Author: Sana Johnson-Quijada MD

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Your False Intuition

The curse of “intuition” in Data Science - Towards Data Science

You can’t listen to your intuition all the time. You have to have a healthy dollop of distrust for your own inner voice. The siren’s song of our inner self to isolate and “do it on your own”, however dulcet and powerful, are dooming.

When Marsha suffered a dramatic loss in the stock market, she became crippled by anxiety and irritability. It had the further outcome of estranging her from her spouse and friends. She spent all her clean, controlled, but lonely time, alone, like a many thorned beautiful rose in a glass vase.

Marsha and I tugged with this concept, like holding onto different ends of a rope. She did not want to go to therapy. She did not want to disrupt her flow.

Sometimes our lives are “in flow,” but it’s not a healthy flow. We are doing some healthy behaviors, such as exercising, getting our sleep, eating well. However despite this, our emotional disease progresses, unchecked by uncomfortable deliberate efforts. Sometimes we are medication adherent even, and yet our behaviors and emotions are not kind to ourselves. We remain in a condition of suffering, isolated; unable to connect to self and others.

During these times, we need to disrupt the flow. It is laminar, even lovely in its quiet arc, that dishonestly soothes. We need in this case, turbulence and a different direction.

If what you are doing isn’t working, add turbulence and do what is uncomfortable. In Marsha’s case, we both laid the rope down, (smile,) and she pursued a day hospital where she worked on changing her automatic thoughts toward those that were kind to herself. When something triggered her, how she responded, and before she even knew she was thinking about it, was healthier.

Question: Have you ever been misguided by your own thoughts? How do you safeguard against an intuition that may not be kind? Please speak and tell us your story?

Self Care Tip: Don’t let your own intuition be your only voice of reason. Be a friend to yourself.

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NAMI – in case you want to join us…

Maintaining Your Mental Health During
COVID-19 Crisis
Due to COVID-19 Public Health protocols NAMI Temecula Valley will be hosting our Mental Health Forum online.
Wednesday May 20th 2020. 

 Our Guest Speaker:    Dr. Johnson-Quijada 

This is from the NAMI website:

Wed, May 20, 6pm – 8pm

Description: The forum begins with sharing, and resources. Following this, every month a pre-selected guest speaker will take the podium and share their expertise with you.
All questions and answers will follow the Mental Health Forum. The forum is held monthly on the third Wednesday and is open to individuals 18 yrs. and over.  DURING COVID-19 CRISIS JOIN US ONLINE.
JOIN ZOOM MEETING
https://us02web.zoom.us/j/89884260271?pwd=NllEOXkvRmlNdERWUXVtelRHTzhPUT09

Meeting ID: 898 8426 0271
Password: 417783
One tap mobile: +16699009128, 89884260271#, 1#, 417783# US

Dial by your location. +1 669 900 9128 US (San Jose)

Some notes: Share and care will begin at 6pm, and the presentation will begin at 7pm.

 Install and test Zoom ahead of time at the following link: https://support.zoom.us/hc/en-us/articles/201362193-Joining-a-Meeting

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Dealing with it! Covid and Mental Health

Let me tell you a story.

Once there was a young man who couldn’t negotiate the world around him well. He ostracized his peers with his behaviors. He was easily offended. He didn’t enjoy much and people could sense that, like a divining stick whenever he was around. Do you recognize him? Have you heard this story before? 

Let me tell you another story of a middle-aged woman who lost her son suddenly to asthma. He was sleeping in his apartment in New York far from home. They spoke the night of his death on the phone, not knowing that it was their last conversation. This mother was awoken the following day by her son’s wife who screamed at her that her son was not breathing. This mother spent the next three years in seemingly mental silence. She felt like she turned off. She did not understand how this could have happened. She was not forgiving. She was called aloof by others. Other people did not remember her son like she did. Other people did not feel it inside of their bodies; feel it inside of their emotions; feel it inside of their spirit. Other people did not stop hearing God. Other people did not, as she did, and it left her very alone. Have you heard the story? Do you know her?

Once there was a teenager at work. Her boss pressured her to drink while on a break, and then keep drinking until she was drunk. He was her boss. She was afraid. Afraid of losing her job. Afraid of him. He forced himself on her and although intoxicated at the time, she did not blackout. She remembers over and over and over. She remembers, almost like rewatching a movie. Scenes from that day intrude during school. They intrude when she is with her parents. They intrude when she is trying to sleep. This teen avoids anything that reminds her of his stink. She avoids stores with bells that chime over the doors upon entry. She unfortunately hasn’t avoided alcohol though and that has been another form of misery to her. Do you know her? Maybe you have met.

There once was a boy who kept getting in trouble because he couldn’t focus. There once was an elderly man who only remembered his younger days and nothing new would stick. There once was a worry wort who couldn’t get out of her head. There once was… 

There once was you.  What is your story? And how do you deal?

We are currently in a quarantine. (There’s news! Smile.) And people want to know how to cope during this time of unanticipated stress.  

I’d like to ask you. How have you dealt with your emotional pain so far, apart from quarantine? All these stories could have potentially isolated us in our suffering. There’s nothing quite as potentially isolating as mental illness. It destroys our ability to see ourselves. We become disconnected from self and others. We lose empathy, trapped in our own suffering. We are called “selfish” because no one can give what they don’t have. We lose our ability to chose freely, because the mental illness chooses for us. But you know that you have come up with coping skills to deal. You have brought your suffering into the space of your healthy and become more whole doing it.

These are the same coping skills to fight the tendency toward emotional isolation in quarantine. 

Questions: What are your super-power coping skills you swear by? Please tell!

Self-Care tip: Fight the isolation from quarantine with the basics you already know, if you ask yourself. Keep on!

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Mother’s Day – tied to a horse

Sometimes I don’t want to respond to the, “Happy Mother’s Day’s,” as I keep feeling all the many conflicting but authentic bits of motherhood under me, like thumping behind a free willed horse I’m tied to, who’s aiming through Nottingham’s Sherwood Forest. There’s so much pressure to be the cherubic woman on Mother’s Day. Really? Heals! Whilst roped behind a horses bum!

