Self-Care Is Not A Moral Issue

Facial emotions.

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I am writing a series of blog-posts outlining self-care in which we examine the tenets of self-care:

Self-Care Tip #263 – Experience, use, observe and interpret emotions, but don’t moralize them.

We sometimes forget about the involved journey to a healthy Me.  Because of this, we become fearful that it means alone-care, apart-from-God-care, selfish-care, excluding experienced-and-professional-input-care and so on.  It’s not.  Self-care is collaborative, yet that doesn’t negate the fact that it must start and end with Me.

When we take care of “Me,” we can connect more with others, including God, have more inside of us to give to others, and have more interest in the world around.  The opposite disables our abilities to do those things.  No one can give what she doesn’t have.

We have this person, “Me,” to take care of.  This “Me” is valuable, of high priority, to be celebrated and cheered on.

Please, shake it off.  Self-care is not a moral issue.  It just is.  It is a choice, a freedom and an opportunity.  It is not about salvation and has no influence on our worth.  It just is.

We are more willing to buy into the, “It just is,” self-care tool when we understand where emotions and behaviors come from – the brain. This biological stance is the evidence for deescalating our drive to moralize emotions and behaviors.  They are not from an aura, a gear we can shift, or any nidus of control outside of our human bodies.  Emotions are how we interpret the world around us.  They are not linked to morality.  Please don’t take them to the pulpit.  If you do, I will still be polite, although breathing through a mask.

Emotions are our interpretive lens for our physical self.

Questions:  How’s the clarity of your lens holding out after considering this part of self-care?  What influence does what you “see” with your emotions have on your ability to befriend yourself?  Please tell me your story.

In The Space of Anger, Remember You Are a Friend to Yourself.

The Rage of Achilles (1757)

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Bullying:  Series Continued.

  • #144 Leave Space In Your Beliefs To Grow
  • #163 ”He’s Never Hit Me.” Abuse.
  • #251 Just Ordinary Bullying – The Bully and The Bullied
  • #253 How to Be A Friend To Yourself When Thinking About Your Bully
  • #254 Free To Do Self-Care, Despite Our Bully
  • #255 Bullying That Includes Life-Threatening Behavior.

You are saying this to provoke me!

Paula was angry.  Her hold on her composure was tenuous.  I backed off before she lost her cool.  No one feels good when they do that.  If she felt this way around this mostly unthreatening environment, she must be suffering its effect on her relationships or lack thereof in her other life environments.  No one feels good when they can’t trust themselves.

I am not going to sit here and take this from you!  You are doing this on purpose!

And Paula walked out.  That was it.  That was all I got.  For now, my opportunity to help was over and I was left to wonder after her.

1.  In taking care of ourselves around anger, the first step is to ensure our personal safety.  Deescalate if possible the tension.  But most importantly, do what we must to be safe.  If we have to leave to do that, than we leave and it is over.  I commend Paula for leaving before she acted out on her anger.  That is good coping going on.

For myself, if she had continued to escalate, I could call for help or leave.

2.  The next step, (exclusively per Dr. Q), for those experiencing the anger…  Well there are many, and if it is happening often, should probably include medical interventions along with other considerations of her biopsychosocial self.

For those subjected to the anger, it will be most friendly to themselves to process their own emotional response to the anger-trigger.  “Do I feel angry too?  Do I think I am responsible for her emotions? Do I think what went down here is about me?”  Get our personal out of the stuff that isn’t.  Why make it about us if that isn’t true?  It is another thing if we were poking her with a skewer or had initiated our own emotional diarrhea before she did.  But that just takes us back to step #1.

3.  Finally, for the “victim,” take some time to tease out if we are putting ourselves in a position that isn’t safe repetitively.  “Is there a pattern?  Do we find ourselves in the space of anger or other negative emotions often?  How often?  Do we allow this person to treat us in a negative way that we would never allow anyone else to treat us?”  The answer to that will be telling about our self-friendliness.

