Choices

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Intent and Context Matter

 

A Beautiful Mind by Sylvia Nasar

Image via Wikipedia

 

Self-care is selfless, but doing things for yourself is not always self-care.

A reader commented, “I believe that if I’m NOT taking care of myself and feeling joy, then that IS self-centered….”  Too eloquent.  Love it.

Some of our confusion comes from the changing scenarios of self care.  The intent sometimes gets blurry.  The intent is hard to tease apart.  Sometimes what feels like taking care of ourselves is in fact, selfish.  For example, let’s say “hypothetically,” my husband, who is a palliative care specialist, chooses to work on twitter #hpm, play chess, or play guitar.  This is potentially positive and friendly to the self.  However, it depends on intent.  Sometimes we don’t know our own intent though.

There is also the context of what is happening.  Let’s say we were all fighting, and then my husband goes off to read Oscar Wilde.   Is this self-care or a way of abandoning and taking himself out of the present?  Self-care puts us into the present.  Whereas selfishness takes us out.

In another context, taking yourself out of the present is necessary to ultimately put yourself back in.  Doing this requires thought processes that can abstract and empathize (connect emotional content).

I rely a lot on intent! (Ahem!)

There is a mind disease called schizophrenia.  This disease is famous for hallucinations, hearing voices that other people don’t hear, seeing things that other people don’t see.  However the core symptom of schizophrenia is less famous.  It is the thought form, concrete and disconnected.

Concrete thinking is named well, unlike many other medical conditions.  (Think diabetes!  Who would know what that has anything to do with!?)  But concrete thinking is plain, hard, and flat like my sidewalk.  For example, if I asked what does the parable mean, “A bird in the hand is worth more than two in the bush?”

  1. Concrete thinkers might say, “Birds make a mess so we don’t want a lot of them.”
  2. Further, if their thoughts are also not connected, they might say, “Birds migrate in the winter and the bush is wet.”
  3. Contrast this to connected thought that abstracts, being able to answer, “If I have an opportunity to take something good, it’s better to take it than gamble for what I might not be able to keep in the end.”

Different emotional illnesses have trouble abstracting, but fewer have disconnected thoughts like schizophrenia.

If you are in a relationship with someone who has trouble abstracting (traumatic brain injury) and/or connecting emotional content (ADHD for example,) you might misinterpret his or her behaviors as selfish.  Being able to empathize after all is part of most Disney fairy-tail romances.  What more do any of us want?  Right?

Wrong.  The capacity to empathize doesn’t matter much if the intent is missing.

Wrong.  The ability to abstract doesn’t connect if the intent to connect us is not there.  The knowledge does not matter.  It is the context.

In the film, A Beautiful Mind, Russel Crowe plays a character that suffers from schizophrenia.  The woman who loves him, struggles to understand the way he loves her back.  His disease steals his attention.  His disease takes his time.  He seems selfish.  Their love survives when she discovers his intent in context.  He stays present in the relationship, despite all his limited capacity to relate.  Further, agreeing to the treatments of his generation, limited that they are, he is doing selfless self-care.

At the end of the day, I’m a grateful piece of dirt who means well.  Saying that up front immediately lets you get very familiar with me.  (I could have said “grateful piece of sh–,” but that would have been selfish.  The s-bomb is just playing with the word to have fun!)  Part of why I believe in God is because I know He goes for the losers.  He goes for the piece of craps out there.  That’s what the beatitudes are about.  He pours it on. (Intent and context, baby!)  At the end of the day, we are neither angel nor beast.  We are just human to Him.

Self-Care Tip #78 – Keep self-care selfless.  Be a friend to yourself. 😉

Question:  What do you think?  Please tell me your thoughts.  Please tell me your story.

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Choose, Gladly, Using Resources

Being a friend to yourself includes choosing, being glad that you can, and using resources to make your choice a good one.

Mrs. Smith told me with a barely noticeable arch in her back that she was still planning on God healing her daughter.  I don’t know if Mrs. Smith thought about how her daughter felt about that.  Was Kristy personalizing her illness?  Did she think God rejected her?  The problem of her continued illness must show something more than a physical flaw in her perhaps.

Will we know it when we are healed?  Until then, what to do?

Years ago, I met Fran.  She was pulling her hair out.  Her annoyed husband disrespected her for it.  Fran kept willing herself to stop.  She said,

I’m doing it less now I think.

The good news for Fran is that she responded well to fluoxetine.  Her anxiety decreased and she almost stopped pulling out her hair.  She’d wear her growing bristles pressed down with bobby-pins and hide it with her long hair.  As her hair grew longer, she had fewer bobby-pins and I knew she was taking her medication.  There were other problems between Fran and her medications.  Taking medication shamed her.  And, she blamed her fluoxetine for her weight gain and rash on her face.  She felt uglier than ever in her husband’s eyes.

I don’t pull hair any more.

Fran stopped her fluoxetine and half her head went bald.  She did not lose weight and she still had a rash on her face.  Fran went back on her fluoxetine and she has cycled on and off of it this way over the years we’ve worked together.  Somehow despite all our time together, Fran does not believe me when I tell her that when she is better symptomatically, she is not healed.  Fran does not grasp that her behaviors come from something at a genetic level.  We can treat her, influencing the way her genes express themselves, but in her case, not cure her.