Look! There’s Marian! She’s sagging and her right boob is slung over her shoulder. Nifty!

“Way to go Marian! You look terrific!”

See. We all lie for love. 

Marian responded with a rude gesture but she was smiling. Oh, the inconsistencies women wrestle must be expressed!

There’s the number one: Being a mother is the best freaking thing of my life! I’m so glad I’m a mommy! And, thank you for making me breakfast. Yum!

Once a year.

Get away from my babies, world! You can never love them like me!

But numbers two through ninety-nine are always rudely jostling for position. Motherhood is like a stutter on repeat of, it’s really not about you!

Or wait, it is! If they fail, ie, turn into a collage of psycho-murderer blended with a throw-up fake and furry do-gooder, it’s all on me! Like getting ticketed when your kid shoplifts Snickers at Target. All time low. (I know you’re asking if that happened to me.)

One hundred stays quiet, squat and permanent: Those kids will leave you in the end. And then you are old.

But I think the reason we yell, “Happy Mother’s Day!,” to each other (and please don’t forget the apostrophe! There’s nothing that reminds us of what failures we are as mothers than bad grammer! Or is it gramm-ar?), is so that we remember, we have each other. We are really not alone.

Happy Mother’s Day, Peeps! You look great!

(Ow! Don’t throw things at me!)

And if you don’t get it, than you don’t get. Maybe read this again in ten years.

Self care tip: Stay connected. You are not alone.

Questions: Tell us about your Mother’s Day. Boys too! We want to hear you.

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Connection in Loss

Visiting Mom today, we were separated by a window. Our mobiles were our speakers, like a microphone between a jail cell and her visitors. She put her hand up and splayed her fingers over the glass. Mom so wanted us to be glad visiting, not bummed by her condition, that while crying about the many things worth crying over, she pushed laughter out, and tossed her hair back and animated herself. Her act of love. Literally.

This month, my brothers, cousins and I have been closing down my parents house. We go in turns, distantly from each other, to do what our bodies can. My folks moved there, to Crown Ranch, more than fifty years ago. There’s been a lot to work through. Because of the quarantine, Mom hasn’t been allowed to participate. And so, through these two weeks since Dad died, she, and we have been saying goodbye in foreign ways. Goodbye Dad. Wave at Crown Ranch. Eyeball each of our individual idea relationship constructs, like the person with her suitcases would before moving to a different country. Awkwardly. Lumps of emotion in closed throats.

Mom was crumpled in her chair, crying. I, and my family, were on the other side of the glass.

“It’s all gone.” Mom’s voice came through the speaker phone. Her hands covered her face for a moment. We quietly sat on the other side.

I want to talk to you about loss and connection but I’m not able to do much more than tell you bits of this story. Finding connection through loss is a win though. And as we always say here at, Friend to Yourself, we are created for connection.

Mom received Dad’s belongings from the nursing home last week. When we left her today, she said, “I’m going to go smell Daddy’s clothes.”

We put our hands up against hers for a moment. And we were glad. She did it.

Questions: What have you lost?

What do you remember? 

Self care tip: Find your connection even through loss. You are not alone.

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Briefly Loved

I used to gather rocks shiny stones precious metals and things, I thought had permanence, but now I will only go for cuttings with stems just so, bright red or pink I think on top

I like to look at hunks of wood, see the life-rings layered, a round embrace, years upon years in evidence

I like to see a cloud well formed in a frameless sky, or wispy shapes of nothing but Cyrus percolating droplets, hints rain

I once liked mountains and property, a deep footed house surrounded by trees, I once liked, permanence

now I prefer the open, unlined, spaces that cannot be so easily defined

I like to remember that I am temporary as was my father dead now, his ashes are breath behind my ear, dead like my niece some 15 years ago dying like my mother whose days blow down the sidewalk, crumpled leaves

I like to see things of beauty that are short-lived reminding me why pretend I am more than just barely, I thought barely a moment barely worth reckoning in fact nothing at all, wetted pages of Mozart or Chopin I’ll reach for them and watch them tear in my hand

I want to see a mood a whim and other changing things give me nothing that stays or I know you lie you are not any greater than Babylon nor am I

I am nothing but for who made me, else to pretend I want not, I have an old set of China from my mother’s wedding day you can finish that thought

When I was young my legs were strong my joints did not hurt my hair was thick I had potential like you I had use I had years ahead like a thick bank roll of quid and now my neck has wrinkles and I am gray and

my dad died a week ago today

I don’t want anything more than a flower than the truth that we are this this creature this creation this borrowed bit

I will holler louder come Lord Jesus come I will shake my fist it’s just temporary anyways like this

This is enough, “Carry-on,” the officer said, “nothing here to see,”

my dad died a week ago today 

and even that is over please delete when you are done, no tip on self care just a poem. Keep on.

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Blessings surround me

David Robert Johnson, MD

Hello Friends,

Thursday, Redlands Community Hospital was able to make an exception and allow us to spend three ultimate hours with Dad In the ICU. He was smiling and attentive. Interested and listening. He had a happy day. We told him our thoughts. Read to him your many notes of love. He especially perked up with my cousin’s report of starting to read a Bible Dad had apparently given him some time ago. That kind of thing has been his and my Mom’s life passion and I don’t think there was much of a better way to say goodnight.

Dad was getting tired. He had started to grimace. There was blood coming out if his ngtube. His pressures were rising and his heart rate was up. Dad said he was ready for his fentanyl. Then he fell asleep.

Around 2am the next morning, Friday, we are told, Dad was asleep and then he wasn’t.

This is the “time,” and he’s not suffering. We are all glad about it. But there is so much of me that still wants him here. My right-arm feels like a knife is in it. My joints hurt. I have a headache. Even in the condition he was in, I would take him if I could.

I will be waiting my whole life for him; for that fortune of being loved by him again. The ground will never be the same under my feet.
Today my Dad died.

There’s never been an Easter weekend like this for me. I’m super grateful for the many layers in our experiences. I feel like blessings surround me. Goodness and mercy follow me all the days of my life and I shall dwell in the house of the Lord forever.