Self-Care Tip #259 – In the space of anger, remember you are a friend to yourself.

Questions:  What patterns, if any, do you see in your life, or someone you love re: anger?  What empowers you towards self-care in the space of anger?

Anger – Sometimes There Doesn’t Have to Be A Reason

A metaphorical visualization of the word Anger.

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Self-Care Tip #244 – When emotions and behaviors come without being asked by you, think about the medical reasons.

She needed to keep going, Minka felt hurt and angry.  Control and failure nipped at her.  She wondered what it would take for her to recognize her own success.

Minka had a child who provoked her.  But worse for Minka, was not perceiving progress in their relationship.  Minka was bewildered by it.  But still and more so, angry.  She asked me what she needed to do to be happy and feel like what she did when life was good.  It reminded me of the man who came to Jesus and asked,

Teacher, what good thing must I do to have life forever?  (And listed off all his good deeds.)

Just as I was thinking about this, sure enough, Minka listed off her self-care efforts, angrily as if they failed to redeem her.

Turning this around in my mind, my thoughts ran over a differential – the 3 C’s, her temperament, her biology, other medical conditions, other influencing stressors and I wondered if Minka was angry in other situations as well.  (See The Biopsychosocial-How-To.)

No one really likes themselves much when they are angry.  Anger is pulled through the capillaries and passed on until it colors all of us red.  It is a confusing emotion; internally preoccupying.  Many people don’t remember chunks of their lives during which they said things and did things in anger.  It just disappeared into the white noise of the emotion.  During anger-binges, people can black-out too, much like alcohol.  Often times anger comes without invitation.  Often times, anger is not something that will leave by invitation either.

So we know already that the 3C’s apply to this kind of anger.

I didn’t cause it, I can’t control it, I can’t change and or cure it!

Minka hurriedly answered that they didn’t work for her but she had tried.  It was on her self-care list apparently.

I don’t want to blame my daughter.  I know I’m responsible for how I feel but I keep holding her responsible even though cognitively, I know she’s not.

That was pretty big.  In my opinion, she could put that on her self-care list and check it off as well.  Steller.

the

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Through further disclosure, I learned that Minka hadn’t enjoyed anything much lately – not only her daughter.  She was irritable, edgy, felt superior to others and then kicked herself over it.  Minka said she tolerated less and less of what life touched her.

I wrap those descriptors in the same nap-sack as anger and mood.  They are on the affective spectrum and for Minka, it wasn’t for lack of trying hard enough, for lack of being spiritual enough (it makes some of us uncomfortable to say this), or missing a puzzle piece from her psyche.  Minka was medically unable to put her anger aside and connect with her daughter.  Minka’s medical condition was isolating her not only from her daughter but most other bits of life touching her.  She was ill.  She wasn’t choosing those emotions.  Now came the job of helping Minka see that and go for help in the right direction.

Question:  What is your opinion about behaviors and emotions coming without being invited or chosen?   …without a “reason” for being there?  Please tell me your story.

Related Articles

Patient on Patient Crime – Our Response to Our Own Illness

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Self-Care Tip #238 – Think about your response to your own behaviors and emotions.

Bianca agreed with her husband.  She was too depressed.  She never wanted to go out and cried a lot. Perhaps she even deserved to be cheated on and abandoned because she was so unbearably dull.

Pause button.

We have discussed where behaviors and emotions come from – the brain.  We have identified the brain as human material, matter, biological and as susceptible as anywhere else on the body to illness.  In short, We could say at this point that Bianca is in a Major Depressive Disorder – a medical disease.   There are many medical diseases secondary to design, behaviors or lack of behaviors.  Or for other reasons.  However, I don’t know many medically ill that when the spouse walks out on her, we say,

Well of course!  She had cancer!

Or,

He lost his leg in a car accident, get someone else!

But throw in some aberrant emotions and behaviors for unacceptable time, and the escaping spouse is given running shoes as a gift from their concerned community.