We are a team.  She and I, and sometimes her husband, and sometimes her sister.  I give her medications when she thinks she needs it.  I don’t leave her when she doesn’t.  Either way, we keep trying.  It is very hard for Fran to know that she has not been healed.

I don’t have many clear examples of treatment-to-cure in psychiatry.  The statistics vary between diseases as to their rates of recurrence.  The brain being human, we can yell at the serpent for our insanity.  However, in the end, here we are.  As Billy Joel says in his great ’70’s hit song “My Life”

Either way it’s okay to wake up with yourself.

The opportunity to choose our own answers, to decide what to do about it, and believing if we are sick or not sick  – is all our own.  These can be hard decisions but until we lose capacity to choose, we own them.  Decision making capacity of course is a medical decision.  But competency is a legal decision made in a court of law.  Having the right to choose is a beautiful privilege.  This does not mean to ignore counsel, evidence, data.  On the contrary.  That would not be a friendly thing to do to yourself.

Self Care Tip # 75 – Choose well and be glad you can.  Be a friend to yourself.

Question:  What do you think?  Agree or disagree.

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Believe What You Say! It Might Make a Difference.

If you want to get passionate about something, You have to believe it.  Many people speak it, read it, plan on it, but they don’t believe it.  Do you?  Do you believe that you can actually start doing what you want to do, feeling what you want to feel, become who you want to be?

And how bout the opposite?  Too many of us quietly or loudly hold our negative patterns.  A Heathcliff with Catherine scenario in Bronte‘s Wuthering Heights – slowly bringing on our own demise.  Reminds me of the mistletoe, a parasite on it’s host but accepted and beloved nonetheless.

MIT neuroscientist Sebastian Seung gave a wonderful TED conference, “I am my connectome.”  He tells us the good news that we are more than our genes. Our memories are not “stored” in our genes.  They live amongst the neuronal connections.  He empowers us saying that because we can change our neuronal connections, we can change our behaviors and habits – which are based on neuronal memory (indian trails.)  You see, because our habits are really memories ground into the fiber of our minds, and not into the constitution of our matter, we can make different ones.

Wow!

We may not have pixie dust or elf stones, but we do have power.  We can stop, drop and roll! to that destruction in our lives.  We can be friendly with ourselves at any level of our beings – neuronal to behavioral and emotional.  Mr. Seung, that is great news!

Self Care Tip #70 – If you are going to do it, have courage and believe it!  Be a friend to yourself.

Question:  What do you think?  Please tell me your story.

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Down With Guilt!

Down with guilt, I say!  Let that mighty tree be felled and burnt and each season that brings up new creepers into life again – let them be taken down!  Guilt!  How many times it has weakened us.  A sickness, that ebbs the energy and confuses the mind.  Often unrelated to deed or intent, in comes the uninvited guest.  As in Mansfield Park, guilt is our own Henry Crawford courting Fanny Price.  He may dress well – in church attire, in a business suit, or in a child who thinks she should spend more time with grandma.

Like lucifer’s apple, guilt brings knowledge that can’t be trusted.  Swallow it and you’ll be looking for fig leaves.  See if any good will come of guilt.  I dare you.  See when you plant it, what will grow.  See when you hide it, how you are tethered.  Let it educate you and notice that you grow smaller.

Today a friend asked me how things were.  I remembered yesterdays.  Wonderful with sunny emotions.  A collection of connected moments.  I wanted to say something about them.  I was looking in at a shop window.  Chocolates on the shelves behind the glass.  But remembering today, I was denied.

I yelled from my darkened face.  And then I yelled again.  That was the morning.  Then the kids went to school and I went to work.  What a way to walk.  I thought of this and out popped:

I yelled at the kids which I hated, but I don’t hate myself.

It even surprised me.  Saying that to my friend, let me realize that today wasn’t an all-or-none parenting moment.  Many earlier days that began much the same weren’t so forgiving.  And because I didn’t forgive myself so easy, I didn’t forgive others so easy.  The anger chases it’s ratty tail, you know until Guilt tires him out.

Because I didn’t spend the day guilty, the afternoon and evening had a chance.  Down with guilt!  Up with new chances!  Hooray!

Self Care Tip #68 – Take the new chance!  Be a friend to yourself.

Question:  How have new chances redeemed you?  Please tell me your story.

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Our Changing Reality

She had been gone for 3 months helping her mother transition from life to death.  However, instead of it being a melancholic experience, she felt better than she had since a time she couldn’t calendar.  Back when she had a respect for herself.  Back when she had youth, she had hope, she believed in a generous future.

I had no way of knowing what it was like for me until I left the situation.

Reality is only as real as our perspective.  She came back to a new perspective and her reality changed.  She saw an impoverished life.  She saw need to stop waiting for the better of future’s promises.  She saw disrespect when caring for her disabled daughter and emotionally abusive husband.  She hated disrespecting herself.  She felt this and she rebelled inside.  Holding back her furry with the flimsy lid of guilt-glue.  She cried.  She had just let her mother go and feeling good about letting her daughter and husband go now embarrassed and shamed her.  But there it was.  The thought she hadn’t thought before.  Reality had changed.

