emotional illness

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“He’s Never Hit Me.” Abuse.

Self-Care Tip #163 – Name abuse when it is there.  Be a friend to yourself.

Alexandria (Alex) was crying a lot.  She was trying to divorce her husband but he wouldn’t leave.  He wouldn’t speak.  He only yelled.  He yelled at her, alone, in front of their kids, in the morning, when he came home from work, he yelled.  And he never spoke to her any more.  It’s been weeks since they spoke.  When I asked her if she thought she was abused, she said, “No.  He’s never hit me.”

Mar de Emociones / Emotional Landscapes

What do I do?  I can’t go on like this but everything I try, he won’t listen!

There are so many things many of us would tell Alex.  But would any of it make sense if she didn’t know she had rights?  If she didn’t know what was happening to her?  If she didn’t know, this is abuse.

The “Do You?” questions, per Dr. Quijada, to ask yourself if you aren’t sure if you are abused:

Do you feel good about yourself when you are together?

Do you feel scared?

Do you feel like you have choices?

Do you have effective boundaries; observed boundaries?

Do you say, “No,” and are heard?

Do you have a balance of power?

From the outside looking in, we could answer these questions for Alex.  But anyone who is or has been abused in any way knows that from the inside, answering these questions is hard.  It was hard for Alex.

Alex missed a few beats.  She didn’t want to see herself as abused.

Identifying abuse, naming it, is a start towards the other side of things.  It is reaching the peak of a hill or mountain of life-stuff, taking the view in after the fog lifts, and knowing that things are the way they are.  This is abuse.  A tangible thing.  Not the drifting mist of fights or arguments that once stalked you, leaving you bewildered and empty-handed.  Simply naming abuse is the start of empowerment.  Name it.  Name it out loud.

“I am abused.”

Alex said,

Wow.  I didn’t know that what he is doing is abuse.  I didn’t know.

After we talked about the name of what she was suffering, she talked about what she thought she could do about it, such as:

Call 911 if she feels unsafe.

Record him.

Say the words out loud, “I am valuable and should be treated well.”

Get a restraining order.

…And other things.

Alex didn’t have a lot of extended family support, so for her, that was out.

Alex said,

I feel more empowered.  I didn’t know I could do that.

And there it was.  A dandelion growing out of the cracked cement.  Hope.  A redistribution of the unequal power.  Alex was growing a plan.

Question:  What would you tell Alex, yourself, or anyone else in her position?  How do you see words being a form of abuse or not?  Please tell me your story.

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

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

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

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

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

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

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

Go low and slow.

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

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

Yes April!

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

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

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

Yes April!

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

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Keep Talking

Day 349 of 365 - Self Care/Friends!

Self-Care Tip #160 – Keep talking.  Be a friend to yourself.

Lingering in the afterglow of what all of you have said in your comments over that past six months, I am distracted in the best of ways.  The comments so often complete the post.  We are a team you know.  I hope that more of you noncommenters will shuck off your shrouded lovely selves and say something to us.  Because it is not true on this blog, that casting your bread upon the water just makes soggy bread.  Nope.  You’ve all been my living examples of this.

Yesterday, Nancy wrote,

“But to associate self-care with freedom actually made me feel free today….”

I could have cried because… I just can’t say all the many reasons why she blew me away with that.  I don’t have enough fingers to point with.

Sarah,

the civil war inside of us.

Mr. Rick C. in his Blog-Jacking #2,

Folks, you have not experienced incomprehensible demoralization until you have had a Flowbee lock onto your head with the full force of a ShopVac behind it.

That one just won’t stop coming back!  The visual itself is an almost permanent gift.

Kevin Blumer keeping things light talking about stress,

I love stress I absolutely love it being busy 10 pizzas to make in 2 mins…

Some days ago, Pattyann wrote,

I think it is much easier to ask for help and receive it when we stop looking at an illness as a personal failure.

Is there any better way of saying that?

Our own articulate CarlDAugostino who shows so much interest and respect to so many of us gave me this,

I have never really heard of this “self -friendship journey” It is a wonderful concept…

Yes, you show me that I matter and that I am not alone and that it turns out, …taking care of myself has been a pretty good idea after all.  You show me that it starts (goes across a few oceans and continents) and ends with “Me.”   Thank you, all of you for that.  There are soooo many things you’ve said, (you know who you are) that have totally rocked me.   Keep talking.

Question:  What shows you that it starts and ends with you?  Please tell me your story.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Please Don’t Say “But”

Christopher Robin in his Disney depiction.

