behavioral health

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Full Treatment Response Means a Better Future

wethree by Nancy Denomme

Self-Care Tip #140 – Push for full treatment response.  Be a friend to yourself.

Frankie was 45 now, feeling it, and feeling grumpy.  “I’m on Lexapro!” she said as if that should exempt her from her present condition.  She had teenagers.  “Enjoy these times when your kids are young.  It just gets worse!”  Frankie thought that if her kids weren’t stressing her out, she’d be fine.

Maybe parenting and other life-stressors do get worse as we progress through years.  Even if it’s true, it isn’t the point.

Frankie told me that she had felt “normal” until the last approximate four weeks when she wasn’t able to let stress go.  She was taking things personal, even when her mind knew they weren’t about her.  She didn’t like herself as much and was angry when she thought that her kids were thinking the same thing about her.  She was just a little angry.  Not like she was before she was taking medication.  “I’m not so bad.  I’m ok.  I’ll be fine.”  About 70% of Frankie believed that she was still good.  About 30% of her knew at some level that she wasn’t.

“Frankie, stress is always going to happen.  It won’t get better necessarily when your kids move out.  Life will keep the spin on.  Frankie, the difference can be in you, not life.  How you cope can be different.  Things don’t have to feel that hard to get through.”

We talked about partial treatment response and what that meant in regards to disease progression.  Depression progresses as does anxiety as disease processes.  Also, people lose response inconsistently to various treatments.  However, it is not the time to throw our hands up and say, “Bummer!  Life really is harder on me than necessary!”  It is the time to say, “This is medical.”  And explore if there are any other things we can do to improve treatment response and decrease disease progression.

Leaving ourselves partially treated is leaving a leaky pipe in the wall of our health structure.  We will worsen faster, more dramatically, and be harder to treat in the long run.  We will lose treatment options over time simply by not doing as much as we could earlier than later.

This is not to say, that if this blog-post finds you at a “later” position in life, that it is of no use.  Unless that’s how you see your future.  Which if true, I’d respond that this is distorted thinking.  Possibly secondary to the disease process and all the more reason to get treatment, again, sooner than “more” later.

I was so happy to have had this brief discussion with Frankie because it resonated with her.  Her approach to her self-care tweaked and she saw her negative emotions and behaviors were coming from her condition more than from the chaos around her.  She made friendly choices to heal.  Medically heal.

Later in our treatment together, I asked her about how her kids were.  Frankie brightened up with stories of their successes.  I asked further if they were stressing her out, and she looked at me like, “Why in the world are you asking me that!?  That’s out of left field!”  She had already forgotten that she had held them responsible for her feelings not too long ago.

Question:  What barriers have you been up against to get full treatment response?  Please tell me your story.

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Feeling Human. Get to Work.

mycountryroads.blogspot.com

Some days, I feel more human than others.  Today was one of those days.  “Chalk full,” as my Aussie-friend says, with stuff.  Started when I got up with the usual dishes, laundry, breakfast and such.  Thankful for it you know.  Means we’re living here.  Moved on to the car dealership to get some work done on my mom-van.  They said thank you and promptly shuttled me and my 3 small children to the mall.

Spending time with kids at home can be too crazy for me on a good day.  Spending time with the kids, without transportation, in the mall 3 days before Christmas….  Words cannot describe it so well.

Four hours later, the shuttle came back for us to collect their $730-some dollars.  I said thank you and drove my kids home.  This was around 2:30pm.

carpetcleaningbluepoint.com

We found our basement flooded.  Really flooded.  It is 9:41 and I just sat down.  My basement is now mostly just wet.

I am tired.  But still grateful.  I fell a little more in love with our house today, thinking, “I will do this for our house.”  “Home.”  (Myuaaah!)

You can yell at things and sometimes people you love and it doesn’t have to mean you love them any less.  A bang-up fight in fact can make the bond even stronger.  I fought with my home today.  My fingers are numb.  My back hurts.  After the rain I can fix the original sin causing the flooding.  However, I imagine that because it is still raining, I’ll have to do this again tomorrow.  There’ll be more fighting.  More love.

The thing that got me through today most of all, was the commonality.  Work.  Work just has to be done.  So human.  To live is to work.  There is no emotion attached unless I put it there.  Work is.  There is a lot of life satisfaction when we do it and don’t get all personal about it.  Don’t dance around, away, negotiate it.  Get it done and or don’t.  Either way, you get what you worked for.

Self-Care Tip #139 – Get up and live.  Work it.

Question: When have emotions, issues, temperature gotten in the way of your work?  Please tell me your story.

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Things Will Always Be About “Me”

Common Clownfish (Amphiprion ocellaris) in the...

Image via Wikipedia

Self-Care Tip #138 – Stay aware of “Me” to be more present with them.

