Month: April 2011

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Give Yourself Over to Connection In Your Good-Bye

Michael Scott (The Office)

Image via Wikipedia

Hello folks.  Just cried my eyes out watching the well-developed character of Michael Scott close out his work at The Office.  What is it that moved me so much?  The connection.  Michael Scott, played by the talented Steve Carol, ended his performance with the question,

They say that at your death-bed you’re never going to wish you spent more time at the office.  Not me.  I’m going to wish I had more….  Who are the people you work with?  Your very best friends in the world.

I could barely breath at this point.  Pile of tissues on the table.  My stunned husband letting me blubber goo on his shirt.  He asked,

What is it that you liked so much?

Only my husband would ask what I liked in the middle of a good cry.  He knows that crying doesn’t mean I don’t like what’s happening.  He knows my twisted ways.  Connection is lovely enough to like, miraculous enough to marvel over, worthy enough to lose my cool over.  It is after all one of our favorite topics here at FriendtoYourself.com.  It is after all what you and I have shared, working so hard for, spending hours every day writing or whatever it is that each of us do to grow that fragile yet strong wonder of humankind – connection.  This bit of self-care follows us into heaven, or leads. Who knows, follow and lead, when we are connected.

Within the friendly grip of connection, in this marvelous episode, we see that good-byes might bring us even closer together.  I see this all the time in crisis settings, hospitals, illnesses, pending closures to something that was loved.  The closure draws us closer into what good the connection had offered us.  To improve what we had previously thought was so good that it was beyond improving.  To draw forth, our greater selves.

Self-Care Tip #  – Give yourself over to the miracle of connection in all your good-bye’s.

Questions:  What makes connection part of self-care?  How have you been a better friend to yourself by the influence of connections?

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The Testimony of The White-Headed People – Connection and Aging

Once again, I find myself in a café.  This doesn’t happen often enough for me.  But here,Almond paste tart with chocolate mouse and blueberries

I am

at the wonderful le Croissant Bakery, indulging not only in the quiet of my private thoughts, not only in my delectable chocolate croissant with coffee, but also in the ambiance.

Here, there is this completely lovely group of white-headeds, maybe ten of them at a table, sharing the treasured community of each other.  None of them walk completely upright.  One is wearing his oxygen tubing with tank in tow.  The ladies are coiffed irregardless of their folding skin and thin hair.  Fruit tart

I am

so blessed to be in their community, testifying to me that aging doesn’t have to be done alone.  Flourless Chocolate cake with Ganache inside

I am

sure, 100% sure, that none of them are aging as they dreamed.  Each of them have outlived many loved ones and the ground they walk on has changed many many times.  They have, each of them, learned to walk again after suffering the type of loss that put’s any of us in bed.

I am

blessed.  This collection of café moments they have together does not account for these losses.  This does not resolve their ongoing conflicts or pain.

But none of them,

Almond paste tart with chocolate mouse and blueberries

I am

100% sure, did not let those things keep them from having this moment together today.

All this sureness without having checked my notes with them?  Yes.

I am.

Crumbs on a Plate

Image by rockbadger via Flickr

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The Relationship Between God and The Me In Self-Care

Self-Care Tip #247 – Find the relationship God has in your self-care.  Be a friend to yourself.

Many of us are still getting bothered by the concept of “everything starts and ends with Me” from a Judeo-Christian perspective.  The largeness of the Me is bothersome and takes up too much space.  It seems to say that Me is bigger than God, Me is the Alpha and Omega and not God and that in the lap that starts at Me and comes back around to Me – God could be in that loop or not.  It seems to say that Me gets the “glory” and not God.  I agree.  This all does sound ugly put this way don’t you think?  And because I am a Judeo-Christian from the Western religions (although loosely at times when religion gets thick and boring), and because I love God, I don’t feel good implying that life is grand without Him.  Ugh.  Life is without Love from this perspective.  Not grand.  Ever.

Some of us feel better saying there is self-care, and then there is spiritual-care.  They are different because spiritual care is coming to Awesomeness so greater than Me that all of Me worships and humbles myself to Him.  Something like that.

From my perspective, I am really ok with saying self-care includes God or saying label them separate from each other – as long as they both come together.  I am wondering what your thoughts are.

I know we have discussed this a couple of times before and if you want to reference some of those blog-posts, please see:  Self-Care is Not unChristian, Set Your Self-Care Free, Emotions Don’t Have Intrinsic Moral Quality.

Questions:  How does your spirituality, view of your Higher Power, and your religion intersect with your take on self-care?  How do these views influence your action in self-care?  Please tell me your story.

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Mental Illness Relapses When Medications Are Stopped

Free face of a child with eyes closed meditati...

Image by Pink Sherbet Photography via Flickr

Self-Care Tip #246 – Collaborate with your physician to change your medications.

It keeps happening.  People are stopping their medications and then getting more sick.  Recently it was Olivia.  I can always tell when she’s off medications – she personalizes things way more and she acts like a victim to many many random things.  She is irritable.

Olivia, did you stop your meds?

Olivia on medication was not a super easy-going person but she dropped much of the edge, her thoughts were clearer and she was able to see other people around her.  Today Olivia felt like her bullets were in place and about to fire.  She answered my question obliquely.

