Great to ground in reality. That voice in our head…
Remember there are no dividers between God and mental health. Some patients think they have to chose; either get to go to a psychiatrist or to a pastor. Reminds me of the “seers”, like the Witch of Endor. Go to her to ask for help and you lose God’s presence in your life.
When Saul saw the Philistine army, …terror filled his heart. He inquired of the Lord, but the Lord did not answer him by dreams or Urim or prophets. Saul then said to his attendants, “Find me a woman who is a medium, so I may go and inquire of her.” 1 Samuel 28:3-25
When I was a little kid, I thought that when I would go do something bad my angel would stay behind. She couldn’t come into that bad space. Like if I went to see a bad movie, my angel would wait for me outside the theater. And with some my patients, maybe they think if they come into my office they have to leave their angel at the door.
Brent asked the question, quietly as if someone would overhear, “Will God help my depression?”
Wow, that’s such a great question.
So God is not a vending machine. But God is in all of “these things”. God is in the space that psychiatry and the “God-topic” occupy. He/She is in all of these things that He provides us; treatments, friends, medications, clean air, stable government, and what not. (I’ll say, “He,” because that’s traditional.) He gives Brent medication and God is a better psychiatrist than I am. He gives patient’s NAMI, (National Alliance on Mental Illness), and psychotherapists, and so many other treatment options.
Brent replied, “I’m glad to hear you talk about this because it gives me hope. And I want to renew my faith in God and start practicing my faith and saying daily prayers to Him. So it’s good to hear you as a psychiatrist here talk about God, and God helping me heal, so that makes me feel good.”
The next question is what type of God do we believe in if it’s not this God? This God who is in this space? This God who isn’t held back? Who isn’t an either-or God? This God is a God who cares about our depression. Why would we even want a God that is otherwise?That wouldn’t be very loving.
Brent replied, “God, who could help us in every way and doesn’t … that’s … I mean, basically God should be one that doesn’t allow violence and suffering and sickness.”
But there is suffering and violence and sickness. So who’s God in all of that?
B, “I don’t know. That’s a question I have.”
That’s the question that we need to struggle with through our suffering. Because it’s one of the purposes of our life, to find out about the love of God. Because God is … I believe that God is love, otherwise I don’t want anything to do with him. We have this job to do, find out individually who God is. Use our suffering as a tool. Such as, while we are suffering, it may be an opportunity in a way to say, “Why am I suffering? Why is there this pain when God is love?” It’s huge, right?
The struggling with our view on God’s character is muddied by comparisons as well. sIt looks like “everybody else is fine,” like God is being a God to them but not to Me. And that’s just mean. So, based on our premise, God is love, this can’t be true.
Brent said, “I know, but that’s how I feel.”
Thinking that it is true, God playing favorites, or God with limited love-supply, is one of those creepy feelings in the relationship. Something sinister. A Bogey loose wreaking havoc on our foundation. And if this foundation is havocked, it is hard to launch. Imagine pole vaulting off of a mound at the beach. This inconsistency with our view of who God is is either about God or about us though. And that’s a stop-drop-and-roll point. A point when we realize there is an inconsistency that we shore up.
Brent replied almost in a relieved voice, maybe a little like getting something off his chest, “It’s probably about me, not God, because He loves us all the same. So it’s probably more about me. Maybe with my sickness I don’t …
I’m not thinking right, you know? And I perceive myself as being worse off than I actually am.”
Me, “Would it be that you have something God doesn’t want, so He doesn’t want you?
B, “Well, I don’t think so. God loves us all. That’s my feeling.”
Me, “Okay, so it’s not that you’re so bad.”
Me, “Is it that God can’t quite get it right? Like, He’s just doing His darnedest but it’s not enough.”
B, “Maybe that’s it.”
That would be pretty lame, God. (I’m speaking directly here.)
Who is God? And if God is that week, again, I’m not really interested.
Using the premise that God is love is more than Truth. It is also a self-care tool. We can use it to clarify distortions about why we are in the condition we are in. We need this premise to keep us from isolating from Love. To launch better. We need this premise to have connection in our lives.
Self-Care tip: Use the premise, God is love, whenever you can.
Question: Where are the places that the bogey is wreaking havoc in your life?
People often come to psychiatry afraid. Not only from what the diseases do to them but also of psychiatry itself. They think it might harm them. They think pills will change them into someone else. Will diminish them somehow. But that’s not the agenda of medical therapy. The agenda is to improve their quality of life. The intention is to allow for a greater ability to experience connection, with themselves and with others.
In our relationship with God, we often think the same thing. We think God is here to restrict us. To limit us. To suppress us with rules. But God’s agenda is to increase our quality of life. To increase our connection to self and others. To heal. To reconnect is in essence healing.
In “Patriarchs and Prophets” it explains that we are purposed here on this earth to love and be loved.
My patient, Evelyn, was telling me at one of her lowest points in life she didn’t pray. She said she didn’t know what to say to God. The pain and suffering of losing her son and then almost losing her daughter disconnected her. That’s the biological psychological and sociological paradigm in action. It was wack. God’s agenda is to bring us back to what we all want in the 1st, middle, and last place. God’s agenda is good. She/He has our back and also the bank to spend on us toward healing.
I can imagine walking into God’s office. Furniture all feng shui. There’s a diffuser in the back and some great lighting. But I’m afraid. I’m afraid of myself and my condition, but also afraid of what She/He might do to me. Somehow, I’m at yet able to understand that God is someone pretty great who wants good, and never anything bad for me and I’m willing to engage in treatment.
If God weren’t, it’s got to make us all wonder, what kind of beast are we worshiping here? Who is God? I’m thinking God is at least as kind as I think I am. Probably more. Wink.
Question: Who is God? What’s God’s intention.
Self care tip: Give it a go. There is healing bank there for you and Me.
There are no dividers. This is no surprise to perceptive temperaments. They are the people who cut windows into every wall. Grazers chasing the next butterfly who never want to barn-up for the night. Perceptive temperaments are idea makers and if you pair that with the intuit, then you have someone who is basically a human filing cabinet. They vacuum information and it gets dispersed and organized between all the gazillion neurons in their brain without them even knowing they are doing it. They’re not using flash cards or lists or calendars. Information makes its way into a connection and bigger picture. The rest of us live by sweaty lines and frames and structure and the idea that in reality, there are no dividers is mind blowing. It’s Roadrunner dynamite to our deliberate order.
Information is fluid and related at every contact point. This is true also for God. It is true, as well, with God and psychiatry. I think in part it may be why “the church” has such difficulty filing a hole into the idea that emotions and behaviors are moral issues v that they might also be biological. Scrambling that together, egg yolks and all, is unpalatable to many in this well packaged culture, filled up to the brim with temperaments that don’t naturally allow for that.
It’s a beautiful concept though. God has no dividers. God is inside it all, perfused, smeared, imbued. When we think of a limitation to our ability to see God in something, or vice versa, the limit is with us. God made it all. He/She has got the master key to all those doors.
Question: Where does God not make sense in your life?