I’m told that it is bad for a counsellor to tell someone specifically what to do.  Turns out that my job includes some counseling.  I ran into a former patient today at a coffee shop.  She saw me typing on my computer and learned about this blog.

But you do meds!

Apparently sometimes I’m not that great of a counselor.  Or maybe I am if she didn’t realize I was, with her, all along.

I had to stop and say hello!  I’ve missed you!

(Whew!)

Today, I kept thinking about the way reality changes when we let our perspective get some air.

This daughter/mother/wife will never be the same woman she was before she left for 3 months.  She didn’t know.  And now she did.  She can’t stuff that knowledge.  She can’t disappear it.  She is left with a knowledge.  Is it better?  I think so.

We played with options as we talked.  A window opened in the room and a breeze came through called hope.  That was lovely to share with her and I am grateful.

Maybe when with determined labor we are trudging on in life, we might think of this.  With this memory, we could more willingly accept the urge to walk away just to see for a time.  Maybe a knowing, that we were missing, will come and change us.

Self Care Tip #67 – We might be in a different reality if we walk away.  Be a friend to yourself.

Question:  What has your own experience been?  Please tell me your story.

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What’s Happening in Your Space?

Almost finished a triathlon today.  If it wasn’t for that chafing because I forgot my biking shorts, I think I would have.  I was wearing surfer shorts.  I will never poke at people who whine about chafing.  They’re right!  It hurts!  Enough for me to cut my run in half twice.  And I walked.   People I saw afterward kept saying “At least you finished!”  I felt like I had to confess but then I’d want to explain so I left it all out which I know in itself is a little lie if there is any such thing as a little lie, so I’m atoning by confessing to you.  There.  (Breath.)

The truth is, even though I cut across lawn, and walked the cross walk, and broke all sorts of athlete-codes of honor, I had such a wonderful time.  With all my abbreviating, I caught up with my brother, Vance Johnson, and his 10% body fat.  He’s always been sensitive, so he kindly slowed to walk me down the last stretch.  We don’t get to spend enough time together and even a few moments like that are golden!  We were laughing and strolling and probably looking too pleased to be appropriate for the last 40 yards of a long race.  So, of course it took us both a few extra seconds to realize what the woman had yelled as her large frame thundered by.  “If you aren’t going to race, get off the road!”  It was extra shocking because it was like a parallel universe suddenly collided ours.  We were happy.  I with my swollen inner thigh, and Vance with his little sister as audience.  It was over-cast, perfect weather for the day.  The beach was a few yards to our right.  Everything else was San Diego green.  Then, Pow!  “Get off the road!”

At first, I was ticked.  “Listen …,” I said in my mind.  Not nice.  But then I saw my brother.  How could I be angry?

There were many scenarios of this woman’s life that a carousel flashed on the screen in my mind.  Maybe none of them were true. Maybe she was simply an avid committed athlete who found us people soiling her turf.  Whatever the situation was, she was finishing the race and looked like she’d done well for her potential.  She hadn’t cut lawn and street.  She wasn’t walking.  She was running or galloping or something.  But she wasn’t happy about any of it.  Looking back, she might see us as the reason her mood soured.  Regardless the reason or the date and time of onset, she was sour.

It was only a few moments really that my thoughts stayed on her.  Vance had moved on to another subject and I didn’t want to miss it.  Reflecting now though, of course I’m struck by the perspective of success and failure.  A race is a perfect stage for demonstrating something with a beginning, middle and ending.  Sounds like a shortened version of life.

I’m not sure who first said that there is only one beginning and one ending to life.  “It’s the journey that matters.”  Probably God.  Someone who is timeless and infinite would get that.  Today He blessed us with that.  I can’t count on myself to have it the next time.  God knows I’ve been the one screaming something like, “Get off the road!” enough times before.  But next time, I hope I remember what God gave Vance and me today.  I hope I will succeed as happily as I did today when I lost the race.

Self Care Tip #65 – Get into the in-between spaces in your life and go for the joy!  Be a friend to yourself.

Question:  What have you been finding in your own space?  What do you think?

If you’d like to read more blog posts on the journey, read here.

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There is Room In Our Wanting Selves

Having another child born, our hearts somehow open up and make more love, more space where things once seemed crowed up like hobos in a boxcar.  Our time and energy does that too.  Feeling like you can’t do another thing by 6 PM?  Feeling like watching TV on the couch is an accomplishment at that point?  I’m telling you that this changes.  Do what you want.  You may not realize it yet but you want something special.  You want something that you were designed to do.   When you discover what that is, activity becomes joyful, congruent with your inner self.  Somehow there is more room in your day.  More energy that comes with no strings attached.

