The following is a lightly edited transcript of a speech that Jim Ott gave at the 2024 Emerge Solutions conference: “Together We Thrive.” Ott is a school psychologist and an aha! Process consultant.

Hey, everybody. My name is Jim Ott. I’m a national consultant with aha! Process. I also should say that my background is as a school psychologist; I’ve been working with children and families for really 40 years now. It’s hard to even say that word and understand how significant that is, but yeah, about 40 years I’ve been working with families and children primarily at school, but I also have been involved in a community initiative here in my hometown of Dubuque, Iowa, that has addressed poverty and family systems through the lens of Bridges Out of Poverty and Getting Ahead in a Just-Gettin’-By World. And so the thing that I want to spend a little time talking about today is the intersection of mental health and poverty. We certainly live at a time when mental health has really become a prominent topic of conversation, and much of that is for the good.

It’s allowed us to talk about things that in, I guess I would say in my youth, in my upbringing, and even in my young and middle adulthood, were the kinds of things that were maybe kept secret. It was kept as something that, oh, if a person had a mental health problem that was something that wasn’t really discussed or talked about in a way that could yield real positive outcomes for people. And now we have just so much emphasis that people are much more aware. And the good news to that for me is that people can recognize this in the early stages so that it doesn’t become a problem that takes more time to get out of. Well, in my work with families in schools, as well as through Getting Ahead and the community leadership we have, we certainly encountered a lot of mental health challenges for people, both for people in poverty, but also even among those who are contributing to our program through volunteers.

I saw it with teachers that I worked with who were under a lot of stress. Mental health is just a common kind of a thing. And what I would like to talk about then to start with is this idea of mental health. And one of the things I think is really important is to distinguish between mental health and mental unhealth. So usually when people hear the word, and I do this with audiences, I’ll say, “When you hear the words mental health, what comes to mind?” And people, some people will give all the right answers, but often the kinds of answers are depression. ADHD, anxiety disorders, bipolar, and then they might talk about doctors and therapy and medication. So when you hear mental health, we default to what is really mental unhealth and mental illness. But when I talk about physical health, if I say, well, what comes to mind when we think of physical health?

And the topics almost always center around diet, I need to eat better and exercise, I need to move more. So when we talk about physical health, we tend to focus on how do I improve my physical health? And one of the things that we can do in our work with all families, regardless of what you’re doing, but for me thinking about this through a Getting Ahead lens is to help people understand across all divisions, this isn’t a poverty problem. This is just a stress and instability problem. To understand that mental health is really much more or should be more about how can I become stronger? How can I become more resilient? How can I regulate my emotions in a more stable way over time as opposed to the typical or the kind of cultural conversation about mental health, which will often default to the individual as what is wrong with me?

Which is not always a helpful way to look at things, because especially in this time that we live in, if people are experiencing anxiety, if they’re experiencing stress, if they’re experiencing profound sadness that even lends itself to depression, well, I would argue there’s nothing wrong with you that isn’t wrong with a lot of us right now. And having that frame can allow us to address mental health issues through a lens of how do I get healthier, which is what we think of with physical health, not what’s wrong with me and how do I get a diagnosis that can explain what is going on within me. So when I talk with people who come from, I guess within our Getting Ahead programs especially, what are the concepts I’ve encountered that I think is worth mentioning is that for people who are living real lives in real stress, in real instability, there’s really kind of a fine line between how much we sort of orient ourselves towards, oh, there’s a mental health problem versus there’s maybe just a learned lifestyle stress-related problem.

It’s not as cut and dried as sometimes we like it to be. The traditional middle class, of which I am a lifelong card-carrying member, has a tendency to view mental health through more of a medical model, which says if you get a diagnosis, then there is a cure. And it’s a very kind of cause-and-effect way of looking at it. But often the things that look like mental health diagnoses are really a product of a stress-produced long-term chronic stress lifestyle. And those are things that can be addressed in ways to bring people into stronger mental health without having to think immediately, oh, if you have a diagnosis and if you take these pills, everything will be fine. Now I’m getting it, this is a short little video, so I don’t want to get into somebody, don’t email me and say, but medication really helped me.

I know medication can be very helpful, but it isn’t the solution to any mental health issue all by itself. There’s always more that has to be done. So one of the things that we discovered in our Getting Ahead work, and this involves the Getting Ahead theory of change, which if you’re interested in that, please look into this a little bit more, but the Getting Ahead theory of change, contrary to many approaches to working with people in poverty, a lot of times the approach to working with people with poverty is if we give you the stuff you need, you’ll be fine. Okay, these are just simple relief programs, like here’s a check, here’s some food, here’s some clothes. Well, we can pretty well say that hasn’t been effective. We’ve been doing that for a long time, and it can help people in certain situations, but that approach that if you get stuff then you won’t be in poverty clearly hasn’t been quite the right thing.

