Sleep

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The Biopsychosocial-How-to Be a Friend to Yourself

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There is interplay between biological, psychological, and social issues that make us who we are.  You can work as a team not only  with your family, physicians, therapists, and whomever else is involved in your team approach to getting friendly with yourself – but you can also team up with yourself so to speak.

Think:

1.  Biology

Anything going on materially with my physical body?

Medical illnesses, temperament, sleep issues, diet, exercise, air, rash….

2.  Psychological

i.e., thoughts, emotions, and behaviors.

Things like lack of self-control, coping skills, catastrophizing, and negative thinking.

3.  Social

Such as socioeconomic status, culture, poverty, technology, and religion can influence health.

Think God, friends, marriage, parenting, work, unemployment….

We can do this not only with others who are here to help us, but also in our own thoughts.  We can start seeing ourselves as more than one part or another.  Separate and disconnected.  This might take some practice or it might be natural for you.  Just start wherever you are and run this through yourself.  When you’re stressed, break it down.  Take it apart to bring it back together.

Read more about this at “Forget About Divisions In Knowledge.”

Question:  How do you see the connections within yourself?  How has this played into your healing processes?  Please tell me your story.

Self-Care Tip #125 – See yourself as parts that make up your whole.  Be a friend to yourself.

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You Can’t Barter With It. Sleep.

Today, clinic was all about sleep.  Sleep being the ugly stepchild of many homes, its delicate nature is ignored, disrespected, discredited.  We are forgetting the contribution to the unit.  Every system suffers if sleep isn’t allowed to run it’s healing cycles round and round through a 7 hour night.  Medications don’t work as well if the very neurotransmitters that they work on don’t get replenished.  The meds are throwing a work-bee without the workers coming in.  Our memories drift away, unconsolidated without the deep stages 3 and 4 coming over and over to weave them into us.  Our cortisol levels don’t get staged and none of our bits and parts heal very well.

Every night we need to heal.  So much happens daily.  There is taking without asking.  We don’t know our cupboards are empty until we are down right sick.  That’s too far.  Why get to that point?

Believe that sleep is medical, structural, biological.  The results of what it does are nonnegotiable and don’t leave room for the reasons we give for why it isn’t served up.

I’m a night owl.

I take long showers.

I’m too anxious.  I can’t turn my thoughts off.

I work the night shift.

Some people think that they can fight sleep with coping skills, water, interpersonal relationships, work, arguments, computer time, hobbies, exercise, medications, and all their good reasons why they can’t get enough.  “Sleep” has heard it all.  Break it into your belief.  This fight is already won.  By sleep.  You will always lose.  Sleep will always win.  You must or you suffer.

Sleep.

It’s not personal.  It’s objective so quit making it personal.  Don’t even let yourself go to that cookie-jar full of excuses, no matter how you crave them.  Just work it out.  Work it out.  No one can really tell you how.  They’re your excuses that make sense to you, so what will you do with them?  What will you do?

Read more blog-posts on this here.

Self-Care Tip #122 – Sleep well to live well.  Be a friend to yourself.

Question:  Why do you buy into this or don’t?  If you buy it, what will you do or have you done?  Please tell me your story.

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Put The Struggle Down and Take 3 Steps Back

I almost gave up on tonight’s post.  But after taking a Glee break watching Kurt get bullied, get defended, then get out of his school, I felt more refreshed.  Go figure.  What I have to tell you about self-care tonight is to go back to the basics.

When you become inundated with all the good things out there to do, go back to the basics and let it rest.  Get your sleep.  Take your omega 3’s and vitamin D.  Take your medications regularly and step back from the struggle not to.  In fact, if possible, put all struggles down and take 3 steps back.  There is time enough to pick them back up when ever.  Go to sleep and sleep well.  If you don’t think you will, take something to help.  Something safe that will protect your deep sleep.  Then, get up, worship God, exercise and see what’s next.

Any time you want, any time you need, any time, you can go back to the basics any time.  These are mine.

Good night folks.

Self-Care Tip #120 – Get basic with yourself.