The second thing I learned from Toastmasters is that no matter how good I get at doing the 1st lesson, in my eyes, things will always be about “Me.”  No matter how skilled or self-aware or Mother-Theresa I become, “Me” won’t disappear.

Mother Theresa, by the way, did exactly what was congruent with her temperament.  Doing what she did for others tied her in more closely than ever with them …her.  Doing what she did naturally only made her more present with herself, her own journey, her own awareness of self and at some point with others.  There is a symbiotic relationship so to speak.  Remember Nemo and his home in the sea anemone?

Doing well for myself and for others is not a problem of effort towards altruism or other saintly motives.  It’s a matter of biology.  More than ever, I believe in hard-wiring.  Acting like it isn’t about “Me” is boring and even irritating at times for others to watch.  Even when we are trained actors or Toastmasters in this case.

When we say that the acts of heroism someone did was temperamentally congruent, it takes a little shine off.  Would you still call Mother Theresa a saint if you knew this?  How about “Me?”  That shouldn’t make it any less wonderful, what we do in life when we do it this way.  Yet the sense of enchantment gets a little fainter.  It’s a shame because who we were made to be is magical.   Doing what we do best by design is what our personal angels might have a hand in, I think.

If we can’t keep sight of ourselves, of “Me” while still seeing who’s around, there might be something medical going on.  No one wants you to disappear.

Question:  How do you keep it about you even while remembering that it isn’t?  How do you live symbiotically?  Please tell me your story.

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Stop Blushing. It’s Not About “Me.”

Beckwith James Carroll Lost in Thought

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Self-Care Tip #137 – Take yourself out of it to be more present in it.

When I started Toastmasters, I blushed, I stammered, I um-d my way through every talk.  I thought about “Me” a lot.  I thought about others in relation to Me.  I kept thinking, “What’s the worst thing that can happen?”  (Which, by the way, is supposed to desensitize Me and make Me feel better.)  But I just got more doe-eyed in the headlights.

I lasted about a year in this speaking club before life grew over it and I dropped out.  I still consider myself a Toastmaster, though, and, many friendly critiques later, I remember my hard-earned lessons:

1.  In other people’s eyes, it is not about “Me.”

Bob Freel, from Toastmasters International, often coached us to think about our emotional connection with our audience.  He made it clear that the reason so many of our talks stunk was that we were so caught up in ourselves.  We were not looking at “their” faces.  Thinking about “their” feelings.  Speaking to “their” interests.

Now how does this relate to self-care you ask?  Well, when anxiety hits my patients, they seem to find a little solace hearing that most of the things people do or say around them, to them, about them, etc. has nearly nothing to do with them.  Even when they are named by the person speaking.  That can be confusing, but just because our name may be on someone’s lips, on the program, on the tag — that doesn’t make it about us.

I am amazed at how true this is when flipped around too.  When I think about how often I’m thinking about others, (or not thinking about others,) I stop in my own tracks.  I’m pretty darn self-absorbed.  Yet, that is not a bad thing.  It’s just how it is.  For all of us.

Pulling our own selves out of the equation, helps us in fact to be more present in it.  For our own selves and later for others.

Sometimes we just can’t do this though.  That’s when we need to think biology is getting in our way from getting out of ourselves.  Let’s do it and stop blushing.

To read about #2 on this fine list, tune in tomorrow fellow friends-to-ourselves!

Question:  How has pulling your own self out of the equation helped you be more present in it?  Please tell me your story.

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What Are You Getting From Pain?

For most people the aftermath of a punch in the face means a phone call to the police or a trip to A&E. But not Lucian Freud. His reaction to a nasty altercation with a taxi driver was to put the pain and anger aside and head to the studio to get his rather impressive black eye down on canvas.

guardian.co.uk – Lucian Freud

Self-Care Tip #136 – Get something other than anger from your pain.

Naked came I out of my mother’s womb, and naked shall I return thither: the Lord gave, and the Lord hath taken away.

Say it however you want, everyone gets and everyone looses.  We could say, “Life,” if you prefer.  Or insert wherever you think good things come from and where they go.

Who hasn’t just gotten their fingers around something they wanted, realizing more and more each moment that they really wanted it, pleasure rising, gratitude and satisfaction driving itself deeper inside – just to find it somehow escaping their grasp?

Morris Venden, preached it.  He had a low, hound-dog voice, a face to match and severe social phobia he struggled with life-long that just added to his beauty.  He preached his own shared experiences with people.  People like me and you.

A man working a job he never liked finally retires and buys his little house to grow old in, a garden he could play with, and a year later finds the love of his life suddenly dead with cancer.   And it all turns to ash for him.

 

Early portraits by Lucian Freud

Your firstborn dies.

You were cruel in a debase way.

You develop mental illness.

Your divorce is ugly.

