Death

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More on Dying

Tonight my husband cast this up on our monitor/TV. “This was my colleague.”

A couple who worked in palliative care used social media to share their experiences after one of them received a terminal diagnosis. It was later featured on The NewYorker.

https://www.newyorker.com/culture/the-new-yorker-documentary/what-is-it-like-to-be-dying

Watching with him the face of dying threw me back to watching my Dad. The way they both, Kathy Brandt and my dad, smiled up with tight faces, skin pulled over bones. So much love there. Dad would smile and I heard him say in it, “I love you Sana. Will you still love me while I die?” There is an insecurity I imagine in that process of saying goodbye.

Then when Kathy Brandt apologized to her audience for her condition. Her “weakness” was something to say sorry about. We also apologize for our weaknesses; for things we had nothing to do with other than that we are the carrier of some biology gone bad – major depressive disorder, cancer, alopecia… Name it. It will take you a while to cover all the things that we apologize for that describe our humanity more than they describe our fault.

Maybe we apologize rather, not in shame, but in empathy toward our listeners. There is a consideration of what our defect imposes on them. That could be. But I wonder what would happen if we didn’t apologize. Instead, allow the others to let our flawed selves just hang out there in the space between us, bringing them into a greater awareness of what we are going through. “Hello. There is no brush off here. Rather come be in my suffering and we will commune. You and me.”

There was no mention of God, what happens after death, or the meaning of life. I don’t know what they believed. They seemed like they just wanted to share the basic experience, the breathing, (…my dad rattled again in my mind when I heard that,) the changing face and body, the personality coming through, the relationships affected and so forth. This gives us space to be there with them, without doctrines setting up lines and corners we have to navigate. Not so bad. I appreciate them.

Speak: Let us know what you think of this documentary. Give us your adjectives. What notes does it hit for you; the resonance you hear and where you find your community. Speak!

Selfcare tip: Allow yourself not to apologize.

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Interim Post – floating home

Dad died and maybe it’s been about a month. I don’t remember the date. Now that I think about it, that seems like a failure. A “D” grade. How could I forget the death date? But I have been finding myself edging away from thinking about him and his death.

People talk to me about him and they say things like, “Isn’t it nice that he is resting now? He suffered for a long time.” And it is.

They say, “He really didn’t have much to live for any more. He couldn’t walk, talk, interact much.” And he didn’t.

Dad died about a month ago but Friday was the first time I said the words just so. My poor friend stuck her foot in it and I cringed for her. “How are your parents doing?!” she asked almost aglow. My parents brought that out in people. Good will and community. There was that moment when I wanted to protect her from Dad’s death and Mom’s isolation. But the knowledge grabbed me like a great wind and threw me up against it’s rocky finality. I looked her straight in the eye and responded, like I was gripping my seat in a Boeing 747 going down.

“Dad is dead.”

“He died about a month ago. And Mom is in an assisted living. She’s doing well, thanks.”

I hadn’t said those words out loud till then, to that unsuspecting kind face. Why hadn’t I? Dad is dead.

On Dad’s last night, Mom leaned over his face. (When Dad aged his bones seemed to protrude looking almost like a steering wheel, and the rest of his face sunk inward.) Mom pulled on his bones, trying to make eye contact. Dad had a hard time turning his head. She was crying. “You’ll always be my prince, Rob. You are a prince.” And Mom wasn’t glad for him to leave.

Even now, looking it up feels too tiring. Just when did Dad die? I don’t remember the date. Dad died about a month ago. And this month, has been full of work, and family, and wading through COVID-19. Dad’s ashes are sitting at the funeral home waiting to be buried whenever we are allowed to do it in person. People keep asking when the memorial is. And time is filling in the space between him and I. A foam. A retardant.

Telling my friend, saying the words, cleaned out some of the space. I had been, in general, fine over the past weeks; well cushioned and buoyed. Now, not as much. And I find that although it frightens me, and although thinking about Dad makes me feel unprotected and vulnerable to those somewhat odd congratulations on his death, contrasting with the apologies of others, although all this, the water I am in feels mostly like it is carrying me home.

This post is an interim post. I’ve not got selfcare tips to share. Just my journey. With you.

Keep on!

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Resist The Lure of Suicide

Dangerous Risk Adrenaline Suicide by Fear of F...

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Sometimes I wonder, how come other people get to get away without having to deal with this?  Why can’t I get a break?

Heidi wasn’t talking about fair or foul fortune in life.  She was talking about suicide.  Heidi found the suicide idea alluring and promising.  She found life unfair and death a form of equalization.  She reminded me that suicide contagion is a real effect.  I didn’t know this before.  I don’t know when it became an understanding for me, but it was after medical school and definitely after residency.

So much of what I know, came to me outside of those places of learning.  So much of what I know, came from my patients and a settling effect into my specialty of practice.  I have learned, in one way of consideration, too much about suicide.  In that way, I wish I didn’t.

There are good things too, of course.  Suicide is no more moral or amoral than another act in life, it is simply (if one could use such a word with this) and most objectively the last.  I remember commenter Mike J said on December 17, 2011,

Whenever I feel suicidal I remember that I’m going to be dead a long time. As bad as the pain is, I understand but, why rush to get there?  

Life is like pizza or sex, even when it’s bad it’s kinda good.

I know.  Who wants eat bad pizza?!  Sigh.  Each to his own 😉 but you get the meaning – clever man.

Mike J has used this to inoculate himself perhaps to build suicide resistance.  He and you might be interested to know that the CDC takes the risk of “catching” suicide so seriously that they have made formal recommendations for our protection.  In reading them, we find friendly ways to protect ourselves not only from suicide, but also from the contagion of other extreme thoughts that actions such as suicide cluster in; such as self-injury, catastrophizing, all-or-none thinking, and self-flagellation.

