Sequestering Physicians from the Muggles

muggles

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.

Self-Care Tip:  Get you some Grace, with Grace.

Love Relationships for Power or Dependence

He takes care of me.

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.

Exercise and the Brain – and Dancing to Enrique Iglesias

taylor swift

Greg went to arrange his annual colonoscopy.  Because he was having a chronic cough, his gastroenterologist (GI specialist) was wise enough to schedule him the “double dip” colonoscopy and endoscopy.  Greg was not pleased.  He was less pleased when Dr. GI found gastritis (inflammation) in his colon, an ulcer (inflammation) in his stomach, and esophogitis (location of inflammation intrinsic to word, esophogitis.)

I got the scoop on Greg’s inflammation story when he came in to see me, (yours truly, psychiatrist, brain doctor.)  And why?  Because of his colon and stomach?  Well perhaps.

True.  Greg was not happy.  He had not been happy for a very long time in fact.  Greg was suffering.  And no, he could not exercise.  He just could not.  Fill in the blanks of why he could not.  We have all given those reasons.

Discussing Greg’s story with him, we agreed that ignoring the inflammation story of his GI would be ignoring something that just might relate to the, “Why?” of why he was in to see me.  The same inflammatory process affecting his gut was affecting his brain, the same brain where his emotions and behaviors came from.

Inflammation.  We think about pus-filled blisters, puffy painful knees, spitting back spasms.  But do we think about frothing road rage?  Do we think about forgetting car keys in the supermarket where we bought five things we did not want and nothing of what we planned?  Do we think about divorce?  About losing our job, or not wanting to get out of bed?  When we hear about inflammation, do we think about brain disease?  I think not, Count Powerball.

The other day, we were in the Kaia, “Juicy JAM” class.  (Seriously. That is what it is called.) Coach Becca does these Juicy JAM classes about once every three to five months with us, just for fun.  It combines dance with athletics in a way that is designed to burn calories, yet effectively reduces grown women, responsible women of our community, parents, book-keepers, encyclopedia saleswomen, psychiatrists, (I am just guessing at least one of us moves like a psychiatrist) and such…, into giggling, hopping, human bumper cars.  And it is hard!  It is not easy to squat, pop, and then pull your fisted arm down super latino-drama-style over your just so angled body to Enrique Iglesias… I think it was, “Tonight I’m Loving You.”

By the time we had survived our first number, all I knew was that Becca looked really good.  Me, eh, not so much.  It is too bad we can not collect disability for this, not being able to dance.

When we dance, we do not usually notice how everyone else is dancing around us, as much as we think about how we are, ourselves.  Like any other behavior or emotion, we are trapped by our own design.  Look who is telling us that after all!  Our own brain.

Then Becca’s tattoo pokes out and we all think, she is such a bad ass!  (It’s right there just above the line of her pants.)

Where do these emotions, and behaviors come from?  Do they come from the good merit we have earned by hard work?  Maybe a really sweaty muscle bending Juicy JAM work-out?  No they do not.  You are right.  The emotions and behaviors come from our brain.  They come from that bit of us that is, after all, connected to the rest of our body.  Our body, where our muscles pump, where our pancreas balances our insulin levels, where our bowels, which flaunt the highest number of serotonin receptors of our whole selves, move and flow.  Our bodies, where nerves stop or start sending pain signals to our brain, where our heart and lungs pump all the blood that touches every part of us like a master control room – this is what matters to our brain health.  It is a relationship, like Garth will always go with Brooks.  Body goes with brain.  An inflamed body, an inflamed mind.

Now we know you are all thinking about bowels and what exercise does to bowels, and you are uncomfortable.  As you should be.  At least standing at a respectful distance.

I’ll never forget some months ago, and probably most of my Kaia-peers won’t either, when Coach Alyssa was taking us through Kaia-flow, a series of twisting yoga poses slash killer exercises.

Good job women!  This is also great for your stomach and bowels.

I thought, there-after only about stomach and bowels!  It was like a beacon.  No matter what I did, I was thinking about my gut.  And then like the answering horn of a trucker to a kid’s arm signal, “please honk,” there I went.  A slow twist, quiet music in the background, the soothing voice of Alyssa urging us on, and, honk.

There was no way to hide it.  No way to pass it off on my dog or kids or farmland creatures.  I was in the middle of the room and suddenly, like Taylor Swift on a center stage, everyone heard and looked.  Just one more bit of savory evidence that exercise decreases inflammation.

