Anxiety

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Bullying That Includes Life-Threatening Behavior

Bullying:  Series Continued.

  • #144 Leave Space In Your Beliefs To Grow
  • #163 “He’s Never Hit Me.” Abuse.
  • #251 Just Ordinary Bullying – The Bully and The Bullied
  • #253 How to Be A Friend To Yourself When Thinking About Your Bully
  • #254 Free To Do Self-Care, Despite Our Bully

Bullying is a broad term.  We could call it “dirty,” meaning non-specific.  Here we’ve spent several days discussing it and stil trip on the dirt.  What we want to do is tease life-threatening events included in the broad category of bullying apart from the…, I don’t know, can we call them lesser degrees of bullying?  Anything that isn’t perceived as life-threatening can lay in that heap, let’s say.

Teddy bear - Rory

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Each of us must figure out where we are in these two categories.  What type of bully did I or do I have?  (I have to smile when I say “My bully.”  Sounds like a teddy bear or blankie.  And it sooo is not!)  I think when we can do this, we can know even more about our self-care options.

There is a main category named, “Bullied.”

Event perceived as life-threatening -> you folks on the right.

Event perceived as non-life-threatening -> you folks on the left.

On the right, we have some who have Post-Traumatic Stress Disorder (PTSD) and some who don’t.  I’ve seen mothers get it after a traumatic birth and post-partum period when their baby might have died.  I’ve seen people get it from watching terribly violent movies.  Of course we’ve all seen or been survivors of abuse, war, or other near death experiences who become angry, irritable, nervous and suspicious of others.  We’ve watched our once cuddly personality disappear.  Everyone in this system is hurt and hurting – bully and bullied and those connected to either.

Not all survivors go on to develop PTSD after life-threatening events and we can’t clearly say why.  These people on the right straddle the line with those on the left.

We also have current events and past events.  We can number there order of passing in our lives.  For example,  1.  saw our mother beat up for years by our father, 2. watched Silence of The Lambs, 3.  excluded and conspired against in high school by mean click, 4.  neighbor strong-arms you into getting rid of your dog and paying him money for perceived damages.

PTSD can set in at any point on that time line because of the conditioning/changes the life-threatening event did to the brain.

Those on the left didn’t get much attention today.  I’m sorry about that.  You guys are just as important but my agenda today was to clarify.

Questions:  How does this clarification help you, if at all?  How would you try to define bullying?

Self-Care Tip #255 – Know what type of bully you had or have to know how to approach yourself in friendship.

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What Do You Say About Bullying?

Rally

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Bullying:  Series Continued. 

  • #144 Leave Space In Your Beliefs To Grow
  • #163 ”He’s Never Hit Me.” Abuse.
  • #251 Just Ordinary Bullying – The Bully and The Bullied
  • #253 How to Be A Friend To Yourself When Thinking About Your Bully
  • #254 Free To Do Self-Care, Despite Our Bully

Being a friend to ourselves in the context of bullying has been one of the most difficult things to get positive about, to talk about with hope, to feel empowered and to claim our freedom to self-care.

Why is that?

How do we claim our freedom to self-care?

We talked a lot about kids, many of us hopeless to a degree about their vulnerability to bullies.  But what about adults?  What are some examples of empowered adults in the context of being bullied?

Our own Sarah McGaugh of birdinyourhand blog-site asked yesterday,

What should we do to keep from getting angry when we are forced to interact/negotiate with a bully? Say, in the line of work, when we have to sit in a meeting with them or something. Some people come into those situations with only fight in them. Usually in my previous position I was fairly good at diffusing them…but I would still feel the anger over it. How do we not let a bully get into our inner world, and still deal with them?

How can we respond?

I would love to hear from you.

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Free To Do Self-Care, Despite Our Bully

Demonstration in London supporting Serbia

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Bullying:  Series Continued.  (I didn’t even realize I was writing a series until now!)