Thank you for being a reader here and sharing in life with me so well. We will wait together.

Goodnight for now Dad.

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Living, Ready to Die

Mori-To-This-Favour-Oil-Painting

Do you ever have thoughts about wanting to die?  If so, why do you want to stay alive?  What’s worth living for?

Think of 3 things worth living for.  For me, I answer — to lose the rest of my baby weight, (my last child was born 13 years ago), God, and family.  Whatever any of our three things are, I call those “hope”.

Hope only belongs to the living.  Even when you are actively dying, hope means you are indeed still alive.  Those three things you think are worth living for now are the things you will reflect on during end of life. They are what you will use to determine whether you have lived a life worth living or not.  In all the in between moments, keep those things in front of you and then you will be ready to die if you must.

Self-care Tip: Live, ready to die.

Questions: Are you ready to live and to die? What is in that space for you?

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I don’t care if California falls into the ocean and other perceptions

To all the Californians, the colored, the women, the children, the childless, the divorced, the unmarried, the impoverished, the uneducated, the honking laughers, the unclicked chicks, the benchwarmers, the undistinguished, the immigrants, the gay, the mismarked, and the misunderstood:

On a dry freezing day in Montana, while the barometer read, “2 F,” I waited for the shuttle to take me into town. My child had developed congestion in some sort of viral expression and just couldn’t breath well. The nearest pharmacy was about 10 minutes away and I thought, “I can do this.” 45 minutes till the next shuttle, so I parked myself by the door as a look-out. I let the valet men know so they could assist, something like wrangling a wild Montana horse, I supposed, to get me into the shuttle. (Not sure who the horse is in this metaphor.) I felt like I was in the team. We looked warmly at each other in between this moment and that. I thought, “They are on this.”

At exactly 1045am, when the shuttle was scheduled to come through, I approached the desk. “Have you seen it yet?” One of the men there smiled at me. It looked inclusive. Then he said, “They already came and left.”  “You’re joking,” I said. Sure that he was having a laugh with me in our conspiratorial way. Team members, you know. “No I’m not. They left about 5 minutes ago.” I was out. Suddenly I was alone and it felt cold and I thought, “My child! I’m letting her down.”

I turned away from the valet men, non team members, and reported to the front desk about it. “They left me.” Humiliating tears sprung to my eyes. Oh my word. I had survived strip down yelling sprees from attendings on the hospital wards, pimping teachers, discriminating male figures, angry patients, bird droppings on my head, and I didn’t cry.

I wonder if the front desk felt more awkward with a grown woman crying over a shuttle ride, or if I did. But within 20 minutes they had one of the security men put to task.

Security-man started right in. “Where are you from?”

Me: “California.”

Security-man: “Oh. I think Californians have something wrong with them.” Chatter chatter.

“If California fell into the ocean, I wouldn’t mind.” Chatter chatter.

“If the wall went up around California, and just left the rest of us alone, that would be fine.”

Security-man was in his second career, after having retired from working security in a prison. We commisserated on our mutual experience working in prisons. Me in psychiatry and him in security. He was happy to empathize, “Yah! I’ve seen some crazy ones! There are real wacko’s out there. People who eat their poop and stuff like that.” “You psychologists are treated rough,” and dropped the label, psychologist, several times in a knowing way.

He threw in a few more pearls. “I don’t believe in abortion.” “Californians who work, pay for all the unemployed lazy people in their state.” And then with a confident nod, “Trump is going to win the elections.”

Security-man was graciously driving me, what could have cost $40 for a private shuttle. He smiled and probably thought the whole time, “This girl gets me.” Or, “Isn’t she lucky to get a free education on the way things should be?” To him, he was engaged in friendly banter. By the time he dropped me off back at the lodge, he used my first name, saying, “Sana, people like to visit California, but living there?!” Chortle chuckle.

I didn’t cry, but wouldn’t that have been a more reasonable time to have teared up? Visceral responses can be unpredictable. The generosity, the kindness, the friendship, juxtaposed with the aggression was bewildering.

I was sputtering about all this to my home huddle when we met up for lunch and I guess wore them out a bit in a self-righteous diatribe. My wise child asked me, would you have rather taken the ride with Security-man or have paid $40 for a hired shuttle? Or have waited for the next free shuttle 1-hour later? Sheeze. Can’t an elite Californian wallow a little? Fine then. I prefered Security-man in his inconsistencies, kindnesses and cruelties. I know he is defining the world from his brain.

Sometimes we don’t think we are being aggressive but we are. I thought to myself, “How am I being aggressive toward others?” I know I am stigma-imbued and bigoted toward others, but by definition, I won’t be able to see it. That’s how stigma works. We think we are pure minded. We think we see things clearly. We believe in “the right.” It’s not always this kind of abutment, not always this stark, but it is there. It is here.

Back in California, I am checking the tide, water sloshing up to my knees and I’m touting, “Everything is ok folks. We are good. The rest of you though….”

Now I see through a glass dimly…

The brain is vulnerable to our humanity, our health, the condition we find ourselves in at any point along life’s line of time. (Job security… Too much?) Some day, we will have a healthy brain. A healthy everything and then we will see clearly and face to face. Until then, I’m confident we will, all of us, define what we believe is true and real by the condition of the brain in our head, along with the perfect super-human protective grace of God.

For presently we see through a glass in obscurity; but then, face to face. Presently, I know in part; but then I will know fully, even as I have been fully known. 1Cor 13:12

Self-care tip: When being slammed by the hurt and twisted brains around us, contemplate our own distortions and the grace we are surrounded with despite ourselves. Then look forward with hope.

Question: How have you improved your life experience when stigma and bias hit?

Keep on!

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Science and God Awkwardly Related

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God and science are as awkward together, culturally, as someone walking in on you in the bathroom, mid stream.

People think science and God can’t be related. Like there’s a gap.

My son and I watched, “The Exodus Decoded,” a 2005 documentary, directed and starring Simcha Jacobovici, and James Cameron. In this, the history of the Biblical Exodus is presented through a scientific paradigm.