With this understanding, we can perhaps consider exercise like a pill.  Like a prescription.  Do exercise because we do what is friendly to ourselves.  Do exercise because we like being friendly to others.  We know that we cannot give what we do not have – to ourselves or to others.  We exercise because if we do not, we will be the barking mom we do not like, dad, sister, child or whomever.

We will not be nice to our partners when we have ill brains.  We will not feel pleasure as deeply.  If we are kindly toward ourselves, such as exercising, we will protect the soft underbellies of them others we love.  We will treat ourselves better.  We will.

One hour later, after dancing or twisting our inflammation, shame, and inhibitions into the ground, after passing a little gas, we are reduced to inspiration, humbly thinking, “Yes. I am that good.”  And that is the Magic there. We are bad arss.  Body meets brain meets community meets Magic.

And for you scholarly folk who don’t believe me when I say, exercise decreases inflammation decreases brain illness, here are a few articles:

Question:  How have you noticed your body speaking on behalf of your brain?  Or vice versa?  Please tell us some of your story.

Set Your Self-Care And Moral Jailer Free.

Repost

Self Care

Image by Mskadu via Flickr

Self-Care Tip – Set your self-care free.  Be a friend to yourself.

Self-care just is.

The problem about saying self-care starts and ends with Me is that people forget about the journey it travels between here and there.  People become fearful that it means alone-care, apart-from-God-care, selfish-care, and so on.

When we take care of “Me,” we can connect more with others, including God, have more inside of us to give to others, and have more interest in the world around.  The opposite disables our abilities to do those things.  Again we say, “Can’t give what we don’t have.”

God gave us this person, “Me,” to take care of.  He considers “Me” valuable and of high priority.  He celebrates with me and cheers me on.  He stands beside me and He doesn’t see self-care as having exclusionary implications to anyone else.

Please, shake it off.  Self-care is no more of a moral issue than anything else.  It just is.  It is a choice, a freedom, an opportunity.  It is as much about salvation as any other act of good or bad, and has no influence on our worth.  It just is.

Lord, What must I do to be saved?

– Paul’s Jailer.  Me.  Could be you.

Questions:  How do you speak to the stigma in your church, community or self toward being a friend to yourself?  How do you get to Me, despite the pressure to pay-up to all the others around you in emotional and physical energy first?  How is your relationship with God when you are friendly with yourself?  Please tell me your story.

The Holidays and Lonely Me

Feeling anxious about Christmas, or whichever December holiday celebrated?  We are not alone.  We think we are.  We worry about the in-laws, parents, money, gifts for our kids, keeping the romance, abandonment, alcohol abuse, anniversary-grief of loved ones lost, and on and on.  I’m thinking now especially of our dear blogger-friend, Lisa, who is spending this first Christmas without her mom.

Lisa, we are standing with you.  We are weeping with you.  You are not alone and we value you.

In this precious sum of days, “the holidays,” going into the space that holds our fear seems almost morally wrong.  (Do we really have the responsibility we perceive we do to be “festive?”)  The smiles and joy appear to occupy any organ-cell(s), from the lowest creature to our neighbor, who doesn’t deserve more than a broken shoe in his stocking.  We think,

How can this be?  Why don’t I feel joy or care?

Even when our mind knows the true answers that we are not chosen to suffer, we are not alone and that we are safe to be in the space of our fears – even then, we don’t perceive it.  In the cold environment of our lonely selves, white breath condenses, freezes and, made heavy in winter-thought, falls to the ground before the “knowing” has a chance to reach the rest of us.

There are no universal-tips to dispense, cups of warm cocoa or four-sided tickets, except this.   Remind any part of us that can hear our friend, that is to say Me:

We weep together.  

We are present with our suffering.  This does not take sincerity away from the things we actually do still enjoy and feel pleasure with.  Inversely, feeling pleasure does not deny the grief or other negative feelings.  

We will make it past this.    

We love ourselves and see our flaws as tools to use towards furthering our efforts in self-care – potential assets.  

We claim our freedom to choose to start over at any time, to choose not to be a victim and to go where our intuitions wrongly advise us not to – our fears and shame.

We take our medication, despite stigma. 

We account to ourselves, despite what has happened in our lives.  

We keep it basic when things complicate.  We return to the home of Me whenever our view  of where we are in time films over.

Keep on my friends.  We are persons of courage and value.

Questions:  What fears complicate your holidays?  How are you friendly to yourself during this time?  Please tell us your story.

