (18:00)
Ari compares talk therapy with prescribing medication to help people with their mental health. He believes both methods of therapy can be helpful if administered the right way. He says people should not assume that prescription medication is being abused. He says that sometimes for patients he sees at the rehab center, opioids can be very helpful for them during a physical therapy session when their pain would otherwise be so excruciating it could hinder doing their rehab exercises. (19:00)
Ari talks about helping his patients manage their pain. He says that pain is not just a physical experience. It’s a cognitive experience, an emotional experience, and even a spiritual experience. He says research has shown that negative thoughts and emotions have the power to increase pain while positive ones can alleviate it. He uses therapy methods such as mindfulness and meditation, which can help people observe their thought processes about pain and then start to make shifts from a negative to a more positive and realistic thought process. (22:00)
Noah asks Ari if everyone could benefit from therapy. Ari says he thinks most people could get something out of therapy, but there are a lot of different types of therapy available, so people need to find their right fit. He says it is important for people to attend to their mental health the same way they attend to their physical health. (24:00)
Ari says to him the word “happiness” means contentment, fulfillment, and purpose. He says that most people desire a sense of meaning in their lives, not just joy. (26:00)
Ari says people in recovery need to know that they can find value in themselves, even if they have limitations. He says our culture emphasizes measuring people by how much they can produce and achieve, but people need to know that we all have intrinsic value. (26:30)
Ari explains mindfulness, which is an important method he uses in his therapy. He explains it as non-judgmental attention to our present experience. It’s a way to be, without trying to fix or do something in the moment. He says it is important for people to be aware that they can still find value in life—take some downtime for pleasure, interact with family members, etc., while still working toward their big goals. (27:00)
Ari concludes by saying that people should not see their medical problems only as a setback. He says the people who cope the best with their problems are those who look at their situation as an opportunity to learn or grow from. Instead of only seeing their injury in a negative light, its helpful for people to try to find the positives they can get out of it. (28:45)
Question: When has therapy helped you or your loved one?