A Young Man’s Wrenching Journey

Children!

On Jun 18, 2013, Anon wrote:

Hello Dr. Sana L. Johnson-Quijada,

Thank you for coming to talk to share some of your experiences and views associated psychiatry. I am sorry I have not emailed you sooner.  This was my first year taking three sciences and when it came time to study for finals, I pretty much ignored everything except school.

Thank you for giving the class and myself some exposure to psychiatry. Your talk was very intriguing, especially how you see a person, in particular how their brain health affects their personality. When you started to talk about homelessness it brought back painful and confusing memories from my childhood.

My parents divorced when I was seven and the majority of my time was spent with my mother because my now deceased father had a difficult time keeping a roof over his head and doing the activities of daily living. When I was a little older I even loaned my dad some money when his car was impounded. I could not understand why my dad was in the situation he was in and why I was seemingly more capable than him. I loved him very much and wanted to help him in any way I could.  But in the end, I could not make any of his decisions for him.

My older brother is living in a shelter and he reminds me of my dad in so many ways. When we lived together, before my parents divorced, my brother was just about as hard to get along with as my dad, and my dad was physically abusive to him. I was so confused and could not understand why we could not love each other or ourselves. My dad’s incessant fear of doctors and my brother’s fervent choice to self medicate only complicated the situation we were in.

My heart goes out to my family and people like them and I have a strong desire to help people. Your short talk resonated with me and I was intrigued by psychiatry because I thought it might be a way for me to help. How do I learn more?

Sincerely,

Anon

On Jun 18, 2013, at 5:16 PM, Sana Quijada wrote:

Hey. So good to hear from you. I remember you well. Sniff. Big hug. You are not alone, dear man. 

How to learn more?  Hmm. I would start by attending some local NAMI meetings. Follow up with me in a bit after you do and we can keep the lines open and ideas flowing. It is an honor to connect with you. 

I celebrate your focus and completion of finals. 

I would love to post your email letter on FriendtoYourself.com … 

Your story is seriously powerful.  As my six-year-old says, boom! Smile. 

Till next time,

Sana Johnson-Quijada MD
www.FriendtoYourself.com

On Jun 24, 2013, at 5:00 PM, Anon wrote:

Yes you may post my email I feel honored. It took a lot of courage to write and I am glad you were receptive.

This is a "thought bubble". It is an...

Questions:  How would you recommend a young person find out more about psychiatry, before pursuing years of study?  How did you investigate your profession before committing?  

How do you talk about your family of origin history?  How do you find the courage to share these things, to find community in what hurts?  Please tell us your story.

Self-Care Tip:  Find the courage to connect with others and your story.

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Name Your Fear To Know You Are Free

She knew the Horned King‘s secret name.

His name?  … I never realized a name could be so powerful?

Yes….  Once you have courage to look upon evil, seeing it for what it is and naming it by its true name, it is powerless against you, and you can destroy it.

The Book of Three by Lloyd Alexander

Science Fair Wins Ribbons

Image by OakleyOriginals via Flickr

Mistakes and the mist of shame thicken about us and it is hard to hope.  As if each effort of our intended labor produced Seconds and Flops we must stand in our Besties beside what we have done to get a participant appreciation ribbon tagged onto our lapel.

And somehow standing there, the layer of sweat thick under too many clothes, we remember the secret name, it comes and we whisper.  We whisper it; our last courage still enough for that.  There is a moment of surprise, as if we and whatever pressed us down didn’t know we might still live.

We can see now that we are not alone; just there, in fact you are there with your own passed over table.  I remember you working nights on it, your tired eyes, a happiness in your muscles still.  In those days.

We can see that we are special for more than injury; we hear now.  We feel concern for more and taste newness that filled the space.  The secret name.

We won’t tell you or it wouldn’t be secret any more.  But now that we remember we are free.  Now that we have the knowing, we will keep the power, thank you.

There is power in a name.

We won’t forget what came after evil and will speak more readily into dark spaces, will wait less and fear less because we have already been there.  Going toward the pain like that.  What’s the worst that can happen when you name your fear?  It takes no more than a whisper to be strong.