You father commits suicide.

You have a disabled child, and then another.

You’re paralyzed.

You prostituted yourself for drugs.

When I heard Venden give this talk the first time, I thought I got it.  Even now after years and after darkness, I think I get it.

Before one of his talks, when I was still in medical school, Venden asked me to sing this with him.

Angels never knew the joy that is mine, for the blood has never washed their sins away, tho they sing in Heaven there will come a time, when silently they’ll listen to me sing “Amazing Grace.”

We stood there on stage.  Me smiling too largely because that’s what I did in front of people.  He, uncomfortable, a little blunted and suited with a thick knotted tied, stood a few paces away.

And it’s a song holy angels cannot sing, ‘Amazing grace, how sweet the sound. ‘And it’s a song holy angels cannot sing. ‘I once was lost but now I’m found’

I looked at his droopy moustached face and his eyes were red and wet.

Holy is the Lord, the angels sing, All around the throne of God continually.  For me to join their song will be a natural thing.  But they just won’t know the words to “Love Lifted Me.”

This is what Morris Venden thought he was getting from pain.

What ever our pain-story is, was, and becomes, holding the anger is gripping the ash.  For Morris Venden, he took care of himself by finding this instead of anger – more knowledge of God’s love.  Moving his grip to that was his self-care.

Question:  What are you getting from your pain?  How do you do self-care when you lose?  Please tell me your story.

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The Presence of Stress Doesn’t Make the Disease Process Any Less Important

sciencealive.wikispaces.com

Self-Care Tip #135 – If it’s medical, call it medical and not stress.  Be a friend to yourself.

New to me, Stacy came because of her problems with violence.  She was enormous.  5’11” and 200 pounds, she was just too big for her parents to handle her any more.  She was precious to them, their only child.

Taking Stacy’s history, I asked, “Does your family have a religion you practice at home?”  Stacy’s parents were giving her history since Stacy was disabled and used very few words.  Mom looked at me, and asked, “Why?  Why are you asking about our religion?”  She was sensitive.  Worried that I was packaging her up in a religion-box, she personalized my question.  I explained that religion is part of family culture and the question was simply part of getting to know them.  She relaxed a little and then said, “We have more of an ‘Autism’ home-culture these days!”

Mom looked tired although still very much engaged in her daughter’s life.

It often happens, when someone see’s me in clinic for the first time, that my questions take them by surprise.  They aren’t used to someone so directly and objectively asking and speaking about them and to them.  So it went with Stacy’s mom.  Question after question, she seemed to be in a mild state of wonder.  It wasn’t gun fire but she might have felt like it was.

“Does anyone in your family have emotional illness?  Any depression, anxiety, suicide, drugs, alcohol…?”  Why do I want to know about the family? her face said.  “No!  No one.”  I was just ready to move on to further history when she said, “Well I… I have been depressed a little on and off but I don’t have depression.  Who wouldn’t feel depressed with this stress?!”  And then Stacy’s case manager said, “Who wouldn’t feel stressed in your situation?!” and smiled and laughed with her to put her at ease.  Stacy’s case manager is a nice person.  She is bonded to the family and cares about each of them.

We completed our history and formulated a treatment plan together.  Stacy had sat mostly quietly through the hour and her parents were now at ease.  Before they left, I was able to share with Mom a couple of sentences on taking care of herself.  On seeing herself as important and in doing so, was giving Stacy the best gift she could.

What I would like to say to Stacy’s mom and to her case manager is that thinking depression is because of stressors is a great lie.  There might be some initial correlation but it is often not the point .  The real issue is medical.  I wanted to tell Stacy’s case manager that she should know better than to promote this.  I wanted to tell Stacy’s case manager that helping Stacy’s mom not minimize what she was going through was friendlier.

Stacy’s mom is not my patient, but I did pick up that she is sad, fatigued, personalizes things that aren’t about her, anxious, a little hypervigilent and suspicious, and that something biological was likely going on.  Everyone has stress, but not everyone reacts the same way.  Some of us get ill for biological reasons.  Using the stressors as decoy to the disease only preserves the state of suffering.  And it affects everyone.  Mom was part of Stacy’s recovery too.

Question:  How do you see the relationship between stress and mental illness?  Please tell me your story.

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Having Mental Health Means Sleuthing Magical Perceptions Sometimes

Black Magic (comics)

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Self-Care Tip #134 – Looking past the dark magic in your life might require medication.  Be a friend to yourself.

Much of what psychiatrists do at work is help with misperceptions.  Seeing something one way does not make it true.

In Scientific America, there was a great article, “Magic and the Brain: How Magicians ‘Trick’ the Mind,” By Susana Martinez-Conde and Stephen L. Macknik | November 24, 2008 | 17.  It tells us that we misperceive things so easily, that people use that quality to entertain others.  Magicians use it to entertain and exploit the limits of cognition and attention.