Question:  What are your basics?  Please tell me your story.

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The Great Lie.

One of the great lies of mental illness is that, “If things weren’t so stressful, I wouldn’t feel so bad.”  Look inside ourselves now and see them.  All the numbered and ranked stressors we tick off to explain how we feel and/or behave.  How about someone we love.  Do we tell them, “Of course you feel that way!  Look at all you’re going through!”

Because major depressive disorder (MDD) is mainstream enough, I’ll use it as an example.  Who, when they are down, doesn’t look for reasons why?  Say there is an additive effect of stressors such as home conflicts, financial duress, and poor sleep.  Since these events, you haven’t felt pleasure, you’ve felt sad and depressed.  You aren’t motivated or interested in your usual.  And where you normally would seek people out when you felt down, to get more energy, now you just want to be alone.  And so on.  You are able to say that you started feeling this way progressively since triggered with those stressors about 3 months-ago.  Before that you were “fine.”

Many people in your life, have told you that you are just going through a bad spell.  You have believed them but say, “Even if this is a bad spell, if it goes on much longer I think I’d rather die.”  Your best friend responds, “Anyone would be depressed if their boss was that evil!”

My answer, “No.”  Feeling down is appropriate to stress when it doesn’t disrupt your life for more than two weeks at this level.  And it is never normal to want to die.  Everyone has stress but not everyone responds to stress in the same way.  Not everyone if put under your same triggers would develop MDD.

Would you have developed this disease if you weren’t put under these stressors?  I can’t say.  We develop illnesses for many reasons.  One of the many reasons is external stress.  A hypothesis supporting this is that stressors trigger our genes for MDD much like we know cancer genes can be turned on by stress.  However, we do not have a direct correlation to the stressors as being entirely causal events.

Even if it were, none-the-less, we are left with the disease process in progress.  It is not an adjustment reaction to stress.  It is medical illness.

Feeling this way is not normal for what you are going through.  Telling yourself that it is, that is the great lie.

Self-Care Tip #118 – Don’t believe the lie if what you’re going through is affecting your function in life.  Be a friend to yourself.

Question:  What whispering lies are you struggling against?  Please tell me your story.

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Regardless The Reasons Not To, Go Get Your Sleep

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Self-Care # 113 – Regardless of the reasons not to, go get your sleep.  Be a friend to yourself.

I was speaking with Sheri about her sleep problems, and we aired some of the fears that she hadn’t realized influenced her related choices.

Here’s her current scenario.  She is a survivor of multiple trauma’s involving her children.  Currently only 2 of her 7 member household sleep through the night.  It’s been years since the rest of them did.

Sheri said,

I can’t just let them cry (speaking about her 8 month old infant and toddler.)  That’s child abuse.

Now this is a smart, well-read woman.  She’s read “Baby Whisperer,” “Babywise,” “Dr. Spock,” and just about every other parenting book out there.  She believes her intuition however and her intuition tells her that if baby cries, baby needs her.

Sheri tells me,

On a good night, when I am woken up only 6 times or less, I feel much better the next day.

(Um, did anyone else notice what she said?  A good night.  Ok.)

Sheri says when she sleeps “well,” her thoughts are clearer, her mood is more positive, she is a more effective parent and wife.  Sheri is telling me what I tell others.  However information and knowledge are not always enough.

Sheri knows she needs more sleep but she feels trapped between what she knows in her mind and what her gut tells her.

Question for Sheri:  When you get up to soothe the babies, are you doing it more for you or for them?  I got no direct answer to that question and let it rest.

Suggestions for Sheri and any other listening parents stuck between their mind and their intuition:

1.  Clean out the spare room and put 2 small beds in there.  Nothing else in the room.  (Remember sleep hygiene.  The bedroom is only for sleep and for sex and if you aren’t having sex, all you get to do is sleep.  Sounds silly when in context of babies?  This is however true.  Regardless of your age.)

2.  Put a fan outside the closed door to the baby’s room.

3.  If you hear the baby crying, get up and help.  If you don’t, than sleep, and baby can teach themselves to fall back to sleep without your help.

