Rip the rug out, fall on our knees, and scramble

These topics that we take coffee breaks over; loneliness, selfishness, God, sleep, medical, these are common enough, no? 

running crazy

The idea at, Friend to Yourself, is that these ideas are all common and in-common.  They all start and end with Me. 

The irony of loneliness being common enough for books to sell on it!  Laugh about it a little. Don’t you want to shout out in the self-help section of the book store, under L’s, “I feel lonely!”?  And then you wake up from the zoning-out moment and realize people take turns apparently to peruse.  That must be the why no one is standing there with you.  But what if we just said it.  If we told our kids, for example? “I feel lonely.”  Someone in the cashier-line who notes your book? “I feel lonely.”  What if we told?  Someone.  We would be kinder to Me than staying quiet.  It starts with Me. 

Loneliness in company is ironic but not exclusive.

Or take the topic of selfishness. 

Self-care is now becoming so politically correct.  It’s losing its potency.  Comparing self-care with selfishness isn’t even provocative any more. Snore. 

But what shall we use to describe the prejudice against us?  Even from ourselves to ourselves. Where shame wires in is the button.  So as it turns out, I am selfish.  I am. But taking care of Me is more than that.  Self care is more than selfish care.  It is selfless. Ironic.  It is different than altruistic.  I can’t give what I don’t have.  Self-care is homage.  Homage to Who made Me.  It is worship.  It is respect. 

Is there anything more disrespectful to those we love than giving them a whole lot of care-giving labor without asking them permission?  I love you therefore you get to tk care of me because I never did. 

It is freedom.  It is power.  Self-care is humility. 

I am not a noun.  I am movement.  A verb.  We can’t get polite about self care.  We can’t be PC.  Rip the rug out, fall on our knees, and scramble.  It is marvelous to move.  Self-care is selfish and selfless.  Dichotomous but not exclusive. 

The distance, the aloofness, the academia with which we mouth, “Selfishness,” as if it were a bobble to teethe over and spit out, mouth again, and let it fall to the dirty floor. As if it weren’t part of us.  …If we describe it just right, we can pull it out.  A foreign object. 

We here at, Friend to Yourself, speak.  But we do also.  How do these break room topics become more than the words?  They all start and end right here, with Me.  That is how.

Another coffee room topic we are awkwardly polite with is the “God” word. 

I have never been someone who could quote Bible verses.  Some mistake this for unfamiliarity and disuse. 

Maybe they’re the same ones who think self-care is as proper as saying, “women have rights,” who took “gay” and made “same-sex,” or those who enjoy writing up packets of hospital procedure for admissions but have no idea about sickness. 

I’ve been this person one time or another too.  The one who handled self-care so much that it lost its shape.  Who forgot that the whole point is Me. 

It is the disconnect between Me and these as topics; God, selfish-care, loneliness.  They are not topics if they are of full use.  They are not the same as a travel game.  Open up.  Play around.  Lose a piece.  Shelve it.  Clean out and send to charity. 

Bring something out as sacred, sensitive, vulnerable and personal as loneliness with common frequency will bring loneliness into company.  Ironic but not exclusive.  Enough to join the perception of ourselves with our life journey.  Freedom.

Each one of these topics is good for a book of their own.  But we don’t want to talk about any of those if we lose Me. It’s not functional. It loses context.  Discussing marine biology at a bridal show.  Interrupting a friend telling you about her soccer goal with an observation about dark matter at the Exploratorium exhibit.  It’s interesting in a state of disconnect only so much as anything is out of context. This is why I think bringing them together and finding the Me in the beginning and end of them is a great way to look at self-care.

Self-Care Tip:  Name it.  God agrees.  :0  (That was forward!)  Start and end with Me.

Question:  Challenge yourself.  Challenge us.  What doesn’t start and end with me?  Why?  Please tell us your story.  We need to hear you.  Keep on.

Sweaty and Worried – Generalized Anxiety Disorder

Hank had to sing an Italian song for his tests.

His music instructor did not believe that he had been practicing two hours a day. When Hank asked his voice teacher to sign off on those hours, his voice teacher still did not believe him.  He had nothing to feel shame about.  “Then why did I?” Hank wondered.  Card in his hand, signed off, Hank resentfully kicked at the rocks covering the path back to administration.

Looking out over mostly empty hard wooden seating in the music hall, Hank slaughtered the song. Even so, it was still the best performance he had ever done.  His father was there in his stained tie and largeness.  His mother in her too many colors, smiled loudly.  She was tone deaf.  Frank’s shame followed him.  He had practiced.

Hank’s older brother dressed in silk shirts, a big gold medallion, a tuft of hair coming out of his barely suppressed neckline.  When they prayed, Hank heard these smacking noises, and thought, “Pray for my nausea,” hoping they would stop kissing.  His brother always had a girlfriend.  The girlfriend was at his recital.  There were noises.

Everyone was scared Hank’s brother would marry too early and maybe marry for the wrong reasons.  His dad was always like, “Wait, wait!” But with Angie, Dad was like, “Get married now!”  Angie was the best in a long line of noisy kissers.

They asked Hank to sing at their wedding.  They insisted.  His brother, his brother’s girlfriend, his parents – they spoke in harmonics all at once.  “Hank!  You sing like Sinatra! Don’t worry so much! You should sing!”

In a rented tuxedo, Hank sang.  The mike didn’t work.  Aunt Augusta told him to sing louder.  Aunt Augusta didn’t hear well, even if there was a mike.  Hank forgot his words and had to start over.  Sweat filled his shirt and he thought about the dry cleaning.