Self-care tip: Relax into the knowledge that wherever you or your thoughts are, there is God.
I imagine some day I’ll understand why users think drugs are healthier options for them then medications.
“Doctor, I don’t think my wife will be comfortable with me adding another medication. It seems like I’m already taking so many!”
Context: Brennon is using THC “for sleep” he explains. Not recreation. It’s “medicinal.”
Boy. We are going to have to redefine what “medicinal” means in the urban dictionary vs. in the medical.
It’s as if the masses out there are acting like it is stigma behind any opposition of THC vs. science. Folks, there may be stigma involved but it’s mostly science. THC is, 99%, not medicinal.
My cousin is a hospice nurse and she and I were discussing this. Along the meandering conversation way, we came across, that in her field, many are taking CBD. (I know most of us think CBD is THC-free but it’s not unless it’s thoroughly governed by the FDA.) When we were in our wandering conversation about this, I imagined out loud to her, “If I were dying, I’d want to take a good trip on LSD, do a line of cocaine, and have free access to heroine. Why not?! “
My cousin politely explained that in end-of-life, most people, not apparently ignoramus blind bigots such as myself, prefer to stay alert in their last moments with their loved ones.
That makes a lot of sense. My “free ticket” to white clouded oblivion suddenly didn’t look as appealing. I’d like that too. I’d really like to have connection with my loved ones. At any time.
This is the effort in psychiatry as well, believe it or not. When we medicate, we are seeking to align ourselves with the patient’s agenda, toward connection and not away. Toward quality of life and not to harm. Toward hope. When we encourage to take medication, it is not to seek oblivion and isolation. Rather medication is for connection.
Brennon is not alone. Many think that medication takes us away from connection. Away from connection to ourselves by turning us into something we are not. “Doctor, I don’t want to take anything that will turn me into someone I’m not.”
Away from connection to God by taking our willingness to submit to His/Her will, away from His/Her power and toward depending on science instead, as if there is an either/or. No, there is no either-or unless we put it there. There are no dividers between science and God. He/She made them both. They are fluid to Him/Her.
Nor is taking medication taking us out of connection to our partners, nor our family who thinks medication is a cop out and whom are loaded with their own journey of self-discovery over their own self-stigma toward medication. As if taking medication makes our patients less loyal to their loved ones, thereby less connected.
It’s so layered why we think medication is worse. Even worse than mind-altering THC. Even worse, than the disabling illness, or whichever idea it may be.
Question: What is medication worse than for you?
Self-care tip: Seek connection, “even” through medical ways. Be a friend to yourself. Keep on!
Delicious rocky road Baskin and Robins chocolate cake was staining Fred’s teeth bright vampire red from the frosting. It mesmerized me as we bantered. Though, not enough to completely distract from the trigger setting off my sympathetic tone.
“So, you are writing about God and psychiatry?” (Ba-boom!)
Fred is an enormous genius, well published and internationally acclaimed. (I’ll call him, “Dr. Fred” to give some cred, because he really is all that.) He’s super kind with real attachment to his friends and the random stranger, but still intimidating as heck when he wants to grapple ideas. I sent up a prayer that God be in this talk and not my pride in the talk. I botched up good once or twice but in the end, if nothing else, I was blessed.
In his own life journey, Dr. Fred had done his own Jacob-like wrestle with God. He was still recovering from it, I think. I respected him so much. Some of us are given the chance to wrestle and we choose not to. Fred had courage and character. He brought his all to this interest of who is God.
To clarify my starting line in this discussion, I offered up my little premises;
- God is,
- God is Love,
- and We Are Designed for Connection.
He nodded. “Ok then.” I felt a little deflation in his interest because much of his personal wrestle was prior to that line/premise I drew – “God is.” Even so he rallied and engaged.
“Ok then. What if you were to say that we should bring and deliver love ourselves? In all interchanges. In all encounters. We bring love. What’s wrong with that? Do I need to have this God in that case?”
Honestly. My little corner of the world, my home, my church, my grocery store, all would be better if I/we lived this way. I am proud and blinded by it. I interpret the world and call what is real and truth as defined by my own sight and how good could that be by definition? I am not loving enough.
The idea of bringing love is wonderful. That’s not a difficulty for me in concept. My difficulty is where it starts from and ends from. It’s a place of disconnect. A place that start autonomous from a Creator. A Maker isn’t there at the end either tying me to Him/Her. Connection. With what I understand of Dr. Fred’s perspective is that even if we were to bring love, give love, generate love, in the end, we are alone. Disconnected. It is because we are created and connect at all points that we are never alone.
I guess, inherent to the word “Love,” well it means connection to most of us. So this is a hard bridge to shimmy. It’s like water water everywhere and nothing to drink. We have this sense of goodness, kindness, call it love, in our lives, but we are still alone. I’m cringing because I don’t have it. This sounds pompous and I’m sorry. Forgive me. I’m offensive. But I don’t think God is offensive. So I’m getting it wrong. Help me?
When we run into something that doesn’t fully make sense, the problem’s not with God. It’s with us.
I am a Christian whose church doesn’t like a lot about her.
So, I was standing on stage singing songs, my service/therapy dog, Timothy, chose to lie down, belly side up one step down with his goods in full view of the saints. I think that’s when I officially lost their favor. Timothy comfortable on the raised dais, …just no. Next thing I knew, Pastor and I had the most awkward phone call of my life. Basically I learned that emotional support animals and therapy animals, no matter their licensure in these, are not legally defended to attend church.
But church is different than God. To me, it is full of people like me. Proud. Blinded by pride. Defining the world around them, what is truth, what is real, all through their senses, no matter the biopsychosocial condition of their organ; their brain. They need me as much as I need them partly because none of us can be a mirror unto ourselves. Sometimes we both get that, and it’s lovely. Other times, not so much and we fall apart. In the end, though, I remain connected. Connected because I am created. I am carefully made. I am wonderfully made. Marvelous are God’s hands that made me. My soul knows it well. Ps 139:14.
Self-care tip: Find your connection. There is Love.
Question: Tell us about connection in your life. Where is it? What is it? We need your voice.
I’d like to introduce you to “Emotional Support Goose – Unconventional Wisdom and Support,” found on Facebook. Please check it out and let us know your thoughts – smile.
Ladies and Gentlemen! It’s time to go to sleep! Wait. Not till you read this.
PsychU, a patient education website, has invited me to present on sleep. These are their questions and how I hope to respond. Do you have any recommendations, other interests, directives? Please help me! Smile.
1. Dr. Johnson-Quijada, in what ways is sleep important for our behavioral health?
Sleep rudders our biology ship, (if “rudders” may be used as a verb.) Our biology is the reason we have emotions and behaviors. Take out the brain and we don’t have any problems with emotions and behaviors. So the biological health of the brain and body is where our focus should begin with when thinking about emotional and behavioral well-being. This is not in exclusion of other import paradigms, such as the psychological or sociological influences on what make us who we are.
But let me ask you,
Now think about it and answer your true beliefs.
I was speaking with a wonderful physician the other day to whom I asked this question, (let’s call her Doctora.)