Suicide is contagious as a learned behavior, which is part of why it is so confusing for Western Cultures to conceptualize it in any way apart from morality.  Another reason we have a hard time not moralizing suicide is that we still struggle with where emotions and behaviors come from.  (But moralizing emotions and behaviors is for another discussion.)

When I heard Heidi say those words,

Sometimes I wonder…

despite the patients I have known who’ve died by suicide, despite the knowledge gained in clinical practice and despite the diagnosis I had already reported to her insurance carrier – I had an autonomic response.  My skin erupted in goose pimples, breathing sped up and I realized I was afraid.  Despite being a psychiatrist whom our community imagines thinks of who is going to commit suicide next all the time, I am not.  I am not that jaded.  I am affected and I am still taken off guard.  “Heidi,” I thought.  “No.”

Heidi had the “benefit” of media exposure to suicides, media who was promoting suicide contagion through learned behaviors but also as activating her already infirm brain to increase in degree of illness, producing more suicide-thought symptoms.  When I weighed Heidi’s risk of hurting herself knowing her medical condition, I had thought, “Ok.  She’ll make it. We’ll do this and she’ll heal.”  But when the knowledge of news-worthy suicides spread in her, I knew her medical risks might be catalyzed and I knew enough to be afraid.  “No Heidi.”  What to do?

The CDC tells us to turn the copycat-suicide risk upside down by using the  media, which the gypsy in me really likes.  Instead of being silent and afraid, we can describe the help and support available, explain how to find persons at high risk for suicide, and tell about risk factors for suicide.

Today is Christmas and you may be wondering why I am speaking about suicide today.  It is because I’m hoping that by going toward our fears and our places of pain, that they will lose power over us.  I am hoping that on Christmas, which is for some a positive time, that we have a knowledge that Christmas is for others much less.

Furthermore, I am hoping that we know that we and Heidi are up against our illnesses as well as media-poisons.  And most importantly, I hope that we also know that we have power.  We don’t have to be a victim and we are free to choose.  At every level, we are free.  In every paradigm, we are free.  We are free until we do not – AKA, die.

I’ll take it.  I hope Heidi and you do too.

I hope you will speak into the wind if it be windy.  I hope you will look into the flash if you must and I hope you will fight against your own destruction as long as you can choose.   I hope you know that you are free.

Questions:  How do you oppose the lure of suicide, even when you have to oppose it repetitively and against multiple forces?  Please tell us your story.

Self-Care Tip:  When others inappropriately describe suicide and when your thoughts tell you to die, be your own friend by speaking about suicide, even to yourself, with this knowledge.

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If You Want To Die, Tell Others.2011/10/17
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Grief Can Be Treasured At The Same Time That We Celebrate Life

Self-Care Tip #283 – Find the treasure in your grief while celebrating life.

Today is my daughter’s sixth birthday.  If ever there was a person who doubled the love she received, it is this chid.  She is all passion.  Yes, both ways, but that isn’t to judge.  Just, there is so little I can offer in words to describe her power of self.

They're asleep!

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Tonight, we pushed two twin beds together so she and I could sleep beside each other.  Her sister slept nearby on another twin bed.  Her brother set his bed up in the closet.  (I know.)

If I wasn’t so tired, old and broke, I might be made vulnerable by times like this to having more kids.  Since that’s not going to change, these chubs are what we will stick with.  Happily.

My mind is turned toward God by this girl.  I somehow arrive in the moment praying when with her, perhaps for strength and patience or for humility and gratitude.  I learn from her.

Mommy, when I’m scared I talk to Jesus.

Often in times like this, I think of my niece, dead now six years, and how her parents and we wanted what was, what was stripped.  Still grieving and still living the life with us and in us, our braided thoughts and emotions easily lose their flow.

But today I have this clarity.  My niece is gone now six years and ten days.  Today my daughter is six years old.  Today I am sleeping with my three children.  Today I know that this is precious but this is not all we want.  We want what comes after our living years.  We want to let loose to Love the grief and the life; to untangle.  Not more.  Not less.  But we want.  We want what we have, now, although still in the unknown dimension of our forever.

In psychiatry, we are alert to grief that warps the ability to engage in life.  Grief that mars the connections of survivors.  Grief that becomes pathology, brain disease and a medical condition.  This grief disables and, for example, in the case of my daughter’s birthday today, would dissolve my ability to feel pleasure.

It is difficult to gain access to treatment as many of these survivors have ill opinions about medical care.  Such as; fearing medications will mute their connection with the deceased; mute their grief, or in other words, tribute/offering to the deceased; take away the personal punishment for surviving…

Questions:

  • What do you say to these weeping lives?  How can we de-stigmatize medical care for them?
  • How have you been able to treasure your grief and the life with you and in you?
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How To Be a Friend to Yourself When Thinking About Your Bully?

I love real life John Waters freeze-frames

Image by TheeErin via Flickr

Self-Care Tip #253 – Humanize and forgive your bully.

How to be a friend to yourself when thinking about your bully?

Have you noticed that when we think about our bully, we don’t feel so good.  Just thinking about him!  Sheeze!  In our last post on bullying, Nancy said,

Wow! This one brought up WAY too much pain. I’m feeling very vulnerable and uncomfortable and hurt and stupid at the moment. 

There are jumbled emotions that flood us, such as anger, shame, helplessness, anxiety or more.  Our autonomics may even trigger, making us hypervigilant as if we were being attacked.  We are in defense mode – all the while sitting alone in a chair at our desk, in the quiet of our bed while falling asleep, or any other place of our generally hum-drum lives.  These feelings and nervous system changes come in a time and place when we are not in danger.  They come without us realizing their approach, stealth feet and skilled hands; we are in their company before we know it.