The Gift of Desperation

Life (23/365)

LIFE

Misty sounded relieved,

Yes.  That’s it.

She had just realized that life isn’t fair.  Sure.  She knew that before, but she just realized what she knew.  Don’t we all love that moment when our senses join up – sight, hearing, taste, touch, smell, emotion, intellect, spiritual and the rest.  That is a lot to coördinate after all and sometimes some of them don’t make the train.

Misty was a single mom of three.  Her ex-husband was what she called, “Disney-Dad,” and her kids relished their time with him.  Misty complained that she didn’t get to spend the special times with her kids.  She mainly took care of them, but missed out on irresponsible fun.  She was sure her kids wouldn’t look back and think of her like they would their father.  She was getting angrier about it all the time, ruminating about it and it was getting in the way of her ability to connect with others and feel pleasure.  There it was in front of her blocking her from seeing her kids even, let alone herself.

Then after weeks of this along with medication and talk therapy, she told me,

Yes.  That’s it.  Life is not fair.  There are many other things in my life that aren’t fair either and if I look for them, I could spend my whole day every day counting them off.  

It broke my heart a bit to hear her and see her there.  Humble like that; she would I think affect you the same way.  So real.

Yesterday, Carl D’Agostino replied to our post about growing our understanding of our choices beautifully.

…we wait until we are at our wit’s end before we seek assistance…. considering reaching out as personal failure or inadequacy re: our own self-esteem…. Foolishly we wait until our way just is not working anymore. That is why AA calls this a gift: the gift of desperation. …For many, the depths into which we have succumbed are now found not to be so deep at all and in fact, ladders are readily available if we use them in recovery. 

Ah Carl.  Say it again.

The gift of desperation.

Too good.  Don’t you think?

Questions:  Have you ever received the gift of desperation?  What did it bring you?  Where did it take you?  What did it do to you?  Do you still have it?  Please tell me your story.

Self-Care Tip – Celebrate your gift of desperation.

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.

Emotions – One Part of The Multi-Paradigm Weave That Makes Us Who We Are

Immanuel Kant developed his own version of the...

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Yesterday we spoke about the emotion, happiness, as it connects to and does not connect to spirituality.  Traditional western religions squirm  or  more, disagree when they hear this.  Everything is spiritual in their school of thought.  However, as our understanding of where emotions and behaviors come from, we have happily disentangled ourselves from the stigma and judgment that comes from the way many people have (mostly unwittingly and often without intended malice) abused us with mental illness.

I know that I have also been in this crowd of prejudiced.  Coming out of that has been fun.  There is still so much that I think I see clearly but don’t, as it is for us all.  The growth we’re talking about is part of the high adventure that brings pleasure to life.

To say it plainly:

  1. Emotions come from the brain.
  2. Emotions are not always directly chosen as we can’t directly choose the way our brain works.
  3. Emotions are what we use to interpret the world around us.
  4. Emotions don’t have intrinsic moral value.  Morality is bigger than the way we feel.
  5. Emotions are not constant between us.
  6. Emotions are a sense.  We’ve called them the Sixth Sense.  Senses are subjective and not objective.

How does this fit into your biopsychosocial model of how you see yourself?

Biology.  Psychology.  Socially.

How does it influence the way you befriend yourself?

How might this influence stigma surrounding emotional illness?

Emotions are just one of the many things that make us who we are.  Many many things.  As we tease these bits of ourselves apart, it is not the same as denying the multi-paradigm weave that makes us who we are.

Self-Care Tip – Enjoy your emotions but don’t put your life on them.

Presence – What is Turning In You?

How the pages turn slowly in life

Image by Nina Matthews Photography via Flickr

It’s summer break already and that means more Mom-time for the kids,… and a few other things.  But if there’s more Mom-time for the kids, we all know what there is more of for Mom.  These things come together and equal more spending-money-time combined with less work-time.  This can’t be without consequence.

I’m thinking stress, memory-makers, lots of kissing marshmellow-cheeks and tears to show.  Always tears.  The kids cry of course but if I do, its all,

Mom!  Oh NO!  Mom!  Stop crying!  Agh.  I can’t stand it when you do that!

Lots of exclamation points are involved.  I’m thinking this summer will have some of that because some days are stressful and painful.  Others are just too beautiful to leave unstained with tears to sign my name by.  Get ready kids!

Tonight, this is what I have.

