Name Your Fear To Know You Are Free

She knew the Horned King‘s secret name.

His name?  … I never realized a name could be so powerful?

Yes….  Once you have courage to look upon evil, seeing it for what it is and naming it by its true name, it is powerless against you, and you can destroy it.

The Book of Three by Lloyd Alexander

Science Fair Wins Ribbons

Image by OakleyOriginals via Flickr

Mistakes and the mist of shame thicken about us and it is hard to hope.  As if each effort of our intended labor produced Seconds and Flops we must stand in our Besties beside what we have done to get a participant appreciation ribbon tagged onto our lapel.

And somehow standing there, the layer of sweat thick under too many clothes, we remember the secret name, it comes and we whisper.  We whisper it; our last courage still enough for that.  There is a moment of surprise, as if we and whatever pressed us down didn’t know we might still live.

We can see now that we are not alone; just there, in fact you are there with your own passed over table.  I remember you working nights on it, your tired eyes, a happiness in your muscles still.  In those days.

We can see that we are special for more than injury; we hear now.  We feel concern for more and taste newness that filled the space.  The secret name.

We won’t tell you or it wouldn’t be secret any more.  But now that we remember we are free.  Now that we have the knowing, we will keep the power, thank you.

There is power in a name.

We won’t forget what came after evil and will speak more readily into dark spaces, will wait less and fear less because we have already been there.  Going toward the pain like that.  What’s the worst that can happen when you name your fear?  It takes no more than a whisper to be strong.

Self-care Tip – Speak into your dark spaces the name of your fear.  Be a friend to yourself

Question – What reminds you that you are free despite the fears that tell you otherwise?  How is freedom your truth in life even when your senses tell you otherwise?  Please tell us your story.

Related Articles

No One is Choosing For You – Know Your Choices For Health

Yesterday we asked some pithy questions re: Why Psychiatry?  Your responses were received with gratitude and humility.  It takes courage to understand our connection with psychiatry considering ongoing stigma.  Today we’re reviewing that some and taking it one bit further.

When referred to a psychiatrist for medical care, we can feel confused.

Why is my physician sending me away?  Does this mean I’m at my last resort?  Does this mean I’m that sick?, or,

Does he think I’m crazy?  I’m not insane!, or personalizing with,

Does my physician not want to work with me?  I’m that bad of a patient?  Cast off?

Our expectations when we first see our psychiatrist are often also similarly reactive.  Maybe,

I’ll give this one chance but if she doesn’t fix whatever it is that’s going on, I’m out of here. 

I am not going to be dependent on medications!

I do not want to be made into a zombie!

Are we looking for a cure?

Also, we might be confused by the amount of time that she spent with us the first appointment as compared to our follow-up appointments.

I need to talk about my problems!  I need time!

There’s a lot to take in.

Unfortunately, when we are referred to a specialist, often our referring physician hasn’t effectively communicated as to why we are being sent there.  This is for many possible reasons, including Me not hearing him.  Many other reasons are also understandable with insight but we aren’t always given the opportunity to hear the inside story of why our physician does what he does.  That doesn’t mean we have to accept it.  But if we do, we did and it’s our choice.

Choice

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We have choices.  Before accepting the referral, we can ask, Why?  Keep asking why until we are satisfied with our level of understanding.  Schedule a follow-up appointment with the referring physician if necessary to gain more time if we think we need it.  Sometimes, despite our physicians best efforts, we won’t understand as well as we’d like and we have to make our choice with the information we have.  We can read up on our symptoms ourselves.  I read in Twitter from @NathanBransford,

The 11th Commandment: Thou shalt not ask someone a question thy could easily Google thyself.

That’s ridiculous although I cracked up.  The World Wide Web comprehensively and including Google or any other source within that World Wide Web are not designed to practice medicine.  When we read something, we need to ask for qualifications behind the author of the print, references and so forth.  The Internet is a tool worth our attention but you decide how far you are willing to take what you read before you consult with your own physician.  I think if Doctor Seuss were alive today, he’d write a book (or many) about health care; Oh The Tools We Can Use!  (Maybe Carl and Thysleroux will do a series or a post on this?  Should be fun.  – Asking, “Why?”  Becoming our own friend.  Connection.  Going towards shame, pain, anxiety.  Growing bank – and more.)

And so that brings us to today’s questions:  What choices do you perceive you have in referrals like these?  In your continuing medical care?  In your ability to collaborate with your physician?  In obtaining an understanding of your illness(es)?  Please tell me your story.

Self-Care Tip – Grow your understanding of your choices for your health and medical care.

Related Articles:

  1. Stay Connected For Your Sake and For Theirs
  2. Connecting To Others Is a Condition of Freedom
  3. Safety in Connections

Why Psychiatry?

An American Lady butterfly against a cloud-fil...

Image via Wikipedia

If we have ever seen a psychiatrist, then there has been some point in our lives when someone told us to go or we told ourselves.  I have some questions for you.

How did you hear about psychiatry?

What are your thoughts?

What did/do you understand?

Please tell me your story!

Self-Care Tip – Explore your connection with psychiatry.

Safety in Connections With Others

Nami 01

Marcy came in looking like a question mark.  Despite her gorgeous face and swank, she still looked uncertain.

Marcy was born into chaos.  Get this.  Her father who spent her whole childhood using drugs, alcohol and strange women, who was emotionally and mentally absent most of her life, who is possibly still using, is the one person in the whole world Marcy calls her confidante.  “He gets me.  I can really talk to him.  Even my husband doesn’t understand me like he does, you know, emotions.”

Marcy, despite years of fear, panic attacks, the survivor of abuse and neglect was clinging to her dad.

