mental illness

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Bring Your Separate Selves Together – Personal Journey

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Self-Care Tip #199 – Bring together what you are naturally inclined to do with what you spend your energies on.

When we do what we like to do, what is congruent with our hard-wiring, what is naturally inspiring, fatigue becomes part of our pleasure in my life.  Cliché,

Enjoy the burn,

…is common for a reason.  There are times when pain, fatigue, difficulty and hard-surfaced days are bits of what make life journey one of richness, rather than diminished.  I was reminded by Jaclyn Rae’s Blog-post today, that when we can say,

I’ve learned that I’m tired but still want to do what I do,

…we are paddling the same river our life is floating down.  When we by mental illness, misfortune, choice or neglect, don’t – we are more observant of our lives rather than participants to them.  We find being present in the process difficult.  It’s not something everyone can do in all aspects.

However, we don’t have to be defined by those particulars, choosing instead to do the hard work of processing our choices, our energy and where it comes from, our emotions and see how they weave into our constitution.  Then, some time when breathing hard, limping and spent, we will remember this and reconnect the experience with the choice and the emotion a little quicker.  We will less often separate from the water our life is traveling.  Not become observers but participate more often, more actively, more tangibly with that kernel in us that stays, our essence.  (See blog post, My Essence.)

In the marvelous work, “His Dark Materials” trilogy, Philip Pullman describes us as split persons, a body and a spirit (“demon”) that might be parted by neglect, carelessness, abuse, or other disasters.  But when it is separated, the body suffers and is disconnected from it’s life purpose, what brings pleasure and presence in the world around.  (See blog post, Soul and Body.)

There are medical illnesses that do this, as mentioned above, and in those cases, perhaps all to do is get medical care, heal, treat and get on with life.  Other times, it might be that we forgot ourselves in the midst of caring for children, a demanding job, an opinion that victim-hood defines our life possibilities or what not.  We have options.

As Jjen reminded us some days ago,

The bad doesn’t disappear but it is not a qualifier for the rest of life’s potential.

Questions:  How have you reconnected to your life journey?  Your essence?  What is constant about you in your changing self?  Please tell me your story.

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So Many Choices, So Little Time …For Self-Care

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Self-Care Tip #198 – Being a friend to yourself might be saying,

No.

Our culture is brimming.  Brimming with…, well take your pick; walking the dogs, turning in a take-home test, watching The King’s Speech, writing a journal entry, making pancakes or reading Savvy – we have options.

However, today and often, options are stalkers we think difficult to restrain.  …More difficult, say than filing a restraining order against your husband.

Walter filed for divorce with his unhappy wife.  Vengefully, his wife turned around and filed a restraining order on him and just like that, he was unable to see his kid for over two months.  That was easy.  All she had to do was file it.

And when we have these many options, all we need to do is say, “Yes,” to one and to the rest,

No.

I love it when my four year-old son is rocking carelessly on my outstretched legs, flopping about, a happy-drunk bird-on-a-wire, and predictably although unintentionally falls.  Crumpled on the floor, he flicks his bangs back and says rather coolly,

I was okay, Mommy.  I was okaaaay.

I had tried to rest on the couch and type, doing my self-care thing after doing Mommy-stuff with the kids for a large chunk of the day.  But telling him to stop doing that really cute thing he does was not so easy.

According to The Economic and Social Research Council,

Having older siblings is not related to children’s happiness with their family, but having younger siblings in the household is associated with lower levels of satisfaction and this effect is greater the more younger siblings present in the household.

It turns out that children feel more happiness in their homes when there are fewer younger children.  They perceive that there is less energy available for them from their parents with each born child.  And I’m here to say, there is.  With my son on the floor, flicking his hair and going,

I was okaaay…,

my middle daughter kissing my shoulder and burrowing into my arm like an ear-wig, my eldest daughter came back to ask for the sixth time if I would play jump rope with her – I remembered this study.  So true.  I don’t need more options, i.e. more children who ask and I say,

No.

With these many wonderful options, choosing Me, is not always easy.  (See post, “‘You’ Are the Best Gift.”)

Now throw in a little inappropriate guilt, some ruminating thoughts, self-loathing, bad sleep, some low motivation and energy and choosing Me becomes the hardest thing anyone has come up against.

Questions: How do you choose you when you could pick so many other great options?  How has this helped quality of life for you and others in your life?  Please tell me your story.

