Like a gold ring in a pig’s snout is a beautiful face on an empty head.
It was just too funny.
Like a gold ring in a pig’s snout is a beautiful face on an empty head.
It was just too funny.
Look Mommy! Look at my note!
She pulled out a crumpled treasure.
It was a white paper. Blank. I paused with the, “I’m very interested,” and, “I’m a good Mom to whom you want to divulge your innermost thoughts and secrets to,” expressions on my face. I am you know. All that. Sniff.
Another mystery maker, handy, said,
Where’s your pen?!
She was getting agitated. I did not get it. I was less of a P.I. than she had hoped. She had a non-P.I. mom. Just great.
A third wheel rolled in and stuttered out,
You need the pen, Mommy! You need it! You need the light!
I noted the multiple exclamation points hovering about and knew the sand in the glass was almost out. Communication needed to be received or my three secret agents were going to increase their level of effort. Be warned.
I am an emotions-Jedi after-all. I sense these things. The Force is strong in me, still, young Padawans.
Then, there it was. Under the blue penlight, shown the hidden messages.
No. I do not remember them. Just the sense of them. And…
And, I thought it was a super illustration of how brain illness is there but not generally seen.
I am sure this was disconcerting to my investigative kids, who had dreamed I would do what they wanted with my life and thoughts. I wish they would just let me be me! (Flipping hair.)
Brain illness does not get as much air time as cancer. It is not as obvious as a withered hand. Nor a rash. Nor a big outcropping of plantar warts seeded across the soles of our feet – brain illness is not.
Brain illness does not engender connection easily because not everyone has the Force in them. Not everyone is a Jedi like you and I. It does not have the advantage to connection as a name tag illness. Brain illness does not wear itself on our visage like an invitation to others to embrace us in shared experience.
Where is the Light?
Right. In us. We are the light. We are what brings awareness to this secretive suffering. We are secret agent Jedis. Yes. Exclamation point. Exclamation point. Exclamation point.
Questions: What would brain illness look like if it was visible?
How has brain illness become more of a shared experience? How can it?
Please tell us your story.
Self-Care Tip: Share your experience.
Bernice flushed. A pink perfused her face and neck. Her eyes looked away.
Why don’t I feel better?
Bernice was one of those fortunate lasses who flushed and blushed no matter what emotion she experienced. When I first met her and she told me some of her story, she was also a-flame.
I’ll do anything to feel better.
She though she was feeling bad because her husband did not love her.
I knew, however, that this was not why. She did not understand why she was feeling so bad. It was a conundrum to her.
She began intensive psychotherapy and pharmacotherapy. In two weeks, she forgot she did not want to live. In four weeks, she remembered why she did want to live. In six weeks, she liked herself again. She was still blushing, but she was alive and well.
We sat separated by a small desk and laptop. I was typing notes and watching the pink bloom. Too sweet.
Why do you think you feel better, Bernice? What is making the difference?
We all know something about the relationship blood has with the lung and heart. We know that all the blood in our body flows through those two organs. They are the hub of our body, the authority of the blood communication. For better or worse, they are also a filter. Pollution can clog them, hence heart attacks, cancer.
So with emotions and behaviors, we know there is a grand central station where they come from. Things that assault the hub such as a a death in the family, similar to a glob of cholesterol toward the heart, stress on us affects brain health.
Red hair distracted me from these thoughts. Bernice had a lot of it. Irish I guessed from who knows how many generations back. I remembered the red-head girl who won the beauty contest my Mom forced me into when I was ten. Awkward. I pushed my focus back.
Irish Bernice had experienced what happens when we approach healing at the central station of behavioral and emotional illness. The brain. She stumbled, trying to explain her story, although, intuitively, she had insight into, “Why?”
I don’t know! I’m trying hard to be mindful and I’m treating my husband differently. (I.e. They are having sex again.)
She paused and her face reddened.
Well, I really like my meds! I think they help a lot too! I am feeling calmer and I don’t cry as much. I’m sleeping through the night…
She peetered off into her averted gaze. I wondered that the conjunctiva of her eye-balls were still white, inside the almost crimson lid and cheek around them.
We with Bernice ask why the medical paradigm including psychotherapy, nutrition, exercise, community, medications, ECT, is the best way to healing a sickness. It is not about the healthy exercise in itself. It is about what all these have in common. They all act upon and draw forth emotions and behaviors from the brain. Their vital exchange with our brain, the grand central station, are much better understood when we start with understanding of what brain health offers.
