Love to Pee

peeThe little boy was standing in the tennis court by the fence, facing out.  Doing what?  Sure enough. 

“I’m nature peeing,” he said.

Have you ever seen as much happiness than in the faces of little people peeing?  Well, I love to pee, too. I think most of us do. That is until we pee inopportunely. Or poo. Ahem. 

I’m getting older and realize that my happy peepee-ing days are numbered.  Three kids later, into my forties, and like the garden faucet outside with minerals crystallized around a corroded fixture, dripping “will,” (ahem,) start. Soooooooo, sooooooome day, …urine will yellow my underwear. Kids, without discretion, will announce that I smell. And for the innocent, and a once happy pee gone horribly wrong, I will be ashamed.

The pelvis is like a woven basket. Muscles criss-cross in a wonderful design between a supportive frame, like plant fronds and wood. 

When I was an eleven-year-old, I travelled to the African continent.  It wasn’t every country, wink, but a few on the southern side. I don’t remember enough of my childhood. Who knows why. But I do remember, in every African market place, I looked on women and children weaving leaves and grasses. They didn’t even have to watch their projects. Their fingers had memory of their own.  Instead, their eyes were watching us watching them. Brilliant more-than-white smiles in chocolate black skin, turned their curious faces up.

My Mom, a lover of all things lovely, looked. She loved them all – the people, the baskets, the freedom of being in Africa, and more. Then the blood of generations of hagglers and market yellers whipped through her Lebanese veins with increasing energy, distracting her from a bigger picture.  She wished mightily for baskets.  She would have purchased every one and made us carry them all back to our home, eleven hours by airplane, if she could. (Those were the days when people smoked inside airplanes. You and I understand what that meant. That air inside airplanes was the same air everyone inside breaths. It was a long flight.)

A decade-plus later, World Market opened. I wondered about all the faces and fingers it must have taken to make all those gorgeous creations, now for sale in Temecula, CA, for twenty some dollars a piece.

How could I be so clueless as a twelve-year-old, but I was, and I didn’t know about the fingers that deftly moved, the brilliant plant dies, the tight strength that remained in a basket, like hands clasping, between each fiber. The baskets held memory.

These are the baskets I think of when I think of the marvel that the pelvis is.  These are the baskets I think of when I think about how much I will despise losing continence. When losing continence, I will also remember that little guy making “nature pee.”  I will pull the backing off another panty-liner and say, I used to really like to pee. 

Our emotions and behaviors are similar to the joy of peeing and the pelvic basket. We at one point in our life may have loved to live, loved to speak with friends, loved our hobbies and our stamps, and our cooking pans. Some day later, we wake up, and people notice the difference, like the urine smell in incontinence, people notice our emotions and behaviors “leak.” Kids point, even, “Mommy, why does Bridget’s Mom always wear those sweat pants? She’s in the same sweat pants every time we see her!”

It’s awkward. People don’t know what to expect from us. Our emotions and behaviors are not what is socially acceptable and they stop knowing how to speak to us. Our professionals who are supposed to help us don’t even know how to speak to us. They shorten their visits with us. They tell us how to feel, “Just decide. Make a choice. Choose to be happy.”

When people don’t know what to expect, it divides us and separates us and is uncomfortable for all. This discomfiture, (less often consciously aware,) is a barrier in knowing how to speak to a psychiatric patient. It takes a heck of a lot of self-awareness on each party’s side to look inside ourselves and figure out where our discomfort is coming from.

What will you think of when you “wet your pants?” Or of someone you are with? Feel your energy get sucked into the earth by a depressed colleague? Notice acid escaping your stomach into your throat when an angry child’s emotions fill a room? Your thoughts start to buzz when the white noise of anxious Dad comes around.

Remember the pleasure that came back in the day, see into our Me, identify the nidus of discomfort, and then let it lose it’s power over us – then the unexpected with be an encounter of mutual respect.

Knowing how to talk to a psychiatric patient, means that we are okay not knowing what to expect, not personalizing what isn’t about us, and allowing for a context that is in many ways unknown. With this, we will pull the backing off a panty liner and get on with it.

Questions:  How has the unexpected behaviors of your, or of others you know, been treated by your medical providers? How have you treated yourself in those scenarios? Please tell us your story.

Self-care tip: See into your Me to be better at speaking with the unexpected.