I am licking my finger and turning a page.  I feel the book as the page slowly fights the air to pass over.  I haven’t seen the other side yet but the way the page lifts up and toward me, I know that this part is significant in itself.  Lick my finger, press it down and sweep up.  Up and passing over, just.  The page is turning and so are we.

Question:  What is turning in your life?

Self-Care Tip #280 – Pay attention to what is turning in you.

Paging A Testimony! Will A Testimony Please Call Back?

Swearing in 06
I ask five Questions 1.2.3.4.5.  
Will you give your testimony?

Q1:  What does being “a friend to yourself” mean to you in real-time life practice?

A1:

Q2:  What helps you do this at one time vs. another?

A2:

Q3:  What still hinders your efforts?

A3:

Q4:  What has pushed you past those barriers?

A4:

Lastly.

Q5:  How do you understand the interplay between biology and choice in being “a friend to yourself?”

A5:

P.S. – I had a hard time finding a picture for this!  I have no idea about who’s who and it took forever to find something that I think won’t trigger any political uprising amongst you fine readers…  But… if I didn’t, please don’t take me to the stand! (Bad humor wink.)

We Try Knowing We Will Fail. The Wonderful Journey Of Flawed People.

The t-shirt

Image by plαdys via Flickr

It’s 9:23 PM and our little kids are still awake!  They’ve cried.  They’ve laughed.  We’ve cuddled.  We’ve spanked.  They’ve taken two showers and brushed their teeth twice.  We ate several times.

I was riding my bike, watching a movie, (I love that!), and my daughters were taking turns coming in to complain, wet me with their tears, snuggle, hold me; you get it.  My exercise and my movie were peppered with refreshing breaks.  Sitting on the couch chair nearby with my five-year old during one of these intermissions, holding her, I was able to say,

It’s okay.  

I was able to do this because I was the one in the casita getting pumped up and my husband was the one in the house herding children to bed.  He had the tough job that turns me into a turnip and I had this.

You can do it.  You can try again.  You can try again, even if you are trying for the one-hundredth time.  You try and you try and you try again because that’s what makes our lives beautiful.  The trying part mostly.  Not the arrival.  

And that’s when I grabbed her and held on.  I suddenly felt so blessed.  From this off-night, I was given the reminder that the trying part of life is where it is at.

It’s 9:33 PM and I think they’re asleep.  Sigh.  Tonight was awesome.

We are flawed people.  We try, knowing we will fail.  Who does that?!  Why would anyone do that to themselves!?  Smile.  Ah.  Sounds wonderful.

Questions:  How is your journey?  Have you been enjoying your failures lately?  Please tell me your story.

Self-Care Tip #273  – Enjoy your failures.

In Mass and Individually, We Are Beautiful – Lady Gaga

Someone, who has experience fighting for her emotional and behavioral health, advised me to listen to Lady Gaga – Born This Way.  She said, “Don’t be scared by it!  Just listen!”

So I did.  And then I did again.  Her message is not, “Don’t stress out.  Don’t work hard.  Just be who you are.”  It is rather, “Figure out who you are and embrace that fully.”  By her own example, she tells us to work harder than anything else on embracing that.  Gaga says, love this unique self and respect it openly and privately.  She tells us that we are all beautiful in mass and individually.

So let us know what you think!  Is her message our message here at FriendtoYourself.com?  Are you uncomfortable with loving yourself so well?  Please tell me your story.

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.

Mental Illness Relapses When Medications Are Stopped

Free face of a child with eyes closed meditati...

Image by Pink Sherbet Photography via Flickr

Self-Care Tip #246 – Collaborate with your physician to change your medications.

It keeps happening.  People are stopping their medications and then getting more sick.  Recently it was Olivia.  I can always tell when she’s off medications – she personalizes things way more and she acts like a victim to many many random things.  She is irritable.

Olivia, did you stop your meds?

Olivia on medication was not a super easy-going person but she dropped much of the edge, her thoughts were clearer and she was able to see other people around her.  Today Olivia felt like her bullets were in place and about to fire.  She answered my question obliquely.

There are sooo many reasons I am better without those in me!   I used to not be able to feel God.  When I prayed, I didn’t sense His Spirit.  Besides, I’m doing fine.  There’s nothing wrong with me.  I’m happy!

The biggest bummer about getting into the scene after the medications were stopped verses before, when stopping them was just a consideration – is that the patient doesn’t see themselves clearly.  They don’t see how bad it’s gotten.  They can’t be objective largely because they are using the same organ that is ill to describe itself.  If I could have discussed it with her before she stopped her medication, she would have been in a healthier state and more able to weigh her risks and benefits of medication verses no medication.