Self-Care Tip: Use brain health, as the grand central station of Me, to handle the multiplicitous paradigms that make us who we are.
Question: Is it helpful to use brain health as a tool toward who you consider yourself to be, rather than a definition of who you are? Does it influence where you spend your energies? Your blame? How you approach shame? Your hope? Please tell us your story.
What is psychiatry?
Components intersecting at cross-point where stands Psychiatry:
Who should go into psychiatry?
What is brain illness?
We are not in this to cure anything. We enter psychiatry to improve quality of life – through approach of the biopsychosocial model.
Self-Care Tip: Approach brain illness w/o expecting a cure, but rather a process.
The train was tarnished from soot. The engineer, Jack, grimaced over the craft, while he hauled wood into the fiery oven hidden in her belly. She was a steam engine and her whistle sounded through the air like a shiver breaking ice.
Indians watched from a bouldered distant peak. They saw the smoke and marked its passage with each puff.
Just then, a mischievous current sucked up that chimney-spew like a genie to her lamp and the loud wind masked the sound of her turning wheels. To the unfamiliar natives looking on, the tiny far off train appeared to have stopped, silent to them now and no smoke to ribbon the air.
Not so, though. Jack did not know they were watched, he and his steely lady. He did not know he was described in the mind’s of others.
Moving. Not moving. Progressing. Stopped.
But the sensory descriptors were misleading.
Music please. (Perhaps tom-tom pow wow drums.)
As in this tidy little parable, we think that when we get relief from symptoms, it means that the disease process is better.
Anxious? Have a beer and vuala! Better. Can’t sleep? Smoke some weed and, “Aaaah.”
No? “Of course not!” we say. “We don’t do those plebeian substances. We use our medications as prescribed. We don’t abuuuuse them. If we need more, we ask for more.”
This dialogue is usually regarding benzodiazepines. “Doctor, I can’t take antidepressants or those other meds! Why is everyone always pushing drugs on me? I’m just taking klonopin.” Or, “Doctors over-prescribe! I just need xanax!”
Brain disease runs something like the steam engine train.
The steam coming out of the chimney is what we see in symptoms, such as, anxiety, inner tension, fear, insomnia, irritability and so forth. Get rid of the smoke and we think the disease is dealt with. However, the train is still going. The disease is still progressing, although not as notably disruptive as before. To stop the train, we must stop the engine, or the disease process. I’m not saying we must cure the disease, rather, just slow or stop the disease progress to treat it effectively.
Our goal is more than symptom management. Our goal is to treat the underlying illness to preserve brain health and prevent against further injury.
Self-Care Tip: When medically indicated, consider medical therapy.
Question: When your symptoms improve, how do you continue toward treatment goals? How do you go past getting “better” to full treatment? Please tell us your story.
The five-minute warning wasn’t enough for my daughter.
Mommy, please tell me when it is fifteen minutes before it’s time to leave. So I have time to finish my game.
The truth is, sometimes I forget to give a warning at all and we just have to go when we have to go! Warning or no warning. But my daughter had a point that reminded me how often we take for granted or even assume we have a right to be warned. Oh the rights we possess! Or not. Well, not really. We don’t have many rights in life and “the fifteen minute warning” isn’t one of them.
We have the right to love and friendship, (with who is another discussion,) but not much else. Yet even without the right, many of us have the privilege of “the fifteen minute warning.” And time tics away and what have we done with it?
At work we are told about working better as a team member.
At home we are asked to stop yelling when we are upset.
We are warned. Time passes. Pride keeps us from being friendly to ourselves often enough. Friendly would be to forget about how we are right and hear the warning. Being right is over-rated. Friendly is the crisis. Friendly is to go toward the wanting.
If we can’t do this even though we know we hear, maybe we don’t have what it takes? That’s a turn in the warning to get an opinion of “why” from a medical professional and then to respond to the recommendations. “The fifteen minute warning” is designed to improve our experience and readiness. If we can’t, than shift gears into finding out why.
Questions: What warnings have you heard that improved your experience and readiness? Please tell us your story
Self-Care Tip: Deliberately use warnings as the privilege that they are, rather than entitlement, to be friendlier to yourself.
Have you ever noticed that hating the person who hurt you is never enough? The damage does not respond. The edges do not come back together. Hating them harder, hating them more effectively, with your voice, with your body, committing your talents toward their detriment, recruiting forces, community – this is not enough. Finally, you grow plans from dragon teeth. You wish them death and an after-life of repeating hateful deaths. It is still not enough. You are left with you.
