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Listen to Your Mind and Body When Doing Something As Simple As Cleaning

I Heart Cleaning

Image by Valerie Morrison via Flickr

Self-Care Tip #170 – Listen to your mind and body when you do things like cleaning, even if it makes you feel better or worse.  Be a friend to yourself.

Whenever someone in the house can’t find something, I ask them to please just start cleaning and sooner or later they’ll find it.

Today my kids and I spent two hours cleaning their play room.  My daughters were amazed at all the treasures they found tucked under, over, this way and that way in their clutter.  Although there was a lot of crying and gnashing of teeth along the way, in the end everyone was happy and pleased with themselves.

One of the blog-sites I enjoy reading is “Earthquakes and Rattlesnakes” by Zahara.  The other day she said,

I have a lot on my mind.  It seems when my mind is in a jumble, my house is in a jumble.  Cluttered, disorganized.  Can I unclutter my mind by cleaning my house?  Probably.

According to BBC News, cleaning improves mental health through the exercise that is inadvertently done.

And as Louise Hay once said,

Cluttered closets mean a cluttered mind. As you clean the closet, say to yourself, ‘I am cleaning the closets of my mind.’ The universe loves symbolic gestures.

But there are times when this goes awry.  In Obsessive Compulsive Disorder, people may clean ritually and compulsively to avoid an egodystonic fear; a fear they know doesn’t make sense but still terrifies and overwhelms them.

Or in Major Depressive Disorder, the illness affects their brain and body so much so at times that they can’t do basic life functioning, such as cleaning their house or even showering.

So I’ll tell the mothers out there such as myself, the BBC News, Louise Hay and the rest of us that cleaning is good self-care.  The milieu around it is also a good indicator on when it is time to go get professional help.  Listen to your body and mind.

Questions:  When and how has something as simple as cleaning improved your mental state?  When has something as basic as doing your activities of daily living shown you that you or someone you love might need to see their doctor?  Please tell me your story.

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Say, “I Can’t Control This” When You Can’t

Playing in the Sink

Image by Paul Mayne via Flickr

Self-Care Tip #169 – When there is negative chaos, remember and say, “I can’t control this.”

Carol had worked there for seven years.  The supervisor had just asked her for more hours and Carol felt almost good to be able to say she didn’t have any more to give.  Yet when Carol got the email that her job position was closing in a month, she was physically affected.  Her autonomics (“fight-or-flight” reactions) were on full alert.  If there was an attacking bear, she might have out run him.

Healthy Carol had been to enough 12-Step meetings to remember, “I can’t control this.”  She said it a few times and turned it over to her Higher Power.  She did not crave or relapse in her addiction’s disease.  Her pulse was still fast and her hands were still tingling for the next several hours but she didn’t “use.”  She went to her meeting and she pushed on.

When Carol thought about her future and the things she could do to prepare, she inevitably thought about the things she couldn’t do.  She said,

I can’t control this.

When Carol imagined what other people would think after hearing about her unemployment, she said,

I can’t control this.

In mental health we struggle with that a lot.  The emotions that grow self-loathing, the behaviors that distance us from our support and loved ones, and/or the physical changes that keep us from performing – are all confusing.  At what point do we say, “I can’t control this?”

I remember a Seinfeld joke about water faucets in  public bathrooms.  The ones that you have to hold down to keep the flow going.  I’ll spare you the misery of me trying to retell it and get to the point.  Why do they have those faucets?  It’s as if they think people will have a water party in there or take free sponge baths if they could turn the faucet on long enough actually to wash their hands.

baby elephant | playing in the water

Image by Adam Foster | Codefor via Flickr

When we say something like “I can’t control this” to the idea of emotions and behaviors, the general fear is that people will take wild liberties, – splashing emotions around and behaving like elephants after the summer Serengeti drought ends.  Mayhem will ensue and the staunch healthy-minded with dry pants will have to clean continually after us.  Not many people want to be sullied by the emotions and behaviors of others and this, “I can’t control” business is a boundary issue.  Maybe stigma is one of the ways we change out the faucet on others.

There are some very primitive characters and severely ill people who might say in fact that they cannot control all feelings and behaviors.  This is more than most of us armored with some healthy coping skills would believe or say.

“I can’t control this,” is not a free pass to vandalism, vengeance, volley-ball or any other very vexing behavior.  It is not there to hand over like a ticket to other people for their excuse, justification or condolence of our situations.  It is there for us to hold up to ourselves for the purpose of honesty, submission to our Higher Power, humility and healing.  No one can control the flow out of that.  That is free self-care.

Questions:  When have you felt like you had to explain to others your behaviors and feelings even when you didn’t have an explanation?  How did you bring it back “home” to your own self-care and get past the stigma?  Please tell me your story.