Magicians aren’t the only ones to exploit that.  We do.  We exploit ourselves.  Tsk.  Not too friendly and not generally as entertaining.

How is having our misperceptions a form self-exploitation, you say?  Because we nurse them and drive our own selves into the ground with them.  No one else is doing it when down to the last trick.

It comes to me that when we feel disconnected from others, we are mistaken.  Some magic turned us awry and we don’t see the gazillioin links touching us all around.  When we feel worthless, when we think we are despised, when we feel singled out for suffering, that be black magic my friends.  When we think our lives our so hopeless that we would be better off ending them, look for the mirrors.  Look for the rabbits and top hats.  We aren’t seeing things right.

When I move the curtains across my clinic day, I often find medical diagnosis hiding behind.  Some sort of biology giving us the slip.

My dad often told me, “Things are never as bad as they seem.”  I realize he was talking about this kind of magic.

Question:  How have you gotten past self-harmful misperceptions?  How have you seen another do it?  Please tell me your story.

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When You Are Hurting, Remember Why You Want To Live, And Live For That

 

greaterlearning.org

Self-Care Tip #133 – When you are hurting, remember why you want to live, and live more purposefully for that.

My daughter has a viral upper respiratory infection.  She is laying on the floor in her sleeping bag that has the stuffed puppy dog head for a pillow.  She just wants to be near me today while I work.  She wakes up and coughs, I check her out and dose her if she’s febrile.  She goes back to sleep.  Awakens.  Trundles up to drink some mango juice, water, eat 3 noodles, comes down again and lays there, pink in the cheeks, red eyes and chafed upper lip.

Sometimes when one of the kids is sick they stay home if I’m here.  It usually stresses me out but I’ve been getting better at believing more that we can take what comes and still get the work done.  Today, in-between patients, I laid down beside her.  Face-to-face.  She leaned in, opened her eyes and smiled!

She is one of the most delicately framed little people I know.  My nuclear family has never had small bones so this must be from someone on my husband’s side.  My daughter swung that tiny arm, warm with fever over my neck, put her face on mine, and fell asleep.

Lying there, thinking I’m so glad I could do this for her, suddenly felt wrong.  It flip-flopped over in my mind and I realized that I was glad.  But for me.

Having her near me while I work is a connecting force.  To both of us but maybe more for me.  My family has been exchanging this virus for 2 weeks now.  It hasn’t been hell but it has not been a delight.  Yet here I find myself delighted.  I wonder how long I’m going carry this gladness around.

Come what may in this world, it is these surprising moments that convince us about the rest.

In psychiatry, I’m required to ask each patient if they have thoughts of wanting to die.  Then I ask, “What do you want to live for?”  That catches some people off guard and I’ve gotten looks that could defend anyone in war.  But we aren’t at war and eventually they tell me why they want to stay alive another day.

At some level we all answer that question even if indirectly.  Everyone suffers.  If I were asked, my daughter’s smile would be on my list.

I am often amazed by good things that come out of bad.  Knowing that, gives hope.  But it also gives purpose and we can choose to angle ourselves more purposefully towards that rather than passively.  We can choose to live for the reasons we think worth living for.

My husband prays, “God please turn my posture toward you today.”  I’ve always loved that.

Question:  Why do you want to stay alive?  What are you living for?  Please tell me your story.

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The Process Of Coping With Triggers Such as Anger Includes Awareness

Two people in a heated argument about religion...

Two people in a heated argument about religion when Mahmoud Ahmadinejad spoke at Columbia University. Click the audio button found above and to the left to listen to them. (Photo credit: Wikipedia)

Self-Care Tip #132 – Awareness comes over and over again when you are a friend to yourself.

A reader posted in response to yesterday’s blog, When Someone Is Afraid Of You, You Don’t Have To Be Afraid Of Them. Just Be,

Sometimes it feels like any negativity dirties me up forever. I have a really difficult time dealing with any of the more negative emotions…. I am not sure how to “just be” with respect to those emotions…it always feels like anger whittles away my soul. Any ideas for coping through the times when we get really angry?

Taking care of ourselves requires awareness.  Just seeing it for what it is.  Being tuned in.  Having that degree of knowing.  Insight.

Awareness is sort of like “I love you’s.”  When we hear them, we might need to hear it again 5 minutes later.  There are no available stock options.  If the love doesn’t keep coming, than problems start.  Same with awareness.  We restore our own awareness how best we can, over and over again.  It slips and when new feelings come up, it may seem like it never happened.

My dad came over a week ago and spent the day with me and the kids.  The joy of just being able to spend a whole day with him was unique.  It was a different company than when he visits for an hour or on a timeline.  This day was all ours.  He left his car, and his cell phone behind.  He rode with me and the kids, sans detractors.  We were relaxed together.  Present.  There was a lot more time of just sitting quietly doing our thing but sharing even in silence our own selves.

