Branding and Branded. Stigma Goes Both Ways.

 

mentalhealth.wa.gov.au

 

Oh, the struggle to understand that behaviors may have something to do with the brain! I shake my fist at stigma! I shake my fist at prejudice!

Now, I can go on a little calmer and say, if you are struggling with this yourself, you are not alone. Even if you are the one propagating it. You stand on the shoulders of others.

In Jesus’ own words:

Father, forgive them for they know not what they do.

He was talking to me, I know, and you.   We have all been rude and ignorant in our own time and our own place.   We find ourselves holding 2 positions, accuser and accused. The context of our various roles changes with knowledge, coping skills, experience, maturity, pain, mental capacity and so on.   But that we hold both roles in some space of time and place will never change in this world.   Even in heaven when we “see face-to-face” we won’t be completely informed.  We know we will continue learning timelessly. What will change is the abuse, the prejudice, the judgement.  Once and for all, we will finally let that go and believe at a chromosomal level that God is and deserves to be the only Judge.

There must be a genetic component to our double lives in this world. This tendency towards stigmatizing. We know there is a lot that isn’t genetic and for that we fight to grow ourselves and grow others for our own sakes and for theirs. The benefits reciprocate as much as the pain does. And even though being branded feels personal, it is not.

For more relating to this, read the blog posts Forget About Divisions In Knowledge, and Forgive to Get Friendly With Yourself.

Self-Care Tip #109 – Don’t take it too personally when people sneer. Be a friend to yourself.

Question: How do you keep yourself objective when prejudice hits you or someone you love? Please tell me your story.

Your Life. Your Choice. Why Are You Still Negotiating?

 

 

Self-Care Tip #102 – Take what is yours and live.  Be a friend to yourself.

Cheri came, still dressed in work scrubs, with her 2 daughters, 8 years old and 3 years old.  Having finished their dinner date, they were swinging by for her appointment before going home.  Cheri told her kids, “Get out now and go sit in the lobby!  If you don’t listen to me I’ll….”  Turning to me, she said, “It’s never enough!  I just took them to dinner and they do this to me!  No matter what I do…!”

1.  Cheri tells me she’d like to cope better with simple stressors such as redirecting her kids

2.  We talk at length about her perception of her kids abusing her.

Cheri is married.  Her husband laughs at her for “…having to take those drugs to be normal!”  “…But he just sleeps his problems away.  He doesn’t deal with them like I do.  He has no idea!”

3.  We talk more about her perception that her husband is responsible for her place in life.

Cheri believes if she doesn’t take more than 2 pills a day, she is less “dependent” on drugs.  She says, “I don’t want to go on like this!”  Her tears continue talking when her voice stops.  She is ashamed.

4.  The concepts supporting taking care of yourself as being the kick-off point to caring for anyone else comes up.

5.  We talk some more about who is “The Why” for what we do or don’t do.

Cheri feels less shame, but it’s still there.  She is willing to give a new medication a try but clearly doesn’t buy it all yet.  She’s going home with her girls to her husband with new pills.  And hope?  Yes.  It is all connected.  It all pulses together and is a living negotiation of sorts.

Disease <–> behavioral/emotional negative symptoms <–> victim role <–> self-neglect <–> greater crisis <–> seeking help <–> responsible self-care <–>  healing <–> fewer behavioral/emotional negative symptoms <–> emotional abuse from husband may continue but is no longer seen as responsible for personal choices and self-care <–> less shame <–> further healing and so on….  (Lub-dub…Lub-dub…)

 

hbofamily.com

 

Cheri is still negotiating her deal in life.  She doesn’t realize that it’s already hers for the taking.  Her life.  Her choice.

The deal is already made.  Take it or leave it.  Your life to live.

Question:  How are your negotiations?  Do you see them as still in progress or settled.  Please tell me your story.

Your Heroic Self – Waiting For Normal

Self-Care Tip #82 – Have courage to go for what is lovely to you in life.  Be a friend to yourself.

Pretty, blond, about 5’6″, slender, in her 30′s, mother and wife, no funny shapes or movements but Britt still asked me, “Am I normal?”  It takes guts to ask someone that.