How could he stand her!  Of course he left.  She wasn’t taking care of his needs.

You see the disparity and when written this way, it looks really ugly and I apologize.  I’m not trying to thumb people for biases and prejudice.  Both parties are hurt.  I’m also not trying to say that this happens only in marriage.  It happens in almost any setting.  Emotions and behaviors are just not considered to be symptoms of disease.

Have you ever heard the term, “Women on women crime?”  Well this is something like that.  I’m thinking much of this will improve when we treat ourselves with more insight and understanding consistent with our biopsychosocial model.  If we don’t do this first, who will.  We aren’t responsible for how others treat us, but we are responsible at least for ourselves.

This is one more wonderful way of claiming our right to say, self-care starts and ends with Me!

Questions:  How can we wrap our beliefs around this seemingly enigmous concept that when someone is crotchety, negative, irritable, inattentive or boring – it might not have been because they chose to be that way?  How do you own if in yourself?  Please tell me your story.

Where Do You Think Behavior and Emotion Come From?

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Self-Care Tip #229 – See yourself as a friend by including biology in your self-perception.

In clinic, out of the clinic, here, there, if I were to pick one barrier to treatment anywhere, I’d pick the misunderstanding that behaviors and emotions come from somewhere other than the brain, and then from there, the outcropping of understanding why.

I don’t think most of us say it in so many words, but it’s intuitive. Maybe when pressed we’d say, “Where else do they (behaviors and emotions) come from?!” And then agree, the brain. But the connection that allows for self-care is missed. The connection that allows us to choose the freedom to feel good and behave well for our own sakes is lost in the shame of failing to do those very things.   The stance of courage it takes to be our own friend when we don’t even want to be in our own company, takes a lot to maintain.

The marvelous @MarjieKnudsen, tweeted a reference to a wonderful post by Sarah Boesveld, How ‘self-compassion’ trumps ‘self-esteem’. I enjoyed reading it very much as I felt it spoke to me and my generation with great perception… except! that it was without mention of biology, the brain; i.e. where behaviors and emotions come from.

In clinic, Naomi told me about her “failure” when ever she felt anxiety come on.

Why do I feel depressed when I feel the anxiety come?

I’m wondering what you think, reader, about this simply related story and the question.

I mirrored Naomi’s question,

Why do you think you feel depressed when that happens?

Today (similar to Naomi,) girl-crush, alias Rachelle Gardner, Literary Agent, wrote about feeling like a failure as well.  She asked at the end of her post the pithy questions,

What about you? How have you failed? What kind of wisdom has helped you deal with it (i.e. sense of failure)?

And I thought, how to answer? Here I am again “in the presence” of someone wonderful who in her post didn’t make it apparent that she was considering that this emotion might be a symptom of something biological.   We are willing to look under every rock, be in the space of our emotion and ponder reasons why.  We have the courage not to “run” even when we don’t like ourselves, but haven’t said it out loud to ourselves yet,

I might feel this way because my brain is dishing it out.   I might otherwise have not done anything to set this emotion or these behaviors in motion, other than being alive.

Girl-crush remains despite response.  So readers, don’t be scared to answer what you think.   If you even care, I’ll still admire the socks off you! – even if you think you are hyper every day since conception because you ate too much sugar.

Questions (In case you want me to write them again, which I’m really happy to do – anything you want so I can hear your responses): Where do you think your behaviors and emotions come from? …such as a sense of failure and/or a depressed mood? What has helped you deal with it? Please tell me your story.

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.

Guilt Furiously Chasing You Is Commonly Experienced In Illnesses Of The Brain

Orestes Pursued by the Furies, by John Singer ...

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Self-Care Tip #221 – If you feel chased down by guilt, stop running and get friendly with yourself.

I’m so busy!  I am trying to work, raise three kids, and be a wife!  …and I’m just spread so thin!

