Paradigms

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Toughing It Out! …Is Not What You Think.

Mental Health of our Military

Image by Truthout.org via Flickr

Self-Care Tip #114 – Tough it out.  Be a friend to yourself.

Trying to tough it out is good it’s just not what most people think.

Many people think that toughing it out means staying med-free and getting through melancholy, anxiety, emotional chaos with gritted teeth.  They gather a degree of commendation from weathering out the behavioral and emotional problems until they either feel better or don’t.

This is not the kind of toughing it out that I’m calling worthy of our life efforts.  It is in fact the opposite.  Toughing it out is doing what may be socially and culturally counterintuitive.  Getting medical care sooner than later.  Not waiting to see what will happen before getting medical care if it is indicated.  Believing the medical data, the physician you trust, the knowledge that mental illness is medical, biological and often PROGRESSIVE over time.

Waiting means you are getting more ill on a cell level and at higher risk for your future and waiting is not being tough.

Toughing it out is digging into your courage bank every day to take that pill when you feel ashamed of it.  Toughing it out is fighting for your brain’s future.  Toughing it out is sacrificing what ever you need to, to give your loved ones and yourself the healthiest you possible.  Even if that means talking yourself into it, going up against your fears, ignoring prejudice, ignoring opposing recommendations from your favorite sources.

picasaweb.google.com

This calls for thick skin.

Candace tells me she still intuitively can’t believe this, even though her mind tells her it is true.  She takes her medication but it still hurts a little every time.  Like she’s betraying herself.  Like she must grieve for herself.  Candace says the apparent calm, decrease in anxiety, improved relationship with her children, and the flowering hope eases her inner psychic pain.  Candace is drawing strength every day from the growing evidence of health.  Candace is tough.

Question:  What are you getting tough with in your life?  How do you do it?  Please tell me your story.

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Grieve to Be Present With Yourself

 

Maria Yakunchikova "Fear" 1893-95

Image via Wikipedia

 

We grieve when we get sick.  And we grieve again when after getting well, we get sick again.  Then the grieving can be even more terrible because you know what’s coming.  In Pearla’s case, she didn’t know she was grieving but she knew she was sad and terrified at the same time.

I asked her if she thought that staying in bed, loosing interest, isolating, crying jags out of the blue might be related her grief about getting sick again.  She said no at first and then said, “I’m disappointed.  I thought this was over for me.”  All over, she couldn’t trust herself.

Pearla was afraid. And that fear was always there.  Now she couldn’t put it out of her mind.  “What if I have another panic attack?  I can’t take it!”  “What if,” was always on her mind.

Readers, a panic attack is more terrifying than just about any immediate experience.  If you’ve never had one, it is almost impossible to imagine the depth of terror it causes.  It is so horrible, that people even change professions because of it.  I remember a surgeon who actually went back to residency and studied a new specialty because he linked his panic to his profession.  That’s another 4 years of grueling work, readers.  That’s the kind of fear panic produces.

Pearla was not only in the throes of this fear, she was also in the throes of grief.  This is a deep sadness any of us who have lost a beloved hope can relate to.  Pearla didn’t know that was why she didn’t want to get out of bed.  All she knew is over the last 2 weeks she was loosing herself and in exchange, getting something she desperately did not want.

Somehow though, after hearing about her sadness from her own mouth, Pearla agreed.  She saw the grief and after seeing grief, she could be more present with it.  It was almost like her face materially came out from hiding.  Grief lost some hold on her.  She was a little less sad and a little less afraid.

Self-Care Tip #111 – Let yourself grieve.  Be a friend to yourself.

Question:  How do you grieve?  Was it worth it to you?  Please tell me your story.

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Wearing A Bit Of Disguise For The Sake of Being Open

Self-Care Tip #110 – Find your masquerade and let it teach you how to be open.

We often talk about taking masks off.  About being open and “face” our lives with courage.  However doing that isn’t always as easy as saying it.  Sometimes doing the opposite makes it easier in preparation for when we have courage to try again.  Sometimes putting the mask on makes it easier to more completely know and be known.

On Twitter today, this came from bigfishtopdogs Theresa BradleyBanta:

Here’s my #FF. These people rock! They engage!
And there was my name.
I wondered why we can say these high-fivers so spontaneously on Twitter from people we know only a few pixels deep.  I “met” Theresa BradleyBanta on her blog site bigfishtopdogs.com only a few days ago and she’s already telling people that I “rock!”  It is so cool!  (Just as an aside, she rocks too.  Her site is all about coaching and mentoring on entrepreneurial endeavors.)

Getting that fresh compliment almost stung when I realized how I preened underneath it.  Here in the real world, I don’t know who to show my feathers to.  My reply to Theresa was

Wow. How come I can’t hear anyone say that in “real life?”.  Twitter is like a smokey dark room where anything can happen.

