Adolescence

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Finalé – Me Again. Everything Starts and Ends With Me – Even Emotions and Behaviors.

We are doing a narrative series on understanding where emotions and behaviors come from:

  1. Emotions Are Contagious – Emotions shared
  2. Our own Emotional Junk – Emotions hidden
  3. Positive Emotions and Behaviors are Contagious Too 
  4. Our Conscious Self is Our Board and Paddle at Sea – Small conscious self and BIG unconscious self
  5. Biopsychosocial Model – Biological, Psychological, Social selves
  6. Me! 
  7. Finalé – Me Again.  Everything Starts and Ends With Me – Even Emotions and Behaviors.  (Today’s post.)

We have covered in our series that emotions are contagious.  We know that if we take care of our own first, we might not be as “susceptible” to negative “contagion” in turn and perhaps, be more available to giving and receiving positive “emotion-contagion.”  Further, we hope that if we do this, we might be able to choose to be with people we love even if they don’t do their own self-care.  We can have that connection without personalizing what isn’t about us.  Sigh.  That is nice, isn’t it?  Then …out at sea (away from our narrative for a day,) we talked about the pleasure in engaging with what bits of biology are directly available to us and the relationship we maintain with the big expanse of our unconscious biology.  We reviewed our biopsychosocial model as a tool, and then restated the simplicity in looking for and at Me to discover where emotions and behaviors come from.

Today we leave Rob and meet Iva for our Finalé.

Mother and daughter

Image by Video4net via Flickr

Self-Care Tip #272 – Look!  Me Again!

Iva was crying.  Things could not go on as they were.  It must stop!  The tension and recurring emotional crisis’ between her and her daughter were cancerous to her family.

Iva was trying.  She’d come a long long way.  On antidepressants now, exercising three to five times a week, down twenty pounds and into her honey-moon clothes from many many years ago.  She felt so much better about herself.  She was no longer yelling at every stressor, she felt pleasure again and liked being with her kids, including her daughter… when her daughter wasn’t throwing fits.  However, her daughter was “fits-ing” one to three times a day still.  Iva felt like she had lost control as a parent and gave a lot of blame to her little girl.  This is why Iva came in.  Something wasn’t right about that.  It was evading her, however, what that something was.

To be clear, “little” in this case meant four years old.  Four years old and they could hardly be with each other.  Iva trembled thinking about the teen years ahead.  Iva wondered how a four-year old could drum up so much drama and wield so much power.

Why didn’t she listen?  Why did her daughter make her resort to spanking and punishments to get obedience?  Why did she whine all the time?  

Crying again, Iva was still able to break this down as to where her emotions and behaviors were coming from and specifically keep it about “Me.”  That was our job as we crunched this together.

Emotions shared – Iva had negative emotions that her four-year old was susceptible to?

Emotions hidden – Iva hadn’t gone towards her own something or other?  Maybe she didn’t even realize the negative emotions she felt toward her daughter in the first place to go towards them and see what was there.

small conscious self and BIG unconscious self – Iva had an opportunity to play, work, know and own this little portion of what made her who she was.  The BIG unconscious self she was doing well taking care of with her basic needs – time with her Higher Power, medication compliant, exercise, sleep, diet, water and so on.

Biological, Psychological, Social selves – (A whole bunch of stuff you’ll have to read the previous blog-posts on!  Awesome paradigm.)

And then, finally, Me.  In the space between her and her daughter, Iva had forgotten that it was about Me.  Iva was putting a lot of blame on her little girl.  That’s a lot of pressure for a child to shoulder.  It is not appropriate for a parent to shame her child this way.  This isn’t a moral statement unless we make it one.  It just is.  It-is-not-appropriate.  That’s all.  Iva circled back around and saw herself there.  Her Me.

Iva left thinking things were looking up.

Questions:  Even in your most difficult relationships, how do you own your emotions and behaviors?  Or is there a reason for them outside of yourself?  Please tell me your story.

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It Is My Choice to Take Care of Someone, Even in The Context of Suicide

Detail of The Death of Socrates. A disciple is...

Image via Wikipedia

I was a teenager I think when a woman in our church suicided.  Dad pointed out the man sitting alone.

His wife just killed herself.

Dad asked me what I thought of suicide.  Imagine.  What a compliment really for a teen, to be asked her thoughts.  Being a “Feeler,” I oozed something empathic I’m sure, but still I only remember what Dad said,

I believe God has a special way of seeing these cases.

This was at a time when culturally most of the western world saw suicide as sin.  It was quite forward for Dad to say what he did again later to the grieving man in the pew.  I did not realize at the time, but now I see that people judged him and his wife for what she did.

Later in psychiatry training, my attending said,

Suicide is the most selfish act anyone can do.  It is the ultimate punishment aimed at those who still live.

