brain illness

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The Energy in Stigma, Yours for the Taking

unicorn

There are nothing like lightbulb jokes in the operating room to make you plume your feathers.  The other day, my nurse “enlightened” me with them.

How many psychiatrists does it take to change a lightbulb?  One, but the lightbulb has to be willing to change.

How many surgeons does it take to change a lightbulb?  One, because while he holds it, the world revolves around him.

How many nurses does it take to change a lightbulb?  If it’s during shift change, no one will touch it.

That is as far as we got, but please share yours, especially if related to psychiatry :).

Lightbulb jokes are common, clean, dirty, and fairly ageless. It does not take the brightest lightbulb in the room (Teehee!) to know that they are so because they capitalize on stereotypes.  Stereotypes, likewise, are widespread, and fairly ageless.  Even in something as objective as brain disease. i.e., The brain is carbon matter, a human organ, mushy grey stuff. The brain gets sick like any other part of the body, human organ, and people bits. Brain gets diseased, people behave and feel diseased.

A primary care physician’s assistant, “PA,” was sharing with me the other day about how she deals with stereotypes when she approaches patients who need treatment toward brain health.

I tell them about all the executives and professionals who get treatment ‘because the stress gets to them and they have nervous breakdowns.’  Then they don’t feel so bad about accepting treatment because they associate themselves with these successful people.

Stereotypes can be positive, negative, or neutral.  Everyone has them.  We clinicians, patients, grocers, those who want nothing to do with medical care, and even executives and other professionals (smile) have them.  But what, in dealing with stereotypes, is friendly to Me?  It starts there.  With Me, one little, or largely valued Me.

We stereotype ourselves and maybe that is why we stereotype others.  For example, this struggle of what to call illness of the brain is common, widespread, and fairly ageless. A Menninger Clinic blogger wrote eloquently about it recently, “Does reframing mental illnesses as brain disorders reduce stigma? by JON G. ALLEN, PHD.”  Most pithy, I thought was this,

…we should be skeptical of the view that regarding psychological problems as brain disorders will abolish stigma. Although the disease model decreases blame, this shift comes with a cost: It increases pessimism about recovery and might also contribute to perceived dangerousness.

I have never forgotten the Spiral Dynamics idea that in the magical level of consciousness, there is a sense of being disempowered. “Perceive dangerousness” is magical. Behind negative stereotypes, there is magical thinking.  We give over what is not to be given and take what is not to be taken.  We have fear.  We feel victimized.  We lose what is freely our own.  Disempowerment is terrifying. There is a lot more stigma out there than there is information but giving stigma and/or negative stereotypes power is our own choice.

A fellow blogger wrote to me how he approaches it,

Change brain illness to mental illness. Our problems really are brain illness from physical dysfunction but I can accept that my psyche is sick easier than my brain is sick.

Stereotypes may scare us but they can also inspire.  It is up to the individual, to Me, how to respond.  As in lightbulb jokes, we who are targeted by stereotypes can take pride in them.  They are not the same as “stigma” although there is overlap when negative.  Stereotypes can be neutral or even something to be proud of.

How many psychiatrists does it take to change a light bulb? None–the light bulb will change when it’s ready.

How many psychiatrists does it take to change a lightbulb? None. It’s their job to help people find their way in dark places!

There is nothing like the kind of energy in stigma and negative stereotypes to inspire us.  Such force, such Magic, these can get the punk in any of us to love who we are.

I used to be quite turned off by the beatitudes thinking I was supposed to want to be a wimp, and couldn’t quite make myself do it.  Now I realize, being a wimp is just what it is.  The blessing is what is inherently available to Me in my “condition.”

1 Now when he saw the crowds, he went up on a mountainside and sat down. His disciples came to him, 2 and he began to teach them, saying: 3 “Blessed are the poor in spirit, for theirs is the kingdom of heaven. 4 Blessed are those who mourn, for they will be comforted. 5 Blessed are the meek, for they will inherit the earth. 6 Blessed are those who hunger and thirst for righteousness, for they will be filled. 7 Blessed are the merciful, for they will be shown mercy. 8 Blessed are the pure in heart, for they will see God. 9 Blessed are the peacemakers, for they will be called sons of God. 10 Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven. 11 “Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me.