That theory of change isn’t working. Similar to that is if you don’t do the things that we tell you to do, then we’ll take away some of that stuff that’s not working. In a lot of programs, the Getting Ahead theory of change says that people are problem solvers and that if you give them the right information in a way that they can objectively look at it. If you give people an opportunity to step back and objectively look at something and give them the resources, connect them with resources and knowledge, people know what to do in terms of what’s best for themselves, and we’ve discovered that when we’re working with people in mental health and with mental health issues, if we can spend more time getting into what is actually happening neurologically in your brain, we have so much good information about what’s happening with people’s brains and in a physical description of fight and flight and emotional reactions and why do we deal with stress the way we do and strategies for regulating that. We have so much good information.

What is wrong with me? I can’t keep my mouth shut. I keep yelling at everyone. What’s wrong with you? There’s something wrong with me, when actually, biologically, physiologically, neurologically, these are the things that are happening. When we make that work objective, then it gives people permission not to see it as a personal evaluation of their character, but as a physical neurological issue that can be dealt with through effective strategies. And we’ve done that with enough people that we can really say using a Getting Ahead theory of change, which is let’s give you some good information and then as a group work on how we can support each other in applying this information, has really, really been helpful. So those kinds of things are really important. The mental models, we do some pictures of how your brain works and we kind of help label some of the parts, and I won’t go into all that right now, but those pictures help people to step outside of their own immediate experience and understand what’s happening in a meaningful way.

So among the things we talk about is the fight or flight mechanism, which is largely non-conscious. In other words, we have a fight or flight reaction before we’re telling ourselves a story about it. One of the things we talk about in all the Emotional Poverty books that are part about how process is the idea that our brains are motivated by two main things: safety and belonging. Now safety is easy. We just want to stay alive. As I heard one guy say, our brains are pretty much designed to keep us alive until dinner so that we don’t become dinner. And so we just have a brain that instantly reacts to perceived threats, but it doesn’t do it at a level where we’re conscious of it, and so our non-conscious brain has that fight or flight reaction. And then we have to begin to tell ourselves a story about what’s happening, and we can help people to intercept the story and recognize that sometimes our story is trying to make sense out of a normal reaction, but the story might not actually be the healthiest or best way to interpret what’s happening.

Then we can give people strategies for how to recognize what’s happening in their body and brains and get into better storytelling so we don’t just become reactive. Now, this is mental health stuff for everybody, but it’s particularly helpful for people who are living in chronic stress. Mental health is really a reaction to stress. How do we deal with stress if we live in relatively stable lives? Well, again, the second thing is belonging. We want to be in an environment where we belong. One of the ways that we define belonging is can I come into this environment and predict reliably what it’s going to be like? Is it stable predictability, even predicting instability? I don’t want to get into that. We want to be in a place where we can reliably predict what things are going to be like because then our brain doesn’t have to work so hard.

And so belonging is when you walk into a place and you’re not on edge in a sense of what’s going on here? How do I have to react? What am I going to do? When we can help people develop an understanding of the storytelling that goes to belonging, we can help them feel more regulated in situations. But if you live in chronic stress, it’s very difficult to walk into any environment and feel like it’s predictably stable. If it’s not predictably stable, then you’re on edge, then you’re reacting, then you’re not making decisions and you never necessarily feel like you belong because your brain is saying there’s something here that could hurt you. Now, it doesn’t matter if it’s physical pain, emotional pain, just the stress of life in general, but your brain perceives all of it, kind of the same as a threat. And if you don’t have any places where you can go or times where you can just rest and reliably predict what’s going to happen, then you lose that sense of belonging, which leads to a second thing that we talk about quite a bit.

Stress isolates. We all sort of know by experience that when we’re stressed, part of what we want is just to be left alone. Okay? If you’re a parent, you understand this. If you have more than one kid, in fact, even if you have one kid and you are stressed and they’re stressing, you just want some distance between you and the source of that stress, and stress will almost always lead us to a period of isolation. But the problem with isolation is that isolation is mentally unhealthy. It’s not good for us to be alone.