Self-care Tip – Speak into your dark spaces the name of your fear.  Be a friend to yourself

Question – What reminds you that you are free despite the fears that tell you otherwise?  How is freedom your truth in life even when your senses tell you otherwise?  Please tell us your story.

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Choose Back! …As Long As Life Chooses You.

A Girl On A Footbridge

Image by jyryk58 via Flickr

Self-Care Tip #241 – As long as life chooses you, it is your right to choose back – so do.

Although I am not a geriatric psychiatrist, I have still been given the pleasure of serving a “golden” few.  What has impressed me has been their willingness to start over.

Starting over takes courage and humility whether it is deliberate or not.  Sometimes fear dances between the lines of all the emotions and intentions. But still, wouldn’t you agree that it takes courage and humility to negotiate fear?

(Enters Hans.)  Hans was seventy-three years old.  He had struggled with brain illness on and off he thinks since he was at least twelve.  There were big spaces of time when his disease exacerbated, and he largely suffered.  But he chose, at this age, to try again for improved brain health.

Is there a time when we start thinking, don’t keep trying to start over?  Maybe in the dying process.  In case you don’t know, the dying process is a specific term.  It means the time when a person is facing impending death.

This area of medicine is not my specialty but I imagine at some point we want to stop with that starting over process, give up, but not in a hopeless way.  In a way that says,

I can stop trying for new anything and sit in the space of what I already have in me…

…Which hopefully includes all the ingredients and interrelations of life.

But how far before that point in life do we consider starting over reasonable?  I’ve heard of kids being told they’re too young to ride a bike, or cut with a knife, or understand the dinner conversation.  No one bobs their head at that.  But find a seventy-three year old who believes that after a lifetime of perceived failure by onlookers or themselves, who still says,

Now let’s give this another go,

…and if it hasn’t been said, it’s been thought,

give it over already!  You’ve hit your seventy-times-seven chances!

It’s like they’re shopping in the teen-ware.  We blink our eyes and angle our heads.  Even the thought of starting over as a real option feels indiscreet.

(Enters Hans.)  Hans is seventy-three.  He is starting over.  Humbly and with courage, he pursues brain health in the face of stigma.

I think I had celebrated my six birthday when my dad asked me if I felt any different from how I felt when I was five.

Yes!  I feel older!

 Then he asked me how old I thought he was.  When I answered some enormous number like, “twenty-two!” he asked,

Does forty-four seem old to you?  

Of course it did!  But I had an intuition that if he was old, than he’d die, so I said a definitive,

NO!  Daddy you’re still young!  You aren’t old!

Now, almost that same age myself, I am in awe of him and the others in their golden or not so golden years (Enters Hans) who believe that as long as life chooses them, they will choose back.  It is their freedom.

Questions:  When all your senses don’t sense pleasure in life, or you feel old and useless, or you feel that you’ve failed too many times, how do you choose to start over?  Who has inspired you and what did they do?  Please tell me your story.

Where Does Courage Come From?

I want to do that, but I have no idea where I’m going to find the courage!

This is real folks.  People think this, say this, believe this and behave accordingly.  The other day, a young woman in her forties with a rolled scroll of precious problems including joint disease, extreme morbid obesity, nicotine dependence, depression, anxiety, obstructive sleep apnea, eczema, gastroesophageal reflux disease (GERD), heart palpitations, diabetes, hyperlipidemia and polycystic ovarian disease – this woman told me these words.

I have no idea where I’m going to find the courage!

Where does courage come from?  Is there an odds ratio, statistics, intuition barometer or what?  Where do we find courage?  (I am remembering the dear Lion in The Wizard of Oz.)