Questions:  How have you been able to use stereotypes and stigma as something toward friendliness in your life?  

What have you found is inherently blessing you from where you find the condition of life to be?

How might you use the energy in them toward being good to yourself?  Please tell us your story.

Self-care tip:  Use the energy available in Magic to empower you, rather than disempower.  

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What would brain illness look like

Look Mommy! Look at my note!

 

crinkledShe pulled out a crumpled treasure.

See?!

It was a white paper. Blank. I paused with the, “I’m very interested,” and, “I’m a good Mom to whom you want to divulge your innermost thoughts and secrets to,” expressions on my face. I am you know. All that. Sniff.

Another mystery maker, handy, said,

Where’s your pen?!

She was getting agitated. I did not get it. I was less of a P.I. than she had hoped. She had a non-P.I. mom. Just great.

A third wheel rolled in and stuttered out,

You need the pen, Mommy! You need it! You need the light!

I noted the multiple exclamation points hovering about and knew the sand in the glass was almost out. Communication needed to be received or my three secret agents were going to increase their level of effort. Be warned.

I am an emotions-Jedi after-all. I sense these things. The Force is strong in me, still, young Padawans.

Then, there it was. Under the blue penlight, shown the hidden messages.

No. I do not remember them. Just the sense of them. And…

And, I thought it was a super illustration of how brain illness is there but not generally seen.

I am sure this was disconcerting to my investigative kids, who had dreamed I would do what they wanted with my life and thoughts. I wish they would just let me be me! (Flipping hair.)

Brain illness does not get as much air time as cancer. It is not as obvious as a withered hand. Nor a rash. Nor a big outcropping of plantar warts seeded across the soles of our feet – brain illness is not.

Brain illness does not engender connection easily because not everyone has the Force in them. Not everyone is a Jedi like you and I. It does not have the advantage to connection as a name tag illness. Brain illness does not wear itself on our visage like an invitation to others to embrace us in shared experience.

Where is the Light?

Right. In us. We are the light. We are what brings awareness to this secretive suffering. We are secret agent Jedis. Yes. Exclamation point. Exclamation point. Exclamation point.

Questions: What would brain illness look like if it was visible?

How has brain illness become more of a shared experience? How can it?

Please tell us your story.

Self-Care Tip: Share your experience.

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Allow yourself to transcend the naming of your symptoms

French political cartoon of French cardinal Je...

Mental illness, diseases of the mind, behavioral disorders or however our community allows it to be named, it is all inadequate.

Mental illness, is a stale description.  It has sat in the open community air, over the many years when our awareness grew too slowly, when stigma and ignorance gave it the old cold frost-bite.  It reminds of me of the, Confessions of Georgia (Anne) Nicolson series, by the most hilarious Louise Rennison, When Georgia Anne says, “Have you gone mental?!,” in one-thousand-and-one ways.  There is just so much sniffing and eye swirling around the term.  I do not mind Georgia Anne using it at all.  It is fresh in her mouth.  It is not, however, winter green in ours.

Dr. Thomas Insel, Director of the National Institute of Mental Health, states that these terms are “impediments to progress.”  He uses the term, brain disease, as a way to diminish barriers to scientific investigation, hopefully leading to earlier detection and treatment.

Others, however, challenge even this term, brain disease, stating that it is premature and narrow.  The illnesses that demonstrate emotional and behavioral pathology involve more than brain and mentum.  They include the magic, the internal/external stressors, the arguments and the weather.  They include the intersecting paradigms that make us who we are, often referred to as the biopsychosocial model.  These, “Others,” argue that it is presumptuous to name pathological symptoms of emotions and behaviors with, “brain disease,” until we know what the brian does in the first place.

Questions:  But what do you think?  Are the terms we use more impediments to progress than they are tools toward?  Do you have any recommendations?  How have these terms affected your life?  Please tell us your story.

Self-care tip:  Allow yourself to transcend the naming of your symptoms.  

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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.)

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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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When I Can’t Take Care Of “Me”

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Self-Care Tip #130 – Ask for help.  Be a friend to yourself.