Marcy was lost in the headlights of the oncoming life.  She thought after having spent her entire life afraid, it was time to heal so she though she’d give medication therapy “a try.”

After initiating medications for Marcy’s post-traumatic stress disorder and after her panic-attacks stopped, Marcy started attending NAMI.  What a believer in NAMI she became!

They just make it easy for me to talk about myself, say things I can’t even tell my husband, and they know what I’m going through.

Listening to her talk about them was letting fresh air into our room.  Hope floated in.  Now Marci doesn’t believe that her dad is the only one in the world she can connect with at this level.  Now Marci does not feel as alone.  Why?  Because she went and got connected.  She whacked through the briar hedge of misperceptions, biases and insecurities between her and others.

Marci still thinks largely of her father, but he’s not the only one.  He has some competition to the throne which means, Marci has a better chance of being influenced by someone healthier.  Rather than attack Marci’s attachment with her Father, NAMI is giving her more to fill her heart with.

Self-Care Tip #285 – Find safety in healthy connections with others.

Questions:  When have the connections in your life saved you from warped views?  How do you think we could do better with this?  Please tell me your story.

Me! Where Emotions and Behaviors Come From

steps 15

Image by Erik - parked in Cairo these days via Flickr

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!  (Today’s Post)

What we have covered so far in our series is that we know 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.  Yesterday we reviewed our biopsychosocial model as a tool for further understanding where our emotions and behaviors come from.

Self-Care Tip #272 – If you are ever unsure about where your emotions and behaviors are coming from, it is always safe and true enough to say, “Me.”

Where do emotions and behaviors come from?

Me.

For example:  Me <–> Emotions Shared <–> Me <–> Emotions Hidden <–> Me <–> small conscious self and BIG unconscious self <–> Me <–> Biological, Psychological, Social selves <–> Me… round and round, starting and ending and starting with Me.

Rob and Yesenia were both breathing hard.  Rob was pale and Yesenia flushed.  Where to start?  With Me.  This is what I shared with them both.

Put your spouse down and take three steps back!  Own your own self.  Take care of your own self.  In the process, you will be able to pick each other up again and share love.

Questions:  What are you holding, carrying, using to explain where your emotions and behaviors come from?  How have you been able to put those down and hold yourself?  Please tell me your story.

Taking Care of Our Own Emotional Junk Empowers us Not to Take Care of Theirs

Women Only - Choose your Favourite-Bangalore-n...

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Yesterday we started a narrative series on understanding where emotions and behaviors come from:

  1. Emotions Are Contagious
  2. Our own Emotional Junk (today’s post)

Yesenia and Rob chorussed,

Yes! I am worse when Yesenia is not doing well. Who can cope around that!?

Yes! Rob is making me sicker!

Saying emotions are contagious is not the same as explaining causality or fault. It’s talking about an influence. I didn’t want Rob to misunderstand me. Saying emotions are contagious is information to use to empower us; not to make us feel like victims. It is to help disclose our own vulnerabilities, our own needs and our own quest towards healing and presence.

But how to be present with “falling knives,” as Cindy described this in yesterday’s comments?

It starts and ends with Me. So getting back to Me simplifies things and short-cuts our confusion.

It’s easier for us to be around so much charged air when we have already gone toward our own flaws, pain, emotions and anxieties. It is easier for us to not make something personal that isn’t if we have already stayed in our own nasty space for a time, did that process over and over, and each time stayed long enough to see what is there/what will happen until we realize – not much. (That was what I like to call a “super-sentence!) Taking care of our own junk helps us be available for other people when they are spilling theirs. We are less controlled by shame and fear.

This may not happen when complicated by our brain disease. Personalizing things may be inevitable if we do not get medication therapy. Being present with our own journey might not happen without medical help.

Sometimes when we are ill, we feel like we are spectators of our own life story, standing off to the side, just watching the show. With healing, we join with that living active self and can be present and whole. With healing, we don’t have to personalize someone else’s emotion-spills. With healing, we can improve our quality of life. When they don’t fight for brain health, such as taking needed medications, or whatever it is that would have been friendly for them to do – we don’t have to make it about us.

And! And if we choose to, we can be with them. We can be with the people we love! Isn’t that great?! Even when they don’t do their own self-care. Even then. Or not. But we are choosing now rather than reacting defensively.

Kaily said it yesterday like this,

Now, when I notice that my mood is starting to mimic the negative mood or negative atmosphere around me, I stop myself and realize that just because those around me are negative, stressed, uptight, etc., I have the choice and the power to stay positive and at peace within myself. Just because everyone else is jumping off the cliff doesn’t mean that I have to follow.

Self-Care Tip #268 – Taking care of our your own emotional junk helps you not try to take care of theirs.

Emotions Are Contagious – Such as, Anxiety.

We are starting a narrative series on discussing where emotions and behaviors come from:

Anxiety bubbled, frothed and infused the air.  Yesenia could barely catch a breath.  Here’s the thing.  Yesenia is not in treatment with me.  Her husband, Rob, is.  Yet it was Yesenia who filled our space.  There was barely room for Rob and I to sit or speak with all that anxiety around.  Rob was breathing faster every moment and his face didn’t have much color.  …Where to start?

Unknown source

(What do you think? think?  think? echo echo echo…)

It was too early in our work together to expect Rob to know this, but emotions are contagious.  Anxiety is very contagious.  To say this another way we could say, the emotion of anxiety around us influences how our genes express themselves.  It is further explained by saying that my “patient” isn’t only Rob.  My patient includes the system he lives in, i.e. his home milieu, wife, kids, work and so forth.  But especially his wife.  Because of Yesenia’s untreated emotional disease, Rob’s emotional disease worsens.  The inverse is true as well and so we go round and round gaining momentum.  Like a big ball of hard packed snow gathering speed and girth as it rolls down the mountain, anxiety grows.  …Where to start?