I just finished this heart-squeezing book, “Waiting For Normal,” by Leslie Connor.  (Yes!  I finally read a book!  It took me 5 times as long but it was no less pleasurable.)  Connor tells us about pre-teen Addie who grew up on the waves of her bipolar mom’s chaos, salvaging bits of wreckage along the way to survive.  Addie is the life-preserver her mom uses for life.  Addie’s own buoy through it all is her hope of one day finding normalcy.  She uses all her smarts to avoid the thrust her mom’s messes force on her.  It requires her full attention.  Addie must have looked pressed for something because her Mom finally asked her

What’s so special?  What are you chasing after?!

Addie was fisting optimism when she answered

I’m not chasing after anything.  I’m waiting.  Waiting for normal.

Later Addie explains to her mom

Normal is when you know what’s gonna happen next.  Not exactly what because probably nobody gets that.  But normal is being able to count on certain things.  Good things.  And it’s having everyone together – just because they belong that way.

My son used to have shaggy hair with curls that flew at the world around him.  He came home the other day and told me he wanted it short.  I finally figured out that because none of the other boys in his class had longer hair, neither should he.  He showed me pictures of what his hair should look like.  The whole process was too cute.

We are all looking for normal.

Putting aside defining normal, for now I am content to just contemplate the largeness of the effort to find it.  The journey, the process, the coming into such a thing reveals the beauty in one’s character and essence.  It is that, rather than the “hair-cut” that makes me say, “Wow!”

When Britt, my patient, strove towards her health and normalcy, her intent in context was lovely.  She seemed to me, in those moments we shared together, as one of the great heroes of our day.  A woman of courage.

Self-Care Tip #82 – Have courage to go for what is lovely to you in life and appreciate the beauty in your heroic self.  Be a friend to yourself.

Question:  Have you struggled with the question, “Am I normal?”  Please tell me your story.

Connect With Others to Get Friendly With Yourself

Self-Care Tip #81 – Connect with others.  Be a friend to yourself.

So you have bought into the famous, “You are not alone” stock.  After 2 months on psychotropics (medications for emotional illness,) you finally have an interest in people.  You are at least a little motivated and less afraid of things that move.  You don’t feel like you are the reason for original sin and more often than not, you think happiness might be more than what shopping can offer.  What is this strange and unfamiliar sensation?  And what to do with it?

It is time to connect.  Many of us get to the point where we no longer want to hide, we don’t hate ourselves, and we don’t hate others.  We get to the place of showing our under-belly just a little to the big wide world and are shocked that the only thing we feel is the wind as everyone is rushing by!  Just when we start wanting what we spent so much time hiding from, we seem to have forgotten how to connect with others.

It is no secret.  America is culturally impoverished.  We have little of cobblestone streets to meander down, dressed in clean clothes after a days work, checking up on neighbors and gossip.  We have few degrees of activity between full throttle and dead/no heart beat.   Come now!  How to connect in a world where our parents expected us to pay rent when we turned 18years old?

If you find yourself in something of this situation try on one of these basic tools and see what fits.  You can’t expect them all to.  So if you strike out a few times, keep on!

1.  Volunteer – for example, and in no particular order…

2.  Meetup.com – an awesome site to find people interested in what you are interested in.  e.g. book clubs, skiing, small business, Italian

3.  Support groups

4.  Write!  Although this at first thought may appear isolating, it is not necessarily.

  • Blog!  :)
  • Journal

5.  Toastmasters

There is so much more.  Please let me know your thoughts and I’ll keep adding to this list!

Self-Care Tip #81 – Connect with others.  Be a friend to yourself.

It Might Be Your Brain

How are you feeling? If it’s not good, it might not be “you.” It might be your brain.

When you don’t feel good, look at what’s happening inside.  Think about where feelings come from.  It’s hard to use your brain to think about your brain.  (Read more at “Basic but Effective.”)  But what to do?  Doctor Dolittle‘s pushmi-pullyu’s might have been able to tell us something of our missed opportunities by not having two heads and two brains.  (Unfortunately they’re extinct!)