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Choose Self-Care At Your Most Elemental Level

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Self-Care Tip #167 – Choose self-care at your most elemental level.

Carl, who writes blog-site, StillFugue, said after yesterday’s post on self-care being for everyone,

Sometimes depression blocks this type of self-care regardless of how good our cognitive strategies are.

Carl reminded me of Dr. Lang.  He was a physician, a father, a man of high character who never had depression in his life.  Then after a series of life stressors depression expressed itself and he, who once was the warm-fuzzy in the hospital, the man who never lost his optimism, the man who turned anyone’s bad mood around – this man came to me under a black cloud, heavy with melancholy, and raining tears.  He cried all the time.  This giant of a man cried and cried on his wife’s shoulder, and she was bewildered by him.  She told me he had done this for a month now, although the depression started about four years ago.  He kept wanting her to read to him the book of Job and cried more barely hearing the words.  He had already been through a series of well-chosen medications, but still he sank deeper.  No form of treatment kept up with the leak in his ship.  What was self-care for Dr. Lang?

Did Dr. Lang have good coping skills?  Well he wasn’t coping well now even though he knew the strategies.  He didn’t understand why he couldn’t use the coping skills.  Did he have intelligence?  Yes.  Did he have resources?  Yes.  However, none of that is what this was about.  Asking Dr. Lang to cope with his feelings is the same as asking someone blind to see.  Physically, biologically he could not.  His brain could not.  Much of his ability to choose behaviors and emotions were drowned by illness.

So again, the implied question comes to us, – “Is self-care for everyone?”

Mr. Rick C. threw this life-saver out in response to our question,

During times when chaos ensues, either internally or externally, self-care seems to become the basis on which all other positive actions are built.

Sarah McGaugh also referred to self-care as “action,”

A call to action may also be a higher calling than one’s own self….

What action did Dr. Lang do?  He cried on his wife’s shoulder and read the Bible, i.e., he leaned on the support he had built up before the hard times came.  After failing medications, he sought another opinion and other treatments.  Sure, he couldn’t get out of bed otherwise even to bathe himself, but he had made it to my office.  What did Dr. Lang do?  He got electroconvulsive therapy (ECT) and in two months, along with his medication (only one antidepressant was needed at this point), Dr. Lang was no longer crying.  In four months, he was laughing again.  In six months, he stopped ECT altogether and maintained his emotional health with his monotherapy medication.  It’s been seven years since Dr. Lang went through all that and he has not relapsed yet.

I pick out so many points that I consider self-care choices Dr. Lang made.  They changed over time for him according to his needs and abilities, but he didn’t want to die.  Even at his worst, when he could barely remember why life was so important, that wisp of hope was enough to live for.  It was a higher calling to him, higher than his own dark wants.

That was Dr. Lang’s choice.  He chose self-care at his most elemental level.  It was his response to the call of hope.

Questions:  But what about you?  What do you think?  Is self-care for everyone?  Please tell me your story.

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Celebrate Insight, Choice, and Hope. Celebrating Can Be Self-Care.

A young paper wasp queen (Polistes dominulus) ...

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Self-Care Tip #161 – Celebrate your insight, your choice, and your hope to be a friend to yourself.

I realize autism has taken over my life and I’m not sure how I feel about that.

When April said this, I jumped.  The insight into her situation, the implication of her own ability to choose, the hope of what those potential choices might do for her and her children – all these leapt at me, so of course I jumped.  Startled.

April was the parent of three lovely although autistic children.  She was wiping her face.  “I never cry.  I’m usually really strong.”

And then she said those words.  Her realization.  I don’t know how much thought she had put behind them.  She certainly didn’t have much time to self-actualize.  Getting only a couple broken hours of sleep every night.  Responding to complaints from the school.  Springing towards her son every time he tried to hit himself in the head to stop him.  April was busy.  Mostly all that I had been able to do so far in our treatment together was help her kids via medication therapy.  We were clearly still working on things in that department.  She was willing to wait for us to make our slow way towards her children’s health, even though she was falling apart in the process.

Go low and slow.

Nothing like a cowgirl psychiatrist in the saddle.  I try to keep my spurs off and make no more than one medication change at a time.  Then, when something happens, negative or positive, we know what we are looking at.  April’s children were taking their time getting to their therapeutic responses.  But at least we hadn’t done more harm than good.

We had made the changes to our plan of care that we were going to make, and April was about to leave.  She had just said what she said and my mouth was open.  Unfortunately for April, I’m not consistently articulate.

Yes April!

And then she left, while I was still bouncing on the chair.

I don’t know if she’ll celebrate that marvelous epiphany.  If she does, I know her kids will benefit.  I’m confident about that.  If she does what is not intuitive, that is self-care, she will still be able to do what is intuitive.  Taking care of our kids is the most natural instinct.  Wild dragons and other mythical or natural creatures could not keep us away from it.  Now taking care of them well, however, is something that definitely is more likely to happen when we as parents are healthy, too.

