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.