Feeling bad, irritable, guilty, sad, like everything is flat, nervous, emotions that are out of proportion or inappropriate to the situation or trigger?  These feelings might have nothing to do with “you” and everything to do with your brain.  At some point if you get tired of beating yourself for the holes in your purse, if you don’t understand why things feel the way they do, if you want to rest, think medical.

Fred came in with his father, hiding himself in his shirt, in his father’s shirt, like a mouse who couldn’t find his hole.  The teacher from his special education class came in to help give history and told me about everyone’s efforts to bring him out.  Skinny, Fred preferred not to eat in front of people.  He started shaking in strange situations and climaxed into a tantrum if pushed to transition too quickly.  He was vulnerable to physical contact and avoided anyone touching him.  When he was really upset, he banged his head so hard that he had to wear a helmet.  When I asked his parents if they thought he was anxious, they said no.  No he wasn’t nervous his teacher said.  Hmm.

I told Fred’s parents.  I restated to Fred’s teacher.  I just said back to them the story they had just told me.  I told them about Fred and asked them what they thought.  After hearing Fred’s story again, did they think Fred might be behaving this way because he was suffering on the inside?  

We can’t give what we don’t have.  Asking Fred to come out and play so to speak, wasn’t something he had to give yet.

After treatment takes effect, then Fred will be able to pull his head out of his shirt and he will do it without being asked to.  It doesn’t do any good for Fred or anyone else to push him to do behavioral changes if he simply can’t.  Fred is not a pushmi-pullyu.  He has no spare brain to offer when the other is ill.

I told Fred’s father that I thought Fred was suffering inside.  Something in his father clicked.  He teared up and nodded and said “Yes!  He is suffering.”  That meant a lot to Dad.  To know that much about his son.  To know that what had confounded him for so long came from somewhere.  It had a name.  This thing might be treated.  Fred might suffer less.

Self-Care Tip #76 – If you don’t feel good, think about your brain.  Be a friend to yourself.

Question: Do you every feel like you expect yourself to give what you don’t have?  Please tell me your story.

Get Treatment to Move On – Addictions

Molested by his cousin, neglected by his parents, he watched his intoxicated father beat his mother.  Thinking she would die too many times, he ran away, returned in a police car over and over again, as if wanting to get away was a crime.  He came back and raped his neighbor, more than once.  He spent a lot of time trying to get sex even though he knew it was ruining him and others.  He lost interest in almost everything else.  He suffered uncontrollable impulses.

He was 18 years old when he left it all for the safety of prison.  During the next fifteen-some years he was diagnosed, treated, and kept.  But kept for what?  For eating.  He gained weight, until he needed 2 seats to sit in.  Eating became his preoccupation.  He didn’t have sex.  He had food.

He was released to a home for sexual offenders, put on a diet and lost weight.  He lost it big and fast and felt in control.  He started purging and not finishing his meals.  He thought about purging all the time.  He knew he shouldn’t do it.  His voice was changing, raspy and his throat hurt but he still purged.  He wasn’t having sex.  He wasn’t over-eating.  He was purging.

For whatever reason, no one had yet seen the pattern.  Mostly everyone saw sex offender.  Me included.  I was trying.  I was trying to treat him with empathy, trying to get past the bile that comes when I think of rape, trying to consider the courageous things this man was doing now in life.

In one of my favorite scenes from the film, Rachel Getting Married, Kim played by Anne Hathaway argues with her sister about her own chances to have a future:

Rachel: Kym, you took Ethan for granted. Okay? You were high for his life. You were not present. Okay? You were high.
Kym: [Whispering] Yes.
Rachel: And you drove him off a bridge… and now he’s dead….
Kym: Yes, I was. Yes, I was stoned out of my mind. Who do I have to be now? I mean, I could be Mother Teresa and it wouldn’t make a difference, what I did. Did I sacrifice every bit of… love I’m allowed for this life because I killed our little brother?

I thought of this and somehow through all that trying, I did. And because I could empathize, a space opened up for me to be more objective.  That’s when I saw it.  I saw the pattern.

