Month: May 2013

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Roughly What We Covered With The University Students

Psychiatry logo

Psychiatry logo (Photo credit: Wikipedia)

What is psychiatry?

Components intersecting at cross-point where stands Psychiatry:

  • The practice of medicine
  • The practice of business
  • The practice of one’s personal life
  • The doctor-patient relationship
  • The pursuit of Quality of Life

Who should go into psychiatry?

  • Consider temperament
  • There are areas of medicine that are more procedural based versus more weighted toward patient-doctor exchange.
  • The medical system is incentivized by codes and governed by layers of administration.
  • But the question begins with Me; what am I incentivized by?  Again, consider temperament.  Temperament encompasses perceived moral values, and where pleasure comes from.

What is brain illness?

  1. Biological
  2. psychological
  3. sociological

We are not in this to cure anything.  We enter psychiatry to improve quality of life – through approach of the biopsychosocial model.

Questions for you:  

  1. What is psychiatry?

  2. Who should go into psychiatry?

  3. What is brain illness?

Self-Care Tip:  Approach brain illness w/o expecting a cure, but rather a process.

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NAMI Riverside Group – connection

The NAMI Western Riverside Peer Support Group will have a special guest speaker, Sana Quijada, M.D. Dr. Quijada will speak on the bio-psycho-social model in approaching self care. We are inviting all that want to come.

Date: Thursday, May 30
Time: 6:00 P.M.
Location: 4095 County Circle Drive, Riverside

Besides speaking, Dr. Quijada is author of the book, Friend to Yourself: Sleep, and the principal writer on the blog, http://www.FriendtoYourself.com. She believes that self-care is not weak but rather courageous. It brings us to humble accountability for our lives, not seeking to erase our history but still reminding us that we are free to start over any time.

Dr. Quijada is a board certified psychiatrist having completed psychiatry and fellowships at Harvard Southshore. She is currently the medical director of two facilities, the Loma Linda University Partial Hospital Program of Murrieta and the University Surgery Center, Department of ECT. She is known for her focus on being a friend to yourself.

The mission of FriendtoYourself is to define, teach and learn self-care, attack guilt, stand up to shame, live as we choose despite stigma and work harder than we ever have on perhaps the hardest job of our lives.
I hope you’ll consider joining us in this special speaking event.

Amanda Wilbur
NAMI Western Riverside Affiliate
Riverside Peer Support Group Facilitator

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Patient-Doctor Relationship

shoes

Tonight I pulled together all the posts we have on the patient-doctor relationship into one page.  Please let me know your reactions.  This is a journey I am really grateful to travel with you.  Keep on.

 

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Allow yourself to transcend the naming of your symptoms

French political cartoon of French cardinal Je...

Mental illness, diseases of the mind, behavioral disorders or however our community allows it to be named, it is all inadequate.

Mental illness, is a stale description.  It has sat in the open community air, over the many years when our awareness grew too slowly, when stigma and ignorance gave it the old cold frost-bite.  It reminds of me of the, Confessions of Georgia (Anne) Nicolson series, by the most hilarious Louise Rennison, When Georgia Anne says, “Have you gone mental?!,” in one-thousand-and-one ways.  There is just so much sniffing and eye swirling around the term.  I do not mind Georgia Anne using it at all.  It is fresh in her mouth.  It is not, however, winter green in ours.

Dr. Thomas Insel, Director of the National Institute of Mental Health, states that these terms are “impediments to progress.”  He uses the term, brain disease, as a way to diminish barriers to scientific investigation, hopefully leading to earlier detection and treatment.

Others, however, challenge even this term, brain disease, stating that it is premature and narrow.  The illnesses that demonstrate emotional and behavioral pathology involve more than brain and mentum.  They include the magic, the internal/external stressors, the arguments and the weather.  They include the intersecting paradigms that make us who we are, often referred to as the biopsychosocial model.  These, “Others,” argue that it is presumptuous to name pathological symptoms of emotions and behaviors with, “brain disease,” until we know what the brian does in the first place.

Questions:  But what do you think?  Are the terms we use more impediments to progress than they are tools toward?  Do you have any recommendations?  How have these terms affected your life?  Please tell us your story.

Self-care tip:  Allow yourself to transcend the naming of your symptoms.  

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Planning helps, even on vacation

A boy in a children's swimming pool.

A boy in a children’s swimming pool. (Photo credit: Wikipedia)

It is amazing how little time there is to write when living through a day as perfectly uncomplicated as string cheese, reading books and guarding the swimming pool.  In between this higher living, I have been thinking and thunking about what we will say to the university folk about psychiatry, but it has been as if space got in the way of clear thought.