Sometimes people think of hiding behind things as a way to do indiscrete lascivious acts that you wouldn’t want to do if you were identified.

I propose that a little hiding is a good thing for ourselves.  To get up close and personal.  To share over-the-top compliments and receive them.  It doesn’t mean something bad unless we use it badly.  I propose that when we disguise a little on occasion, we might remember how to act more freely when we are in the open – how to, when we try again.

Having the courage to try again and again to connect gets easier when we have fun reminders as to why we want it so bad.

Question:  What have your positive experiences been when you were a little less inhibited?  If fantasies could come true, how would you like it to carry over into your “real” life?  Please tell me your story.

 

 

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Branding and Branded. Stigma Goes Both Ways.

 

mentalhealth.wa.gov.au

 

Oh, the struggle to understand that behaviors may have something to do with the brain! I shake my fist at stigma! I shake my fist at prejudice!

Now, I can go on a little calmer and say, if you are struggling with this yourself, you are not alone. Even if you are the one propagating it. You stand on the shoulders of others.

In Jesus’ own words:

Father, forgive them for they know not what they do.

He was talking to me, I know, and you.   We have all been rude and ignorant in our own time and our own place.   We find ourselves holding 2 positions, accuser and accused. The context of our various roles changes with knowledge, coping skills, experience, maturity, pain, mental capacity and so on.   But that we hold both roles in some space of time and place will never change in this world.   Even in heaven when we “see face-to-face” we won’t be completely informed.  We know we will continue learning timelessly. What will change is the abuse, the prejudice, the judgement.  Once and for all, we will finally let that go and believe at a chromosomal level that God is and deserves to be the only Judge.

There must be a genetic component to our double lives in this world. This tendency towards stigmatizing. We know there is a lot that isn’t genetic and for that we fight to grow ourselves and grow others for our own sakes and for theirs. The benefits reciprocate as much as the pain does. And even though being branded feels personal, it is not.

For more relating to this, read the blog posts Forget About Divisions In Knowledge, and Forgive to Get Friendly With Yourself.

Self-Care Tip #109 – Don’t take it too personally when people sneer. Be a friend to yourself.

Question: How do you keep yourself objective when prejudice hits you or someone you love? Please tell me your story.

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It’s Time To Grow Up

 

 

http://www.creativeartgallery.com/

 

Fragile Annie writes a blog called, “It’s Time To Get Over How Fragile You Are.”  Isn’t that a great name?  She own’s her frailty, own’s that it has affected her life, and own’s what it’s time to do now.  All in a name and a title.

When I was in psychotherapy, talking on about injustices suffered, my feelings, the rightness of my condition – my therapist said, “It’s time to grow up Sana.”  I still feel the punch in my stomach and the quiet immediately following.  I couldn’t breath for a bit.  Just nodded my head.  “Ok.”  …I said, “Ok” a few times.  I don’t remember much else of what he told me but I don’t think I’ll ever forget that.  He’d be satisfied with his work with me if he knew.

After all, it’s not such a small thing to grow up, or “get over” our frailty.  It’s not such a small thing to see our need.  It’s not so little to act on it.  These are things that champions do.  These are things any coach, parent, therapist, teacher would be proud to be a part of.  These are the things that make the difference between falling victim to your history, or claiming the rights to your now and to your future.

Think about what is upsetting you the most.  What seems to keep at you and trip you and keep you back and keep you right where it left you last?  It’s time to grow up.

Self-Care Tip #106 – In Fragile Annie’s own words, “It’s time to get over how fragile you are.”  Be a friend to yourself.

Question:  What has knocked your breath out in a good way, sending you off towards growth?  Please tell me your story.

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Growing Up Is Not Necessarily The Same as Growing Away

 

cant decide so dance

Image by faster panda kill kill via Flickr

 

Self-Care Tip #105 – Grow up, think on your own, and stay connected.  Be a friend to yourself.

Staying connected doesn’t mean loosing your freedom.  Staying connected doesn’t mean immaturity.  And independent thought doesn’t mean disconnecting from others or your foundation in life.

When we move into adulthood, we move into roles requiring responsibility, autonomous decision-making, teaching like parents.   This is confusing don’t you think when we were designed to be connected?  Well when something feels so wrong inside, listen to it.  There is a incongruence with what you intuitive know.  Independence includes dependence

Adulthood means learning to have creative thought while being willing to learn.  It means disconnecting while remaining connected.  It’s not all-or-none.  It’s seeing the strength in vulnerability.  Part of taking care of “Me” includes choosing dependence.