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Self-Care Tip #152 –  Please don’t say “but” to be a friend to yourself.

She wanted to explain why.  Her sons did not hear.  So she explained why to me.  I listened.  What I learned was…

…It is her choice.  Forget about explaining her “why.”  She knows that they can only hear themselves.  If she wants to be in their lives, she has to be with whom they are in this moment, trumpeting her failures, bemoaning their losses.  If she wants to be with them she’ll meet them there in the gutter and remember their value when she smells stench.

If you’re going to be with the sick, you can’t expect them to mop your brow with tender caresses.  Remember yourself.  If you want to be with your sons, than be where they are, apparently breathing fire and your name is the flame.  Still want to be with them?  Don’t explain why then.  Just be with them, like Christopher Robin when Poo was stuck in the tree trunk.  Just stand there until they can get out and be.  Being present.

If you say “but” it means you didn’t hear. “I’m sorry but,” is not saying I’m sorry. “Yes but,” is worse than many more obvious offenses. See the eyes roll? Hear the sighs?  Watch the words fall apart into letters that pile up like a wall in front of whatever it was that was said in the 1st place.

In some such scenarios it can be a first come first serve. Wait your turn to complain. Wait your turn to present your case.  If you didn’t get there first, listen.  And let the air fill up with all the things that someone wanted to say, and don’t open windows.  Just breath.  Just stay and breath and listen to them if you choose to.  If you choose to be a part of that person, where they are now, stay and be and breath.  Another time if and when they can be with you, you can explain the why.  Maybe they will never be able to give you that gift.  But are they worth it to you?

For her, she decides moment by moment.  You can’t give what you don’t have and sometimes she has what it takes to give that gift and sometimes she does not.  When she doesn’t, she isn’t standing beside their bodies stuck in a tree hole.   She’s off taking care of herself like she should be.  They’re still worth it to her.  And in her story, when she’s gone from them it doesn’t equal her abandoning them.  It means she can’t give just then.

For others, being gone may mean that it is not worth it.  That is fair.  It is a free choice to give a gift.  Gifts are free.  Listen or walk away. …But please don’t say “but.” No one will hear you.

And staying present doesn’t mean more than just that.  It doesn’t make you guilty by association.  It doesn’t give you a “go to jail” card.  If you don’t judge yourself that is.  Wow.  What a gift.  Standing present with the one you love.  Even when they are not being nice.  Even when they are not healthy-minded and say all manner of evil against you, still stand beside them, a witness to their value.

Nor does being present turn you into a noodle.  For pity’s sake, it means only what it means to you.  There is love.  And love is stronger than anything. …But please don’t say “but.”  No one will hear you no matter how much you love him.

And that is what this aching heart-mother taught me about presence.

Question:  How has avoiding the “but” in your dialogue affected the reception of what you’ve said?  Or vice-a-versa?
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Your Personal Fight For Emotional Freedom

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

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

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

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

Let There Be Peace on Earth, by Gill Vince

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

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

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

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

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

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There is Less Space Between Emotions And Science Than We Think

The supermassive black holes are all that rema...

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Self-Care Tip #147 – Bridge the gap between emotions and science.  Be a friend to yourself.

She had been through a lot – Aimee.  Lost her baby brother to medical disease.  Was in a stressful marriage and didn’t like her work.  There was more but you get the drift.  She found herself thinking that things would be different if things had been different.

Would they?

Readers, I am referring specifically to her medical condition.  Not to the fact that the universe is different because her brother died.

Madeleine L’Engle talked about death affecting the whole universe.  She compared it to the death of a star.  In death, the star creates a hole in space dark and large, enough so that the absence of it has its own gravitational force, a “black hole.”  L’Engle says that when any part of creation dies, we are all touched.  Life knows and the absence of that bit of creation leaves the surviving universe changed forever.

Aimee wasn’t talking about that.  Aimee thought her emotional illness was largely secondary to her life stressors.  Because this influenced Aimee’s choices regarding her medical treatment, I had to tell her no.  Gently.  It was hard for her to hear.  “Aimee, your sadness you feel now, four years after your brother’s death, your isolation and amotivation, your low sex drive, your difficulty feeling pleasure in other things, your sleepiness during the day – these things are not because you have suffered your brother’s death, nor because your marriage is hard.”

There are times when directly saying things is the more gentle approach.  No one going through what Aimee is going through wants to hear about how I feel about it.  Yuck.  There’s not much that is slimier than going to someone for objective feedback and getting their emotions and personal opinions all over you.