Sometimes we do agree together, patient and physician, to stop medications and sometimes we don’t.  Doing it together is the key though.

Questions:  How do you work with someone who wants to come off their medication?  How about yourself?  Has this ever been a problem for you and if so, how did you deal with it?  Please tell me your story.

Sleep Does Not Lose As Gracefully As He Lets Us Think

Cougar sleep

Image via Wikipedia

Self-Care Tip #244 – Sleep when the day is over, and play another time.  Be a friend to yourself.

Sometimes it is hard to let the day end.  Michael told me that he was having trouble sleeping.  I asked him to tell me more and heard him describe fun-filled hours of movies, computer, phone-calls and late-night snacks that were disturbing his sleep-initiation.  Just listening to him, I felt a yearning catch spark in me to have the freedom to be spontaneous again.  You might know what I mean.

The opportunities to be spontaneous have shrunken up as our choices have brought us expanding fillers for time, attention, money, energy, emotion, personal resources and magic.  It is no wonder that letting the day end meets reluctance.  Those last few hours that sleep called shot-gun for are ours with less fist than big brother used to stage.  Sleep doesn’t put up much fight …at first.  At first, it concedes to us.  It lifts it’s chin casually until given turn.  However, much like the loan shark, sleep will never go unpaid.  It will take it’s due.  Maybe just not tonight.  Maybe you won’t hear about it until later.  And there are no promises that it won’t take by force, from one part or another of our body, our brain, our beauty, our emotions – debts are not forgotten here.

Michael says, as if he were the victim here,

It takes most people about thirty minutes to fall asleep.  But me!  It takes me hours to.  

We started talking about sleep hygiene and Michael just wasn’t interested.  I asked him to simply read about it and just see what he thought he might be able to start with.  One change maybe that he thought was tolerable.

These negotiations are sometimes best when the patient feels like they came up with the idea.  Michael is going to read about this and hopefully become his own advocate.  He will hopefully “sell” it to himself with the information both from facts but also from experience.  It’s no accident that Costco sets up samples at ever turn of their superstore.  Nor that we can never seem to leave without spending at least $100 in cash – not credit!  Cash!  (Argh.)  Maybe Michael will sample and decide to sleep rather than play at night.  He might have to “taste it” to believe and choose for himself.

Spontaneity will always lure us, dangle her jangly jewelry, give her side-ways glance and make us long for those midnight hours to open up in playful company.  However, sleep is not as gracious as it seems.  Don’t be fooled.

Question:  Do you consider sleep hygiene important to self-care and why?  How do you see it related to you being a friend to yourself?  Please tell me your story.

Interrogatives of Self-Care

Cover of "The Elephant's Child"

Cover of The Elephants Child

Poem by Rudyard Kipling

following the story “Elephant’s Child” in “Just So Stories


I keep six honest serving-men
(They taught me all I knew);
Their names are What and Why and When
And How and Where and Who.
I send them over land and sea,
I send them east and west;
But after they have worked for me,
I give them all a rest.

I let them rest from nine till five,
For I am busy then,
As well as breakfast, lunch, and tea,
For they are hungry men.
But different folk have different views;
I know a person small
She keeps ten million serving-men,
Who get no rest at all!
She sends em abroad on her own affairs,
From the second she opens her eyes
One million Hows, Two million Wheres,
And seven million Whys!

Self-Care Tip #233 – Define self-care with your adverbs.

The Interrogative adverbs of self-care:  what, where, when, why, who and how.  These are also known as The “Five W’s” (and one H) of self-care ;).

What is self-care?

Where?

When do we do self-care?

Why do self-care?

Who?

How do we do self-care?

I asked my daughter today,

M:  What does taking care of yourself mean?

D:  Taking care of myself so I’m healthy and can have fun when I’m old.

M:  How do you do that?

D:  I don’t know.  I can’t think of that.  (Conversation ends without flourish.)

These are our questions.

Questions:  Please pick one or more of these and answer from your own self.  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.

Bring Your Separate Selves Together – Personal Journey

National Museum, Czartoryski Collection

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Self-Care Tip #199 – Bring together what you are naturally inclined to do with what you spend your energies on.

