Month: November 2010

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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.

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Don’t Waste Your Time. Do Your Thing.

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Self-Care Tip #101 – Don’t waste your time if you don’t have to on things you aren’t good at.

Ben is almost 16 years old.  His parents are happy because he’s not as depressed, more interactive and more interested in connecting with others.  They came with him to see me.  Ben gets easily overwhelmed trying to tell me about himself and his parents often interject to help him out.

Ben’s parents are parents to admire.  Patient and clear-sighted regarding values and presence.  I’ve caught my breath more than once in the company of their comfortable regard and affection for their disabled children.  (Ben’s sister also suffers from mental retardation.)

During clinic, Ben struggled to tell me he was bothered and stressed by the school staff pressing him to learn things he didn’t care about.  He lost his words over the bits about how it related to his self-esteem and looked at him mom.

Mom told me Ben doesn’t care about some of the topics he’s taught and he gets sad and anxious when he thinks about it.  He’s embarrassed by it because he doesn’t finish as quickly as others and misses some of his lunch time.

I’m not a high school educator but I still told Mom and Dad that they can feel more confident advocating for Ben’s interests and needs with his teachers.  Ben will excel more in areas he is interested in.  He will find more pleasure in them.  He will be more empowered emotionally.  He will  be more ready for his adulthood needs.

The pressure many of us grew up with to be good at everything, is bogus.  We shouldn’t.  What we should do, is be good at what we are talented at.  We should be good at what we are interested in.  In fact, be shameless about it.  I spoke about this in the post “Do What You Were Designed to Do,” amongst others if you want to read more.

Ben with his parents looked at me with something of relief.  They had “permission” to do what they wanted.  The rest is mostly a waste of time.

Question:  What has opened you up to doing what you want to do in life?  What has that done for you?  Please tell me your story.

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It’s Not All Good

 

soundtrackcentral.blogspot.com

 

Self-Care Tip # 100 – Don’t forget what you know to be true, when other people don’t keep up with your learning curve.

You have finally started to understand that You take care of you.  You bought into that when you do, you can do more of what you want to do for others.  You believe that the responsibility to be healthy in mind and body starts and ends with the “Me.”  Isn’t that wonderful?  Yes.  Don’t forget it when other people don’t keep up.

Cynthia was on a self-awareness high.  She saw through open eyes her neglected self.  She was astounded looking at her thrashing person giving her last bit of stuff to the jobs she infrequently satisfied.  Instead of feeling defeated, however, she now felt empowered.  She was so ready!

It went well for a time.  Her husband noticed, approved, commended, and encouraged her.  They talked about it.  Her kids, reluctantly let go of her legs so she could leave to exercise.  At work, she personalized less and was not as interested in office politics – contented to do her own job.  Then it slowly started.  People started resenting her for it.  Her peers starting making jabs.  The kids would climax and tantrum just as she was about to leave to exercise.  But what really surprised her, and not in a good way, was when her husband got upset.  Not a lot.  But enough that the guilt she had talked down seized the opportunity to multiply.  It was like gremlins.  When the guilt gets wetted like that, it multiplies!

Doing what is right is not always celebrated.  Cynthia is working through that now and every day, as it is for you and me, she is finding the courage to get past that.

Question:  What has surprised you good or bad in your journey towards self-care?  What have you needed the most courage for?  Please tell me your story.

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Anxiety, White Noise Blocking Self-Care

 

 

 

To expose what anxiety is, and how getting help and giving help is difficult, I will introduce you to a family I’ve been working with.  Maybe this will sound familiar to some who want to get friendly with themselves but haven’t yet identified anxiety getting in the way.

Bob and Andy tell me their son Frank is better.  However, even better, he is still anxious.  He is partially treated.  Partially and not fully in remission to disease.  Frank is disabled by mental retardation, pervasive developmental disorder, and anxiety.  His parents are squirming in their chairs when we talk about his conditions.  They are nervous.  Mom looks at Dad and Dad looks at Mom.  Frank’s case-manager who is assigned to him from the regional center to help coördinate care, responsively starts to squirm.  Frank’s case-manager says to his parents, almost without being able to stop herself, “What do you think?”

It’s hard being around anxiety without responding in body and mind.  Anxiety spreads quickly, an emotion-gas from an open valve.  Anxiety enters us without asking.  It pulls on our nerves so our muscles and mouth and thoughts can’t relax.  Anxiety was in the room with all of us.  Frank was not the only one needing help.