Today he called, “To check on the tribe.”  He reminded me that it had been “just” a week since we spent that time together.  In my business of filling cereal bowls, the office, picking up dirty kleenex, training our dog where to poop – our time with Dad seemed like a long time ago.  I told him half jokingly, “Dad, we aren’t a bank account.  You have to keep coming.  You don’t accrue interest on what you put in.”

So is our own self-care.  It’s not that we are starting from scratch every time we take a bath.  It’s more that when we get into the flow of caring for ourselves inside and out, it becomes a regenerating, constantly investing rhythm that may at some times take thought and at others just happen because that’s who we’ve become.

One step of coping is that regenerating, repeating, purposeful process of awareness.  Our reader’s question about coping with getting angry put simply, requires awareness.  Because coping is soooo much more than just that, I’m sure it is too simple but it’s a start.  From there, come other bits of coping.  But without awareness, hmm.  Not much is going to happen.

Question:  What is your process of coping with triggers such as anger?  Do you think about it or is it cued subconsciously?  Please tell me your story.

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Self-care Begins and Ends With “Me” – Own It

lovingyourpet.org

Self-Care Tip #129 – Self-care begins and ends with “Me” – own it.  Be a friend to yourself.

Yesterday we talked about connecting self-care with pleasure to make it sticky.

Today, We’ll talk more about some of the adjustment issues of why we don’t do self-care on the obvious, such as nurture vs. nature.  We’ll talk about the nurture part.  Specifically, our own not what our parents did to us.

Why don’t we stand up to our personal needs?  We don’t.  We don’t own the friendly changes that we would benefit from.

Carol who used to abuse methamphetamines and alcohol many years ago, now tells me that smoking is her only vice and she needs to have at least one.  She says she doesn’t want to stop even though her feet and hands are blue from not getting enough oxygen.

Another part of the answer is that we are so overwhelmed by the wrong we see around us.  We qualify and quantify it away, desensitized to our own needs.

“Have you seen that dietitian?!  How can she possibly give advice on weight loss when she can’t see her feet?”  And we ignore our own central fat, knowing that it has meaning.  Meaning like, we have unseen fat layering onto our central organs.  Meaning, we are more likely to develop metabolic illnesses such as diabetes.

We don’t own it.  We don’t “Just do it.”  We talk about other people and draw lines between their mistakes making pictures that we can hide our own problems behind.  We can make sense of why they are suffering so.  Yet our own problems are some sort of enigma.  Yet to be determined by science!  Open-mouthed, hands splayed in a why stance, we can’t connect our own dots.

All health begins and ends with “Me.”  Including mental health.

Find yourself again.  Amidst all the world’s needs, you still are important.  Peel off Channel 4 News, the internet, the fears about what is outside your front door, and see yourself there under it all.  Needing self-care.

Question:  How do you keep view of yourself despite the distractors?  Please tell me your story.

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When Self-Care Gives Pleasure, You Will Be Friendlier To Yourself

Self-Care Tip #128 – Connect pleasure with self-care.  Be a friend to yourself.

There’s a reason we have bad habits in our life.  It’s not only the loops, the neurological grooves in our brain, it’s also that they bring pleasure!  It’s not so unbelievable understanding obesity, drugs, addictions, poor sleep hygiene, inactivity, whatever it is when we think about the amazing effect that dopamine has on our pleasure center!  Ah.  Say, “Dopamine!”

Our real question with ourselves should be why we so often expect ourselves to do “good” things if they don’t give us pleasure?  How do we expect to stop over-eating if the substitute we offer our biological selves is suffering?  How do we expect to exercise, if we’d rather poke needles into our eye-balls than jog a mile?

We’re smart people, we have knowledge and we know what to do.  But, knowledge isn’t the answer always.  The “language of the heart” is dopamine, is feeling good.  How can we link what we want to do with ourselves objectively with feeling good.  It would be nice to pair up our dopamine with friendly habits and not those that are self-destructive.

How to do that might be worth some effort figuring out.  Figure it out individually if we want it to succeed.  The reason for the discussion here is not to give directions, but simply to draw attention to our need to find our own feel-good buttons and how we can wire them up to self-friendly behaviors.

I’m struggling through this also.  I hope to share this awareness with my kids before they move out, so I better get busy!  Can’t do that too well until I do it well for myself.

Today when I went on a mommy-date with my daughter, instead of taking her to Starbucks, we went and bought Bendaroos.  That was all I could come up with in the 10 minute date we had allotted for something feel-good.  Maybe she’ll develop shopping addiction instead of food addiction.  Time will tell, but I hope she got out of it the pleasure of creating shapes with Bendaroos instead.  Hopefully when she get’s creative, dopamine squirts out in her brain like a geyser.