(What do you think? think?  think? echo echo echo…)

Self-Care Tip #267 – When suffering from emotional illness, remembering that emotions are contagious (no matter who they come from) is useful to your self-care.

Questions:  How have you experienced the contagion of emotions?  or seen it play out in others?  Please tell me your story.

Bullying That Includes Life-Threatening Behavior

Bullying:  Series Continued.

  • #144 Leave Space In Your Beliefs To Grow
  • #163 “He’s Never Hit Me.” Abuse.
  • #251 Just Ordinary Bullying – The Bully and The Bullied
  • #253 How to Be A Friend To Yourself When Thinking About Your Bully
  • #254 Free To Do Self-Care, Despite Our Bully

Bullying is a broad term.  We could call it “dirty,” meaning non-specific.  Here we’ve spent several days discussing it and stil trip on the dirt.  What we want to do is tease life-threatening events included in the broad category of bullying apart from the…, I don’t know, can we call them lesser degrees of bullying?  Anything that isn’t perceived as life-threatening can lay in that heap, let’s say.

Teddy bear - Rory

Image via Wikipedia

Each of us must figure out where we are in these two categories.  What type of bully did I or do I have?  (I have to smile when I say “My bully.”  Sounds like a teddy bear or blankie.  And it sooo is not!)  I think when we can do this, we can know even more about our self-care options.

There is a main category named, “Bullied.”

Event perceived as life-threatening -> you folks on the right.

Event perceived as non-life-threatening -> you folks on the left.

On the right, we have some who have Post-Traumatic Stress Disorder (PTSD) and some who don’t.  I’ve seen mothers get it after a traumatic birth and post-partum period when their baby might have died.  I’ve seen people get it from watching terribly violent movies.  Of course we’ve all seen or been survivors of abuse, war, or other near death experiences who become angry, irritable, nervous and suspicious of others.  We’ve watched our once cuddly personality disappear.  Everyone in this system is hurt and hurting – bully and bullied and those connected to either.

Not all survivors go on to develop PTSD after life-threatening events and we can’t clearly say why.  These people on the right straddle the line with those on the left.

We also have current events and past events.  We can number there order of passing in our lives.  For example,  1.  saw our mother beat up for years by our father, 2. watched Silence of The Lambs, 3.  excluded and conspired against in high school by mean click, 4.  neighbor strong-arms you into getting rid of your dog and paying him money for perceived damages.

PTSD can set in at any point on that time line because of the conditioning/changes the life-threatening event did to the brain.

Those on the left didn’t get much attention today.  I’m sorry about that.  You guys are just as important but my agenda today was to clarify.

Questions:  How does this clarification help you, if at all?  How would you try to define bullying?

Self-Care Tip #255 – Know what type of bully you had or have to know how to approach yourself in friendship.

What Do You Say About Bullying?

Rally

Image via Wikipedia

Bullying:  Series Continued. 

  • #144 Leave Space In Your Beliefs To Grow
  • #163 ”He’s Never Hit Me.” Abuse.
  • #251 Just Ordinary Bullying – The Bully and The Bullied
  • #253 How to Be A Friend To Yourself When Thinking About Your Bully
  • #254 Free To Do Self-Care, Despite Our Bully

Being a friend to ourselves in the context of bullying has been one of the most difficult things to get positive about, to talk about with hope, to feel empowered and to claim our freedom to self-care.

Why is that?

How do we claim our freedom to self-care?

We talked a lot about kids, many of us hopeless to a degree about their vulnerability to bullies.  But what about adults?  What are some examples of empowered adults in the context of being bullied?

Our own Sarah McGaugh of birdinyourhand blog-site asked yesterday,

What should we do to keep from getting angry when we are forced to interact/negotiate with a bully? Say, in the line of work, when we have to sit in a meeting with them or something. Some people come into those situations with only fight in them. Usually in my previous position I was fairly good at diffusing them…but I would still feel the anger over it. How do we not let a bully get into our inner world, and still deal with them?

How can we respond?

I would love to hear from you.

Free To Do Self-Care, Despite Our Bully

Demonstration in London supporting Serbia

Image via Wikipedia

Bullying:  Series Continued.  (I didn’t even realize I was writing a series until now!)

  • #144 Leave Space In Your Beliefs To Grow
  • #163 “He’s Never Hit Me.” Abuse.
  • #251 Just Ordinary Bullying – The Bully and The Bullied
  • #253 How to Be A Friend To Yourself When Thinking About Your Bully

Bit’s and parts of us are unbelieving in what number of options to self-care that we have, when it comes to being bullied.  I don’t say this lightly about terrors.  Terrors change us irrevocably and hurt to the brink of our own abyss.

The question is, are we free to do self-care even when we are bullied?

Yesterday, Carl in his candid way, said,

Empathy and forgiveness? You gotta be kidding. Do you know what it is like for a twelve year-old to face this…  for an entire school term? Probably not? Cope? Isn’t coping with a chronic negative stimulus as debilitating as being unable to cope….  There may be situations where “book smart” stuff is not applicable because we cannot negotiate with the bully.

Go Serbia

Image by SanforaQ8 via Flickr

We cannot negotiate with the bully.  True, to the degree that Carl said, if I understand him.  (Carl you will surely set me straight soon.)

It is true that people who like to fight, fight well.  People who bully generally will bully better than I can ever defend myself.  They have had a lot more practice.  Have you heard this?  You never want to go up against someone who has nothing to lose because the only one that will lose is you.