David Foster Wallace, the great philosopher and educator who lived and died with depression said,

there is no experience you have had that you are not the absolute centre of. The world as you experience it is there in front of YOU or behind YOU, to the left or right of YOU, on YOUR TV or YOUR monitor. And so on. Other people’s thoughts and feelings have to be communicated to you somehow, but your own are so immediate, urgent, real.

This is our normal baseline, described by Wallace.

Frank is this multiplied by a thousand.  That’s what anxiety does to us.  It throws out sticky tendrils to snag and real in any part of our various efforts to get out of ourselves and connect with others, to empathize, to hear, touch, see, smell, taste anything outside of “Me.”  It is distracting and worse, suspicious.  Bob and Andy are suspicious of me.  They are suspicious of my intention.  They are suspicious of the medications I speak of.  Bob and Andy are having trouble hearing past the white noise, anxiety.

Self-Care Tip #99 – Identify the anxiety in your way.  Be a friend to yourself.

Question:  How are you taking care of yourself despite the barriers?  How has this been good v. bad for you?  Please tell me your story.

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Getting Away From All-Or-None Thinking

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Image by DanaMums via Flickr

Self-Care Tip #98 – Getting out of all-or-none thinking may mean getting medical help.

Number five 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, when they thwarted her every effort at having a good family experience.

A reader eloquently commented what I now want to write on my mirror, about her walk through and away from all-or-none thinking:

..really only part of my day was ruined – the part when I was hurt or angry or frustrated or depressed, etc. – and, even then, only PART of me was totally miserable. I was still able to think about other things, get things done around the house, talk to a family member or friend. It’s really calming to know that I can hurt and still function because there are so many pieces of me and my life that are still okay. Suddenly, everything seems to be easier to deal with.

In an earlier post, “Adequate,” we talked about the truth being in the gray.  As my Dad so often told me,

Things are never as bad as they seem.

I had a hard time believing that at times when I was a kid, and now that I’m old-er 😉 I buy it cognitively but find I often doubt is at an emotionally intuitive level.  However, things do get much much much better for all of us after good sleep, exercise, water, and if medically needed, medication.

All-or-none thinking, extreme thinking, catastrophizing isn’t just about coping skills.  It can also be about our medical condition.  It’s very difficult to modulate emotions when you are emotionally ill.  I’ve heard so many confounded people say that they just couldn’t stop themselves from going into extreme emotions.  They struggled with reactions way past what the experience warranted.

A kid doesn’t listen to words and Dad is kicking a hole in the door.

A couple argues over levels of intimacy and the girl finds herself in the bathroom with a cutting tool.

Work is another day of punitive treatment by an employer with lesser intelligence and she’s vomiting up food.

In these examples, we reflexively coddle the person, saying, “Anyone would be upset if….”  However that is not true entirely.  Enabling someone’s illness is easy to do.  Bad things happen to everyone.  But not everyone responds in a way that is repeatedly unhealthy to themselves.

In order to treat ourselves well, we need to take care of our physical/biological/medical needs.  Say hypothetically that we are getting our sleep, and all that good stuff, yet still have involuntary inappropriate extreme emotions, think about an organic reason.  Give yourself a break.

I have told my Dad, “True, things are never as bad as they seem, but only as long as you get out of their current seeming-reality.”  Getting out of that reality, may mean getting medical help.

Be a friend to yourself.

Question:  How do you stay “adequate?”  Please tell me your story.

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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?

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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

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What We Get For Our Work

 

 

Number three on Bella’s List:

Farmer Brown hired help to get his crop in.  Half way through the job, he realized he needed more help, so he got some.  This happened at least 3 times before the job was finished.  Come paying time, Farmer Brown gave everyone the same, $100.  “What’s going on here!?” the people who worked the longest complained.  “We should get paid more!”

Farmer Brown, …well you probably know that this is my version of the story from Matthew 20:1-16.  The Farmer gave them more than money.  But what did he give?

What are we getting for what we do?  Intuitively we probably think, like the hired farm-hands, and like my patient Bella, that we aren’t getting what we should at times.

“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.

