I’m going to try something a little different today. I’m posting a dictation between a patient of mine and me because I think it has flow and a nucleus. (There are a few small changes made in liberty, and no identifying data.) Let me know what you think of the content.
Psychiatrist: …And so we were talking about perfectionism, right?
Psychiatrist: And about how you are not being kind to yourself when you expect yourself to be all healthy.
Patient: I’m not being kind to myself when I don’t want to take this or that because I don’t do synthetics. (This is what my patient was using to describe medications.)
Psychiatrist: I like that you used the word synthetics, because I’ve never put it in that perspective with patients, and you did that for me.
Patient: Well, there are non-synthetic and there are synthetic.
There’s body recognizing things, plants, and then there are the synthetics, what the pharmaceutical companies produce. And I’m a very negative pharmaceutical company person.
Psychiatrist: Compare that to other inconsistencies in our life. Such as, I’m going to be all-natural, I’m only going to wear hemp.
Or take it to the point where I’m going to weave my own clothes because it’s really natural and I know exactly what’s in it. Versus saying that I’m moving forward and I’m going to take what science has offered to us. I’m wearing polyester right now.
Or, I’m willing to take over the counter “herbs” because they don’t have the pharmaceutical stamp on it, or maybe I like that it grows out of the ground. But none of that has been governed. Aside from the “he-said-she-said evidence,” there’s often little science behind some popular over the counter remedies either.
Let’s consider that perhaps the study data, comparing in a regulated way, one patient with another, defined synthetic agents, and then allowed my body to be its healthier self. It gave us objective data. Numbers. Sure they have their flaws and weaknesses as we learn in statistics that all does. Poke holes in it as you wish, but at least there is a degree of transparency.
Patient: Maybe for me it’s more trust, because I feel like people are so over-medicated today. And it’s easy to write out a prescription than to really deal with the issue.
(Me, on the sly: This view, that practitioners prescribe for reasons other than for the medical benefit of the patient, is one that I honor with humility, and stand up and listen when others voice it. Annals fill the internet search engines on it, I’m sure. I will still pick at it a little, I’m a stubborn nubby person like that.
Let us note together that the word, “easy,” in this context isn’t so kind to our person. Taking medication to treat a medical illness is often not easy. It is one of the most courageous acts in someone’s life. And this wonderful lady, who came into my scary office, was a great example of this kind of courage. She wasn’t here doing what was easy. She was giving her emotional entrails a work-over with her psychiatry venture.
This patient, whom I will name hereafter, Lady Courage, was “really dealing” with the issue, in contrast to her self-described mores. Might we suspect the insidious tendrils of “Mister Stigma” shaming her? Yet here she was… Just fabulous!)
Lady Courage: I’m more one that, “Let’s really deal with your issues, and then your mind should come around, everything should come around.” That’s how I view it, because if you don’t fix the underlying problem you’re never going to fix the problem with meds.
Psychiatrist: Okay. But you’re willing to say there might be some inconsistencies in that right now.
Lady Courage: Right, no, I’m not …
Psychiatrist: It might not be entirely false, but it might not be entirely true.
Lady Courage: Exactly.
Psychiatrist: We were saying, “I can be healthy but still have disease in my life.”
Lady Courage: Yes, that’s true.
Psychiatrist: Because I don’t have to be perfect.
Lady Courage: Right. And I do find that a little bit hard. But since you put it in that aspect of being, “healthy with disease,” I can see that. I probably never saw that before, because I did always separate the two, either you’re one or the other.
Lady Courage: Yeah.
Psychiatrist: That’s poignant. Is that how you see God as well?
Lady Courage: In what aspect? Like, yeah … Well, you know what? I try to strive to walk in His ways. I haven’t always walked in His way, so I do have guilt about that, but I shouldn’t have that and I know He’s already said He’s forgotten it, He’s washed me clean. So it’s just receiving it for myself. And that just is faith. And I know then it makes me feel like I’m lacking a little faith, but I know I should be stronger. But, yeah, The Word is something that I strive to follow, and it’s hard.