Dependence never takes away freedom.  Sometimes when I listen to people telling me how I should feel or think, I feel caged and start doing things to make me feel less caged.  Unfortunately sometimes that isn’t a healthy thing, like eating chocolate or… well it’s often eating for some reason.  Other people do this too.  They may cut on themselves or bang their head.  Unnecessary, because we are free no matter.  Drugs.  Whatever it is that in the moment somehow springs you from the phantom cage only to put you in another.

Question:  How do you live free yet connected?  How do you deal with feelings of infancy, immaturity, loosing freedom when it comes?  Please tell me Your story.

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Forget About Divisions In Knowledge.

The World Is Flat

Image via Wikipedia

Self-Care Tip #103 – Forget about divisions in knowledge.  Be a friend to yourself.

Knowledge does not separate into parts of religion, diet, stars, or geometry.  It is one thing, although we may not see its entirety.  Like the blind men with the elephant, we might be standing by the foot or the trunk.  But it is one thing.  Spiritual truth, nature, physics, medicine, music, art, it’s the same story told in pieces and in different ways.

Working in psychiatry, I’ve struggled with this because it so often affects my freedom in practice.  It so often affects people’s choices for treatment, people’s choices for lifestyle and their own empowerment with self-care.  It affects the choices people make in medication therapy and in physicians.

Merging the tables of learning affects our quality of life either way.  If we are able to do this, we have less conflict, fewer chairs to walk around.  If we can’t, we find ourselves constantly checking the seating charts.  It’s terrible throwing a party where people don’t know what connects them.  There’s the same discomfort inside of us when our life paradigms are afraid of each other.

Take Crystal.  She is a Latina Catholic.  Or make her protestant Filipina, or say White Texan.  Crystal grew up thinking that what was said by her tias (aunts,) or her pastor, or performed by her grit and spine, lay like bookmarks between human behavior issues and the rest of her life.  Behaviors may have something to do with the church, or emotions with the girls room, or nothing to do with anything in her mind.  Thinking behaviors and emotions might relate to what gave her black hair color, and to why water separates from oil is just bizarre to her.

When, Thomas Friedman wrote The World Is Flat: A Brief History of the Twenty-First Century, he was talking about a leveling of the playing field of commerce.  To take it further, I hear him talking about a flattening of prejudices, knowledge, access to information and hierarchies.  The world is too flat to separate the brain from the rest of the body.  When the world is flat, working as a psychiatrist means enlisting all of science, religion, social issues, hobbies, food preferences, and all the other things that make someone’s life worth living for their treatment.  When the world is flat, a patient trying to get help for their emotional-behavioral illness doesn’t separate it from anything else in their journey.

It turns out that we have a lot of information on where emotions and behaviors come from.  We should use it, don’t you think?

Of course, we don’t have it all.  Not close.  We don’t know how the soul factors in.  We don’t know what miracles are.  We don’t know God face to face.  But we do know that it is the same table of knowledge.  It is the same elephant in the room.  It all comes from the same Love.

Walk around.  Feel around.  Let your quality of life get better.  Don’t cut yourself off from another part of you if you don’t have to.

Question:  How are you keeping your personal journey one that is connected?  Or not?  Please tell me your story.

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Your Life. Your Choice. Why Are You Still Negotiating?

 

 

Self-Care Tip #102 – Take what is yours and live.  Be a friend to yourself.

Cheri came, still dressed in work scrubs, with her 2 daughters, 8 years old and 3 years old.  Having finished their dinner date, they were swinging by for her appointment before going home.  Cheri told her kids, “Get out now and go sit in the lobby!  If you don’t listen to me I’ll….”  Turning to me, she said, “It’s never enough!  I just took them to dinner and they do this to me!  No matter what I do…!”

1.  Cheri tells me she’d like to cope better with simple stressors such as redirecting her kids

2.  We talk at length about her perception of her kids abusing her.

Cheri is married.  Her husband laughs at her for “…having to take those drugs to be normal!”  “…But he just sleeps his problems away.  He doesn’t deal with them like I do.  He has no idea!”

3.  We talk more about her perception that her husband is responsible for her place in life.

Cheri believes if she doesn’t take more than 2 pills a day, she is less “dependent” on drugs.  She says, “I don’t want to go on like this!”  Her tears continue talking when her voice stops.  She is ashamed.

4.  The concepts supporting taking care of yourself as being the kick-off point to caring for anyone else comes up.

5.  We talk some more about who is “The Why” for what we do or don’t do.

Cheri feels less shame, but it’s still there.  She is willing to give a new medication a try but clearly doesn’t buy it all yet.  She’s going home with her girls to her husband with new pills.  And hope?  Yes.  It is all connected.  It all pulses together and is a living negotiation of sorts.