There are sooo many reasons I am better without those in me!   I used to not be able to feel God.  When I prayed, I didn’t sense His Spirit.  Besides, I’m doing fine.  There’s nothing wrong with me.  I’m happy!

The biggest bummer about getting into the scene after the medications were stopped verses before, when stopping them was just a consideration – is that the patient doesn’t see themselves clearly.  They don’t see how bad it’s gotten.  They can’t be objective largely because they are using the same organ that is ill to describe itself.  If I could have discussed it with her before she stopped her medication, she would have been in a healthier state and more able to weigh her risks and benefits of medication verses no medication.

Sometimes we do agree together, patient and physician, to stop medications and sometimes we don’t.  Doing it together is the key though.

Questions:  How do you work with someone who wants to come off their medication?  How about yourself?  Has this ever been a problem for you and if so, how did you deal with it?  Please tell me your story.

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Self-Care Works You, Pushes You, Tires You Out Until You Are Happily Spent On Your Friend – You

two-girls-exercising-cayucos-beach2

Image by mikebaird via Flickr

What is being a friend to yourself?

Being a friend to yourself is more than getting our manicure, shopping, watching movies, being spontaneous and doing what we want.  In fact, often times, being a friend to yourself is not doing what we want.  Sounds great right?

Being a friend to yourself might be the hardest work you ever do.  For a time, it might feel like you are turning your back on your family, being selfish, sacrilegious and unfriendly.  You won’t get kudos from your support groups.  You won’t be noticed or hear thank-you very often.  I’m sure you can’t wait to hear the rest!  “Where can I sign up?”  Right?

Being a friend to yourself is taking accountability for our lives.  It says, everything starts and ends with Me.  It looks for accountability for our actions, our feelings, our health, our spirituality or connections in Me and not towards any external locus.

When we are a friend to ourselves, we don’t apologize and then say, “but….” We make amends for what we believe we are responsible for.  We do this without clarifying and justifying our behaviors.  We are not victims even though we may have been victimized, hurt, misused and forgotten.

Being a friend to yourself protects us against apperceiving that we are defined by anything we don’t choose.  Public opinion, stigma or even our pain does not define us. Our pain is not special. We are special.

We believe that we are free.  Free to choose self-care.  Free not because of the men who died for our freedoms, not because of our behaviors or spending power, but we are free because we are human.  Being our own friend is a privilege that we can choose freely to exercise or not.  No one can make it happen except Me.  Just like no one can make me love you or demand a gift because of the inherent freedom within them.  These things happen only because we believe in them, won over by Love.

We become our own advocate, admirer and treasure of high value.

When we are a friend to ourselves, we don’t deny our history but we claim the freedom to start over any time.  The history does not define us.  We are more than actions good or bad.  We have an essence that is timeless and unchanged by the ravages of illness or misuse.

Being a friend to yourself means caring for the specifics of your body, your simple needs that lead to complex outcomes.  Your exercise, your sleep, your diet, water and air are all worth fighting for.  These things you do for yourself become your currency.  You find that the better friend you are to yourself, the better you become for others.

At this new place of safety for you, where you give less, you give more to those you love.  You discover the mystery that no one can give what she doesn’t have.  Just like any bank, we deposit and withdraw and must protect our basic assets before we are taken over and lose the freedoms because we were poor managers of this one body that God gave us.

Everyone pull out your wallets and please empty them on the desk.  How much do you have?  How far will that take you?  Do you ever go a little crazy wondering where you will get more?

Now imagine that this is your body.  You have these assets; this currency.  Currency like your energy, positive emotions, interest, motivation.  You have bank when you can move around, walk, and muscles to lift your child, this vision to admire her new dress.  This is money, this beauty that you offer your significant other, your body, and your shape.

Now you are giving to your children.  Up in the night when they wake up and you can’t sleep afterwards.  You skip exercise the next day, in fact, why even talk about it.  You haven’t exercised in a year or more.  It’s been really hard when your body is either pregnant or recovering from pregnancy over the past seven years.

You never lost the weight and for some reason, now that you want to, your body is firmly telling you, “No.”  You don’t care enough about not having had sex with your husband in four months, but it does bother you that he uses porn so much.  You don’t talk about it.  You’re too tired.

Your child now develops eczema.  She’s nervous and complains of stomach-ache often.  She cries a lot and you can’t remember the last time you enjoyed being with her or any of your kids.  No doubt.  You do love them.  That’s what all this is about, right?  You are sacrificing everything for them and would do it again.  They are your life and when they move out in 15 years, you’re moving with them.  Husband or no husband.  What else do you have?  You aren’t even interested in anything to want to do anything else besides bleed yourself for them.

You can see that this story isn’t anyone’s fantasy.  But can you see that the mother-character – she’s not very nice.  She is not nice to herself and not that nice to anyone else either.  Even though many people are on her list of party invites, she is not connected much to any of them.  You can bet that her family enjoys her about as much as she enjoys herself.  She is angry with them for this but doesn’t realize that she feels ashamed by it more than angry.  Betrayed.

Now enters the victim-role this mother plays.  Oh boy.  I know.  You probably don’t want to hear about it.  It hurts just to start in like this, huh?  So let’s not.  Let’s draw another picture.

Look at your wallets again.  Now how do you get what you need to keep it full?  How do you get what you want to give and splurge on the ones you love?  Where does all that money come from?