Hank has never had a girlfriend and he is almost twenty-five.  Standing in front of all those people without the song lyrics, the only words that came to him were, “I am like a sweaty doorknob.”  His brother, facing a battle of his own between his ruffled shirt and his manliness, did not help.  Hank thought, “He is probably waiting for prayer so he can start kissing.”

The second year of college, Hank got caught with pornography.  “Hank!” His mother pulled his ear, towing him while she shook the fisted magazine through the house.  He didn’t listen to her words.  He only listened to his memories asking his music instructor for his signature. Was it as bad as the wedding?  Talking to Sarah or walking across the campus greens were bad. He fingered his worries like a beaded necklace.  He worried a lot.  Worry and shame.  He wished he could have a girlfriend but thought that was a hopeless cause.  Hank was already planning on buying a new magazine before Mom had thrown that one in the garbage.

It is so easy to explain away why Hank is the way he is.  We have heard enough to say, his parents, his brother, his isolation, his treatment from teachers.  We can use these to say, “Who wouldn’t be anxious, worried, down, and isolated, when going through these experiences?”  If we did though, we might miss the generalized anxiety disorder, the medical.  Conceptualizing the medical in this way can be so difficult.  We could call it, “the un-reasons why” we feel and do what we do.  So then we don’t have to deny it.  The un-reasons why don’t have to make sense.  They are un-reasons, after all. We don’t have to deny them by our inherent need to point at the cause and effect, or explain into uselessness the reason we are this way.  We don’t have avoid eye contact just because they can’t be seen.

Hank, like so many of us, is included in the statistics that generalized anxiety disorder, or GAD, is one of the top reasons why we don’t get intimate with others.  The anxiety is distracting.  It isolates us.  It preoccupies our thoughts.  It fills us with self-doubt and develops over time, almost inevitably if not treated, into depression.

Getting by with something as subtle as GAD, or other brain illnesses such as degrees of depression, have potentially devastating effects on what occupies our life-line.  The moments that construct the overall devastation may be explained away by one injustice or another, by what are thought to be personality quirks, or simply by neglect of self. But they could be different. The moments, the otherwise same moments, could be different.  The same rude, distrustful teacher, the rejection from Sarah, the quiet mike – those moments could have been different with the same guy, different only in his brain health.  Brain health makes the sameness different.

As Nancy A. Payne, of New York University (NYU) Silver School of Social Work, wrote about treating brain illness,

“There is tremendous satisfaction gained from facilitating the transition from profound illness to equally profound recovery.”

The life-line takes courage to look at.  It takes courage to believe that the effect of our negative thoughts and distorted perceptions could indeed have that pervasively profound effect.  It takes courage to consider that medical treatment can likewise, profoundly change our quality of life.

Hank tried to take his life with a rope before we met.  I’m so glad he didn’t break his neck or die.  He is now well treated and his disease is in remission.  His life-line has changed.Bo-J0zyIEAA_Y3h

Questions:  What are you brave with?  What do you spend your courage on?  Tell us about it.  We gain so much from community and connection.  Keep on.

Self-Care Tip:  Look also at the un-reasons, at the reasons less apparent, at what isn’t seen – look  into those reasons of why we feel and do.

Between Me and Thee While We Are Apart

apart

I woke up and thought, I love and am loved. I heard the birds. I recognized different songs. I know “our” birds outside our door. So grateful. The morning noises in the house, kids – This is what I pray about when I pray, “Be between me and thee while we are apart one from another.”

Every day takes us.  We go toward and away.  We connect and disconnect.  What do you hope stays close when you weave your pattern?  When you are taken into your day?

It may be a day.  It may be education.  It may be divorce, bankruptcy, or a change in condos that takes you.  It may be as simple as getting a haircut.

As hairstylist Jane said, “I see people come in here all day trying so hard to be unique, and I can’t believe that they don’t see just how un-unique they are.”  She was noticing that “unique” implies disconnect. Those of us in this condition may be grooming toward disconnectedness and missing that even the pursuit of this is inherently a connecting force between me and thee.

Let us acknowledge the connections, not fear them.

Back in the day, there was Laban and Jacob, who had shared space for many years.  When they separated, they artfully practiced connection.

Now therefore come thou, let us make a covenant, I and thou; and let it be for a witness between me and thee.And Jacob took a stone, and set it up for a pillar.And Jacob said unto his brethren, Gather stones; and they took stones, and made an heap: and they did eat there upon the heap….And Laban said, This heap is a witness between me and thee this day. And Mizpah (“watchtower”); for he said, The LORD watch between me and thee, when we are absent one from another.

Here, many centuries later, we remember our declaration of independence from Great Britain on July 4, 1776.  It is our watchtower of sorts, a time when we celebrate our freedom, beautifully crafted into what brings us together.  Freedom is not synonymous with disconnection.  It is the ability to choose, to move in and out, to live with boundaries that are made of ribbons rather than walls, to have distance and still remain close to where our heart is.

Questions:  What connections over Independence Day weekend are you celebrating?  Please speak out.  We need to hear you.

Self-Care Tip:  Let your uniqueness and freedom be a connecting force in your life.  Be a friend to yourself.

Media Used Educates

media

Me:

Jasmine, I’m so honored to collaborate with you on this important post juxtaposing the various ways media shapes stigma and your own testimony.

Guest Post from Jasmine:

I love old ads, Victorian, retro, apothecaries…  not only are they works of art, but are full of the funniest jokes.

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It would be a lot easier to laugh at the ad agencies if it wasn’t for the fact that we buy it.  These ads are proof that our health depends on our willingness to look at more than media.  Just because we read it on the internet, see a commercial on TV, it doesn’t mean it’s the right path.

