Guilt Furiously Chasing You Is Commonly Experienced In Illnesses Of The Brain

Orestes Pursued by the Furies, by John Singer ...

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Self-Care Tip #221 – If you feel chased down by guilt, stop running and get friendly with yourself.

I’m so busy!  I am trying to work, raise three kids, and be a wife!  …and I’m just spread so thin!

It was new for Connie to think that where she was at in life was linked with her choices.  Somehow she intuitively felt taken along by it all, a current of life as people say, of either randomness or design.  Who could know, but it was more than her choices, she was sure, and she resented the influence on her life’s design.  Not that she had intended on taking over what was playing on her.  She just simmered in the house of cards hoping that when she got to make a play of her own, she’d make a good one and come out better for it.  In the mean time, she just had to keep moving fast.

Things would have been fine, except that over the past six months, she hadn’t been enjoying what she was living for, her kids, parenting, being a wife or her employment.  Yes, she was also  living for God but no, she wasn’t enjoying Him either.  Did she want to?  Did she feel guilty about it?

I feel guilty all the time.  It’s the guilt that gets to me.  It’s like I can’t see or feel much else.  Just when I think I’m about to get into what I’m doing, guilt comes chasing at me in a fury!  Distracting me and worrying me.  I’m on edge more and irritable from feeling defensive, and trying to get away from whatever this is.

Connie looked at me when I said,

Self-care begins and starts with “Me.”  Although we may be living for others and other things, even living for God, if we don’t take care of ourselves, our health first, our emotions and behavioral health included, we can’t give much, in the way of living, to those others.

I could see her pupils change and I got a little excited.  She was hearing something that affected her whole body and I sensed it was hope.  (See, I am an Emotions Jedi.)

We talked more about approaches she was using, prayer/meditation, exercise, grit and determination, waiting it out for better days to come and others.  Then I introduced the medical paradigm.  (You’ve heard me say it.)

Behaviors and emotions come from the brain.  We culturally think that they are volitional, under our control.  But how much can we really control of what the brain does?  Some.  But when we do the best we can with what we can control, and our behaviors and emotions are still hurting us, affecting our quality of life, damaging our relationships and connections – we need to look for biological reasons.  That’s where choice can still come into play.

She was looking and nodding.  This was at her “consideration stage” of introducing these new ideas.  I said,

I thought of telling you about this when you talked about guilt Connie because maybe your guilt is coming because of a brain illness.  It’s common in several emotional illnesses, like depression or anxiety, and in these illnesses it commonly comes in force, like you’ve described.

Her pupils had reduced to their earlier size, and her posture said she was winding down for that visit.  Whatever we discussed after that would be low yield, so we made a follow-up appointment and called it a day.

These days later, remembering Connie gets me thinking about what I would have said if she had been available to still hear more.  This bit about freedom to choose self-care, yet saying we have little to do with how our brain works can get confusing.  It might seem contradictory.  Tomorrow, I’m going to discuss it more, but for today, it would be wonderful to hear what you think.

Questions:  With behaviors and emotions coming from a material biological organ, the brain, yet knowing that we are free to choose for our self-care, what gives?  How do these ideas jive?  How have you seen it play out in your life?  Please tell me your story.

Goodbyes Are A Way To Connect

15th century adaptation of a T and O map. This...

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Self-Care Tip #184 – Respond to your goodbyes deliberately to be friendly to yourself.

One of the Regional Centers that I work at is closing their telemedicine clinic.  This means I’ve said goodbye to many beloved patients and their families, whom I’ve worked with since round 2003 I think.  Saying goodbye to people we respect and enjoy is not as casual as we stylin’ people make it look.

Two days ago I said goodbye to my girlfriend of around five-plus years and her family.  Moving far far away makes the flat world feel lumpy and luminous.  I now have all her leftover food and knock-offs she didn’t want to haul across the lengthening world to remind me that she is gone.

Watching parents and/or grandparents age is also an exercise in saying goodbye.  My parents have a hard time making it over to visit on week-ends for all the funerals they go to.  Their calendar sends over that whispering voice that they are growing old.  “Look,” it says.  “See me.  I am aging.  Time is connecting and taking me with it.” Even so, their essence holds its own, apart from Time.  That makes me feel more comfortable.  When that whisper gets louder I may respond differently, I can’t know until then.  But for now, this is good.

