My Inner Demons and I are on the Same Side – Living in the Now

“I stop fighting my inner demons. We’re on the same side now. T-shirt”

― Darynda JonesSecond Grave on the Left

 

Monday came. I was not ready to tackle the day. I lay in bed a few minutes longer while I started to dread and plan for the day’s appointments, calculating drive times, meals, and accommodate everyone else’s schedules before I had even thought to blink open my eyes.

It dawned on me at some point that I was living out a day that hadn’t even begun yet.

The anxiety of the impending tasks, or the overwhelm that comes with trying to handle everything before it arrives, you know this too? The exhaustion that eventually overtakes us makes us ridiculously absolutely not excited about our lives.

Living in the future instead of now is like sprinting ahead of our own feet, if only we could! The only task we have to do is to actually wake up.

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Blood, Sweat, and Imperfections – Mommy Don’t Look!

Naked and Voyer

Naked and Voyer

Blood soaked and layered with fallen governments, the Acropolis remains, a witness and teacher to a summer fling. 

A tour of the Acropolis and its new museum taught much. #1 – Never go on such travel without a tour guide. She made all the difference. Without her, I might have lasted for an hour, or an hour and a half. I would have thought, “Check! Did the Acropolis! Next?” With her, I felt like I couldn’t get enough. Four hours later. Evi was an intelligent, independent woman, making her way in the world, with the talent of putting ideas together. Another mentor to pick up along my life journey. #gratitude.

(I’m going to try to describe Athens, as seen by a psychiatrist. Smile.)

Evi integrated the paradigms at play, seamlessly, and in flow, from the 800’s B.C. to the 400’s A.D. She spoke about the mathematics involved in The Parthenon architecture, the classical culture seen in the architecture such as the emphasis on the human senses, the development of language and democracy, and more.

None of the construction of The Parthenon is “perfect.” The columns slant, and the stairs bow in their middle. All of this is done to capture the human senses. It was constructed so that when you stand at one corner, you can see almost the entire construct, like inflation of air rounds a balloon. When you look straight on, you are almost able to see entirely around the balloon’s girth. The architect sacrificed perfection toward the ultimate and most valued goals – to experience all the human senses to their fullest, and the classical construction. 

The Greeks developed the idea that whatever is created by man, (scantily garbed statues, architecture, ship making, etc…) should demonstrate, but not surpass the excellence of the human at his or her absolute best. Perfectionism smechsonism.

The kids were a bit horrified by the genitals everywhere. “That’s inappropriate!” or “Mommy, don’t look!” with a hand posturing the Stop! sign, improved my experience 10-fold. 

The Greeks in the 400 A.D.’s recognized the irony in the loveliness of human senses; sight, emotions, spirit, intellect, etc, integrated with the flaws. We are greater, in the best of our imperfect self, than the perfect, mathematical, or any other kind of perfection, eg., 1 + 1 = 2, in a perfect world. 

For example, by tilting the columns, the architect understood that it would give an illusion of straight columns, yet still capturing more of the circumference as seen by the individual. Straight would be perfect. Tilted but looking straight is more representative of a human at her best. Never perfect. And the illusion created by the tilted columns made the construct look shorter, thus not surpassing “the human” capacity to sense it’s grandeur. 

Also, the government ruler at the time, Pericles, was the first known leader to integrate a form of democracy. He used citizens and slaves for the labor. Yet he paid them, including the slaves! Furthermore, he gave them freedom in their work to form independent decisions, stating that someone who is told what to do, doesn’t learn anything. Someone who makes their own mistakes, has the opportunity to learn from his mistakes. This was the fulcrum which our civilizations turned on toward human rights and free thought. Pretty powerful.

The Greeks gave their alphabet to the world, from which Latin developed, and thereafter the Latin languages. For example, I never knew that “Agoraphobia,” comes from the location, named at the time, “Agora,” where all the debates were held, again, inspired by this ruler during the 400’s B.C., spurring on freedom of thinking. You can imagine what happened during heated debates. Some people would suffer anxiety in that context, which would deteriorate into a disabling fear of being humiliated by another potential panic attack when in public places.