My son was discombobulated. “Mommy do you believe that!? What do you think? Do you think science explains the miracles God did? I don’t.”
True. He hasn’t had the benefit of decades of higher education to influence his thoughts but irregardless, he is not alone in this.

A pharmaceutical representative I was speaking with explained, “People feel like religion or spirituality are emotion-based whereas science is coming from a field where you have to be objective and unbiased. I think also like you get too much feelings involved, you know? No go.”

Is it like, “God and state,” so is God and science? Like it’s wrong to relate it. Is it not ethical?

Many of us think, mixing these ideas leads to less validity. If that were true, what does it say about who God is? That would be a pretty limp God, who is separated from “one” of His creations with another. Nor is it that kind to “Me”. Me Me Me. Remember? Everything starts and ends with Me here at Friend to Yourself. If keeping science and God separate were true, it increases disconnection in my life. And we are created for connection.

Question: In the words of my son, “What do you think? Do you think science explains God’s miracles?” Or what?

Self-care tip: Allow the gap to fill in between your Higher Power and the explained in your life, however you will. It will improve your self-care.

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God in the Space of Synthetics

Hello Friends!

I’m going to try something a little different today. I’m posting a dictation between a patient of mine and me because I think it has flow and a nucleus. (There are a few small changes made in liberty, and no identifying data.) Let me know what you think of the content.

Psychiatrist:  …And so we were talking about perfectionism, right? 

Patient:  Yes. 

Psychiatrist:  And about how you are not being kind to yourself when you expect yourself to be all healthy.

Patient:  I’m not being kind to myself when I don’t want to take this or that because I don’t do synthetics. (This is what my patient was using to describe medications.)

Psychiatrist:  I like that you used the word synthetics, because I’ve never put it in that perspective with patients, and you did that for me. 

Patient:  Well, there are non-synthetic and there are synthetic. 

There’s body recognizing things, plants, and then there are the synthetics, what the pharmaceutical companies produce. And I’m a very negative pharmaceutical company person. 

Psychiatrist:  Compare that to other inconsistencies in our life. Such as, I’m going to be all-natural, I’m only going to wear hemp.

Or take it to the point where I’m going to weave my own clothes because it’s really natural and I know exactly what’s in it. Versus saying that I’m moving forward and I’m going to take what science has offered to us. I’m wearing polyester right now. 

Or, I’m willing to take over the counter “herbs” because they don’t have the pharmaceutical stamp on it, or maybe I like that it grows out of the ground. But none of that has been governed. Aside from the “he-said-she-said evidence,” there’s often little science behind some popular over the counter remedies either. 

Let’s consider that perhaps the study data, comparing in a regulated way, one patient with another, defined synthetic agents, and then allowed my body to be its healthier self. It gave us objective data. Numbers. Sure they have their flaws and weaknesses as we learn in statistics that all does. Poke holes in it as you wish, but at least there is a degree of transparency.

Patient:  Maybe for me it’s more trust, because I feel like people are so over-medicated today. And it’s easy to write out a prescription than to really deal with the issue. 

(Me, on the sly: This view, that practitioners prescribe for reasons other than for the medical benefit of the patient, is one that I honor with humility, and stand up and listen when others voice it. Annals fill the internet search engines on it, I’m sure. I will still pick at it a little, I’m a stubborn nubby person like that.

Let us note together that the word, “easy,” in this context isn’t so kind to our person. Taking medication to treat a medical illness is often not easy. It is one of the most courageous acts in someone’s life. And this wonderful lady, who came into my scary office, was a great example of this kind of courage. She wasn’t here doing what was easy. She was giving her emotional entrails a work-over with her psychiatry venture.

This patient, whom I will name hereafter, Lady Courage, was “really dealing” with the issue, in contrast to her self-described mores. Might we suspect the insidious tendrils of “Mister Stigma” shaming her? Yet here she was… Just fabulous!)

Lady Courage: I’m more one that, “Let’s really deal with your issues, and then your mind should come around, everything should come around.” That’s how I view it, because if you don’t fix the underlying problem you’re never going to fix the problem with meds.

Psychiatrist:  Okay. But you’re willing to say there might be some inconsistencies in that right now.

Lady Courage:  Right, no, I’m not … 

Psychiatrist:  It might not be entirely false, but it might not be entirely true. 

Lady Courage:  Exactly. 

Psychiatrist:  We were saying, “I can be healthy but still have disease in my life.” 

Lady Courage:  Yes, that’s true. 

Psychiatrist:  Because I don’t have to be perfect. 

Lady Courage:  Right. And I do find that a little bit hard. But since you put it in that aspect of being, “healthy with disease,” I can see that. I probably never saw that before, because I did always separate the two, either you’re one or the other. 

Psychiatrist:  Wow. 

Lady Courage:  Yeah. 

Psychiatrist:  That’s poignant. Is that how you see God as well? 

Lady Courage:  In what aspect? Like, yeah … Well, you know what? I try to strive to walk in His ways. I haven’t always walked in His way, so I do have guilt about that, but I shouldn’t have that and I know He’s already said He’s forgotten it, He’s washed me clean. So it’s just receiving it for myself. And that just is faith. And I know then it makes me feel like I’m lacking a little faith, but I know I should be stronger. But, yeah, The Word is something that I strive to follow, and it’s hard. 

Psychiatrist:  So do you feel like God is, “either/or,” in the way He looks at you? What about the parts of you that are diseased? 

Lady Courage:  Well, no, yeah, He’s going to heal that. 

Psychiatrist:  But what if He doesn’t right now? What does that mean about who God is?

Lady Courage:  Well, He sent me here probably in hopes that you can help me to heal. He provides these avenues for us, so that we can get healed. 

(Folks! So good! Smile.)

Psychiatrist:  So you somehow think that God enters into the space of the synthetic. 

Lady Courage:  Well, yeah, I guess so, yeah. I do, okay. It’s so contradictory, but in one aspect I do take a thyroid medication that is a synthetic, but I know I have to take that and I understand it and I don’t feel it’s abusive. And I look at my blood work and I know where I’m supposed to be and how much I should be, so I feel confident. But when it comes to things like this that I’m not used to taking, and that don’t show up on labs, and it involves transforming my brain, I’m not really on board with that. 