Now, to get back to me…?  huh.

You can read a related post here.

Question:  How are you linking self-care with pleasure in your life?

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The Healing Process Can Be Confusing.

Self-Care Tip #127 – Because feelings can be confusing during self-care, keep connected to someone(s) objective.

A colleague told me the other day about his patient.  Of course he didn’t name him, but I’ll call him Brent.  Struggling with melancholic depression for many years, Brent started medication therapy.  He began feeling better emotionally.  But at the same time, he started to believe that he didn’t love his wife any more and started a dialogue with her about possible divorce.

It’s tempting to judge Brent.  Easy to say, “What the…!?”  Still, because we don’t know the full story, nor his thoughts, nor consider ourselves his Judge, we won’t.

Self-care can be a tricky road.  It’s not all ah-ha moments and nirvana.  Have you been there?  Confused by your feelings as you heal?

A common reaction to improving is associating the things in our “ill” life – when we were feeling terrible – with other elements that may not have had anything to do with our bad feelings.  Perhaps Brent’s wife was guilty by association and at some level he may have connected her to the dark emotions he so desperately never wants to feel again.  Bits of this idea are also in a previous post about panic disorder and grief.  For example, someone may change her profession because she believes her previous work is causally linked to the way she felt when ill.  Maybe Brent wanted a change in spouses for the same reason.

When we are going through the healing that self-care brings, we might not find our new emotional baseline for a while.  During that time, and because feelings are often not trustworthy, stay connected to the support network, confidants, the trusted few who can be our third-party advisors.

Although taking action on for our own health involves lifestyle changes, knowing when and how to get feedback is key.

Question:  What has confused you about your healing and self-care journey?  Please tell me your story.

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Have The Courage To Be Known

 

 

 

Driving my kids to their dental appointment today, we passed a corpse.  I could see the top of his head, bits of the gurney, but mostly the shape of his blanketed body.

In the first chapter of Le Petit Prince (The Little Prince,) by Antoine de Saint-Exupery, Prince describes how he is a misunderstood artist with hidden undeveloped talent.  He had drawn a postprandial (after dinner) boa constrictor, large with the elephant inside his stomach.  Unfortunately people who looked at his picture saw a hat instead.  Better with words than picture, Prince narrated rather his great loneliness amongst all creation and a yearning to connect.

This morning, seeing the blanketed corpse, I remembered the boa constrictor that Prince related to.  The futility the Little Prince felt about getting connected.  The inevitable misunderstandings that left him as a hat instead of boa constrictor that just swallowed an elephant whole.

http://www.angelfire.com/hi/littleprince/However, Prince refused the constraints other people’s perceptions offered him.  He refused the constraints by believing even still that he could connect with others.  In his simple way of living, he tried, going from planet to planet to be known as the Prince he was and not that other thing.

Driving today, I was very upset by what I had seen.  The facelessness of the man shaped in his blanket.  Covering him up and no one crying over him.

Someone was there with a clipboard and I could see an investigation was underway.  Of course necessary, but yet it upset me.  I kept seeing the boa constrictor that swallowed an elephant whole all day and thought about the man’s life, connections, and hopes.  Was he understood? Did he refuse perceptions and demand to be known and to know, giving others the same courtesy of life’s desire?

I cried over him today.  The same desire being inside of me, somehow the corpse who had been the man and I shared that relation.  So I cried for my brother and hoped someone had seen him.  As I hope to be seen.

Live as courageously as The Little Prince and believe.  You can connect.

Self-Care Tip # 126 – Demand with your life, to be known.  Connect.  Be a friend to yourself.

Question:  What obstacles to connecting have you been covered with?  How have you refused them?  Please tell me your story.


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Go Toward The Pain To Get Connected

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Audrey came in looking fresh.  Better than before for sure.  She had an aura that brought to mind the moment just when tearing off wrapping paper.  It was nice to see her.

I am doing better.  I’m able to let more of the little things go, like the house doesn’t bother me as much when it’s not clean.

She was more able to do self-care with less forethought.  What did take her by surprise though, was her guilt.  She could see that it was inappropriate but insight didn’t entirely remove what shouldn’t be there.  She said these thoughts and feelings were something her husband likely never struggled with.  She didn’t think he was worried about her home doing dishes when he was at work.  However, the reverse for her was true.  She gave a coughing laugh.

I do!  I feel bad when he does the things.  It doesn’t make sense.  If he wasn’t washing dishes when I was working he’d just be watching TV.  But I still feel bad.

For her, working her job, taking her jogs, and attending Mommy groups were all in a grey category of “extras” for life.  Not necessary but bonuses she was spending their retirement on.  However, despite this, she looked the champion she was when saying,

I still am able to take care of myself.  Even though those thoughts come.