When we do what we like to do, what is congruent with our hard-wiring, what is naturally inspiring, fatigue becomes part of our pleasure in my life.  Cliché,

Enjoy the burn,

…is common for a reason.  There are times when pain, fatigue, difficulty and hard-surfaced days are bits of what make life journey one of richness, rather than diminished.  I was reminded by Jaclyn Rae’s Blog-post today, that when we can say,

I’ve learned that I’m tired but still want to do what I do,

…we are paddling the same river our life is floating down.  When we by mental illness, misfortune, choice or neglect, don’t – we are more observant of our lives rather than participants to them.  We find being present in the process difficult.  It’s not something everyone can do in all aspects.

However, we don’t have to be defined by those particulars, choosing instead to do the hard work of processing our choices, our energy and where it comes from, our emotions and see how they weave into our constitution.  Then, some time when breathing hard, limping and spent, we will remember this and reconnect the experience with the choice and the emotion a little quicker.  We will less often separate from the water our life is traveling.  Not become observers but participate more often, more actively, more tangibly with that kernel in us that stays, our essence.  (See blog post, My Essence.)

In the marvelous work, “His Dark Materials” trilogy, Philip Pullman describes us as split persons, a body and a spirit (“demon”) that might be parted by neglect, carelessness, abuse, or other disasters.  But when it is separated, the body suffers and is disconnected from it’s life purpose, what brings pleasure and presence in the world around.  (See blog post, Soul and Body.)

There are medical illnesses that do this, as mentioned above, and in those cases, perhaps all to do is get medical care, heal, treat and get on with life.  Other times, it might be that we forgot ourselves in the midst of caring for children, a demanding job, an opinion that victim-hood defines our life possibilities or what not.  We have options.

As Jjen reminded us some days ago,

The bad doesn’t disappear but it is not a qualifier for the rest of life’s potential.

Questions:  How have you reconnected to your life journey?  Your essence?  What is constant about you in your changing self?  Please tell me your story.

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.

Do You Feel Pleasure? Lacking The Ability to Feel Pleasure Leads to Suffering.

Grazing in Spain

Self-Care Tip – Enjoy what you do or else find out why you don’t.

Pleasure.

I often ask patients when I am taking their mood history,

Are you able to feel pleasure?

I need to figure out how to ask this without you or anyone thinking that I want to know more about lube and feathers.  No, thank you very little.  But what I am trying to ask about is the ability to enjoy what you are doing.  It is not necessarily “joy” but at least it includes having a positive sense about you while you are progressing through something.  Being able to feel pleasure does not mean being happy at a fiesta or while doing kangaroo jumps with your child.  It does not mean changing your personality so that someone who prefers to work turns into someone who is playful, or a grazer* turns into a barn animal*.

Feeling pleasure does not mean that we achieve our fantasies.  It does not mean we are on vacation.

To understand what pleasure is, it helps to understand ones temperament.  It is enjoying what you do when you do your thing.  For example, if you are someone who in any given day or mood and regardless of weather or wealth would want to complete the work for the day – when you do that, are you feeling it?  Are you feeling pleasure?  Or, to contrast, if you are someone who would more often choose an unstructured and unmarked day – how is it going down for you?  Are you feeling pleasure?

Pleasure when you are doing your thing is quality of life.  If you do not feel it, life is crackers without soup.  It comes and goes dry and without anticipation.  If you do not feel pleasure, you lose your perceived connections around you and including with yourself.  Suffering is when you feel alone, even from your self.  Losing the ability to feel pleasure results in suffering.

Goodenough, PhD

Not everyone connects that emotional illness is a state of suffering – whatever one or combination of illness(es) come to us in.  Looking in at ourselves, at our Me, from the outside, we observe expressions and behaviors that we interpret from our own bank of information and intuition.  When I tell someone, what you are observing in your child, or wife or whomever is my patient at the time with mental illness – when I say,

They are really suffering,

it tugs our unconscious awareness into consciousness   We often do not actively know about this internal world where there is no pleasure.  We do not know that lacking pleasure leads to suffering.

Are you able to feel pleasure?  Do you find it harder to feel pleasure than you used to?  What things do you still enjoy? How long has it been since you last felt pleasure?

The ability to feel pleasure is a wonderful gift.

Questions:  What has helped you most in healing your suffering?  What has helped you connect again with others when illness pulls you away?  Please tell me your story.

*Reference:
Temperament definitions according to Dr. Q:
grazer = someone who comfortably wanders from idea to idea
barn animal = someone who is goal oriented and does not like things unfinished

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