Work.  You said it sisters.  And so this is you.  You are a mother of how many?  Three?  Two?  Who do you live with?  What are your jobs at home and elsewhere?  How much of that can you do if you don’t have energy?  Motivation?  Interest?

Oh but you do.  You take care of your basic needs.  You exercise even when your kids are pulling on your sweat pants all the way out the door to the gym.  You don’t get up for your kids at night as quick.  You let them cry it out or do what ever it takes for them to get themselves back to bed.  You take medication if you must to get back to sleep after you are awoken.  You practice sleep hygiene and although you miss, you desperately miss having spontaneous late night TV, you don’t.  You go to bed.  Recently you lost twenty pounds and you are working all your resources to keep it off.  You can’t believe how hard it is to keep off even though you can barely believe how fantastic it feels every day without that weight.

You take your medication because you understand that emotions and behaviors come from the brain.  When you used to not feel pleasure, it wasn’t because you didn’t want to, try to, pray to.  It was because the symptoms from the condition of your brain health were emotions and behaviors in the down direction.  And thank goodness!  Now when you see your kids, you not only love them, you like them.  Sometimes it takes your breath away.  You just can’t believe that you didn’t feel this before.  You like your kids.

I can go on.  But I think you get it.  No one can give what you don’t have.  Now show me your wallets.  Put whatever you took out back in.  Not much?  No worries.  You are your own friend and will take care of yourself.

I know I’m making it sound like being a friend to yourself isn’t that fun.  Having fun isn’t the agenda of friendship.  The agenda is doing what is positive for your friend.  It is some of the hardest work you’ve ever done.  It means connecting with others because you know it is good for you – even though you are shaking, nervous or just plain don’t want to.  It means going out to find love when love doesn’t find you.  It is hard!  It isn’t necessarily doing what is smooth and easy, although sometimes it may be.

Self-care is a discipline of action, presence or whatever is called for by you, your friend.  It takes your natural genius, the things that came to you without working, and it uses those to steer your energies.  It uses those to tell you where you will be working like a mad-dog at times to find the most pleasure and be the most productive, have the most service to offer, be connected in the most intimate way with those you love – God and man.

Self-care is not for the people who need it.  It is for those who want it.  If you don’t want it, stop listening and be on your way.

Questions:  What is called for by you, your friend, to do?  What has pushed you, worked you, tired you out until you were happily spent on caring for your friend, you?  Please tell me your story.

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Sleep Does Not Lose As Gracefully As He Lets Us Think

Cougar sleep

Image via Wikipedia

Self-Care Tip #244 – Sleep when the day is over, and play another time.  Be a friend to yourself.

Sometimes it is hard to let the day end.  Michael told me that he was having trouble sleeping.  I asked him to tell me more and heard him describe fun-filled hours of movies, computer, phone-calls and late-night snacks that were disturbing his sleep-initiation.  Just listening to him, I felt a yearning catch spark in me to have the freedom to be spontaneous again.  You might know what I mean.

The opportunities to be spontaneous have shrunken up as our choices have brought us expanding fillers for time, attention, money, energy, emotion, personal resources and magic.  It is no wonder that letting the day end meets reluctance.  Those last few hours that sleep called shot-gun for are ours with less fist than big brother used to stage.  Sleep doesn’t put up much fight …at first.  At first, it concedes to us.  It lifts it’s chin casually until given turn.  However, much like the loan shark, sleep will never go unpaid.  It will take it’s due.  Maybe just not tonight.  Maybe you won’t hear about it until later.  And there are no promises that it won’t take by force, from one part or another of our body, our brain, our beauty, our emotions – debts are not forgotten here.

Michael says, as if he were the victim here,

It takes most people about thirty minutes to fall asleep.  But me!  It takes me hours to.  

We started talking about sleep hygiene and Michael just wasn’t interested.  I asked him to simply read about it and just see what he thought he might be able to start with.  One change maybe that he thought was tolerable.

These negotiations are sometimes best when the patient feels like they came up with the idea.  Michael is going to read about this and hopefully become his own advocate.  He will hopefully “sell” it to himself with the information both from facts but also from experience.  It’s no accident that Costco sets up samples at ever turn of their superstore.  Nor that we can never seem to leave without spending at least $100 in cash – not credit!  Cash!  (Argh.)  Maybe Michael will sample and decide to sleep rather than play at night.  He might have to “taste it” to believe and choose for himself.

Spontaneity will always lure us, dangle her jangly jewelry, give her side-ways glance and make us long for those midnight hours to open up in playful company.  However, sleep is not as gracious as it seems.  Don’t be fooled.

Question:  Do you consider sleep hygiene important to self-care and why?  How do you see it related to you being a friend to yourself?  Please tell me your story.

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What Comes To Me From Others Is a Gift

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Image by krystal.pritchett via Flickr

Self-Care Tip #246 – Take care of yourself and expect that what comes from others is a gift.

Do you ever ask,

Why does drama follow me?!

It is just darn hard taking care of ourselves (including taking psychotropic medication.)  Much of the rest of the world has difficulty with it too.  Despite our best efforts to go towards what is friendly, we might decide that choosing the company of un-self-cared-for loved ones is more friendly to ourselves than cutting them off.  That is our choice.  If we want them in our lives, we are not able to just take the bits that are friendly.