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Getting or Giving Bad News Without Fear

Slalom skier

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I was reading an article on awareness of obesity the other day telling us that many times, people don’t know they are obese until they are told by someone else.  Ouch.  Pass the Band-Aides.  But it aired our need to stay connected, speak up, and listen.  It also prompted me to reflect on mental illness.  How often I’ve sat with someone’s emotions-history in my hands, looked at them and realized they didn’t know.  They were there, emotions bleeding all over the place but didn’t grasp their injury.

Um, excuse me ma’am.  Let’s apply some pressure on that and get you some help.

Bloody news like this reminds me of my friend Jack.  He was waterskiing with my brother and I when we were college’ish-age.  Jack was not so capable on the water, although he wasn’t afraid.  As you probably know, three is the perfect number for waterskiing – one to drive, one to hold the flag when the skier is setting himself up, and then of course the skier.  Any more and there are way too many polite smiles and way too much advice for the bobbing body in the water.  Jack was working on his slalom moves, thrilled with his progress and after about the third fall, was still ready for another go.

Hit it!

Our boat, Rosewater, eased him out of the water and he was up.  Jack has a way of celebrating like no other.  He whoops and yells and his whole body joins in.  And so he was in his happy place, up on a single ski, unconcerned with the world at large.  It was lovely.  Until the wake of that other huge boat threw him down and his face slammed into his spectacular single ski.  Up he came and we just looked at him, quietly at first.  Jack paddled up to the boat and wondered if he should try again.

Um, sorry Jack.  Let’s apply some pressure on that and get you some help.

Jack had a huge gash, copiously bleeding all over his face and he had no idea.  He was wet already, cold from the water and didn’t feel a thing.  I still feel the creepies skittering up my arms and chest thinking about it.

When we told Jack, he was a little unbelieving.

Are you sure?  Is it bad?  I think I’m alright.  It’ll wash out and I can try again….

Oh there wasn’t much pleasure in telling him the bloody news.  Generally there isn’t that much pleasure in telling someone they are fat or suffering from mental illness either.  It’s the follow-up to that statement where the fun comes in.  The hope that we link the first punch-line to.  Good news is, …along comes the second punch-line.  Hope.  And presence.  Being with someone where they are at, as they are, and with patience doesn’t mean leaving him in the dark, bleeding out.

The reverse is true of course as well.  If we don’t stay connected with others, we may lose the opportunity to see ourselves through their eyes.  It is an opportunity.  When we are with someone we trust, respect and think see’s us as the precious thing that we are, it is.

Self-Care Tip #195 – Stay connected with others and listen without fear – something good is coming.  Be a friend to yourself.

Questions:  How do you deliver “bad news?”  What is the best way you’ve ever been given “bad news?”  Please tell me your story.

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Stop! Before Hurting Yourself or Others

scream and shout

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Self-Care Tip #192 – Before hurting yourself or others, stop.

Sometimes all we can do is leave.

Not being created as a limp noodle, that’s what Brenda said.

In the moment of conflict with her daughter, she had used up the coping skills she thought of and in the end, her purse had no more gum, lip-gloss, candy-money or crayons.  She couldn’t stop the acidic emotions from taking their turn to burn.  Brenda yelled (yes she knew it wasn’t right) and then she yelled again, this time to her husband that he was on kid-duty.  She left.  The mom-van keys were the last thing left in her purse of things to do to stop the burning she was giving and receiving.

Emotional abuse is equal to or more damaging than physical or sexual abuse.  This made Brenda gulp, who could still hear her own mother screaming with bulging bubble-packing veins and eyes.  Brenda didn’t know she could say,

Let’s stop.  It hurts Mommy.

When she first had her babies, tiny with soft bones, fluffy warm sweet cakes just out of the oven, Brenda was scared.  Her pediatrician gave her baby care directives that said things like,

If you are angry and feel like you’re going to shake your baby, stop!  Call for help.

And there was a number.  Now that her kids were older, her pediatrician never gave her helpful sheets of instructions and rescue phone numbers.  Brenda drove away to stop, hoping to come back with more available to offer.

Not bad, huh?

Question:  When you can’t think of any more coping skills during a crisis, how do you stop?  In what feels like an emotional emergency, what have you seen others do that you think is useful?  Please tell me your story.

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Just to Feel Pleasure

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Self-Care Tip #189 – Heal for yourself, and you’ll see that also, everyone heals.

The best thing I ever did was go on antidepressants.

Bianca sat, but her whole body was talking.  She was telling me about her changing life.  She had read some of her journal from a year ago when she pounded on herself for her behaviors.  She thoroughly grieved the time with her children when they heard her scream about small things that kids do.  She told me about her sons face when she was irritable.  He showed all the waiting tension that an open child will when waiting for Mom to lose it.  She was trying to push it aside and think rather about how she now could finally enjoy them.  Bianca said,

I just had no idea before how much better life could be.