My husband just came home from a tech conference.  He was told by famous Silicon Valley junkies, while sitting in an audience of other wannabe’s, “Don’t do a startup.  You’ll fail.”  It was a secondary message that returned intermittently – unless you can’t sleep at night because you need to solve a problem – if you are trying to do a startup company for any other reason than for your own sanity, you won’t make it.  These people were doing what they were doing because they felt like it was their life’s nectar.  It was their pearl of great price.  Their efforts were fueled by their own genetic design.

In medical school, I used to look around me confused by the obvious natural positive responses of other students.  I looked at myself and thought I was a fake.

I looked at them and thought, “There’s the real thing.  I wonder what it feels to be the real thing.”  I know.  Sad huh?  Ah well.  Turns out I’m a flaming extrovert.  I get energy from being with people.  Being alone takes energy from me.  Wether it happens slowly or quickly, either way eventually I have to resurface and connect with someone to re-tank.  Every day when I sat down to study, I felt alone, energy sucked out of me, the ground was going to swallow me up.  And I did it still.  Ground through my long hours long enough to make it to where I belonged.  With you in psychiatry :).

Here’s the news.  We are all “The real thing!”  Yah!  We have our own greatness.

I’m not talking about opportunity to reach that greatness.  Some of that we are given and some of that we make.  I’m just ringing our bells with the idea.  If you want to read more about this, read the blog posts on temperaments.

Question:  Are you doing what you want?  Please tell me your story.

Self Care Tip #64 – There is room in your wanting self for more.  Be a friend to yourself.

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Get Treatment to Move On – Addictions

Molested by his cousin, neglected by his parents, he watched his intoxicated father beat his mother.  Thinking she would die too many times, he ran away, returned in a police car over and over again, as if wanting to get away was a crime.  He came back and raped his neighbor, more than once.  He spent a lot of time trying to get sex even though he knew it was ruining him and others.  He lost interest in almost everything else.  He suffered uncontrollable impulses.

He was 18 years old when he left it all for the safety of prison.  During the next fifteen-some years he was diagnosed, treated, and kept.  But kept for what?  For eating.  He gained weight, until he needed 2 seats to sit in.  Eating became his preoccupation.  He didn’t have sex.  He had food.

He was released to a home for sexual offenders, put on a diet and lost weight.  He lost it big and fast and felt in control.  He started purging and not finishing his meals.  He thought about purging all the time.  He knew he shouldn’t do it.  His voice was changing, raspy and his throat hurt but he still purged.  He wasn’t having sex.  He wasn’t over-eating.  He was purging.

For whatever reason, no one had yet seen the pattern.  Mostly everyone saw sex offender.  Me included.  I was trying.  I was trying to treat him with empathy, trying to get past the bile that comes when I think of rape, trying to consider the courageous things this man was doing now in life.

In one of my favorite scenes from the film, Rachel Getting Married, Kim played by Anne Hathaway argues with her sister about her own chances to have a future:

Rachel: Kym, you took Ethan for granted. Okay? You were high for his life. You were not present. Okay? You were high.
Kym: [Whispering] Yes.
Rachel: And you drove him off a bridge… and now he’s dead….
Kym: Yes, I was. Yes, I was stoned out of my mind. Who do I have to be now? I mean, I could be Mother Teresa and it wouldn’t make a difference, what I did. Did I sacrifice every bit of… love I’m allowed for this life because I killed our little brother?

I thought of this and somehow through all that trying, I did. And because I could empathize, a space opened up for me to be more objective.  That’s when I saw it.  I saw the pattern.

Addictions migrate.  Someone who may have started out as a food addict, might turn to gambling, and then later to alcohol.  Someone with sex addiction, might turn to food and then later to purging.

It can be like that game I used to play at Chucky Cheese, trying to hammer down the little animals that pop out of holes.  We need to treat the disease of Addiction regardless of how it’s dressed, or else it will keep popping up.  And like Kym, if we do, although perhaps terribly wrong in some unchangeable ways, we will still have a future.  If you’d like to read more about this “kainos” (Greek word for the opportunity to be made new,) read the post New versus New.

Self Care Tip #62 – Get treatment to move on.  Be a friend to yourself.

Question:  What do you think?  Please tell me your story.

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Claim Your Brain

My mind, like rusted gears, was not moving well.  It hadn’t been really since my 1st pregnancy 8 years ago.  There are few things that dumb us down as much as pregnancy and children!   Hormone changes, lack of sleep, fluctuating from 145-200-145 pounds three times, and then the subsequent growing beloveds around me to contribute to mental dissociation.  Simple sensory overload from talking, yelling, crying, petitioning, inquiring kids factors in.  You may read more about sensory issues here.

Daily writing, like a staunch governess, found my brain under cobwebs, bug carcasses, and musty stench.  (Hello old friend!  There you are!)  This helps to explain the joy gripping my hand, like girlfriends on the playground, when I sit down to write!  The world is active to me, including rather than excluding me. My in-between moments used to hang like an old woman’s breasts.   Now much more time full of nourishing thoughts bless me.  I am in awe.

My patient came in sighing deeply.  He wasn’t better.  No, he said.  He lacked motivation and interest and connection from the world.  He felt selected out to suffer.  A dumping ground for misfortune and misunderstood.  Efforts through medication, after medication changes were like looking for love in all the wrong places.