For now I will celebrate this.  April has insight.  She has choice.  She has hope.

Yes April!

Question:  What has your life been about?  Where is your choice and hope?  Please tell me your story.

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Self-Care is Freedom, is Democracy, is Because We Are Accountable

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Self-Care Tip #159 – Be accountable for and to yourself.

It was about 100 degrees Fahrenheit, which in my part of the world is considered hot.  But in Washington D.C., I considered that temperature general anesthesia.  I was breathing it in and trying hard to remain alert.  Just when I thought I could hold out no longer, I saw him.  Big and expressive, the long form of Abraham Lincoln was there, surrounded by loud irreverent people.  My brother and I were wiping sweat out of our eyes trying to keep track of our kids.  We wanted to read the Gettysburg Address for our kids, and found ourselves screaming.  The kids could barely hear the words above the disinterested rabble around us.  Despite all this, I was choking; a weepy, sweaty, nearly anesthetized but free American.

Four score and seven years ago our fathers brought forth on this continent a new nation, conceived in liberty, and dedicated to the proposition that all men are created equal.

Now we are engaged in a great civil war, testing whether that nation, or any nation, so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

Just down the corner from Lincoln is a president’s list of sites to see, informers and reminders of who we are and where we came from.  However, none of them were “my Lincoln” experience.

But, in a larger sense, we can not dedicate, we can not consecrate, we can not hallow this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us—that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion…

A couple of days ago, writing the post about how stress intersects with medicine, I remembered “my Lincoln.”  It may seem like a stretch at first but take a minute.  Self-care is a way of saying, “I am free.”   In places where life is cheap, almost without value, self-care is not much of an option.  It is because of freedom that we can extricate the meddling fingers, the invasions, and be the keeper of our own private spaces however we choose to.  It is because of freedom that we can tell people that although my brain is ill and although I take medication, I am equal. Saying that is self-care.  Saying that is possible if we take that freedom to keep our own accountability for our own selves.  Accountability is not the same as blame.  Having accountability for our freedom is not the same as being at fault for what came before freedom, nor our current conditions.

—that we here highly resolve that these dead shall not have died in vain—that this nation, under God, shall have a new birth of freedom—and that government of the people, by the people, for the people, shall not perish from the earth.

If you’re not accountable to your inner self, if you’re only accountable to your actions, or you’re only accountable to what others determine and define about you, than you are not free.  You are blamed.

Accountability is such a tender privilege.  We might lose it if we forget who we are, where we came from and our rights to freedom.  Democracy is self-care.

Question:  How do you see the relationship between self-care and your freedoms?  Please tell me your story.

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No Matter Why, Where, or What Happens, Self-Care Starts and Ends With Me

Cover of "To Kill a Mockingbird: 50th Ann...

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Self-Care Tip #158 – No matter why, where or what happens, self-care still starts and ends with Me.

It’s no secret that I look at behavior through many paradigms.  Most of what I’ve shared on this blog is medical because I’m a physician.  That’s my specialty.  I’m not a physicist and don’t spend my posts on explaining how physics influences our behaviors – although I believe it does.  However, I don’t want you to think that I think behaviors and emotions exist within only the medical paradigm, even though that’s what you hear me talk mostly about.

According to Dr. Q, the roughly sketched breakdown of how stress intersects with medicine:

1.  Stress influences how we behave and feel. We “see” the stressors, and we see the emotional and behavioral responses, and we know their sources.  We know that emotions and behaviors are produced by a human.  Where else?  Anything magical or otherwise comes from Someone from another place.

2.  Stress influences our medical condition. Stress will awaken sleeping genes that carry the names of different diseases; cancer, major depressive disorder, schizophrenia, and so on.  Would those genes have awakened on their own without the external trigger flipping the switch?  We don’t always know.

3.  Because there are so many factors that influence the reasons a disease process demonstrates itself, we cannot say that it is causally related to the stressors.  Many people try to do this, and sometimes the disease’s labeled cause comes down to the jury’s decision.  But we don’t have to have read, “To Kill A Mockingbird” by Harper Lee to know that people’s opinions and judgments are biased.

4.  People try to find the reasons why.  This is natural and in my opinion appropriate.  However, where we look for the reasons for the feeling and behaviors is equally important.  Seeking accountability for how we feel and behave to come from outside of ourselves, to come from external reasons, to come from a source to fault is more often missing our chance to get friendly with ourselves.

“It just is,” as many say, and the 12-Steps would say “Surrender what is out of your control to your Higher Power.”  These are not inconsistent with owning that mental health begins and ends with Me.