It was new for Connie to think that where she was at in life was linked with her choices.  Somehow she intuitively felt taken along by it all, a current of life as people say, of either randomness or design.  Who could know, but it was more than her choices, she was sure, and she resented the influence on her life’s design.  Not that she had intended on taking over what was playing on her.  She just simmered in the house of cards hoping that when she got to make a play of her own, she’d make a good one and come out better for it.  In the mean time, she just had to keep moving fast.

Things would have been fine, except that over the past six months, she hadn’t been enjoying what she was living for, her kids, parenting, being a wife or her employment.  Yes, she was also  living for God but no, she wasn’t enjoying Him either.  Did she want to?  Did she feel guilty about it?

I feel guilty all the time.  It’s the guilt that gets to me.  It’s like I can’t see or feel much else.  Just when I think I’m about to get into what I’m doing, guilt comes chasing at me in a fury!  Distracting me and worrying me.  I’m on edge more and irritable from feeling defensive, and trying to get away from whatever this is.

Connie looked at me when I said,

Self-care begins and starts with “Me.”  Although we may be living for others and other things, even living for God, if we don’t take care of ourselves, our health first, our emotions and behavioral health included, we can’t give much, in the way of living, to those others.

I could see her pupils change and I got a little excited.  She was hearing something that affected her whole body and I sensed it was hope.  (See, I am an Emotions Jedi.)

We talked more about approaches she was using, prayer/meditation, exercise, grit and determination, waiting it out for better days to come and others.  Then I introduced the medical paradigm.  (You’ve heard me say it.)

Behaviors and emotions come from the brain.  We culturally think that they are volitional, under our control.  But how much can we really control of what the brain does?  Some.  But when we do the best we can with what we can control, and our behaviors and emotions are still hurting us, affecting our quality of life, damaging our relationships and connections – we need to look for biological reasons.  That’s where choice can still come into play.

She was looking and nodding.  This was at her “consideration stage” of introducing these new ideas.  I said,

I thought of telling you about this when you talked about guilt Connie because maybe your guilt is coming because of a brain illness.  It’s common in several emotional illnesses, like depression or anxiety, and in these illnesses it commonly comes in force, like you’ve described.

Her pupils had reduced to their earlier size, and her posture said she was winding down for that visit.  Whatever we discussed after that would be low yield, so we made a follow-up appointment and called it a day.

These days later, remembering Connie gets me thinking about what I would have said if she had been available to still hear more.  This bit about freedom to choose self-care, yet saying we have little to do with how our brain works can get confusing.  It might seem contradictory.  Tomorrow, I’m going to discuss it more, but for today, it would be wonderful to hear what you think.

Questions:  With behaviors and emotions coming from a material biological organ, the brain, yet knowing that we are free to choose for our self-care, what gives?  How do these ideas jive?  How have you seen it play out in your life?  Please tell me your story.

Check Your Read. Even When You Feel Shame, Bullied and Herded, You Are Free.

Eve covers herself and lowers her head in sham...

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Self-Care Tip #219 – Check your read.  Be a friend to yourself.

I’ve been reading the comments on suicide, thinking and reading and starting who knows how many posts for today, but just couldn’t pull it together.  I spent my time rather drawn to the same words that I hear so many others say as well in clinic, in church, on the street, in the home.  Instead of seeing them find their place in me like I normally do with this kind of crowd, the words kept their space; word-snobs – crutch, selfish, dependent, moral and other words, dusting and reapplying in their reflection.

I had to think, “Why?  Why am I staring like this?”  And so the rest of the day, I perused those thoughts, licked my finger, flick, next, paper-cut and so on.  After all, this is SELF-care I’m talking about, implying I am starting with me.

At last, after rereading yesterdays and past comments, I found the shame I was avoiding.  Why I feel shame about these things isn’t important in this post.  (Maybe another post.  So if you have nothing else to keep you reading, you’ll have that dish to bait you.)

