What is The Difference Between Self-Care and Selfish Care

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So what’s the difference between self-care and selfish care?

We hear this a lot here at, Friend to Yourself.  It is a question that can feel like an attack but also an opportunity.  Some people laugh when they say it.  Others do more of a huff.  Self-care shares with selfish care the condition of taking.  That has potential to be confusing.

Let us start with musing, what happens when we give to someone who doesn’t value themselves?  We give and give and they take and take but there lacks the receipt of value, only matter.  The person receives.  The person however doesn’t perceive the, Why?

Once there was Fred.  Fred asked Carl, “Hey man, would you please ask him for me?”

Carl has a childhood school friend he has stayed in contact with through the years.  Carl’s school friend, whom he used to call “Weasle”, is now Attorney at Law, Craig Anderson.  As Carl has nurtured the relationship through the years, sometimes it was easy and fun, and sometimes he nurtured it because it was just smart.  They worked in the same circles.  Once they had shared love of basketball and although they no longer meet on the court, they still meet up.  Carl saw in Craig someone worth investing in through the years, sometimes what Carl invested into Craig was intuitive and other times more deliberate.  Carl considered Craig a valuable contact.

Fred said to Carl, “I just need some information.”  How did Carl respond?  What Carl had with Craig is friendship.  However, he also has “social collateral.”

I remember when I was growing up trying to understand how much money my dad had.  I’d ask him about it, which I now realize is not completely appropriate.  He’d always tell me he was rich because of all the friends he had.  He said, “People are always the best investment.  The people you know, the friendships you have, will always bring you much more than money will.”  It was an early sight into “social collateral.”  I did not get it then.  I didn’t see the appropriate and natural intermingling of what is personal with what is bank.

Fred was asking Carl for his hard earned bank.  Before handing this over, Carl wondered, “Toward what purpose?” “What will that take from the social collateral I have?”  “What will I get from this?”  Fred had a sense of these concerns but he pushed the thoughts away.  He didn’t bring it up openly.  He asked without planning on accounting for what he was asking for.  Is Fred doing selfish care?

Let’s put Fred and Carl on the other side of this page for now.  Let us introduce Susan.  Susan is Lucy’s sister.  Lucy is known as “Floozy Lucy” amongst certain company.  Susan has rescued Lucy many times from life-threat, from financial ruin, from chaos.  Susan gives emotions, money, time, and once even her car to Lucy.  As Lucy continues to self-sabotage, however, we have a word for what Susan is doing – “enabling.”  What if Lucy valued herself more? How the dynamics between Susan and Lucy might be different.  Lucy taking from Susan would be more of self-care perhaps.

Our culture says we need to give give give and the taking is more whispered about.  It is not applauded like a big donation to the church.  It doesn’t consider what taking had to occur to allow someone at some point in their life to be in a position to give.

Over Easter this year at a small church in Corona, CA, I saw one of the best resurrection plays I’ve ever seen, including that compared to what I saw at the Crystal Cathedral years ago. The music, the props, the acting, all amateure.  However, the energy in the room, the connection between the congregation and the stage, and especially the awareness of our Higher Power was intense.  Out of all of this, what hit me the strongest was that the Judeo-Christian culturally celebrates everything about our God who sacrifices, who lives for others, who gives gives gives… but the whole point of what S/He did and does is Me.  Everything about God is His value for Me.  Without Me, that whole story is pretty mute.

Now put God in Carl’s position with Me.  Put God in Susan’s place.  Why would God want someone who gives to others but doesn’t take?  And take well, know they are a person of value.  The taking reflects quite a bit on the Giver.  The taking reflects quite a bit on the taker as well.

Take to grow your sense of personal value.  Take with increased self-awareness of your personal value.  Take to reflect on your connections well.  Take to be a better giver.

These are thoughts I’ve been rolling around.  What do you think?

questions:  What’s the difference between selfish care and self-care?  How do you take with a sense of your own value?  How does taking reflect on those you are connected to?  Please tell us your story.

Self-Care Tip:  Take to be a friend to yourself.  Keep on.

Come join us

Greetings NAMI Family and Friends,

To follow up with excellent information after

“May is Mental Health Awareness Month,”

Dr. Sana Johnson-Quijada, MD.

Board Certified Psychiatrist

will present

“Caregivers and Self Care”

Date: Monday, June 2, 2014

Time: 7:00pm – 8:30pm

Location:

Riverside County Mental Health Administration Bldg.

4095 County Circle Dr., Riverside, 92503

_____

NAMI Español meets at the

Riverside County Mental Health Administration Bldg.

on the 3rd, Monday of the month.

Information will be available about

Family to Family and Peer to Peer Classes at the meeting.