Disease <–> behavioral/emotional negative symptoms <–> victim role <–> self-neglect <–> greater crisis <–> seeking help <–> responsible self-care <–>  healing <–> fewer behavioral/emotional negative symptoms <–> emotional abuse from husband may continue but is no longer seen as responsible for personal choices and self-care <–> less shame <–> further healing and so on….  (Lub-dub…Lub-dub…)

 

hbofamily.com

 

Cheri is still negotiating her deal in life.  She doesn’t realize that it’s already hers for the taking.  Her life.  Her choice.

The deal is already made.  Take it or leave it.  Your life to live.

Question:  How are your negotiations?  Do you see them as still in progress or settled.  Please tell me your story.

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It’s Not All Good

 

soundtrackcentral.blogspot.com

 

Self-Care Tip # 100 – Don’t forget what you know to be true, when other people don’t keep up with your learning curve.

You have finally started to understand that You take care of you.  You bought into that when you do, you can do more of what you want to do for others.  You believe that the responsibility to be healthy in mind and body starts and ends with the “Me.”  Isn’t that wonderful?  Yes.  Don’t forget it when other people don’t keep up.

Cynthia was on a self-awareness high.  She saw through open eyes her neglected self.  She was astounded looking at her thrashing person giving her last bit of stuff to the jobs she infrequently satisfied.  Instead of feeling defeated, however, she now felt empowered.  She was so ready!

It went well for a time.  Her husband noticed, approved, commended, and encouraged her.  They talked about it.  Her kids, reluctantly let go of her legs so she could leave to exercise.  At work, she personalized less and was not as interested in office politics – contented to do her own job.  Then it slowly started.  People started resenting her for it.  Her peers starting making jabs.  The kids would climax and tantrum just as she was about to leave to exercise.  But what really surprised her, and not in a good way, was when her husband got upset.  Not a lot.  But enough that the guilt she had talked down seized the opportunity to multiply.  It was like gremlins.  When the guilt gets wetted like that, it multiplies!

Doing what is right is not always celebrated.  Cynthia is working through that now and every day, as it is for you and me, she is finding the courage to get past that.

Question:  What has surprised you good or bad in your journey towards self-care?  What have you needed the most courage for?  Please tell me your story.

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What We Get For Our Work

 

 

Number three on Bella’s List:

Farmer Brown hired help to get his crop in.  Half way through the job, he realized he needed more help, so he got some.  This happened at least 3 times before the job was finished.  Come paying time, Farmer Brown gave everyone the same, $100.  “What’s going on here!?” the people who worked the longest complained.  “We should get paid more!”

Farmer Brown, …well you probably know that this is my version of the story from Matthew 20:1-16.  The Farmer gave them more than money.  But what did he give?

What are we getting for what we do?  Intuitively we probably think, like the hired farm-hands, and like my patient Bella, that we aren’t getting what we should at times.

“The day has been ruined!” Bella said.  Her eyes sparkled and flashed as she spoke of her injury.  Bella was not so pleased with her labor’s reward.

The real point of our stories here – the hired farm-hands, Bella’s, and our own story – is figuring out the reference point of why we do things.  Everyone makes their reference point in their own way.  Find your reference point.  Just find it.  You’ll get more for your dollar, so to speak.

You might remember from some earlier posts, about doing what is congruent with our hard-wiring, i.e. our temperament.  This gives us more joy in our work, we are better at what we do, we feel less self-pity, and an energy generated simply by our own natural interest drives our efforts.  As a believer in biology, I’d list temperament not as a reference point, but as an influence of how we search for and how we define our reference point.

Finding our reference point is not impossible if we don’t do what comes natural to us.  Finding our reference point is impossible though if we aren’t looking.

After searching in my special way for why I do what I do in life, I found God.  Is that true?  Just ‘cuz I said God is my reference point, doesn’t make it true.

Self-Care Tip #95 – Find your reference point.  Be a friend to yourself.

Question:  Have you actively, purposefully used your biology (like a hoe in the field) to find why you do what you do?  Is it helpful?  What have you found?  Please tell me your story.

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Walk Away From Your Junk

the rogers park young women's action team

Image by samuelalove via Flickr

Number one on Bella’s List:

There are endless new beginnings.  Had a bad day?  Stop right where you are and call-it out.  Then if you want to, if you are willing, if you are able you can start again.

But who is able?  Anyone who wants.  Even the severely disabled can say at some level that they want to end the hurt.  New beginnings are a privilege.  They are the dandelions we pluck and make a wish on.  It reminds me of when Jesus,

walked right through the crowd and went on his way.

The people were trying to push him over the cliff and they just plane didn’t see him walk among them and away.  We do that sometimes with our “start-over” opportunities.

There’s an interplay of forces that make our new beginning possible or impossible.