Aimee left saying she understood and with a new medical treatment for the medical illness propagating emotional and behavioral symptoms in her.  We’ll see if she did some days from now.  But what about you?  Do you believe that her emotions and behaviors were secondary to medical illness?

Readers, life stress will continue to happen.  What may change is how we respond to it.  If our response does change and it isn’t serving us or others well we need to think that we might not be interpreting how we feel objectively.  We might be having changes to our biology that “taste like chicken.”  It helps to get a physician’s opinion – someone who sees behavior as more than the spirit, the abstract, the puppet of our volition.

Question:  How do you bridge the seemingly abysmal distance between emotions and science?  Please tell me your story.

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The Presence of Stress Doesn’t Make the Disease Process Any Less Important

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Self-Care Tip #135 – If it’s medical, call it medical and not stress.  Be a friend to yourself.

New to me, Stacy came because of her problems with violence.  She was enormous.  5’11” and 200 pounds, she was just too big for her parents to handle her any more.  She was precious to them, their only child.

Taking Stacy’s history, I asked, “Does your family have a religion you practice at home?”  Stacy’s parents were giving her history since Stacy was disabled and used very few words.  Mom looked at me, and asked, “Why?  Why are you asking about our religion?”  She was sensitive.  Worried that I was packaging her up in a religion-box, she personalized my question.  I explained that religion is part of family culture and the question was simply part of getting to know them.  She relaxed a little and then said, “We have more of an ‘Autism’ home-culture these days!”

Mom looked tired although still very much engaged in her daughter’s life.

It often happens, when someone see’s me in clinic for the first time, that my questions take them by surprise.  They aren’t used to someone so directly and objectively asking and speaking about them and to them.  So it went with Stacy’s mom.  Question after question, she seemed to be in a mild state of wonder.  It wasn’t gun fire but she might have felt like it was.

“Does anyone in your family have emotional illness?  Any depression, anxiety, suicide, drugs, alcohol…?”  Why do I want to know about the family? her face said.  “No!  No one.”  I was just ready to move on to further history when she said, “Well I… I have been depressed a little on and off but I don’t have depression.  Who wouldn’t feel depressed with this stress?!”  And then Stacy’s case manager said, “Who wouldn’t feel stressed in your situation?!” and smiled and laughed with her to put her at ease.  Stacy’s case manager is a nice person.  She is bonded to the family and cares about each of them.

We completed our history and formulated a treatment plan together.  Stacy had sat mostly quietly through the hour and her parents were now at ease.  Before they left, I was able to share with Mom a couple of sentences on taking care of herself.  On seeing herself as important and in doing so, was giving Stacy the best gift she could.

What I would like to say to Stacy’s mom and to her case manager is that thinking depression is because of stressors is a great lie.  There might be some initial correlation but it is often not the point .  The real issue is medical.  I wanted to tell Stacy’s case manager that she should know better than to promote this.  I wanted to tell Stacy’s case manager that helping Stacy’s mom not minimize what she was going through was friendlier.

Stacy’s mom is not my patient, but I did pick up that she is sad, fatigued, personalizes things that aren’t about her, anxious, a little hypervigilent and suspicious, and that something biological was likely going on.  Everyone has stress, but not everyone reacts the same way.  Some of us get ill for biological reasons.  Using the stressors as decoy to the disease only preserves the state of suffering.  And it affects everyone.  Mom was part of Stacy’s recovery too.

Question:  How do you see the relationship between stress and mental illness?  Please tell me your story.

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Forget About Divisions In Knowledge.

The World Is Flat

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

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

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

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

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

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

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

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

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

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

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Your Life. Your Choice. Why Are You Still Negotiating?

 

 

Self-Care Tip #102 – Take what is yours and live.  Be a friend to yourself.

Cheri came, still dressed in work scrubs, with her 2 daughters, 8 years old and 3 years old.  Having finished their dinner date, they were swinging by for her appointment before going home.  Cheri told her kids, “Get out now and go sit in the lobby!  If you don’t listen to me I’ll….”  Turning to me, she said, “It’s never enough!  I just took them to dinner and they do this to me!  No matter what I do…!”

1.  Cheri tells me she’d like to cope better with simple stressors such as redirecting her kids

2.  We talk at length about her perception of her kids abusing her.

Cheri is married.  Her husband laughs at her for “…having to take those drugs to be normal!”  “…But he just sleeps his problems away.  He doesn’t deal with them like I do.  He has no idea!”