I took a nap, but when I awoke, although rested, there it was.  The space and timelessness of no schedule plugged up whatever clever thoughts were waiting to come.  It was like those expensive tires that patch themselves when you ride your bike over a nail.  I imagine there is green foamy stuff all over my brain, stopping up holes where super thoughts might have tried to pass through.  And before it could be clearly grasped that this was not accidental, that these thoughts were wanted, indeed solicited and not hot air, wouldn’t you know it!  The day is over and I am flattened.

And so for tomorrow I am planning, rather than hoping.  I plan to write.  And I know when too!  And it will not disallow the necessary open space.  I will write and have my space with it.  My cake and eat it, you know, or some other sort of adage to explain that planning can enhance and add much flavor to the space of time around us.

Self-Care Tip:  Plan for what you want to do.

Question:  How does planning improve or diminish your space?  Please tell us your story.

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What do you think they need to hear?

Hello, Friend to Yourself Community!

Please let me know what you think these fine folk need to hear from us?  It is our chance to talk to college pre-med students!

English: red apple

This is the caption of our invite-letter:

Dear Dr. Quijada,

Thank you for participating in MDCN 204: Introduction to Medicine at —-University. It is my pleasure to have you join our lecture series this year. 

Students are very excited about the prospect of meeting a physician and learning more about medicine. For many of them this is a firm choice and they would like to add to their knowledge base, while others are simply exploring medicine as a possible health career. Many students in the class are freshman, but several are sophomores, and juniors; a few of them are seniors.

I am really looking forward to hearing your thoughts, questions, if you were them, and recommendations.

Thank you friends.  Keep on.

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Creative Hard Work On What is Personal

I created the graphic myself.

Wouldn’t you know it!  She spends all her best of self at work.

Do not be misled by her personal life.  She does well at work.  When she wants to increase her network, she goes to more community mixers.  Before she falls behind on what is new in her market, she reads, she studies, she goes to conferences, and more.  She is curious, asks why and explores where her thoughts take her.  She is productive and independent.

That is Katalyn at work.  It is what it is for Katalyn.

This is the same girl that asks, “Why am I alone?”

Katalyn, you, Me, we in our culture are ashamed of others seeing us strategically build up what we term, “personal” but not “professional.”  It is what it is, but we have freedom to choose.

Is a personal network any less valuable if it came by deliberate effort, rather than a fairy godmother?  How bout study?  We are ashamed to go to a 12-step group but not the chamber of conference.  It is what it is.

Self-Care Tip:  Put as much creative energy and hard work into your personal life as you want.

Question:  When you reflect on it, do you believe personal connections should “just happen” as if by magic?  How so?  What successes do you have from hard work?  Please tell us your story. 

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Our Wanting Could Make Our Reality A Whole Lot Better

Fantasy Garden Goddess by Tucia

Fantasy Garden Goddess by Tucia (Photo credit: Tucia)

Katalyn was forever bewildered by the contrast between the success of what she called her life and the failure of her relationships.  As the assistant to the director of Polk Hill’s only advertising firm, she knew everyone.  She was a blooming flower, her petals unfurled and her ability to know just where to turn the pitch was like opening to the sun.  She had talent. But more than that, Katalyn was a darn good worker.

Sitting across from me in the couch chair, her long and graceful fingers tapped the chair arm as if they were used to keeping time with her moving thoughts.  “Here it comes,” I said to myself, and tried to relax into the complexity of her story.

“Why am I alone?  Why aren’t I in a relationship?”

Katalyn chewed her lip and blinked a little faster.  “I will not cry!” I could almost hear her mind say.

Time cracked open there into reflection.

We all have this dissonance in our life story.  We make our choices with where we put our hard work.  But we leave our fantasies disconnected from this investment of ourselves.  We think that fantasies, (fantasy as in: contemporary, epic and/or paranormal – not necessarily fish-net hose,)…  We think that fantasies should materialize via magical forces rather than deliberate efforts. Irony, again.  Qualifying accessibility to our fantasies, (or we could say, wants,) this way verses to what we think is real is our own doing.

Reminds me that we treat our loved ones worse than any stranger.  Put our best years and best hours of the day into impersonal labor, we give this way.  We think the least of our own beauty, success and intrigue, and the most in those we know little about.  Then we wonder about the disconnect.