Some of us are more dramatically affected by this than others.  Wonder about why that is.  I’m wondering if it has to do with our different perspectives of who will take care of us.

Feeling like someone else is going to take care of Me is a trap.  Expecting someone else to find us for love, to expect leadership, to follow without accounting for our steps, to decide without knowing we decided, thinking someone else decided for us – these are traps.

Drama-icon

Image via Wikipedia

What do we expect other people to be for us?  We will interpret the drama we encounter differently when we are our own leader.  If we take care of ourselves and if we come in a state of readiness then we can offer more of these gifts and visa versa.  Gifts are free and as free of agenda as our flawed selves can give.

We embrace our emotional self, our thinking self, our judgmental self, our sensory self, embrace and live ourselves up most fully, and we are most friendly when we do it with the freedom our lives were designed for.

Drama will always come up as long as we think that someone is worth being in our lives.  We will remember that we chose them and can choose quantity of time, the volume, the reception and the degree of connection.  We can choose freely what we will do or not do with them and live and die surrounded inside of ourselves and outside of ourselves by the connections we fought hard for.

Questions:  Why do you think drama is in your life from the perspective of self-care?  Since you’ve been more in tune to being a friend to yourself, has anything happened to the drama in your life?  Please tell me your story.

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Our Feelings Begin and End With Me. We Are Not Victims.

Freedom is useless....

Image by rAmmoRRison via Flickr

Self-Care Tip #245 – Our feelings begin and end with Me.

Are we victims of victims?  I know I blame people and am not above a good rant on all the why’s “I feel this way!”….  However, the cleanest air I’ve ever breathed is when I’ve stepped out of that space and started naming myself responsible for my own feelings.

Slavery comes in many ways.  Thinking about being a slave by our own design is an odd twist but choosing the victim role does it.  Choosing freedom to self-care is liberation by the same government.  This is a cornerstone of understanding the “Five W’s and One H” of self-care.

Victims also generate victims not only of themselves but also of others.  Somehow the emotions, heavy, immobilizing, irritable, angry, coming off of the person in the victim role are absorbed by others if those others aren’t seriously insightful and vigilant against them.  Considering this, we can understand the difficulty of being present, in the moment and not either running away or trying to change the person in the victim role.  (Remember the 3 C’s?)  Anyone porous to them is at risk.  Too often, we all find ourselves pointing, pounding, pity-party preaching victims – none of us naming ourselves responsible for our own feelings.

We know that we are more prone to personalizing things when we suffer different emotional illnesses.  In this case, we can’t help but catch the familiar features of depression.  There are other illnesses of course with these symptoms, but an irritable depression is one of the most difficult to endure for all parties. Sometimes, simply gaining insight into our coping skills can make us better friends to ourselves.  That is such a relief.

Too often however, being the victim is not fully under our control.  Too often being the victim is a symptom of the disease process that came without an invitation.  Also, just as often or more, the person in the victim role doesn’t have insight into any of these aspects – their choice into slavery, their influence on others, their medical condition generating these symptoms or their options to gain healing.

I could easily tell you a number of word-pictures, maybe describing the before or after treatment, maybe letter-layering the innumerable ripples that self-care made on the world after treatment or maybe I will more easily just not.  All these stories bring me, at this late hour of our week, too close to those contagious emotions and I’d just rather not.  Maybe you’d like to share though?

Questions:

  • When you started owning your feelings for things that you never thought had anything to do with you, what were your thoughts?  How did it ripple out of you and affect others?
  • What do you see at the cornerstones of self-care?
  • Please tell us your story!
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Anger – Sometimes There Doesn’t Have to Be A Reason

A metaphorical visualization of the word Anger.

Image via Wikipedia

Self-Care Tip #244 – When emotions and behaviors come without being asked by you, think about the medical reasons.

She needed to keep going, Minka felt hurt and angry.  Control and failure nipped at her.  She wondered what it would take for her to recognize her own success.

Minka had a child who provoked her.  But worse for Minka, was not perceiving progress in their relationship.  Minka was bewildered by it.  But still and more so, angry.  She asked me what she needed to do to be happy and feel like what she did when life was good.  It reminded me of the man who came to Jesus and asked,

Teacher, what good thing must I do to have life forever?  (And listed off all his good deeds.)

Just as I was thinking about this, sure enough, Minka listed off her self-care efforts, angrily as if they failed to redeem her.

Turning this around in my mind, my thoughts ran over a differential – the 3 C’s, her temperament, her biology, other medical conditions, other influencing stressors and I wondered if Minka was angry in other situations as well.  (See The Biopsychosocial-How-To.)

No one really likes themselves much when they are angry.  Anger is pulled through the capillaries and passed on until it colors all of us red.  It is a confusing emotion; internally preoccupying.  Many people don’t remember chunks of their lives during which they said things and did things in anger.  It just disappeared into the white noise of the emotion.  During anger-binges, people can black-out too, much like alcohol.  Often times anger comes without invitation.  Often times, anger is not something that will leave by invitation either.

So we know already that the 3C’s apply to this kind of anger.

I didn’t cause it, I can’t control it, I can’t change and or cure it!

Minka hurriedly answered that they didn’t work for her but she had tried.  It was on her self-care list apparently.

I don’t want to blame my daughter.  I know I’m responsible for how I feel but I keep holding her responsible even though cognitively, I know she’s not.