I look at my bottles of pills.  “Of course it’s safe, otherwise they wouldn’t be aloud to sell it in the grocery store”, I think to myself.  Or, “they must be okay because my doctor said so.  Somebody would have gotten in trouble for it by now, if it was bad”.

That kind of thinking gives away our power.  We are no longer responsible when we make it everyone else’s fault if something bad happens to us.  Even if the doctors and companies get sued, it is Me who will suffer the most.  There is nothing more important than our health.  How can we deal with life when we are distracted with health issues?  How will we treat people the way they deserve, when we’re not feeling well?

The point is that what we see in popular culture isn’t there to educate us.  It is there to entertain. Or make a sale.  Or push its other entrepreneurial agenda.

media

I’m trying to focus on smoking because there is no way anyone could deny they hurt you in some way.  Pills are different because there is a different mindset with that, and I’m saving that for another day…  But smoking clearly isn’t healthy.  My dad was one of those people who smoked 1-3 packs a day and said that it’s a myth that people are getting lung cancer from cigarettes.  He jogged everyday and worked out… with a cigarette in his mouth.  If he was alive, I would like to ask him if he thought he would be a better athlete with more stamina if he at least didn’t smoke while working out.  I know the times are different and we know more now than we did back then… But I smoked enough cigarettes in my day to know that I would hack up a lung every morning and had a regular cough, until I quit.

Questions:  How do we tell people what to listen to?  Not just listen to other dramatic people and what we want to hear… not kid ourselves and run away from the real solution, whatever it may be?

-Jasmine (I’m 39, a wife, a mother and I’m cRaZy!)

 http://lakeelsinorelife.com 

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Self-Care Tip:  Use media material for entertainment and look in better places for education and counsel.

Twitter chat – PTSD

Please join twitter chat today. First one of our kind! Smile.

#yourMH chat on PTSD 12-1 pmET

Best Practices & Tools

Always use #YourMH in your tweets.

They keep track of all of our questions T1, T2, T3, etc. We recommend that you reply with T1, T2, T3 to follow Twitter chat.

If you are planning your responses to the questions from @drgabycora in advance, target your answers to 100 characters to allow room for #YourMH as well as room for retweets to mention your handle.

Use http://twubs.com/YourMH and sign in using your Twitter handle to participate. This tool has a lot of great features including:

a. Automatically adding the appropriate #hashtag(s) (#YourMH, #PTSD) to all of your tweets (so you don’t forget when replying and engaging with the audience).

b. It has a pause button that allows you to pause and slow down the Twitter stream.

c. It can also remove retweets so you aren’t seeing multiples of the same message.

Be sure to have your Twitter mentions page open in a separate window. Check it periodically throughout the chat. Many people don’t know how to participate and/or forget to use #YourMH, so you may receive some questions or comments there. Be sure to complete your reply with #YourMH, so that everyone can see the benefit of your comments/answers.

Have fun and remember you don’t have to reply to everyone!

Love comes out of that?!

hope

Hello Friends.

I write to you so many times “in my mind,” which makes me a great writer! Wink.  But even there, I am grateful to have you to write to.

I just got done watching, Fault in Our Stars, with our local hospice team and, oh my word!  I had to breathe through it.  I was terrified I would lose it several times there.  Not being one of those damsels who cries pretty, I was seriously grateful to be sitting in darkness.

So where have I been?  Trying to figure out this friend to yourself thing.  Still.

I had one of my favorite discussions with a patient the other day on where and why good comes out of bad.  Do I love this conversation because it is about an epic force, an energy and a Truth that wins and kicks bad stuff, like, fungus armpits, dead children, divorce, broken friendships, finding yourself alone in a huge space, depression and a brain that you’d rather not be living?  Do I love this discussion because I feel so freaking right?  I do.  Do l love it because I need to participate in it one more time, now, and now?

Probably.

I’m hoping I’m not right though.  I’m pretty sure that even these eyes see dimly and the Truth is even better.  I’ve been told I don’t know it all.

The chat goes something like this,

(Context is status post some real, personal, bleak disclosure.  I’m facing them, and sometimes they look at me.  I sit in an erect chair with a lap desk and laptop computer between us.  Just enough.  Sometimes my service dog, Timothy is present.

One of us inevitably brings up a curving effort toward hope.  Maybe,)

…Love is stronger.

Yeah…

But I don’t know if there is a question mark or a period at the end.  It sits there in the room with us, like it is a squirrel scratching at its whiskers.  It can go in different directions.

Where would it go for you?

Does Love bring good out of bad as if it needs the bad, like dirt around its roots?  Does Love turn the bad into fertilizer, and grow into some apple tree?  We know Love is stronger than bad.  We know Love wins.  But we think, do I have to be loved like this?!  Rather not.

Love is and Love brings good out of us in any context because where Love is, there it is.  Think about presence.  Honest self-awareness.  When you found it was more important to still be able to walk than care if your t-shirt was inside out.  Love is more true than that.  It is more true than looking into her eyes, than hot water over skin.  Love is.

As Green says in the voice of Hazel Grace, “I hope this enough for you.  This is your life. And I love you.”

Question:  What is stronger in your life?  Why?  What happened to disclose such honesty?  Please tell us your story.

Self-Care Tip:  Love wins, even for you.  Keep on.

Sending a message to the hope out there, to the love I know exists, to the friend who knows me, the place I can always call part home, part critique, part play-fellow, counselor, walking stick.  Hello.

Caregiving and Selfcare

Fallen_tree2Being a caregiver is, well, …giving!  There is a need.  We respond to the need.  We give.  There is taking from what we give.