  • #144 Leave Space In Your Beliefs To Grow
  • #163 “He’s Never Hit Me.” Abuse.
  • #251 Just Ordinary Bullying – The Bully and The Bullied
  • #253 How to Be A Friend To Yourself When Thinking About Your Bully

Bit’s and parts of us are unbelieving in what number of options to self-care that we have, when it comes to being bullied.  I don’t say this lightly about terrors.  Terrors change us irrevocably and hurt to the brink of our own abyss.

The question is, are we free to do self-care even when we are bullied?

Yesterday, Carl in his candid way, said,

Empathy and forgiveness? You gotta be kidding. Do you know what it is like for a twelve year-old to face this…  for an entire school term? Probably not? Cope? Isn’t coping with a chronic negative stimulus as debilitating as being unable to cope….  There may be situations where “book smart” stuff is not applicable because we cannot negotiate with the bully.

Go Serbia

Image by SanforaQ8 via Flickr

We cannot negotiate with the bully.  True, to the degree that Carl said, if I understand him.  (Carl you will surely set me straight soon.)

It is true that people who like to fight, fight well.  People who bully generally will bully better than I can ever defend myself.  They have had a lot more practice.  Have you heard this?  You never want to go up against someone who has nothing to lose because the only one that will lose is you.

When someone is agitated, in psychiatry we learn that it is good not to make eye-contact.  Avert the body.  Keep your voice low and don’t engage as much as possible.  It reminds me of letting the mist of early morning dew expire the coals in the camp fire.  Getting attacked is something we want to avoid.

Early on in my training, I was rounding on the inpatient psychiatry ward.  We often have people who are agitated admitted there and this morning, I remember it was about seven AM on a Sunday….  This particular patient hadn’t slept well.  He wasn’t well-groomed and he scowled.  All the nurses where in another room in a nurses meeting and I didn’t notice he and I were alone in the hallway.  I looked him in the eyes directly.  I didn’t concern myself with tempering my interview.  I was still sleepy myself and wanted to get out of there as quickly as possible to start my Sunday stuff at home.  (I know.  Stellar attitude for a resident-physician, right?)  He grabbed me around the waist and I nearly lost my water!  I screamed at him like a she-dog and he let go.  That was all.  No big deal right?  Well I was ticked at him and at the nurses for not being available.  No one was at the nurses station, which is illegal too.

In truth, I was pretty much an idiot on all accounts.  It doesn’t condone the assault but I have since been better about not negotiating with the bully.  

That probably wasn’t exactly what Carl was talking about but it is related.  It is by no means a full year of negative harassment, but when responding to the concept of not being able to negotiate with the bully, I don’t know at what point in degrees of trauma experiences that becomes true for us.  Perhaps it isn’t a matter of qualifying them or quantifying them.  Perhaps more depends on the victim.  I don’t know.  Do you?

What I do know, is that Carl and I are both partly wrong.  We can.  I don’t know about then.  We can now.  We are free even from those molesting monsters because of who we are.  We were created free and those horrors can’t extinguish that bit of us.  We are free not because of the protection or lack of protection we’ve lived in life.  We are free.

We don’t claim to know all the innumerable forms of suffering out there.  That is not what this self-care engages with.

Questions:  How do you find yourself free at this time in your life, despite it all?  How do you describe your freedom, even with your bully?  How have you seen others in this context?    Please tell me your story.

Self-Care Tip #254 – Free yourself from your bully.

Additional Resources:

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How To Be a Friend to Yourself When Thinking About Your Bully?

I love real life John Waters freeze-frames

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Self-Care Tip #253 – Humanize and forgive your bully.

How to be a friend to yourself when thinking about your bully?

Have you noticed that when we think about our bully, we don’t feel so good.  Just thinking about him!  Sheeze!  In our last post on bullying, Nancy said,

Wow! This one brought up WAY too much pain. I’m feeling very vulnerable and uncomfortable and hurt and stupid at the moment. 

There are jumbled emotions that flood us, such as anger, shame, helplessness, anxiety or more.  Our autonomics may even trigger, making us hypervigilant as if we were being attacked.  We are in defense mode – all the while sitting alone in a chair at our desk, in the quiet of our bed while falling asleep, or any other place of our generally hum-drum lives.  These feelings and nervous system changes come in a time and place when we are not in danger.  They come without us realizing their approach, stealth feet and skilled hands; we are in their company before we know it.