Shame comes when implied or direct judgment creeps into our space.  It herds us.  We are bullied and lose our personal boundaries.  It touches and violates.  That is what shame does.  Any time our perception of freedom feels threatened, it is normal to want to defend ourselves.  Separating from stigma is a normal response.

Claiming the shame, however, isn’t forced on us.  It is our choice.  Once we own the shame, then wanting to get away from reminders of it, of course, is natural for anyone.  But jog back and see.  The perception of shame was never forced on us.  We are free.  We are free to feel, to perceive, to believe, to choose or to stop rubbernecking at the sparkling drama.

He made me so mad…!

She really hurt me.

You ruined my life!

I don’t want to take medications because my husband makes fun of me.

I take Prozac but I don’t have mental illness.  I’d be ashamed to…

It is a normal response to not want to be in the space where we feel these things.  That is natural and what many have thought worth fighting for.  But what if our perception, our Sixth Sense, wasn’t getting a good read?  A war might have been avoided.  Our lives might be lived differently.

We really are free, already, to choose.

Question:  How do you see shame affecting your ability to be friendly with yourself?  Or others?  How have different perceptions put you in a place that felt more free and safe?  Please tell me your story.

Self-Care Is About More Than “Me”

Self-Care Tip #208 – If for no other reason, get friendly with yourself simply to survive and you’ll see what that means later.

my self care reminders

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It is not unusual to think of “selfish-care” when we hear “self-care.”  I can imagine children gripping their mother’s skirts more tightly, husbands pulling their helpmate’s hands away from this influence, church-folk sniffing over rejections to service-calls or friends personalizing the way their phone doesn’t ring as much as it used to.  This is a natural response, although it is a false perception.  Think – feeling suffocated by her penance, he’s wearing a martyr’s cross or she’s giving to us from victimhood.  Those are the times we would rather not receive the gifts of time, person or anything dripping with that kind of guilt and implied debt. This kind of service comes from someone impoverished, giving on credit.

I’ve been known to say, “We can’t give what we don’t have.”  Or as Jasmine said,

You can’t give someone a ride if you’re all out of gas!

So when is self-care selfish?  To be true to what self-care is, I’d say almost never.  However, because the question comes from such an intuitive fear in any of us, “never” can’t be an entirely fair answer.  To answer it best though, we need to turn it over and go back to trying to discover why we wanted self-care first.  What brought us here?  Jacqui said it well in yesterday’s post-comments:

Ditto about ‘self-care boot camp’. I may steal that one. You’ve given me permission to be selfish if need be. It’s all about self-preservation.

Sometimes we are reduced to self-preservation.  It has an intensity to it, a survival mode of live or die, which may be appropriate to a desperate condition in life.   Many of us know what that feels like.  So in this context, self-care is in part about survival.  Alright.  But is survival a selfish need?  Are we worth that little?  Does the life in us hold value only at that level?

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You hear the clomping my words are making and can follow that I answer, no.  Survival has far reaching significance.  I matter.  You matter.  We have value beyond our own selves and Me booting up to live better also ripples over those same infinite number of connections.

I am confident that if for no other reason than getting friendly with yourself simply to survive, you will still see at least some of what more that means later.  Self-care is about more than Me.

Question:  When do you think self-care is selfish?  Why do you think self-care is not?  Please tell me your story.

Love – Take What is Already Yours. You Have Been Given Love.

Stef's Present with Handmade Wrapping

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Self-Care Tip #194 – Take what is already yours.  Be a friend to yourself.

Parenting, we hold the power in the relationship between us and our child/ren.  If we are emotionally maltreated by our child/ren, we parents are still the ones with the power.  What are we giving to her if we teach her that we will take the terrible words and dark emotions?  When we take the projected anger when we have the power to choose not to, what message are we giving to ourselves about ourselves?  What is the message if we say by our actions that Love demands from us to accept, to take and to be a victim to the emotional abuse?  Is that what love tells us?