“Goodbye” is something that begs a response.  “Oh yes!  Goodbye!  See you later.”  I even say, “See you later” to people I know I have less than one percent chance of running into again.  The word calls to me and I respond.  The word implies a disconnection, but even so, beckons us to connect.  It spreads us over the space of our time shared and into the future apart.  Peanut butter and jelly, it sandwiches us up with the one who says “Goodbye” when we say back, “Until then.”

Today with these people and remembering all the ones I won’t get to see before my contract ends, I feel the pull to respond.  My response can be something deliberate.  It is another bit of something I get to choose.  I hope it will connect me.

Question:  How have you responded to the goodbye’s in your life?  How has it been a connecting force for you?  Please tell me your story.

Free to Be Accountable

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Self-Care Tip #97 – Protect your privilege to be accountable and your freedom of choice.  Be a friend to yourself.

Number Four on Bella’s List:

“The day has been ruined!” Bella said.  Her eyes sparkled and flashed as she spoke of her injury.  Bella was not so pleased with her labor’s reward.  She was not so satisfied with being accountable for her children‘s behaviors.

Are parents accountable for their children’s behaviors?  That can be a question at the level of the law and a question of cultural moral values.  From a psychiatrists stand-point, is there a medical interplay?

A subspecialty in psychiatry is called consultation liaison, which is psychiatry for the medically ill and usually hospital based.  In this setting we often get asked is a patient has decision-making capacity.  I spoke about it briefly in the post, “Choose, Gladly, Using Resources.”  This is difference from competency, which is determined by the court. Decision-making capacity is a medical assessment of the patients ability to:

1.  understand:

  • their illness,
  • it’s consequences,
  • it’s relationship to their values

2.  manipulate their options,

 

3.  and communicate their decisions.

Can kids do that?  Medically it depends on their developmental level.  The court however has its own forum on that – I won’t try to go there as psychiatry isn’t law.

Another area in psychiatry where we decide that someone does not have the freedom to choose and we hold someone else accountable for them (called a “5150“) is when they are:

  • not able to provide for themselves food, shelter, clothing
  • a danger to themselves
  • danger to others

Are kids able to do these things?  From a medical perspective, it depends on their developmental level.  Deciding what we want for ourselves and for our children is a privilege for those who are able.  It is also a privilege for us who want it.  Freedom is not free, as they say.

Please watch City Councilman Joel Burns tell us about bullying and how we need to be accountable to each other: “It Gets Better.”  Completely amazing testimony and speech.  Cuts out all the b.s.

Question:  What do you think about our accountability to our children and to our community?

Choose Well, What You Will Live For

Self-Care Tip #96 – Choose well, what you will live for.

Yesterday we discussed finding our reference point for why we do what we do.  All day today I found my thoughts returning there and had to spend another blog-post-opportunity on it’s “friendliness.”  I was happy to find that I was not the only one when I got a reader‘s response:

I’m still coming out of the fog of doing anything for survival-as-a-habit.  As in, being in panicked survival mode even when all is calm and safe–that is no way to live, any dog knows better than to live like that.

I contrast her response with my colleague’s:

The intentions of any life is self-serving.  Altruism doesn’t exist except in God, (which I accede not to understand), and people can’t rise above their own genetics.

Now this man is the kindest, sweetest, most generous man you’d ever meet and he doesn’t say these things with any meanness, anger towards a past offense, or to turn people from God.

However, contrast his take on our reference point in life with the reader’s above.  She talks about her choice.  Can a choice transcend our genetics?

You may remember some of a previous post mentioning the work of MIT neuroscientist, Sebastian Seung. His research tells us that memories are stored in our neurons and not in our genes.  Eg. Habits are memories and not genetic therefore not permanent.

There is an interplay between choice and genetics.  YES!!@!!  We aren’t robots!  😉  Nor are we a picture without a frame.  We so often don’t think about all the good that our genetics do for our lives.  There’s just so much talk about how we fight our genetics.  We have been given both a design and free choice.  Of course we can’t change our design, but as our reader later said so well:

For some people it is a process just to ask “why am I doing this?” … AND actually ask that question to themselves. (man-o-man the times I have asked everyone else why I was doing something) Maybe it will take sometime for an answer to come, but asking means we are on our way!

Choice is the gift from God that the apple and the serpent and thousands, or billions of years (what ever is true) can’t take away from us.  Only you can.

Be a friend to yourself.

Question:  Where are you in process between your choice and your design?  Is the interplay one that is smooth or rocky for you?  Please tell me your story