Is there no hope?  What can we do so we don’t feel victimized all over again.

Humanize

1.  Do research on the bully.  Find out about him on the internet.  See what others have said about him.

This helps us:

  1. see him as a human, mortal, without superhuman powers.
  2. feel like we are less alone in this.
  3. realize that we are not chosen, so to speak, to suffer at his hands.  He is a bully and not just around “Me.”
  4. we didn’t cause his behaviors.  He chooses his behaviors because of the same biopsychosocial paradigm that we choose ours.
  5. realize that he hasn’t chosen to do his self-care, making him more vulnerable to his own negative feelings and behaviors.

Forgive

  1. Humanizing our bully helps us move towards empathy and forgiveness.
  2. Anger debts only hurt Me and that’s not friendly to Me.

Grow our self-confidence

  1. Such as doing our own thing.
  2. Grow our own natural genius.  Work hard at it and see how it is there for us, like a friend when we are feeling pushed down.  Our friend will be standing beside us, reminding us of our value when this remembering tries to beat us down.  Our friend will be there reminding us that this negative event in our life does not define us.

Now if they continue, these rememberings, and if these rememberings are frequent enough that we believe our quality of life is affected, we may be looking at something else.  There are other medical illnesses that can disable our abilities to cope.  In this scenario, I am thinking especially about Post-Traumatic Stress Disorder (PTSD.)

In PTSD, we relive experiences of trauma (which we perceived to have been life threatening to ourselves or observed by us in other(s).)  We may also feel hypervigilant, as if we are about to be attacked at times when our lives are not threatened.  We might have nightmares and avoid things that remind us of the trauma event as well.

PTSD is easily reactivated by other stressful situations – such as being bullied.  When we have a history of PTSD that has been quiet for a time, even years, we are more vulnerable to stressors reactivating it’s symptoms.  Then, although the said stressor may not have been a life-threatening stressor, we perceive similar feelings and neurologic changes we did when in the life-threatening situation.  Then, although the said stressor may be over and not recurring, those PTSD symptoms start happening all over again and may continue indeterminately – propagated by the disease process and not our bully event.

This might be endured and it may go away in time without treatment.  But it isn’t good for anyone while it is happening.  PTSD can improve with medical therapies.

Question:  How have you been able to humanize and forgive your bully?  Please tell me your story.

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Just Ordinary Bullying – The Bully and The Bullied

Physical bullying at school, as depicted in th...

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Self-Care Tip #251 – Help yourself break it down if you think you are a bully, or are bullied.

I was just bullied, folks.  I know.  Takes a certain someone to bully me but that person and the bullying materialized and I was left with my autonomics all barking, pupils dilated, and I had to break it down.  I was bullied.

Now, after some time and a good wonderful chat with my beloved, I am able to experience the pleasure of joining the popular group of bullied-adults.  It seems to be a posh crowd now who acknowledges that adults are in fact bullied – not only kids.

What is bullying?  I’ve linked this blog-post to various web-articles that have stated this question and answered it well.  The part I would like to highlight is the emotional bullying.

When we perceive either consciously or subconsciously that we are:

  1. Afraid
  2. Powerless
  3. Receiving implied threats (direct are obvious to us readers but the implied threats are not always as clear to us readers or others out there)
  4. Supposed to stay quite about it

Does any of this sound familiar?  If it does, you  might have read the blog-post, “He’s Never Hit Me.”  Much is the same.  I’m not able to say all that is different between emotional abuse and bullying as I don’t know of any formal scientific way of separating them.  However I will propose that emotional abuse is when it is repeated and includes system issues including the victim feeling shame and deserving of that treatment.  Bullying perhaps may not be repeated or it may and it might not be done to someone who is in a relationship with the bully before it happened.  (This is just Me, Dr. Q saying this though.  Just today in my research I have already found other sources describing it differently.)