It is difficult to receive maltreatment from anyone.  And because of the suffering involved, we can misinterpret the message, “This is the sacrifice that Love demands” – the sacrifice is doing what other people want before taking care of yourself.

It is difficult not to receive maltreatment as well.  Which choice is more consistent with our understanding of Love?  The words in the message might be the same, “This is the sacrifice that Love demands.”  However, the interpretation of the message, of what the sacrifice is – that meaning is different.  The sacrifice is, rather, taking care of yourself first so that you have the best of you to offer to others.

To read more on this topic, please see posts, Criticize if You Love MeListen to The Intention in What People Say and Stop! Before Hurting Yourself or Others.

Because we as parents hold the power in the relationship, we can feel trapped by our own power.  What a confusion for many of us.  Holding power but feeling helpless.  Holding a stick in both hands, so to speak, not seeing that we can still use our occupied hands for anything else in the mean time.

This kind of choice takes Love.  This is the kind of choice that is a work of a life-time or of a moment, but is life.  See, Let It Go and Keep Going.

We can’t teach others that we are valuable and how to treat us with Love if we don’t do it ourselves for ourselves.  When we act on Love, self-care means that we don’t accept treatment that is inconsistent with Love.  If we accept bad treatment, we are saying that self-care is accepting our lack of choices versus making the choices that are still available despite the circumstance.

FriendShip... A gift of God.

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This of course applies to any relationship.  It applies to any connection, whether it is in the work-place, marriage, if you are the child in the parent-child role, friendships – take your pick.  You can choose Love.  You can choose.  Self-care starts and ends with “Me.”

Freedom is a gift.  No matter how many times it is wrapped up and placed in our hands, if we don’t open it, use it, own it, we will never have it.  Freedom to choose has been given to us before we were born, just like our salvation.  The salvation will never be taken away.  Nor the freedom.  Both are elemental and constant.  But if we don’t pull on the ribbon, lift the lid and take – we can’t expect anything but living without what was inside.  Does the title “victim” even hold if it was our choice not to take what was already ours?

Question:  How do you claim your freedom to choose when all you perceive at the time is what has been taken away?  Please tell me your story.

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.

Work Hard to Take Care of Yourself If You Want An Easier Time Taking Care Of Others

Self-Care Tip #174 – Work hard to take care of yourself if you want an easier time taking care of others.

My marriage has never been better.

Freedom Press (UK)

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Kirsten had good posture.  She made eye contact and she wasn’t fidgeting when she told me about the changes in her life.  I hadn’t seen her in clinic for two years and apparently in that time she had set her husband free.  She was seeing less of him than she ever had and they were both busier than any other time in their lives.  Yet their marriage was at its peak.  I felt like I was getting off the point of why she came and wondered if asking her for details was unprofessional.  I did want to know.  Lucky for me, she wanted to tell and I just let it happen, as if I was doing her a favor.

I admit, sometimes I get something out of my clinicals.  I’m not always the best therapist.  I don’t always keep things about my patient when I let myself receive, or even actively take from them.  None of us are that altruistic.  Therapy is supposed to be one place any of us can go, and know that when we go, we can expect to receive everything except the fee-for-service.  Therapy should be the closest thing to a one way street in this non-altruistic world.

To my rescue, Kirsten said,

He has been meeting with friends, exercising, eating out and working the 12-Steps twice a week.

Yes he was sober, but he was also a bunch of other stuff.  Taking care of himself, he became a better husband.  Better body, clearer mind, happier, more attentive, less angry; she could hardly stop listing.

Freedom is useless....

Taking care of himself took a lot of work but it made taking care of her a lot less work.  True, she wasn’t the center of his life, she gave up on some fantasies, she didn’t ask him for more time, but all those in the past had only grown her own point of anger and blame and not the marriage dreams she thought they would – letting them go was a good thing.  Yet, cutting him free still felt risky to her.  She came to me because she was becoming more aware of what that fear was doing.  When she was afraid, she was sabotaging herself.  Bits of herself recognized that she could feel as free as her husband did.