Psychiatrist: So do you feel like God is, “either/or,” in the way He looks at you? What about the parts of you that are diseased?
Lady Courage: Well, no, yeah, He’s going to heal that.
Psychiatrist: But what if He doesn’t right now? What does that mean about who God is?
Lady Courage: Well, He sent me here probably in hopes that you can help me to heal. He provides these avenues for us, so that we can get healed.
(Folks! So good! Smile.)
Psychiatrist: So you somehow think that God enters into the space of the synthetic.
Lady Courage: Well, yeah, I guess so, yeah. I do, okay. It’s so contradictory, but in one aspect I do take a thyroid medication that is a synthetic, but I know I have to take that and I understand it and I don’t feel it’s abusive. And I look at my blood work and I know where I’m supposed to be and how much I should be, so I feel confident. But when it comes to things like this that I’m not used to taking, and that don’t show up on labs, and it involves transforming my brain, I’m not really on board with that.
Psychiatrist: So when you use the word transforming my brain, I understand you’re saying that it’s making you into something different?
Lady Courage: It can alter your brain, yes.
Psychiatrist: Okay, so that’s the part I think that’s very scary for people, because they think it’s making them into somebody they’re not. But in reality the medications are there for healing who you already are. So for example, today you feel more like yourself than you did last week.
Lady Courage: Well, yeah, last week I was desperate and hurting and losing weight and scared.
Psychiatrist: And today you’re closer to who you think your healthy self is.
Lady Courage: I think today I’m … Yes, I’m much closer to my healthy self.
(Q: Closer to who God is creating you to be? Closer to God’s will even?)
Psychiatrist: In all of these scenarios, at each point we want to think, “What does this say about who God is?” If He or She, (but we will say He to simplify because it’s culturally appropriate,) is kind and loving like you mentioned, then would this belief, X, Y or Z, be true?
Self-Care Tip: Lay out our beliefs next to that standard, that premise in our life. And because we’re a lot crueler to ourselves, then we would allow other people to be, it can rescue us on occasion.
Questions: “What does this say about who God is?” Please speak out!!! …and, Keep on!
Great to ground in reality. That voice in our head…
Remember there are no dividers between God and mental health. Some patients think they have to chose; either get to go to a psychiatrist or to a pastor. Reminds me of the “seers”, like the Witch of Endor. Go to her to ask for help and you lose God’s presence in your life.
When Saul saw the Philistine army, …terror filled his heart. He inquired of the Lord, but the Lord did not answer him by dreams or Urim or prophets. Saul then said to his attendants, “Find me a woman who is a medium, so I may go and inquire of her.” 1 Samuel 28:3-25
When I was a little kid, I thought that when I would go do something bad my angel would stay behind. She couldn’t come into that bad space. Like if I went to see a bad movie, my angel would wait for me outside the theater. And with some my patients, maybe they think if they come into my office they have to leave their angel at the door.
Brent asked the question, quietly as if someone would overhear, “Will God help my depression?”
Wow, that’s such a great question.
So God is not a vending machine. But God is in all of “these things”. God is in the space that psychiatry and the “God-topic” occupy. He/She is in all of these things that He provides us; treatments, friends, medications, clean air, stable government, and what not. (I’ll say, “He,” because that’s traditional.) He gives Brent medication and God is a better psychiatrist than I am. He gives patient’s NAMI, (National Alliance on Mental Illness), and psychotherapists, and so many other treatment options.
Brent replied, “I’m glad to hear you talk about this because it gives me hope. And I want to renew my faith in God and start practicing my faith and saying daily prayers to Him. So it’s good to hear you as a psychiatrist here talk about God, and God helping me heal, so that makes me feel good.”
The next question is what type of God do we believe in if it’s not this God? This God who is in this space? This God who isn’t held back? Who isn’t an either-or God? This God is a God who cares about our depression. Why would we even want a God that is otherwise?That wouldn’t be very loving.