Regardless though, what to do?!  I was bullied!

Break it down:

  1. Go to the fear.  Think about where it is coming from.
  2. Think about the power.  “Why am I feeling powerless?”
  3. Clarify the threat perceived.  We don’t have to do this collaboratively with the bully – who may after all, lack all ability to gain insight for whatever reason.
  4. Get it out of the closet as soon as you can.  Talk about it with someone.  Go to any authority who might have information to empower you.  If the bullied is doing something that is wrong, we want to know!  Right?!  If not, we want to know that too, and be as clear about it as we can.  This also helps gather an “army” around you… or you could call it support :).

Andy Becker from the Leadership Post says,

It’s not enough to say bullying is not tolerated; we need to empower ordinary adults to help stop it.

Well today, I guess I’m an ordinary person getting ordinary bullying.  The bullying isn’t special.  The way it affected me isn’t that special either.  But I am.

Similarly, the bully isn’t being served well acting out.  It’s not friendly to either of us.  We are both ordinary special people who deserve better.

Questions:  What has helped you when you felt bullied?  …or, …What has helped you stop bullying?  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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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

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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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Anger – Sometimes There Doesn’t Have to Be A Reason

A metaphorical visualization of the word Anger.

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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

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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

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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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Choose Back! …As Long As Life Chooses You.

A Girl On A Footbridge

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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!

Montmartre

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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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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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Number One Reason For Relapse In Mental Illness

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Self-Care Tip #230 – Remember why you feel the way you do.

Olive was doing well.

How are you doing Olive?

Oh fine.  Just fine,

Olive would say.  And she was.  A sense of rightness filled her when she thought about it.  Right with the world, her garden, her work and even her kids.  She wondered that there had ever been a time when she hadn’t been.

It was almost easy for Olive to forget about why she was better.  Almost, except for her probably thirty seconds of opening the lid, dumping the contents into her hand, tossing them, all of them into her mouth.  One swallow with water and it was over.  Thirty seconds she thought.  I’m doing it for my kids.

Then came the best reason she ever needed.  And despite knowing that she had done this before and had relapsed, something about the rightness of the reason made her feel like the relapse wouldn’t be allowed.  The rightness would keep it away.  After all, she was stopping her medication for her kids.  If she didn’t have medical insurance than she would be a huge burden financially and she would die before doing that to her children.

So quietly Olive stopped.

By stopping medication, many of us have this sense of eliminating the reason we started the medication in the first place.  Take medication.  Disease continues.  Stop medication.  We are superior.

When my son was about one year old, he learned that if he turned his head away from you, it was as good as denying your existence.  Turn.  You’re gone.  Turn back.  You reappear.  Turn.  And just like that, you’ve been eliminated.  Even now, remembering it delights me.

Not so cute however, is the number one reason for relapse in mental illness – stopping medication.  For Olive, she turned her head, and hoped her recurrent Major Depressive Disorder would not be there when she turned back around.

How are you Olive?

(Sigh.)  Fine.  Just Fine.  (Sigh.)

But Olive wasn’t.  Even though she knew she had been better on her medications, she couldn’t see any more, how much better.  Her face tightened up, her thoughts wandered and she exploded more.  Self-loathing of course followed and she felt like her suffering was unique to her.  No-one understood her, especially her ungrateful children.  She was doing this for them, just like everything she did through her whole unappreciated life.  This was all wrong.

Is this why I worked all those years and raised them?!

Readers, you may not agree with the crystal clear logic that emboldened Olive’s heroic stopping of her medications, but it’s not the only one out there.  This being the number one reason for relapse implies that there are many that seem to make really good sense.  So forget about they specific “why” of why Olive turned, and just know that many of us do.  Many.

Question:  What has helped you stay on your medication when it seemed to make sense not to?  What do you think about people who choose to stay on medications for life?  Please tell me your story.

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Where Do You Think Behavior and Emotion Come From?

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Self-Care Tip #229 – See yourself as a friend by including biology in your self-perception.