Sure, there are the despicable situations of abuse, trauma, violence and other horrible biology changing events.  These are known to cause the one non-genetically related psychiatric disease process called post-traumatic stress disorder (PTSD.)  These are situations consistent with our previous post on not being responsible for our history but being responsible for our futures.

5.  Stress, other than in situations of PTSD, is not causal for the progression of mental illness.  Everyone has stress, but how we deal with it, how we cope makes the difference.  Even horrible events, such as losing ones wealth and the sequelae of it are not causal for the continuance of brain disease.

6.  Medications, lifestyle change, Love and various other therapies effectively influences the way genes express themselves, our biology, and our medical condition….

7.  …In so doing, medications, lifestyle change, spirituality and various other therapies effectively influence our emotions and behaviors.

Question: How has your understanding of how stress intersects with with how you feel and behave affected you?  Please tell me your story.

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Go Toward Mental Illness and Take It To The Floor

Sean and Cheryl: Drama on the dance floor

Image by gwilmore via Flickr

Self-Care Tip #155 – Go toward the real issue.  Be a friend to yourself.

Little woman, she had pinched toes in her four-inch heals and wonder what her size has done for her.  Mindy was anxious.  Even though I wonder about her stressors, like possibly her height and the history she is telling me, I know something else.  Even though I wonder about her parenting and marital stressors, and about growing up in a small town but now living with giants, I don’t wonder what she thinks.  Mindy describes these giants as people with large accomplishments, things she would not try herself and that means something to her, but not what she thinks it does.  Mindy wanted to see how things went.  Apparently six months of this wasn’t long enough.

We could spend the next five years breaking all this up and apart and tossing it like a cranberry salad.  But Mindy’s anxiety is mostly not about the salad of life.  Mindy’s feelings are a bit about the stressors and a lot about her brain.

Mental illness is not a small thing.  We trim it down when we say otherwise.  The unfavored sister, Mental Illness isn’t spoken to much at the table.  Her more popular sisters, Stress and Life-Triggers, get a lot of the attention.

With some effort, people who once worked around Mental Illness like it was barely there take a chance and go straight at it, full charge, and swing that woman onto the ballroom floor.

I went for that dance with Mindy.  And she wasn’t talking about waiting and seeing how things went for long.  I told her, like I’ve told you, that how we feel and interpret our stressors comes from our brain.  I told her that mental illness gets worse if it isn’t treated and treated to as full a response as possible.

We weren’t talking about life stressors at that point.  We were talking about her medical condition.  Once treated, Mindy will continue to have life stressors.  We will hopefully also see however, that she responds to life stressors differently.

Question:  How do you make sense of the seemingly meaningfulness of how stress affects us with the seemingly less meaningful concept that we feel that way because of our brain and not because of the stress?  Please tell me your story.

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Work Hard If You Think You’re Worth It

Road Trip!

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Self-Care Tip #144 – Work hard if you think you’re worth it.

On the last day of our family road-trip, thinking about self-care and I don’t know where to go with that!  In the past when I thought about road trips, I’d sooth myself with visions of ice-cream stops, cheese puffs, and other expected and unexpected delicious treats to enjoy and bribe the kids with.  However, I’m taking care of myself these days, (hard work!) which subsequently results in me taking better care of my kids, …my family.  They had a nap, which was nice but now they are awake, refreshed and talking.  A lot.  So close to my head in fact that it feels like I have headphones on.  Volume adjuster not currently functioning.  Oh where are the bags of junk food!? (Disclaimer:  No offense intended to my kids.)

But old habits die hard, so I imagine this one will hold on at least as long as our road-trip.  In the mean time, without inserting needles into my eyeballs, I am thinking instead about self-care.  Thankful, despite gritted teeth and ringing ears, that I will lose the baby-fat before I forget that I was any different before the babies.  The memory is already distorted a bit by the fact that I have thrown away any clothes I used to wear and haven’t allowed any pictures of me below my shoulders to pass before my eyes in years.  I’m a happy frog in a Jacuzzi getting hotter and hotter and have to find a way out before I get eaten by someone French.  (Disclaimer:  No offense intended to the French.)

Thankful also about the ripple effect to my kids.  I’m gifting them a healthy me (because I will succeed), to offer them and theirs in their future.  I’m gifting them better odds that they won’t be in my same position in time.
I’m gifting my husband as well with the hope he continues to voice that I am around to care for him when he is dyeing.  Whenever that is.  (That is a gift if it ever happens!  He can be a real baby when he’s sick.)  (Disclaimer:  No offense intended to my husband.)

And I haven’t forgotten about you either.  You will have me indefinitely to chirp on and on about self-care.  It really is the holidays!

It’s a good thing I’m belted in because I might start levitating. OH!  I just remembered I have ear-plugs in my purse!  Yes!