When we talk about this, some of us hear the tap, tap of a bookkeeper balancing ins-and-outs.  Tap, tap, take, take.  We feel dangerously close to objectifying what is Magical.  Objectifying what we get from giving loses at this point in our thoughts the bigger circle of love that motivates us.  Let’s acknowledge and respect that.  The bigger reasons are so worth aspiring to and treasuring.  You who believe in what is more than the numbers of our motives and behaviors, please continue to nurture us with this wisdom.  Be patient as we wander in the corners and cracks and in the places we don’t understand so well.

The point of giving, others pursuing the caregiver’s story later respond, is what we receive.  The love, the satisfaction of observing what our efforts contributed to in another’s rescue.  Perhaps, knowing we participated in saving a life.

Am I a caregiver?  Are you?  Well, maybe we think we are excluded from this category because we don’t liaison between one suffering life-being with the world around.  But are!  We all are caregivers by the definition of what is means to be living.  Living is connection.  We, each of us, are connected to the Universe and the different points from there to here where we stand.  Connection is inherent to living.  To live is to be connected.  To disconnect is to die.

This is somewhere along the philosophical thought experiment of, “If a tree falls and no one hears it, does it exist?”  I am told by those who might be wiser that it does not.  I don’t get it and what does that say about me? ;)

Observation vs. reality.

Connection is like that.  It is not perceived sometimes, and sometimes it is perceived.  This is important to Me.  To the part of each of us that is more than our senses.  More than Time and the condition of our health.  More than brain illness.  This is important to caregiving because by increasing our self-awareness of our role in connection, and thereby caregiving, we have an opportunity to increase our ability to combine the Magic of it with the “accounting ins-and-outs.”  Thereafter, we are lead to increase our transparency to others, increase our connectivity and increase our experience in Life Quality.

Magic is compatible with that which is known.  More even, they are not divided, whether we know it or not.  Magic and that which is known, just are.  We are arrogant people any way we turn the talk, of course.  None of us without agenda.  None of us without projectile pride.  But despite this, we have Grace and whether we hear the tree or not, Magic and knowledge have made allowance for us.

Caregiving comes with connection.  We give, we receive, and we do it with agendas.  Increasing our self-awareness through the process, although it feels at times like ringing out a cash register, and feels soiled by the sound of that which taking brings, – self-awareness of our agendas brings more freedom.  We are more free to give by choice rather than martyrdom.  We give without perceiving ourselves the victim to those to whom we give.  We are more free to give to our other agendas.  We are more free to consider our own needs as needs-of-value from one who is also Loved and valued, Me.

Question:  Might increasing our consideration of our “Me” increase our giving well to others?

Do you consider yourself a caregiver?  How so?  Please tell us your story.

Self-Care Tip:  Give well to yourself to give well to others.  Keep on.

What is The Difference Between Self-Care and Selfish Care

pencils

So what’s the difference between self-care and selfish care?

We hear this a lot here at, Friend to Yourself.  It is a question that can feel like an attack but also an opportunity.  Some people laugh when they say it.  Others do more of a huff.  Self-care shares with selfish care the condition of taking.  That has potential to be confusing.

Let us start with musing, what happens when we give to someone who doesn’t value themselves?  We give and give and they take and take but there lacks the receipt of value, only matter.  The person receives.  The person however doesn’t perceive the, Why?

Once there was Fred.  Fred asked Carl, “Hey man, would you please ask him for me?”

Carl has a childhood school friend he has stayed in contact with through the years.  Carl’s school friend, whom he used to call “Weasle”, is now Attorney at Law, Craig Anderson.  As Carl has nurtured the relationship through the years, sometimes it was easy and fun, and sometimes he nurtured it because it was just smart.  They worked in the same circles.  Once they had shared love of basketball and although they no longer meet on the court, they still meet up.  Carl saw in Craig someone worth investing in through the years, sometimes what Carl invested into Craig was intuitive and other times more deliberate.  Carl considered Craig a valuable contact.

Fred said to Carl, “I just need some information.”  How did Carl respond?  What Carl had with Craig is friendship.  However, he also has “social collateral.”

I remember when I was growing up trying to understand how much money my dad had.  I’d ask him about it, which I now realize is not completely appropriate.  He’d always tell me he was rich because of all the friends he had.  He said, “People are always the best investment.  The people you know, the friendships you have, will always bring you much more than money will.”  It was an early sight into “social collateral.”  I did not get it then.  I didn’t see the appropriate and natural intermingling of what is personal with what is bank.

Fred was asking Carl for his hard earned bank.  Before handing this over, Carl wondered, “Toward what purpose?” “What will that take from the social collateral I have?”  “What will I get from this?”  Fred had a sense of these concerns but he pushed the thoughts away.  He didn’t bring it up openly.  He asked without planning on accounting for what he was asking for.  Is Fred doing selfish care?

Let’s put Fred and Carl on the other side of this page for now.  Let us introduce Susan.  Susan is Lucy’s sister.  Lucy is known as “Floozy Lucy” amongst certain company.  Susan has rescued Lucy many times from life-threat, from financial ruin, from chaos.  Susan gives emotions, money, time, and once even her car to Lucy.  As Lucy continues to self-sabotage, however, we have a word for what Susan is doing – “enabling.”  What if Lucy valued herself more? How the dynamics between Susan and Lucy might be different.  Lucy taking from Susan would be more of self-care perhaps.

Our culture says we need to give give give and the taking is more whispered about.  It is not applauded like a big donation to the church.  It doesn’t consider what taking had to occur to allow someone at some point in their life to be in a position to give.