In clinic, out of the clinic, here, there, if I were to pick one barrier to treatment anywhere, I’d pick the misunderstanding that behaviors and emotions come from somewhere other than the brain, and then from there, the outcropping of understanding why.

I don’t think most of us say it in so many words, but it’s intuitive. Maybe when pressed we’d say, “Where else do they (behaviors and emotions) come from?!” And then agree, the brain. But the connection that allows for self-care is missed. The connection that allows us to choose the freedom to feel good and behave well for our own sakes is lost in the shame of failing to do those very things.   The stance of courage it takes to be our own friend when we don’t even want to be in our own company, takes a lot to maintain.

The marvelous @MarjieKnudsen, tweeted a reference to a wonderful post by Sarah Boesveld, How ‘self-compassion’ trumps ‘self-esteem’. I enjoyed reading it very much as I felt it spoke to me and my generation with great perception… except! that it was without mention of biology, the brain; i.e. where behaviors and emotions come from.

In clinic, Naomi told me about her “failure” when ever she felt anxiety come on.

Why do I feel depressed when I feel the anxiety come?

I’m wondering what you think, reader, about this simply related story and the question.

I mirrored Naomi’s question,

Why do you think you feel depressed when that happens?

Today (similar to Naomi,) girl-crush, alias Rachelle Gardner, Literary Agent, wrote about feeling like a failure as well.  She asked at the end of her post the pithy questions,

What about you? How have you failed? What kind of wisdom has helped you deal with it (i.e. sense of failure)?

And I thought, how to answer? Here I am again “in the presence” of someone wonderful who in her post didn’t make it apparent that she was considering that this emotion might be a symptom of something biological.   We are willing to look under every rock, be in the space of our emotion and ponder reasons why.  We have the courage not to “run” even when we don’t like ourselves, but haven’t said it out loud to ourselves yet,

I might feel this way because my brain is dishing it out.   I might otherwise have not done anything to set this emotion or these behaviors in motion, other than being alive.

Girl-crush remains despite response.  So readers, don’t be scared to answer what you think.   If you even care, I’ll still admire the socks off you! – even if you think you are hyper every day since conception because you ate too much sugar.

Questions (In case you want me to write them again, which I’m really happy to do – anything you want so I can hear your responses): Where do you think your behaviors and emotions come from? …such as a sense of failure and/or a depressed mood? What has helped you deal with it? Please tell me your story.

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Choosing Perspective

choose

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Self-Care Tip #225 – If you can’t choose a better perspective on your own, it might be time to choose it via a medical route.

Feeling trapped?  Overextended?  Used and neglected by others?  It might be true.  But why do we get in these impossible places?

In the Wrinkle In Time by Madeleine L’Engle, towards the end of the story we find ourselves in a room with Charles and It.  Charles is trapped by It.  He has disconnected from his own thoughts and has given himself over to the control of “It.”

Charles’ sister, Meg, comes in and reminds him about Love and that changed the perspective of everything.  It reminded Charles about why he wanted to choose for himself, to have his own thoughts, to love and receive love.  And then, with that, Charles was reconnected with himself again, whole and sharing space with Love.

The changing perspective turned what seemed an impossible bondage into freedom.

When we feel disconnected from our personal journey, impossibly overextended and trapped, remembering our freedom to choose, freedom because of Love can make all the difference.  The perspective shifts.  The impossible becomes possible.  Magic.

Sometimes, choosing is thwarted by brain disease.  When we can’t extricate ourselves, when guilt plagues us, when we feel like things are about us that really aren’t, when the emotion jarring us is inappropriate to the context – we need to use that as a cue to choose to get “free” via medical help.

Questions:  When have you felt trapped?  When you did feel trapped, how did you find your freedom?  Please tell me your story.

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Self-Care Woven and Unravelled Simultaneously for Best Results

Change is good--Kente Cloth Loom

Self-Care Tip #222 – See the different parts of your self-care as independent yet dependent on each other.

One of my truest pleasures would be to teach well.  My temperament is, per Myers-Briggs, designed to be a teacher and I agree that I feel inner congruence when I’m doing just that.