  • Humility – a willingness to learn.
  • Biology – a physical ability to stop, drop and roll the fire that’s scorching our emotions
  • Insight
  • Choice – choose it

Bella told me more of her story.  After she said, “The day has been ruined!,” her husband took them all to the table.  He told the kids, “Mom’s right.  The day is ruined.  Now who wants to start over?”  And then they all prayed for a new start.  They walked away from the junk.

Self-Care Tip #93 – Start over any time, every time you want.  Be a friend to yourself.

Question:  Do you find this to be true for you?  Is it a real option to start-over when you want?  Please tell me your story.

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    Recipe for Treating Panic Disorder, According to Me

     

    shoponline2011.com

     

    Recipe for Treating Panic Disorder, According to Me:

    1.  If it’s taking you to the emergency room feeling like you’re going to die, or your spouse can’t peel you off with your phone calls and new needs – you have a medical illness.  Get medication.

    2.  If you are afraid of being humiliated by an episode so much that you avoid public places, or if you are more fearful than not – you have a medical illness.  Get medical treatment.

    3.  If you are panicking out of the blue, without something setting you off/triggers like finding your husband in bed with your dentist – this is biological.  Get a medical physician’s opinion.

    4.  If you are awakening from sleep in a panic attack, when you feel like you have to get out of bed and escape and the episode lasts for about 10+ minutes before you recover yourself – this is not because you’re not trying hard enough.  Get on a serotonerigic therapy and a sleep aid(s).

    5.  If you are drinking more alcohol to relax and out of fear of going to bed – get suspicious and get smart.  Medication therapy or alcohol?  It stumps me when someone says they don’t feel comfortable with taking medication that has beed studied in double-blind studies on thousands of people and reviewed and analyzed and more… but they do feel comfortable with alcohol.  That’s not friendly with yourself.

    6.  If you think you are going crazy and realize your fears and suspicions don’t make sense; if you think you are possibly going psychotic over and over – you’re having a medical illness of the brain and body called panic disorder.  Get to your nearest treating physician and trust them.

     

    juno.cumc.columbia.edu

     

    7.  If this is you, don’t go get insight or supportive psychotherapy at least until you have been on medication therapy for 6-8 weeks.  What you are going through is not because your mom yells at you too much.  It doesn’t have to have a reason.  It is medical.  Treat it medically.  If you go to therapy too soon, you will see that you can’t give what you don’t have.  (I may have offended some people saying this.  Sorry.)

    8.  If you don’t get treatment, expect that depression may likely follow soon.  Anxiety and depression are bedfellows and can’t be apart for long.

      Self-Care Tip #92 – View Panic as a medical illness.  It is.  Be a friend to yourself.

      Question:  Have you or someone you known used a similar recipe or a different one?  Please tell me your story.

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      You’ll Be Less Bored if You Do

       

      Rocky Balboa

      Image via Wikipedia

       

      Self-Care Tip #89 – Practice being real.  Exercise it!  Be a friend to yourself.

      Sara Stein MD and author of Obese From the Heart, wrote

      There’s nothing romantic or mysterious about advanced age. It’s painful and difficult for everyone, but there are good moments.

      I like that.  We could say it about a lot of other things too.  Just today in clinic for starters, Mary said she’s falling asleep during the day, but is doing less self-injury since starting topiramate.  Max has gained about 20 pounds but he is over his Staphylococcus infection and he’s sleep through the night.  Marge is crying because there is no cure for her son’s illness, but he can still be treated medically and protected against further disease progression.

      Any time someone asks me how I’m doing, I’m in a paradox.  It’s the drive I struggle with to express emotions purely and completely that can be my own Rocky (Dir: John G.Avildsen, 1977) experience or it can kick me in the back-side.  Doing what Dr. Stein so eloquently did isn’t as easy as it looks.

      “Fine,” I say.  “Things are wonderful.  Thanks for asking.”  (Snore.)

      Or, (trip,) “I’m tired and parenting is difficult, and as much as I talk about it, I can’t seem to figure out how to take care of myself.  But I’m also really good and haven’t been this happy in a long time.” (Panting holding my sides.)

      Being real without boring or tiring yourself out might take some practice.

      The “real-thing,” blogger Film Fan wrote

      Philadelphia Museum of Art, Benjamin Franklin Parkway, 26th Street, Philadelphia, Pennsylvania, USA.  The most famous location in Rocky is probably the stairs he jogs up during the ’Gonna Fly Now’ training montage. The good news is that you can re-enact the scene and jog up and down them, the bad news is that there are 68 steps… That’s quite a few if you’re jogging.