3.  We talk more about her perception that her husband is responsible for her place in life.

Cheri believes if she doesn’t take more than 2 pills a day, she is less “dependent” on drugs.  She says, “I don’t want to go on like this!”  Her tears continue talking when her voice stops.  She is ashamed.

4.  The concepts supporting taking care of yourself as being the kick-off point to caring for anyone else comes up.

5.  We talk some more about who is “The Why” for what we do or don’t do.

Cheri feels less shame, but it’s still there.  She is willing to give a new medication a try but clearly doesn’t buy it all yet.  She’s going home with her girls to her husband with new pills.  And hope?  Yes.  It is all connected.  It all pulses together and is a living negotiation of sorts.

Disease <–> behavioral/emotional negative symptoms <–> victim role <–> self-neglect <–> greater crisis <–> seeking help <–> responsible self-care <–>  healing <–> fewer behavioral/emotional negative symptoms <–> emotional abuse from husband may continue but is no longer seen as responsible for personal choices and self-care <–> less shame <–> further healing and so on….  (Lub-dub…Lub-dub…)

 

hbofamily.com

 

Cheri is still negotiating her deal in life.  She doesn’t realize that it’s already hers for the taking.  Her life.  Her choice.

The deal is already made.  Take it or leave it.  Your life to live.

Question:  How are your negotiations?  Do you see them as still in progress or settled.  Please tell me your story.

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Don’t Forget Your Friends Chose You Too

 

 

Ok folks.  Not much time to write tonight.  My girly girlfriend is moving out-of-state and we’re off soon on something of a Ta-Ta! date.  Why in the world do I feel rejected?!  If I were French I might think it was the language of the heart.  But I’m not French so I can’t say what they’d say.

Friendship requires ongoing navigation through life.  You can’t ever just sit back and expect safe waters.  The close pals go far away and although they’ll always be friends, here we find ourselves, beached and sifting sand.  Finding gold is thought to be infrequent I think when sifting sand.

Today my daughter told me her classmate’s father lost his job.  Big ouch.  She told me, “Mommy, I wish money covered the streets everywhere so no one would ever not have enough.”  She hasn’t entirely learned what gives value to the dollar.  Friendship is like that.  Valuable and uncommon.

My friend told me once that I chose her and she chose me.  It’s awesome to be chosen!

So I’m off to rub my coins together and be with my friend.  She is a treasure.

Self-Care Tip #90 – Don’t forget that your friends chose you too.  Be a friend to yourself.

Questions:  Have you noticed that you’ve been chosen too?  Please tell me your story.

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Rebel Against Your Own Intuition

Cover of "You've Got Mail"

Cover of Youve Got Mail

Self-Care Tip #87 – Be a rebel towards your own intuition.

My husband was telling me about how consumers are demanding a more human approach to industry.

In the 1990’s the film written and directed by Nora Ephron, You’ve Got Mail, showed us how the small personal touch was muscled out of business by the book-superstore.  Today, my husband told me that the inverse is happening now because technology allows it to.  Counterintuitive to thinking, the very thing that took out the mom-and-pop store is the very thing that is bringing it back.

Author of the blog CreatingBrains, Joana Johnson, wrote a post, “Is Barnes & Noble Changing for the Worse?”  She describes their palliative efforts to feel their way through the current changes in the book sale market.  Clearly, buyers and readers are wanting something different from the superstore ambiance again.

Readers have written in to me about their demands for a more human approach to their own selves.  Here are 2 recent examples.

My mother always said that it was selfish to attend to your own needs when you were a wife and mother.  I’m happy to see a Christian woman refute that so eloquently.

I have been recovering from a complete emotional breakdown for 16 years and… the hardest thing I have had to convince myself to do for nearly 70 years now is learn to be a friend to myself.

These women are rebels in their own way and time.  I’m not a sociologist but I see these changes influenced also by technology and information.  It’s not so easy to stay barefoot and pregnant these days even if you wanted to.  “All things bright and beautiful” beckon to us.  Nor is it quite as easy to fool ourselves into believing that we’ll be able to take care of anyone – children, work, rescue dogs – if we haven’t taken care of ourselves first.  And although we still try to all the time, we just can’t believe any more that we can give what we don’t have.  Our current upside down economy is also testimony to that.

I wrote a blog post some time ago titled “A Woman’s Work,” that largely speaks to this as well.  Because of many contributors, including temperament and conditioning, in many of us self-care is not intuitive.  It is disruptive.  Taking care of ourselves is even a bit scandalous …but it is more humane and it is possible.