Over Easter this year at a small church in Corona, CA, I saw one of the best resurrection plays I’ve ever seen, including that compared to what I saw at the Crystal Cathedral years ago. The music, the props, the acting, all amateure.  However, the energy in the room, the connection between the congregation and the stage, and especially the awareness of our Higher Power was intense.  Out of all of this, what hit me the strongest was that the Judeo-Christian culturally celebrates everything about our God who sacrifices, who lives for others, who gives gives gives… but the whole point of what S/He did and does is Me.  Everything about God is His value for Me.  Without Me, that whole story is pretty mute.

Now put God in Carl’s position with Me.  Put God in Susan’s place.  Why would God want someone who gives to others but doesn’t take?  And take well, know they are a person of value.  The taking reflects quite a bit on the Giver.  The taking reflects quite a bit on the taker as well.

Take to grow your sense of personal value.  Take with increased self-awareness of your personal value.  Take to reflect on your connections well.  Take to be a better giver.

These are thoughts I’ve been rolling around.  What do you think?

questions:  What’s the difference between selfish care and self-care?  How do you take with a sense of your own value?  How does taking reflect on those you are connected to?  Please tell us your story.

Self-Care Tip:  Take to be a friend to yourself.  Keep on.

Come join us

Greetings NAMI Family and Friends,

To follow up with excellent information after

“May is Mental Health Awareness Month,”

Dr. Sana Johnson-Quijada, MD.

Board Certified Psychiatrist

will present

“Caregivers and Self Care”

Date: Monday, June 2, 2014

Time: 7:00pm – 8:30pm

Location:

Riverside County Mental Health Administration Bldg.

4095 County Circle Dr., Riverside, 92503

_____

NAMI Español meets at the

Riverside County Mental Health Administration Bldg.

on the 3rd, Monday of the month.

Information will be available about

Family to Family and Peer to Peer Classes at the meeting.

_____

Have you visited our website?

www.namiwesternriverside.org

_____

We hope to see you at June 2nd meeting!

With warm regards,

NAMI Western Riverside

PO Box 4145

Riverside, CA 92514

(951) 369-2721

Facebook: NAMI Western Riverside

“The best exercise for the human heart is reaching down to lift someone else up.”

- Tim Russert

Know You Are Blessed

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Think of the worst of us.  Think of the worst about us.  Think of those with self-loathing.  Those with low self-awareness, the violent, and the violated, think of them.  Where is the blessing?

Blessed are the depressed and anxious.

Think of the healthy.  Think of the diseased.  The misunderstood, the ones who live miles apart from connection, who ever push like a dingy from the peer into waves and self-destruction, think of them.

Blessed are the poor and lonely. 

Where is the blessing when your real estate is brought low by the creeping up of low-life.  Where is the blessing when you get cancer just when you might retire, when your own body calls you stupid, when you lose your eyes after training as a surgeon?

Blessed are those whose bodies are dying.

Think of every corner, every shadow and open space and the turns you still don’t know about inside of your life.  Think of the unacceptable, the character you wrestle against to moderate away from extreme.  The rope you swing on and try to bring to rest, think of the grey you think you will never achieve.  This bit and chapter, this part of your construction, this surprise in how you deliver is Loved.

There is no aberration from the norm that can separate you from that Love.  There is no addiction or misdemeanor or illness or mutated cell that can lose blessing.

This is fact.  Our life is to live with it.

Blessed am I.  Blessed am, “Me.”

Question:  Where is the blessing in what you like least about yourself?  Please tell us your story.  We need to hear you! Keep on.

Self-Care Tip:  Be your own friend in adversity as in prosperity.  Know you are blessed.

What to do!? On-Line Physician Bullying.

I’ve been to this great APA meeting, great that is, because of the people!  Wow!  The fellow attendees, the exhibitors, the speakers – just, WOW.

I’m going to try to share content with you but it will take me time.

bully

For today, “Are You a Sitting Duck Online?,” reminded me of our earlier discussions on the doctor-patient relationship and a previous post, on July 11, 2012, that went like this:

Hello Friends.

Please tell me how I’m doing on this.  Just out,

Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice

This is important to me as I treasure both my medical practice and our community, connection, exchanges on-line.   I don’t want to do anything that jeopardizes either, nor the implication that if I did, that means I would have mistreated a patient.

Thank you for this, what I call, a “good problem” to have – the joy of medical practice and participation in social media/networking.

So many of you resonated with this and engaged.  I am still super grateful.  I’d love to continue with you in further discussion and with your comments!

For me, one of the many reasons I was so excited about this recent talk at the APA is because of the mucho online stuff connected to my name that affects my patients and the dynamics in our patient-doctor relationship.

In my practice, these are just a few sites that have wrong information (demographics) on me:

  • healthgrades.com
  • vitals.com
  • betterdoctor.com
  • ucomparehealthcare.com
  • insiderpages.com

They didn’t ask to clarify my demographics.  They didn’t ask me if I wanted them to become an on-line reference on my behalf.  They use my practice information to drive “eye-balls” to their site so they can get advertizing money and more.  They impose incorrect information about my practice, knowing that in so doing, I will be pressed, (I call it bullied,) into contacting them with my correct information.

If I don’t do this expensive effort, (money, time, emotional expense – all in limited supply, to correct what they post incorrectly,) patients will continue to tell me that they couldn’t find my contact information.  When they Google me, instead of my website coming up, these other sham pages pop up.

Some patients call dead numbers or even drive to incorrect locations to find treatment.  Instead of whomever is behind these websites being held responsible, the medical providers are.

These are the notes I took from my colleagues, as I heard them say.

Unfortunately, I was late to the meeting so I missed two of the four speakers.  Even so, this is worth it.


Dinah Miller M.D., Author of “Shrink Rap” and writing regularly for Clinical Psychiatry News.