I respect Doctora for her character, personality, standard of medical practice and interpersonal beauty. She is a bulldog in the operating room. When patients need studies done that insurances won’t pay for, she tears barriers to treatment apart with vicious tools of rightness. And she cares. She sits. She asks. And she cares. She sees the person in the paper gown, each one for the person she knows them to be and the person yet unknown.
I admire Doctora greatly not only for these qualities but also because it gets personal. I, who have my own special practice of medicine, cannot do her’s.
When just a green bumbler in medical school, there was a fateful day when I shadowed another great artist of medical care into a locker room. I suited up in that blue sack they call scrubs. I put little blue sacks over my tennis shoes too.
Do you know why there are blue sacks on the surgeon’s shoes? So what is on our shoes won’t contaminate the operating room. But also so that when wet things come out of the human body and fall onto their feet, their toes won’t feel squishy. Yep. That’s what was going through my mind as I scrubbed my hands, each finger and each finger nail the ten minutes it takesto reach what is considered clean.
Surgery in progress, the color red mixed with a smell and monstrous sensual force that clobbered me to the ground. I swooned, gagged and promptly ended my surgical career.
There is nothing more irritating to a surgeon than someone who doesn’t appreciate the “fun” of “cutting.” Yes. I irritated this mentor and others too I’m afraid.
This doesn’t keep me, unfortunately, from pleasuring in telling people, “I am licensed to do surgery.” I am you know. Any Jane with a medical license can pick a scalpel up and bring back the dark ages, or contemporary, depending on who holds the license. I’m irritating to my mentors, remember. It reminds me how anyone can go online and pay to become a marriage registrar, i.e. perform a marriage ceremony for couples. My brother did that twenty years ago and has yet to perform the marriage ceremony for a willing couple. For real judges and clergy, this might be irritating too and that makes me a little happy as well.
Anywho, Doctora and I were rolling with the injustices haranguing us in the practice of medicine, both from the angle of the physician and the patient. I was pumping her up for being the cutting-wonder who she was and she was dutifully marveling at my jabber-mouth work that she would, “never be able to do in a million years.” Somehow this brought us round to how our culture avoids embracing the biological paradigm of anything inside our skull but is so willing to celebrate it for any other part of our human bodies.
Where do emotions and behaviors come from?
Doctora answered me with a frozen breath. Then after I warmed and soiled the air with a lot of jabbering and she was finally able to speak, she said,
I would just be horrified if my brain got sick!
I wondered if it was scary enough to clobber her to the ground, but I do agree. Terrifying. Don’t you think?
So sleep is important from a basic rudder-rudimentary perspective of healing, restoring, and preserving our biological identity.
If we don’t sleep well, a disease process may develop.
During sleep, we heal from injuries, both physical and mental. Our brain actually shrinks for a small period, squeezing out, like a sponge, the toxins that accumulate during the day. It becomes smaller in mass without the fluid that filled it. The toxins drain into our cerebral spinal fluid (CSF) and after a period, the brain absorbs new clean CSF and expands in size again. Without deep sleep, the brain retains the toxins it accumulated during the day and those toxins go on to damage the brain cells, summarily over time, potentially harming the brain health and leading to disease.
These treatments relating to sleeping well are often better than pharmaceuticals when it comes to processing and treating stress. When we sleep, we allow our broken neuronal connections to regenerate. We re-stock our shed with ingredients like cortisol, hormones, and neurotransmitters that are fertilizer for well-nourished thinking, kind behaviors, and stable emotions. During sleep, our memories consolidate; they find their place in the folds between our cells and root down into our rich minds.
I have seen regular, restorative sleep bring someone from a place of mental decline to no longer needing psychotropic medication. Everything works better with sleep.
2. What are some of the tools that you like to use to help people develop better sleep hygiene?
Sleep Hygiene, according to Dr. Q!
1. Bed is for
The bedroom is only for sleep and for sex. This means no food, no phone, no TV. If you are not having sex, then all you get to do here is sleep. This might be an adjustment for the entire family, if your spouse is used to clicking on the late news or your kids want you to read them stories in your bed. But your subconscious has to recognize this place as a sanctuary, and not the place to read one last chapter or check Twitter.
(I have yet to have someone tell me that this improved their sex-life, but one would think!…”)
No naps longer than 20 minutes during the daytime. If you are tired and have the luxury of lying down during the daytime, do it! But set your alarm to wake you up in 20 minutes, and then make sure you wake up fully. You can take these “power naps” 20 times a day if you want to, as long as they are no more than 20 minutes at a time. Anything longer will break into your deeper stages of sleep and throw off your sleep cycle (also known as sleep architecture or circadian rhythm) at night.
Exercise, but not before bed. Exercise during the day can help to regulate your sleep cycle by making your body tired at night, but make sure you do not crowd it against sleep initiation. Try to get 40-60 minutes of aerobic exercise, 5-7 days a week. Look at it like a pill, prescribed by a doctor. This is something you need to do not for your waistline, but for your medical and emotional health. Every day, tell yourself, “I’m exercising so that I will feel good, so that I will sleep good, and so that I can do what I want in life.” Some say, “I’m exercising for my brain!”
Keep the lights dim before bed, and turn off the screens early. Darkness releases melatonin from the pineal gland in our brains, which helps to regulate our sleep cycle. Light suppresses it. Melatonin is a cornerstone in sleep architecture. Having your face six inches from the computer or TV before you lie down doesn’t give your body much time to turn itself off. (Some people who feel they must be on the computer or TV before bed have found that wearing sunglasses for at least the last 30 minutes helps.)
Go to bed and get out of bed at the same time every day. Enough said there.
6. 30 Minute Get Up
If you go to bed but cannot fall asleep in 30 minutes, get up and do something else until you feel sleepy. Then go to bed and try again. Refer back to the other rules when choosing your activities (no screens, no reading in bed, etc.).
No caffeine in the second half of your day. Period. No matter how good that iced latte looks. Decaffeinated is the way to go!
Do not use alcohol to sleep. Alcohol is a depressant (will make you depressed) and also blocks deep sleep. Alcohol hits the same receptors in the brain as the benzodiazepines mentioned above.
Do not smoke before bed or if you awaken from sleep. Nicotine is stimulating. (It also decreases blood flow to the penis, so that’s one less of only two allowable bed activities we are allowed… Bummer.)
10. Sleeping Aids
If you cannot fall asleep in 30 minutes, consider taking a sleep aid. Do not take any over-the-counter sleep aids except natural melatonin, valerian root, or chamomile. Others almost all contain diphenhydramine, which blocks your deep sleep. You may end up sleeping a longer amount of time, but you will not be getting restorative sleep.
If you talk to a doctor about a prescription sleep aid, do not take benzodiazepines, such as diazepam (Valium,) temazepam (Restoril,) clonazepam (Klonopin,) alprazolam (Xanax,) or lorazepam (Ativan.) These also block deep sleep. Sleep aids that don’t block deep sleep and sleep architecture include atypical benzodiazepine receptor ligands – such as zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata). Trazodone (Desyrel) is also safe for sleep structure and maintenance. The newest FTY (Friend to Yourself) sleep aids are Belsomra and Silenor. Sometimes people will find that combining sleep aids, such as zolpidem with trazodone, is more effective rather than using only one agent. Some of these wash quickly out of the body, and some take a full eight hours.