Self-Care Tip #87 – Be a rebel towards your own intuition.  Be a friend to yourself.

Question:  What barriers are you passing to care for yourself?  What is making it possible?  Please tell me your story.

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Why Are You Walking The Road Alone?

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

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

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

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

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

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

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

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

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Get Gangster on Your Shame

 

Photo by Wesker

 

Shame.  Ah what a cloaked villain!  In this post I’m going to tell you about why shame is not an enemy you want to ignore.

“Michael Corleone” in The Godfather Part II was not the 1st to say it, but maybe was the first to make the quote famous

Keep your friends close and your enemies closer.

Not many people would at first think that keeping shame close might be a good thing, but I’m here to tell you that it is.

Meet Bill the highway patrol.  He’s been seeing me for melancholic depression.  Sometimes he feels a little better, but those times even still are not so great.  Bill has told me about where he thought his anxiety and fear came from.  His story made sense to him.  This wouldn’t be too much of a problem except that he thought about it often.  Very often.  He was running in sprints away from it.  Somehow after all the time he’d spent reluctantly in the presence of his fears, he hadn’t realized that shame was connected.  Shame of being treated the way he had been.  Shame of being misused.  He hadn’t faced his fears because he was always angled away from his thoughts of shame.

If we don’t go where the shame is, we won’t be free from its effect on us.  Fear is a big bad bully.  Until you turn around and say stop, you’ll be running for a long time.

 

 

We all need to be a bit “gangsta” at times.  Ignoring shame is not.  It’s not emotion-street smart.  I’m waiting for Bill to think, “What’s the worst thing that could happen?”  And sit in the feelings that come with those thoughts long enough to realize that he’s still ok.

In obsessive compulsive disorder, there is a psychotherapy treatment called “exposure and response prevention.”  In this treatment, the person with the ego-dystonic fear exposes themselves to their fear for a progressive amount of time.  They realize that after going where the fear is over and over and materially seeing that nothing bad happens, the fear looses more and more control over them.

This is effective in any anxiety condition, including shame.

Self-Care Tip #83 – Get gangster on your shame.  Be a friend to yourself.

Question:  Has shame bullied you?  Please tell me your story.

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Your Heroic Self – Waiting For Normal

Self-Care Tip #82 – Have courage to go for what is lovely to you in life.  Be a friend to yourself.

Pretty, blond, about 5’6″, slender, in her 30’s, mother and wife, no funny shapes or movements but Britt still asked me, “Am I normal?”  It takes guts to ask someone that.

I just finished this heart-squeezing book, “Waiting For Normal,” by Leslie Connor.  (Yes!  I finally read a book!  It took me 5 times as long but it was no less pleasurable.)  Connor tells us about pre-teen Addie who grew up on the waves of her bipolar mom’s chaos, salvaging bits of wreckage along the way to survive.  Addie is the life-preserver her mom uses for life.  Addie’s own buoy through it all is her hope of one day finding normalcy.  She uses all her smarts to avoid the thrust her mom’s messes force on her.  It requires her full attention.  Addie must have looked pressed for something because her Mom finally asked her

What’s so special?  What are you chasing after?!

Addie was fisting optimism when she answered

I’m not chasing after anything.  I’m waiting.  Waiting for normal.

Later Addie explains to her mom

Normal is when you know what’s gonna happen next.  Not exactly what because probably nobody gets that.  But normal is being able to count on certain things.  Good things.  And it’s having everyone together – just because they belong that way.

My son used to have shaggy hair with curls that flew at the world around him.  He came home the other day and told me he wanted it short.  I finally figured out that because none of the other boys in his class had longer hair, neither should he.  He showed me pictures of what his hair should look like.  The whole process was too cute.

We are all looking for normal.

Putting aside defining normal, for now I am content to just contemplate the largeness of the effort to find it.  The journey, the process, the coming into such a thing reveals the beauty in one’s character and essence.  It is that, rather than the “hair-cut” that makes me say, “Wow!”

When Britt, my patient, strove towards her health and normalcy, her intent in context was lovely.  She seemed to me, in those moments we shared together, as one of the great heroes of our day.  A woman of courage.

Self-Care Tip #82 – Have courage to go for what is lovely to you in life and appreciate the beauty in your heroic self.  Be a friend to yourself.

Question:  Have you struggled with the question, “Am I normal?”  Please tell me your story.

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Connect With Others to Get Friendly With Yourself

Self-Care Tip #81 – Connect with others.  Be a friend to yourself.