We talked about cognitive distortions, tapping into things that used to make him happy, road-blocks in poorly designed neurological grooves – volunteering at the library or animal shelter, journaling, sharing his life story with others, exploring his spirituality.  No.  No good.  Nor could he consider psychotherapy as he’d been through too much of it already to consider it again.  And he just couldn’t get interested in groups such as through NAMI.

His brain, assaulted by stressors, disease, and disuse was growing silent.

Being a friend means yelling, fighting to reclaim your journey, finding something to connect you to your process of life.  My patient was letting squatters take his property simply by being absent.

Self Care Tip #60 – Claim your right to health.  Be a friend to yourself.

Question:  What has helped you connect with your own journey in life?  What do you think?  Please tell me your story.

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Keep it In The Relationship

She is a level-headed woman generally.  Objective by nature.  But now she asks, “What should I think?”  No longer taking birth control because she says she doesn’t need it.  They aren’t having sex.  Her husband uses porn and now openly gawks at other women walking by.  She says she doesn’t really care.

When a couple stops touching, the relationship is virtually over.  Few people revive their intimacy after too much time without sex.  Not everyone will believe this and may think it is too primitive for a true relationship of love.  But that’s the stats folks.  What to do if you physically can’t have intercourse?  Figure it out.  Must touch for intimacy.  Sounds like a bumper sticker.

Reminds me of a mighty river that suffers interference of dams and rerouting waterways.  Eventually a dry riverbed that once roiled with current and depth is left baking in the sun.  Even Paul the Apostle who never married recognized that if you aren’t physically intimate with your spouse, your nonphysical connection is also lost.

Physical intimacy is of course only one paradigm of intimacy.  And just about any one can say that, “Sex doth not a love make.”  Nor am I talking about finances, floss left in the shower, or how someone squeezes the bottle of toothpaste.  But whatever the many reasons are explaining the space on the couch, it ain’t good.  

So what did I tell her?  I certainly didn’t tell her “What she should think.”  I did review that we can’t trust our feelings.  “That’s true” she said.  “I hadn’t thought of that.”  Feelings lie all the time.

Question:  What do you think?  Agree or disagree.

Self Care Tip #59 – Keep it in the relationship.  Be a friend to yourself.

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Take What is Yours

It doesn’t have to be that complicated.  “I only go two places.  The tattoo parlor to hang out with my buddies or the beach.”  He says he doesn’t have a cell phone or a computer.  I see him every week with his wife, doing what he can to support her as she teaches a class for my 3-year-old. He smiles and chortles and pokes with satire.  He has shown me his skin art several times and it is easy to see what these represent.  The people he loves and who love him.

In the film written and directed by Derrick Borte, “The Joneses,” we watch a pseudo-family move into a gorgeous home with intent to market their wares to the unsuspecting towns-folk.  As they are instruments in sales, they become infected with purchasing-power-fever.  As their own fantasies grow of being the perfect family unit, so does the definition of what it takes to be one.  Being happy individually as well as relationally equals easy access to riches and easy life.  The glitch is that they are not a family nor does the new this or that belong to any of them.  Like making a deal with Ursula the purple octopus-witch, they are ensnared.  It becomes a hard choice to regain the rights to their lives.  In the end, they barely escape with the understanding of what they can really claim as their own – love.

The other day when our dog was dyeing, at bedtime I was able to debrief with our daughter about her feelings.  “I know you love me Mommy but it felt like you loved Maggie more than me.  Even though I knew you loved me more, I didn’t feel it Mommy.”  For someone who can barely see around her Ego, that’s pretty amazing!  From her beautiful child-self, she told us that love is there even when we don’t feel it.

My husband was telling me his “Good News,” quite different from  rights of passage like a fraternity.  It is that God is already right here with each of us and unrelated to our performance.  We all have Love, regardless of lost opportunities, low-character, higher learning, or technology.

It’s not that complicated.

Self Care Tip #51 –  Take what is yours.  Be a friend to yourself.

Question:  Agree or disagree?  What do you think?  Please tell me your story.

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New Verses New

She died this morning.  After a day and a night of confusion, stumbling gate, and suffering, our gentle gorgeous Maggie died.  She is returning to carbon ash and giving us another reminder of what can be delivered to the living by death.

With the children taken to school, my husband came home to share grief with me.  He had just listened to a podcast by Rob Bell about the word “new.”  In Greek there are 2 common words used for “new.”  One connects newness to Time.  As in the young in age and old in age.  This is traditionally how our culture interprets “new.”  Another use of “new” uses the concept of renew without connecting it to time.  There is a newness in you as you are in time.  It’s a great overlap into the concept of presence.  But where my big gratitude went out to was knowing how many opportunities to being made new we have.

Some of us have the propensity to wait until we “hit bottom”  before we come looking to be made new.  I don’t mean this in any way that is judgmental.  Please see my blog posts on temperament if you want to read more about this.  If we were fortunate enough not to have picked up any self sabotaging habits, then in some ways we’ve got an easier time of it as the the years roll by.  However, few of us are, and getting crushed over and over again like recycling cans hurts a lot – us and ours.