And in fact, we don’t really work out things well by ourselves. We need other people’s brains to help us solve things, which is why Getting Ahead is just such an amazing thing, and I’ll get to that in a second. We need other people, but stress causes us to isolate. Isolation is mentally unhealthy. Acting in ways that are mentally unhealthy ultimately lead to what become diagnosable, diagnosable mental illnesses, mental health issues, which further isolate us, which is even more mentally unhealthy, which makes us isolate—do you see where this going? It becomes a cycle of isolation. And one of the things that happens within that cycle is people begin to live with, I guess I would say, an identity that’s based on their shame. I’m not successful. I won’t be successful. I can’t trust anybody. There isn’t anybody who truly cares for me.

A lot of really mixed-up stories come when we get isolated. When you live in chronic stress and you’re consistently feeling the need to isolate yourself from healthy connections, it doesn’t mean you’re not in relationships. We talk about generational poverty being dependent on relationships, but are they relationships of intimate support where you can process your stress? Not always. And one of the things I’ve found in the Getting Ahead groups I’ve done is the relief that comes when people who have shared experiences are able to share those experiences out loud with each other and come to the realization, “I’m not alone. I’m not the only one.” You can almost see people just go, “Oh, I’m not the only one.” And it’s one of the things that people who’ve done Getting ahead will tell you. There comes a moment within the first couple, three, four weeks where the group all of a sudden is not a group of individuals, but a group that is joined together by their common shared experiences.

It is a fascinating thing. One of the things I’ll say to people who are doing work in poverty in the mental health realm is, as people who come from generational stability or generational middle class, we will often perceive the hidden rules of people in poverty as being wrong or dysfunctional, or there’s something wrong with who they are. And one of the things that has started to happen is to label those as mental illnesses. I think we need to be careful that a difference in hidden rules is not necessarily a mental health issue. It may simply be a different set of survival skills based on what a person needed to survive their environment when they were growing up. For example, in middle class, if we are in middle class stability, if we are in a conflict situation, we are expected and we value at a moral level the ability to restrain emotional reactions and sit down and rationally process the situation.

We value that, but we value it more than just a good idea. We value it morally. But oftentimes in chronically stressful environments, there isn’t time for those kinds of conversations, and it may have never been modeled by the adults that were in your environment. And so problem solving can be a little bit more emotional, a little more bombastic sometimes, feeling like it’s going to be violent even if it never actually gets there. And people in middle class who value rational conversations will think that the people have some kind of a mental health issue, whatever it is, they might say they’re narcissistic or borderline personality disorder or just they’re crazy. We might not say that out loud, but let’s be honest, that kind of comes into our mind. But actually what we might be viewing is a hidden rules difference. And we believe, and I 100% support that hidden rules is a concept that can be learned and practiced, but we have to expose people to that concept and give them environments to practice it because we have to rewire our brains. As I like to say to teenagers that I work with, it took you 16 years to get this messed up.

You’re not just going to change it in six months, and if you’re 30 years old, 35, 40, got a few kids, you don’t just rewire your brain in a Getting Ahead session. But we can begin that process through objective examination of the concepts in a way that can help people begin to make decisions that are their own decisions, not things they’re being told to do. And then we can help people and support them as they essentially rewire their brains. Getting Ahead is a fantastic place to do this, and I’ll just mention this again. What I love about Getting Ahead is that it’s community-based, and speaking as a psychologist, speaking as a guy who’s been working in mental health for a long time, we don’t get better alone. It just doesn’t work. Now, therapy can be good. Therapy can sometimes be hard to access for everybody.

There’s limited resources for that, and sometimes they’re very expensive. But community experiences where people feel seen and known and accepted and they can begin to see that they’re not alone are one of the most powerful mentally healthy things that we can do. So in Getting Ahead, and we recently have added a Getting Ahead ACEs and PACEs supplement that deals with adverse childhood experiences, these things can be so powerfully effective in helping people recognize that maybe I’m not having a mental health issue, maybe I’ve just got a lot of stress and maybe the people around me do too. What could we do differently about it? So we work on those strategies and we do all kinds of things, all the pop mental health stuff that you can watch TikTok videos. Don’t watch TikTok; it’s terrible. Watch on Instagram. All the videos you can see about how to breathe properly, how to relax, things like meditation practices, prayer, things that people do.

We work on some of those through the lens of there’s nothing really wrong with you that’s not wrong with all of us. All of our brains kind of react the way that yours does under stress. Now, how do we learn to handle that better? It’s exciting work, and it’s fantastic when you see somebody doing this work and working in a community and seeing their wins as they come back and share those and inspire others to do it. I’d love to talk with anybody about this. Obviously, I’m kind of passionate about it. If I can be of any service to you or to anybody else, please get in touch with me through aha! Process, and you can call them, and they will put you in touch with me, and I’d love to have that conversation with you at some point. Thanks for listening today.