      If you ever want to get bored quick, try to be happy.  Try it.  Try to be good.  Try to ignore the monotony.  If you want to be bored, draw your house with a window and a door and a sun shining in the corner.  It’s no good for boredom when you draw in the shadows and colors.  But doing that well might not be natural for everyone.  We might need to get into a training program, like Rocky Balboa before we can be in the presence of the bad and the good of our lives without loosing our breath.

      It may take practice to be real, but you will be less bored if you do.

      Question:  How do you find being real with the good and bad of your life affects you?  Please tell me your story.

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      Why Are You Walking The Road Alone?

      Part of humility is not isolating.  You have to be able to receive to be a friend.  Dan Allender Ph.D. calls it suffer the kindness.

      From looking at him, I didn’t guess at first that Fink was lonely, but he was.  Under-appreciated, whenever Fink thought about making new friends, he remembered that he wasn’t young any more.  All his “real” friendships were made when he hung-out for hours, had spares in the trunk so to speak.  If one relationship didn’t develop well, he still had time and possibilities that the future offers.  In this sense, Fink had been rich.  He had after all that, maybe 3 friends he considered “real.”  But over the last several years, with real jobs and families of their own, his real friends weren’t returning his calls.  Now, he thought, he may as well as not have given them his special self.  Now he was older and not so rich.  Fink kept picking at that scab, even though he knew it wasn’t so masculine to be upset about your neglected special self.

      At times we are lonely, but have trouble valuing the relationships being offered.  We see ourselves as something set apart.  This might be part of our drive to self-preserve.  Bits of neurons fighting over signals in our brain telling us that we need to dominate to propagate our genes.  Maybe.  But there is that intersection when choice crosses.

      We remember from Sebastian Seung‘s work that our memories are not stored in our genes.  That gives us something tangible to work with.

      I remember walking on the beach with a girlfriend when we were still in medical school.  I told her, “I’m tired of feeling bad about things I never had a choice in!”  It still seems wasteful to moralize things like temperament and our nature.  In fact, we’ve argued the opposite at length in previous blog posts.  Embrace that part of you and run with it! we said.

      So what do we do with Fink?  For starters, tell him that his drives are what they are.  The real question is, what’s he going to do with his genetic drives?  Do good things with that energy?  (If we can call genetic drive an energy.)  Or will he do things that aren’t so good for him.  There comes the choice.  Fink.  Suffer the kindness.  (Thanks Dan Allender!)  In the end you will be happier and healthier for it.  Even if you are half as hot as your genes tell you you are, who cares if you are walking the road alone.

      Self-Care Tip #86 – Suffer the kindess.  Be a friend to yourself.

      Question:  What has been a barrier in your life from connecting with others?  Please tell me your story.

      Related Articles
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      Self-Care is not unChristian

       

      Don’t be afraid of self-care.

      Self-care is Christian and scientific.  I have awareness of the culture that frowns on taking bad behavior out of the church and into the laboratory.

      A few days ago we talked about self-care not being selfish.  That circuitously brought up the question about how “the church” feels about this blog.

      Confusing “the church” with Christianity can be problematic.  I have confused them in the past.

      When my brother started talking evolution, I felt cold and clammy suddenly.  After my mini-panic attack, he told me about reading the entire works of Darwin and I had another mini-panic attack.  “There’s no way evolution didn’t happen.  There’s just too much evidence supporting it.”  I was confused.

      It took me a long time to realize that I didn’t have to be worried about differences between me, science and God.  Funny that my comfort level grew with this as I realized how little I knew.  In fact, my joy expanded, when I realized I would spend all eternity growing my knowledge.  That is a lot of everything that just won’t fit into any box I can think of.

      iwantthatpainting.com/Why-does-it-always-rain-on-me.html

      Now when something crashes through a pet-paradigm, I remember that it’s ok.  (Down fear!  Get down anxiety!  Heal dogs!)  I may see a different reality.  Parts of me may become changed by that knowledge, trauma, death of a dear one.  Becoming changed and different is ok.  Because God is the same.  God already knows whatever about evolution, or that the world is round.  He knows that we try to turn medical symptoms into something spiritual, like depressed mood.  He knows it and He’s still here.  He is the prototype of presence.  Now that people can look into the brain and say where feelings and behaviors come from, we can get past that and on to the next revelation.  So what if it is medicalized.  Science and spirituality are not exclusive of each other.

      So is self-care Christian or scientific?  Things aren’t that binary.  Self-care is both.

      Self-Care Tip #84 – Don’t be afraid of self-care.  Be a friend to yourself.

      by

      Your Heroic Self – Waiting For Normal

      Self-Care Tip #82 – Have courage to go for what is lovely to you in life.  Be a friend to yourself.

      Pretty, blond, about 5’6″, slender, in her 30’s, mother and wife, no funny shapes or movements but Britt still asked me, “Am I normal?”  It takes guts to ask someone that.