If you don’t do this already reader in your own bedroom, don’t feel too bad.  I remember giving a lecture to a room full of physicians and asked them, “Who had their bedroom set up this way?”  Not one of them raised their hands.

Changing our bedrooms to be appropriate for good sleep hygiene is a cultural change for the family.  It moves activity out of the bedroom obviously and into the home’s community space.  Everyone has to renegotiate that space.  A personal hide-out can be harder to find.

But it works!  Just Google “sleep hygiene” and you’ll read oodles on this.  You don’t have to believe me.

I’ve worked with disabled kids even, who have a ton of biological reasons not to be able to sleep through the night.  However, many of them did once their parents helped them with their sleep hygiene.  This method can crack some of the hardest cases of insomnia.  If these kids can do it, we can too.

If you can’t easily get into the groove of good sleep hygiene, you are not alone.  Keep trying.  It will be worth it.

Question:  What are your barriers to getting good sleep?  Or, what has helped you do whatever it takes to get your sleep?  Has either choice been worth it to you?  Please tell me your story.

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Getting Away From All-Or-None Thinking

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Self-Care Tip #98 – Getting out of all-or-none thinking may mean getting medical help.

Number five on Bella’s list:

“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.  She was not so satisfied with being accountable for her children‘s behaviors, when they thwarted her every effort at having a good family experience.

A reader eloquently commented what I now want to write on my mirror, about her walk through and away from all-or-none thinking:

..really only part of my day was ruined – the part when I was hurt or angry or frustrated or depressed, etc. – and, even then, only PART of me was totally miserable. I was still able to think about other things, get things done around the house, talk to a family member or friend. It’s really calming to know that I can hurt and still function because there are so many pieces of me and my life that are still okay. Suddenly, everything seems to be easier to deal with.

In an earlier post, “Adequate,” we talked about the truth being in the gray.  As my Dad so often told me,

Things are never as bad as they seem.

I had a hard time believing that at times when I was a kid, and now that I’m old-er 😉 I buy it cognitively but find I often doubt is at an emotionally intuitive level.  However, things do get much much much better for all of us after good sleep, exercise, water, and if medically needed, medication.

All-or-none thinking, extreme thinking, catastrophizing isn’t just about coping skills.  It can also be about our medical condition.  It’s very difficult to modulate emotions when you are emotionally ill.  I’ve heard so many confounded people say that they just couldn’t stop themselves from going into extreme emotions.  They struggled with reactions way past what the experience warranted.

A kid doesn’t listen to words and Dad is kicking a hole in the door.

A couple argues over levels of intimacy and the girl finds herself in the bathroom with a cutting tool.

Work is another day of punitive treatment by an employer with lesser intelligence and she’s vomiting up food.

In these examples, we reflexively coddle the person, saying, “Anyone would be upset if….”  However that is not true entirely.  Enabling someone’s illness is easy to do.  Bad things happen to everyone.  But not everyone responds in a way that is repeatedly unhealthy to themselves.

In order to treat ourselves well, we need to take care of our physical/biological/medical needs.  Say hypothetically that we are getting our sleep, and all that good stuff, yet still have involuntary inappropriate extreme emotions, think about an organic reason.  Give yourself a break.

I have told my Dad, “True, things are never as bad as they seem, but only as long as you get out of their current seeming-reality.”  Getting out of that reality, may mean getting medical help.

Be a friend to yourself.

Question:  How do you stay “adequate?”  Please tell me your story.

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Taking Care of Yourself Is Not Selfish

The line between self-care and self-centeredness is a thin line.  We are part of the narrative.  We are not the narrative.

I’ve got some heat lately folks for talking about “Me” in a way that excludes the import of “You.”  How does anyone talk about the importance of the self without sounding seriously arrogant, disinterested in others, egocentric, ungrateful and rude?  Clearly it’s a learning process.  That’s something of what I’m hoping will evolve this year as we journey together.  Please let me know what you think on this subject.