Audrey, by thinking about, talking about, and materially man-handling these thoughts, she was able to join her personal journey.  These things became connecting forces in her life.  They drew her closer to her family and not away.  Resentment dissipated and she was able to take part in her available positive emotions and thoughts.

It could have been different.  It had been different at other times, before medications and other positive deliberate choices in her life.  But it wasn’t now.  The could-have-beens trickled away together, the other near misses that sometimes we know about and sometimes we don’t.  There they go…

Going toward the pain in life, not averting from it, is a connecting force in our lives.

Question:  What have you been avoiding?  What has it done for you when you went toward the pain?  Please tell me your story.

Self-Care Tip #124 – Go toward the pain to feel connected.  Be a friend to yourself.

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“You” Are The Best Gift

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Self-Care Tip #123 <–> Take care of yourself.

Before I was found by my man, my brother Vance Johnson used to tell me, “Become the woman whom the kind of man you hope to marry some day would want.”  It was one more thing that helped keep my focus off of searching for boyfun-friends and on to living my life.

Of course it doesn’t end when we get what we want.  When we stop growing, we stop living – as Sarah said in the blog-post, “You Are Enough.”  Regardless of where we are in life, we are responsible for being the person that the people we want in our life want to be with.

Many of us deteriorate under the guise of service, employment, obligation, parenting, care-giving or whatever reason.  We neglect ourselves and then give that battered up self to our hopes and to the people we love.

Don’t be misled.  If asked, those very people we are serving would say, “Just take care of yourself.”  If you don’t believe it, reverse it.  What do you want to say to the over-extended people you love?

Jennifer who is a stay at home mom, tells me that she feels so guilty when she takes time to go for a run.  She laughs, saying her husband wants her to go.  He comes home and tells her, “Go!  I’ll watch the kids.”  Yet she still feels bad.  She thinks about her husband’s long day at work and the kids moods, their needs, what she could do for them, and she can barely force herself to leave.  Once she does, she says she always feels great about herself and them, and comes home having more than she did before to offer.

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Taking care of ourselves, is giving the best gift to the people we love.  “Me.”  Taking care of ourselves might be the most selfless thing we could do.  It keeps us connected to our life journey, which by definition includes keeping us connected to the very people we love.

Keep on!

Question:  Where are you in your journey?  Taking care of yourself, connected, disconnected?  How does it affect those you love?  Please tell me your story.

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Do The Opposite. For Your Self.

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Self-Care Tip #121 – Do the opposite, do the “un,” and go where you don’t want to go.  Be a friend to yourself.

Frank, accomplished in chess, employed in a 3 digit salary job, married with children, and he heard that things were going well.  From other people.  In his opinion, Frank believed the inside life-details were more destructive than the redemption of the apparent details.  Frank listed himself off to me like a confession, but he got little relief from the exercise.  It didn’t change that he was still addicted to sex, ashamed and the addiction was changing his ability to function in the other areas of his life.  He was taking more risks and realized that if he didn’t get clean, he’d lose “everything” but the addiction.  Not wanting the addiction didn’t make it go away.

How many of us wrinkle our nose at the Frank’s out there!  How we avert.  Either side is not really good or bad.  It just is.  Frank is addicted.  And we are ignorant.  Sex addiction is in the recesses and communes of where any of us live.  And, “we” are no better than they or worse.  It just is that way.  The qualifiers are the stink that kill our connections.  The qualifiers are rotten.

One thing I love about Jesus’ earth-story is that He was always un-everything.  He was Un-segregation, un-rules, un-prejudice, un-divided, and many people thought he was un-qualified.  Wherever these things were, He went there.  I love seeing people who use Him to draw lines between their spaces.  To say, “This is because Jesus wouldn’t…”  Hmm.  Jesus wasn’t scared of mucking up in the chaos of people’s lives.  Jesus not being scared is actually the wrong way to say it.  Let’s say rather, Jesus honed in straight to the muck and chaos, drawn there because He couldn’t and didn’t want to stay away.  We are not so loving as that but who cares about motives?  I also say with confidence that Jesus/God understood biology much better than we did then, now or will.

When we can look at each other objectively, when we don’t personalize what isn’t about us, we can let go of some of what separates us.  It goes both ways.  We are afraid of Frank and what he does.  Frank is afraid of what he does and of us.  But it’s not the fear so much as it is the qualifiers that ruin us.  Bad, good, Clang!  Down go the dividers.

None of this is meant to minimize the pain that these things bring on, such as addiction.  Rather, taking away whatever is dividing us helps us be more present with the pain, with each other, and often leads to healing.  It is another opposite, another “Un,” another Jesus-move.  Doing just the opposite of what we think should be done.  Got to love that Man!