I don’t know what you think, but I couldn’t help wondering.  I still do.  I think this may be true for some and not others.  I haven’t had a chance to ask them.  They’re dead.

Suicide is terrifying to a psychiatrist.  We all tremble at the thought.  Statistically we know women attempt it more than men, but men are more “successful” when they do try.  They use methods that are generally more lethal than women.  They don’t get a chance to realize that in a month or a day they will want life again.  Or an hour.  They could have lived.

In the intensive-care unit of a hospital, “unsuccessful” suicide attempts hover in life in a space where their self-injury placed them.  The nurses are kept running between medicines, treatments, physician orders and prayers for these lives that tried to die.  Sometimes, the “chronically suicidal” become familiar patients to this critical care ward and that has it’s effect on those who have spent themselves so heroically to save them.

A nurse once told me angrily about her patient who kept coming back.

I fought for that woman’s life!  I prayed over her!  I worked all night for several nights and didn’t know if she would live until much later.  And then she was transferred out to the step-down ward (to a floor where the patients aren’t in such a life-threatening condition), and that lady probably never knew what I went through to keep her alive.

Then later, she came back, and later again, almost dead but not dead.  She kept trying to kill herself!  Finally, when she was conscious again, I just told her how it is.  ‘Listen!  I fought hard for you!  You better go out there and live!  You better figure out what it is you want and go for it.  Stop trying to die!’

This lady-patient was hurting more than herself.  Suicidal thoughts and attempts are dangerous.

There was a patient who tried to use his bed-sheets as a noose before the nurse lifted his wet body from the door frame.  In the emergency room (ER) he was examined, x-rayed and determined fit to return to the ward.  Alive.  Talking to the ER physician, I learned that the reason most people die when they hang themselves isn’t because of suffocation.  It’s because they break their neck.  Done.  No more chances to choose life.  Even an hour.  My pulse was still beating on me to the rhythm of, “He could have died!  He could have died!”  This time, no broken neck.

Regardless of our culture, we are not the judges of these people who want to die.  Regardless of our emotions, their emotions before, any previous conflicts, regardless, we cannot measure their final act by degrees or intentions.

We fight together for their lives and they may or may not know about what that does to the rest of the world.  When we don’t want to fight for them any more, we should change jobs.  It is our choice, each of us.  Whether we are fighting as professionals or as a wife, brother, friend, volunteer or the hired tutor, we fight for their lives because we choose to.  If we cannot keep it up without judging, shaming, accusing the suicidal, we need to own that and take care of ourselves first.  “Can’t give what you don’t have.”

The truth is, suicidality is hard for everyone.  It is hard in ways and in people that aren’t talked about, such as the nurses or the x-ray tech who is the first to find the cervical fracture (broken neck) on film.  It is hard for the church parishioners, the person separated by seven-degrees or the grocer.  Suicidality is hard for all of us.  We give what we choose to give and remember to say, “I can’t control that,” when we can’t.  It is our choice.

Self-Care Tip #182 – Taking care of someone is your choice, even in the context of suicide.  Be a friend to yourself.

Question:  How has suicide touched your life?  Please tell me your story.

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The Good and Bad of Anxiety

In response to yesterday’s blog, a reader wrote,

I often feel my flight and fight response triggered even in situations (mostly social) that should not (theoretically) even be frightening. What do you think about that?

This is like the degrees of water temperature in our shower.  Pretty much every one falls somewhere on the spectrum of this type of anxiety.  When is it ok, and when does it become not ok?  My brother, friend, mentor, Cameron Johnson MD said in so many words

Anxiety is what makes us work hard.  If we didn’t have anxiety, we’d all be slobs.  We’d stink.  We wouldn’t get our homework done.  We wouldn’t say as many nice things.

My children still see most things in all-or-none fashion.  They would say at this point of the discussion, “Anxiety is good.”

A teenager I treat began responding to her medication.  Her mom began to complain.  “She never let this happen before!”  Her room was a mess.  She was less prompt to obey and she started voicing her opposing opinions more.  In some ways, without the anxiety, it was like her mom was getting to know her for the first time.  

This was however, better than anything this girl and her mom had hoped for.  Now the girl wasn’t throwing up, having panic attacks, avoiding just about any social experience.  She was making eye contact with me and she was able to present in class.  She told me that she can’t even think about how she felt before.  It was so bad.

It is really hard for any one who has never suffered from debilitating anxiety to realize the level of suffering and terror it causes.  Someone who may look stuck up, aloof, disinterested, quiet, bored, may in fact be at hells door.

My children might now say, “Anxiety is bad.”

And so to my reader quoted above, I’d say with my children, anxiety is good and anxiety is bad.  Come and paint the stars with me for a time.  Talk and tell me your story.  We shall in degrees of mind and manners, unwind the mysteries together.

Self Care Tip #49 – If anxiety is affecting you in a negative way, consider a medical reason.  Be a friend to yourself.