Guilt

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Bringing it Inside

“I read a lot of self-help books, but look at all the difference it’s made in my life!”  Sarcasm noted.  My friend was coming out of a dark melancholy of several years and complained that bringing something from your head into your life is hard.  Another case of trying to keep it real.

People call what we do “word play.”  Mouth flappers.  Those of us whose actions can’t keep up with our mind-matters fend off judgement like OJ Simpson. We’re guilty alright but it’s not murder folks.  Let’s get into the empty seats to applaud the performance of Good Intentions.  Good intentions come in degrees. There’s the thought, the desire, and then the levels of action that happen before and until execution.  Not all life is like playing horseshoes.  There is “win” in process too.

But my friend’s real beef was with the expectation she had that those books and their words would marinate her.  Soak her until she smelled and tasted and essentially became something new and better.  She didn’t think they did.  How does someone somehow bring what is out there inside?

If you want more about some of the biological play on this, read this post.  Basically if you are trying to grow, you are most successful working with a growing-style that is congruent with your temperament.  There are other intersecting paradigms also, including spirituality, external stressors and biology.  Bringing it inside is a balance between paradigms in life.

If I were speaking to my friend though, I’d applaud her thoughts, desires and degrees of action that have constituted her journey of Good Intentions.  I’d invite her into the stands with me and take some time to watch a replay of the parts of her life that made her glad.  That in itself opens us up to what needs to come in.  And we are more able to keep on.

Self Care Tip # 55 – Applaud.  Be a friend to yourself.

Question:  Do you ever lose yourself in processing?  Tell me your story.

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Afraid of Meds

A colleague told me,

I want to get off my sleep meds because I don’t want to be dependent on anything.

Dependence.  Lazy, pass-the-buck, unimaginative, immoral, chemical abuser.  Maybe even doctor-shopper depending on who is speaking.  When someone says it, before we talk about medication use, biology, etc… we need to know what is behind that word.  Working with the tip of an iceberg of prejudice might sink us before navigating much treatment.  Even physicians after 25+ years of education and more of medical practice, find it hard to shed these cultural prejudices about psychotropics (medications used in psychiatry).  What does the word dependence mean to you?

To psychiatrists, substance dependence means that the body has become accustomed to something.  We don’t get as much physical or emotional boost we used to using a substance, such as to nicotine, alcohol, illicit drugs, or prescription medications.  We now need more to get the same effect we would have gotten before with less amount.  It includes physical and emotional cravings – like sweating, shaking and yearning.  A lot of time is spent to do whatever it takes to get it.  Can’t cut back.  Keep doing it even though spilling into personal and professional space.  Keep using even though aware body and mind are worse for it.

Was this a description of my “dependent” colleague?

How about abuse?  Substance abuse is when we do dangerous, mean, and/or irresponsible things when using.  Was he hitting his wife when he was under the influence of a sleep medication?  Was he taking sleep medications when he was at work because he liked how they made him feel?  Driving with them?  You get it.

This guy is no dummy.  Yet he felt guilt and shame about appropriately using a medication for a medical reason.

I was seeing a woman for the first time in my clinic.

“Doctor is this medication going to make me addicted?”

We spoke about her fears.  Turns out, she thought her medication would prejudice the world against her.  Change her personality.  Make her crave it if she ever wanted to stop.  Steal from her geriatric mother and eventually, who knows?  Panhandling?  Now how am I supposed to work with that?  How she ever got the courage to come and see me in the first place with all that on her back, must be pure grit.

So here’s the dirt.  Some medications have no dependency risks.  Some medications do.  Some people abuse any medication they can get their hands on.  There are rave parties where there is a kitty – a bowl full of whatever pills anyone in attendance donates to.  They take them out randomly and swallow to get whatever surprise awaits them.  Is one class of medication more often abused than another?  Yes.

As a prescribing physician, I have sworn to not intentionally do any harm.  As a patient, you contract with me to take your medications as prescribed and safely. We’re in this together.  We will talk about any recommendations and you will hear the risks and benefits to treatment.  You will decide.  There is no conspiracy to turn Americans into bad citizens through psychotropics.

Self Care Tip #52 – Find out where your fear is coming from.  Be a friend to yourself.

Question:  What are your fears about psychotropics?  Agree or disagree with this post?

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