Dr. Miller told us about the difficulty of “patient” (or nonpatient, i.e., sham-patient) reviews online.

Who can review the physicians?

  • your patients
  • Friends and lovers
  • enemies
  • trolls – a negative internet stalker

Every practitioner has an idea that they are a pretty good doctor.  So it isn’t easy for any of us to hear otherwise ;).  After getting unsolicited feedback from a person who took the time to write a comment on a site that listed her, a site that listed her profile without asking her, Dr. Miller chose not to play the victim.  She decided to call “Health Grades,” and with her persistence, they took her information down.

On “Vitals” – she got an answering machine with a person’s voice mail and no name and number.  So she called CEO, Mitch, who stated she wasn’t able to take her profile down.  She didn’t ask to open herself up to trolls.

Dr. Miller asks, what shall we do, as physicians?

  • do nothing
  • write a response
  • try to call the company

There are many whose livelihoods depend on public opinion.  For example, waitresses/waiters – many lose their jobs if they get even one negative reviews.

The practitioners in the group responded with resonance with Dr. Miller’s ideas.  They also had thoughts that if left alone, the democratic process would win out over time, truth would come out and such.  (Maybe the nearby statue of Liberty played into our thoughts :).)


Paul S. Appelbaum, MD, Dollard Professor of Psychiatry, Medicine & Law, Columbia University

Principles that Might help physicians Identify Constructive Responses

  • Responses should be Effective
  • Practical
  • Compatible with medical ethics
  • Positive rather than negative consequences

Problematic Responses by Individual Physicians

  • Request removal by website – typically declined.  Saying you’re writing a public article on it might help.
  • Contact the patient who wrote a negative response to request removal – Patient not likely to remove response, many patients post anonymously, most websites won’t allow patients to remove them
  • Flood site with fake positive reviews – deceptive, embarrassing if discovered, ? inducing a person to rely on a statement that may be used to their detriment (fraud)
  • sue patient for libel – identify patient might be difficulty, people have a right to their opinions – would have to prove statements untruthful and not merely opinion, $$ in money/time/and emotion

Encourage Satisfied Patients to Post Reviews?  We could refer to a firm to do this.  $$

Some sites, similar to “Vitals” offer the option to the practitioner to respond to a posted review.

Negative Reviews:

If we do respond – how?  We don’t want to come across arrogant or insulting.  We fear violating patient-doctor confidentiality. In the end, we recognize we don’t have the last word.  We may respond with a soft word of concern.  “If you would call my office, I’d be happy to schedule at no fee to speak with you about this and see if I can help.”

Can Patient Reviews Be Controlled?  There once was a company that tried this.  “Medical Justice” developed a form that gives control over of copyright of all reviews to MD.  – Didn’t work.  See article, “Company tries to stifle online reviews with patient ‘gag orders’.”

Another idea is that medical practitioners help themselves by coming together to develop an internet ombudsman.  This would be a medical/mental health professional not involved in care of patient.

  • Independent (unrelated party) investigation of physician about the case.  A successful investigation may give a third party opinion.  There’d have to be a reason for the world to trust this opinion.

It is difficult for healthcare professionals to protect themselves from inaccurate complaints about their care.

Positive Reviews

Does it put undue pressure on the patients?

A sign in waiting room perhaps.  Make the information available w/o practitioner knowing if they have or have not commented.

There is a dissonance between the position of being a business person that says we must practice democratically and compete fiscally, yet stay in congruence with what tradition holds us to.


The issues addressed in the talk weren’t specifically about being bullied by sham-websites, but it included that idea, along with other difficulties physicians are experiencing in the rapid transition of 3000 years of tradition as a healthcare providers to spending the majority of their time serving patients first to now, the reckless $ burden of running a media vulnerable business.

In the practice of psychiatry, a traditionally extreme-private practice, this is dissonant to many.

Q:  How do we treat the extremely delicate practice of psychiatry as a business when we are held to currently minimally defended standards like this?  Please speak out and let it flow!  We need to hear from you!  …and, Keep on.

Self-Care Tip:  Deal with internet sham-sites and reviews in a method that is consistent with Me, and temperament, while doing the least damage to oneself. It will be better for oneself as well as others.

 

Turn Toward Something Better

Had a great time at, “Seams of Gold.”  Great example of how community is friendly to “Me.”  Met a wonderful man.

Me:  Hi!  I’m Dr. Quijada!  I’m a psychiatrist.

Him:  I’m Frank.  I’m a recovering Alcoholic.

Got to love love that kind of company.  Thank you to all who participated and volunteered.

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Found after our evening, was thinking about that darn “justice” ever skirting so much of Me.  The way becoming the victim to abusive treatment drives “Me” into helplessness all around us.  Things like money turn us to blame and ugliness.  In the end, telling our story, we hear from our own selves more about the behavior of the curmudgeon than would ever leave cause/change/control space for an innocent like “Me.”  Yep.  It’s them.

Using the behaviors and emotions of others is never useful to explain/justify the emotions or behaviors of “Me.”  We are as free to choose to be a victim as we are to not.

Programs like, Seams of God, and people like Frank, remind us that turning toward something better is, Way!  It is way, like opening a window to a hot room, like turning the lights on, like biting into a ripe home-grown cherimoya.  Turning toward something good rather than away from “bad” is choosing to be free.

Be free. Everything starts and ends with Me.

 

Keep on, dandies.

your own,

Q

 

Join us at, Seams of Gold!

The University Surgery Center, Department of ECT, and myself will be joining our community at Seams of Gold, where we will share life changing stories of ​resilience, restoration and hope.