Brent replied, “God, who could help us in every way and doesn’t … that’s … I mean, basically God should be one that doesn’t allow violence and suffering and sickness.”
But there is suffering and violence and sickness. So who’s God in all of that?
B, “I don’t know. That’s a question I have.”
That’s the question that we need to struggle with through our suffering. Because it’s one of the purposes of our life, to find out about the love of God. Because God is … I believe that God is love, otherwise I don’t want anything to do with him. We have this job to do, find out individually who God is. Use our suffering as a tool. Such as, while we are suffering, it may be an opportunity in a way to say, “Why am I suffering? Why is there this pain when God is love?” It’s huge, right?
The struggling with our view on God’s character is muddied by comparisons as well. sIt looks like “everybody else is fine,” like God is being a God to them but not to Me. And that’s just mean. So, based on our premise, God is love, this can’t be true.
Brent said, “I know, but that’s how I feel.”
Thinking that it is true, God playing favorites, or God with limited love-supply, is one of those creepy feelings in the relationship. Something sinister. A Bogey loose wreaking havoc on our foundation. And if this foundation is havocked, it is hard to launch. Imagine pole vaulting off of a mound at the beach. This inconsistency with our view of who God is is either about God or about us though. And that’s a stop-drop-and-roll point. A point when we realize there is an inconsistency that we shore up.
Brent replied almost in a relieved voice, maybe a little like getting something off his chest, “It’s probably about me, not God, because He loves us all the same. So it’s probably more about me. Maybe with my sickness I don’t …
I’m not thinking right, you know? And I perceive myself as being worse off than I actually am.”
Me, “Would it be that you have something God doesn’t want, so He doesn’t want you?
B, “Well, I don’t think so. God loves us all. That’s my feeling.”
Me, “Okay, so it’s not that you’re so bad.”
Me, “Is it that God can’t quite get it right? Like, He’s just doing His darnedest but it’s not enough.”
B, “Maybe that’s it.”
That would be pretty lame, God. (I’m speaking directly here.)
Who is God? And if God is that week, again, I’m not really interested.
Using the premise that God is love is more than Truth. It is also a self-care tool. We can use it to clarify distortions about why we are in the condition we are in. We need this premise to keep us from isolating from Love. To launch better. We need this premise to have connection in our lives.
Self-Care tip: Use the premise, God is love, whenever you can.
Question: Where are the places that the bogey is wreaking havoc in your life?
People often come to psychiatry afraid. Not only from what the diseases do to them but also of psychiatry itself. They think it might harm them. They think pills will change them into someone else. Will diminish them somehow. But that’s not the agenda of medical therapy. The agenda is to improve their quality of life. The intention is to allow for a greater ability to experience connection, with themselves and with others.
In our relationship with God, we often think the same thing. We think God is here to restrict us. To limit us. To suppress us with rules. But God’s agenda is to increase our quality of life. To increase our connection to self and others. To heal. To reconnect is in essence healing.
In “Patriarchs and Prophets” it explains that we are purposed here on this earth to love and be loved.
My patient, Evelyn, was telling me at one of her lowest points in life she didn’t pray. She said she didn’t know what to say to God. The pain and suffering of losing her son and then almost losing her daughter disconnected her. That’s the biological psychological and sociological paradigm in action. It was wack. God’s agenda is to bring us back to what we all want in the 1st, middle, and last place. God’s agenda is good. She/He has our back and also the bank to spend on us toward healing.
I can imagine walking into God’s office. Furniture all feng shui. There’s a diffuser in the back and some great lighting. But I’m afraid. I’m afraid of myself and my condition, but also afraid of what She/He might do to me. Somehow, I’m at yet able to understand that God is someone pretty great who wants good, and never anything bad for me and I’m willing to engage in treatment.
If God weren’t, it’s got to make us all wonder, what kind of beast are we worshiping here? Who is God? I’m thinking God is at least as kind as I think I am. Probably more. Wink.