When the extreme, when the hate that is to say, is not enough something is wrong. But it’s not what you think. The thing that is wrong is not that.
We could say you are a sinner. We could say pray more. We could say exercise, destress, do yoga, karate, eat less sugar and drink grass juice. We could and perhaps we do. But this time, please put that aside. It is not disqualified. It’s just not the bit we are going to talk about. Don’t be mad at me.
The hate is in the brain. The brain picked this to perseverate on and return to like the tongue over a canker. Lick. Ouch. We don’t ask for these emotions. We don’t ask for these behaviors. They come, symptomatically telling us a story about our condition. Hear the story?
It goes something like this. We are persons who know enough to know that this is a feeling stronger than deserved. This is a response not entirely rational. This is a behavior that we would choose not to do otherwise and nor would a friend of ours support. Our mother would tell us, “No.” We experience a whole body response that surprises some level of our awareness and that part stands by uncertainly with her fingers picking at her lip.
The story tells about the other times when we endured worse and responded without as much personalizing. We remember that someone else we knew acted like this and we didn’t think much of it. We thought they were “off.” We realize that what we are experiencing might not have as much to do with the crime as we thought. It might just be that we are not feeling and behaving well. It might be our brain.
That darn double-crossing organ! How is anyone supposed to trust themselves? It’s tough but we have each other and we have our story and we have grass juice. We have God. We have medication. We have ECT (electroconvulsive therapy.) We have acupuncture, our support groups and DBT (dialectical behavioral therapy.)
Considering where emotions and behaviors come from is the bit that gives us a chance to find and be found by help. Hate is a very strong emotion from the brain and it isn’t so friendly to Me. If we can’t put it aside, consider the brain.
Self-Care Tip: When emotions and behaviors come that you don’t want, and won’t go away even when you say, “Please,” consider your brain health.
Even car accidents happen for “good reasons!”
Wanda didn’t want to hear the reasons.
Anything could sound like a good reason for bad performance. It is what it is. Just own it!
And Wanda was out. And just as quickly as she concluded, I flashed back to the quivering resident who messed up on internal medicine rounds. I stood there with my spine like a steel rod. My white coat felt heavier with my fair-weather reference books bulging in my pockets.
Keep your chin up and look at her! I told myself.
This wasn’t the first time for me, so I had the “luxury” of practicing a previous well-described lesson from my attending on how to respond to feedback. Those days seemed like a series of stings, burns and frost-bite, but I am grateful for that at least – the knowledge of how I’m supposed to “take it.”
Wanda came back into my mind’s focus as memories of internship faded. Wanda wasn’t even mad at me. She was telling me this story as an example of her difficulty coping with anger. Here she was asking for help while justifying her position. Don’t we all, though?
I saw the irony in her criticism of those who gave reasons for their foibles as compared to her own explanation for anger and medical care. Yet again, aren’t we all inconsistent like this? Wanda is not alone. She even had good insight too. Explaining away our mistakes is shabby, lacks class and is insincere.
Some time ago in a post, Please Don’t Say “But”, we talked about this, which later we termed “presence.” But why see a psychiatrist about these things? Because insight is only worth so much. If the mechanics to respond to the insight aren’t well, then you’ll be able to withdraw from your self just that. In Wanda’s case, it was spitting anger, hot to the touch and not much safe. It had quite an effect on her interpersonal relationships and quality of life.
But Wanda was suffering in more than her apparent psychological and sociological selves. She was also suffering in her biological self. (See biopsychosocial model.) Wanda, was ill.
When we find that we can’t do what we want, don’t respond the way we intend, have negative emotions and behaviors we didn’t invite, see the associated deterioration in our connections and quality of life – when we are suffering, we need to look for help. It’s hard to be productive and survive without support. Any bit of nature will tell you that. Ask a peach tree if you don’t believe me.
Question: Does it make sense to you that emotions and behaviors might be all we have to show us that we are medically ill? If not, please tell us why.
Self-Care Tip: When insight isn’t enough, consider a medical consult. Be a friend to yourself.
Baby I have been here before
I know this room, I’ve walked this floor
I used to live alone before I knew you.