I see courage coming from our ability to make decisions.  Being able to decide comes from many paradigms, including my favorites as broken down through the biopsychosocial model (listed in no particular order):

  • Biological – temperament (genes or personality,) mental health/brain health (the brain being the organ we use to make decisions with,) developmental (the neurodevelopment of the brain is different at different ages,) things we put in our body (diet, illicit drugs, alcohol or nicotine,) medical illnesses, sleep issues, exercise, rash, ingrown toe-nail….
  • Psychological – self-control, coping skills, catastrophizing, negative thinking, thoughts, emotions, and behaviors….
  • Sociological – culture (including home, religion, race, gender,) stressors on our body, social support, God, interpersonal relationships (friends, marriage, kids, colleagues,) parenting, unemployment….

(WHEW!  Recovering my breath.)

Where do we find courage?

I drew a picture in the air for her psychological self,

17th century

Image via Wikipedia

I see you 100 pounds lighter, not smoking for the past six months at least, off of six of your twelve medications, your medical problem list shortened down to two or three.  You are able to feel pleasure again.  It is a real option for you.

If you don’t, I see you growing demented, paralyzed and dying from a heart attack.  I can’t say when these things will happen but they will happen if you don’t start taking care of yourself.

Where does courage come from?

For her biological self, I targeted the language of her temperament.  I remembered that we make decisions either through thought or feeling.  She was a “Feeler.”  I drew forth my light saber and went for the emotions.

You can do this!  Think of the gift you’d be giving yourself and to those you love.

For her sociological self, I talked about everyone in the family choosing with her, including husband.  Talking about how this changes the family culture, not to smoke together, setting boundaries with her husband to care for herself and thinking about getting other support networks like starting to go to church again or calling her pastor.

Question:  Where does courage come from for you?  Please tell me your story?

Self-Care Tip – Use your biopsychosocial model, that is to say all of what makes you you, to find your courage.  Be a friend to yourself.

The Spider Sat Down Beside Her – Mental Illness

Self-Care Tip #178 – Find your courage and answer to stigma.

The Little Miss Muffet scenario explained by D...

Image via Wikipedia

Something as simple as taking pills can sabotage us.  The act of putting it in our mouths signifies all sorts of things from religion, to freedom, to personal identity and beyond; even someone who is trustworthy versus not.  Pill – take away her children.  No pill – could be president.  Pill – discredit whatever he says.  No pill – worth listening to.

Martha is a mother of four lovely girls.  Her husband is divorcing her and she wonders what he will do in the process.  She’s been depressed in the past and anxious with a history of panic attacks.  She took two years to get over them using breathing exercises and other therapies. She didn’t use medication.  I don’t need to tell you what her husband thought of meds or of her during that time.  It was a miserable time for her.

Now, during this new stressful time, she has relapsed in mood and anxiety problems and is terrified that if her husband finds out, he’ll take the kids.  Martha sees mental illness as a bullying tool for anyone to dump her over.  Little Miss Muffet is a story she often has compared to her situation.  The spider is the mental illness she feels is dangled over her to her demise.  Martha is bullied and scared away.

Taking pills makes me feel like I’m crazy!

Note: it’s a type of crazy she interprets as being something different from the crazy of mental illness.  For Martha, the crazy that comes with medication therapy is more sinister and discrediting than the worst experience of terror any of us have ever gone through, i.e. panic attacks.

Every day, we who take medication for emotional illness have to answer to those accusations.  We contend with the fingers pointing our way, the jeering in our memory of loved ones and the boxed presumptions we find ourselves in.

This may sound a little dramatic to some out there, although familiar.  To others, it is an understatement of what they courageously confront to take care of themselves.  Each of us must come up with our own answers and find our own courage.

Martha finally decided on medication treatment and within two days she was amazed to find that she could eat without throwing up and no longer felt anxious.  She still insisted that taking medication was only temporary but getting a pill dispenser had helped her get past some of her daily battle with stigma.  She just opened the lid and poured the pills into her palm, threw them back and swallowed without looking.  Martha found it easier not to dispense each pill each day out of each bottle.  It was also easier for her to keep this information secure in the confines of our office.  For Martha, for now, this was how she answered.

Question:  How do you answer to stigma?  How do you maintain your sense of freedom when other forces tell you that you are not free?  Please tell me your story.