11. Sleep With Me
Do not sleep with your pets or children. Pets and children are disruptive, and no one gets the rest they need. Get the sweet buddy-dog out of bed.
It is not personal. It is sleep hygiene.
I’ll insert here, that one thing that gets left out of most sleep talks, is how to be awake.
Because, the opposite of sleep is not just slogging around in a haze. It is alertness, attention, and memory.
Sort of abandon sleep hygiene for a while. Give yourself a break from the disappointment. And then be firm on the effort of daytime alertness.
Practically, all of this means reading, writing, talking, and moving. No nap unless before noon. The body requires all these to be alert. And vice-versa for alertness.
This is where I additionally bring in the concept of a stimulating medication such as provigil. Don’t confuse this with taking caffeine. Caffeine is metabolized way too fast to be helpful in this regard. There are others one may discuss with their treatment provider.
3. What parting words do you have for other practicing psychiatric healthcare professionals regarding this topic? How about for the consumers?
For providers and consumers alike, remember our identity is as humble as the cells from which is is generated from. Our identity is as vulnerable as those cells are. The basic needs of the body, such as sleep, lead to the most beautiful and marvelous developments that this life can bring. Without our biological health, without healthy sleep, everything in our body and what our Me connects to, is affected.
Questions for you, readers: Again, do you have any recommendations, other interests, directives?
Please help me!
I’m sitting here in a volunteer medical clinic for a 60K attendee camporee. It’s humid and hot and we are seeing a lot of dehydration, amongst other things.
As a psychiatrist, I’m humming the Hallelujah chorus as I discover how much general medicine I still remember, from gout, viral rashes, respiratory and ear infections, cuts and bruises, and so forth. The group I came with teases me that if someone comes in for a cough, two hours later they will have disclosed that they were abused as a child and be swallowing prozac. I am ignoring this implication that I am missing “the point” by treating for psychiatric needs. Ignoring and missing, at least it’s consistent.
Our theme from this camporee week is appropriate. We have been looking at the life of David. In these, we see a whole lot of psychiatry going on, both medical/biological, and that which has to do with volition. King Saul demonstrated a sure biological mental illness. And David pretended to be crazy – call it, “acting out.”
God put this in the Bible for some reason(s). Question: What does this say about God’s character? I mean, we certainly don’t look up to people with acting out behavior, like David. Nor do we necessarily look up to people with mental illness like Saul, either. What does this say about who God is? Why does God put this in the Bible?
The Bible didn’t describe this as psychiatric, behavioral, acting out, or general medical. It just told the story. These ages later, we can do more with the story. Here in time, with the knowledge that the generations have given us, we could say something psychiatric was going on. But generally, despite this knowledge, we ignore the medical condition. We still talk about them with a weighted moral perspective, as if they departed from their spiritual walk in these behaviors, rather than consider the medical condition of their brains.
David is getting a javelin thrown at him while playing the harp. Patton State Hospital for the criminally insane might have housed king Saul if he were alive today. Then, David is in front of the Philistines with King Akesh, where he “pretended to be insane; and while he was in their hands he acted like a madman, making marks on the doors of the gate and letting saliva run down his beard.” (1Sam 21.)
Dr. Martorell, a neonatologist, told me,
“I see so many people afraid to discuss problems such as depression, anxiety, other psychiatric illnesses and even family problems or abuse. Yes, partly due to the fact that they may be judged as not having enough faith or not taking care of their health or not following certain principles.
Primary Care Nurse Practitioner Carrie stated,
“God and psychiatry go hand in hand I believe, but many Christians don’t think psychiatry has anywhere to go in the church. This is sad because my mom had bipolar, but nobody could help her. She needed the ‘extra help’. The church thinks we should be able to handle it ourselves.”
You may have seen the lock-down type who says, “Keep it in the family. Don’t tell others what goes on here. It’s none of their business.”
Dr. Martorell said,
Our cultural or family upbringing has a lot to do with how free we feel to discuss these issues. In certain cultures mental health problems are simply not discussed. If it gets brought up, the family directly or indirectly tells the affected person suffering not to discuss these outside the home, as though it were some dark secret that cannot be disclosed.
Nurse Carrie said,
“Everyone thinks we should deal with things on our own, and we shouldn’t have to talk to people about our problems and what’s going on in our lives.”
Ironically she is describing a condition of the church of independence. Yet inherent to being a believer is the learning to depend on someone else, God.
Nurse Carrie said,
“Why is it with depression and such, we can’t work as a church and have medical get it done.”
Many say, ‘If you go see a psychiatrist, it’s a sign of weakness. You’re not a good Christian.’ These are the comments I’ve heard of through the years. You should just pray, and God can take everything away.”
When my aunt suffered colon cancer, she didn’t get medical treatment in the beginning, preferring to have herself anointed, and follow a “homeopathic” approach. Later as it progressed, she changed her mind and found it was too late. So although largely, it isn’t only in psychiatry that we misrepresent who God is, we need ask ourselves, Who is God if what we believe about this is true?
Dr. Martorell shared,
As a neonatologist, I see infants born prematurely. Their brain develops outside the womb and are simply not the same as those that develop in a dark, quiet environment listening to mother’s heart rate, free of noxious/painful stimuli inside the womb. As much as we try to imitate a womb with our incubators we can’t provide the same care. When these infants are followed up for years, some develop physical deficits such as cerebral palsy, blindness, the need for oxygen, and the inability to eat on their own. These physical problems are easily seen and various treatments can be provided. They are also at greater risk for developing learning deficits, hyperactivity/inattention problems, depression, anxiety and some academic papers even suggest increased risk of schizophrenia. The thought behind these is that billions of synapses are occurring during pregnancy and the way these synapses connect is different in premature infants. It is also interesting to note that the brain volume preset at birth occurs during the last 4 week of pregnancy. As these children grow up they need treatment for physical problems as well as psychiatric problems they may develop.
I realize that it is not just in our churches that we are afraid to address this issue but I see it in the families of my newborns. So many of these moms self medicate with illicit substances in order to treat their anxiety or depression. Our culture as a whole has neglected to look at these issues as a medical problem that needs treatment. So many children and teens are committing suicide. Our own “well educated” health professionals have some of the highest suicide rates and yes it is occurring in our christian institutions as well as outside.
Nurse Carrie said,
“In this kind of approach, people are saying S/He’s not a loving and forgiving God and S/He doesn’t understand us. If you deal with psychiatry, you’re a sinner. Why can’t you get it done with God on your own. He’s not a loving God, saying this person is not allowed to take medication. The pastor’s describing a cruel God because he’s not allowing the person to get the help he needs. Like if someone’s leg is bleeding and you refuse to give that person a band-aid.
But, God is always loving. This can’t be true.