Ah.  That’s better.  I know I’m working hard for good reasons.  And all the reasons start and end with “Me.”

Question:  Why are you working so hard for yourself?  What has been the hardest thing for you on your self-friendship journey?  Please tell me your story.

 

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Lament, Celebrate, Negotiate to Take Care of Yourself

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Self-Care Tip #146 – Negotiate to get friendly with yourself.

How do you fit in socially when you’re taking care of yourself?  To be social you need another person.  How does that socialization become compatible with self-care?

These were the questions my brilliant sister-in-law, Trixie Hidalgo asked.  It isn’t so apparent really and I get what she’s asking.  Self-care is not all about the self.  There is clearly an exchange.  We are getting something from our environment that in turn is taking from us.  That environment can be anything, such as music, movies, books, work, or interpersonal relationships.  We negotiate with that.  We agree to what we get and what we give contextually.

How does one person in wanting to define self-care for themselves harmonize the exchange?  It’s a reduction of laments and celebrations.  For example, in going to medical school I lost time, opportunity to be a young mother, and joined without directly asking to, the competitive world that is culturally considered masculine – to name a few.  Yet the celebrations, although never equal to the losses, and vice versa, I agreed to.  I made the exchange between myself and my social context.

The self-care skill comes in the experience of your own self-discovery.  How does one do this?  Look inside yourself over and over again.  Lament.  Celebrate.  Negotiate.

For You:  I’m dying to hear your responses.  I have a feeling that they will complete the post, as so often they do.  Please tell me how you reconcile the effort towards self-care with the inherent social context.

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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 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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Choose Well, What You Will Live For

Self-Care Tip #96 – Choose well, what you will live for.

Yesterday we discussed finding our reference point for why we do what we do.  All day today I found my thoughts returning there and had to spend another blog-post-opportunity on it’s “friendliness.”  I was happy to find that I was not the only one when I got a reader‘s response:

I’m still coming out of the fog of doing anything for survival-as-a-habit.  As in, being in panicked survival mode even when all is calm and safe–that is no way to live, any dog knows better than to live like that.

I contrast her response with my colleague’s:

The intentions of any life is self-serving.  Altruism doesn’t exist except in God, (which I accede not to understand), and people can’t rise above their own genetics.

Now this man is the kindest, sweetest, most generous man you’d ever meet and he doesn’t say these things with any meanness, anger towards a past offense, or to turn people from God.

However, contrast his take on our reference point in life with the reader’s above.  She talks about her choice.  Can a choice transcend our genetics?

You may remember some of a previous post mentioning the work of MIT neuroscientist, Sebastian Seung. His research tells us that memories are stored in our neurons and not in our genes.  Eg. Habits are memories and not genetic therefore not permanent.

There is an interplay between choice and genetics.  YES!!@!!  We aren’t robots!  😉  Nor are we a picture without a frame.  We so often don’t think about all the good that our genetics do for our lives.  There’s just so much talk about how we fight our genetics.  We have been given both a design and free choice.  Of course we can’t change our design, but as our reader later said so well:

For some people it is a process just to ask “why am I doing this?” … AND actually ask that question to themselves. (man-o-man the times I have asked everyone else why I was doing something) Maybe it will take sometime for an answer to come, but asking means we are on our way!

Choice is the gift from God that the apple and the serpent and thousands, or billions of years (what ever is true) can’t take away from us.  Only you can.

Be a friend to yourself.

Question:  Where are you in process between your choice and your design?  Is the interplay one that is smooth or rocky for you?  Please tell me your story

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Why Are You Walking The Road Alone?

Part of humility is not isolating.  You have to be able to receive to be a friend.  Dan Allender Ph.D. calls it suffer the kindness.

From looking at him, I didn’t guess at first that Fink was lonely, but he was.  Under-appreciated, whenever Fink thought about making new friends, he remembered that he wasn’t young any more.  All his “real” friendships were made when he hung-out for hours, had spares in the trunk so to speak.  If one relationship didn’t develop well, he still had time and possibilities that the future offers.  In this sense, Fink had been rich.  He had after all that, maybe 3 friends he considered “real.”  But over the last several years, with real jobs and families of their own, his real friends weren’t returning his calls.  Now, he thought, he may as well as not have given them his special self.  Now he was older and not so rich.  Fink kept picking at that scab, even though he knew it wasn’t so masculine to be upset about your neglected special self.

At times we are lonely, but have trouble valuing the relationships being offered.  We see ourselves as something set apart.  This might be part of our drive to self-preserve.  Bits of neurons fighting over signals in our brain telling us that we need to dominate to propagate our genes.  Maybe.  But there is that intersection when choice crosses.

We remember from Sebastian Seung‘s work that our memories are not stored in our genes.  That gives us something tangible to work with.