So you have bought into the famous, “You are not alone” stock.  After 2 months on psychotropics (medications for emotional illness,) you finally have an interest in people.  You are at least a little motivated and less afraid of things that move.  You don’t feel like you are the reason for original sin and more often than not, you think happiness might be more than what shopping can offer.  What is this strange and unfamiliar sensation?  And what to do with it?

It is time to connect.  Many of us get to the point where we no longer want to hide, we don’t hate ourselves, and we don’t hate others.  We get to the place of showing our under-belly just a little to the big wide world and are shocked that the only thing we feel is the wind as everyone is rushing by!  Just when we start wanting what we spent so much time hiding from, we seem to have forgotten how to connect with others.

It is no secret.  America is culturally impoverished.  We have little of cobblestone streets to meander down, dressed in clean clothes after a days work, checking up on neighbors and gossip.  We have few degrees of activity between full throttle and dead/no heart beat.   Come now!  How to connect in a world where our parents expected us to pay rent when we turned 18years old?

If you find yourself in something of this situation try on one of these basic tools and see what fits.  You can’t expect them all to.  So if you strike out a few times, keep on!

1.  Volunteer – for example, and in no particular order…

2.  Meetup.com – an awesome site to find people interested in what you are interested in.  e.g. book clubs, skiing, small business, Italian

3.  Support groups

4.  Write!  Although this at first thought may appear isolating, it is not necessarily.

  • Blog!  🙂
  • Journal

5.  Toastmasters

There is so much more.  Please let me know your thoughts and I’ll keep adding to this list!

Self-Care Tip #81 – Connect with others.  Be a friend to yourself.

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Be Empathic to Others to Get Friendly With Yourself

 

Drawn by early 20th-century commercial cat ill...

Image via Wikipedia

 

Self-Care tip #79 – Be empathic to others.  Be a friend to yourself.

Yesterday I wrote about considering intent and context when comparing self-care with selfishness.  That carries over to the people sharing life with those of us who have mental illness.  Do they see us as selfish?  For example, how is the spouse of the Panic Disorder going to make sense of the 40 phone-calls he gets while at work?

Mary’s husband told me that she’s been calling him “all day,” terrified she was going to die.  Checking to see when he was coming home.  She couldn’t go to the market because people would laugh at her.  Afraid.  Afraid.  Just plain afraid.  Really, everything had become about her.  She was like a scared kid.  Frankly it was annoying.  He was in a stressful work situation with the economy slumping.  People he knew were being laid off.  The other day he had to leave in the middle of an important job to go home and reassure her.  She was sobbing in the living room.  Sure she was going crazy.  He realized that he might have to tell his boss what was going on but what was going on?!  Who had his wife turned into.

In yesterday’s blog, we spoke about the ability to abstract v. concrete thinking.  Being able to abstract helps with empathy – connecting emotional content between people.  To put yourself in someone else’s shoes, as if you were them.  This is a critical part of relating, i.e. being in a relationship.  Many different mind illnesses affect our ability to abstract, including panic disorder.

In Mary’s case, she was not empathic when she was anxious.  She was thinking about herself.  Understandably, if you read the part about her believing she was going to die or go crazy.  But when you’re married to her, empathizing with her gets old.  It’s not so easy when it seeps into your work life, you haven’t had sex for months, and you have to do everything that has anything to do with going outside of the home.  Some part of you knows it’s not true, but another part of you screams, “Get over it you selfish child!”

Is Mary selfish?  Some might be able to answer even after all the phone-calls and unrecognizable behaviors, no.  Mary is not selfish.  They can do this specifically because they can abstract.  They can empathize.  They can consider the context of Mary’s disease and the intent of her behaviors.

Not everyone does this.  Not everyone is able to let “It” be about someone else.  Not everyone doesn’t have to have “It” be about them.

The best thing for those in relationships with someone emotionally ill, is to view the way they are behaving as biological.  When treated medically, than Mary or whoever it is in your life can do their own self-care.  But until then, staying in their lives requires maintaining an empathic view that considers intent and context.  It also means furthermore, doing your own self-care individually.

There are over-lapping flaps to our lives.  Scales on the back of an armadillo.  Me as encased by my body.  Me, that includes the space between me and you.  Me, that includes you, because you will always be a part of me.  Self-care really involves all that by degrees.  A chain-link.

So the question is, can empathy be chosen?  With money in the bank and wisdom, yes.

Self-Care tip #79 – Be empathic to others.  Be a friend to yourself.

Question:  Does any of this ring true for you?  Please tell me your story.