…If you’re feeling your hands closing into a bracing grip, it is probably because you, like many, really don’t want to be schooled – which has happened in my less refined moments, so caution is understood.  This is not what I hope to do here.

After yesterday’s blog-post and comments received, it shows that I have not taught as well as I implied to myself.  Implied intimacy is a danger of any familiar relationship, including with ourselves.  The beauty of you guys, is you help me say things “out loud” decreasing misunderstandings.  You guys are teaching me and I thank you.  So whatever this is we are doing, learning, schooling, teaching or whatever it is that Mr. Rick C. does – what we are doing here together is mucho-much fun.

As we unravel the rug together, we see these threads,

  • emotions and behaviors appropriate to context – yesterday we spoke about guilt
  • emotions and behaviors inappropriate to context – yesterday we spoke about guilt as a symptom of medical illness
  • the magical miraculous beyond our current understanding – before we “see face-to-face” – yesterday Carol Ann mentioned the changing power of God
  • freedom to do self-care and related choices
  • what choice yet remains when other choices are lost either by action or disease
  • (this last one I’m just putting in here to finish the pretty rainbow) – helps me get in the barn where I’m comfortable

The reason I think it’s important to see these together yet apart, as well as we can (through a glass dimly), is that too much of one or another of these, diminishes the results of our self-care intentions.  Don’t mistake this for preaching that one can get too much of God in their lives.  It just isn’t true and not in our best interest to get waylaid.

Questions:  How do you see yourself more effective in your self-care efforts and what has influenced those improvements?  In what way have certain bits of your self-care gotten “too much” attention?  Please tell me your story.

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Guilt Furiously Chasing You Is Commonly Experienced In Illnesses Of The Brain

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Self-Care Tip #221 – If you feel chased down by guilt, stop running and get friendly with yourself.

I’m so busy!  I am trying to work, raise three kids, and be a wife!  …and I’m just spread so thin!

It was new for Connie to think that where she was at in life was linked with her choices.  Somehow she intuitively felt taken along by it all, a current of life as people say, of either randomness or design.  Who could know, but it was more than her choices, she was sure, and she resented the influence on her life’s design.  Not that she had intended on taking over what was playing on her.  She just simmered in the house of cards hoping that when she got to make a play of her own, she’d make a good one and come out better for it.  In the mean time, she just had to keep moving fast.

Things would have been fine, except that over the past six months, she hadn’t been enjoying what she was living for, her kids, parenting, being a wife or her employment.  Yes, she was also  living for God but no, she wasn’t enjoying Him either.  Did she want to?  Did she feel guilty about it?

I feel guilty all the time.  It’s the guilt that gets to me.  It’s like I can’t see or feel much else.  Just when I think I’m about to get into what I’m doing, guilt comes chasing at me in a fury!  Distracting me and worrying me.  I’m on edge more and irritable from feeling defensive, and trying to get away from whatever this is.

Connie looked at me when I said,

Self-care begins and starts with “Me.”  Although we may be living for others and other things, even living for God, if we don’t take care of ourselves, our health first, our emotions and behavioral health included, we can’t give much, in the way of living, to those others.

I could see her pupils change and I got a little excited.  She was hearing something that affected her whole body and I sensed it was hope.  (See, I am an Emotions Jedi.)

We talked more about approaches she was using, prayer/meditation, exercise, grit and determination, waiting it out for better days to come and others.  Then I introduced the medical paradigm.  (You’ve heard me say it.)

Behaviors and emotions come from the brain.  We culturally think that they are volitional, under our control.  But how much can we really control of what the brain does?  Some.  But when we do the best we can with what we can control, and our behaviors and emotions are still hurting us, affecting our quality of life, damaging our relationships and connections – we need to look for biological reasons.  That’s where choice can still come into play.

She was looking and nodding.  This was at her “consideration stage” of introducing these new ideas.  I said,

I thought of telling you about this when you talked about guilt Connie because maybe your guilt is coming because of a brain illness.  It’s common in several emotional illnesses, like depression or anxiety, and in these illnesses it commonly comes in force, like you’ve described.