Afraid to Talk to the Psychiatric Patient

Afraid to Talk to the Psychiatric Patient


Pastor Dave had always been a softy. He was the chubby boy who cared. The one helping in the kitchen when his siblings were outside and elsewhere. Taking care of his little sister after their mother diminished her with words. After seminary school, he knew he was designed for this.  He was destined to care for those who had needs.

Driving down Highway 79, he pulled over for the man shambling along the sidewalk, thumb out. Dave asked,

Where ‘ya going?

This wasn’t the first time Pastor Dave has picked up stinky, filthy people. He loved serving the homeless. His church had one of the largest programs for the homeless in their county and he knew that if he weren’t employed by the church, he’d be doing it anyway. That’s how he knew he was doing what he was brilliant at and when he saw this man sitting in the passenger seat, his energy went up.

Unfortunately, after fifteen years of picking up the homeless, Pastor Dave picked up someone who was hearing persecutory command type hallucinations. Pastor Dave was taken off guard with the first fist to his face. He wasn’t expecting the second either. Raising his arms to cover himself, he took several punches to his gut. Falling down, his head broke on the car frame and then asphalt below.

It was many months later, his jaw wired shut, and wet tears rolling down a scabbed face in my office that we met. I felt scared. I didn’t know what I feared at first. Yet somehow he nailed it for me when he told me that he didn’t know how to look at the world any more.

This attack on Pastor Dave’s body was an attack on his identity, his sense of self. His belief of what he thought his very DNA had been created to do was traumatized. It was like someone who had been raised to be a baker, was never able to get into a kitchen after fifteen years of bread and pastry dough. Pastor Dave was bewildered by his visceral response to even thinking about talking to someone with possible mental illness. He felt like throwing up looking at them. He shook. And without freedom to serve others, his energy dropped and dropped and became the vapor of a memory of some other person. That guy with energy was almost like a story of a previous acquaintance.

In my research about this topic, how to talk to a psychiatric patient, I’m learning about attitudes and stigma out there toward them. It’s incredible. But there are not many who take it to the street and help us just talk to each other.

Many months later, I asked Dave his answer. He said, at this point, he had become a psychiatric patient himself and supposed it just started there. With one’s self. Too good.

Everything starts and ends with Me.

I ask with you, how do we talk to psych patients?

When we say, “Give it up, give up the stigma, get the attitude of gratitude and get out there and be kind,” are we talking about getting into a shark tank? No. We’re not encouraging people to put themselves in a place of danger. What are we saying?

Question:  How do you talk to a psych patient? Please share your stories.

Self-care tip: Have a day knowing you are a person of value. Let this moment and then the next, for today, be one when you let yourself join into the great and the not so great parts of who you are, more than a spectator, more than either-or, more than healthy brain or unhealthy brain. Keep on!

Funny or Quirky? – How to talk to a psych patient

Ok.  So how about any funny, quirky, odd, and somehow memorable (without be aweful) stories about how people talk to psychiatric patients?

Have you observed or experienced any?

Please speak! :) We need to hear you.

Thank you, Farida – A Woman of Courage


Dear Farida,

I’m writing to you to thank you for the opportunity to share your experience with postpartum depression and anxiety. You are in a class where the most courageous of the courageous live. I remember when I told you that and you asked,

Why? Why do you say that? I can hardly get up in the morning. When I think about going into public places, I want to throw up! I don’t look people in the eye. I avoid everyone. I know they will see that I am crazy. I am ashamed.

When I drive, I have to pull over at least once every two miles to catch my breath.

Some days, I don’t shower. I smell. I don’t eat so my breath stinks too. I don’t want to exist. Why would you say that about me?

And that is exactly why. That and the fact that you pushed despite the wall of fear and bottomless gloom and came through our office doors. You came again. You swallowed medications you at first didn’t believe in. You took chances every time you put hand-to-mouth, hand-to-mouth, with those damn and blessed pills that remind you every time that you have this illness. You did that long enough to start believing and to hope again. You do that even when you think you don’t need to anymore.

You are brave.

There are too many of us out in our community who don’t know about this incredible heroism. It is heroism when mother fights for her health, wife fights for her health, fighting for her family. You have the guts to start with yourself. Over and over again. You are the hero who, when it feels like regression to say the words, “I need help for the way I feel,” when it feels like failure to take pills, “…to live better,” when thoughts don’t make sense with feelings and are collectively, exactly at that point in time, when the word “crazy” is broken out into all it’s bright rainbow glory, you are the hero just then.

