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!
As there are so many views on what “God” means, and because that’s not what we want to debate here, we have a useful premise.
God exists.God is personal.
Nor is our purpose to worry over the function of religion, to roll between index and thumb the business relationship between us and God, nor to tidy up the religious wars between our nations.
The purpose here is to discuss how to be a better friend to Me, in the context of the premise, God is and God is personal to Me.
If God is, then He is personal. Otherwise, there is no point to God, as far as you and I are concerned.
Question: How do we treat ourselves well in the context that God is personal to Me? If God exists and isn’t personal, what is the point of Him? How does working under the premise that God is and God is personal improve the way you care for yourself? Please speak out. We need you.
Self-care Tip: Accept that God is and is personal to you and keep on.
When in the exam room, we do not want it to be about the physician. However many of us don’t want it to be about the patient.
Some of us want it to be about the system, whatever system we are in, so that the system can run as smoothly as possible and get all our protocols met. Are we are making physician-robots? We isolate them and ourselves. There is a pressure when working in a system to sequester the physicians, such as wizards from the Muggles.
As physicians, we care better for our patients when we realize what we are getting out of the relationship. We give much better when we know what we are hoping to get and perhaps hoping not to get. We give better even with medical care. Is it comforting to think that when it is medical, it is objective, about data? More safe, perhaps. However, this binary logic, is false. We do not practice in such. We practice in a place where people smile and cry and bond and connect and receive from us and give to us. When we practice, it is personal. It is obvious that it is professional. The delusion is that professional is an either/or condition. Either professional or personal. Not both. Never both. That is a buttered wall to grip before sliding into patient doctor sexual relations. Sneeze.
There is a term called, Grace, you may have heard of. Grace is the condition of receiving without purchase. Having been gifted and celebrating in the gift without qualifying it. Perhaps getting a great review from a patient on-line you are expected to respond to, and just saying, “Thank you.” We have a hard time with this in our world. “Getting” well.
I struggle with “getting.” I cannot describe yet how to get well. How to receive. When a patient gives to me, I struggle not to qualify what I am getting in the same way I qualify taking a trip to Hawaii, “Oh, I’m going to a medical conference.” Or, “Look at this new patio set I got from Home Depot! It was totally on sale. I got a great deal.”
In practicing medicine, we need to grow to an acceptance of what we receive, and receive with Grace.
I am sure being a patient is better when we realize what we are getting from the exchange too. We get more, or perhaps differently, than what the insurance and copay gives purchase to. I hope the patient-doctor relationship is more than what can be had on the street of a Turkish bazaar.
Question: What are you getting from your patient-doctor relationship? What is your clinician getting from you? How can you receive with Grace? Does this affect your accountability to yourself? Is this an act of friendship to Me? Please tell us your story.
Marrying for security is like bombing for peace. It was not too long after saying this when Amy told me she had been served divorce papers. She had been seeing me for several years. In that time, we had worked through her most recent episode of major depressive disorders and a debilitating anxiety. She had done marvelous. Courageously fought for her own health, to be accountable to herself and grow. Is it that surprising that when that happened, he left her?
Abuse. When one partner uses the power in them to dominate and control the other.
On the other side, there are those of us choosing the abused role such as for the security of logistics. Example, “I take care of his/her basic needs, s/he buys me health insurance.”
Marriages, or committed Love bonds, require full dependence on each other. That is different than power. It is not qualifying that each of us have different levels of power. Of course. But using that power to generate intimacy is like having sex to become a virgin.
Question: How can you grow dependency in your love relationships? Even with yourself? Please tell us your story.
Self-Care Tip: Move away from power as a method to increase intimacy.
hey if you are too stinky we will ask you to leave not really sorry (Photo credit: stevendepolo)
Some of our most difficult cases are when we, the medical care-givers, think we know better how to take care of someone than we do take care of ourselves.
When a person maintains decision making capacity, but whose brain health disables them, if we care, we care.
Monty was one of these. He was ill! He was ill on so many tectonic plates, no one near him could keep their footing. His quality of life wasn’t what he wanted. He was disconnected from meaningful relationships. He was suffering. However, he couldn’t decide to engage in therapy.
Monty wanted to go “natural” but couldn’t name any natural therapies he’d be willing to try. He didn’t want to continue suffering, but couldn’t accept medications “just yet.” We went into one option after another, invested time together learning about brain illness and coming to terms with the biological involvement in where emotions and behaviors come from, and we did it many times. Monty had a full informed consent.
Deciding not to treat or to treat is not easy for any of us. Watching Monty step away into the foggy chaos of sex abuse and obsessive compulsive rituals was really hard.
We fight for our freedoms when we fight brain illness. I suppose we fight for the freedoms of others as well, simply by taking care of our own selves. Letting Monty choose even when his choices are affected by his illness is still his right and I defend him. We all who take care of ourselves have more to offer Monty than if we didn’t, including a defense against the losses that brain disease brings – like processing information.
I’m not sure yet how to explain how taking care of ourselves influences the freedoms of those around us who are less inherently free by brain illness. I suppose like anything good, freedom is contagious, a little bit of light in any room, Love being stronger than death and the Gettysburg address – this is along those lines. It makes a difference to the Monty’s out there that we all take care of ourselves.
Self-Care Tip: When frustrated that you can’t help others, get yourself healthy. It’s contagious.
Question: Have you been in the place where you thought you knew what was better for someone else then that person’s own choices? How did you deal with that? Please tell us your story.
Please do not state the obvious, thanks 🙂 (Photo credit: Wikipedia)
We, many, share the not so friendly distorted belief that we are entitled to understand everything. Bull bullhorn in hand, supported by the scaffolding round our personal renovations, we trumpet our oppression per the noncommunicating swine we once called our relations.
“Isn’t it our job to try to understand?” you ask. Well, no. The duty to understand starts with Me and ends with Me. (I think I just felt a poison blow dart pierce my flesh! Stop that! Is this being received well!? Hello? Anyone?! Ouch! Not another dart!)
Motives too easily change to build a case against each other rather than reconcile or to account for our Me. What does someone owe us, if not to let us understand them? Nothing. Sounds harsh? Or maybe, not so harsh. Not as harsh as being victimized. Not as harsh as spending one’s bank on illusive control of what isn’t ours to control. Not as harsh as the crescendo anger swells into when a child watches her parents behave poorly. Not as harsh as watching your beloved friend “un-choose” you. No. Claiming title to the thoughts and behaviors of others is generally and commonly done with little insight, but it can only be policed by the individual on either end. After all, everything starts and ends with Me. (Plink! Hear the pennies dropping?)
We deserve as much as the value of our own self. Understanding others will come perhaps or perhaps not. But it is as deserved as any other gift. That is to say, not.
Question: How do you stay in your space, when you are grieving the behaviors of those you love? How do you keep your entitlement to, “Me,” where you have title? Please tell me your story.
Self-Care Tip: Something as easy as remembering, “They don’t owe Me anything; even understanding,” can be friendly. Keep on.