Bianca’s face became tight and she didn’t make eye-contact,

There’s no way to describe what it’s like to not enjoy your kids – My own kids! – for most of their born lives and then wake up and experience something different.  I just can’t explain what it means to now actually like being with them.  I’ve always loved them but I didn’t feel the pleasure and I hate that.  I want that time back but I can’t have it and I can’t give it to them either.

I’m so scared it will end, the pills will stop working and I’ll lose this new life.

Before her medication, Bianca worked hard at taking care of herself.  She was a check-list of responsible self-care.  Bianca thought it was important that I knew this.

  • Aerobic exercise – check!
  • Healthy diet – check!
  • Sleep hygiene – check!
  • Bianca talked about God but things got confusing for her there.  She didn’t like to think about Him being on “a list.”  He was in her life and didn’t feel He failed her even though she couldn’t feel pleasure or joy.

Still, she continued to coil up and release hard punchy words at her kids and then hate herself for it.  She had prayed so much about this and wouldn’t even mind if God had to puppet her, if that’s what it took, in order for her to treat her kids better.  She could not stop herself from being what she called,

Crazy Mommy.

But now, after she was treated, Crazy Mommy was gone.

Aside from dropping the shame, the best thing for Bianca was knowing that her kids could trust her, felt safe with her and that she felt safe with herself.  Everyone was healing subsequent to Bianca healing.

How many of you have told us a similar story.  A similar rescue.  Yet, never-the-less others of us are afraid to go there.

Question:  How are you present with others who don’t understand your rescue story?  How do you stand beside someone who needs medical help for emotional illness but won’t accept it secondary to stigma?  Please tell us your story.

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The Achilles In Us All – To Our Own Demise

Cover of "Troy - The Director's Cut [Blu-...

Cover of Troy - The Director's Cut

Self-Care Tip #188 – Don’t avoid the obvious to be a friend to yourself.

Have you ever watched someone make a bad decision?  Probably, if you’ve watched anyone.  We all do make bad choices.  But a really bad one?  One that when you hear it going down, you can almost feel the hair on your neck point south.  We ask ourselves why no one stops them.  We perhaps have tried to reason, to force, to pull favors to buy them away from this choice.

If you do this, ….

Maybe weeping some.  Maybe they’ve done this same variety of bad choice before; many times perhaps.

The problem is bigger than our own selves of course.  The people in our wake, being tumbled about by our bad choices, these people suffer.  It’s irresponsible.  Sure.  Those tumbled people are responsible for there own self-care too, but they aren’t responsible to accept us back with open arms when we drive our boat over them.  We don’t connect that the reason they are back there bobbing in the water is in part because we don’t have insight into our behavior.

Brad Pitt played Achilles in the movie Troy, Directed by Wolfgang Petersen.  If you remember, he died in the end.  Movie critic, described what killed him well.

Achilles is moved by love of glory and knows that he will die young if he pursues it, but his reputation is all that counts because all he is a warrior and the best one, at that.
Self-care includes stopping the kill that our own “Achilles heel” is making on us; i.e. that (or those) big thing(s) that everyone else but us can see that in the end will kill us.

Carl Jung describes the inferior function of someone’s personality type as their Achilles’ heel.  Myers called this the shadow.  It is the part of us that has the least amount of conscious awareness (otherwise known as insight.)  This is the part of our temperament that we are not comfortable with.  Although it may strengthen with maturity, it can be the death of us if we don’t take it seriously.  We will always have it, true.  But with deliberate effort and with working no harder than what self-care has already proven to be (the kind of bleeding effort that makes us plead “Mercy!”) …then we can grow.

Then perhaps after performing the hardest work of our life, we may be fortunate enough to die from another reason in the end.  🙂  We also may be fortunate enough to have people in our lives who feel safe with us.  People who feel they can trust that we will treat the precious connection between “Me and Thee” responsibly by taking care of ourselves.

Questions:  How has your Achilles been influencing your life?  How have you helped yourself to stop avoiding “the obvious?”  Please tell me your story.

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Get Out Of The Company Of Comparisons. Forget About Fairness.

Tail lights, lights, rain on my windshield, co...

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Self-Care #186 – Forget about fairness.

It’s raining here; herding us.  I don’t like driving at night, but driving in the rain at night is worse.  Driving in the rain at night, with a rabid sheepdog tailgating me is still worse.  However, I do love slowing way down when I’m tailgated.  That was nice.  And seeing some family, including my folks, made it all worth it.