When someone is agitated, in psychiatry we learn that it is good not to make eye-contact.  Avert the body.  Keep your voice low and don’t engage as much as possible.  It reminds me of letting the mist of early morning dew expire the coals in the camp fire.  Getting attacked is something we want to avoid.

Early on in my training, I was rounding on the inpatient psychiatry ward.  We often have people who are agitated admitted there and this morning, I remember it was about seven AM on a Sunday….  This particular patient hadn’t slept well.  He wasn’t well-groomed and he scowled.  All the nurses where in another room in a nurses meeting and I didn’t notice he and I were alone in the hallway.  I looked him in the eyes directly.  I didn’t concern myself with tempering my interview.  I was still sleepy myself and wanted to get out of there as quickly as possible to start my Sunday stuff at home.  (I know.  Stellar attitude for a resident-physician, right?)  He grabbed me around the waist and I nearly lost my water!  I screamed at him like a she-dog and he let go.  That was all.  No big deal right?  Well I was ticked at him and at the nurses for not being available.  No one was at the nurses station, which is illegal too.

In truth, I was pretty much an idiot on all accounts.  It doesn’t condone the assault but I have since been better about not negotiating with the bully.  

That probably wasn’t exactly what Carl was talking about but it is related.  It is by no means a full year of negative harassment, but when responding to the concept of not being able to negotiate with the bully, I don’t know at what point in degrees of trauma experiences that becomes true for us.  Perhaps it isn’t a matter of qualifying them or quantifying them.  Perhaps more depends on the victim.  I don’t know.  Do you?

What I do know, is that Carl and I are both partly wrong.  We can.  I don’t know about then.  We can now.  We are free even from those molesting monsters because of who we are.  We were created free and those horrors can’t extinguish that bit of us.  We are free not because of the protection or lack of protection we’ve lived in life.  We are free.

We don’t claim to know all the innumerable forms of suffering out there.  That is not what this self-care engages with.

Questions:  How do you find yourself free at this time in your life, despite it all?  How do you describe your freedom, even with your bully?  How have you seen others in this context?    Please tell me your story.

Self-Care Tip #254 – Free yourself from your bully.

Additional Resources:

How To Be a Friend to Yourself When Thinking About Your Bully?

I love real life John Waters freeze-frames

Image by TheeErin via Flickr

Self-Care Tip #253 – Humanize and forgive your bully.

How to be a friend to yourself when thinking about your bully?

Have you noticed that when we think about our bully, we don’t feel so good.  Just thinking about him!  Sheeze!  In our last post on bullying, Nancy said,

Wow! This one brought up WAY too much pain. I’m feeling very vulnerable and uncomfortable and hurt and stupid at the moment. 

There are jumbled emotions that flood us, such as anger, shame, helplessness, anxiety or more.  Our autonomics may even trigger, making us hypervigilant as if we were being attacked.  We are in defense mode – all the while sitting alone in a chair at our desk, in the quiet of our bed while falling asleep, or any other place of our generally hum-drum lives.  These feelings and nervous system changes come in a time and place when we are not in danger.  They come without us realizing their approach, stealth feet and skilled hands; we are in their company before we know it.

Is there no hope?  What can we do so we don’t feel victimized all over again.

Humanize

1.  Do research on the bully.  Find out about him on the internet.  See what others have said about him.

This helps us:

  1. see him as a human, mortal, without superhuman powers.
  2. feel like we are less alone in this.
  3. realize that we are not chosen, so to speak, to suffer at his hands.  He is a bully and not just around “Me.”
  4. we didn’t cause his behaviors.  He chooses his behaviors because of the same biopsychosocial paradigm that we choose ours.
  5. realize that he hasn’t chosen to do his self-care, making him more vulnerable to his own negative feelings and behaviors.

Forgive

  1. Humanizing our bully helps us move towards empathy and forgiveness.
  2. Anger debts only hurt Me and that’s not friendly to Me.

Grow our self-confidence

  1. Such as doing our own thing.
  2. Grow our own natural genius.  Work hard at it and see how it is there for us, like a friend when we are feeling pushed down.  Our friend will be standing beside us, reminding us of our value when this remembering tries to beat us down.  Our friend will be there reminding us that this negative event in our life does not define us.

Now if they continue, these rememberings, and if these rememberings are frequent enough that we believe our quality of life is affected, we may be looking at something else.  There are other medical illnesses that can disable our abilities to cope.  In this scenario, I am thinking especially about Post-Traumatic Stress Disorder (PTSD.)

In PTSD, we relive experiences of trauma (which we perceived to have been life threatening to ourselves or observed by us in other(s).)  We may also feel hypervigilant, as if we are about to be attacked at times when our lives are not threatened.  We might have nightmares and avoid things that remind us of the trauma event as well.

PTSD is easily reactivated by other stressful situations – such as being bullied.  When we have a history of PTSD that has been quiet for a time, even years, we are more vulnerable to stressors reactivating it’s symptoms.  Then, although the said stressor may not have been a life-threatening stressor, we perceive similar feelings and neurologic changes we did when in the life-threatening situation.  Then, although the said stressor may be over and not recurring, those PTSD symptoms start happening all over again and may continue indeterminately – propagated by the disease process and not our bully event.

This might be endured and it may go away in time without treatment.  But it isn’t good for anyone while it is happening.  PTSD can improve with medical therapies.

Question:  How have you been able to humanize and forgive your bully?  Please tell me your story.

Our Feelings Begin and End With Me. We Are Not Victims.

Freedom is useless....

Image by rAmmoRRison via Flickr

Self-Care Tip #245 – Our feelings begin and end with Me.