I remember walking on the beach with a girlfriend when we were still in medical school.  I told her, “I’m tired of feeling bad about things I never had a choice in!”  It still seems wasteful to moralize things like temperament and our nature.  In fact, we’ve argued the opposite at length in previous blog posts.  Embrace that part of you and run with it! we said.

So what do we do with Fink?  For starters, tell him that his drives are what they are.  The real question is, what’s he going to do with his genetic drives?  Do good things with that energy?  (If we can call genetic drive an energy.)  Or will he do things that aren’t so good for him.  There comes the choice.  Fink.  Suffer the kindness.  (Thanks Dan Allender!)  In the end you will be happier and healthier for it.  Even if you are half as hot as your genes tell you you are, who cares if you are walking the road alone.

Self-Care Tip #86 – Suffer the kindess.  Be a friend to yourself.

Question:  What has been a barrier in your life from connecting with others?  Please tell me your story.

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It Might Be Your Brain

How are you feeling? If it’s not good, it might not be “you.” It might be your brain.

When you don’t feel good, look at what’s happening inside.  Think about where feelings come from.  It’s hard to use your brain to think about your brain.  (Read more at “Basic but Effective.”)  But what to do?  Doctor Dolittle‘s pushmi-pullyu’s might have been able to tell us something of our missed opportunities by not having two heads and two brains.  (Unfortunately they’re extinct!)

Feeling bad, irritable, guilty, sad, like everything is flat, nervous, emotions that are out of proportion or inappropriate to the situation or trigger?  These feelings might have nothing to do with “you” and everything to do with your brain.  At some point if you get tired of beating yourself for the holes in your purse, if you don’t understand why things feel the way they do, if you want to rest, think medical.

Fred came in with his father, hiding himself in his shirt, in his father’s shirt, like a mouse who couldn’t find his hole.  The teacher from his special education class came in to help give history and told me about everyone’s efforts to bring him out.  Skinny, Fred preferred not to eat in front of people.  He started shaking in strange situations and climaxed into a tantrum if pushed to transition too quickly.  He was vulnerable to physical contact and avoided anyone touching him.  When he was really upset, he banged his head so hard that he had to wear a helmet.  When I asked his parents if they thought he was anxious, they said no.  No he wasn’t nervous his teacher said.  Hmm.

I told Fred’s parents.  I restated to Fred’s teacher.  I just said back to them the story they had just told me.  I told them about Fred and asked them what they thought.  After hearing Fred’s story again, did they think Fred might be behaving this way because he was suffering on the inside?  

We can’t give what we don’t have.  Asking Fred to come out and play so to speak, wasn’t something he had to give yet.

After treatment takes effect, then Fred will be able to pull his head out of his shirt and he will do it without being asked to.  It doesn’t do any good for Fred or anyone else to push him to do behavioral changes if he simply can’t.  Fred is not a pushmi-pullyu.  He has no spare brain to offer when the other is ill.

I told Fred’s father that I thought Fred was suffering inside.  Something in his father clicked.  He teared up and nodded and said “Yes!  He is suffering.”  That meant a lot to Dad.  To know that much about his son.  To know that what had confounded him for so long came from somewhere.  It had a name.  This thing might be treated.  Fred might suffer less.

Self-Care Tip #76 – If you don’t feel good, think about your brain.  Be a friend to yourself.

Question: Do you every feel like you expect yourself to give what you don’t have?  Please tell me your story.

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A Little Bit is Not Enough – Claim Full Health

The good news is, I just ate 3 chocolate chip cookies.  You already know the bad news.  Has nothing to do with my post.  I’m just sharing it for the sake of your own

Schadenfreude 🙂

…Onward.  Question:

Does emotional disease get worse even while on medication therapy?  Sometimes.  It does so more often when the disease process is treated but only partially treated.  Read a little more about this in this post if your interested.  A primary care physician recently told me, “I think the term ‘Partial Responder’ is a marketing gimmick to get physicians to prescribe more medications.  I don’t think it even exists.”

There’s a lot to be said about interview skills in sussing out the partial responder.  If I asked someone if they felt better, many things play into their response. Everyone’s responses are biased of course.  We don’t have sterile minds.  For example there’s the patient who wants to please their physician.  “Yes I’m better!”  i.e. “Yes you’re a good doctor!”  There are the patients who don’t want to be patients and minimize whatever they’re going through.  There is the physician who leads the interview.  “So, you’re feeling better?”  “The medication is helping?”

Partial response means that at the end of a full treatment initiation period, there is some disease remaining but a reduction of disease.  For example, in depression, I may no longer be suicidal, but I still have trouble feeling pleasure in life.  In cancer it means that there is tumor reduction of at least 30%.