Thursday, May 1, 2014  

​6:30 pm to 9:00 pm, Doors open @ 6:00 pm

“Event is Free”

PLEASE COME!  :)

 

A Father’s Lament  contopolos

On May 29, 2010, we lost our 26 year old son, Nick, after a 14 year struggle to find long term, affordable, quality recovery and care from mental illness and addiction. During Nick’s brief life, both he and those of us who loved him were left with a fatal absence of hope while we struggled, as do many others, to navigate our society’s haphazard, fragmented “system of care”.

Months after Nick had died, I recalled a former broadcast on CNN with a woman who had suffered enormous loss after Hurricane Katrina. The interviewer was asking this lady how, in the face of such loss, she was able to continue on and now help others. She said, “at some point, I stopped asking “why me” and began asking “what now”. That statement, in conjunction with an honest admission from my pastor that “during Nick’s life, he had absolutely no idea how to understand nor how to help us”, was what led to the “what now” of Seams of Gold community service events.

Seams of Gold is named after the ancient pottery art of “Kintsugi”. In this ancient art form of Kintsugi we find the inspiration in how we respond to the fragile beauty that surrounds us.”

Seams of Gold is a FREE multi faith, multi denominational community service event. All are invited.

We are asking that all who have been affected by mental illness and addiction as well as those who love and serve them, to come and be inspired, informed, educated and equipped. Join us, as through the prism of our tears, we pilgrimage together towards a “better day” of empathy, compassion and care for those who suffer.

Recovery is Powerful, it is Possible and it is Beautiful! 

                                                                                                                                  –  Jim Contopulos

 

The beauty of the Santa Rosa Ecological Reserve in southern California provides the backdrop for a father’s lament. Seams of Gold founder Jim Contopulos invites the viewer to join him on a journey as he reflects upon losing his beautiful son to addiction and mental illness.

“Birthed from Pain… Inspired by Art”

                                                                   

http://www.youtube.com/watch?v=VGZ1ESOlvbM

Violence and Originality for friendship

Guest Post!

…keep reading…

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Learning new ideas and concepts releases Dopamine, the “feel good” neurotransmitter/messenger.  I find this theory consistent with my personal experience as I am studying for the boards.  The new concepts, when I grasp them and link them to things I already know, do seem to bring a tiny packet of fell goodness.  So, as I study, i really try to capitalize on this mechanism of feel-goodness.  Maybe I can get addicted to learning.  That would be a great addiction.  I think in some ways, I already am.

Using Dopamine in enhancing our everyday life and getting addicted on life:  Creative expressions can cause release of Dopamine – proven by both science and by our everyday observations of living our life.

Gustave Flaubert, of Madame Bovary, famously said:

Be regular and orderly in your life that you may be violent and original in your work.

To me, this fits.  I find I don’t need to lead a wild and dangerous life.  I don’t need external thrills.  I get my Dopamine from being able to be violent and original in my thoughts and ideas – Quite the thrill.  The regularity and order I try to effect gives me the time and space to be just that – violent and original.

The most cutting truths live in works where the artist is violent and original.    Flaubert, of Madame Bovary, said, “be regular and orderly in your life so that you may be violent and original in your work. “. He is fiercely unapologetic in the way he worked.  I like that.  Be violent and original in one’s work, all the while freeing one’s mind to achieve that end by being regular, mundane, and orderly in one’s life.  The creative juices that thusly pulsates in the artist’s veins more than makes up for the seemingly boring and orderly exterior.

Questions:  What role has learning played in your “feel good” self?  What helps you be violent and original in a way that is friendly to Me?  How do you channel your ferocity in the most friendly way?  How has the boredom otherwise affected your quality of life?  Please comment and tell us your story.

Self-Care Tip:   Be violent and original in a way that is friendly to Me

 

Dr. Chin Tang is in his last year of psychiatry residency training, on his way to Fellowship in psychopharmacology through University of California, Irvine.  He is happily married with much adored children.

Dr. Tang says he likes being my friend because in so doing, he is more “emancipated to be as weird and eccentric” as he is, by nature, meant to be.  Dr. Tang really knows how to make a girl feel great.  Thank you, Dr. Tang! :)  Keep on.

How Do We Age Well?

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Ella Rose

In preparing for retirement, for aging, we put money away like Smaug The Dragon who knows his coin.  We imagine we will gain freedom, retain vitality, interest, and motivation, perhaps enjoy the affection of those we served through life.  But do we prepare for what is really coming?

I’ve been asked, how do we age well?  And guess who asked.  An aged man.  I tugged on my chin a little to hide my discomfiture.  After all, I would like to sit at his table and listen in on his story of doing what he had inevitably done, grown old.  I’d like to hear what he is pleased with.  And what he regrets.  I’d like to hold up the memories, like picture slides to the light, and see if I recognize anything.  Maybe something I might relate to.  Something I might more deliberately emulate.  I might feel more secure, knowing what he has done before me.  Maybe I’d think I am safe.

Remember that song,

A foolish man built his house upon the sand, A foolish man built his house upon the sand, A foolish man built his house upon the sand and the rains came a tumbling down.  The rains came down and the floods came up, The rains came down and the floods came up, The rains came down and the floods came up and the house upon the sand went splat!

(The hand motions make the song.)

But why ask me about aging?  Do I look so old already?  What the!?  Fine then.  I’d like to say, grow old continent and stock full of Botox.  Nah.  That wasn’t it.  (Mind wandering already you see.)

Or maybe, we who are aging wonder quietly if this person, or that might have a trick of doing it better.  This person wants to hold up my picture slides to the light and gather security to them.  That person wants to do more than hoard coin, and another doubts the vitality and wonders if she’d know what to do with it if it were waiting there for her after all in the end any way.  “How do we age well?”

Start with Me.