I’ve seen your flag on the marble arch
Love is not a victory march
It’s a cold and it’s a broken Hallelujah…
– Leonard Cohen
Relapsing in brain illness is the pits. The prodrome, as it starts creeping into our awareness, is worse than knowing we are about to walk into a spider web with the spider and his dinner still in it. It’s so horrible that even before the prodrome hits, imagining a relapse can trigger foreboding and anticipatory anxiety.
What will I do if I…?
Dear God no…
Recently we did a brief series on ECT and discussed how ECT can improve brain health, signal neurogenesis and trigger healing. This brought many of us to wonder about what causes brain damage. It became apparent that many of us had forgotten that brain illness, in fact, damages the brain. We still have a hard time, despite all our progressive activism and awareness, believing to the core that the brain is human, that emotions and behaviors come from the brain and that a diseased brain is what generates disease symptoms as seen in emotions and behaviors. We still have a hard time believing that the brain responds to medication, much like the liver does.
What?! Depression causes brain damage?
Now compound that with the spider’s cousin, Medication-For-Life, and you’ll see us doing a funny walk-hop-dance in the dark to avoid what we wish we weren’t getting into.
The wonderful bit about all this is that staying on medications, even for life, is the best way to dodge the worst of it. Sure, even with medications, as prescribed, compliant and all that fluffy five-star behavior, we still relapse. “Depression should be considered as a continuous rather than an episodic process,” as stated so well by French biomedical expert, Vidailhet P. But, (this is really good news,) when we relapse, we do not drop as fast, we do not fall as low and we do not hit as hard when medication compliant. Staying on medication is prophylactic against those miseries. Staying on medication is protective against progressive brain disease and it’s deteriorating effects. Staying on medication is friendly.
Self-Care Tip – Stay on your medication.
My dad is turning seventy-seven tomorrow folks. He could have died a gazillion times before now, but it is the tumbling of those near-deaths into big life that teaches and recruits me. He makes life feel like open space, warm skin, color and lyrics. Now his spine is crumbling, his legs are weak, his lips are always moving in and out like a rabbit and he’s almost too hard of hearing to comfortably socialize with. Still, it is the life, the interest he has, the way he doesn’t stop growing that somehow dims the many times he might have died. Why does the one time he will die seem impossible to juxtapose against any future then? Where will life go, if he is not there to infuse us with his humble will? I think it may fall asleep with him but I know it will not and I cannot imagine it otherwise.
These past few posts we have talked about “special efforts” for brain illness. We asked, “Is there any treatment you think is too extreme to consider to get brain health?” We have not said the reason we cannot fairly answer.
I don’t know how life will be without Dad; we never know how life will be when our brain is bad and then more bad. It’s hard to tell. We can only imagine and usually our imagination will be wrong anyhow.
Any answer to this question, “Is there treatment you think is too extreme to consider to get brain health?” is shaped by our understanding of what “extreme” means. It changes shape and margins with the degree of brain illness. With each turn, as our disease process exacerbates, so progresses our willingness to believe what is reasonable versus what is “extreme.”
Many of you have told us of your own specifics in your fight for brain health. People do heroic things and I’m thinking you and I might have a bit of a living hero in us. In part, it is the inherent unknown in growth that testifies to life itself.
“Is there treatment that you think is too extreme to consider to get brain health?” I imagine my answer would be, no. Please tell us more about yours. Your view from your degree of extreme helps. Keep talking.
Self-Care Tip – Let the hero in you speak, grow you and testify to life.
Demanding what we cannot give is a cruel relationship with ourselves. It is cruel that we must have insight to pursue health treatment for the brain whose variety of illness destroys our capacity to see into ourselves.
It’s one thing for us to choose not to do what we see is to be done. We all choose not to take care of ourselves by degrees. We all make choices against information and sight;
Smoking, exercise, sugar intake, sleep hygiene, working more hours, avoiding interpersonal connections, soda, driving fast, jay-walking, hand-washing, self-medication, self-injury, brushing hair from the top down, splashing our soup, flossing, nose-picking and eating with our mouth open.
Insight is there and we choose not to.
Even so, it is arrogant to presume insight into our own human condition and the more I know, the more I agree with the humility of any great teacher – there is so much out there that we don’t see into. However this is critically different from the inability to see into and that is the cruel irony of requiring a decision that our brain is unable to be informed about.
There are a number of these. I’m wondering if you can tell us about your own story of what healing has done for your ability to “see?” It’s a service to many to know that fighting for brain health is at the core of being a friend to yourself.
Self-Care Tip – Fight for brain health – it is at the core of being a friend to yourself.