The priests of the Greek gods served also as their community’s medical practitioners. For example, they used snake venom to both treat headaches and prophylactic against strokes. It turns out that snake venom is an anticoagulant. Totally brilliant. Snake venom in Greek, is called, “physika”, which means “venom.” The caduceus, a symbol that we still use for the physician’s medical practice, shows a snake wrapped around a staff. Later Aristotle used “physika” to name his treaty on nature and the work evolved into “physician.” Way cool. 

The self-care tip: Work your damndest, while embracing and integrating your imperfections along the way, and in this Grecian effort, you will gain the greatest sensorial experience with the world around you, the individual beside you, and your own self.

Question: 1. How do your imperfections enhance your best self? Please tell us your story!

A Tiffany Diamond Isn’t This Good

Patient-noncompliance-terrorism

I’m in San Bernardino today, working in a small community clinic. I am in the company of four licensed and practicing physicians who are donating their time. I am blessed.

One physician I’m working with tells me he has taken care of himself in his medical practice, “basically by not being a hypocrite.” He describes this by lifestyle choices of diet, exercise, etc… He likes surfing, which surprised me! “That’s why I’m skinny.” The man is not wearing california-traditional surf-wear. He’s wearing a general Sears-white button up with black slacks and comfort shoes. And he is old! He is in disguise. The age-disguise. I judge people too often by what I “see,” and this guy is a total surprise. Mr. cool.

There are medical students, college students, and nursing students here as well. One of them is a phenomenally gorgeous import to the US with a magical accent. Currently she’s eating a large bagel with cream cheese, dressed in a pencil skirt, stethoscope slung around her neck. Maybe I hate her just a little. She told me about her own “really good” personal experience with psychiatry and counselling. Her parents divorced when she was in college and “it helped” her get what she needed to get through it. Maybe I love her a lot. A woman of courage.

A patient I saw is a mother of seven. You may think, “Let’s just stop right there.” Anyone who wants to use “all her eggs” would need “help.” This woman has had to be sooooo strong! She’s been abused, used, neglected, and more since she came into this world. Even so, she pushes forward. She demonstrates self-value and Love. Where did this come from, I wondered.  Who taught her or gave her that? Today, she has even finally come into a willingness to get in the space of cultural dissonance, and consider for the first time, medical care for her emotional and behavioral needs. “I need it! I will do anything to get out of all ‘this.'” These words should come in a velvet lined blue and ribboned box. Gimme. Gimme.

We are talking now in the break room about patient and self-experienced medical health care stories. A hospitalist is explaining the difference he sees in his patients between noncompliance versus nonadherence to clinical directives. It’s a like a rocket just shot off! Every one is bothered in some way. You may remember from previous posts in this blog site about the “Number one Reason for Relapse” – treatment noncompliance. I now renege. Let it be known, I was wrong. I’d like to say, “nonadherence.” Forgive me! Noncompliance is an arrogant judgment, implying a decrease of mal intent or purposeful disobedience. There are many paradigms of reasons that interplay into any of our choices and performance in our personal medical care. I love that! Yes.

My colleagues here today, our patients, we all have much to teach each other, much to learn from each other. Today I came here thinking, I want to treasure the person in front of me “right now.” It makes a difference when I engage that way in “whatever.” #Gratitude for one more day where that happened. Those day are surrounded too often by many others when I forget.

Self-care Tip: Treasure the person in front of you.

Question: Who is in front of you right now? How can you treasure this person, this experience, this…? What are you getting from it? How is this perspective and what you get, kind to you?

Be a friend to yourself. Keep on!

I’m peaking in my career

  
Supposedly, I’m peaking. And this isn’t about egg yolk and marenge pie. I’m 43 years old, have been in medical practice for fourteen years, and am looking at a canyon in 360-degrees from where I stand. That’s what the data says. I wonder if I am going to do the electric slide or how I’ll boogie through the next years of medical practice. I try to think, “This is the best moment of my life, right now,” any time self stigma and fear of mortality creeps in. (That’s not saying, “This is as good as it’s going to get!” Ha!) I want to cherish the gift of practicing medicine, for however long I am blessed with it. 