Psychiatrist:  So when you use the word transforming my brain, I understand you’re saying that it’s making you into something different? 

Lady Courage:  It can alter your brain, yes. 

Psychiatrist:  Okay, so that’s the part I think that’s very scary for people, because they think it’s making them into somebody they’re not. But in reality the medications are there for healing who you already are. So for example, today you feel more like yourself than you did last week. 

Lady Courage:  Well, yeah, last week I was desperate and hurting and losing weight and scared. 

Psychiatrist:  And today you’re closer to who you think your healthy self is. 

Lady Courage:  I think today I’m … Yes, I’m much closer to my healthy self. 

(Q: Closer to who God is creating you to be? Closer to God’s will even?)

Psychiatrist:  In all of these scenarios, at each point we want to think, “What does this say about who God is?” If He or She, (but we will say He to simplify because it’s culturally appropriate,) is kind and loving like you mentioned, then would this belief, X, Y or Z, be true?

Self-Care Tip: Lay out our beliefs next to that standard, that premise in our life. And because we’re a lot crueler to ourselves, then we would allow other people to be, it can rescue us on occasion.

Questions: “What does this say about who God is?” Please speak out!!! …and, Keep on!

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Going to the Witch of Endor

Remember there are no dividers between God and mental health. Some patients think they have to chose; either get to go to a psychiatrist or to a pastor. Reminds me of the “seers”, like the Witch of Endor. Go to her to ask for help and you lose God’s presence in your life.

When Saul saw the Philistine army, …terror filled his heart. He inquired of the Lord, but the Lord did not answer him by dreams or Urim or prophets. Saul then said to his attendants, “Find me a woman who is a medium, so I may go and inquire of her.” 1 Samuel 28:3-25

When I was a little kid, I thought that when I would go do something bad my angel would stay behind. She couldn’t come into that bad space. Like if I went to see a bad movie, my angel would wait for me outside the theater. And with some my patients, maybe they think if they come into my office they have to leave their angel at the door.

Brent asked the question, quietly as if someone would overhear, “Will God help my depression?” 

Wow, that’s such a great question. 

So God is not a vending machine. But God is in all of “these things”. God is in the space that psychiatry and the “God-topic” occupy. He/She is in all of these things that He provides us; treatments, friends, medications, clean air, stable government, and what not. (I’ll say, “He,” because that’s traditional.) He gives Brent medication and God is a better psychiatrist than I am. He gives patient’s NAMI, (National Alliance on Mental Illness), and psychotherapists, and so many other treatment options. 

Brent replied, “I’m glad to hear you talk about this because it gives me hope. And I want to renew my faith in God and start practicing my faith and saying daily prayers to Him. So it’s good to hear you as a psychiatrist here talk about God, and God helping me heal, so that makes me feel good.”

The next question is what type of God do we believe in if it’s not this God? This God who is in this space? This God who isn’t held back? Who isn’t an either-or God? This God is a God who cares about our depression. Why would we even want a God that is otherwise?That wouldn’t be very loving.

Brent replied, “God, who could help us in every way and doesn’t … that’s … I mean, basically God should be one that doesn’t allow violence and suffering and sickness.”

But there is suffering and violence and sickness. So who’s God in all of that? 

B, “I don’t know. That’s a question I have.”

That’s the question that we need to struggle with through our suffering. Because it’s one of the purposes of our life, to find out about the love of God. Because God is … I believe that God is love, otherwise I don’t want anything to do with him. We have this job to do, find out individually who God is. Use our suffering as a tool. Such as, while we are suffering, it may be an opportunity in a way to say, “Why am I suffering? Why is there this pain when God is love?” It’s huge, right? 

The struggling with our view on God’s character is muddied by comparisons as well. sIt looks like “everybody else is fine,” like God is being a God to them but not to Me. And that’s just mean. So, based on our premise, God is love, this can’t be true.

Brent said, “I know, but that’s how I feel.”

Thinking that it is true, God playing favorites, or God with limited love-supply, is one of those creepy feelings in the relationship. Something sinister. A Bogey loose wreaking havoc on our foundation.  And if this foundation is havocked, it is hard to launch. Imagine pole vaulting off of a mound at the beach. This inconsistency with our view of who God is is either about God or about us though. And that’s a stop-drop-and-roll point. A point when we realize there is an inconsistency that we shore up. 

Brent replied almost in a relieved voice, maybe a little like getting something off his chest, “It’s probably about me, not God, because He loves us all the same. So it’s probably more about me. Maybe with my sickness I don’t … 

I’m not thinking right, you know? And I perceive myself as being worse off than I actually am.”

Me, “Would it be that you have something God doesn’t want, so He doesn’t want you? 

B, “Well, I don’t think so. God loves us all. That’s my feeling.”

Me, “Okay, so it’s not that you’re so bad.”

B, “Yeah.”

Me, “Is it that God can’t quite get it right? Like, He’s just doing His darnedest but it’s not enough.”

B, “Maybe that’s it.”

That would be pretty lame, God. (I’m speaking directly here.)

Who is God? And if God is that week, again, I’m not really interested. 

Using the premise that God is love is more than Truth. It is also a self-care tool. We can use it to clarify distortions about why we are in the condition we are in. We need this premise to keep us from isolating from Love. To launch better. We need this premise to have connection in our lives.

Self-Care tip: Use the premise, God is love, whenever you can.

Question: Where are the places that the bogey is wreaking havoc in your life? 

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We are not here to turn you into something bad

People often come to psychiatry afraid. Not only from what the diseases do to them but also of psychiatry itself. They think it might harm them. They think pills will change them into someone else. Will diminish them somehow. But that’s not the agenda of medical therapy. The agenda is to improve their quality of life. The intention is to allow for a greater ability to experience connection, with themselves and with others.

In our relationship with God, we often think the same thing. We think God is here to restrict us. To limit us. To suppress us with rules. But God’s agenda is to increase our quality of life. To increase our connection to self and others. To heal. To reconnect is in essence healing.

In “Patriarchs and Prophets” it explains that we are purposed here on this earth to love and be loved.