Why would any of “us” want to be connected to the addict, or to whomever is doing something hurtful, scary, negative whatever it may be?  Why?  For your self of course.  Our life is better if we are.  That is a motive I think is worth pursuing.

Question:  How has your life gotten better when you did the opposite of what you felt like doing?  Please tell me your story.

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Put The Struggle Down and Take 3 Steps Back

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

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

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

Good night folks.

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

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

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You Are Enough.

Self-Care Tip #119 – Remember that you are enough.  Be a friend to yourself.

Forrest Gump (after watching his girl Jenny throw rocks at her childhood home of abuse,)

Sometimes, I guess there just aren’t enough rocks.

That movie grabbed almost everyone’s heart-strings.  And when I saw my patient Sarah, I kept thinking about Jenny throwing rocks.

Sarah started crying.  I’d never seen her do that in the 8 years we’d worked together.  She was one who talked in spurts.  Sometimes saying nothing for many visits, and then she’d start questioning me about foods, diet questions, or parenting.  Then quiet some more.  Today out of the blue came her tears and words.

When she started on her disclosure, I tensed up thinking, “What am I supposed to say?  She’s never done this before!”  I realized that being a psychiatrist, I should know the answer to that question and got even more insecure because nothing came to mind.

Her lovely face crumpled over the story of her “stupid” father.  He never let her go to school.  He was violent.  Sarah is now teaching herself how to read; and more tears, her lovely face trembling.  She is a mother and there are no books in her home for her children because she is ashamed of herself.  “My dad is an idiot man.”

Post traumatic stress disorder (PTSD) can last a lifetime.  The horrors that are relived by the survivor can be unspeakable for them.  We never know what people are going through really inside.  They could be a survivor like Sarah or Jenny.

So far, I hadn’t said other than a few “psychiatry-sounds” like “hmm,” and “Oh.”  Don’t be too impressed but I remembered someone somewhere wiser than me put it this way,

Sometimes it’s better not to say anything.

And I really didn’t.  She did.  And she did it wonderfully.  We ended up talking about authors she hoped to read eventually.  She’d heard of Isabelle Allende and wanted to get to her books some day.  We hadn’t even started talking about medications yet.  Sarah left after saying that when she stopped learning and growing, she would be dead.

What hit me was that Sarah wasn’t looking for more than me.  I searched, wanting to give her more and came up with what I hoped was an appropriate facial expression.  In a way, by not speaking much, I was able to receive and be blessed by her story.  I might have missed that.

My mentor, author of blog CreatingBrains.com, encouraged me when I was unsure about teaching others.  She said, “Look at your life and who you are.  You would be surprised.”

When we are insecure about something, it helps to remember that we are enough for the task at hand.  As individuals.  We have in us all the days that came before, the experiences, the generations that handed us down, the God who made us and as per my belief, never leaves us.  We have so much.  Considering all this, be still and know.

Question:  When have you been amazed at all that was inside you?  Please tell me your story.

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The Great Lie.

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

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

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

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

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

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

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

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

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

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Pebbles to Diamonds

 

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Self-Care Tip #117 – Notice, you got diamonds out of stones!  Be a friend to yourself.

Cindy replied to yesterday’s post (that had some discussion on functional mental illness,) “I understand Miranda’s feelings completely.  Some days it’s all I can do not to down tools and scream ‘What about ME?’”

That is one of the lovelies that these illnesses bring to us.  In our honest moments, we can, like Cindy did, perceive our own traits that resemble them.  Perhaps, if we are lucky, that will lead to empathy, one of the great human experiences.  To be able to put yourself in the hypothetical place of someone else.  To imagine what they think and feel.  “If I were in your shoes…” and so forth.  If you’d like, read more on this at this post.

Illness is often considered a step in the dyeing process.  Others see it as part of the living process.  Of course, it is both.  We are all on level ground when it comes to having been born, coming into life, and knowing we will equally die.  Illness reminds us of our like-natured frailty and of course the opposite – resilience.  Whether seeing our own illness or someone else’s, we have this privilege of being blessed this way.

My Dad used to tell me a story (author unknown) when I was little.  It’s been a long time but I remember it this way.

Three travelers were walking when they heard a voice telling them to bend down, pick up pebbles and put them in their pockets.  The voice told them further that in the morning they would be both happy and sad.  The travelers did but not equally.  Some pockets were more full than others.  In the morning when they awoke, their stones had turned to diamonds.  Whoever gathered many stones were happy even though all of them wished they picked up more stones.  But whoever gathered few, well, they were not happy.  They still had diamonds but the comparison soured them and they finished their journey full of “what if” thoughts and not thoughts about the obvious.  They got diamonds out of stones!

We are all similar, with the opportunity to say thanks in seemingly off times, such as mental illness.

Question:  What have your “stones” turned into?  Please tell me your story.

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