The last two days we’ve talked about self-care,

1.  Bringing pleasure to be sticky

2.  Starting and ending with “Me.”

The natural progression is to now discuss,

3.  Taking care of ourself when we cannot.  When we Cannot take care of “Me.”

Still responsible for the single person that God gave us to take care of, “Me,” we lie down unable to move.  Unmotivated, maybe too scared to do what we need to do, emotions awry, other medical problems chorusing in with pain, stomach upset, even infertility – our own brain betrays us in our need.

When we cannot trust our own brain, our own selves, whom can we trust?

Some of us have found our answers to that.  Our lives starting and ending with God, we go where He is.  But the brain is ill and, sometimes, suspicious of the rest of us around without a visible halo.  When people point at me, and say, “God can heal me.  Do not you believe that?!” I say, “Yes.  God is the Great Psychiatrist.  I love that we are in the same line of work.”  And I do.

I do my best to help tell, educate, and offer opportunities that lead to healing for ill people to choose.  It is their choice.  Self-care in the context of illness, of losing the ability to care for yourself, is a place of vulnerability.  We show our jelly sides, the places without defense and we ask for help.  Taking care of our selves includes asking for help.  Scary, undefined, entrusting yourself with outside sources takes the courage that only those with mental illness could know.

Asking for help does not mean that the thread of self-care has left you.  It cannot really.  You being its source.  Do not be confused by the obvious.  Outside help does not mean you are not doing self-care.

When we cannot do our own self-care, we ask for help.  Asking for help is self-care.

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(In reality, everyone doing self-care needs to know when to ask.  Healthy or ill, we cannot be good at it all.  We are creatures who need each other.)

When we cannot trust our brain, find someone(s) else we are willing to invite to join our self-care efforts.  Ask for help.

Question:  How has asking for help been for you?  Please tell me your story.

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Forget About Divisions In Knowledge.

The World Is Flat

Image via Wikipedia

Self-Care Tip #103 – Forget about divisions in knowledge.  Be a friend to yourself.

Knowledge does not separate into parts of religion, diet, stars, or geometry.  It is one thing, although we may not see its entirety.  Like the blind men with the elephant, we might be standing by the foot or the trunk.  But it is one thing.  Spiritual truth, nature, physics, medicine, music, art, it’s the same story told in pieces and in different ways.

Working in psychiatry, I’ve struggled with this because it so often affects my freedom in practice.  It so often affects people’s choices for treatment, people’s choices for lifestyle and their own empowerment with self-care.  It affects the choices people make in medication therapy and in physicians.

Merging the tables of learning affects our quality of life either way.  If we are able to do this, we have less conflict, fewer chairs to walk around.  If we can’t, we find ourselves constantly checking the seating charts.  It’s terrible throwing a party where people don’t know what connects them.  There’s the same discomfort inside of us when our life paradigms are afraid of each other.

Take Crystal.  She is a Latina Catholic.  Or make her protestant Filipina, or say White Texan.  Crystal grew up thinking that what was said by her tias (aunts,) or her pastor, or performed by her grit and spine, lay like bookmarks between human behavior issues and the rest of her life.  Behaviors may have something to do with the church, or emotions with the girls room, or nothing to do with anything in her mind.  Thinking behaviors and emotions might relate to what gave her black hair color, and to why water separates from oil is just bizarre to her.

When, Thomas Friedman wrote The World Is Flat: A Brief History of the Twenty-First Century, he was talking about a leveling of the playing field of commerce.  To take it further, I hear him talking about a flattening of prejudices, knowledge, access to information and hierarchies.  The world is too flat to separate the brain from the rest of the body.  When the world is flat, working as a psychiatrist means enlisting all of science, religion, social issues, hobbies, food preferences, and all the other things that make someone’s life worth living for their treatment.  When the world is flat, a patient trying to get help for their emotional-behavioral illness doesn’t separate it from anything else in their journey.

It turns out that we have a lot of information on where emotions and behaviors come from.  We should use it, don’t you think?

Of course, we don’t have it all.  Not close.  We don’t know how the soul factors in.  We don’t know what miracles are.  We don’t know God face to face.  But we do know that it is the same table of knowledge.  It is the same elephant in the room.  It all comes from the same Love.

Walk around.  Feel around.  Let your quality of life get better.  Don’t cut yourself off from another part of you if you don’t have to.

Question:  How are you keeping your personal journey one that is connected?  Or not?  Please tell me your story.

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