I was very excited about having a morning to myself today and had built up a storybook page turning space of time for me.  However my night went bad, and like opening the oven door too soon with the bread still rising, I just didn’t get up well.  Partly in denial that the day was already slipping away, I kept going towards my hopes.  The clock sped up and I finally got out the door with the kids buckled to where they needed to go.  And then I realized I forgot my computer and phone.  Not so easy to work without those.

I live in the hills and although I’m not far from street lights and normal trafficked buildings, getting between me and them takes me through many blind 25 mph corners, steep hills over narrow roads.  Today I felt like I got caught in those hills.  My mom-van felt off-balance and the tight corners treated my tires cruelly.  I went back home to get my computer and back down to town finally.

I had great intentions for today.  However, I got stuck and stuck again.  That is what it can be like when we try to treat ourselves well.  It can feel like the roads swallow us up and we just can’t get there.

As my husband says, “That’s how it rolls!”

Question:  How do you see self-care differently from self-centeredness?  Please tell me your story of friendship.

Self-Care Tip #77 – Don’t get confused.  Taking care of yourself is not selfish.  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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Freud Did Not Know

Bad dreams.  Just woke up from one.  There’s a lot out there on dreams in mental health.  After all, they come from the brain.  When Freud was looking at things, he saw dreams as “unconscious wish fulfillments.”  However since Freud rocked our world, we’ve learned so much more about brain biology and Freud was wrong.  Oochie ouchie.  Just saying that makes me feel like his still very much alive reputation will come at me like an angry ghost and be mean!

Dreams are just that, dreams.  Sometimes they are good, but often they are scary, bad, and even terrifying.  Why?  According to Dr. Quijada ;), yours truly, they are commonly symptoms of emotional disease or side effects of medications, etc….  In anxious states, we dream.  After going through life threatening events to  ourselves or witnessing it in another, we get nightmares.  When there is a disconnection is our sleep architecture, we can get “parasomnias” such as night terrors.  Some medication such as Trazodone can cause vivid dreaming where people say they dream “in color.”  And on and on.

Freud didn’t know this, so no offense taken.  However, we do.  Enough with the hocus pocus moral dilemmas that are discussed in our own thoughts and among some ongoing therapies.  First look to biology to give us the answer. Even after having a nasty scream-your-lungs-out dream, remember that your brain is mortal, human, made up of carbon and not aura.

Sometimes even that much information can help people sleep better.

Self Care Tip # 43 – Don’t make too much out of your dreams.  Be a friend to yourself.

Question:  Do you agree or disagree?  Did this help you in any way?  Please tell me your story.

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Get to Know Yourself to Be A Friend to Yourself.

On the Threshold of Eternity

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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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Do This.

A basic recipe to becoming a friend to yourself:

Before, during and after # 1-6.  Love.  Find it.  Go to it.  Be in it.

1.  Sleep well regularly

2.  Aerobic  exercise at least 5 to 7 days a week.  Try to hit 60 minutes as many days as possible.

3.  Take your supplements:  Omega 3 and vitamin D.

4.  Do what gives you energy.  This means what is congruent with your inner self.  If all stressors disappeared, along with all roadblocks, what would you want to do?  Do what ever that is as regularly as possible.  Is it playing basketball?  Is it playing with children?  Is it canvassing?

5.  More on the above.  Get creative with it.  Grow in that area.  To do this requires work.  So the 5th ingredient is to work.

6.  Reflect on yourself.  Take stock.  Are you feeling more friendly with yourself?  If not or if not enough, consider medications.

This is not a complete recipe.  I didn’t speak about diet, water, air.  Can’t live without them.  But for now, I wonder what this recipe will make for you.  Please let me know.

Self Care Tip #27 – Do this.  Be a friend to yourself.

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Basic but Effective

Keeping things simple is easier said than done. When I’d come home from a lecture, confused about what happened in there, I’d think I was the problem. Then my brother told me that someone really needs to know what they’re talking about to be able to teach it clearly. Those mostly innocent professors suffered this silent abuse from me thereafter. Everyone needs a defense.

We each often find ourselves listening to the instructions of our own internal dialogue. The familiar sarcasm, “Doctor heal thyself” comes to mind.

