This is an intelligent, balanced, and very useful guide to becoming a knowledgeable and confident actor in pursuing your mental health. It will also help you to approach mental health professionals as an equal partner.—Andrew Solomon, Professor of Clinical Psychology, Columbia University, and author of Far From the Tree and The Noonday Demon, winner of the National Book Award

This book is a must read for those who experience or have a family member with a psychiatric condition. Dr. Sederer gives moving descriptions of patients and their suffering and sage advice about interventions. His deep experience in working with those afflicted with mental illness comes ringing through, page after page.—Maria Oquendo, M.D., Ph.D., President, American Psychiatric Association, and Professor of Psychiatry, Columbia University Medical Center

Lloyd Sederer has written this book to help laypeople and practitioners see what's right before their eyes, but often unnoticed. He explores four secrets—that behaviors have meaning, that attachment is central to health (and recovery), that doing more often means doing more harm, and that chronic stress may be the most debilitating condition of life...This is well worth reading, digesting, and using as a foundation for interactions between clinicians and the people they aim to serve.—Paul Gionfriddo, President and CEO, Mental Health America

There are secrets hiding in plain sight, so writes Dr. Lloyd Sederer in his new (10th!) book, which can make a real difference in the lives of people with mental and addictive disorders and their families. He is not only right; he reveals these secrets using stories, anecdotes, science, and history. This is a must and wonderful read for clinicians and for those affected by these all so common conditions.—Linda Rosenberg, MSW, President and CEO, National Council for Behavioral Health

Sederer's thoughtful and provocative book could not be timelier. It arises out of a seemingly confusing moment in mental health and poses an immense creative challenge: to draw out the rules, or laws, that govern the psyche as it adapts to an ever-changing world. His laws or secrets—often counterintuitive, yet full of clinical utility—illuminate his profound understanding of patients and their particular predicaments. There's a powerful thread of wisdom that runs through Sederer's writing like a bright red line, reminding us that by identifying the driving tenets of clinical care, we refresh and deepen our engagement with it in the future. I read this book in a single setting, and felt so much wiser at the end.—Siddhartha Mukherjee, Pulitzer Prize–winning author of The Emperor of All Maladies and The Gen

We've been honored to have Dr. Lloyd Sederer as a regular on my SiriusXM show to discuss his writings on mental health and addictions, as well as his film and book reviews. His expertise extends to every aspect of the human struggle with mental problems, from science to history, from popular culture to the drug war, as this Secrets book reveals. He is an uncommonly compassionate medical professional and public servant—and he's a terrific writer too.—John Fugelsang, SiriusXM radio host

A noted mental health professional casts light on some of the dark avenues of our lives.

Writing for his fellow psychiatric practitioners, but in language accessible to lay readers, Sederer (The Family Guide to Mental Health Care, 2013, etc.)—chief medical officer of the New York State Office of Mental Health and the medical editor for mental health for the Huffington Post—identifies what he characterizes as four secrets that illustrate opportunities in plain sight for therapy. One is the thesis that behavior serves a purpose. That purpose may not be readily discernible, but, the author writes, a cornerstone of good psychiatric practice is finding the right language to allow the patient room for self-expression: We have to ask more, in a manner that allows a person to respond, over time, knowing that they will not be judged or harmed when allowing another person access to their private and sometimes previously inaccessible thinking. The challenges are numerous, but Sederer's insistence on there being a discoverable reason for mental illness helps ferret out why, for instance, smart young people should fall victim to anorexia nervosa or what logic underlies manic depression. The author writes that mental health is a product of both nature and nurture; we cannot help our genes, and people have only so much control over whether their families are supportive or they are able to earn a decent living. It is in that scenario of environmental control that another of Sederer's secrets emerges, namely that chronic stress is the enemy. The stress response, like all behavior, has a purpose, but acute inflammation and the endless fight or flight of modern life takes its toll. Blending cutting-edge science with therapeutic art (positive thinking is good protection against stress and beneficial to our health), the author offers an optimistic view of what we can do to improve our well-being.

A helpful owner's manual for those in possession of emotions—and, more to the point, those possessed by them.—Kirkus Review, 05/09/2017

It seems that Dr. Sederer has undertaken two tasks in his book and through his public service:

1. To make mental health issues more accessible to the public through his writings in the Huffington Post. In the book, secrets 1 and 2 pertain to this task by offering more of a psychological-formulation insight that is often overlooked in mental health practices.

2. Secrets 3 and 4 offer more systemic insights as to how to reduce the science-to-practice gap on a system-wide level, which fit with Dr. Sederer's role as medical director for the New York state mental health system.

While the book does not offer insights or literature that were not already known, Dr. Sederer's neat, clear, and succinct packaging of this knowledge into a short 100-page book makes these issues very approachable and practical to lay readers and practitioners alike.—Noa Heiman, Ph.D., Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, American Journal of Psychiatry, 05/01/2017

In the second section of the book, he goes on to examine treatment for the individual, stressing that there is no one right option to fit everyone. He is critical of the fact that (amazingly) 90% of US recovery centres are based on Alcoholics Anonymous, which studies estimate is only effective for 5–10% of those who use it. A doctor's job, he argues, is to help their clients to find whatever combination of treatment works for them, and he takes us through the virtues of various options: 12 step, motivational interviewing, contingency management, and medication-assisted treatment among them. It's reassuring to see his reminder that methadone maintenance can be life-saving; reassuring also that he emphasizes the need to treat mental and physical comorbidities in addition to the addiction alone. UK policy makers would do well to be reminded of this.
No quick-fix solution here, then, just wisdom and humanity. For those who work in the field and are already versed in Sederer's arguments there is perhaps little new information, but it's certainly refreshing to read a book on the subject that contains so much empathy and common sense. For those new to the subject—including medical students and addiction trainees, if there are any of the latter left—it's an excellent eye-opener: I shall be recommending it.—Jenny Drife, Lancet Psychiatry, 07/02/2018