_____

Have you visited our website?

www.namiwesternriverside.org

_____

We hope to see you at June 2nd meeting!

With warm regards,

NAMI Western Riverside

PO Box 4145

Riverside, CA 92514

(951) 369-2721

Facebook: NAMI Western Riverside

“The best exercise for the human heart is reaching down to lift someone else up.”

– Tim Russert

Know You Are Blessed

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Think of the worst of us.  Think of the worst about us.  Think of those with self-loathing.  Those with low self-awareness, the violent, and the violated, think of them.  Where is the blessing?

Blessed are the depressed and anxious.

Think of the healthy.  Think of the diseased.  The misunderstood, the ones who live miles apart from connection, who ever push like a dingy from the peer into waves and self-destruction, think of them.

Blessed are the poor and lonely. 

Where is the blessing when your real estate is brought low by the creeping up of low-life.  Where is the blessing when you get cancer just when you might retire, when your own body calls you stupid, when you lose your eyes after training as a surgeon?

Blessed are those whose bodies are dying.

Think of every corner, every shadow and open space and the turns you still don’t know about inside of your life.  Think of the unacceptable, the character you wrestle against to moderate away from extreme.  The rope you swing on and try to bring to rest, think of the grey you think you will never achieve.  This bit and chapter, this part of your construction, this surprise in how you deliver is Loved.

There is no aberration from the norm that can separate you from that Love.  There is no addiction or misdemeanor or illness or mutated cell that can lose blessing.

This is fact.  Our life is to live with it.

Blessed am I.  Blessed am, “Me.”

Question:  Where is the blessing in what you like least about yourself?  Please tell us your story.  We need to hear you! Keep on.

Self-Care Tip:  Be your own friend in adversity as in prosperity.  Know you are blessed.

What to do!? On-Line Physician Bullying.

I’ve been to this great APA meeting, great that is, because of the people!  Wow!  The fellow attendees, the exhibitors, the speakers – just, WOW.

I’m going to try to share content with you but it will take me time.

bully

For today, “Are You a Sitting Duck Online?,” reminded me of our earlier discussions on the doctor-patient relationship and a previous post, on July 11, 2012, that went like this:

Hello Friends.

Please tell me how I’m doing on this.  Just out,

Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice

This is important to me as I treasure both my medical practice and our community, connection, exchanges on-line.   I don’t want to do anything that jeopardizes either, nor the implication that if I did, that means I would have mistreated a patient.

Thank you for this, what I call, a “good problem” to have – the joy of medical practice and participation in social media/networking.

So many of you resonated with this and engaged.  I am still super grateful.  I’d love to continue with you in further discussion and with your comments!

For me, one of the many reasons I was so excited about this recent talk at the APA is because of the mucho online stuff connected to my name that affects my patients and the dynamics in our patient-doctor relationship.

In my practice, these are just a few sites that have wrong information (demographics) on me:

  • healthgrades.com
  • vitals.com
  • betterdoctor.com
  • ucomparehealthcare.com
  • insiderpages.com

They didn’t ask to clarify my demographics.  They didn’t ask me if I wanted them to become an on-line reference on my behalf.  They use my practice information to drive “eye-balls” to their site so they can get advertizing money and more.  They impose incorrect information about my practice, knowing that in so doing, I will be pressed, (I call it bullied,) into contacting them with my correct information.

If I don’t do this expensive effort, (money, time, emotional expense – all in limited supply, to correct what they post incorrectly,) patients will continue to tell me that they couldn’t find my contact information.  When they Google me, instead of my website coming up, these other sham pages pop up.

Some patients call dead numbers or even drive to incorrect locations to find treatment.  Instead of whomever is behind these websites being held responsible, the medical providers are.

These are the notes I took from my colleagues, as I heard them say.

Unfortunately, I was late to the meeting so I missed two of the four speakers.  Even so, this is worth it.


Dinah Miller M.D., Author of “Shrink Rap” and writing regularly for Clinical Psychiatry News.

Dr. Miller told us about the difficulty of “patient” (or nonpatient, i.e., sham-patient) reviews online.

Who can review the physicians?

  • your patients
  • Friends and lovers
  • enemies
  • trolls – a negative internet stalker

Every practitioner has an idea that they are a pretty good doctor.  So it isn’t easy for any of us to hear otherwise ;).  After getting unsolicited feedback from a person who took the time to write a comment on a site that listed her, a site that listed her profile without asking her, Dr. Miller chose not to play the victim.  She decided to call “Health Grades,” and with her persistence, they took her information down.

On “Vitals” – she got an answering machine with a person’s voice mail and no name and number.  So she called CEO, Mitch, who stated she wasn’t able to take her profile down.  She didn’t ask to open herself up to trolls.