I don’t think the pastor has a right to tell the parishioner that.”
Maybe we just succumb to the awkwardness of it all. Too awkward to talk about God in our community. Too awkward to talk about psychiatry in our church. There are so many reasons we approach emotions and behaviors this way but in the church or outside of it, let’s consider the question, What does this ay about God’s character?
I was cleaning up a leg laceration about 1 1/2 inches long and 2cm deep. I placed the triple antibiotic ointment and approximated the edges with steri-strips, yet still encouraging the patient and her guardians to take her to the urgent care to get stitches. This wasn’t a sterile environment and our supplies were limited. While working on the wound of the young teen, I asked a few brief psychiatric intake questions. It turns out, no. She didn’t have anxiety, or depression, or psychosis. What do you know!? Not everyone does. But she and her guardians were super pleased to pray together before they left and I was blessed by them.
God is a God of love and the kind of God that cares about all of it in all of us. S/He is kind and not miserly, discriminatory, or punitive in interest and connection to us.
It sounds like from what i’m writing that psychiatry isn’t seen as a legitimate form of medicine in the church. Or maybe the church doesn’t refer to it, or support it.
A friend from my group read this post and responded.
“We hear a lot about emotions and behaviors in the church, and related directives. We don’t hear however about where emotions and behaviors come from.
I hear, ‘just pray more,’ or that I am lacking in faith. The people in the church get defensive, as if they have to defend God. And that’s not it. Honestly, it’s not complimentary to me that they think I’m insulting God. They are in a way attacking my spirituality. But I know God is helping me and He’s here with me. But I’m still this way. I still feel this way.
There’s a taboo that mental health and disorders all get grouped into this one cringeworthy word, “Crazy.” We’re almost protecting God from crazy by staying away from it in the church. We forget about the sin factor. The separation between us and God. The loss of connection. The word crazy isn’t very nice. So if we say crazy and we say psychiatry and God, it’s almost like we are besmirching God.
Self-Care tip: Ask, and ask again, What does “this” say about the character of God? It comes back to “Me.”
Question: Do see the Bible and your church talking about psychiatry? Where and how? What does it say about who God is?
Me: So Doctor. What do you think about the concept of God and psychiatry?
(I was speaking with a palliative care physician. We’ll label his answers as “P”, for palliative care physician.)
P: I’m not sure what you’re asking.
Me: Well some of us find it hard to think about emotions and behaviors as anything but related to moral values, right and wrong, good or bad, voluntary or involuntary, by choice. We have a hard time not thinking about them as largely spiritually related and not related to our biology.
P: God cares about our whole person, the “biopsychosocial.” That’s all part of it. It just turns out that culturally many of us mainly focus on the the psychosocial, and not the biological. We don’t think about that.
Interestingly, in the hay-day of homeopathic medical care, God told Ellen White to create an allopathic medical school; a school that taught scientific medical care. Thus, Loma Linda University was born, (then named College of Medical Evangelists). So clearly God wanted us to practice medicine also from a biological and scientific approach.
It’s hard to reach the culture though. If it’s total science or total religion, we’re still missing the whole person. The idea that emotions and behaviors come from our brain, well it’s not in our church. It’s not in our popular community either.
To me, psychiatry should not be distinguished form any medical specialty. But in the public mind, they’ll say, “Oh I’m not going to see a shrink.” They’ll see their general doctor, or pastor, but not go to the psychiatrist.
I wonder, was that problem created by the medical community separating this out or from the basic community culture?
Me: You’re first a product of your culture before you become a product of your medical training and the community of medicine, I suppose. It’s like those old adage’s about taking the person out of the “X, Y, or Z” place of birth, but never taking the “X, Y, or Z” out of the person. So as practicing physicians, pastors, therapists, or girl-friend next door, we’ll go through 30 some years of education learning otherwise, and then still believe at a visceral level that emotions and behaviors are a product of our life stressors and learned patterns, more so than the medical condition of our brain health.
Question: Do you see this in your community as well? Do you see the moralizing, qualifying, and quantifying of emotions and behaviors without considering their biological origins? Please speak!
Self-care tip: Consider what this says about who God is if this is true. What does it say about his character? In doing this as self-care, it will come back, around as a “place of safety” for what may otherwise be full of land mines.
Margarit was a lovely twenty-something, with blue-black bouncing hair above a slim pixy framed physique. She smiled easily and chattered like she was on telephone call that was about to lose reception. Her hands moved, conducting her thoughts between us. She was dressed like one of the cool girls on campus, out of my echelon, and who just might stab me in the back if I didn’t know better. But I did. She wasn’t mean. She was super sweet, like honey, and cane sugar, and mangos. Margarit was nice. But she had always wondered if she was being so nice all the time, because she was too nervous to be otherwise.
She came because she was constantly preoccupied by worries over things, “no one should be worried about”.
There had been the counsellors, therapists, and pastors consulted. Margarit and her parents had done their due diligence. With initiating each effort toward getting help for Margarit’s anxiety, they anticipated some degree of success. They thought things would get better. And sometimes they did, in degrees, and for a period of time. but the anxiety always came back. It got to the point that Margarit was put in home school, referenced her looping thoughts for everything, and was socially immobilized.
Maybe you’ve read, Gulliver’s Travels, 1726 by the Irish writer and clergyman Jonathan Swift. When Gulliver shipwrecked and washed ashore unconscious, the numerous tiny Lilliputians effectively tied him down. The rope anchors were so small, like acupuncture needles, yet Gulliver could not move. That’s what anxiety does to us. We become internally preoccupied by it and can’t think much outside of our thoughts. We are immobilized.
The anxiety Margarit had been harassed with since a child took her freedoms away. It chose for her before she even knew what she would decide. Example; friends want me to go to the mall with them. “No,” Before her thoughts could even play with the option. Maybe she wouldn’t have gone anyways. Or maybe she would have. The anxiety chose first though and she wasn’t given the chance.
By Margarit’s third visit, she had improved significantly. She was getting to know herself, she thought, for the first time. I met the parents this visit and they looked at me as a front. I supposed it had been them up against so much for so long now, that they had learned to go at the world this way, like a man plow they both held on to. They asked me why no one had ever recommended for Margarit to seek medical treatment for anxiety.
"We would have done anything asked by one of these professionals we took her to. We thought they should know what to do, but they didn't tell us to get her medical help."
In my mind, I flashed to Naaman being told by Elishah to dunk in the dirty Jordan river seven times to cure his leprosy (2Kings 5). Psychiatry is the filthy river and dunking in it is the nonsensical act of taking psychotropics based on magic and miracles. They were here reluctantly having preferred to start with clergy and therapists, beat up by inappropriate guilt, but ready now to consider that anxiety, in Margarit’s case, is a medical symptom of a biological illness.