Are we victims of victims?  I know I blame people and am not above a good rant on all the why’s “I feel this way!”….  However, the cleanest air I’ve ever breathed is when I’ve stepped out of that space and started naming myself responsible for my own feelings.

Slavery comes in many ways.  Thinking about being a slave by our own design is an odd twist but choosing the victim role does it.  Choosing freedom to self-care is liberation by the same government.  This is a cornerstone of understanding the “Five W’s and One H” of self-care.

Victims also generate victims not only of themselves but also of others.  Somehow the emotions, heavy, immobilizing, irritable, angry, coming off of the person in the victim role are absorbed by others if those others aren’t seriously insightful and vigilant against them.  Considering this, we can understand the difficulty of being present, in the moment and not either running away or trying to change the person in the victim role.  (Remember the 3 C’s?)  Anyone porous to them is at risk.  Too often, we all find ourselves pointing, pounding, pity-party preaching victims – none of us naming ourselves responsible for our own feelings.

We know that we are more prone to personalizing things when we suffer different emotional illnesses.  In this case, we can’t help but catch the familiar features of depression.  There are other illnesses of course with these symptoms, but an irritable depression is one of the most difficult to endure for all parties. Sometimes, simply gaining insight into our coping skills can make us better friends to ourselves.  That is such a relief.

Too often however, being the victim is not fully under our control.  Too often being the victim is a symptom of the disease process that came without an invitation.  Also, just as often or more, the person in the victim role doesn’t have insight into any of these aspects – their choice into slavery, their influence on others, their medical condition generating these symptoms or their options to gain healing.

I could easily tell you a number of word-pictures, maybe describing the before or after treatment, maybe letter-layering the innumerable ripples that self-care made on the world after treatment or maybe I will more easily just not.  All these stories bring me, at this late hour of our week, too close to those contagious emotions and I’d just rather not.  Maybe you’d like to share though?

Questions:

  • When you started owning your feelings for things that you never thought had anything to do with you, what were your thoughts?  How did it ripple out of you and affect others?
  • What do you see at the cornerstones of self-care?
  • Please tell us your story!

Your Pain is Not Special. It Is Normal.

Self-Care Tip #243 – See yourself as special rather than your pain and know that you will find your normal again.

What is your normal?

When we were kids, we all had a perspective of what normal was.  Let’s say it was “here.”  Let’s imagine we were lovely then, nurtured and emotionally bonded.  We struggled through peer conflicts, social anxiety and rivalry.  We wanted a bike.

Two Sisters

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Then we got a little older.  Maybe our parents divorced.  Maybe, a sibling died.  Maybe we were abused or in an accident and damaged.  Damage changes normal.  What we never would have thought would be acceptable in our lives became acceptable.  We suffered.  We lived.  Life was indiscriminate and ignored our status.  We think there must be a mistake.

What is our normal at one point, filtered through remaining hopes, grew into regenerating fantasies, through real potential and it moved again.  We are older now and more suffering comes.

Where is our normal?  We survive our child, our own dear perfect boy, hanging from a tree.  Normal?  No dear God!  No!  And we continue to live.

Two years.  Two years are what it takes for our biology to catch up to the shock.  Two years are what it takes for us to begin to accept and realize that in this new normal we care again.  We choose it in fact.

People don’t remember his name or talk about him and we can’t remember his eyes.  We are ashamed and lose our breath from panic just trying to see them.  We want to bang our head because we know there is something wrong about feeling normal! Ever! Again! after that.  But we do.

Our normal mutates over financial ruin, abandonment and a growing healthy list of disfiguring illnesses.  We accept them and say yes please.  Live.  We want to live.  This is acceptable.  This is normal.  Our friends die.  Our memory.  We can’t find our teeth.  Our heart stops.  We die and the world finds normal.  The world chooses just like we did.

What we don’t think will ever be allowed to happen while we brush hair, clip our nails and microwave food, happens. We endure these changes.  We find normal again.

What is your normal?

My brother, Vance Johnson MD, is a physical medicine and rehabilitation specialist.  He said that during his residency, close to 100% of spinal cord injury paralysis survivors he worked with wanted to die after their injury.  Many of them would beg him to let them die.  They would cuss at him for keeping them alive.

I leaned very heavily on the studies and data during those times.  It was very hard.

Vance said that what kept him faithful to his task was knowing that close to 100% of them after two years would be glad they were kept alive.

Even the ones who were basically breathing through a straw and that’s all that moved on them; even they wanted to live.  These people found a new normal.

Where is our normal?  We will want it.  We will adapt.  Biology will catch up to our reality.

Remember that your pain is not special.  You are special.  Not your pain.  Pain is normal.

Question:  When this happened to you, how did normal find you despite the rubble?  How does this concept feel to you, that your pain is not special?  Does it make you angry or what?  Please tell me your story.

Where Do You Think Behavior and Emotion Come From?

Animation of an MRI brain scan, starting at th...

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Self-Care Tip #229 – See yourself as a friend by including biology in your self-perception.

In clinic, out of the clinic, here, there, if I were to pick one barrier to treatment anywhere, I’d pick the misunderstanding that behaviors and emotions come from somewhere other than the brain, and then from there, the outcropping of understanding why.

I don’t think most of us say it in so many words, but it’s intuitive. Maybe when pressed we’d say, “Where else do they (behaviors and emotions) come from?!” And then agree, the brain. But the connection that allows for self-care is missed. The connection that allows us to choose the freedom to feel good and behave well for our own sakes is lost in the shame of failing to do those very things.   The stance of courage it takes to be our own friend when we don’t even want to be in our own company, takes a lot to maintain.