Is there no hope?  What can we do so we don’t feel victimized all over again.

Humanize

1.  Do research on the bully.  Find out about him on the internet.  See what others have said about him.

This helps us:

  1. see him as a human, mortal, without superhuman powers.
  2. feel like we are less alone in this.
  3. realize that we are not chosen, so to speak, to suffer at his hands.  He is a bully and not just around “Me.”
  4. we didn’t cause his behaviors.  He chooses his behaviors because of the same biopsychosocial paradigm that we choose ours.
  5. realize that he hasn’t chosen to do his self-care, making him more vulnerable to his own negative feelings and behaviors.

Forgive

  1. Humanizing our bully helps us move towards empathy and forgiveness.
  2. Anger debts only hurt Me and that’s not friendly to Me.

Grow our self-confidence

  1. Such as doing our own thing.
  2. Grow our own natural genius.  Work hard at it and see how it is there for us, like a friend when we are feeling pushed down.  Our friend will be standing beside us, reminding us of our value when this remembering tries to beat us down.  Our friend will be there reminding us that this negative event in our life does not define us.

Now if they continue, these rememberings, and if these rememberings are frequent enough that we believe our quality of life is affected, we may be looking at something else.  There are other medical illnesses that can disable our abilities to cope.  In this scenario, I am thinking especially about Post-Traumatic Stress Disorder (PTSD.)

In PTSD, we relive experiences of trauma (which we perceived to have been life threatening to ourselves or observed by us in other(s).)  We may also feel hypervigilant, as if we are about to be attacked at times when our lives are not threatened.  We might have nightmares and avoid things that remind us of the trauma event as well.

PTSD is easily reactivated by other stressful situations – such as being bullied.  When we have a history of PTSD that has been quiet for a time, even years, we are more vulnerable to stressors reactivating it’s symptoms.  Then, although the said stressor may not have been a life-threatening stressor, we perceive similar feelings and neurologic changes we did when in the life-threatening situation.  Then, although the said stressor may be over and not recurring, those PTSD symptoms start happening all over again and may continue indeterminately – propagated by the disease process and not our bully event.

This might be endured and it may go away in time without treatment.  But it isn’t good for anyone while it is happening.  PTSD can improve with medical therapies.

Question:  How have you been able to humanize and forgive your bully?  Please tell me your story.

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The Testimony of The White-Headed People – Connection and Aging

Once again, I find myself in a café.  This doesn’t happen often enough for me.  But here,Almond paste tart with chocolate mouse and blueberries

I am

at the wonderful le Croissant Bakery, indulging not only in the quiet of my private thoughts, not only in my delectable chocolate croissant with coffee, but also in the ambiance.

Here, there is this completely lovely group of white-headeds, maybe ten of them at a table, sharing the treasured community of each other.  None of them walk completely upright.  One is wearing his oxygen tubing with tank in tow.  The ladies are coiffed irregardless of their folding skin and thin hair.  Fruit tart

I am

so blessed to be in their community, testifying to me that aging doesn’t have to be done alone.  Flourless Chocolate cake with Ganache inside

I am

sure, 100% sure, that none of them are aging as they dreamed.  Each of them have outlived many loved ones and the ground they walk on has changed many many times.  They have, each of them, learned to walk again after suffering the type of loss that put’s any of us in bed.

I am

blessed.  This collection of café moments they have together does not account for these losses.  This does not resolve their ongoing conflicts or pain.

But none of them,

Almond paste tart with chocolate mouse and blueberries

I am

100% sure, did not let those things keep them from having this moment together today.

All this sureness without having checked my notes with them?  Yes.

I am.

Crumbs on a Plate

Image by rockbadger via Flickr

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Your Pain is Not Special. It Is Normal.

Self-Care Tip #243 – See yourself as special rather than your pain and know that you will find your normal again.

What is your normal?

When we were kids, we all had a perspective of what normal was.  Let’s say it was “here.”  Let’s imagine we were lovely then, nurtured and emotionally bonded.  We struggled through peer conflicts, social anxiety and rivalry.  We wanted a bike.

Two Sisters

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Then we got a little older.  Maybe our parents divorced.  Maybe, a sibling died.  Maybe we were abused or in an accident and damaged.  Damage changes normal.  What we never would have thought would be acceptable in our lives became acceptable.  We suffered.  We lived.  Life was indiscriminate and ignored our status.  We think there must be a mistake.

What is our normal at one point, filtered through remaining hopes, grew into regenerating fantasies, through real potential and it moved again.  We are older now and more suffering comes.

Where is our normal?  We survive our child, our own dear perfect boy, hanging from a tree.  Normal?  No dear God!  No!  And we continue to live.

Two years.  Two years are what it takes for our biology to catch up to the shock.  Two years are what it takes for us to begin to accept and realize that in this new normal we care again.  We choose it in fact.

People don’t remember his name or talk about him and we can’t remember his eyes.  We are ashamed and lose our breath from panic just trying to see them.  We want to bang our head because we know there is something wrong about feeling normal! Ever! Again! after that.  But we do.

Our normal mutates over financial ruin, abandonment and a growing healthy list of disfiguring illnesses.  We accept them and say yes please.  Live.  We want to live.  This is acceptable.  This is normal.  Our friends die.  Our memory.  We can’t find our teeth.  Our heart stops.  We die and the world finds normal.  The world chooses just like we did.

What we don’t think will ever be allowed to happen while we brush hair, clip our nails and microwave food, happens. We endure these changes.  We find normal again.

What is your normal?