Her pupils had reduced to their earlier size, and her posture said she was winding down for that visit.  Whatever we discussed after that would be low yield, so we made a follow-up appointment and called it a day.

These days later, remembering Connie gets me thinking about what I would have said if she had been available to still hear more.  This bit about freedom to choose self-care, yet saying we have little to do with how our brain works can get confusing.  It might seem contradictory.  Tomorrow, I’m going to discuss it more, but for today, it would be wonderful to hear what you think.

Questions:  With behaviors and emotions coming from a material biological organ, the brain, yet knowing that we are free to choose for our self-care, what gives?  How do these ideas jive?  How have you seen it play out in your life?  Please tell me your story.

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Where Does Courage Come From?

I want to do that, but I have no idea where I’m going to find the courage!

This is real folks.  People think this, say this, believe this and behave accordingly.  The other day, a young woman in her forties with a rolled scroll of precious problems including joint disease, extreme morbid obesity, nicotine dependence, depression, anxiety, obstructive sleep apnea, eczema, gastroesophageal reflux disease (GERD), heart palpitations, diabetes, hyperlipidemia and polycystic ovarian disease – this woman told me these words.

I have no idea where I’m going to find the courage!

Where does courage come from?  Is there an odds ratio, statistics, intuition barometer or what?  Where do we find courage?  (I am remembering the dear Lion in The Wizard of Oz.)

I see courage coming from our ability to make decisions.  Being able to decide comes from many paradigms, including my favorites as broken down through the biopsychosocial model (listed in no particular order):

  • Biological – temperament (genes or personality,) mental health/brain health (the brain being the organ we use to make decisions with,) developmental (the neurodevelopment of the brain is different at different ages,) things we put in our body (diet, illicit drugs, alcohol or nicotine,) medical illnesses, sleep issues, exercise, rash, ingrown toe-nail….
  • Psychological – self-control, coping skills, catastrophizing, negative thinking, thoughts, emotions, and behaviors….
  • Sociological – culture (including home, religion, race, gender,) stressors on our body, social support, God, interpersonal relationships (friends, marriage, kids, colleagues,) parenting, unemployment….

(WHEW!  Recovering my breath.)

Where do we find courage?

I drew a picture in the air for her psychological self,

17th century

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I see you 100 pounds lighter, not smoking for the past six months at least, off of six of your twelve medications, your medical problem list shortened down to two or three.  You are able to feel pleasure again.  It is a real option for you.

If you don’t, I see you growing demented, paralyzed and dying from a heart attack.  I can’t say when these things will happen but they will happen if you don’t start taking care of yourself.

Where does courage come from?

For her biological self, I targeted the language of her temperament.  I remembered that we make decisions either through thought or feeling.  She was a “Feeler.”  I drew forth my light saber and went for the emotions.

You can do this!  Think of the gift you’d be giving yourself and to those you love.

For her sociological self, I talked about everyone in the family choosing with her, including husband.  Talking about how this changes the family culture, not to smoke together, setting boundaries with her husband to care for herself and thinking about getting other support networks like starting to go to church again or calling her pastor.

Question:  Where does courage come from for you?  Please tell me your story?

Self-Care Tip – Use your biopsychosocial model, that is to say all of what makes you you, to find your courage.  Be a friend to yourself.

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Self-Care Doesn’t Have to Be That Big of A Fight

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Self-Care Tip #215 – Fight as little as you possibly can when reaching for your choices to self-care.

We skipped over that.  We didn’t tug on the medication-or-no-medication rope.  What a relief.  Marsha surprised me.  When we first met, she had been the one who said,

I don’t want medications but I can’t go on like this.  If I choose to start, when can I stop?

In these scenarios, it’s easy to get snagged by the temptation to educate (tug.)  There is the risk that if we don’t educate, we might miss our opportunity to engage her in treatment and get help.  However, because Marsha was willing to at least start medication, even though the duration of treatment was in question, I decided to let the medication argue its own case.  (Standing quietly by the rope.)