Question: Who is God? What’s God’s intention.
Self care tip: Give it a go. There is healing bank there for you and Me.
There are no dividers. This is no surprise to perceptive temperaments. They are the people who cut windows into every wall. Grazers chasing the next butterfly who never want to barn-up for the night. Perceptive temperaments are idea makers and if you pair that with the intuit, then you have someone who is basically a human filing cabinet. They vacuum information and it gets dispersed and organized between all the gazillion neurons in their brain without them even knowing they are doing it. They’re not using flash cards or lists or calendars. Information makes its way into a connection and bigger picture. The rest of us live by sweaty lines and frames and structure and the idea that in reality, there are no dividers is mind blowing. It’s Roadrunner dynamite to our deliberate order.
Information is fluid and related at every contact point. This is true also for God. It is true, as well, with God and psychiatry. I think in part it may be why “the church” has such difficulty filing a hole into the idea that emotions and behaviors are moral issues v that they might also be biological. Scrambling that together, egg yolks and all, is unpalatable to many in this well packaged culture, filled up to the brim with temperaments that don’t naturally allow for that.
It’s a beautiful concept though. God has no dividers. God is inside it all, perfused, smeared, imbued. When we think of a limitation to our ability to see God in something, or vice versa, the limit is with us. God made it all. He/She has got the master key to all those doors.
Question: Where does God not make sense in your life?
Self-care tip: Relax into the knowledge that wherever you or your thoughts are, there is God.
I imagine some day I’ll understand why users think drugs are healthier options for them then medications.
“Doctor, I don’t think my wife will be comfortable with me adding another medication. It seems like I’m already taking so many!”
Context: Brennon is using THC “for sleep” he explains. Not recreation. It’s “medicinal.”
Boy. We are going to have to redefine what “medicinal” means in the urban dictionary vs. in the medical.
It’s as if the masses out there are acting like it is stigma behind any opposition of THC vs. science. Folks, there may be stigma involved but it’s mostly science. THC is, 99%, not medicinal.
My cousin is a hospice nurse and she and I were discussing this. Along the meandering conversation way, we came across, that in her field, many are taking CBD. (I know most of us think CBD is THC-free but it’s not unless it’s thoroughly governed by the FDA.) When we were in our wandering conversation about this, I imagined out loud to her, “If I were dying, I’d want to take a good trip on LSD, do a line of cocaine, and have free access to heroine. Why not?! “
My cousin politely explained that in end-of-life, most people, not apparently ignoramus blind bigots such as myself, prefer to stay alert in their last moments with their loved ones.
That makes a lot of sense. My “free ticket” to white clouded oblivion suddenly didn’t look as appealing. I’d like that too. I’d really like to have connection with my loved ones. At any time.
This is the effort in psychiatry as well, believe it or not. When we medicate, we are seeking to align ourselves with the patient’s agenda, toward connection and not away. Toward quality of life and not to harm. Toward hope. When we encourage to take medication, it is not to seek oblivion and isolation. Rather medication is for connection.
Brennon is not alone. Many think that medication takes us away from connection. Away from connection to ourselves by turning us into something we are not. “Doctor, I don’t want to take anything that will turn me into someone I’m not.”
Away from connection to God by taking our willingness to submit to His/Her will, away from His/Her power and toward depending on science instead, as if there is an either/or. No, there is no either-or unless we put it there. There are no dividers between science and God. He/She made them both. They are fluid to Him/Her.
Nor is taking medication taking us out of connection to our partners, nor our family who thinks medication is a cop out and whom are loaded with their own journey of self-discovery over their own self-stigma toward medication. As if taking medication makes our patients less loyal to their loved ones, thereby less connected.
It’s so layered why we think medication is worse. Even worse than mind-altering THC. Even worse, than the disabling illness, or whichever idea it may be.
Question: What is medication worse than for you?
Self-care tip: Seek connection, “even” through medical ways. Be a friend to yourself. Keep on!