The real point of our stories here – the hired farm-hands, Bella’s, and our own story – is figuring out the reference point of why we do things.  Everyone makes their reference point in their own way.  Find your reference point.  Just find it.  You’ll get more for your dollar, so to speak.

You might remember from some earlier posts, about doing what is congruent with our hard-wiring, i.e. our temperament.  This gives us more joy in our work, we are better at what we do, we feel less self-pity, and an energy generated simply by our own natural interest drives our efforts.  As a believer in biology, I’d list temperament not as a reference point, but as an influence of how we search for and how we define our reference point.

Finding our reference point is not impossible if we don’t do what comes natural to us.  Finding our reference point is impossible though if we aren’t looking.

After searching in my special way for why I do what I do in life, I found God.  Is that true?  Just ‘cuz I said God is my reference point, doesn’t make it true.

Self-Care Tip #95 – Find your reference point.  Be a friend to yourself.

Question:  Have you actively, purposefully used your biology (like a hoe in the field) to find why you do what you do?  Is it helpful?  What have you found?  Please tell me your story.

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Are You a Victim or What?!

 

 

Number Two of Bella’s List – victim or what!?:

Last night I took my 5 year-old daughter on a sleep-over date at a hotel.  Generous I thought …and boy was it!  To me!!  I couldn’t believe how much fun I had.  I quickly realized why I had done this.

A bit of me still wants to float away on wings of the modern-martyred-Mom, and I can, because it did take a lot of time and money and energy and….  But it’s not too friendly to me.  As attractive as that flight may seem, I’ll lose air at some point and take a big fall.  Ouch.  I might fall on my kid too which is against my intuitive effort here.

Being a victim is attractive at some level, no?  My story is a softer example, but we all have tougher ones.  Like Bella’s when “she spoke of her injury.”  The gravity of her injury was created by her perception of things.  Our perception makes our emotional success.  My story about last night with my daughter sounds pretty because that’s how I perceived it.  However, I have other stories that have negative power over me as Bella’s had on her and as yours have on you.

The key here is that when we take the victim role, we aren’t just telling our story or venting.  We are feeling self-pity. But venting is not necessarily self-victimization.  Venting can be healthy.  Venting can be done without taking a victim air-bus to no-where good.  Venting can be a way of being present in your suffering, of going where the pain is and letting it lose power over you.  Self-pity only gives the suffering more power.

The great novelist and philosopher, David Foster Wallace, who courageously lived and died with major depressive disorder, encouraged,

To be just a little less arrogant. To have just a little critical awareness about myself and my certainties.

The willingness to learn or grow is the foot-path away from victim-ville.  Could we even say that being a victim is “arrogant?”  We – Me, my patient Bella, you – have we taken steps to tell our story, to be present, to live with the humility it takes to look at ourselves and not escape/fly-away?

Whatever it is you are going through, it might help to vent it!  Grow and learn and get bigger than that experience.

Self-Care Tip #94 – Get in your own space to choose freedom from self-pity.  Be a friend to Yourself.

Question:  What barriers have you felt to telling your story?  What has made it difficult to be in the space of your own feelings?  Please tell us.

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Walk Away From Your Junk

the rogers park young women's action team

Image by samuelalove via Flickr

Number one on Bella’s List:

There are endless new beginnings.  Had a bad day?  Stop right where you are and call-it out.  Then if you want to, if you are willing, if you are able you can start again.

But who is able?  Anyone who wants.  Even the severely disabled can say at some level that they want to end the hurt.  New beginnings are a privilege.  They are the dandelions we pluck and make a wish on.  It reminds me of when Jesus,

walked right through the crowd and went on his way.

The people were trying to push him over the cliff and they just plane didn’t see him walk among them and away.  We do that sometimes with our “start-over” opportunities.

There’s an interplay of forces that make our new beginning possible or impossible.

  • Humility – a willingness to learn.
  • Biology – a physical ability to stop, drop and roll the fire that’s scorching our emotions
  • Insight
  • Choice – choose it

Bella told me more of her story.  After she said, “The day has been ruined!,” her husband took them all to the table.  He told the kids, “Mom’s right.  The day is ruined.  Now who wants to start over?”  And then they all prayed for a new start.  They walked away from the junk.

Self-Care Tip #93 – Start over any time, every time you want.  Be a friend to yourself.

Question:  Do you find this to be true for you?  Is it a real option to start-over when you want?  Please tell me your story.