My patient, Evelyn, was telling me at one of her lowest points in life she didn’t pray. She said she didn’t know what to say to God. The pain and suffering of losing her son and then almost losing her daughter disconnected her. That’s the biological psychological and sociological paradigm in action. It was wack. God’s agenda is to bring us back to what we all want in the 1st, middle, and last place. God’s agenda is good. She/He has our back and also the bank to spend on us toward healing.

I can imagine walking into God’s office. Furniture all feng shui. There’s a diffuser in the back and some great lighting. But I’m afraid. I’m afraid of myself and my condition, but also afraid of what She/He might do to me. Even so, I’m able to just barely grasp, like a cliff ledge I hang from, that God is someone pretty great who wants good, and never anything bad for me. I’m willing to engage in treatment.

If God were not, it’s got to make us all wonder, what kind of beast are we worshiping here? Who is God? I’m thinking God is at least as kind as I think I am. Probably more. Wink.

Question: Who is God? What’s God’s intention.

Self care tip: Give it a go. There is healing bank there for you and Me.

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Cutting holes in the walls, and God

There are no dividers. This is no surprise to perceptive temperaments. They are the people who cut windows into every wall. Grazers chasing the next butterfly who never want to barn-up for the night. Perceptive temperaments are idea makers and if you pair that with the intuit, then you have someone who is basically a human filing cabinet. They vacuum information and it gets dispersed and organized between all the gazillion neurons in their brain without them even knowing they are doing it. They’re not using flash cards or lists or calendars. Information makes its way into a connection and bigger picture.  The rest of us live by sweaty lines and frames and structure and the idea that in reality, there are no dividers is mind blowing. It’s Roadrunner dynamite to our deliberate order. 

Information is fluid and related at every contact point. This is true also for God. It is true, as well, with God and psychiatry. I think in part it may be why “the church” has such difficulty filing a hole into the idea that emotions and behaviors are moral issues v that they might also be biological. Scrambling that together, egg yolks and all, is unpalatable to many in this well packaged culture, filled up to the brim with temperaments that don’t naturally allow for that.

It’s a beautiful concept though. God has no dividers. God is inside it all, perfused, smeared, imbued. When we think of a limitation to our ability to see God in something, or vice versa, the limit is with us. God made it all. He/She has got the master key to all those doors.

Question: Where does God not make sense in your life?

Self-care tip: Relax into the knowledge that wherever you or your thoughts are, there is God.

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Medication vs Drugs

I imagine some day I’ll understand why users think drugs are healthier options for them then medications.

“Doctor, I don’t think my wife will be comfortable with me adding another medication. It seems like I’m already taking so many!”

Context: Brennon is using THC “for sleep” he explains. Not recreation. It’s “medicinal.”

Boy. We are going to have to redefine what “medicinal” means in the urban dictionary vs. in the medical. 

It’s as if the masses out there are acting like it is stigma behind any opposition of THC vs. science. Folks, there may be stigma involved but it’s mostly science. THC is, 99%, not medicinal. 

My cousin is a hospice nurse and she and I were discussing this. Along the meandering conversation way, we came across, that in her field, many are taking CBD. (I know most of us think CBD is THC-free but it’s not unless it’s thoroughly governed by the FDA.) When we were in our wandering conversation about this, I imagined out loud to her, “If I were dying, I’d want to take a good trip on LSD, do a line of cocaine, and have free access to heroine. Why not?! “

My cousin politely explained that in end-of-life, most people, not apparently ignoramus blind bigots such as myself, prefer to stay alert in their last moments with their loved ones. 

That makes a lot of sense. My “free ticket” to white clouded oblivion suddenly didn’t look as appealing. I’d like that too. I’d really like to have connection with my loved ones. At any time. 

This is the effort in psychiatry as well, believe it or not. When we medicate, we are seeking to align ourselves with the patient’s agenda, toward connection and not away. Toward quality of life and not to harm. Toward hope. When we encourage to take medication, it is not to seek oblivion and isolation. Rather medication is for connection.

Brennon is not alone. Many think that medication takes us away from connection. Away from connection to ourselves by turning us into something we are not. “Doctor, I don’t want to take anything that will turn me into someone I’m not.”

Away from connection to God by taking our willingness to submit to His/Her will, away from His/Her power and toward depending on science instead, as if there is an either/or. No, there is no either-or unless we put it there. There are no dividers between science and God. He/She made them both. They are fluid to Him/Her.

Nor is taking medication taking us out of connection to our partners, nor our family who thinks medication is a cop out and whom are loaded with their own journey of self-discovery over their own self-stigma toward medication. As if taking medication makes our patients less loyal to their loved ones, thereby less connected.

It’s so layered why we think medication is worse. Even worse than mind-altering THC. Even worse, than the disabling illness, or whichever idea it may be.

Question: What is medication worse than for you?

Self-care tip: Seek connection, “even” through medical ways. Be a friend to yourself. Keep on!

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Love without connection

Delicious rocky road Baskin and Robins chocolate cake was staining Fred’s teeth bright vampire red from the frosting. It mesmerized me as we bantered. Though, not enough to completely distract from the trigger setting off my sympathetic tone. 

“So, you are writing about God and psychiatry?” (Ba-boom!)

Fred is an enormous genius, well published and internationally acclaimed. (I’ll call him, “Dr. Fred” to give some cred, because he really is all that.) He’s super kind with real attachment to his friends and the random stranger, but still intimidating as heck when he wants to grapple ideas.  I sent up a prayer that God be in this talk and not my pride in the talk. I botched up good once or twice but in the end, if nothing else, I was blessed.

In his own life journey, Dr. Fred had done his own Jacob-like wrestle with God. He was still recovering from it, I think. I respected him so much. Some of us are given the chance to wrestle and we choose not to. Fred had courage and character. He brought his all to this interest of who is God.

To clarify my starting line in this discussion, I offered up my little premises; 

  • God is, 
  • God is Love, 
  • and We Are Designed for Connection. 

He nodded. “Ok then.” I felt a little deflation in his interest because much of his personal wrestle was prior to that line/premise I drew – “God is.” Even so he rallied and engaged.