Addictions migrate.  Someone who may have started out as a food addict, might turn to gambling, and then later to alcohol.  Someone with sex addiction, might turn to food and then later to purging.

It can be like that game I used to play at Chucky Cheese, trying to hammer down the little animals that pop out of holes.  We need to treat the disease of Addiction regardless of how it’s dressed, or else it will keep popping up.  And like Kym, if we do, although perhaps terribly wrong in some unchangeable ways, we will still have a future.  If you’d like to read more about this “kainos” (Greek word for the opportunity to be made new,) read the post New versus New.

Self Care Tip #62 – Get treatment to move on.  Be a friend to yourself.

Question:  What do you think?  Please tell me your story.

Let it Make You Strong

She is young, golden, blushes easily, bright solar eyes, with graceful speech, not rushed or loud.  Like so many others, she doesn’t believe her beauty.   She came to me to get help.  Crippled by anxiety that hits out of the blue, like a hooded man grabbing her in an alley.  She feels during those times like she is dying or going crazy.  She started avoiding public places and became fearful looking over her shoulder for the next attack.  She was humiliated on all accounts by her uncontrolled emotions and thought people could see how crazy she was just by looking at her.  Branded and tortured.

When Nathaniel Hawthorne wrote The Scarlet Letter, he made plain the cultural pressure to define what is apparent, seen, and interpreted.  But more importantly he made plain the ability of an individual to define themselves on their own terms regardless.  Hester Prynne wore her letter A at first by mandate and then by choice, letting it represent who she was, where she came from, and where she was going.  She wore her letter and when people tried to change its meaning to something culturally less scarlet, “A” for “Able” she made it clear that she is the one who will decide the meaning of her life’s events.  Her and God and no one else.

When anxiety hits, we are scrambling to understand why.  We think, “What could we have done that is so terrible to have brought this kind of torture on?”  As Hester Prynne began her scarlet letter days bewildered by the force of emotion behind her angry neighbors, so victims of anxiety are bewildered by the level of shame and wild fear they presume must be linked somehow to this judgment upon them.  It becomes their life’s work to determine the meaning of a life with this.

Nathaniel Hawthorne writes,

The scarlet letter was her passport into regions where other women dared not to tread. Shame, Despair, Solitude! These had been her teachers—stern and wild ones—and they had made her strong…

Suffering is a schoolhouse for the courageous.

After some months of medication therapy this twenty-something woman said

I’m not so uptight about things.  …I didn’t know my anxiety was that bad until I got out of it.”  What amazed her even more was how better the rest of her body felt.  “Even physically I feel much better.”  No more chest tightness, body aches, and shakes.

She has the rest of her life to figure out how to say what this disease means and how it plays into the way she defines herself.  She will decide I hope.  Not her family, future husband, church, or Brook Shields.  I hope she will take what it teaches her and let it make her strong.

Self Care Tip #57 – Let it make you strong.  Be a friend to yourself.

Question:  What do you think?  Please tell me your story.

If You Are Ill

The 'Glasses Apostle' in the altarpiece of the...

Image via Wikipedia

A reader commented on yesterday’s post, “Afraid of Meds,”

My fear, I think, would be not so much the dependence—but what would happen if I did need that medicine and it suddenly became unavailable, like I couldn’t get my prescription because of a natural disaster or something like that.  …Would going off of those meds cold turkey put me at a real disadvantage?

In my late 20′s I had similar fears, only for me it was related to my eye-glasses.  Because I didn’t tolerate contact lenses, I especially had vivid fears of getting into the driver’s seat of my car without my eye-glasses anywhere to be found.  Living on loans at the time, I took out extra money and got LASIK eye surgery.  Oh the joy when I woke up one morning and could see clearly, high-definition, no glasses to grope around for, freedom!

Unfortunately in neuropsychiatry, we don’t have the privilege yet of offering many curative options like LASIK surgery for emotional illnesses.  I don’t believe it’s too far off in the future.  It wouldn’t be wild to say our children may have those options some day.  For example, embryonic stem cells may offer a cure for disorders such as depression and schizophrenia.  However, until a cure becomes as available as Prozac or even LASIK eye surgery, the reader quoted above has a reasonable fear.  Medication becoming unavailable is a disadvantage.