      I just finished this heart-squeezing book, “Waiting For Normal,” by Leslie Connor.  (Yes!  I finally read a book!  It took me 5 times as long but it was no less pleasurable.)  Connor tells us about pre-teen Addie who grew up on the waves of her bipolar mom’s chaos, salvaging bits of wreckage along the way to survive.  Addie is the life-preserver her mom uses for life.  Addie’s own buoy through it all is her hope of one day finding normalcy.  She uses all her smarts to avoid the thrust her mom’s messes force on her.  It requires her full attention.  Addie must have looked pressed for something because her Mom finally asked her

      What’s so special?  What are you chasing after?!

      Addie was fisting optimism when she answered

      I’m not chasing after anything.  I’m waiting.  Waiting for normal.

      Later Addie explains to her mom

      Normal is when you know what’s gonna happen next.  Not exactly what because probably nobody gets that.  But normal is being able to count on certain things.  Good things.  And it’s having everyone together – just because they belong that way.

      My son used to have shaggy hair with curls that flew at the world around him.  He came home the other day and told me he wanted it short.  I finally figured out that because none of the other boys in his class had longer hair, neither should he.  He showed me pictures of what his hair should look like.  The whole process was too cute.

      We are all looking for normal.

      Putting aside defining normal, for now I am content to just contemplate the largeness of the effort to find it.  The journey, the process, the coming into such a thing reveals the beauty in one’s character and essence.  It is that, rather than the “hair-cut” that makes me say, “Wow!”

      When Britt, my patient, strove towards her health and normalcy, her intent in context was lovely.  She seemed to me, in those moments we shared together, as one of the great heroes of our day.  A woman of courage.

      Self-Care Tip #82 – Have courage to go for what is lovely to you in life and appreciate the beauty in your heroic self.  Be a friend to yourself.

      Question:  Have you struggled with the question, “Am I normal?”  Please tell me your story.

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      Forgive to Get Friendly With Yourself

       

      Professional baseball bats are typically made ...

      Image via Wikipedia

       

      Self-Care Tip #80 – Forgive.  Be a friend to yourself.

      A reader wrote yesterday

      Always intrigued by the possible connection between empathy and forgiveness….

      Great progression of thought.  From both an anecdotal perspective and some biological considerations, David Mullen PhD and Everett L. Worthington Jr. PhD, are two of my favorites.  Other than Jesus, they have and do say it better than just about anyone.  I heard Dr. Worthington speak when still a resident-physician in psychiatry.  The story he told of his mother’s murder and how he came to forgive her murderers seared into my memory and has ever since been a reference for me in my personal life and medical practice.

      The call came on New Years Day, 1996. His brother’s voice was shaky. “I have some bad news,” he said. “Mama has been murdered.”  …Their mother had been beaten to death. Rage bubbled up in him like lava. He heard himself saying, “I’d like to have that murderer alone in a room with just a baseball bat. I’d beat his brains out.”

      Here’s where the empathy came in

      …He tried to picture the crime scene. He imagined how a pair of youths might feel as they stood in the dark street preparing to rob the house. Perhaps they had been caught at robbery previously. They would have been keyed up. The house was dark; no car was in the driveway. No one’s home, they must have thought. Perhaps one said, “They’re at a New Year’s Eve party.“ They did not know that Worthington’s mother did not drive.  …Worthington imagined their shock when her voice came from behind. “What are you doing in here?”

      “Oh, no!” one must have thought, “I’ll go to jail. She is ruining my life.” He lashed out with his crowbar, slamming his mother three times. Panicked, the youths went crazy, trashing the house, both for having their plans ruined and for the shame of having murdered.

      This is part of the process that led Dr. Worthington to forgive the murder.  You can read more in his book, The Power of Forgiving.

      There is an interplay, between choice and biology/non-choice.  It’s uncomfortable to think and talk about.  I can feel the hackles on the necks of my readers start to stand up just writing it and I humbly acknowledge my limitations in sharing this concept.  It is what I have tried to describe through many of my earlier blog posts.  This unlikely union between such polar concepts.

      Being a Christian, I have awareness of the culture that frowns on taking bad behavior out of the church and into the laboratory.  When I think of empathy and forgiveness, I see party-hoppers moving in and out of those very places irreverently perhaps in some people’s minds.

      Some other time we will broach further the idea of self-care being Christian v. scientific.

      Self-Care Tip #80 – Forgive.  Be a friend to yourself.

      Question:  Does any of this resonate with you?  Please tell me your story.

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      Be Empathic to Others to Get Friendly With Yourself

       

      Drawn by early 20th-century commercial cat ill...