You are courageous getting here. Getting here in the first place was and is no small feat. But you took it further. You take it further still. I am inspired.

Dear Farida, Thank you for letting me be your physician. Thank you for letting me believe a little more that I am more than my own emotions and behaviors. For driving me to discover my identity. I am scared too. I’m scared of being that vulnerable to something as seemingly sure, like “brain health.” My own beliefs are being challenged by it. It changes how I see the world. And, I know our community is challenged by you too.

You help me hope, in the context of being someone with a changing body and mind. I’m learning about what I can control and cannot. I’m learning about goodness that is more than cooking a meal for someone, bringing in a paycheck, or basic needs.

You are a part of this journey-discovery.

And agenda – as doctors are not supposed to have any… (Ahem! Anyway!) Your bravery lets me bravely disclose even to myself. My agenda. Being your physician, in the face of so much courage, I think about what I’m working with you for. Thank you for giving me your life story as an opportunity to discover more of why I want to know Me. You are my teacher as well as my patient. I hope to live each day with courage too.

Keep on.

Dr. Q

Question:  What are you doing that is courageous? How is your life one of bravery? Please tell your story.

How to Talk to a Psych Patient, outside of the psychiatrist’s office

So what about other practitioners not in the mental health field?  How do they talk to psych patients?  Do you have any stories of your own that you’ve observed or experienced?

Say the cardiologist?  The nurse checking blood pressure?  The patient on a medical unit for a broken hip?  In these, out of context, contexts, psych patients are still treated differently at times than other “medical” patients.

I’ve heard a ton of stories about the ER (emergency room), when a patient comes in with chest pain, for example…

Tears are flowing down Frank’s stubbled face.  He is shaking, and sweating, and is sure he is going to have a heart attack. Everyone takes Frank seriously, that is until they see Frank’s medication list.  Some not so nice words are exchanged, and so forth after that.

Frank’s story and others like it are all bummer stories. But it hits me hard when later, if one such patient was fortunate enough to press the issue and the work up, and later it is found that they were having symptoms of both anxiety and heart disease, and would have died if that wasn’t discovered. I can’t help imagine and remember real people who were not so “fortunate.”

Or a someone is inpatient on the infectious disease ward for a MRSA+ leg cellulitis.  They are, in the hospital staff’s opinions, a sad patient.

Let’s call her Susie.  Susie’s finger never hits the nurse’s call button. She cries alone and people stay away. Who knows why.  Without asking her about her emotional and behavioral symptoms, they practice as if it was assumed that it is normal for someone in her condition to “get a little depressed.”  Susie recovers from her leg cellulitis and is feeling better.  She is feeling good enough in fact to realize that she doesn’t want to live, and hangs herself by the hospital sheets.

How do we talk to a psych patient?  Please speak out!  Tell your stories.  Tell your thoughts!  Good experiences and bad ones.  Good opinions and lesser.

Keep on!

How to talk to a psych patient??

Hello Friends!

I believe the last NAMI meeting went well. Huzzah!  On to the next…

I was invited to speak at the IACC Annual Conference, April 22nd at the Riverside Convention Center. Guess what they want me to speak about? “How to talk to a psychiatric patient.” Interestingly, I was also asked to speak on the same topic for the AMA Annual Meeting in June. Who would’a thunk?

Before you throw your popcorn at me, please put it into words here, at FriendtoYourself.  What do you think?  What to say?

Will you help me?  How to talk to a psychiatric patient…

Keep on!

NAMI talk

NAMI of Temecula Valley will host an event during their monthly meeting on January 21, 2015, at 6:00 pm at the Assistance League of Temecula, 28720 Vía Montezuma, Temecula, CA 92590.

Sana Johnson-Quijada, M.D., will speak at 7:00 pm on the topic of, “The Effects of Sleep on Brain Health”.  Dr. Quijada attended medical school at Loma Linda University School of Psychiatry, and was Chief Resident at Harvard in 2002.  She has written two books on being a “Friend to Yourself” and facilitates a variety of community presentations.  She currently is in private practice in Murrieta, California. 

For more information on NAMI (National Alliance on Mental Illness) please visit our website at