Dr. Miller asks, what shall we do, as physicians?

  • do nothing
  • write a response
  • try to call the company

There are many whose livelihoods depend on public opinion.  For example, waitresses/waiters – many lose their jobs if they get even one negative reviews.

The practitioners in the group responded with resonance with Dr. Miller’s ideas.  They also had thoughts that if left alone, the democratic process would win out over time, truth would come out and such.  (Maybe the nearby statue of Liberty played into our thoughts :).)


Paul S. Appelbaum, MD, Dollard Professor of Psychiatry, Medicine & Law, Columbia University

Principles that Might help physicians Identify Constructive Responses

  • Responses should be Effective
  • Practical
  • Compatible with medical ethics
  • Positive rather than negative consequences

Problematic Responses by Individual Physicians

  • Request removal by website – typically declined.  Saying you’re writing a public article on it might help.
  • Contact the patient who wrote a negative response to request removal – Patient not likely to remove response, many patients post anonymously, most websites won’t allow patients to remove them
  • Flood site with fake positive reviews – deceptive, embarrassing if discovered, ? inducing a person to rely on a statement that may be used to their detriment (fraud)
  • sue patient for libel – identify patient might be difficulty, people have a right to their opinions – would have to prove statements untruthful and not merely opinion, $$ in money/time/and emotion

Encourage Satisfied Patients to Post Reviews?  We could refer to a firm to do this.  $$

Some sites, similar to “Vitals” offer the option to the practitioner to respond to a posted review.

Negative Reviews:

If we do respond – how?  We don’t want to come across arrogant or insulting.  We fear violating patient-doctor confidentiality. In the end, we recognize we don’t have the last word.  We may respond with a soft word of concern.  “If you would call my office, I’d be happy to schedule at no fee to speak with you about this and see if I can help.”

Can Patient Reviews Be Controlled?  There once was a company that tried this.  “Medical Justice” developed a form that gives control over of copyright of all reviews to MD.  – Didn’t work.  See article, “Company tries to stifle online reviews with patient ‘gag orders’.”

Another idea is that medical practitioners help themselves by coming together to develop an internet ombudsman.  This would be a medical/mental health professional not involved in care of patient.

  • Independent (unrelated party) investigation of physician about the case.  A successful investigation may give a third party opinion.  There’d have to be a reason for the world to trust this opinion.

It is difficult for healthcare professionals to protect themselves from inaccurate complaints about their care.

Positive Reviews

Does it put undue pressure on the patients?

A sign in waiting room perhaps.  Make the information available w/o practitioner knowing if they have or have not commented.

There is a dissonance between the position of being a business person that says we must practice democratically and compete fiscally, yet stay in congruence with what tradition holds us to.


The issues addressed in the talk weren’t specifically about being bullied by sham-websites, but it included that idea, along with other difficulties physicians are experiencing in the rapid transition of 3000 years of tradition as a healthcare providers to spending the majority of their time serving patients first to now, the reckless $ burden of running a media vulnerable business.

In the practice of psychiatry, a traditionally extreme-private practice, this is dissonant to many.

Q:  How do we treat the extremely delicate practice of psychiatry as a business when we are held to currently minimally defended standards like this?  Please speak out and let it flow!  We need to hear from you!  …and, Keep on.

Self-Care Tip:  Deal with internet sham-sites and reviews in a method that is consistent with Me, and temperament, while doing the least damage to oneself. It will be better for oneself as well as others.

 

Turn Toward Something Better

Had a great time at, “Seams of Gold.”  Great example of how community is friendly to “Me.”  Met a wonderful man.

Me:  Hi!  I’m Dr. Quijada!  I’m a psychiatrist.

Him:  I’m Frank.  I’m a recovering Alcoholic.

Got to love love that kind of company.  Thank you to all who participated and volunteered.

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Found after our evening, was thinking about that darn “justice” ever skirting so much of Me.  The way becoming the victim to abusive treatment drives “Me” into helplessness all around us.  Things like money turn us to blame and ugliness.  In the end, telling our story, we hear from our own selves more about the behavior of the curmudgeon than would ever leave cause/change/control space for an innocent like “Me.”  Yep.  It’s them.

Using the behaviors and emotions of others is never useful to explain/justify the emotions or behaviors of “Me.”  We are as free to choose to be a victim as we are to not.

Programs like, Seams of God, and people like Frank, remind us that turning toward something better is, Way!  It is way, like opening a window to a hot room, like turning the lights on, like biting into a ripe home-grown cherimoya.  Turning toward something good rather than away from “bad” is choosing to be free.

Be free. Everything starts and ends with Me.

 

Keep on, dandies.

your own,

Q