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      Self-Care tip #79 – Be empathic to others.  Be a friend to yourself.

      Yesterday I wrote about considering intent and context when comparing self-care with selfishness.  That carries over to the people sharing life with those of us who have mental illness.  Do they see us as selfish?  For example, how is the spouse of the Panic Disorder going to make sense of the 40 phone-calls he gets while at work?

      Mary’s husband told me that she’s been calling him “all day,” terrified she was going to die.  Checking to see when he was coming home.  She couldn’t go to the market because people would laugh at her.  Afraid.  Afraid.  Just plain afraid.  Really, everything had become about her.  She was like a scared kid.  Frankly it was annoying.  He was in a stressful work situation with the economy slumping.  People he knew were being laid off.  The other day he had to leave in the middle of an important job to go home and reassure her.  She was sobbing in the living room.  Sure she was going crazy.  He realized that he might have to tell his boss what was going on but what was going on?!  Who had his wife turned into.

      In yesterday’s blog, we spoke about the ability to abstract v. concrete thinking.  Being able to abstract helps with empathy – connecting emotional content between people.  To put yourself in someone else’s shoes, as if you were them.  This is a critical part of relating, i.e. being in a relationship.  Many different mind illnesses affect our ability to abstract, including panic disorder.

      In Mary’s case, she was not empathic when she was anxious.  She was thinking about herself.  Understandably, if you read the part about her believing she was going to die or go crazy.  But when you’re married to her, empathizing with her gets old.  It’s not so easy when it seeps into your work life, you haven’t had sex for months, and you have to do everything that has anything to do with going outside of the home.  Some part of you knows it’s not true, but another part of you screams, “Get over it you selfish child!”

      Is Mary selfish?  Some might be able to answer even after all the phone-calls and unrecognizable behaviors, no.  Mary is not selfish.  They can do this specifically because they can abstract.  They can empathize.  They can consider the context of Mary’s disease and the intent of her behaviors.

      Not everyone does this.  Not everyone is able to let “It” be about someone else.  Not everyone doesn’t have to have “It” be about them.

      The best thing for those in relationships with someone emotionally ill, is to view the way they are behaving as biological.  When treated medically, than Mary or whoever it is in your life can do their own self-care.  But until then, staying in their lives requires maintaining an empathic view that considers intent and context.  It also means furthermore, doing your own self-care individually.

      There are over-lapping flaps to our lives.  Scales on the back of an armadillo.  Me as encased by my body.  Me, that includes the space between me and you.  Me, that includes you, because you will always be a part of me.  Self-care really involves all that by degrees.  A chain-link.

      So the question is, can empathy be chosen?  With money in the bank and wisdom, yes.

      Self-Care tip #79 – Be empathic to others.  Be a friend to yourself.

      Question:  Does any of this ring true for you?  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.

      by

      The Price of Manure

      In yesterday’s post I asked “What has happened in the space between you and the ones you love?”  A reader responded,

      Think of being loved but not being able to be touched. …Rituals above spontaneity. Of having Lysol applied to everything you touch. Lysol applied to children’s legs and shoes. Not being able to hug your kids after work until after a bath and your inside-clothes on. The tirades. Most things literal and not humorous. Any cabinet or freezer needing to be as stuffed as possible.
      As a young person it seemed very personal and hurtful. …All the lost years….  After all those years now on the mend.

      It doesn’t matter how old we are, it takes courage to live.  There are many astounding parts of this story, but today I draw attention to “the lost years.”

      I don’t know if any of you readers saw the episode last week from the musical comedy, Glee.  It irreverently tossed together a potato salad of high impact emotions.  (Delicious potato salad!)  The best part was as usual the great Jane Lynch.  That woman is brilliant.  She shows us anger, resentment, and personalization through spitting words.  She contrasts this against her thick velvet love for her older disabled sister. Sue Sylvester (Lynch’s on-screen character) has festered the insults she absorbed on her sister’s behalf, ever since she first realized her sister was different.  It was only until her sister, with a still-waters affect told Sue that she didn’t care what others said about her.  Her disabled sister was whole inside.  Sue started to heal too.

      Being present with our dark history, can summarily be our gain.  Especially if in the end we found love, became connected with our journey and with others, and forgave.  It becomes rather an education of sorts.

      When I was struggling with my ambivalence about vocational choices, my dad told me, “Education is never a loss.”  I plunged forward with that as a talisman.  

      Education is never a loss.  Even our school of suffering?  Look at it as a currency of sorts.  It’s all perspective.  Even manure helps you know.  We had to pay $100 the other day for a truckload of chicken-poo for our farm trees.

      Self Care Tip #73 – Find the value in your suffering.  Be a friend to yourself.

      Question:  Do you agree or not?  Please tell me your story.