Not everyone is as good to me as she was.  Some patients, prodded and edgy from the anxiety, want to fight a little.  That anxiety is coiled and full of potential energy.  Feeling put off, up it springs when I say,

Let’s talk about this, if it’s alright with you, after you’re feeling better emotionally.  (Pulling on the rope now, heels three inches deep into dirt.)

Somehow, Marsha let it ride out.  Somehow, Marsha came out on the other side.  She had nearly forgotten about wanting to ever stop her medications.  She never even brought it up in fact.  I did.  I think I had to say it twice to get her to know what I was talking about.

No.  I don’t care if I have to stay on these medications the rest of my life.  I feel so much better!  I’m more myself than I ever was.

 

And there it came.  That beautiful awareness of taking care of our changing selves.  Without much in the way of hand blisters, she stepped by her own volition across the line.  Marsha was a no drama type of girl.  Just in time, I caught the temptation, my own springing up potential energy to pull on the rope when we were on the same team.

Marsha had struggled with disabling mental illness her entire life, and here in the third decade of life, she simply walked over into health.  Gracefully she left her previous self, accepted her new, assumed it was her intended baseline and that was that.  She wasn’t over the stigma, she hadn’t accepted some of the other lifestyle changes entirely but still, she was content to call her team, come what may.  What a woman.

Questions:  How has the process of getting on and staying on medications been for you?  When have you felt more yourself?  How do you define your true self when you change through life?  Please tell me your story.

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Never Let Go of Hope, Even When Depressed and Anxious

Linda, Lake of the Woods Run, 15 K

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Self-Care Tip #214 – Never let go of hope, even when depressed and anxious.

Some blog-posts ago, Be Aware of Your Feelings was written and “M” asked,

What is the difference between depression and anxiety?

Anxiety and depression are like brother and sister.  They often go together.  When we think of “paradigms,” we think of an arch that might intersect with another arch.  However, when I think of the affective (or mood) spectrum intersecting with the anxiety spectrum, I see them weaving, interlaced or chasing each other.  Not a line and nothing tidy.  So understanding the difference also includes understanding their relationship.

In training, I remember presenting a patient with anxiety and depression to my psychiatry attending physician.  I hadn’t clarified the timeline of onset of symptoms.

When presenting, every resident physician knows the moment when they are found out.  The other residents on the rounding team instinctively lean back, try to take a step away even, so the lightening doesn’t singe them when it strikes.  I’m sure I smelled like fear too.

The reason the time of onset of symptoms is important, is that it tells us the primary disease process.  Knowing that, influences the speculations on patient recovery, duration of illness and our choices for treatment.  Some medications for depression can really activate anxiety and the patient might not enjoy the free-fall into hell after starting the antidepressants.  Also, there are some treatments that work better for different disease processes and such.

It’s common for someone who has suffered from depression on and off for years, but never from anxiety, to have their first panic-attack out of the blue, without trigger.  Bummer!  Then they start to roll.  Bam!  Bamm!  BAm! BAAM! BBBAm!  The panic attacks may come in spurts and then go away for a time.  The opposite is also true, starting off with anxiety, and followed by depression.

I don’t think anyone, including “M,” is asking me to talk about the differences between anxiety and depression in that depression is a state of sadness, and anxiety is a state of autonomic nervous system activation.  Rather there is the wonder of why they follow each other in course, why the are so often in each other’s company, why so many medications that treat one will treat the other, why they run in family histories and/or why they are both “so common.”  We have some ideas we use to answer but we don’t have enough objective information to explain.

Some of the good news is that these diseases are treatable.  The sooner they are treated and when treated to full recovery, the better the hope for long-term brain health is.  I have seen people feel defined by these diseases and trapped.  My job isn’t to minimize that, but rather to highlight what might bring hope.  Selling hope turns out to be one of my biggest jobs.  The same attending physician I mentioned above told me that.  He never stopped talking about hope.  Even for me.

Questions:  How do you answer “M’s” question?  How have you seen depression and anxiety move together and how have you responded to it?  What has given you hope when they did?  Or, when you saw this in someone else.  Please tell me your story.

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