My brother, Vance Johnson MD, is a physical medicine and rehabilitation specialist.  He said that during his residency, close to 100% of spinal cord injury paralysis survivors he worked with wanted to die after their injury.  Many of them would beg him to let them die.  They would cuss at him for keeping them alive.

I leaned very heavily on the studies and data during those times.  It was very hard.

Vance said that what kept him faithful to his task was knowing that close to 100% of them after two years would be glad they were kept alive.

Even the ones who were basically breathing through a straw and that’s all that moved on them; even they wanted to live.  These people found a new normal.

Where is our normal?  We will want it.  We will adapt.  Biology will catch up to our reality.

Remember that your pain is not special.  You are special.  Not your pain.  Pain is normal.

Question:  When this happened to you, how did normal find you despite the rubble?  How does this concept feel to you, that your pain is not special?  Does it make you angry or what?  Please tell me your story.

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Your Bridge Between Choosing and Being Chosen By Guilt

INNOCENCE/GUILT

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Self-Care Tip #227 – Find out about your bridge between choosing and being chosen by guilt.

Guilt.

Sometimes we think people who do wrong should feel guilt.  But how many of us improve ourselves or others in response to guilt?  And because this is a self-care blog (wink), I have tooled around with what it is all about and if it is a positive self-service.  In my meanderings I remembered, Schadenfreude.  (Isn’t that a marvelous Americanized German word?!)

Schadenfreude is different from guilt, although often in the same company.  It is a natural response in which we find pleasure at observing another’s demise or suffering.  I speculate that when we see someone feeling guilty and suffering from that guilt, even against our better natures we experience a degree of Schadenfreude, i.e. pleasure.  Because we moralize things, we responsibly feel shame when insight dawns on Schadenfreude, but “it just is.”  It is a part of who we are in this time of humankind’s history.

However would we go so far as to say that we want people to feel guilty when they do wrong because of the motivating reward that Schadenfreude has on us?  For example, Mom is disciplining her children and just won’t stop until someone cries.  I remember hearing jokes about this in mommy groups when my kids were a bit younger.  …Mom thinks silently,

I’m suffering so I want to see you suffer.

Even though we maturely and grandly empathize (the counterpart to Schadenfreude) with the kids, there is a simultaneous “secret Schadenfreude” (a private feeling) that goes on at their failure.  The blend of both can be confusing.

As we continue to travel the bridge between voluntary and involuntary, we are learning more about how choice remains regardless which side we are looking at.  For example, if guilt and Schadenfreude are so natural, so biological, so reflexive, we look for our choice.

Cathy wrote on the blog-post, Choosing Perspective,

I become trapped in my own guilt. Yes it is about perspective but what to do when even changing your perspective provides no relief, only a different source of constraint?

Questions:  I can’t help but wonder what you think about this?  Where and what is your bridge between choosing and being chosen by guilt and other negative emotions?  How do you choose when guilt and other negative emotions come involuntarily and inappropriately to context?  Please tell me your story.

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Go Towards Your Pain to Relieve It

A family mourns during a funeral at the Lion's...

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Self-Care #197 – Go where your pain is to prepare for what happens badly in life.

Yesterday we talked about the power of loss, grief and pain not being one that can take away the potential of life.

Carl appreciated the idea that “scripted cue cards” with platitudes on them to read off for ourselves or for others when something bad happens – “Good comes out of bad,” “I know what you feel like,” and so on – is nothing anyone wants.  His comment included, in true Carl-style, a great question:

But what else can we say to show respectful empathy?

Goodness.  For crying out loud, we aren’t a bunch of calloused puff heads who don’t care or who don’t have a clue when someone is suffering!  We’ve all asked this question and wanted to help.  We’ve wanted to connect, to serve, to answer Carl’s question when we are in or come into the presence of pain.

In self-care, we can’t help others if we don’t help ourselves first.  We can’t give what we don’t have.  Airplane crashing, put your oxygen on before your babies.  Can’t withdraw if the bank account is empty….  We take care of ourselves and find that we can serve others more as a result.  It’s the same way in grief.  If we don’t go where our own pain is in life, if we aren’t present with our life journey, if we don’t fight hard for who we are, it is very hard to know how to answer this question.

There’s something to say about doing the work before the trouble comes and then when it comes, use it to prepare for more.  I love Ecclesiastes 12 which tells us in Solomon’s depressed and yet feisty words,

Remember your Creator
in the days of your youth,
before the days of trouble come
and the years approach when you will say,
“I find no pleasure in them”—

Solomon was talking about self-care here.  Holding us responsible at the elemental level to use the time we have before trouble comes, so that when it comes, we have a way of answering.

Carl gave his own answer,

…live life on life’s terms like it or not.  If we allow Jesus to embrace us and comfort us it will fortify us through life’s unfortunate tragedies.

Question:  What is your answer to Carl’s question?  Please tell me your story.

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Pain Doesn’t Define Life’s Potential

Close-jen-grieve

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Self-Care Tip #196 – When you are hurting, remember the pain doesn’t define life’s potential.  Be a friend to yourself.

Yesterday we talked about giving and getting bad news without fear.  This was received in a spectrum of ways by you, ranging from – no way is bad news something not to be scared of, to, bad news might be something we could face knowing we might find something good in the end.  No one slammed the hammer down, dinging red at bad news equals good all around – except my dogs who don’t listen anyway and are pretty much always happy.

Jjen was brave, saying,

I would have to also agree that in some cases bad news can bring family members, or even friends together that have been estranged. This has personally happened to me. Kind of a bittersweet thing; good in result of something bad and mending a broken relationship.

“Good comes out of bad.”  Not everyone agrees and I don’t blame them.  Some bad things are better left alone to rot and stink out of our lives entirely.  It even sounds patronizing when someone is hurting to say this.  This kind of discovery should be made by the parties involved, without the rest of us holding scripted cue cards for them.