It’s a popular discussion amongst my colleagues these days, about how long a physician should practice. There’s a newer’ish respected program called, PACE, that evaluates physician competency to practice as they get old.  This is a huge shift in the culture of medicine. It’s meant to respectfully assist rather than discriminate with ageism. I try to imagine what it might feel like if I were approached and asked to take the test. 

So what does a psychiatrist rocking her best jeans have to show for herself anyway, you may ask. Well, (tapping the mike), “I’d like to first say thank you to my sponsors….” Wink.  I mean my patients! Thank you. 

…Hey! This peak is crowded! Give me some room!

Ahem. But at my “peak,” at the best of my career, I thought it would be fun to play around with, “Why?” What’s in my doctor’s bag that is so special?

  • Ask, “Why do you want to be alive?”
  • Start all work-ups with a medical work-up. 
  • Give full informed consent with the 5-Treatment Paradigms of Psychiatry
  1. chemical (medication), 
  2. psychotherapy, 
  3. hospitalization (inpatient and outpatient), 
  4. alternatives (such as acupuncture, massage, sleep hygiene, lifestyle change, etc.), 
  5. stimulation therapies (such as ECT or TMS).  There’s nothing else (that I know of 🙂 ) that anyone is going to offer you in psychiatry, no matter who’s clinic you go to. 
    • Push to full treatment response. 
    • Work toward quality of life, not cure, not perfect.  Ask again, “What makes like worth living for?” Design treatment toward those goals. 
    • Routinely and deliberately consider the flow of patient’s treatment agendas with physician treatment agendas. 
    • Mood journal. Nobody believes they were “that bad” after they feel better. Everyone wants to stop treatment when they feel better. (This is why there are so many repeat pregnancies, for example!). We all need our own voice (mood journal) to look back on and speak the truth. 
    • Fight for oxygen. If your patient has sleep apnea, don’t stop working toward treatment compliance. There are no medications that can take the place or make up for oxygen to the brain. 
    • Community. More community. 
    • The third eye – a therapist. None of us can be a mirror into ourselves. We all need someone outside of the “triangle” to speak.

    I’ll be thinking of more as I try to go to sleep tonight, but it’s bed time. I’m off! Sleep hygiene! Arg!

    Self-care Tip: Evaluate your position in your lifeline, and treasure where and who you are with deliberation. Keep on!

    Questions: Where are you in your lifeline? Are you struggling with ageism? What gives you value? Please speak! I, and the rest of us, really need your voice. 

    Know You Are Blessed

    ulysses

     

    Think of the worst of us.  Think of the worst about us.  Think of those with self-loathing.  Those with low self-awareness, the violent, and the violated, think of them.  Where is the blessing?

    Blessed are the depressed and anxious.

    Think of the healthy.  Think of the diseased.  The misunderstood, the ones who live miles apart from connection, who ever push like a dingy from the peer into waves and self-destruction, think of them.

    Blessed are the poor and lonely. 

    Where is the blessing when your real estate is brought low by the creeping up of low-life.  Where is the blessing when you get cancer just when you might retire, when your own body calls you stupid, when you lose your eyes after training as a surgeon?

    Blessed are those whose bodies are dying.

    Think of every corner, every shadow and open space and the turns you still don’t know about inside of your life.  Think of the unacceptable, the character you wrestle against to moderate away from extreme.  The rope you swing on and try to bring to rest, think of the grey you think you will never achieve.  This bit and chapter, this part of your construction, this surprise in how you deliver is Loved.

    There is no aberration from the norm that can separate you from that Love.  There is no addiction or misdemeanor or illness or mutated cell that can lose blessing.

    This is fact.  Our life is to live with it.

    Blessed am I.  Blessed am, “Me.”

    Question:  Where is the blessing in what you like least about yourself?  Please tell us your story.  We need to hear you! Keep on.

    Self-Care Tip:  Be your own friend in adversity as in prosperity.  Know you are blessed.

    Bearable Disappointment

    Guest Post!

    Read on 🙂

    We’re aware as smart single women that we can’t expect perfection.

    But life still manages to throw us curve balls.

    Maybe once you’re into your mid-thirties,

    it shouldn’t be called dating,

    it should be called waiting for the other shoe to drop.