“You can’t have it all” we are told, brewing panic after wasted opportunities.  Not having it all, missing out on more days to share with Maggie, loosing the hope of puppies some day, brought the well-timed discussion about newness straight to our grief.

We are given the opportunity to be made new any time any where regardless.  Any where from greatness to low-living, we have that choice.  When I think of Maggie, I will think of this and hopefully I will choose to be made “new” again.

A “new” heart also will I give you, and a “new” spirit will I put within you: and I will take away the stony heart out of your flesh, and I will give you an heart of flesh.

Self Care Tip #50 – Be renewed.  Be a friend to yourself.

Question:  Do you agree?  Disagree?  Please tell me your story.

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Your flawed self

My niece is sitting beside me and I can barely keep my hands off of her 5 month self.  I am eating a blueberry scone slowly.  She, with her tummy-full of breast milk, is watching every bite, a faint smile on her pink face.  I’m a little afraid she’s learning to eat carbohydrates from me and I want to tell her that I can’t remember the last time I ate one of these.  I start eating faster and turn away so I don’t imprint this on her supple myelinating neurons.

We closet eat, closet smoke, closet shop, closet sex, closet what we want to protect others from but what we independently are strong enough to handle …or not.  There is a term called “self-sabotaging behavior.”  Reducing this, we find that the process of closeting is in fact the handle on the door to that mal-behavior.  Keeping it real is the same as saying get it out of the closet.

My mentor and brother, Cameron Johnson used to say, “Go where the pain or fear is and it will lose control over you.”  People who work the 12-Steps call this “Rigorous Honesty.”  It is a pealing away of all pretense with yourself.

Avoiding rigorous honesty turns into self-sabotage.  We end up cutting ourselves down at the knees.  Anxiety uses fear to make us hide.  In cases that include emotional illness, of course medication will help our work toward honesty.

It is not about whether we hide our bad sides or not – we do.  It is about trying to keep it real.  The only thing to be ashamed about, if we must, is not trying.

So to my niece, I give her my flawed self and when the time(s) come, I will accept hers as well.

Self Care Tip #45 – Show the world your flawed self.  Be a friend to yourself.

Question:  How have you experienced the freedom that comes from going toward the fear?  Please tell us your story.

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Get in Someone’s Space

The woman writes, but only for herself, she says.  “Why?”  I can’t remember her answer.  My thoughts stayed on the question, wondering why we don’t connect with our community.

Dropping off my children at school this morning, I noticed the pubescent girl with blunted face, guarded eyes, crossed arms, standing alone even surrounded by other kids.  Ouch!  I wanted to hover over her.  Guard her from what ever it is that’s scaring her.  Touch her arms and hair and make her understand that she is important to the universe on a small-scale and large-scale.  Of course I might have been arrested if I did, so I just walked on to safety.

Jeff Wise, author of Extreme Fear: The Science of Your Mind in Danger, writes

A feeling of connection to others is nature’s Xanax.

Some of my families with disabled children struggle hard to take care of their own.  They often wait until at cliffs edge emotionally, financially, physically to consider placement for their disabled child.  When helping them get past their barriers to placement, we find guilt, fear and shame in the way.  These children often do better physically and emotionally when they are in group homes and away from the emotional burdens in their nuclear family homes.  We need community and community needs us.  Each of us.  Joana Johnson, neuroscientist, says that placement, is in fact a way families can connect with their community and with their child.

Some skeptic personalities struggle to trust the links between us, not out of paranoia, but rather because it is the hard-wiring in their nature

to question things. There is also the introvert, who is often alone not because they don’t like people, but because that is how they get energy.  However, regardless of genetic predispositions, we are all designed to have community.

Mary Shelley tells us through her Frankenstein, that we are better people in the company of others.  We see forces that keep us from sharing ourselves.  But let us not believe those forces.  Break past.  Let us believe our own better Creator who tells us, connect.  Tell our stories.  Stick a finger out and get in someone’s space.  Do what we must to let them into ours.

Self Care Tip #42 – Share yourself and get community.  Be a friend to yourself.

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Something Decadently Enticing

Oh rotten orange!  I found one stinking up my pantry.  Little fruit flies netting the air above.  Green fur staining my basket below.  The fruit touching it changing colors for no reason other than proximity.

Stay healthy.  Staying healthy is one of the best things we can do for ourselves and for those we “share space” with, those we love.  It is a gift any way you look at it.

Exercise helps, including with emotional health.  Yet, how many of us do?  About 30%.  Some of us use negative self talk to get ourselves out there.  “I’m fat.”  “I’m going to have a heart attack if I don’t.”  “I won’t qualify for that insurance if I don’t.”  All of which may be true.  However, does it work for us?  Apparently 1/3 of the time.

We use the negative feedback to motivate ourselves.  But just as in children, we know it doesn’t work.

If a child lives with approval, he learns to live with himself

-Dorothy Law Nolte

Positive reinforcement is helpful in any context.  Who knows!  Maybe that rotten orange would have tried harder to stay fresh with emotional perks?!

Each of us needs to find our own positive feedback that works.  Our interests are different so it’s not universal.  However, we can be our own behavioral therapist in this.