It is also something that is received easier from another who has been in, or is in their own catastrophe(s), losses, abuse or grief – say Jesus for starters.  I could hear this from Him without wanting to vomit all over the place.  He’s been there, hurt bad, and has been blessed through and by it in ways I will be learning about even after Time unhinges.

When my nine year-old adored niece suddenly died, I didn’t see that.  It’s taken almost six years to see anything good come “from” this unbelievable loss we grieve every moment.  The bad doesn’t disappear for me, but as Jjen said, it is not a qualifier for the rest of life’s potential.

Question:  What has come “from” the bad in your life – more bad or what?  Please tell us your story.

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When You Are Pushed Down, Push Back

A Push and a Shove

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Self-Care Tip #185 – When you are pushed down, deliberately push back with The Force in  you.  Be a friend to yourself.

So much in life pushes down on us.  I am amazed that we push back – considering how awful some of it is.  After 7 years of private practice in psychiatry, I still get caught off guard by some of the particularly horrible stories I am told.  Blinking my own stinging eyes, I look in amazement at the person in front of me.  What I see is this pushing-back Force.

Last week after diagnosing PTSD in Margie, a mother of a murdered son, I could hardly believe that she still chooses life.  She takes care of herself despite.  That’s how amazing she is.  And I’m her psychiatrist!  It’s such an honor.  And thinking about that straining towards life, that thread in us, all of us – I saw that it was the best description of the brilliance and power that is God.  True, sickness can mute our perception of this beautiful thing in us, whether it’s depression or liver disease.  But all of us have seen some of how hard the thrashing against that loss is.

In thinking on this amazing force, this thrashing about, this straining against the push of whatever is set at tipping us over, I named it God in us.  And I thought, for all the time I spend on the stuff pushing me around in bad ways, I’m going to more actively team up with the struggle to live.  I’m going to choose to strain and thrash about and move at that chink of space in the dark room as much as I can.  Hopefully I can be brave too, like that mother of a murdered son, Margie.

I can choose to ally myself, with what I want to live for.  I’m going to partner with that Force that keeps me thrashing against the push and be stronger, like you have readers.

After our post on suicide a couple days ago, many of you responded with your own stories about how you were pushed and pushed back.  Karal said,

Like all difficult experiences we face in life, there is the possibility of growth from the ashes.  It requires strength and a willingness to walk through that fire.  Unfortunately for survivors of suicide (i’m referring to those left behind) we’re often chastised into feeling that our grieving, our walking through the fire is both wrong, and  unnecessary.  I totally disagree.  Like you said, caring for people is a choice, and being a friend to yourself means making sense of, or at least peace with, what may never make sense.

Karal is allying herself with that Force to make as much sense of what will always be jumbled.  I’m not going to quote all the rest of the brilliant comments.  Please read them.  They were amazing demonstrations of pushing back in a collaborative way with The Force that makes their lives worth living.  This is active in us at times, and not deliberate at others.  Being better to ourselves, we could more deliberately choose when given the push.  We are not thrashing alone.  Push back.

Question:  How do you deliberately choose your alliances in your life for working against what pushed you down?  How do you define that Force in you that pushes back?  Please tell me your story.

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Goodbyes Are A Way To Connect

15th century adaptation of a T and O map. This...

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Self-Care Tip #184 – Respond to your goodbyes deliberately to be friendly to yourself.

One of the Regional Centers that I work at is closing their telemedicine clinic.  This means I’ve said goodbye to many beloved patients and their families, whom I’ve worked with since round 2003 I think.  Saying goodbye to people we respect and enjoy is not as casual as we stylin’ people make it look.

Two days ago I said goodbye to my girlfriend of around five-plus years and her family.  Moving far far away makes the flat world feel lumpy and luminous.  I now have all her leftover food and knock-offs she didn’t want to haul across the lengthening world to remind me that she is gone.

Watching parents and/or grandparents age is also an exercise in saying goodbye.  My parents have a hard time making it over to visit on week-ends for all the funerals they go to.  Their calendar sends over that whispering voice that they are growing old.  “Look,” it says.  “See me.  I am aging.  Time is connecting and taking me with it.” Even so, their essence holds its own, apart from Time.  That makes me feel more comfortable.  When that whisper gets louder I may respond differently, I can’t know until then.  But for now, this is good.

“Goodbye” is something that begs a response.  “Oh yes!  Goodbye!  See you later.”  I even say, “See you later” to people I know I have less than one percent chance of running into again.  The word calls to me and I respond.  The word implies a disconnection, but even so, beckons us to connect.  It spreads us over the space of our time shared and into the future apart.  Peanut butter and jelly, it sandwiches us up with the one who says “Goodbye” when we say back, “Until then.”

Today with these people and remembering all the ones I won’t get to see before my contract ends, I feel the pull to respond.  My response can be something deliberate.  It is another bit of something I get to choose.  I hope it will connect me.

Question:  How have you responded to the goodbye’s in your life?  How has it been a connecting force for you?  Please tell me your story.

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It Is My Choice to Take Care of Someone, Even in The Context of Suicide

Detail of The Death of Socrates. A disciple is...

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I was a teenager I think when a woman in our church suicided.  Dad pointed out the man sitting alone.

His wife just killed herself.

Dad asked me what I thought of suicide.  Imagine.  What a compliment really for a teen, to be asked her thoughts.  Being a “Feeler,” I oozed something empathic I’m sure, but still I only remember what Dad said,

I believe God has a special way of seeing these cases.

This was at a time when culturally most of the western world saw suicide as sin.  It was quite forward for Dad to say what he did again later to the grieving man in the pew.  I did not realize at the time, but now I see that people judged him and his wife for what she did.