The marvelous @MarjieKnudsen, tweeted a reference to a wonderful post by Sarah Boesveld, How ‘self-compassion’ trumps ‘self-esteem’. I enjoyed reading it very much as I felt it spoke to me and my generation with great perception… except! that it was without mention of biology, the brain; i.e. where behaviors and emotions come from.

In clinic, Naomi told me about her “failure” when ever she felt anxiety come on.

Why do I feel depressed when I feel the anxiety come?

I’m wondering what you think, reader, about this simply related story and the question.

I mirrored Naomi’s question,

Why do you think you feel depressed when that happens?

Today (similar to Naomi,) girl-crush, alias Rachelle Gardner, Literary Agent, wrote about feeling like a failure as well.  She asked at the end of her post the pithy questions,

What about you? How have you failed? What kind of wisdom has helped you deal with it (i.e. sense of failure)?

And I thought, how to answer? Here I am again “in the presence” of someone wonderful who in her post didn’t make it apparent that she was considering that this emotion might be a symptom of something biological.   We are willing to look under every rock, be in the space of our emotion and ponder reasons why.  We have the courage not to “run” even when we don’t like ourselves, but haven’t said it out loud to ourselves yet,

I might feel this way because my brain is dishing it out.   I might otherwise have not done anything to set this emotion or these behaviors in motion, other than being alive.

Girl-crush remains despite response.  So readers, don’t be scared to answer what you think.   If you even care, I’ll still admire the socks off you! – even if you think you are hyper every day since conception because you ate too much sugar.

Questions (In case you want me to write them again, which I’m really happy to do – anything you want so I can hear your responses): Where do you think your behaviors and emotions come from? …such as a sense of failure and/or a depressed mood? What has helped you deal with it? Please tell me your story.

Guilt Furiously Chasing You Is Commonly Experienced In Illnesses Of The Brain

Orestes Pursued by the Furies, by John Singer ...

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Self-Care Tip #221 – If you feel chased down by guilt, stop running and get friendly with yourself.

I’m so busy!  I am trying to work, raise three kids, and be a wife!  …and I’m just spread so thin!

It was new for Connie to think that where she was at in life was linked with her choices.  Somehow she intuitively felt taken along by it all, a current of life as people say, of either randomness or design.  Who could know, but it was more than her choices, she was sure, and she resented the influence on her life’s design.  Not that she had intended on taking over what was playing on her.  She just simmered in the house of cards hoping that when she got to make a play of her own, she’d make a good one and come out better for it.  In the mean time, she just had to keep moving fast.

Things would have been fine, except that over the past six months, she hadn’t been enjoying what she was living for, her kids, parenting, being a wife or her employment.  Yes, she was also  living for God but no, she wasn’t enjoying Him either.  Did she want to?  Did she feel guilty about it?

I feel guilty all the time.  It’s the guilt that gets to me.  It’s like I can’t see or feel much else.  Just when I think I’m about to get into what I’m doing, guilt comes chasing at me in a fury!  Distracting me and worrying me.  I’m on edge more and irritable from feeling defensive, and trying to get away from whatever this is.

Connie looked at me when I said,

Self-care begins and starts with “Me.”  Although we may be living for others and other things, even living for God, if we don’t take care of ourselves, our health first, our emotions and behavioral health included, we can’t give much, in the way of living, to those others.

I could see her pupils change and I got a little excited.  She was hearing something that affected her whole body and I sensed it was hope.  (See, I am an Emotions Jedi.)

We talked more about approaches she was using, prayer/meditation, exercise, grit and determination, waiting it out for better days to come and others.  Then I introduced the medical paradigm.  (You’ve heard me say it.)

Behaviors and emotions come from the brain.  We culturally think that they are volitional, under our control.  But how much can we really control of what the brain does?  Some.  But when we do the best we can with what we can control, and our behaviors and emotions are still hurting us, affecting our quality of life, damaging our relationships and connections – we need to look for biological reasons.  That’s where choice can still come into play.

She was looking and nodding.  This was at her “consideration stage” of introducing these new ideas.  I said,

I thought of telling you about this when you talked about guilt Connie because maybe your guilt is coming because of a brain illness.  It’s common in several emotional illnesses, like depression or anxiety, and in these illnesses it commonly comes in force, like you’ve described.

Her pupils had reduced to their earlier size, and her posture said she was winding down for that visit.  Whatever we discussed after that would be low yield, so we made a follow-up appointment and called it a day.

These days later, remembering Connie gets me thinking about what I would have said if she had been available to still hear more.  This bit about freedom to choose self-care, yet saying we have little to do with how our brain works can get confusing.  It might seem contradictory.  Tomorrow, I’m going to discuss it more, but for today, it would be wonderful to hear what you think.

Questions:  With behaviors and emotions coming from a material biological organ, the brain, yet knowing that we are free to choose for our self-care, what gives?  How do these ideas jive?  How have you seen it play out in your life?  Please tell me your story.

Self-Care Doesn’t Have to Be That Big of A Fight

Rajasthani women take part in tug of war game ...

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Self-Care Tip #215 – Fight as little as you possibly can when reaching for your choices to self-care.

We skipped over that.  We didn’t tug on the medication-or-no-medication rope.  What a relief.  Marsha surprised me.  When we first met, she had been the one who said,

I don’t want medications but I can’t go on like this.  If I choose to start, when can I stop?

In these scenarios, it’s easy to get snagged by the temptation to educate (tug.)  There is the risk that if we don’t educate, we might miss our opportunity to engage her in treatment and get help.  However, because Marsha was willing to at least start medication, even though the duration of treatment was in question, I decided to let the medication argue its own case.  (Standing quietly by the rope.)