Me, where there is freedom to choose, the chance of change, the place where cause begins.  (The 3 C’s done our way at Friend to Yourself :).)

As a psychiatrist, it’s easy for me to think first of the biology of aging of course – brain health over time and to recall that the brain is connected to rest of the body.  I could tell this aged man that he’ll be wanting to get oxygen to his brain at night and use his cpap regularly.  I could speak of motility and exercise, of caloric intake and sleep hygiene.  We might spend some time on medical care for psychiatric illnesses common in again, depression, dementia, anxiety, and so forth.  We might speak of the inevitable process of losing friends and family, aging past a child or losing pets.  But as many so often remind me, psychiatrist’s only have the truth that their perceptions allow.  ;)

A dear Obstetrics and Gynecology specialist told me the other day that she has become more convinced than ever that the processes of coming into the world and that of leaving the world are the same.  Having delivered countless souls into life, she has been marked, as if the luminescence of so many branded her.  She carries the knowledge of their entry and of those who have already died.

I remember my niece who died at 9 years and 28 days.  Not so old.  Not so aged.  Some how we think of death when we think of aging, not when we think of nine-year-olds.  However my niece did age well.

I suppose aging is like any system, as strong as its weakest member.  The wonder is that if we believe in aging, we believe our lives run on a line, on Time, which is after all, a human construct, a philosophy and based on Magic. Aging well as implied by my OB-gyn colleague, is looking at it from both ends, looking at what is in between, and looking at what is outside of birth and death.  Aging well includes exploring the essence of Me, what bit of Magic came before Time and before zero and numbers and philosophy turned into math.

How do we age well? Does aging imply disease? Aging is linear. They’re different but definitely paired… Help me on this?

keep on.

Bearable Disappointment

Guest Post!

Read on :)

We’re aware as smart single women that we can’t expect perfection.

But life still manages to throw us curve balls.

Maybe once you’re into your mid-thirties,

it shouldn’t be called dating,

it should be called waiting for the other shoe to drop.

Why is it always something?

Unless you’re in a problem free relationship with TiVo.

- Sex and the City

 

Despite the fact that the mention of TiVo dates this quote (remember TiVo?!), it still rings true. And you don’t need to be in your mid-thirties for it to apply. Any woman, or person for that matter, who has dated for a length of time knows the meaning of this quote in his or her bones.

You meet someone. It is electric. You connect over so many things. His father passed when he was small too. She loves Quentin Tarantino movies as much as you do. You both want to travel the world with nothing but a backpack. You share a love of fine wine and cooking extravagant dinners.

Before you know it you are sailing off in a sea of hormones and dreams of a future with this new, amazing person. You spend time at work day-dreaming of all the romantical things the two of you will share and your heart skips a beat when you see a new text/call/email.

You are twitterpated. Crushing, hard.

The intensity of these new-love emotions makes you feel as if this person is your destiny. This is deep and something you have never felt before. He is “the one”. You are ready to introduce her to mom.

Suddenly all of your hopes and dreams come crashing down, shattering into a million smithereens.

It could be any number of different things. “Deal breakers” are different for everyone. Prince charming could have said:

  • “Well, I am a musician, but it’s more of a hobby right now. I work at Big 5 to pay the bills”
  • “I live with my mom”
  • “I don’t actually have a college degree. I said I did because I’m only 20 credits away”
  • “I’m impotent”
  • “I have a daughter”
  • “I don’t want to see you anymore”

Sigh.

At the very least you are disappointed. You might feel devastated. Even worse, you might consider throwing your standards out the window to start a relationship with this individual anyway.

Let’s get real and break it down.

Getting real: You don’t know this person. Really, you don’t. You feel like you do because of the adrenaline, dopamine and serotonin running through you. It is also very likely that you have projected a huge, unrealistic fantasy onto them that has no basis in reality. That whole engagement speech you dreamed he would be reciting on bended knee? Yeah, you made that up in your head. The home-cooked meals and coffee dates with your mother you thought she would be making? Also fiction.

It is so easy to become disappointed and exhausted by dating, and life in general, when we live in the future instead of the present. When we live in the future we set ourselves up for disappointment and hurt feelings.

If you feel wounded by your dating life, only you can change that.

Be present. Make reality your friend.

Being present: Don’t wait for a partner to make your life happen. Enjoy every day. Plan trips. Have fun. Be grateful for everything you do have. You have so much! I keep a gratitude list on my phone that I add to and read when I am feeling sorry for my single self.

Making reality your friend: By realizing that that the initial excitement of dating a new person is not a promise for the future, you will save yourself a lot of heartache. People are often not who you perceive them to be (this is usually not their fault). And while it is frustrating when individuals misrepresent themselves, that is part of the dating game. Have compassion for people who don’t feel comfortable being up-front about who they are, and move on, (without them!).

Putting all your emotional eggs in one basket is your decision. Allow a potential partner to earn that over time. Let them demonstrate through actions who they actually are and that they are trustworthy. As the song goes. “You can’t hurry love, you just have to wait.”

Also realize this disappointment you feel is not personal. It is not a reflection on you. You are worthy of love. Have hope and stay positive. Remain grateful.

Be soft. Do not let the world make you hard. Do not let pain make you hate. Do not let the bitterness steal your sweetness. Take pride that even though the rest of the world may disagree, you still believe it to be a beautiful place.

- Kurt Vonnegut

Question:  How have you and do you endure well when disappointed?

Self-Care Tip:  Remember that this disappointment is not personal.  Keep on.

20140224_182909Jessica Adams:  I am a science teacher in Southern California who thinks about relationships, human health, love and of course science. I am passionate about doing what is right for kids and personal growth.