Later in psychiatry training, my attending said,

Suicide is the most selfish act anyone can do.  It is the ultimate punishment aimed at those who still live.

I don’t know what you think, but I couldn’t help wondering.  I still do.  I think this may be true for some and not others.  I haven’t had a chance to ask them.  They’re dead.

Suicide is terrifying to a psychiatrist.  We all tremble at the thought.  Statistically we know women attempt it more than men, but men are more “successful” when they do try.  They use methods that are generally more lethal than women.  They don’t get a chance to realize that in a month or a day they will want life again.  Or an hour.  They could have lived.

In the intensive-care unit of a hospital, “unsuccessful” suicide attempts hover in life in a space where their self-injury placed them.  The nurses are kept running between medicines, treatments, physician orders and prayers for these lives that tried to die.  Sometimes, the “chronically suicidal” become familiar patients to this critical care ward and that has it’s effect on those who have spent themselves so heroically to save them.

A nurse once told me angrily about her patient who kept coming back.

I fought for that woman’s life!  I prayed over her!  I worked all night for several nights and didn’t know if she would live until much later.  And then she was transferred out to the step-down ward (to a floor where the patients aren’t in such a life-threatening condition), and that lady probably never knew what I went through to keep her alive.

Then later, she came back, and later again, almost dead but not dead.  She kept trying to kill herself!  Finally, when she was conscious again, I just told her how it is.  ‘Listen!  I fought hard for you!  You better go out there and live!  You better figure out what it is you want and go for it.  Stop trying to die!’

This lady-patient was hurting more than herself.  Suicidal thoughts and attempts are dangerous.

There was a patient who tried to use his bed-sheets as a noose before the nurse lifted his wet body from the door frame.  In the emergency room (ER) he was examined, x-rayed and determined fit to return to the ward.  Alive.  Talking to the ER physician, I learned that the reason most people die when they hang themselves isn’t because of suffocation.  It’s because they break their neck.  Done.  No more chances to choose life.  Even an hour.  My pulse was still beating on me to the rhythm of, “He could have died!  He could have died!”  This time, no broken neck.

Regardless of our culture, we are not the judges of these people who want to die.  Regardless of our emotions, their emotions before, any previous conflicts, regardless, we cannot measure their final act by degrees or intentions.

We fight together for their lives and they may or may not know about what that does to the rest of the world.  When we don’t want to fight for them any more, we should change jobs.  It is our choice, each of us.  Whether we are fighting as professionals or as a wife, brother, friend, volunteer or the hired tutor, we fight for their lives because we choose to.  If we cannot keep it up without judging, shaming, accusing the suicidal, we need to own that and take care of ourselves first.  “Can’t give what you don’t have.”

The truth is, suicidality is hard for everyone.  It is hard in ways and in people that aren’t talked about, such as the nurses or the x-ray tech who is the first to find the cervical fracture (broken neck) on film.  It is hard for the church parishioners, the person separated by seven-degrees or the grocer.  Suicidality is hard for all of us.  We give what we choose to give and remember to say, “I can’t control that,” when we can’t.  It is our choice.

Self-Care Tip #182 – Taking care of someone is your choice, even in the context of suicide.  Be a friend to yourself.

Question:  How has suicide touched your life?  Please tell me your story.

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Sharing Will Take You Out of Isolation

Flowers for Valentine's Day

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Self-Care Tip #180 – Sharing will take you out of isolation.  Be a friend to yourself.

If Valentine’s is about Love, today felt like Valentine’s Day to me.  Your support, my friends, came to me like bouquets of home-grown roses, lilies, daisy’s and bird-of-paradise.  You swept me up and carried me over a threshold of something I didn’t want to cross alone.  Thank you.

Carl, dear Carl, is always surprising us.  He told us yesterday about his own amazing dad and then said,

I can truly say I know how you feel.

Even though much of this feels unique to me, I know it is not.  Pain is not unique.  It is our choice to experience it alone or in community.  I choose you.  Thank you for choosing back.  Thank you for my flowers.

Mom has always been a fierce lover of flowers.  She arranges them dramatically and gives them out, believing that their beauty is enough for now.  She never worries about when she won’t have any.  I actually don’t ever remember Mom without them.  She just can’t stay away.  Either she goes where they are, or they seem to some how follow her.  Sounds like story fodder but it’s true.  She will be one of the loveliest in heaven, just because she was designed to be.  I can’t imagine all that Mom will learn on beauty through an existence disconnected from time.  I’ll know where to go when I want to gather some for you.

Mom goes to see Dad every day.  She’s usually wearing something shiny or bright or both.  Dad’s hospital room is in full bloom and there is always food for nurses or visitors.  This is how Mom does her fighting for Dad.  Through beauty.  Not bad, huh?  She washes him every day so she can spare him as many further humiliations that come with illness.  He is lotioned up; more able to receive than he ever is outside of the hospital.  In their own way, he and she give to each other like that.  I’ve seen Dad cry and Mom just push aside the tubing and get in beside him on his electric bed.  In the hospital, a lot can happen.

Tomorrow is Valentine’s Day and Dad said,

Well, I guess I’ll just have to let this one pass.

But if Valentine’s is about Love, he doesn’t have to worry too much.

Since round high school, Dad has told me that I have to sing some day at his funeral, “The Only Thing I Want Is To Be With Jesus,” By Joni Eareckson Tada.  I am sure I never will but he refuses to believe it.

The only thing I want is to be with Jesus.  Just to see Him smile and say well done, what a day that’s gonna be.  I want to feel His strong and Loving arms just hold me to His side, and to be with Him, throughout eternity.  Just to be with Him is heaven enough for me.

My seven year old asked the other day,

Mommy, will Papa be alive when I have kids?