I have found for myself that I never exercised consistently until I turned exercise into something decadently enticing.  I load up 3 large glasses of water and take them to my bike.   My bike is in an alone place.  In front of my stationary bike is our only television.  There I watch whatever I want!  I don’t allow myself to watch TV at any other time.  It is special.  Reserved for my exercise.  I can’t wait to get back to my show or movie almost every morning!

When I want to hit the streets with a walk or a jog, I listen to audio books that I only listen to when I’m exercising.

I have to set aside some persuasive treats that are now linked in my mind to exercising.  Now when I think of exercising, I am nothing but happy about it.  It is behavioral modification at it’s best.  Hopefully this is helping me and those I touch in life.

Self Care Tip #42 – Turn exercise into something decadently enticing!  Be a friend to yourself.

Question:  What positive reinforcement works for you?

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In The Days of Our Youth

We have many chances to start and restart taking care of ourselves.  Lots.

When things get so bad though, sometimes we have to stop everything and declutter our lives to make room for self-care.  It might be dramatic.  It might represent many missed opportunities of self-care that accumulated into a heap of messy angry resentment.  However, we can hope that those times in life are few. The majority of our moments and days we hope are not extreme renovations.

It reminds me of the verse from Ecclesiastes 12:1

Remember now your Creator in the days of your youth, while the evil days come not, nor the years draw near, when you shall say, I have no pleasure in them.”

Even our relationship with God is developed by the little choices along the way.   In personal relationships with God or with man, they hold beauty, they bring pleasure because we did what was right for ourselves “in the days of our youth.”   Because we did, we don’t have much to resent them for.  We are available emotionally to connect with our “Other.”  We can see them. We can be present.

And when the stressors hit, the “evil days,” as they do come inevitably to every relationship, we can say that we remember the good times.  There is bank there to get us through the bad.

As said to me today by the Australian Labradoodles breeder, Tiffany Aveling, taking care of ourselves along the way avoids “death-bed conversions.” Those big swings.  Those, “I’m changing everything about my life,” type of changes. They might be necessary.  However, they usually hurt a lot.

In the film, Avatar, directed by James Cameron, we hear over and over the lovely quote,

I see you.

That is a gift we can give better when we can give the gift of a healthy self.

Self Care Tip #41 – Take the little chances.  Be a friend to yourself.

Question:  What did you think?  Do you see this in action in your life?

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Get to Know Yourself to Be A Friend to Yourself.

On the Threshold of Eternity

Image via Wikipedia

Let us put our efforts toward becoming who we can become, who we were wired to be, who we want to be, what gives us pleasure.

We can get beaten up by wanting.  Wanting to be someone who gets energy from being with people rather than from being alone.  Wanting to be someone who is a finisher rather than grazer.  Wanting to blend and lead and be chosen.

Some of this filters out as we age.  Aging fills our lives up with so many responsibilities that wanting to be anything more than someone who gets solid sleep hasn’t crossed our minds in a very long time.  Children get more of it right than us in this regard.  They have space to want more openly.  Our wanting muffles and cramps when we turn away from who we were genetically designed to be.

My patient came in depressed again.  Depression was familiar for him.  A psychiatrist works with a specific area of medicine.  So I get to see people after multiple medication trials before their primary physician refers them to me.  Well this patient hadn’t found lasting help from medications. He came to me with doubt.  I wish I could say we worked it out.  I can say that we are still trying.

What we are working on influences the way his genes express themselves.  We can’t change the genes but we can affect some of how and when they are activated.   We can do this by choices, such as medication therapy, sleep hygiene and exercise.  Choices are more effective when we know what and who we were wired to be.  What are our natural talents?  What are we interested in?  Feeling inner congruence when we are doing something points the way for this.

In Outliers, author Malcolm Gladwell says

“the biggest misconception about success is that we do it solely on our smarts, ambition, hustle and hard work.”

I don’t know if Mr. Gladwell recognized how closely his thoughts harmonized with Carl Jung‘s regarding temperaments.  Doing what is natural for us recruits our best through the path of least resistance – our interest, our attention, our creativity.  Rather than forced effort, drudgery and dragging feet, time looses some heaviness as we get caught up in inner and outer congruence.

Intuitively, we all surmise that when this happens, we have less stress inside and outside of us.  Ah.  What a relief.  This is what my patient is working on and when he is able to say he is doing what he wants to in life, he is less hopeless and panicked.

Self Care Tip #40 – Get to know yourself to be a friend to yourself.

Question:  What do you think?  Have you been using these tools?  Have they made a difference for you?

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Choose Your Prophesy

A woman today with a frank quick smile found out I wrote FriendtoYourself.com.  She swung open the door to her story.  People like her never bore me.  In brief, she was sad after many life losses.  Then when she made some changes in her life she got better.  “I didn’t know how bad I felt!”  (And who does?)  Now every day has activity she loves.  She gets tearful just telling me about all the gratitude that took her by surprise.

In psychiatry, the way she felt when she was sad is called an Adjustment Reaction.  An Adjustment Reaction doesn’t last long, it is in response to stress, and it goes away when the stressor is removed.