That was pretty big.  In my opinion, she could put that on her self-care list and check it off as well.  Steller.

the

Image via Wikipedia

Through further disclosure, I learned that Minka hadn’t enjoyed anything much lately – not only her daughter.  She was irritable, edgy, felt superior to others and then kicked herself over it.  Minka said she tolerated less and less of what life touched her.

I wrap those descriptors in the same nap-sack as anger and mood.  They are on the affective spectrum and for Minka, it wasn’t for lack of trying hard enough, for lack of being spiritual enough (it makes some of us uncomfortable to say this), or missing a puzzle piece from her psyche.  Minka was medically unable to put her anger aside and connect with her daughter.  Minka’s medical condition was isolating her not only from her daughter but most other bits of life touching her.  She was ill.  She wasn’t choosing those emotions.  Now came the job of helping Minka see that and go for help in the right direction.

Question:  What is your opinion about behaviors and emotions coming without being invited or chosen?   …without a “reason” for being there?  Please tell me your story.

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Your Pain is Not Special. It Is Normal.

Self-Care Tip #243 – See yourself as special rather than your pain and know that you will find your normal again.

What is your normal?

When we were kids, we all had a perspective of what normal was.  Let’s say it was “here.”  Let’s imagine we were lovely then, nurtured and emotionally bonded.  We struggled through peer conflicts, social anxiety and rivalry.  We wanted a bike.

Two Sisters

Image via Wikipedia

Then we got a little older.  Maybe our parents divorced.  Maybe, a sibling died.  Maybe we were abused or in an accident and damaged.  Damage changes normal.  What we never would have thought would be acceptable in our lives became acceptable.  We suffered.  We lived.  Life was indiscriminate and ignored our status.  We think there must be a mistake.

What is our normal at one point, filtered through remaining hopes, grew into regenerating fantasies, through real potential and it moved again.  We are older now and more suffering comes.

Where is our normal?  We survive our child, our own dear perfect boy, hanging from a tree.  Normal?  No dear God!  No!  And we continue to live.

Two years.  Two years are what it takes for our biology to catch up to the shock.  Two years are what it takes for us to begin to accept and realize that in this new normal we care again.  We choose it in fact.

People don’t remember his name or talk about him and we can’t remember his eyes.  We are ashamed and lose our breath from panic just trying to see them.  We want to bang our head because we know there is something wrong about feeling normal! Ever! Again! after that.  But we do.

Our normal mutates over financial ruin, abandonment and a growing healthy list of disfiguring illnesses.  We accept them and say yes please.  Live.  We want to live.  This is acceptable.  This is normal.  Our friends die.  Our memory.  We can’t find our teeth.  Our heart stops.  We die and the world finds normal.  The world chooses just like we did.

What we don’t think will ever be allowed to happen while we brush hair, clip our nails and microwave food, happens. We endure these changes.  We find normal again.

What is your normal?

My brother, Vance Johnson MD, is a physical medicine and rehabilitation specialist.  He said that during his residency, close to 100% of spinal cord injury paralysis survivors he worked with wanted to die after their injury.  Many of them would beg him to let them die.  They would cuss at him for keeping them alive.

I leaned very heavily on the studies and data during those times.  It was very hard.

Vance said that what kept him faithful to his task was knowing that close to 100% of them after two years would be glad they were kept alive.

Even the ones who were basically breathing through a straw and that’s all that moved on them; even they wanted to live.  These people found a new normal.

Where is our normal?  We will want it.  We will adapt.  Biology will catch up to our reality.

Remember that your pain is not special.  You are special.  Not your pain.  Pain is normal.

Question:  When this happened to you, how did normal find you despite the rubble?  How does this concept feel to you, that your pain is not special?  Does it make you angry or what?  Please tell me your story.

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Interrogatives of Self-Care

Cover of "The Elephant's Child"

Cover of The Elephants Child

Poem by Rudyard Kipling

following the story “Elephant’s Child” in “Just So Stories“

I keep six honest serving-men
(They taught me all I knew);
Their names are What and Why and When
And How and Where and Who.
I send them over land and sea,
I send them east and west;
But after they have worked for me,
I give them all a rest.

I let them rest from nine till five,
For I am busy then,
As well as breakfast, lunch, and tea,
For they are hungry men.
But different folk have different views;
I know a person small
She keeps ten million serving-men,
Who get no rest at all!
She sends em abroad on her own affairs,
From the second she opens her eyes
One million Hows, Two million Wheres,
And seven million Whys!

Self-Care Tip #233 – Define self-care with your adverbs.

The Interrogative adverbs of self-care:  what, where, when, why, who and how.  These are also known as The “Five W’s” (and one H) of self-care ;).

What is self-care?

Where?

When do we do self-care?

Why do self-care?

Who?

How do we do self-care?

I asked my daughter today,

M:  What does taking care of yourself mean?

D:  Taking care of myself so I’m healthy and can have fun when I’m old.

M:  How do you do that?

D:  I don’t know.  I can’t think of that.  (Conversation ends without flourish.)

These are our questions.

Questions:  Please pick one or more of these and answer from your own self.  Please tell me your story.

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Choose Back! …As Long As Life Chooses You.

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Self-Care Tip #241 – As long as life chooses you, it is your right to choose back – so do.