To be free of fear for Kirsten, she needed medical help.  Kirsten’s fear came from nowhere, out of the blue and was not only triggered by suspicions about her husband.  To be free for Kirsten’s husband required other forms of self-care.

Question:  What kind of self-care does your freedom need?  How has your hard work on your own self-care spilled over into less work to care for others?

When You Can’t Control This, Emote Empathically

Self-Care Tip #172 – When you can’t control this, emote empathically.  Be a friend to yourself.

A couple of days ago I wrote about being transparent with ourselves and others when we are not in control of things.  (Say, “I Can’t Control This” When You Can’t.)

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It got mixed responses but all worth thinking about.

Jennifer responded on Facebook,

The 3 C’s help me all the time; I didn’t cause it, I can’t control it, I can’t change and or cure it!

Isn’t that wonderful?!

  1. Cause
  2. Control
  3. Change

And it’s helpful to remember that claiming these 3C’s still may not remove us from the stressor.  We are however more present with ourselves and others despite the stressor.

Another reader BeeBlu’s, brought up that famous “fine line,”

I agree that it’s healthy to have this attitude to certain things in our lives, but as you say, it is also no excuse for bad behaviour and letting emotions go into free fall at the expense of others. I think there is a very fine line between the two. bb

…And her signature, “bb,” – awesome.

A line that is thin implies insecurity, danger and something precarious that may end up all wrong.  I wonder about that line.

On one side we have the 3 C’s:  cause, control, change.  On the other side of the line we have responsibility for the boundaries of others.  I wonder if there really is a dividing line after all or if it is just bad lighting.  If there wasn’t, there would be no need to thicken the line, to defend, or to pick sides.

Emotional health makes shadowy lines disappear.  It takes someone who has emotional health to be able to say their 3 C’s and still consider the internal and external milieu of others.  It takes someone who has done their self-care and put money in the bank; someone who has reserve built up that spills over into empathy.  We can’t emote empathically so well when we aren’t emotionally healthy.  The less of that, the more real the line becomes.  The less of that, the more precarious we are.

Gaining emotional health may take medication, exercise, sunlight, granola, grandma’s kisses and all sorts of things.  Each of us has to figure it out for our own selves and just do it.

Questions:  What do you think about this business of shadows, lines, and living cautiously?  When you have been healthiest, how have you been able to embrace both the 3 C’s and emote empathically at the same time?  Please tell me your story.

Tell People When You Fall

It's no laughing matter ladies... Monthly brea...

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Self-Care Tip #171 – Tell people when you fall.

Driving today, I was slowed by a driver ahead of me.  I started to get irritated, (I know, “I can’t control this“), but then I noticed the car had bumper stickers supporting breast cancer.  In less than a moment my mind grabbed memories of faces, feelings, conversations, stories and personal experiences in my memory relating to breast cancer and I suddenly felt a sense of empathy and some sadness.  It left me a bit surprised and I reminded myself I was irritated at this driver.  While trying to tease apart these seemingly opposing reactions, I realized I didn’t care much any more about the slowness.  Mainly I wondered how there was breast cancer connected and I cared.

Providentially, Erin posted today on her blog-site, Healthy, Unwealthy, and Becoming Wise,

Falling finds friends.

I remembered the driver and you readers and thought, “It sure does.  Especially when we let others know.

My Ecuadorian sister, Joana Johnson, often tells me one of the biggest contrasts she see’s between our cultures,

connection.

I spent some time in Ecuador doing some clinical work and learning more Spanish between my second and third year of medical school.  I was rarely alone, which frankly creeped me out a little.  Being westernized, I was used to a huge amount of independence and anonymity.  I wonder who I would be if I had grown up knowing someone was always involved in my life.

You might have heard the proverb asking,

If a tree falls in the forest and no one is around to hear it, does it make a sound?

Or,

Water, water everywhere and nothing to drink.

I don’t want to be surrounded but not witnessed, connected or heard.