“Ok then. What if you were to say that we should bring and deliver love ourselves? In all interchanges. In all encounters. We bring love. What’s wrong with that? Do I need to have this God in that case?”

Honestly. My little corner of the world, my home, my church, my grocery store, all would be better if I/we lived this way. I am proud and blinded by it. I interpret the world and call what is real and truth as defined by my own sight and how good could that be by definition? I am not loving enough.  

The idea of bringing love is wonderful. That’s not a difficulty for me in concept. My difficulty is where it starts from and ends from. It’s a place of disconnect. A place that start autonomous from a Creator. A Maker isn’t there at the end either tying me to Him/Her. Connection. With what I understand of Dr. Fred’s perspective is that even if we were to bring love, give love, generate love, in the end, we are alone. Disconnected. It is because we are created and connect at all points that we are never alone.

I guess, inherent to the word “Love,” well it means connection to most of us. So this is a hard bridge to shimmy. It’s like water water everywhere and nothing to drink. We have this sense of goodness, kindness, call it love, in our lives, but we are still alone. I’m cringing because I don’t have it. This sounds pompous and I’m sorry. Forgive me. I’m offensive. But I don’t think God is offensive. So I’m getting it wrong. Help me?

When we run into something that doesn’t fully make sense, the problem’s not with God. It’s with us.

I am a Christian whose church doesn’t like a lot about her.

So, I was standing on stage singing songs, my service/therapy dog, Timothy, chose to lie down, belly side up one step down with his goods in full view of the saints. I think that’s when I officially lost their favor. Timothy comfortable on the raised dais, …just no. Next thing I knew, Pastor and I had the most awkward phone call of my life. Basically I learned that emotional support animals and therapy animals, no matter their licensure in these, are not legally defended to attend church.

But church is different than God. To me, it is full of people like me. Proud. Blinded by pride. Defining the world around them, what is truth, what is real, all through their senses, no matter the biopsychosocial condition of their organ; their brain. They need me as much as I need them partly because none of us can be a mirror unto ourselves. Sometimes we both get that, and it’s lovely. Other times, not so much and we fall apart. In the end, though, I remain connected. Connected because I am created. I am carefully made. I am wonderfully made. Marvelous are God’s hands that made me. My soul knows it well. Ps 139:14.

Self-care tip: Find your connection. There is Love.

Question: Tell us about connection in your life. Where is it? What is it? We need your voice.

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“Off To Sleep!” with you!

Ladies and Gentlemen! It’s time to go to sleep! Wait. Not till you read this.

PsychU, a patient education website, has invited me to present on sleep. These are their questions and how I hope to respond. Do you have any recommendations, other interests, directives? Please help me! Smile.

1.       Dr. Johnson-Quijada, in what ways is sleep important for our behavioral health?

Sleep rudders our biology ship, (if “rudders” may be used as a verb.) Our biology is the reason we have emotions and behaviors. Take out the brain and we don’t have any problems with emotions and  behaviors. So the biological health of the brain and body is where our focus should begin with when thinking about emotional and behavioral well-being.  This is not in exclusion of other import paradigms, such as the psychological or sociological influences on what make us who we are.

But let me ask you, 

Where do emotions and behaviors come from?

Now think about it and answer your true beliefs.

I was speaking with a wonderful physician the other day to whom I asked this question, (let’s call her Doctora.)

I respect Doctora for her character, personality, standard of medical practice and interpersonal beauty. She is a bulldog in the operating room. When patients need studies done that insurances won’t pay for, she tears barriers to treatment apart with vicious tools of rightness. And she cares.  She sits.  She asks.  And she cares.  She sees the person in the paper gown, each one for the person she knows them to be and the person yet unknown.

I admire Doctora greatly not only for these qualities but also because it gets personal.  I, who have my own special practice of medicine, cannot do her’s.

When just a green bumbler in medical school, there was a fateful day when I shadowed another great artist of medical care into a locker room.  I suited up in that blue sack they call scrubs.  I put little blue sacks over my tennis shoes too.

Do you know why there are blue sacks on the surgeon’s shoes?  So what is on our shoes won’t contaminate the operating room. But also so that when wet things come out of the human body and fall onto their feet, their toes won’t feel squishy. Yep. That’s what was going through my mind as I scrubbed my hands, each finger and each finger nail the ten minutes it takesto reach what is considered clean.

Surgery in progress, the color red mixed with a smell and monstrous sensual force that clobbered me to the ground.  I swooned, gagged and promptly ended my surgical career.

There is nothing more irritating to a surgeon than someone who doesn’t appreciate the “fun” of “cutting.” Yes. I irritated this mentor and others too I’m afraid.

This doesn’t keep me, unfortunately, from pleasuring in telling people, “I am licensed to do surgery.”  I am you know.  Any Jane with a medical license can pick a scalpel up and bring back the dark ages, or contemporary, depending on who holds the license.  I’m irritating to my mentors, remember.  It reminds me how anyone can go online and pay to become a marriage registrar, i.e. perform a marriage ceremony for couples.  My brother did that twenty years ago and has yet to perform the marriage ceremony for a willing couple.  For real judges and clergy, this might be irritating too and that makes me a little happy as well.

Anywho, Doctora and I were rolling with the injustices haranguing us in the practice of medicine, both from the angle of the physician and the patient. I was pumping her up for being the cutting-wonder who she was and she was dutifully marveling at my jabber-mouth work that she would, “never be able to do in a million years.”  Somehow this brought us round to how our culture avoids embracing the biological paradigm of anything inside our skull but is so willing to celebrate it for any other part of our human bodies.

Where do emotions and behaviors come from? 

Doctora answered me with a frozen breath. Then after I warmed and soiled the air with a lot of jabbering and she was finally able to speak, she said,

I would just be horrified if my brain got sick!

I wondered if it was scary enough to clobber her to the ground, but I do agree.  Terrifying.  Don’t you think?

So sleep is important from a basic rudder-rudimentary perspective of healing, restoring, and preserving our biological identity.  

If we don’t sleep well, a disease process may develop. 