Now I’m not great at twisting reasoning powers, so I’ll say this as best I can.  That’s like not getting eye-glasses because we are afraid of loosing them.

So to this reader quoted above and to you I ask,

Question:  What do you think?  Treatment or no treatment?  Please tell me your story.

Self Care Tip #53 – If you are ill, get as better as you can.  Be a friend to yourself.

Related Articles From FriendtoYourself.com

  • Mental Illness Relapses When Medications Are Stopped http://bit.ly/pA4kxo
  • Number One Reason For Relapse In Mental Illness  http://bit.ly/rt1qJf
  • Are Your Meds Safe?  http://bit.ly/lh1cBh
  • Say Yes to Medication And No To Drugs  http://bit.ly/oX12i0
  • Fears of Addiction To Medications for Brain Illness http://bit.ly/oWY8i4
  • Other Fears of Medication For Brain Illness  http://bit.ly/qdHksR
  • Afraid of Meds  http://bit.ly/rjt7wY
  • Full Treatment Response Means a Better Future  http://bit.ly/ph84ZU
  • When It Is Time To Take Medication   http://bit.ly/nbIYLT

Your flawed self

My niece is sitting beside me and I can barely keep my hands off of her 5 month self.  I am eating a blueberry scone slowly.  She, with her tummy-full of breast milk, is watching every bite, a faint smile on her pink face.  I’m a little afraid she’s learning to eat carbohydrates from me and I want to tell her that I can’t remember the last time I ate one of these.  I start eating faster and turn away so I don’t imprint this on her supple myelinating neurons.

We closet eat, closet smoke, closet shop, closet sex, closet what we want to protect others from but what we independently are strong enough to handle …or not.  There is a term called “self-sabotaging behavior.”  Reducing this, we find that the process of closeting is in fact the handle on the door to that mal-behavior.  Keeping it real is the same as saying get it out of the closet.

My mentor and brother, Cameron Johnson used to say, “Go where the pain or fear is and it will lose control over you.”  People who work the 12-Steps call this “Rigorous Honesty.”  It is a pealing away of all pretense with yourself.

Avoiding rigorous honesty turns into self-sabotage.  We end up cutting ourselves down at the knees.  Anxiety uses fear to make us hide.  In cases that include emotional illness, of course medication will help our work toward honesty.

It is not about whether we hide our bad sides or not – we do.  It is about trying to keep it real.  The only thing to be ashamed about, if we must, is not trying.

So to my niece, I give her my flawed self and when the time(s) come, I will accept hers as well.

Self Care Tip #45 – Show the world your flawed self.  Be a friend to yourself.

Question:  How have you experienced the freedom that comes from going toward the fear?  Please tell us your story.

Freud Did Not Know

Bad dreams.  Just woke up from one.  There’s a lot out there on dreams in mental health.  After all, they come from the brain.  When Freud was looking at things, he saw dreams as “unconscious wish fulfillments.”  However since Freud rocked our world, we’ve learned so much more about brain biology and Freud was wrong.  Oochie ouchie.  Just saying that makes me feel like his still very much alive reputation will come at me like an angry ghost and be mean!

Dreams are just that, dreams.  Sometimes they are good, but often they are scary, bad, and even terrifying.  Why?  According to Dr. Quijada ;), yours truly, they are commonly symptoms of emotional disease or side effects of medications, etc….  In anxious states, we dream.  After going through life threatening events to  ourselves or witnessing it in another, we get nightmares.  When there is a disconnection is our sleep architecture, we can get “parasomnias” such as night terrors.  Some medication such as Trazodone can cause vivid dreaming where people say they dream “in color.”  And on and on.

Freud didn’t know this, so no offense taken.  However, we do.  Enough with the hocus pocus moral dilemmas that are discussed in our own thoughts and among some ongoing therapies.  First look to biology to give us the answer. Even after having a nasty scream-your-lungs-out dream, remember that your brain is mortal, human, made up of carbon and not aura.

Sometimes even that much information can help people sleep better.