Not everyone is as good to me as she was.  Some patients, prodded and edgy from the anxiety, want to fight a little.  That anxiety is coiled and full of potential energy.  Feeling put off, up it springs when I say,

Let’s talk about this, if it’s alright with you, after you’re feeling better emotionally.  (Pulling on the rope now, heels three inches deep into dirt.)

Somehow, Marsha let it ride out.  Somehow, Marsha came out on the other side.  She had nearly forgotten about wanting to ever stop her medications.  She never even brought it up in fact.  I did.  I think I had to say it twice to get her to know what I was talking about.

No.  I don’t care if I have to stay on these medications the rest of my life.  I feel so much better!  I’m more myself than I ever was.

 

And there it came.  That beautiful awareness of taking care of our changing selves.  Without much in the way of hand blisters, she stepped by her own volition across the line.  Marsha was a no drama type of girl.  Just in time, I caught the temptation, my own springing up potential energy to pull on the rope when we were on the same team.

Marsha had struggled with disabling mental illness her entire life, and here in the third decade of life, she simply walked over into health.  Gracefully she left her previous self, accepted her new, assumed it was her intended baseline and that was that.  She wasn’t over the stigma, she hadn’t accepted some of the other lifestyle changes entirely but still, she was content to call her team, come what may.  What a woman.

Questions:  How has the process of getting on and staying on medications been for you?  When have you felt more yourself?  How do you define your true self when you change through life?  Please tell me your story.

Never Let Go of Hope, Even When Depressed and Anxious

Linda, Lake of the Woods Run, 15 K

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Self-Care Tip #214 – Never let go of hope, even when depressed and anxious.

Some blog-posts ago, Be Aware of Your Feelings was written and “M” asked,

What is the difference between depression and anxiety?

Anxiety and depression are like brother and sister.  They often go together.  When we think of “paradigms,” we think of an arch that might intersect with another arch.  However, when I think of the affective (or mood) spectrum intersecting with the anxiety spectrum, I see them weaving, interlaced or chasing each other.  Not a line and nothing tidy.  So understanding the difference also includes understanding their relationship.

In training, I remember presenting a patient with anxiety and depression to my psychiatry attending physician.  I hadn’t clarified the timeline of onset of symptoms.

When presenting, every resident physician knows the moment when they are found out.  The other residents on the rounding team instinctively lean back, try to take a step away even, so the lightening doesn’t singe them when it strikes.  I’m sure I smelled like fear too.

The reason the time of onset of symptoms is important, is that it tells us the primary disease process.  Knowing that, influences the speculations on patient recovery, duration of illness and our choices for treatment.  Some medications for depression can really activate anxiety and the patient might not enjoy the free-fall into hell after starting the antidepressants.  Also, there are some treatments that work better for different disease processes and such.

It’s common for someone who has suffered from depression on and off for years, but never from anxiety, to have their first panic-attack out of the blue, without trigger.  Bummer!  Then they start to roll.  Bam!  Bamm!  BAm! BAAM! BBBAm!  The panic attacks may come in spurts and then go away for a time.  The opposite is also true, starting off with anxiety, and followed by depression.

I don’t think anyone, including “M,” is asking me to talk about the differences between anxiety and depression in that depression is a state of sadness, and anxiety is a state of autonomic nervous system activation.  Rather there is the wonder of why they follow each other in course, why the are so often in each other’s company, why so many medications that treat one will treat the other, why they run in family histories and/or why they are both “so common.”  We have some ideas we use to answer but we don’t have enough objective information to explain.

Some of the good news is that these diseases are treatable.  The sooner they are treated and when treated to full recovery, the better the hope for long-term brain health is.  I have seen people feel defined by these diseases and trapped.  My job isn’t to minimize that, but rather to highlight what might bring hope.  Selling hope turns out to be one of my biggest jobs.  The same attending physician I mentioned above told me that.  He never stopped talking about hope.  Even for me.

Questions:  How do you answer “M’s” question?  How have you seen depression and anxiety move together and how have you responded to it?  What has given you hope when they did?  Or, when you saw this in someone else.  Please tell me your story.

Related Articles

Getting or Giving Bad News Without Fear

Slalom skier

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I was reading an article on awareness of obesity the other day telling us that many times, people don’t know they are obese until they are told by someone else.  Ouch.  Pass the Band-Aides.  But it aired our need to stay connected, speak up, and listen.  It also prompted me to reflect on mental illness.  How often I’ve sat with someone’s emotions-history in my hands, looked at them and realized they didn’t know.  They were there, emotions bleeding all over the place but didn’t grasp their injury.

Um, excuse me ma’am.  Let’s apply some pressure on that and get you some help.

Bloody news like this reminds me of my friend Jack.  He was waterskiing with my brother and I when we were college’ish-age.  Jack was not so capable on the water, although he wasn’t afraid.  As you probably know, three is the perfect number for waterskiing – one to drive, one to hold the flag when the skier is setting himself up, and then of course the skier.  Any more and there are way too many polite smiles and way too much advice for the bobbing body in the water.  Jack was working on his slalom moves, thrilled with his progress and after about the third fall, was still ready for another go.

Hit it!

Our boat, Rosewater, eased him out of the water and he was up.  Jack has a way of celebrating like no other.  He whoops and yells and his whole body joins in.  And so he was in his happy place, up on a single ski, unconcerned with the world at large.  It was lovely.  Until the wake of that other huge boat threw him down and his face slammed into his spectacular single ski.  Up he came and we just looked at him, quietly at first.  Jack paddled up to the boat and wondered if he should try again.

Um, sorry Jack.  Let’s apply some pressure on that and get you some help.