The question of why no one had referred them toward a medical approach for their daughter’s illness is a good one, though. I asked a pastor what he thought, and he spoke of the difficulty of not being a medical specialist; not knowing when to refer people. And what of the therapists? Likewise, I guess, that they generally have been trained to approach emotions and behaviors through a psychological and sociological paradigm. And what of the parents themselves? Did they, when their daughter broke her collar bone in the 3rd grade after Christy pushed her off the swings, take her to the emergency room or to the movies for a night out? The ER. But when her daughter showed preoccupied thoughts that permeated her days, affecting her choices, small or large, affecting her sleep, and so forth, they did not think that the thoughts were related to anything medical, coming from her brain. They did not think that the thoughts were more than coping skills, or habits, or choice.
It is a condition of our humanity to want to look at thoughts and behaviors as many bits of our life control to be manipulated intentionally. As if we could. Like “The Matrix.” Or cooking a soufflé. Or driving a 1969 Chevrolet Camero. Shift already! There’s the good intentioned phrase, “Calm down.” “Take a chill pill.”
Oh good. Someone finally said it. If they didn’t I never would have thought of that. Now I am calm because I was told to be calm.
Emotions and behaviors come from the brain. Take the brain out and no matter what chaos hits, we would feel fine. Take the chaos away, and leave the brain in, we are still left with the brain, and what ever condition of health the brain is in. So if the brain is ill, it expresses itself in a way that is ill. If the brain is healthy, the emotions and behaviors are healthy. They are symptoms of a medical condition.
Question: Where do you find your sense of control comes from, considering the biological paradigm? Let’s talk folks!
Self-Care Tip: Consider the biology behind whatever it is that feel and do.
Hi friends. This is unedited. Something unedited really doesn’t have a right to be published online. Ah well. We are all rebels here. Give me your thoughts, mark up for your edits. We need to hear from you.
People come and say, I prayed God would heal me, I did everything right, but I didn’t get better. So I finally came to you. It was my last effort. I’ll do anything. I can’t live this way.
Then we sat together and explored what was happening here.
God is a better psychiatrist then I am, but it is a miracle every time that S/He uses me to answer prayer.
See what God is doing.
I’m grateful I am given these years as I am able to grow in understanding that my job is not as much to see, what can I do. Rather, watch and participate in what God is doing.
The Israelites from Abraham till Jesus came, wondered and wandered around, thinking about what their destiny was. When they got Saul as king, they lost vision of seeing what God can do. Then they broke up into different kingdoms and got more kings. Then they were conquered over and over and they waited to get their victory. Then Jesus came. And showed us that His kingdom was one of love. Could we say, in some ways, it was a disappointment?
I’ve been disappointed at various times of my wandering and wondering how I fit in. Now I am very slowly learning that it isn’t about me.
Do not limit what God can do. Do not squeeze God down to the confines of our own minds.
Ellen White says that we will spend all of eternity learning about the character of God. That’s a lot of content. That a lot of interest.
If we think about all the scholars of scripture; jesuit’s, ravi’s, pastors, people with photographic memories, the wisdom of Solomon, it doesn’t touch all that is waiting there in that space of eternity for us. We are just getting a toe into what will capture our attention for eternity; what will give us purpose, motivation, interest, a wanting to live and connect with self and others for a space of existence that has no parameters to time.
Self care tip: it’s more than Me
Please speak out and tell us your thoughts.
I feel unlikable
It sounds young
It sounds like I’m fishing
But I feel unlikable and it is what it is
I can list my attributes
And do also remember
What others have said
In their own throws of comparisons
It is disconnected though
Me talking to myself
An echo in a cavern
Unlikable might be better said
And I was created for connection
I’ll never survive any pilgrimage on my own
I’m designed to say, “Me too”
But just this
Improves my sense of company
I can’t know why
Writing it out
Makes me think of you reading it
And saying something back
Selfcare Tip: Look for connection. You are not alone.
Question: What improves your connection? Will you tell us an example of a time you turned it around; went from feeling alone to then connected?
One of my strong memories of Marcy will stay, of this Halloween.
She was tired after her day at school. She had gone back to college to get her nursing degree. She was tired, like a shirt that had been over washed in hot water. She was the kind of tired that looked like the good emotions in her water bottle had been slurped down, and the refill was still in the fridge in her kitchen corner. At home. And she was still in the car.
These feelings started to increase and crescendo, and pretty soon she was tieing into memories of failure in her past. A young child who heard her parents yelling at each other in foul language. Marcy heard, “My family doesn’t love each other or me.” A kid who dressed poorly and Mom said, “Go change. You look terrible.” Marcy heard, “I’m an ugly kid.” A teen who didn’t get invited to the parties that she knew were going on. She heard in this, “I’m not likeable.” A young adult who watched her mother walk out on her father. Marcy heard, “I’ll never be someone worth committing to.” And now on halloween, with her daughter coming home from school, Marcy felt like a failure as a student and as a mother.
She told me about this, last week. We were in the quiet space of my office. Lamp light shone over the beta-fish hiding behind his splashing filter.
Marcy told me, she was wilted there, in the seat beside her daughter. Saying words in effort of trying to be understood, she spoke, and she cried. At some point, Marcy realized she thought that if she didn’t go trick-or-treating with her kids, it meant she was a let-down. She wasn’t a good mother.
Not only was she someone who gets tired too easily, she was also a flake.
Marcy threw out a few options; how to make this right for them. Then her mind opened up and processed these. She saw her inner beast let shame go. Something better in her said that she would give what she could, and discharge the rest.
Marcy, in talking it out with her daughter, made herself vulnerable to what brought her shame. In that, she let the truth surface that she was, actually, not “a piece of crap,” after all.
Building on what our living experiences are, rather than disenchanting, they are healing. The easy fantasy that comes from comparison, from fabricated idealism, and from the personalizing of it, is destructive. We can be resilient by building on real experiences. We can be present and connected both to ourselves and others.
Brene Brown speaks on wholehearted living: “It’s about the willingness to be imperfect, to be vulnerable. It’s about the courage to wake up in the morning and acknowledge that no matter what gets done and what doesn’t get done, that I’m enough, and that I’m worthy of love, belonging, and joy.”
Halloween will be a reminder to me of Marcy letting shame go, not identifying with the thin logic of her own self-inadequacies, and of getting into the living of it. That’s courage. That is brave.
Self-Care Tip: Start exploring where your shame is, and let your real experiences speak toward your belonging and self-value.
Question: In what areas of your life do you feel like you are not enough?
What has helped you discover your reality?
Please tell your story! We need to hear from you. Keep on!
What is it like when people talk with you, a psychiatric patient?
How do all the areas we are contending with in stigma affecting your interaction with others? – Demonic possession, shame, violent tendencies, weak character, and poor moral choices?
We want to hear from you. Some stories please.
One patient told me that her parents were angry at her teachers when they were advised to consult with a psychiatrist for my patient’s depression. Her parents were so angry, in fact, that they removed her from her private school and enrolled her somewhere else.
I wanted to ask my patient, let’s call her Brianna, how people speak to her now that she has finally engaged in treatment, as an adult! How do her parents reconcile it? How does her church speak to her?
Briana is among many who suffer at stigma, but her best approach would be to ask how she, first speaks to herself, a psych patient. Does she have biased self talk? We need to start with “Me.”