Telling people about our “falls,” cancer, depression, assault or what not, can feel creepy too, just like I felt loosing some of my anonymity in Ecuador.  However, I now tell myself, “It’s just culture and I can grow.  And I want to.”  Culturally in the “West,” we think of telling about our falls as whining.  That’s a misperception however and a disservice to all of us.  Telling people when we fall is not whining.  The act of telling and the act of whining aren’t contiguous unless we design them to be.

This morning when I saw those bumper stickers, it brought me into the drivers life and connected us.  We are both a little less alone than we were.  These last six months for me have been about taking down boundaries in my well defended life, and I am growing into the difference.  Thank you readers and commenters for that.

Questions:  What has telling others about your “falls” done for you?  How has your culture influenced you in finding friends?  Please tell me your story.

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.

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.

Choose Self-Care At Your Most Elemental Level

Buchenwald-100625-14486-Schwerte-hell

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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.

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.

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

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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.

Connection: It’s Medical But Still Magical

XO with Internet connection, Khairat (India)

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Self-Care Tip #157 – Don’t depend on yourself to find connection.

We are people of a greater ability to bond than our senses, emotions, intuition, reason or technology can account for.  Our connection to each other and to God supersedes our belief in connection.  In this discussion, I am looking at “connection” beyond the paradigm of our perceptions.  Although connection between me and you is all about me and you, our bond also transcends either of us.

Meet gorgeous Candy.  She refuses any medications that might change her appearance in any way, ie. increase her appetite.  She would rather freeze in a catatonic state and die thin than gain weight.  She has come to me after years of struggling with irritability, anger, depression and anxiety.  She has never seen a psychiatrist although these emotions have misshapen her relationships, crippled her parenting skills, and removed her from her community of friends and one marriage.  Her medical condition continues to threaten Candy’s connection with her own self.  It continues to threaten her connections with her now teenage children and her second marriage.  Candy tells me that she doesn’t feel anything for her husband.  When she says this, she looks at me expectantly, as if she just released a big revelation.

When people are initiating treatment, I try not to get into anything personal too much.  Although I gather their personal history, I don’t give much feedback.  I try not to discuss their desire to make sense of all their conflicting feelings.  Sometimes they ask me questions, advice, directives and that’s natural.  However, it would be misguided to answer those questions, because we can’t let our emotions guide us.  I tell them,

Let’s revisit these questions after the treatment has time to take effect and you feel more like yourself.

It’s medical but still magical.  In four to eight weeks, they often hardly remember the questions they had.  The negativity is just a haze in their past.  The resilience comes with emotional health and copes with the simple stressors that used to sever interpersonal emotional ties.

Candy was one of the lucky ones who found the magic.  She felt self-trust more than she had felt her entire life.  Feeling safe with your own self is wonderful.  Much of the population who has not been where Candy has been can’t say the kind of thank you that Candy can.  They don’t know what it means to be lost and then found in this way.  Candy has something very special.

Yet when we think of Candy’s sense of connection, we also look beyond the biology of it.  I did spend some time describing how biology can change our perception of connection, but I didn’t do it to explain how connections are formed.  I described it more to demonstrate that we cannot depend on ourselves to define connections.

Don’t stumble on the philosophies around adjustment issues and conditioning.  Connection with others exists regardless of our fortune in family, money, treatment or maltreatment, biology, and self.  We are connected because there is a force of connection created and present in all of nature, regardless.

Madeleine L’Engle, wrote in “A Stone for a Pillow,”

Perhaps what we are called to do may not seem like much, but the butterfly is a small creature to affect galaxies thousands of light years away.

Our connections are there regardless of where we are at in life.  I would even take it further to say that connections to us even survive the cutting blow from death.

Connection is an eternal truth.  It makes a difference to us just to know that, but even if we didn’t, it doesn’t change our connection.

Question:  How do you make sense of your changing perception of connections in your life?  Please tell me your story.