Ideally, you would find outside input whenever you could. Ideally you would gather counsel, and education. Ideally you would not be alone with your thoughts. However, being alone with our thoughts is often the reality of our non-ideal circumstance and deserves respect. How does one give their own selves good counsel?

Keep it simple. Work with your paradigms you know about and try to tease them apart to clarify where your feelings and thoughts are coming from. Am I sleepy? Am I doing something to my body that isn’t healthy? Is someone doing something to me that must stop? Peel away the reasons why these things are happening. Don’t stumble over them at your most basic level. There will be time later. Keep your counsel on basic needs. Simple. The rest comes naturally, of its own invitation – the layers and complications of life.

To be honest, despite the dangers of taking our own counsel, we do. A friend to yourself does this simply, because that is effective. Like any good teacher, we can.

Self Care Tip #14 – Basic counsel is effective counsel. Be a friend to yourself.

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Keep It Simple

Being a friend to yourself is obviously a changing effort, depending on your needs. It includes many intersecting paradigms including physical health and biology, genetic predisposition, coping skills, what you do to your body, what is done to your body (such as trauma), emotional triggers, spirituality. I’m sure there are more that we will continue to learn about through the ages.

Deciding where your energies will go can be more objective when we tease apart these paradigms. For example, if I’m tired during the day, have irregular sleep hours, feeling emotional and irritable, I’d start with sleep hygiene. This basically says that if you aren’t having sex in your bed, all you get to do is sleep. No food, no phone, no tv, no reading; just sleep.

Where you are going to spend your energies should be as basic as possible. As preventative as possible. As elemental as possible to start out with. Although the efforts you make shift with your needs, being friendly with yourself means picking your battles wisely. You only have so much energy. Keep it simple.

Self Care Tip #13 – Keep it simple. Be a friend to yourself.

Mother’s and Sleep
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Mother’s and Sleep

I was speaking with a friend, mother of 3, including a new baby of 3 months.  Any on-looker could say she had it all.  However, she wasn’t feeling happy.  Looker’s on could also guess just as well some of the reasons why.  Especially those of us who’ve raised infants.  It’s called sleep.  Sleep, the elixir of good living.  Without it, color fades.  Sounds and voices take on an edge like the underside of a long fingernail.  Our thoughts swim about in a mire.  Finding words is confusing and speaking them reduces us to… to what?  Well you’ve been there where my friend found herself struggling to say why she wanted to cry and beat her children.  Just to hear her is enough to make your milk let down.

Hearing someone say get sleep is uncomfortable.  It brings up all the cultural reasons why we don’t get sleep, the emotional reasons, the relationship reasons, and the reasons around discipline.  Well, whatever it makes you feel or think, it comes down to biology.  You won’t feel good and be healthy emotionally and be able to do things you want to do for others if your body and brain isn’t getting restored at night.  So losing sleep may feel like a sacrifice you’re doing for your new baby or husband who wants to stay up and watch movies together, and it may.  However it is also other things.  Losing sleep is taking yourself away from them tomorrow.  It takes from your own journey, disconnects you from your own self.  Losing sleep is a biological cascade that leads to deteriorating goals, including your ability to give well.

There is sacrifice also in letting your child cry for 5 more minutes before going to him at night.  There is sacrifice in going to sleep instead of staying up to play with someone you love.  Don’t be fooled in to thinking that you’re getting your child from her crib when she cries for 30 seconds for her sake.  Don’t be fooled into a mother’s martyrdom.  Babies are also healthier when allowed to self soothe.  Babies are healthier when they learn to put themselves to sleep if they awaken at night.  To get good sleep, look past the guilt, look past the immediate pleasure, look past the distraction, look past and see yourself as you will be tomorrow.  Let that be the sacrifice in your life.  A healthy mom, a healthy wife, and healthy individual for those you love.  Sleep for your own valuable self.  You have a chance to live well.

Self Care Tip #3:  Get sleep for any reason that makes sense to you, but sleep.  Be a friend to yourself.

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