Although I am not a geriatric psychiatrist, I have still been given the pleasure of serving a “golden” few.  What has impressed me has been their willingness to start over.

Starting over takes courage and humility whether it is deliberate or not.  Sometimes fear dances between the lines of all the emotions and intentions. But still, wouldn’t you agree that it takes courage and humility to negotiate fear?

(Enters Hans.)  Hans was seventy-three years old.  He had struggled with brain illness on and off he thinks since he was at least twelve.  There were big spaces of time when his disease exacerbated, and he largely suffered.  But he chose, at this age, to try again for improved brain health.

Is there a time when we start thinking, don’t keep trying to start over?  Maybe in the dying process.  In case you don’t know, the dying process is a specific term.  It means the time when a person is facing impending death.

This area of medicine is not my specialty but I imagine at some point we want to stop with that starting over process, give up, but not in a hopeless way.  In a way that says,

I can stop trying for new anything and sit in the space of what I already have in me…

…Which hopefully includes all the ingredients and interrelations of life.

But how far before that point in life do we consider starting over reasonable?  I’ve heard of kids being told they’re too young to ride a bike, or cut with a knife, or understand the dinner conversation.  No one bobs their head at that.  But find a seventy-three year old who believes that after a lifetime of perceived failure by onlookers or themselves, who still says,

Now let’s give this another go,

…and if it hasn’t been said, it’s been thought,

give it over already!  You’ve hit your seventy-times-seven chances!

It’s like they’re shopping in the teen-ware.  We blink our eyes and angle our heads.  Even the thought of starting over as a real option feels indiscreet.

(Enters Hans.)  Hans is seventy-three.  He is starting over.  Humbly and with courage, he pursues brain health in the face of stigma.

I think I had celebrated my six birthday when my dad asked me if I felt any different from how I felt when I was five.

Yes!  I feel older!

 Then he asked me how old I thought he was.  When I answered some enormous number like, “twenty-two!” he asked,

Does forty-four seem old to you?  

Of course it did!  But I had an intuition that if he was old, than he’d die, so I said a definitive,

NO!  Daddy you’re still young!  You aren’t old!

Now, almost that same age myself, I am in awe of him and the others in their golden or not so golden years (Enters Hans) who believe that as long as life chooses them, they will choose back.  It is their freedom.

Questions:  When all your senses don’t sense pleasure in life, or you feel old and useless, or you feel that you’ve failed too many times, how do you choose to start over?  Who has inspired you and what did they do?  Please tell me your story.

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Being A Student… To Yourself!

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Self-Care Tip #240 – Be a student to yourself.

The PossAbilities Triathlon today was the best.  It was the first triathlon for my young niece.  Doing it with her made it so much more than just a triathlon.  She is someone who works hard on what she loves.

Her father, who is my brother Vance, and I had more time to chat today, thanks to my niece’s excellent pacing.  Vance is a natural teacher as well and he’s been practicing on me our whole lives together.  The fact that we are old now doesn’t change the dynamics much and I think we are both just fine with that.

Today we talked about teaching directly.  Vance said,

To teach well, first you have to understand what their fears are, and waylay them.  Then you inspire, but you can’t inspire until the fears are examined at some level and trust grows.

Isn’t that lovely?  So my question for us today, is how do we do this for ourselves?  Sure, we want to be humble students as well as educators in the teams we work with involving others.  However, reducing this to the basics of self-care, we finger the idea that this can start right here, where things start and end with “Me.”

Understand our fears and let them lose their power over us.  Then spend our time and energy on what inspires us.  This is how we can teach ourselves and learn from ourselves!  What a delight.

Questions:  What do you think about the idea of being a good teacher to yourself?  Is it ridiculous?  Arrogant?  Possible or not?  How do you teach yourself?  Is it the same as a “doctor-heal-thyself” trap, or as described in this bl0g-post, “teacher teach thyself?”  Is there still self-care potential in this, despite its obvious limitations?  Please tell me your story.

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Misrepresentation Of Self-Care Will Inevitably Be Part of Our Truth

Self-Care Tip #239 – Let the misrepresentation be.

In our efforts here at FriendtoYourself.com, we try through our limited selves, our flawed selves, our biased selves to understand self-care as well as we can.  Never-the-less, the process of the ongoing mix-and-separate leaves us ever aware that our work is unfinished.

When I say, “It’s biological,” see that there are other things in the room.  Please see the windows and doors still open.  Please know that I don’t deny that there are other senses than my own, other dimensions and other realities than what we perceive.  The reason I don’t always mention them, credit them for behaviors and emotions, the reason you don’t hear me say often enough that we are not unidimensional is that I speak about my area of experience – the brain.  It is what I do.  I am not an expert at all paradigms.

Acknowledging one reality is not a denial of the other unless… well unless other things happen, which I’m not ready to clarify.  I will throw out that maybe intention to throw them out needs to be there too.  Maybe saying that, we are in danger of being perceived to be denying other reasons.  It reminds me of Escher’s work of repeating beautiful patterns to infinity.

This makes many of us uncomfortable who are designed to be sensory aware, in the moment and  in the barn – contrasted to others who are wired to be connecting big picture concepts and grazers.  (See my blog-posts on Jungian-typology for more.)  I acknowledge this intuitive emotion response with respect and equality to any other of our temperaments, all of which are neither better nor worse than the other.  The discomfort that comes when we are out of our area of genetic-genius does not have moral quality; it just is.