I told Dad and he laughed.  He’s an easy laugh.

That’s a really good question.  What a mind.

Dad has almost died about a zillion times and it’s easy to feel like he will live forever.  All I know is that if he keeps putting me through this, I’ll need you there to take me out of the isolation and remind me that none of us have been chosen to be alone.

Question:  How has pain been a connecting force in your life?  What has helped you share what seemed impossible at once to let outside of yourself?  Please tell me your story.

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Dad Is In The Hospital. My Reality.

Open-face helmet.

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Self-Care Tip #179 – Get inside your reality and be with Love.

When I was eight my family left me at Grandma’s farm for the summer.  There’s not much more inland to go than Iowa.  If the United States of America were a house, Iowa would be perhaps it’s cellar; full of smells, goods and it is a great place to play.  I played a lot that summer – as well as stepping in a cow-pie or two, riding tractors with Grandpa Jack cutting hay, pulling on cow tits and seeing the milk come out to shoot right into the cat’s mouth.  And I gathered eggs from pecking feisty chickens that would scare the bravest of any Coasters (those of us from the East and West.)  Grandma was no-nonsense and didn’t waste much time on coaching.

Just stick your hand in there and take the eggs.

As an eight-year-old you haven’t known real fear until you face down a mother hen in a musty unlit poop filled coup, and reach under her feathered skirts for eggs.

That summer Dad came to get me early.  I was really happy to see him.  Uncle Mel and my cousin Dougy had been in a motorcycle accident.

Dad is an orthopedic surgeon and since my summer in Iowa,  Dad has called motorcycle helmets, “brain-buckets.”  He’s seen a lot of them in emergency rooms, so he knew what his brother had looked like.  Dougy was in a hospital bed being introduced to his now forever useless arm.  I came in shy, because Dougy was so cute.  I was thinking about what he thought of me.  I know.  I did.  Despite my diva-self, despite the horror and grief, Dougy gave me a brilliant white-boy American smile.  I hid under Dad’s arm where I didn’t have to look but could still hear Dad’s voice.  I think I may have even whined.  I’m still embarrassed.

These days, unfortunately I rarely get to see Dougy, but when I do, I still want to hide under Dad’s arm as if he’d remember me there.  I wonder if he remembers Dad’s voice.

Today, Dad is in a hospital bed with a blood clot the size of a rattle-snake crawling up his leg, fighting for his right to walk, let alone live.  It is his voice, or maybe the bed, that brought Iowa back to me.

Cousin Patty was crying at Uncle Mel’s funeral.  She wouldn’t go up to the casket, just sat and cried.  I was a little bummed my cousins weren’t interested in me.  It was who I was at eight years old.

Grandma, who left me unsupervised to gather eggs from angry-chickens, cried and asked me for more kisses.

They taste like brown-sugar!  Give me some more.

Dad’s hands now have Grandma’s same wormy veins, raised over blotched ecchymosis (purple patches from leaking blood vessels into the skin); begging to be touched.

I went to see her with my brother Cam before she died.  She was delirious.  But I trusted her so.  I laid beside her in her hospital bed and looked up for a shoe she told me was stuck in the ceiling.  I thought, “There just might be one and these people don’t believe her.”  I was miffed.  Now I realize I was mostly angry because Grandma was dying.

The farm is gone and I wish I had the metal tub Grandma bathed me in outside on the lawn.  But I do have this connection in me to all she gave, the people who came from her and her showing me how to live and die.

If she was still alive and knew Dad was in this danger, she’d say, “Rob, I’m praying for you.  I Love you.”  And unlike my emotives, that would be about it.  She was from Iowa, you know.

This is my reality.  Dad is in the hospital.

Self-care includes being in our reality.  Sometimes it’s too much for one person to handle.  People need Love.  The reality of the world and of the individual is that we need Love.  We are better to ourselves and others when we can be inside our reality.

Telling you about this is my self-care.  This is part of my Love story.

Question:  What is yours?  Please tell me your story.

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When You Are Hurting – Suffering Just Is

Daughters of a father who was trapped in a col...

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My dad, excellent in his suffering, has shown how to lose, how to spend the time it takes to grieve it and enjoy the rest that makes life worth living.  My dad should have a medal in suffering. If I knew where to get them I’d send word.

Some of his suffering, he played a causal part in, but who cares.  It doesn’t have a qualifying relationship to “deserving” empathy and the spiritual nod.  Those come because of Love, not our performance.

None of us are foreigners to suffering others, ourselves, cause, accident, defined and ignominious explanations.  For reason and for lack of reason we suffer.  No, the etiology of suffering isn’t why we care about its abuse.  Sure we hope not to repeat mistakes that lead to suffering and that makes it’s etiology worth reflection, but not as
a qualifier to caring.

So no.

Between one grief and another, between this fault and that fault, the loss “Is.”  It just Is.  That’s Dad’s presence I’m talking about.

In a culture counting and studying our wrongs and our rights for the purpose of squeezing currency out of it, we need presence.  Presence allows for all the rest.  The healing.  The forgiveness.  The grieving.  The hope that remains.  Presence allows for us to continue valued.

Presence allows us to live for what is still worth living for.

After writing blog-post “When You Are Hurting, Remember Why You Want To Live, And Live For That,” I heard from someone suffering via his fabulous on-line monthly journal “Psyche’s Flashlight.”  He said,

I read this after a recent stint in the hospital, and I can’t tell you how much it resonates with me. This is what saved my life.

Suffering Is.

Question:  What has helped keep you away from qualifying your suffering or that of others?  Please tell me your story.

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Are You a Victim or What?!