Stress is dangerous to us.  It can affect us for different amounts of time, like measuring cups.  During that time, it can affect us to different depths within ourselves, like a scuba diver exploring a coral reef.  If the sad time in this woman’s life went longer, and if she had gotten more sick, it might have become a Major Depressive Episode.  In that case, medication therapy would be appropriate.

Stress affects different intersecting paradigms that make us into who we are, like storm water over farmland.  It crosses over our biology, our genes, what is done to us in life, what we do to ourselves, what is put in our bodies, and how we cope.

Stress can pass over us like a Jewish holiday or it can stay, working, changing, reshaping, adding and taking away bits, always active and busy.  Ants in the walls of our house.  Most often we don’t know what it is doing, for how long, or where it is at work in us.  Stress mutates our cells, turns sleeping genes into loud cancer, depression, anxiety, heart attacks, dementia, old and wasted faces.

But what to do?  Do we avoid stress?  Do we end it?  Do we cure it?  All of that, of course.  My dad told me, “Everyone has problems.  The difference between you and somebody else, is what you do with your problems.”  Not the number of them.

No.  This woman’s story didn’t bore me at all.  The opposite does.

In the film directed by Adam Shankman, “Bedtime Stories,” the character played by Adam Sandler thinks choices have little effect on inevitable negative outcomes. “Life has no happy endings.”  He lives consistent with that belief, until love finds him.  A happy life story can be chosen.  His fantasies are freed to cross the boundary from imagination into the material world where love was waiting, in the shape of family and strangers.  Love showed him that his life had been a self-fulfilling prophecy.  He hadn’t even realized how unhappy he was.  (And who does?)

Self Care Tip #38 – Choose to go towards your fantasies.  Be a friend to yourself.

Question:  What do you think?  What is your story?

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Yell and Someone Will Hear

Today a reader responded to the blog posted on August 30, 2010, “Own It.  Our Life’s Work.”

Al-Anon, a great program. I really feel blessed to have found a 12 step program that is so gentle yet so encouraging with wonderful results for me personally.  It has taught me how to quiet my mind, live in the moment, live and let live, and let go and let God.  All principles I apply daily and the pleasure I get from living this way has enhanced all aspects of my life.  This program is not only for the loved ones of alcoholics but for anyone who has a family member suffering from addiction or if you were raised in a home with perfectionistic standards.  These standards stunt emotional growth and the results emotionally are no different than growing up in a home with addiction.  From the outside the perfectionistic home may look functional whereas the alcoholics home looks chaotic, but the emotional impact is the same.  Growing up this way may result in other acceptable addictions like workaholic, churchaholic, perfectionism, eating disorders etc… …It got me thinking about how thankful I am for Al-Anon.

She said it well.  First hand this woman of courage tells us bits of her story.  She demystified some of the suspicions about a group like Al-Anon.  She invites all of us, by her testimony, to also have courage.  To also share.  To also work on our own battered selves.  She unclosets getting treatment.  She tells us we need each other.  Al-Anon is a group meeting.  There is healing.  Healing is not a condition of stalemate.  She tells us about healing and progress.  We can choose.

In the Wizard of Oz

Tin Woodsman: Help! Help!
Scarecrow: It’s no use screaming at a time like this. Nobody will hear you. Help! Help!

Self Care Tip #37 – Yell and someone will hear you!  Be a friend to yourself.

Question: What do you think?  Please tell me your story.


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An Honorable Goal

“I feel things I had no capacity to feel before!  I can’t believe how much better life is for me.”  She was 2 months into medication therapy and she felt like she was back to whom she wanted to be.  Who she thought she really was.

Before medications, she was “making it.”  Although she was irritable, easily activated by simple triggers, edgy, she was mostly not acting on it. Making it to the end of the day every day was a victory.  Now she realized that if someone told her the difference before treatment began, she would have never believed them.  She hadn’t perceived how rough things were for her.  Now that she knew, she felt joy and sadness.

Getting well is never all good.  There is the daily reminder that you need help.  Every time you take a pill, you have to argue down all the reasons not to.  Sometimes that argument doesn’t last long.  Sometimes you spend more time than any one looking at you would guess.

The justifications for medication don’t only come from ourselves.  We have others “in the know” saying how much better we are.  Or what ever their opinion is.

Some of us are entirely on our own.  Hiding our pills so we don’t have to hear it.  When something goes wrong, the pills are to blame.  It reminds me of menarche and listening to the boys saying empathic things like, “She must be on the rag!” Things said about us when we behave or feel in a way others don’t think we should, can be just as humiliating.

Is there anything that draws more public opinion than behavior?  Being your own advocate may be easier said than done.  However, difficult as it is, it has to be done.  It starts with “me.”  If I don’t fight for my own self, choose for my own self, …well, it results in so many things.

What is surprising is how things look so different once we do take action.  Sticks and stones make more sense.  We have the confidence that inevitably comes when we gave our best towards an honorable worthy goal – a healthy self.

Self Care Tip #33 – Accept help.  Be a friend to yourself.

Question: What do you think?  Agree or disagree?