The emotions will come.  We want them; the senses that interpret our reality.  We will with our sixth sense, our individual genetic  genius, our 10,000 hours of hard work and experience, with magic of what we still don’t understand and with our God – we will take care.  Of our selves, we will find a friend.

Questions:  Do you mind it?  All the bits that you don’t know about self-care still?  Do you mind the way it is misunderstood around you, projected and assuming?  How do you deal?  Please tell me your story.

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Patient on Patient Crime – Our Response to Our Own Illness

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Self-Care Tip #238 – Think about your response to your own behaviors and emotions.

Bianca agreed with her husband.  She was too depressed.  She never wanted to go out and cried a lot. Perhaps she even deserved to be cheated on and abandoned because she was so unbearably dull.

Pause button.

We have discussed where behaviors and emotions come from – the brain.  We have identified the brain as human material, matter, biological and as susceptible as anywhere else on the body to illness.  In short, We could say at this point that Bianca is in a Major Depressive Disorder – a medical disease.   There are many medical diseases secondary to design, behaviors or lack of behaviors.  Or for other reasons.  However, I don’t know many medically ill that when the spouse walks out on her, we say,

Well of course!  She had cancer!

Or,

He lost his leg in a car accident, get someone else!

But throw in some aberrant emotions and behaviors for unacceptable time, and the escaping spouse is given running shoes as a gift from their concerned community.

How could he stand her!  Of course he left.  She wasn’t taking care of his needs.

You see the disparity and when written this way, it looks really ugly and I apologize.  I’m not trying to thumb people for biases and prejudice.  Both parties are hurt.  I’m also not trying to say that this happens only in marriage.  It happens in almost any setting.  Emotions and behaviors are just not considered to be symptoms of disease.

Have you ever heard the term, “Women on women crime?”  Well this is something like that.  I’m thinking much of this will improve when we treat ourselves with more insight and understanding consistent with our biopsychosocial model.  If we don’t do this first, who will.  We aren’t responsible for how others treat us, but we are responsible at least for ourselves.

This is one more wonderful way of claiming our right to say, self-care starts and ends with Me!

Questions:  How can we wrap our beliefs around this seemingly enigmous concept that when someone is crotchety, negative, irritable, inattentive or boring – it might not have been because they chose to be that way?  How do you own if in yourself?  Please tell me your story.

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When Things Get Heated, Remember to Ask Your Friend’s Opinion. You.

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Self-Care Tip #237 – When things get heated, get a second opinion with your friend.

What would my friend say?

When in question, ask.  And who is the friend we are referred to here?  The “Me.”

This is a great check point to give ourselves.  Things get heated between her and him, she gets a second opinion.

Barbara had read this blog and tucked something of its fabric away in her blended space between conscious and sub.  Then one day, while zoning out listening to her husband yell and criticize her, she saw herself.  It was as if she split into the participating Barbara and the observing Barbara.  The participating Barbara suddenly didn’t feel so alone.  The word, or more the concept of “friend” came to mind and she put it together.

Now generally when she is in a situation that hurts and bewilders her, she is remembering to ask her friend what she should do.  Asking used to take longer, but now it comes to mind as quickly as the thought of consulting an intimate partner would.

What would my friend say?

Things weren’t peaceful yet in her life, but just asking her friend what she would do has helped Barbara a lot.  Barbara explained to me that if she were with a girlfriend, say Sally, and Sally gets worked over by her husband, Barbara wouldn’t have any problem thinking of what Sally should do about taking care of herself.  Barbara says that being her own friend is almost the same.

And then for me, it clicked.  I can ask my friend.

What should I do?

Question:  When getting hurt by someone, how can you get friendly with yourself in the moment?  Please tell me your story.

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Self-Care As it Affects Your Professional Self

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Self-Care Tip #236 – Think about what self-care is doing for your professional self.

When speaking with managing editor of the Journal of Participatory Medicine (JoPM,) Kathleen O’Malley yesterday, I struggled to explain the presumed simple description of what effect self-care has had over the past many months on my professional self.  I realized that I hadn’t spoken much about that yet.  The words spilled out, messy and ungraceful.  I’d like to say it better so I’m going to try again, and then many more times.  Self-care has helped me be a better physician.

I see people differently.  I look at them from the self-care angle.  I look for those sticky bits where we can connect and collaborate.  I expect things from them.  I ally myself with their self-respect, with their intuitive desire to be a friend with themselves.  I am bored at work when I don’t do this.  I am bored at work when my patients don’t do this too.  Yes.  My quality of practice has definitely improved.

Who isn’t blessed when they see the courage to face stigma, shame and bewildering illness?  Who isn’t more informed every time someone chooses the freedom to do self-care, chooses to live when disease is damaging them, fights hard like my niece did and shows what that fight is worth?  Who doesn’t learn from that?  Who doesn’t want more?  When someone loses their identity to the defacing ravages of disease but still knows who they are, is for me, one of the best places in the world to be.

Working harder on myself personally is working harder to improve myself professionally.  One healthy is another healthy Me.  Self-care has helped me find more pleasure at work because I know I am responsible about how I feel when I’m there.  I take care of myself when I’m there and then I’m able to give more to my patients because of it, including just being present.