My kids were in on it too.  They were doling out banana smoothie and repeating a favorite theme called, “Make it fair!”  In Parenting, the frequent reminder that life will never be fair for my kids, and wondering if they’ll ever get it, gives me almost as much pleasure as being tailgated at night in the rain.

“Make it fair,” isn’t far from any of our hearts desires.  It’s easy for me to forget humility and judge my kids, but when people aren’t looking, I’m also checking to see how much I got.

I met a girl in clinic, Britt, who was also working this out for herself.  She was holding it in her hands and turning it over; a foreign object.  Britt said,

It doesn’t matter what has happened to me, I’m still responsible for taking care of myself…

She said it many ways, and the tail of her pauses kept flipping up into question marks without actually asking,

With my abuse…?  No one else will…?

I could see her with all the rest of us suffering folk, checking the fluid line in our glasses, saying

With all the hurt I’ve received…

I was poor my whole life…

I just can’t seem to get a break!

For Britt, coming to a point of owning her self-care felt like losing social support.  She had for so long sipped on her succor as a victim in the company of her received wrongs, that she felt awkward.  Britt needed to find a new group of friends.  She stood there toeing the floor,

I have to take care of myself.

Britt will be alright.  She will be emotionally healthier and in better company very soon.  She will move past where so many of us are still gripping our goblets asking about why we didn’t get more.  She will say, without that question, self-care begins and ends with “Me.”

Britt hasn’t been able to do this without medical help.  For her, part of seeing herself as a victim to what life gave her was symptomatic of her major depressive disorder.  She was personalizing what wasn’t personal.  Not everyone will need medication.  Some of us will do well just recognizing that, “Life is not fair,” and will be able to move on.

Question:  How have you gotten out of the company of comparisons?  How has putting fairness aside been a form of self-care for you?  Please tell me your story.

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When You Are Pushed Down, Push Back

A Push and a Shove

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

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

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

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

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

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

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

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

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

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

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

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

His wife just killed herself.

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

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

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

Later in psychiatry training, my attending said,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Pain Can Be Something More and Better Than Just Pain

English: Vladimir Bystrov. 2006 Russian Premie...

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Self-Care Tip #181 – Look for help if your pain never becomes something more than pain.  Be a friend to yourself.

Glee is back!  I’m so glad because it makes great work-out distraction.  Good music, drama, beautiful people, and wonderful ah-ha concepts like,

Use your pain and loneliness to inspire you to make something beautiful.

Can’t remember it verbatim though and I noticed after an hour surfing the web for Mercedes quotes (and getting detoured to all sorts of other fun stuff for grazing) that whoever writes these quotes up didn’t find this one worth it.

Joni Eareckson Tada on the Larry King Show said that when she thanked God for her paralysis, she began to be productive through what paralysis offered.

It is however sometimes impossible to take what hurts and let it fuel our fires.  Sometimes it’s just a cold lump of coal.  Sometimes, we aren’t adaptable.

Luckily we aren’t sitting in a cave during the ice-age and can trust that a bear won’t come and eat us when we are wounded.  But there are other predators.  In my line of work, I could call disease process a preying force.  It takes over more and more cells, space, grey matter, consuming bits of our identity and changing our ability to cope with stress.

It’s easy for people to say, “Turn your pain into energy for creativity,” as if it were a volitional option for you like it was a choice for them.  Or we call it bits of morality; maybe a fourth of an inch on the rim of our gold crown we get in heaven.  Those of us who care about that crown look at our shoes, apologize and promise to try harder.

It is not easy to explain these apologies and inactivity to someone who has never been immobilized by mental illness.  Even those of us who have experienced it first hand have a hard time remembering the real texture of what we went through once it is passed.  Illness can be so awful that even our subconscious shudders when turned back to remember.  It is no wonder that we find it difficult to explain.

However, it doesn’t have to be this way.  If we aren’t able to adapt, aren’t elastic and sit stunned in the presence of pain, immobile to the newness that it can offer – recognize this as a flag to turn towards medical help.

Question:  What was/is your story when you weren’t able to adapt well to stress?  When you didn’t adapt well, what helped/helps you hope for more?  How did you find it?  Please tell me your story.

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The Spider Sat Down Beside Her – Mental Illness

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

The Little Miss Muffet scenario explained by D...

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

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

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

Taking pills makes me feel like I’m crazy!

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

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

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

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

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

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Waiting For Self-Care to Start

Self-Care Tip #176 – Don’t wait to start caring for your self.  

I’ll get to it when things slow down for me.

I can’t handle one more stress on top of the kids and all the people who take, take, take.