Now why would a physician presumably agree that there is a partial response in cancer, but not agree that it happens in mental health?  Anyways….  (Ahem.)  When we partly respond to mental health treatment and don’t push further for full response, about 70% will relapse.  Versus maybe 25% in those who reached their pre-disease baseline emotional health through treatment.

Don’t get lost in this.  The point is, get treated and get fully treated.  Mental illness is progressive and causes changes at the cell level.  The brain is connected to the rest of our body.  The brain is human.  A bit better, is not enough.

Self Care Tip #61 – Go all the way!  Claim health.  Be a friend to yourself.

Question:  Did you find this to be true in yourself or someone you know?  Please tell me your story.

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Claim Your Brain

My mind, like rusted gears, was not moving well.  It hadn’t been really since my 1st pregnancy 8 years ago.  There are few things that dumb us down as much as pregnancy and children!   Hormone changes, lack of sleep, fluctuating from 145-200-145 pounds three times, and then the subsequent growing beloveds around me to contribute to mental dissociation.  Simple sensory overload from talking, yelling, crying, petitioning, inquiring kids factors in.  You may read more about sensory issues here.

Daily writing, like a staunch governess, found my brain under cobwebs, bug carcasses, and musty stench.  (Hello old friend!  There you are!)  This helps to explain the joy gripping my hand, like girlfriends on the playground, when I sit down to write!  The world is active to me, including rather than excluding me. My in-between moments used to hang like an old woman’s breasts.   Now much more time full of nourishing thoughts bless me.  I am in awe.

My patient came in sighing deeply.  He wasn’t better.  No, he said.  He lacked motivation and interest and connection from the world.  He felt selected out to suffer.  A dumping ground for misfortune and misunderstood.  Efforts through medication, after medication changes were like looking for love in all the wrong places.

We talked about cognitive distortions, tapping into things that used to make him happy, road-blocks in poorly designed neurological grooves – volunteering at the library or animal shelter, journaling, sharing his life story with others, exploring his spirituality.  No.  No good.  Nor could he consider psychotherapy as he’d been through too much of it already to consider it again.  And he just couldn’t get interested in groups such as through NAMI.

His brain, assaulted by stressors, disease, and disuse was growing silent.

Being a friend means yelling, fighting to reclaim your journey, finding something to connect you to your process of life.  My patient was letting squatters take his property simply by being absent.

Self Care Tip #60 – Claim your right to health.  Be a friend to yourself.

Question:  What has helped you connect with your own journey in life?  What do you think?  Please tell me your story.

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Freud Did Not Know

Bad dreams.  Just woke up from one.  There’s a lot out there on dreams in mental health.  After all, they come from the brain.  When Freud was looking at things, he saw dreams as “unconscious wish fulfillments.”  However since Freud rocked our world, we’ve learned so much more about brain biology and Freud was wrong.  Oochie ouchie.  Just saying that makes me feel like his still very much alive reputation will come at me like an angry ghost and be mean!

Dreams are just that, dreams.  Sometimes they are good, but often they are scary, bad, and even terrifying.  Why?  According to Dr. Quijada ;), yours truly, they are commonly symptoms of emotional disease or side effects of medications, etc….  In anxious states, we dream.  After going through life threatening events to  ourselves or witnessing it in another, we get nightmares.  When there is a disconnection is our sleep architecture, we can get “parasomnias” such as night terrors.  Some medication such as Trazodone can cause vivid dreaming where people say they dream “in color.”  And on and on.

Freud didn’t know this, so no offense taken.  However, we do.  Enough with the hocus pocus moral dilemmas that are discussed in our own thoughts and among some ongoing therapies.  First look to biology to give us the answer. Even after having a nasty scream-your-lungs-out dream, remember that your brain is mortal, human, made up of carbon and not aura.

Sometimes even that much information can help people sleep better.

Self Care Tip # 43 – Don’t make too much out of your dreams.  Be a friend to yourself.

Question:  Do you agree or disagree?  Did this help you in any way?  Please tell me your story.

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Fear

I dropped my kids off today.  All of them.  We had been very happy about this.  After laboring towards patient parenting for 7 years, I was also looking forward to today.  I’d never had all three out of the house at once, and the strangle squeeze on my insides grabbed me by surprise.

We used to have this black cat when I was a kid who would hide in our plants.  In the middle of the night when I’d occasionally wake up and go to the kitchen to get a drink, she’d jump out at me with her claws.  While walking today between preschool, kindergarten, and 2nd grade, life jumped.  What left me breathless was how easy it was to get rid of my kids.  Appropriately by social standards.  School you know.  They’re doing what they need to do.  And just like that, if I wanted, they could be mostly gone.  I suddenly felt how it could happen to us, easy like that.  Like a body returning to dust.  My spirit, my soul, my essence yelled a loud “Wait!”