What are the common myths? Get the myths out there. Some of what the community says are true myths and some are not myths.
- Time consumption.
- Treatment skepticism – no recovery, there’s less hope for them
- Punishment from God for evildoers.
- Demonic possession
- I am lessened by my affiliation with the mentally ill
The patient is sick after all. We agree. Brain illness and all that. This is Brianna’s identity; her emotions and behaviors paint what she and others see. Perhaps, Briana identifies herself as someone with depression; someone who went over her church and parents directives. That takes a chunk of courage to do.
Self Care tip: Discuss and discover the self stigma we have about our mental illness.
Questions – as listed above :)!
Why do you get out of bed every morning? To go to work? You think, “Life i is about working and then, someday I’ll die.” Are you living to go to school? Perhaps a student for life, the best is to gather and gather. A klepto of information. Ma skzwybe you live, instead, to stay home and not leave. That can be worth it. Leaving home feels like going to one’s death for many, in fact, with anxiety.
Is what you are living for, worth “living for?” Why didn’t you kill yourself last night?m I’m not asking for “13 Reasons” or glamorizing suicide in any way, like it ois, unfortunately, being done in the media these days. I’m just asking. (Straight face. Eye contact.) Why?
Suicide is increasing, this year up by ~30%. It’s sad but I’ve heard the ignorant say, “When our world is being overrun by humans, this is just one more way to improve population management.” Why anyone would say that, let alone to a psychiatrist, speaks toward the unfortunate person saying it more than anything. Even so, these are the people that contribute to our cultural stigma and sentiment, like the wrong colloid for growth. This stigma is best diminished by peer-to-peer influence. Your voice; you speaking up is the painting over the foul-language graffiti. You speaking of your own journey with suicidality or any related diseases changes the ignorance into empathic knowledge.
We are in the mental health equivalent to the industrial revolution. Fortune. We are wealthy in mental health treatment options. Bling! Bling! It wasn’t too long ago when we were trusting depression medical therapies to crude agents bulky, and bluntly stunning our neuroreceptors. These were a big stick coming down on a flower.
Think of the cart and horse transforming into the automobile; course into sleek and refined; slowly moving and grossly impacting changes, contemporarily working rather as specific rapid responses. Now remember your parent, or mine, who never had the opportunity to receive a treatment that would work in a matter of weeks, and without turning her/him into a zombie-blimp.
A child stands there going through his own vasovagal experience, scared and confused while watching his favorite person in the whole world performing like a broken toy. The child tries to make sense and restabilize their once clarified existence. The parent goes through this at first for about six months and then somehow “gets better.” Was it the prayer that worked? Was Momma finally able to “pull through it?” Was it because the child’s behavior finally became “good enough” to please God who then condescended to make his momma better? Momma does well for another 2 years. She’s connected. She’s filled with purpose. The memory turns into something like, “Boston’s worst winter in fourteen years;” briefly print-worthy and then thankfully, not much more.
Then momma is again dark, hopeless and staying in bed whenever she can. The child, Teddy, is now a preteen of ten. This comes back, like finding another letter from his cheating dad’s girlfriend under a magazine in the back of the closet where his golf clubs are. And instead of six months, Momma’s change lasts about two years. (Can we even call it a “change” when it lasts two years?)
The amorphic improvement comes again though, like a miracle, but who can trust it. Miracles aren’t gotten in vending machines after all. I We can’t buy them with a paycheck.
Sadly, as Teddy feared, another some many months later, Momma drops again. This time she plummets rather than drops, into a drunken, more terrible condition. For longer, and the boy is now a teen. He at first appears more calloused. Yet, if questioned, he will show his grief and bewildered young self, just there behind a gentle touch, or a cluster of inquiring kind words. He loves her well. Why can’t she love him? Moms who love their kids will get up in the morning. They’ll shower and they’ll talk. They don’t write suicide notes or leave their son’s to find them half conscious when they get home from school. Not mom’s who love their kids.
Our moms, yours and mine in the seventies, didn’t have the privilege of taking treatments that worked or worked well, and rapidly. We are so blessed. How to grasp the immense difference in our Age; this Age of mental health revolution.
Now a little boy sees this change in his favorite person in the world. She is fortunate enough to receive medical treatment, and within weeks is “back to myself again.” This little family escaped years of decomposition by the ravaging damages from brain illness.
My grandma, Elsie Louise, (isn’t that a great name!), was washing her laundry in a new machine that decreased her labor by many hours. One day, when she was daydreaming about her young handsome husband, or maybe it was the chicken she lost to the fox, when she screamed, jerking out from a terrible pain in her hand. Her fourth finger was gone. She lost it, pulled off by the twisting force of the machine’s internal grips.
Now we place our laundry in a closed lidded box we just walk away from. We don’t even think about the appendages we are allowed to retain. We don’t imagine the privilege.
In psychiatry, it is like this. The treatments we had generations past were better than none. But, enter now into 2018, and we don’t realize how good we have it. We forgot most of the print-worthy stories back then. Not to use the treatments from this revolution, is going back to the darker ages of medicine. The treatments save lives. They bless. They make us rich in life. Bling! Bling! Look at your wealthy character. Healthy.
Why are you still alive? Whatever you answer, fight for that. Take advantage of the mental health revolution and live well.
Questions: What are some stories of those you have loved who missed out on mental health treatment? What are some stories of those who did not? Where is the difference?
Self-care tip: Speak! We need to hear you. You are painting over the foul-language graffiti of ignorance!
All around me I hear people talking about finding your “True Self.” I hear it in podcasts, coffee shops, in magazines and even books.
What the hell was everyone talking about and if there is such thing, how does one find it?
What is meant by “True Self?”
First, apparently, it depends on who you ask. If you ask a therapist you get a vastly different answer than if you ask a spiritual guide. Honestly, even from one person to the next your answers will vary.
These are all synonyms of this mysterious phrase. After looking at countless websites, I like what the Huffington Post said in the article, “What does it mean to be your Authentic Self by Judith Johnson.” “Living in a place of profound authenticity involves being rooted in your deepest beliefs, values, and truth and living a life that is a true reflection of them. It is about being true to yourself through your thoughts, words, and actions.”
So from what I gather, the true self is something that is within us. Is it nature or nurture? Or is it something in between (the damn gray area that surrounds our lives)? I don’t have an answer for this, but from what I read and what I have experienced, it is a real thing. It’s ingrained deep in our heart and soul.
Why do I care about this?
When I was younger, I was working at a camp in Ensenada for the summer. It was one of the best summers of my life and I felt that I was becoming the best version of myself. That same summer I met a girl (yes, you can roll your eyes now). I fell head over heels for her and we ended up getting married. We were together for fifteen years, and often I would look back and wondered what happened to the man I was becoming and why wasn’t I feeling any closer to being a better version of myself? I felt that I was slipping away and losing myself.
I wrestled with why. Did I fool myself that summer? Did that woman I fell in love with strip me of my manhood? What happened?