Don’t take this away!  It’s my only vice!

I don’t have time because I’m working so much.

There are so many good reasons to wait for self-care.  I don’t belittle them.  I do them too.  There’s a reason we here at FriendtoYourself.com call self-care the hardest work.  It is not for anyone who isn’t willing to go through the fire of putting themselves first.

“The fire,” you say?  Yes.  Fred taught me that.  He was down twenty pounds, working out almost every day with aerobic and anaerobic exercises, putting his ear-plugs in when sounds escalated his nerves, more motivated, interested and active.  Fred was growing again.  He said that it had been years since he’d done any of these things for himself and couldn’t believe what the world looked like when he felt so good.

Fred was sad though.  Not depressed.  No, he hadn’t been depressed for at least a year on his medication and even less so since he was taking care of himself physically.  But sad.  His wife wasn’t interested in his changes, she was disconnected emotionally, and more so every day it seemed to him as he began to change physically, emotionally and behaviorally.  His friends were growing distant.  He wasn’t interested in office politics either.  It was a simultaneous coming together of life in himself and a falling away of the life connection in his “previous life,” as he called it.  Surprisingly, the people he loved the most weren’t so happy for him.  Weren’t supportive of him.  He was sad for that.  There are never gains without losses.

This is not to forget the new relationships he was growing.  There was new life all around him and he still maintained hope for the connections he had before.  But those people who he had called his own for years were the ones who gave him all the reasons to wait for self-care.  He was way past waiting.  He was already on the other side enjoying the sun.

Question:  What have you overcome to get at your own self-care?  Is there anything your are still waiting to do?  Please tell me your story.

*Art work (assumed) courtesy of carldagostino.wordpress.com.

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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.)

This road sign image is in the public domain a...

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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.

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Tell People When You Fall

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

Image by zpeckler via Flickr

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.

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

I Heart Cleaning

Image by Valerie Morrison via Flickr

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

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

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

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

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

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

And as Louise Hay once said,

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

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

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

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

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

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

Playing in the Sink

Image by Paul Mayne via Flickr

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

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

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

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

I can’t control this.

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

I can’t control this.

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

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

baby elephant | playing in the water

Image by Adam Foster | Codefor via Flickr

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

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

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

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

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Choose Self-Care At Your Most Elemental Level

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Self-Care is For Everyone, Regardless of Circumstance

Freedom from Want (painting)

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Self-Care Tip #166 – To do self-care, believe that self-care is for you as it is for everyone.

How do we explain self-care to someone still in a deprived situation?  Deprived of freedoms the rest of us assume:  access to water, time, many choices, and so on.  Some time ago we talked about self-care being ours because we have freedom.  Because of democracy, we are free.  Because of those who fought and still fight for our rights, we are free.  Because of our essence, we are free.  We compared it to the Gettysburg Address of all things, and even when writing the blog-post, I was surprised that the correlation was so natural and right.

Carl, our dependable kind cynic, commented on the post Taking Care of Yourself is The Best Part of Your Treatment Cocktail:

Many I know can’t just do what they want to do.  Chained.  Chained by drudgery of work.  (You do not quit at the iron mill to become a poet, not in this economy.)  Chained by responsibility as family supporter.  Limited time and finances.  Limited by age or illness.  The best these people can do is try to find some brief periods of quality hobby or playtime.  Some have the tenacity to survive in spite of, as I did.  But facing the realities profoundly inhibit wellness, and depression deepens and immobilizes us on the worst days.

Many days I try to distill what self-care is and what it means, and it seems to change on me or grow another way just when I think I’ve got it.

…It is accountability for “Me” now and in the future.  It is not accountability for my past, for chaos or for the choices of others.

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…It is freedom.  Personal freedom to say, “This is my body that God gave me and I will choose to take care of it.”

…It is working hard to do what is in the best interest of “Me.”  It is knowing these things may not come easily or naturally or by chance.  Self-care does not mean doing what is selfish or not in the best interest of others.

Is everyone free?  I think we’d all agree, no, in an immediate sense such as, “Freedom from want,” or freedom from mental illness.  But perhaps we might wonder together and even agree about an eternal sense of freedom that is unchanged by circumstance.

Should everyone work hard at taking care of himself regardless of circumstance?  Yes.

Is everyone accountable to himself?  I’d say it depends in which paradigm we’re talking about.

However we answer these questions, I don’t think we really have a chance at self-care for “Me” if we don’t believe it is for everyone everywhere.

Questions: What do you say?  How do you define self-care?  What about those who are limited and chained, as Carl described?

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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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