    Why is it always something?

    Unless you’re in a problem free relationship with TiVo.

    – Sex and the City

     

    Despite the fact that the mention of TiVo dates this quote (remember TiVo?!), it still rings true. And you don’t need to be in your mid-thirties for it to apply. Any woman, or person for that matter, who has dated for a length of time knows the meaning of this quote in his or her bones.

    You meet someone. It is electric. You connect over so many things. His father passed when he was small too. She loves Quentin Tarantino movies as much as you do. You both want to travel the world with nothing but a backpack. You share a love of fine wine and cooking extravagant dinners.

    Before you know it you are sailing off in a sea of hormones and dreams of a future with this new, amazing person. You spend time at work day-dreaming of all the romantical things the two of you will share and your heart skips a beat when you see a new text/call/email.

    You are twitterpated. Crushing, hard.

    The intensity of these new-love emotions makes you feel as if this person is your destiny. This is deep and something you have never felt before. He is “the one”. You are ready to introduce her to mom.

    Suddenly all of your hopes and dreams come crashing down, shattering into a million smithereens.

    It could be any number of different things. “Deal breakers” are different for everyone. Prince charming could have said:

    • “Well, I am a musician, but it’s more of a hobby right now. I work at Big 5 to pay the bills”
    • “I live with my mom”
    • “I don’t actually have a college degree. I said I did because I’m only 20 credits away”
    • “I’m impotent”
    • “I have a daughter”
    • “I don’t want to see you anymore”

    Sigh.

    At the very least you are disappointed. You might feel devastated. Even worse, you might consider throwing your standards out the window to start a relationship with this individual anyway.

    Let’s get real and break it down.

    Getting real: You don’t know this person. Really, you don’t. You feel like you do because of the adrenaline, dopamine and serotonin running through you. It is also very likely that you have projected a huge, unrealistic fantasy onto them that has no basis in reality. That whole engagement speech you dreamed he would be reciting on bended knee? Yeah, you made that up in your head. The home-cooked meals and coffee dates with your mother you thought she would be making? Also fiction.

    It is so easy to become disappointed and exhausted by dating, and life in general, when we live in the future instead of the present. When we live in the future we set ourselves up for disappointment and hurt feelings.

    If you feel wounded by your dating life, only you can change that.

    Be present. Make reality your friend.

    Being present: Don’t wait for a partner to make your life happen. Enjoy every day. Plan trips. Have fun. Be grateful for everything you do have. You have so much! I keep a gratitude list on my phone that I add to and read when I am feeling sorry for my single self.

    Making reality your friend: By realizing that that the initial excitement of dating a new person is not a promise for the future, you will save yourself a lot of heartache. People are often not who you perceive them to be (this is usually not their fault). And while it is frustrating when individuals misrepresent themselves, that is part of the dating game. Have compassion for people who don’t feel comfortable being up-front about who they are, and move on, (without them!).

    Putting all your emotional eggs in one basket is your decision. Allow a potential partner to earn that over time. Let them demonstrate through actions who they actually are and that they are trustworthy. As the song goes. “You can’t hurry love, you just have to wait.”

    Also realize this disappointment you feel is not personal. It is not a reflection on you. You are worthy of love. Have hope and stay positive. Remain grateful.

    Be soft. Do not let the world make you hard. Do not let pain make you hate. Do not let the bitterness steal your sweetness. Take pride that even though the rest of the world may disagree, you still believe it to be a beautiful place.

    – Kurt Vonnegut

    Question:  How have you and do you endure well when disappointed?

    Self-Care Tip:  Remember that this disappointment is not personal.  Keep on.

    20140224_182909Jessica Adams:  I am a science teacher in Southern California who thinks about relationships, human health, love and of course science. I am passionate about doing what is right for kids and personal growth.

     

    Lupita Nyong’o Speech on Beauty – W-O-W! And, thank you.

    “…and my mother again would say to me you can’t eat beauty, it doesn’t feed you and these words plagued and bothered me; I didn’t really understand them until finally I realized that beauty was not a thing that I could acquire or consume, it was something that I just had to be.”

    This woman gets us. Friend to yourself. Keep on.