Taking Stock for the New Year

As we begin a new year, I thought it might be interesting to pause and reflect on the year that has just ended, putting ourselves in the context of our country and our world. On December 31, 2011, I checked out the blog listing of its viewers’ “top 10 stories of the year.” Here they are:

Of course, viewers select their favorites from a menu served up by the media—in this case by CNN; nevertheless, eight of the 10 top stories reflect violence, unrest, disasters, unemployment, and a precarious economy.

It’s not news to any of us that this has been a year with high-stress highlights (and many more we could add), so the events of the year probably reflect a higher than usual set point of stress for us all. Considering the year from the vantage point of a biopsychosocial model of psychopathology, we have been traveling over some pretty rough psychosocial terrain in 2011, intensifying worry and anxiety and taxing our individual and collective resources more than ever. And we are not out of the woods, not by a long shot.

I could itemize how these stresses manifest themselves in our individual professional lives, in APA itself, and most importantly in the lives of our patients and their families, but I think we have all thought about that a lot, so I’ll just underscore the reality and validity of the heightened burdens we have shared. What I would like to emphasize, however, is what resides within so many of us—the resilience, capacity to cope, and power of hope that so often trump the adversities that come our way. While we sustain our efforts to deepen our understanding of the pathophysiology and etiology of psychiatric illness (efforts that are producing huge dividends), we are “waking up” (or perhaps returning) to a person-centered, health-promoting framework of medicine. In my book, a recovery perspective does not deny the reality of illness nor does it insist on “cure” as the only acceptable outcome. Rather, it endorses the importance of evidence-based treatment combined with efforts to harness each patient’s strengths and talents, to minimize impairment in functioning, and to maximize quality of life.

So I thought I’d close with another “highlights of 2011” list that is very different from the CNN list above—the top six papers published in the American Journal of Psychiatry in 2011, as selected by the editor in chief and the deputy editors of the journal. Many of you will have seen this in the December 2011 issue (http://ajp.psychiatryonline.org/article.aspx?articleid=181056), but I thought it fitting to include a condensed version here.

I believe that this list of favorites, one of many that could be compiled, weighs heavily on the good-news side of 2011, and I’m not sure whether the pointer on the scale would point to the good news or the bad news side if there were a way to add it all up. But for sure, though we had a lot to cope with in 2011, there was plenty of progress. Let’s hope that at the end of next year, the reading on the 2012 stress barometer will drop. Let me wish each and every one of you a very happy and healthy new year!