Being present is really a lot to get and a lot to give.  I sense this in my kids who want me to see them.  They call out for observation of activities; riding without training wheels, jumping super high, running in fast shoes, building awesomeness.  But those are code.  They want me to see them.  I just can’t do that when I’m self-neglected.  It carries over in all spheres of my life, including the office.  Who wants to consult a physician who is half asleep in the chair?  (Now if I need a nap, I just go all the way and sleep! j/k.)

I know my self-care is participating in the practice of this kind of medicine with you.  I’m hoping to get better saying it.

Questions:  What has self-care done for you in your professional world?  How has it helped you work better as a team-member?  How has it helped you receive better from others who have something to give – such as teach you or give directions?  Please tell me your story.

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Participate – Work as Part of A Team With Your Medical Providers

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Self-Care Tip – Work as part of a team with your medical providers.

Today I had the pleasure of speaking with managing editor of the Journal of Participatory Medicine (JoPM,) Kathleen O’Malley.  Ms. O’Malley spoke to me about the effort they are making in this online journal to collaborate the work between patients and physicians.  Ultimately, their goal is to eliminate the barriers that keep us each from seeking to learn from the other’s perspective and knowledge.  She tells me that,

We are a team.

When my brother Vance’s baby was born, she was damaged and premature, so tiny and needed help to live.  Now, one year later, I am playing ball with her on the floor.  Her intelligent smile, thriving body and especially the lovely nape of her neck with that baby-curl of hair lipping up makes remembering her near death-dive into life surreal.  I don’t really want to remember it anyway.  But when I cannot help myself, what I like to think of is how my brother and sister-in-law were treated.

The physicians at UCSD were unbelievable.  Vance told me, with somewhat pressured speech from his amazement, how they, without hesitation, included him in their daily decision-making and informed him of any medical study results.  In case you don’t know, in case you have never been sick or been in a medical setting otherwise, this does not always happen.

I know I am guilty of this too.  Hovering over charts, hiding laboratory results, many of us practitioners behave as if our patients were at any moment going to throw us into court.  It is embarrassing, even though the truth is, too many of us physicians are stalked by litigious intentions, whilst the hoards of truly awful practitioners seem to sail away on unsinkable malpractice without pursuit.

Ms. O’Malley and the JoPM are working with all of us to put the bows, arrows, guns and weaponry down and take two steps back.  It is Thanksgiving-day every day there (I call Pocahontas!  I look good with brades.) and at the safe-place that this journal offers, we can learn from each other.  We can collaborate.  We can be vulnerable and not be preyed upon.   We can be sick, we can teach, we can simply observe and hope that like my niece, in time, we will find ourselves growing up in health and love more so because of it.

Please take a gander over to JoPM.  Say hi to Ms. O’Malley.  Read some of the stories from patients and physicians.  Comment if you will and participate for self-care.  It is your right.  You are free to choose.

Questions:  When you have had, or been proxy to (as I was with my niece), a spectacular patient-doctor exchange – what made it so great?  How did you “participate?”  How did participating make a difference for you v. “being mere passengers?”  Please tell me your story.

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Imagine If You Were Your Own Friend, And Take Your Advice

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Self-Care Tip #234 – Imagine if you were your own friend, and take your advice.

Joana Johnson, author of CreatingBrains.com, full-time mom of six, part-time University history teacher, student, wife, confidant, friend and sister-in-law… (no she’s not running for president) …Joana asked me today,

Write a letter to someone you love sharing what you want them to do to take better care of themselves.  You don’t have to give it to them or you can.

Now imagine what letter with what self-care requests would someone who loved you write to you?

…You’re right.  I’m going to have to talk her into running for president.

And so, I offer this challenge to you.  I wonder after you.  I am sitting in waiting.  Please tell us this part or more of your story.

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Moralizing Behaviors and Emotions

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Self-Care Tip #233 – Stop moralizing behaviors and emotions to be a real friend to yourself.

Responses to yesterday’s blog-post, I believe, revealed my point in time position in moralizing behaviors.  It is no excuse, but yesterday for reasons of my own limited perspective, personalizing behaviors, perceived judgment from myself and others, and cultural biases including some good old-fashioned well-intentioned holy roller atmosphere, I hooned in on that darned word selfish.

That word, selfish, reminds me of any class bully who hurts others but maybe not for the reasons assigned by observers.  It is more than that though.  Inherent to its own definition, morality is more than implied.  In efforts to destigmatize it, evolutionaries, such as George C. Williams, coined the term, “the selfish gene.”  We as well, in efforts to peel it off of us “self-carers” here at FriendtoYourself.com, have discussed some of the biopsychosocial reasons for behaving in ways that disregard the needs of others.  We have talked about freedom to choose and losing abilities to choose.  Because we believe in magic, or miracles, or yet unexplained science – however each of us prefers to describe the unknown – we claim some awareness that we still haven’t yet given over fair perspective, despite our intentions.

The wonderful, ever articulate, gentle writer, reader and commenter, Cindy Taylor, reminded me of this yesterday, saying simply,

I found that taking an adrenal supplement has improved my sleeping patterns greatly.

What a girl!  That one and only Cin.

Yet yesterday, somehow, I didn’t say much about those things.

Questions:  What does “selfish” mean to you?  Why and how do you extricate yourself and others from it even though they appear to be just that – selfish?  Please tell me your story.

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