There is something raw and vulnerable about showing our wanting to ourselves.  It is one thing about our wanting in privacy, a place of personal ridicule and shame, and it is another to want in public life-process.

Imagine if Katalyn deliberately allowed herself to relax into her wanting at work as well as in privacy.  What would happen?  How would she do that?  What is the worst that could happen?

Imagine Katalyn as a woman who fantasized as she worked hard.  Would her work experience be different?  What would happen to her quality of life?  What would happen to her perception of reality?

Self-Care Tip:  Let your wanting, (or we could say, fantasies,) out into public.

Questions:  What would be different in your quality of life experience if you deliberately included your wanting into what you perceived was your reality?  What would happen if you worked hard to bring those together?  Have you seen this at work in your life?  Please tell us your story.

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Live with an agenda

dionna, 1991.

dionna, 1991. (Photo credit: paul posadas)

The blue dragon lifted her head from near-sleep.  She knew.  Pouncing onto the rocky ledge gave her the advantage.  No one would challenge her.  The fresh corpse was for her alone.  As she ate the remains of Dionna, the red dragon who had never flown, the memories of Dionna infused her.  The blue dragon in this had saved those memories and would live them into the forwardness of time.  

Why is it that we repeat the mistakes of our forefathers?  It would be nice if we could somehow be able to capture their hard-earned life experiences.  If dragon lore were true, perhaps.

In Papua New Guinea, Congo, cannibals on the Disneyland Jungle Cruise and who knows where else, eating brain to preserve the life force, save your daughters or avoid the mistakes Dad made gets you a bad and yucky disease called, kuru.  Nothing good comes from eating brain.

And so the blue dragon, whose scales shone in the morning sun, began to tremble and seemed confused over the years.  Her brain got holes like a sponge and she laughed at inappropriate times.  

We just cannot get a leg up on wisdom and experience.  We are not made for it.  Each of make our own mistakes, have to work our own fingers to the bone, and other knowing clichés that in this case just are the darn truth.

What blue dragon and kuru are trying to tell us are that the agenda Love has for us is not to build up experiences like some sort of mental tower of babel.  It is not about the mistakes.  It is about our life experience.

We cannot help but wonder, though.  After working in psychiatry for these many years, I wonder what a joy it would be to give that experience, knowledge, skill of practice and such to my daughter some day.  Ah.  As if it had its own life force, passing it on to my daughter feels like a bit of immortality.

When I die, just eat my frontal lobe, darling.  Not the limbic system.

We are meant to live.  In that living, we inevitably repeat foibles and build up muscles and manage to survive all kinds of suffering.  In that living, we are beat up and rejected.  We are perfect.  We are flawed.  We are marvelous.

Maybe the agenda is not to get it better with each generation or to get it right.  Maybe the agenda is to live.

Question:  Have you ever been frustrated at how quickly your gains in life will be/are lost?  What is the agenda of your life?  Please tell us your story.

Self-Care Tip:  Live life with a quality-experience agenda.

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Confidence and Humility Go Together

Here is the good and the bad news.  There will always be something we can do better.

The Bible has a group of books called, the books of prophets.  Two of these are Hosea and Amos, named after the men who are narrating them, i.e. the prophets.  They say,

1.  You have a problem
2.  Recognize Me (God)
3.  Come after Me (God)

Amos talks about a roaring lion that is about to consume us.  Apparently sometimes it is not easy to get our attention and it calls for A Roaring-Lion-Intervention.

(Flip page.)

In the culture of the practice of medicine, the physician is expected to know what is going on including anything and everything that can possibly go wrong involved in the treatment offered.  When things do go wrong, what is worse, knowing it was going to happen or not knowing?  Things will always go wrong.

Roaring Lion

Roaring Lion (Photo credit: Martin_Heigan)

It is what it is that a physician finds herself in the position to work with confidence and direction, knowing that she will be wrong.  Does she need a prophet to tell her?  A lion to roar?  Stop!  Look out!  You have a problem! Well if the Israelites needed it, we can sure as not know that she will too.

Sometimes patients get upset at their treatment and roar on behalf of insight and common sense to their practitioner.

We in medicine, on either side of the white coat, will find it is most friendly to know we, (patient: physician: patient: physician…,) have a problem.  We need to know that we are not God and recognize Who is.  Then know that going on humbly does not mean without courage and confidence.  Who ever faced a roaring lion without?

Question:  Have you heard a lion roaring?  How do you grasp confidence and humility simultaneously?  Please tell us your story.

Self-Care Tip:  Go into practice and treatment with confidence and humility.  Be a friend to yourself.

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