 

 

Number Two of Bella’s List – victim or what!?:

Last night I took my 5 year-old daughter on a sleep-over date at a hotel.  Generous I thought …and boy was it!  To me!!  I couldn’t believe how much fun I had.  I quickly realized why I had done this.

A bit of me still wants to float away on wings of the modern-martyred-Mom, and I can, because it did take a lot of time and money and energy and….  But it’s not too friendly to me.  As attractive as that flight may seem, I’ll lose air at some point and take a big fall.  Ouch.  I might fall on my kid too which is against my intuitive effort here.

Being a victim is attractive at some level, no?  My story is a softer example, but we all have tougher ones.  Like Bella’s when “she spoke of her injury.”  The gravity of her injury was created by her perception of things.  Our perception makes our emotional success.  My story about last night with my daughter sounds pretty because that’s how I perceived it.  However, I have other stories that have negative power over me as Bella’s had on her and as yours have on you.

The key here is that when we take the victim role, we aren’t just telling our story or venting.  We are feeling self-pity. But venting is not necessarily self-victimization.  Venting can be healthy.  Venting can be done without taking a victim air-bus to no-where good.  Venting can be a way of being present in your suffering, of going where the pain is and letting it lose power over you.  Self-pity only gives the suffering more power.

The great novelist and philosopher, David Foster Wallace, who courageously lived and died with major depressive disorder, encouraged,

To be just a little less arrogant. To have just a little critical awareness about myself and my certainties.

The willingness to learn or grow is the foot-path away from victim-ville.  Could we even say that being a victim is “arrogant?”  We – Me, my patient Bella, you – have we taken steps to tell our story, to be present, to live with the humility it takes to look at ourselves and not escape/fly-away?

Whatever it is you are going through, it might help to vent it!  Grow and learn and get bigger than that experience.

Self-Care Tip #94 – Get in your own space to choose freedom from self-pity.  Be a friend to Yourself.

Question:  What barriers have you felt to telling your story?  What has made it difficult to be in the space of your own feelings?  Please tell us.

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New Verses New

She died this morning.  After a day and a night of confusion, stumbling gate, and suffering, our gentle gorgeous Maggie died.  She is returning to carbon ash and giving us another reminder of what can be delivered to the living by death.

With the children taken to school, my husband came home to share grief with me.  He had just listened to a podcast by Rob Bell about the word “new.”  In Greek there are 2 common words used for “new.”  One connects newness to Time.  As in the young in age and old in age.  This is traditionally how our culture interprets “new.”  Another use of “new” uses the concept of renew without connecting it to time.  There is a newness in you as you are in time.  It’s a great overlap into the concept of presence.  But where my big gratitude went out to was knowing how many opportunities to being made new we have.

Some of us have the propensity to wait until we “hit bottom”  before we come looking to be made new.  I don’t mean this in any way that is judgmental.  Please see my blog posts on temperament if you want to read more about this.  If we were fortunate enough not to have picked up any self sabotaging habits, then in some ways we’ve got an easier time of it as the the years roll by.  However, few of us are, and getting crushed over and over again like recycling cans hurts a lot – us and ours.

“You can’t have it all” we are told, brewing panic after wasted opportunities.  Not having it all, missing out on more days to share with Maggie, loosing the hope of puppies some day, brought the well-timed discussion about newness straight to our grief.

We are given the opportunity to be made new any time any where regardless.  Any where from greatness to low-living, we have that choice.  When I think of Maggie, I will think of this and hopefully I will choose to be made “new” again.

A “new” heart also will I give you, and a “new” spirit will I put within you: and I will take away the stony heart out of your flesh, and I will give you an heart of flesh.

Self Care Tip #50 – Be renewed.  Be a friend to yourself.

Question:  Do you agree?  Disagree?  Please tell me your story.

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My Essence – A Matter of Love

Betrayal?

Connecting that behaviors are linked to brain health is often confusing. The distance traveled to reach that point may have been long. It may have involved experiences painful to themselves and their loved ones.

For example, they may have lost a job because they couldn’t get out of bed in the morning. A divorce might have come after changing into someone irritable and angry. A trucker might no longer be able to drive on the freeway because of panic. But once they connect that this change in personality relates to a change in their brain health, how do they feel about that?

Some people feel relief. That they didn’t personally fail. That they aren’t a bad Christian. That it wasn’t because they didn’t try hard enough to “feel good,” to stop itching, to get up and do something with their life, to quit gambling, etc… Maybe they feel for a moment that judgment can be suspended for them.

However there is a group of people, maybe overlapping these, who feel betrayed. Betrayed by their very essence. The question of, if they can’t trust themselves, what is real in life at all? They struggle with the shame of betraying their own person. “Who am I if I’m not…?” and the questions roll on. It must be a question for all of us with changing bodies, Who are you if your mind gets sick?

There is the temporal line of thought, that if your brain changes, your memories, your personality, than you change. Your human form is different. Like getting your arm cut off, you have to grieve and grow a new picture of how you see yourself. A changing person through the span of life. This is in fact healthy adaptation.

There is also a thread in this weave of believing that our essence isn’t wholly related to our changing bodies. That somehow when the various curtains of life fall and open and the final curtain comes around, that this bit remains. I don’t think you can believe this unless you believe in a Love which is stronger than death.

Love is stronger than the death of my neurons, my dendritic connections, stronger than the death of my mind.

The adaptability needed for this life is a no-brainer. We can’t survive if we don’t. It takes courage to adapt when your person is changing. It takes courage when you are loosing yourself. Such courage, like someone in war or flight or determined movement that others could only imagine.

But how you define your essence also matters. I see it as a related step, but also apart from these excellent coping skills. I see it as a matter of Love. It’s win-win when Love weaves through you.

Self Care Tip #16 – Choose Love. Be a friend to yourself.