My reaction can be confused by some as a hidden desire.  Sure, I acknowledge the obvious need for parents, including yours truly, to get space from their kids. But that wasn’t the slap I felt.  It was fear.

I’ve treated many mothers, but one in particular comes to mind.  She voluntarily admitted herself to the hospital because she was afraid she would hurt her baby.  She wasn’t fantasizing about it.  She was having specific vivid imaginings that cut into her consciousness.  After enough of those, she lost confidence in herself and hid.  She confused these day-terrors with a fear that they were really some unconscious desire she didn’t understand.  Common for panic disorder.  It is the medical disease that historically gave us the phrase of “I feel like I’m going crazy!” With medication therapy she returned to a capable woman who trusted herself.

Have you ever noticed that in the Bible, whenever God or an angel is talking, they almost always start out by saying, “Fear not for I am with you,” or some version of that?  I didn’t, until my kids came home from Vacation Bible School 2 years ago, and the refrain for the week was “Fear Not!”  They still scream it at each other with glee.  I love that about God.

However when I hear that Bible verses or prayer or God should make us overcome fear, I am more than bored.  I’m angry.  Fear comes for many reasons.  It isn’t a spiritual thermostat.

Today I did several things to deal with my fear.  I cried.  I prayed.  I went to work.  I felt better.  However, my patient did not feel better after doing those things.  What should God have done for her fear?  I knew that she came to my hospital.  I knew that what she felt were symptoms of a medical illness affecting her human brain.  I knew that medications could play a part in helping her.  Maybe that came from God.

Question: What do you think? Agree? Disagree?

Self Care Tip #31 – Fear not!  Be a friend to yourself.

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Fewer Choices

We have infinite choices in life but they aren’t necessarily the same choices. I don’t know at what age that starts making sense. It reminds me when J.K. Rowling‘s 9y/o Luna Lovegood witnessed her mother killed, which enabled her to see Thestrals. In story form, saying suffering brings sight. Choices can bring us suffering, which in turn might bring us sight. It’s true that we always have a choice but it’s not true that we can choose the same choice again. Nor is it true that we will have the same quantity of choices.

My sister-in-law Joana Johnson, neuroscientist, says we recruit more areas of our brain as we age but use less brain matter to problem solve and think creatively. We can generally multitask better than we could when we were younger although our short-term memory is less available. It is a biological example of renewed options all the while earlier options are no longer available.

As we mature, the beauty is that we have a greater capacity to work with our options. It is obviously not that we have a greater number of options. But isn’t that marvelous!

Scott Anthony, president of Innosight writes, “You can’t do more with less unless you understand what more means.” Hopefully there comes a time when each of us will look into our choices daily for all they can become. Think plate of chocolate lava cake in front of you. Will we get the gift of sight? Anyone can.

Self Care Tip #25 – Get the gift of site. Be a friend to yourself.

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Soul and Body

When we get sick, our identity, who we are, our essence might feel threatened.

In “His Dark Materials” trilogy, Philip Pullman says there is no God so we create heaven ourselves. In regards to our spirit, he says we come from and belong to the evolving universe. Perhaps so many have read this trilogy because it openly speaks about our souls. After it won various awards, we could say the man can write. But also that many of us, along with John Milton in Paradise Lost, wonder who our essence belongs to.

Since so much of our culture puts the definition of identity on behavior, it makes it seem that brain patterns define humanness. How do you see yourself? We all agree that our brain is part of our body. The question of soul comes in to play.

Some believe that the soul is a brain pattern. We might not agree that there is a difference between soul and body (or the brain). But if we did, could we even agree that the body is just that, a house for it, as Mr. Pullman says? This inconstant body, this betraying brain, this changing mind?  We’ve got more bank than that.

This is important to sus out. In the immediate sense, it tells us where to go if you need help. Temple? Doctor? Gym? It will affect your self-view when you go through physical loss. It will affect your hope when you haven’t felt like yourself in years.

Who are we if we need to take medication to behave like ourselves? The question I often hear is, am still me? Do I grieve the loss in order to accomodate the new sick me who has tremors and fear of public places? Then when I get better and lose an arm in a car accident do I need to change my view of my identity again? Then after I get better and get to know the new me, I get breast cancer and undergo a mastectomy. Now who am I? Now I’m old and eat with a wooden spoon and my kids take away my drivers license. I get dizzy at the hospital I used to work at and fall and hit my head in front of colleagues I once mentored. Who am I?

Many people I talk to think, like Pullman, that when they die their soul disperses amongst all the spiritual and material matter across the universe.

I have become comfortable with my own answer. My spirit belongs to and is in the care of Love, which is stronger than any change that happens to my body.

Self Care Tip #23 – Find your identity. Be a friend to yourself.