During sleep, we heal from injuries, both physical and mental. Our brain actually shrinks for a small period, squeezing out, like a sponge, the toxins that accumulate during the day. It becomes smaller in mass without the fluid that filled it. The toxins drain into our cerebral spinal fluid (CSF) and after a period, the brain absorbs new clean CSF and expands in size again. Without deep sleep, the brain retains the toxins it accumulated during the day and those toxins go on to damage the brain cells, summarily over time, potentially harming the brain health and leading to disease. 

These treatments relating to sleeping well are often better than pharmaceuticals when it comes to processing and treating stress. When we sleep, we allow our broken neuronal connections to regenerate. We re-stock our shed with ingredients like cortisol, hormones, and neurotransmitters that are fertilizer for well-nourished thinking, kind behaviors, and stable emotions. During sleep, our memories consolidate; they find their place in the folds between our cells and root down into our rich minds.

I have seen regular, restorative sleep bring someone from a place of mental decline to no longer needing psychotropic medication. Everything works better with sleep.

2.       What are some of the tools that you like to use to help people develop better sleep hygiene?

Sleep Hygiene, according to Dr. Q! 

1. Bed is for  

The bedroom is only for sleep and for sex. This means no food, no phone, no TV. If you are not having sex, then all you get to do here is sleep. This might be an adjustment for the entire family, if your spouse is used to clicking on the late news or your kids want you to read them stories in your bed. But your subconscious has to recognize this place as a sanctuary, and not the place to read one last chapter or check Twitter. 

(I have yet to have someone tell me that this improved their sex-life, but one would think!…”)

2. Naps

No naps longer than 20 minutes during the daytime. If you are tired and have the luxury of lying down during the daytime, do it! But set your alarm to wake you up in 20 minutes, and then make sure you wake up fully. You can take these “power naps” 20 times a day if you want to, as long as they are no more than 20 minutes at a time. Anything longer will break into your deeper stages of sleep and throw off your sleep cycle (also known as sleep architecture or circadian rhythm) at night.

3. Exercise

Exercise, but not before bed. Exercise during the day can help to regulate your sleep cycle by making your body tired at night, but make sure you do not crowd it against sleep initiation. Try to get 40-60 minutes of aerobic exercise, 5-7 days a week. Look at it like a pill, prescribed by a doctor. This is something you need to do not for your waistline, but for your medical and emotional health. Every day, tell yourself, “I’m exercising so that I will feel good, so that I will sleep good, and so that I can do what I want in life.”  Some say, “I’m exercising for my brain!” 

4. Lights

Keep the lights dim before bed, and turn off the screens early. Darkness releases melatonin from the pineal gland in our brains, which helps to regulate our sleep cycle. Light suppresses it. Melatonin is a cornerstone in sleep architecture. Having your face six inches from the computer or TV before you lie down doesn’t give your body much time to turn itself off. (Some people who feel they must be on the computer or TV before bed have found that wearing sunglasses for at least the last 30 minutes helps.)

5. Routine

Go to bed and get out of bed at the same time every day. Enough said there.

6. 30 Minute Get Up

If you go to bed but cannot fall asleep in 30 minutes, get up and do something else until you feel sleepy. Then go to bed and try again. Refer back to the other rules when choosing your activities (no screens, no reading in bed, etc.).

7. Caffeine

No caffeine in the second half of your day. Period. No matter how good that iced latte looks. Decaffeinated is the way to go!

8. Alcohol

Do not use alcohol to sleep. Alcohol is a depressant (will make you depressed) and also blocks deep sleep. Alcohol hits the same receptors in the brain as the benzodiazepines mentioned above. 

9. Nicotine

Do not smoke before bed or if you awaken from sleep. Nicotine is stimulating. (It also decreases blood flow to the penis, so that’s one less of only two allowable bed activities we are allowed… Bummer.)

10. Sleeping Aids

If you cannot fall asleep in 30 minutes, consider taking a sleep aid. Do not take any over-the-counter sleep aids except natural melatonin, valerian root, or chamomile. Others almost all contain diphenhydramine, which blocks your deep sleep. You may end up sleeping a longer amount of time, but you will not be getting restorative sleep. 

If you talk to a doctor about a prescription sleep aid, do not take benzodiazepines, such as diazepam (Valium,) temazepam (Restoril,) clonazepam (Klonopin,) alprazolam (Xanax,) or lorazepam (Ativan.) These also block deep sleep. Sleep aids that don’t block deep sleep and sleep architecture include atypical benzodiazepine receptor ligands – such as zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata). Trazodone (Desyrel) is also safe for sleep structure and maintenance. The newest FTY (Friend to Yourself) sleep aids are Belsomra and Silenor. Sometimes people will find that combining sleep aids, such as zolpidem with trazodone, is more effective rather than using only one agent. Some of these wash quickly out of the body, and some take a full eight hours.

11. Sleep With Me

Do not sleep with your pets or children. Pets and children are disruptive, and no one gets the rest they need. Get the sweet buddy-dog out of bed.

It is not personal. It is sleep hygiene.

I’ll insert here, that one thing that gets left out of most sleep talks, is how to be awake. 

Because, the opposite of sleep is not just slogging around in a haze. It is alertness, attention, and memory.

Sort of abandon sleep hygiene for a while. Give yourself a break from the disappointment. And then be firm on the effort of daytime alertness.

Practically, all of this means reading, writing, talking, and moving. No nap unless before noon. The body requires all these to be alert. And vice-versa for alertness.

This is where I additionally bring in the concept of a stimulating medication such as provigil. Don’t confuse this with taking caffeine. Caffeine is metabolized way too fast to be helpful in this regard. There are others one may discuss with their treatment provider.

3.       What parting words do you have for other practicing psychiatric healthcare professionals regarding this topic? How about for the consumers?

For providers and consumers alike, remember our identity is as humble as the cells from which is is generated from. Our identity is as vulnerable as those cells are. The basic needs of the body, such as sleep, lead to the most beautiful and marvelous developments that this life can bring. Without our biological health, without healthy sleep, everything in our body and what our Me connects to, is affected.

Questions for you, readers: Again, do you have any recommendations, other interests, directives?

Please help me!

(Smile.)

Keep on!