Self Care Tip # 43 – Don’t make too much out of your dreams.  Be a friend to yourself.

Question:  Do you agree or disagree?  Did this help you in any way?  Please tell me your story.

Soul and Body

When we get sick, our identity, who we are, our essence might feel threatened.

In “His Dark Materials” trilogy, Philip Pullman says there is no God so we create heaven ourselves. In regards to our spirit, he says we come from and belong to the evolving universe. Perhaps so many have read this trilogy because it openly speaks about our souls. After it won various awards, we could say the man can write. But also that many of us, along with John Milton in Paradise Lost, wonder who our essence belongs to.

Since so much of our culture puts the definition of identity on behavior, it makes it seem that brain patterns define humanness. How do you see yourself? We all agree that our brain is part of our body. The question of soul comes in to play.

Some believe that the soul is a brain pattern. We might not agree that there is a difference between soul and body (or the brain). But if we did, could we even agree that the body is just that, a house for it, as Mr. Pullman says? This inconstant body, this betraying brain, this changing mind?  We’ve got more bank than that.

This is important to sus out. In the immediate sense, it tells us where to go if you need help. Temple? Doctor? Gym? It will affect your self-view when you go through physical loss. It will affect your hope when you haven’t felt like yourself in years.

Who are we if we need to take medication to behave like ourselves? The question I often hear is, am still me? Do I grieve the loss in order to accomodate the new sick me who has tremors and fear of public places? Then when I get better and lose an arm in a car accident do I need to change my view of my identity again? Then after I get better and get to know the new me, I get breast cancer and undergo a mastectomy. Now who am I? Now I’m old and eat with a wooden spoon and my kids take away my drivers license. I get dizzy at the hospital I used to work at and fall and hit my head in front of colleagues I once mentored. Who am I?

Many people I talk to think, like Pullman, that when they die their soul disperses amongst all the spiritual and material matter across the universe.

I have become comfortable with my own answer. My spirit belongs to and is in the care of Love, which is stronger than any change that happens to my body.

Self Care Tip #23 – Find your identity. Be a friend to yourself.

Good News

Many people see needing to take medication as bad news. But I think about what it would be like without it. Suicide, progressive deteriorating processes in the brain biology, contagious behaviors and moods spreading to those you love, inflammation…. That is bad news. I think about the not so many years ago before most of our medications existed. Before much of our understanding about the brain biology was around. Those times were hard. Misinformed people had ugly ways of looking at others with emotional illnesses. Hearing someone thump out their opinions on the pulpit about human behavior has always been a pleasure for me as well – not! Now we know that our essence isn’t dependent on our brain biology.

But here we are, in the land of milk and honey, depressed economy and all. We have a more informed public opinion (check out NAMI – awesome!), evidenced based medications, etc…. More than ever before in our history, the responsibility to take care of ourselves comes down to us as individuals. The external barriers to treatment are not what they used to be. However, what are the internal barriers? We own our choices. Our beliefs are our own. Letting yourself close off to the good news of medication – that is a tragedy.

Now is the time to fight for yourself. You are worth it. When you see the difference in your life, your perspective on good news and bad news might change a little too. Even public opinion starts with the individual.

Self Care Tip #22 – Be your own advocate. Be a friend to yourself.

Courage to take medication

So when is a psychiatrist going to get around to talking about medications already? Nobody really wants to take medications. But it turns out in this world that our brains are just as human as the rest of our bodies. When they get sick, what does it look like? Behaviors and emotions. Our brains are not hovering over us like a supernatural aura. When our brains get sick, our behaviors are in the fist of control about as much as our liver function is.

The people I see in clinic are some of the most courageous people I know. We find each other at an amazing time when they are aware of their plight, that of being disconnected from their journey. They are humble people, willing to consider that behavior is more than something the “will” or “force of character” can control. They use as many healthy means they can to get healthy. They believe that you can’t give what you don’t have, even to yourself.

Counterintuitive to culture and prejudice, taking medication is an act of courage.

Self Care Tip #11 – When your emotions and behaviors are messing you up, think of the many modalities to getting healthy, including meds. Be a friend to yourself.