Your Personal Fight For Emotional Freedom

crochetingingeorgia.blogspot.com

Self-Care Tip #151 – Fight to be a friend to yourself.

My friend Carl, after reading yesterday’s blog-post, introduced me to this gorgeous song.  I found it on YouTube connected to a slide show of our soldiers.  Thank you to our courageous American troops fighting for the freedoms we enjoy and take and take and take.  We know that when you fight, there are losses.

We all are soldiers of sorts, fighting in life for our own selves for so many reasons.  But it’s not about the reasons or motives.  God takes care of those.  So regardless of why, thank you to all of you out there fighting for your own selves.  You who want your own emotional freedom.  The good that comes from this courageous fight ripples on the life-waves and reaches us.  Thank you.  We know that when you fight, there are losses.

Carl, thank you.  Your personal fight, your courage, touches all of us.  What you do is self-care, is care for us, is care.

Let There Be Peace on Earth, by Gill Vince

Let there be peace on earth
And let it begin with Me.
Let there be peace on earth
The peace that was meant to be.
With God as our father
Brothers all are we.
Let me walk with my brother
In perfect harmony.

Let peace begin with Me
Let this be the moment now.
With every step I take
Let this be my solemn vow.
To take each moment
And live each moment
With peace eternally.
Let there be peace on earth,
And let it begin with Me.

(child)
Let there be peace on earth
And let it begin with Me.
Let there be peace on earth
The peace that was meant to be.
With god as our father
Brothers all are we.
Let me walk with my brother
In perfect harmony.

Let peace begin with Me
Let this be the moment now.
With every step I take
Let this be my solemn vow.
To take each moment
And live each moment
In peace eternally.
Let there be peace on earth
And let it begin with Me.

Question:  How do you see your personal fight for emotional freedom rippling into the space of others?  Please tell me your story.

Courage Not To Presume.

Pony Express

Self-Care Tip #116 – Have courage not to presume.

Courage.  Courage is doing what frightens us.  I heard this definition and as usual I got a little stiff.  Definitions sometimes feel sticky to me and I’m trying to understand why.  Why is my lip curled?

In line the other day for the theater, a grandfather in front of me got talking.  I didn’t get any names; just that he was a grandfather of a 7-year-old girl who owned him.  Naturally he drifted into stories about her, including their most recent vacation to Knott’s Berry Farm.  They rode “The Pony Express” despite his fear and instincts.  I asked him if he was proud of his granddaughter’s courage and he replied, “She wasn’t scared!  So she wasn’t the one with courage.  I was!”  He laughed, and then I laughed, but I walked away to the ticket booth whispering, “What does he know about her thoughts?”

I see so many faces flashing across my mind’s eye.  I see them, and I hear them.  I realize their whispers have become mine because I believe them.  My patients are courageous.  These, who have not told others.  Who have not screamed when they wanted to.  These people who have put on the appearance of calm despite their fears.  They are a study in functional mental illness.

Functional mental illness, although historically refers to mal-behaviors and emotions without medical cause, now after years of increased knowledge and study, it includes their biological organic etiology.

As an example of functional mental illness I’ll tell you about Miranda, a mother of 2.  Miranda says her kids stress her out and she can barely take care of them.  However at her job, she performs adequately and no one would say she seems depressed.  She falls into bed when her kids do between 7 or 8 PM yet never feels refreshed.  Crying while pouring their cereal each day, she packs them dry bread and a pickle for their lunches.  No one would know the courage it takes for her to survive the moment and then the next.  They all presume she is fine.

After teasing apart my thoughts on courage, my lip has uncurled.  I understand that definitions bother me because they can sometimes imply freedom to presume more than one should.  We can never know people’s thoughts, motives, feelings entirely and that bit that we don’t know, may be the bit that changes their story.  If you want to read more, check out this post.

So for now, I can push down my fear of definitions, put on the face of calm, …and what?  Be a friend to myself.

And you?

Question:   Where do you need the most courage to do good for yourself?  How do you deal with your fears?  Please tell me your story.