Jack had a huge gash, copiously bleeding all over his face and he had no idea.  He was wet already, cold from the water and didn’t feel a thing.  I still feel the creepies skittering up my arms and chest thinking about it.

When we told Jack, he was a little unbelieving.

Are you sure?  Is it bad?  I think I’m alright.  It’ll wash out and I can try again….

Oh there wasn’t much pleasure in telling him the bloody news.  Generally there isn’t that much pleasure in telling someone they are fat or suffering from mental illness either.  It’s the follow-up to that statement where the fun comes in.  The hope that we link the first punch-line to.  Good news is, …along comes the second punch-line.  Hope.  And presence.  Being with someone where they are at, as they are, and with patience doesn’t mean leaving him in the dark, bleeding out.

The reverse is true of course as well.  If we don’t stay connected with others, we may lose the opportunity to see ourselves through their eyes.  It is an opportunity.  When we are with someone we trust, respect and think see’s us as the precious thing that we are, it is.

Self-Care Tip #195 – Stay connected with others and listen without fear – something good is coming.  Be a friend to yourself.

Questions:  How do you deliver “bad news?”  What is the best way you’ve ever been given “bad news?”  Please tell me your story.

The Spider Sat Down Beside Her – Mental Illness

Self-Care Tip #178 – Find your courage and answer to stigma.

The Little Miss Muffet scenario explained by D...

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Something as simple as taking pills can sabotage us.  The act of putting it in our mouths signifies all sorts of things from religion, to freedom, to personal identity and beyond; even someone who is trustworthy versus not.  Pill – take away her children.  No pill – could be president.  Pill – discredit whatever he says.  No pill – worth listening to.

Martha is a mother of four lovely girls.  Her husband is divorcing her and she wonders what he will do in the process.  She’s been depressed in the past and anxious with a history of panic attacks.  She took two years to get over them using breathing exercises and other therapies. She didn’t use medication.  I don’t need to tell you what her husband thought of meds or of her during that time.  It was a miserable time for her.

Now, during this new stressful time, she has relapsed in mood and anxiety problems and is terrified that if her husband finds out, he’ll take the kids.  Martha sees mental illness as a bullying tool for anyone to dump her over.  Little Miss Muffet is a story she often has compared to her situation.  The spider is the mental illness she feels is dangled over her to her demise.  Martha is bullied and scared away.

Taking pills makes me feel like I’m crazy!

Note: it’s a type of crazy she interprets as being something different from the crazy of mental illness.  For Martha, the crazy that comes with medication therapy is more sinister and discrediting than the worst experience of terror any of us have ever gone through, i.e. panic attacks.

Every day, we who take medication for emotional illness have to answer to those accusations.  We contend with the fingers pointing our way, the jeering in our memory of loved ones and the boxed presumptions we find ourselves in.

This may sound a little dramatic to some out there, although familiar.  To others, it is an understatement of what they courageously confront to take care of themselves.  Each of us must come up with our own answers and find our own courage.

Martha finally decided on medication treatment and within two days she was amazed to find that she could eat without throwing up and no longer felt anxious.  She still insisted that taking medication was only temporary but getting a pill dispenser had helped her get past some of her daily battle with stigma.  She just opened the lid and poured the pills into her palm, threw them back and swallowed without looking.  Martha found it easier not to dispense each pill each day out of each bottle.  It was also easier for her to keep this information secure in the confines of our office.  For Martha, for now, this was how she answered.

Question:  How do you answer to stigma?  How do you maintain your sense of freedom when other forces tell you that you are not free?  Please tell me your story.

Work Hard to Take Care of Yourself If You Want An Easier Time Taking Care Of Others

Self-Care Tip #174 – Work hard to take care of yourself if you want an easier time taking care of others.

My marriage has never been better.

Freedom Press (UK)

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Kirsten had good posture.  She made eye contact and she wasn’t fidgeting when she told me about the changes in her life.  I hadn’t seen her in clinic for two years and apparently in that time she had set her husband free.  She was seeing less of him than she ever had and they were both busier than any other time in their lives.  Yet their marriage was at its peak.  I felt like I was getting off the point of why she came and wondered if asking her for details was unprofessional.  I did want to know.  Lucky for me, she wanted to tell and I just let it happen, as if I was doing her a favor.

I admit, sometimes I get something out of my clinicals.  I’m not always the best therapist.  I don’t always keep things about my patient when I let myself receive, or even actively take from them.  None of us are that altruistic.  Therapy is supposed to be one place any of us can go, and know that when we go, we can expect to receive everything except the fee-for-service.  Therapy should be the closest thing to a one way street in this non-altruistic world.

To my rescue, Kirsten said,

He has been meeting with friends, exercising, eating out and working the 12-Steps twice a week.

Yes he was sober, but he was also a bunch of other stuff.  Taking care of himself, he became a better husband.  Better body, clearer mind, happier, more attentive, less angry; she could hardly stop listing.

Freedom is useless....

Taking care of himself took a lot of work but it made taking care of her a lot less work.  True, she wasn’t the center of his life, she gave up on some fantasies, she didn’t ask him for more time, but all those in the past had only grown her own point of anger and blame and not the marriage dreams she thought they would – letting them go was a good thing.  Yet, cutting him free still felt risky to her.  She came to me because she was becoming more aware of what that fear was doing.  When she was afraid, she was sabotaging herself.  Bits of herself recognized that she could feel as free as her husband did.

To be free of fear for Kirsten, she needed medical help.  Kirsten’s fear came from nowhere, out of the blue and was not only triggered by suspicions about her husband.  To be free for Kirsten’s husband required other forms of self-care.

Question:  What kind of self-care does your freedom need?  How has your hard work on your own self-care spilled over into less work to care for others?