The marriage didn’t go. I decided I wanted a divorce, which happened to be one of the first real decisions I had made for myself since I met her. Pain of the failed marriage filled me, but I also felt the emergence of the boy 15 years earlier. My “true self” surface and that I didn’t have to look back in remembrance of that person. I decided that I was going to become the man I had always desired (I do not blame my ex for the hindering of this man, but blame myself. More on this in another post).
I care about the true self because I struggled for years to step on the road and begin the journey. Guilt, shame, and fear were around every corner. This trifecta left me questioning everything I did (and I still struggle with it at times). Being in that dark place is hard, and I want to help others know there is a better way. It’s not the easy way, but it’s the better way. Or as my friend, Major Lewis would say, “The hard right over the easy wrong.”
How do you find your “True Self?”
The easy answer is to be real with yourself. The hard answer is that I only know how I did and it might differ from person to person.
In my first marriage, I was a fraud and could become whomever the person I was talking to wanted me to be. I was like Julia Roberts in, “The Runaway Bride.” Depending on what guy she was with, she liked a different type of egg. Poached with one man. Scrambled with another man. I morphed myself into someone in order to be liked. Sadly this left my true self-hiding behind layers of falsehood. I pushed away those close to me in shame. My unconscious was wreaking havoc on me. I was messed up.
Be true to yourself. Look in the mirror, and know who you are. It takes time and won’t happen overnight. The first time I went to the shoe store to buy shoes after my separation I ran out in a panic because I didn’t even know what shoe I liked.
I started by giving myself permission to experiment. I would try things and then evaluate if I liked it. Slowly, month after month, year after year, I began to understand what I liked. Then I would do more of that. The small steps of trying something new and being honest with yourself will start to open your heart up to seeing deeper questions.
Self-care Tip: Take a chance on yourself. Try something new. If you hate it, great! If you loved it, great! Either way, you are opening yourself up to new opportunities and trying to ignite the flame of your true self.
Brandon Fries lives in Southern California with his lovely wife and daughter. It was through his life struggles that he found a path towards happiness.
Introducing a lovely book written byare sisters who felt compelled to share personal and revealing stories about their father as he fell deeper and deeper into the tragic memory robbing abyss called Dementia. The two sisters narrate their experiences born from different perspectives, but very much driven from the same heart.
Please enjoy and comment. Dementia is everywhere. It affects all of us. Whether we have a parent, a spouse, a friend, or a neighbor with dementia, we are affected. Even if a community member is suffering from this, known or unknown, we are affected, although to differing degrees.
Dementia worldwide is estimated at 47 million and is projected to increase to 75 million by 2030. It is a huge economic impact – in the US, $818 billion dollars a year. People with dementia and those with family members with dementia are often discriminated against. Awareness and advocacy are needed. Dementia is a public health priority. Let us know where you stand. Thank you for reading.
Self-care tip: Everyone has a story. Tell yours.
She must be in her mid-thirties, I thought. Kids – it looks like she has kids. She was well dressed, with a pleasant, kind face. Everyday Mom – a person who is easy to like, a person next door who everyone wants to be friends with.
Just right now though, she was spouting angrily, full of righteous indignation.
“And just to think that they could have easily killed him, I just could not believe it.” Her eyes were flashing. “I told them right then and there, I will never take him back to this doctor. He almost died and ended up in the intensive care for DAYS!”
The reason for the outpouring, my new patient, was sitting quietly, fondly looking on as she continued. He looked to be around eighty, which I knew was about 10 years more than his actual age. Recently diagnosed heart failure, stroke last year – this would make anyone look older.
The daughter was at the end of her rant. “So, we just decided to come straight here and find another cardiologist.” She pulled out a large binder. “Here are all his records – we want you to take over now.”
Usually I try to be understanding of my own profession and not be quick to join in the blame game. After reviewing these records, however, it was difficult not to be blunt in my judgment. Her father’s case had indeed been poorly handled – he was prescribed two medications at the same time with predictable life-threatening interactive side effects. His daughter’s diligence likely saved his life – when his mind started slipping, she had checked his blood pressure, found it extremely low, and immediately called for help.
After some painful experiences in my career, I had learned that instead of pronouncing judgment, it was best to find things to praise.
“You are quite lucky to have such a devoted daughter, sir,” I remarked. “If you are not aware, I can tell you – research shows that men with daughters live longer, so you have an edge there.”
The patient smiled. His daughter looked pleased.
As I was going through his medical records, I was relieved that this new patient had been scheduled into an hour-long slot – there was a lot to cover. Making notations in the chart, I asked follow-up questions – what other medical problems he had, what were his habits, when was he first diagnosed with heart disease. The daughter answered most of the questions – not unusual when the patient is elderly; younger people tend to have better memories.
Working through the records, I noticed a condition the daughter had not mentioned.
“So, the prostate cancer – when did you have that?” The daughter looked confused for a moment and then turned to the older man. “When was that, Dad? This must have been a long time before I met you.” They started discussing the possible dates – the patient did not have the best memory.
This snippet in the conversation caught me off guard. First I thought I had misheard the word ‘met’. Surely one would not use that word for one’s own father? Should I ask? Social history is an important part of the medical exam. Also – let’s face it – I was curious.
“That was an unusual word choice,” I started carefully. “So, I assume you are adopted then?”
“Oh no,” the woman answered cheerfully. “As biological as can be.”
The utter confusion must have shown on my face. She decided to have pity on me.
“Well, of course, I didn’t know who he was.”
…. That did not make things any clearer.
“My Mom refused to tell me who my real father was – so after she died, I started looking for him. Went through as many genetic tests as I could – and I finally found him!”
There was an unmistakable triumphant note in her voice.
The patient just smiled and continued looking at her fondly.
She went on. “So, then I asked him to come visit us last year. That’s when he had the stroke. Of course he would be better off here, so I just asked him to stay and he lives with us now.”
I tried not to react. To be perfectly honest, I wasn’t sure how one would react. The commitment she described was flabbergasting… and to a father who had never been in a picture. This woman had taken a virtual stranger into her home and into her life and acted not only as a forgiving daughter but as a caregiver to an elderly man with multiple medical problems.
“Family is family,” she announced. “I am so happy I could finally be with my Dad.”
I must confess that there was a small suspicious part of me wondering if she will stick to it. The old man was not healthy and with the recent stroke needed a lot of help. After the initial euphoria of having a father wore off, would she think it too much?
On the next scheduled visit, the daughter was there, with the same updated binder. The father was looking better – the combination of optimized medications and stable home care had done wonders for his health.
On the visit after, the granddaughter had joined them. She was a bright-eyed little thing, curious about everything and intently looking at her new grandfather’s heart pumping on the ultrasound screen I was showing them. The daughter was making notes about medication changes. While I talked to the her about the home care, the granddaughter was trying to talk the grandfather into playing a game once they got home. The whole visit had an atmosphere of care and contentment.
I never asked more questions about their history. Why had the mother refused to talk about the father? What skeletons were in that family’s closet?
She probably would have told me. But it was not my place to ask. As a physician, I was happy enough that my patient had good social support.
Family is family. In this case, family that almost wasn’t.