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The Elephant is in The Room To Help Us

English: The eye of an asian elephant at Eleph...

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How do I get him to see it?

How do we get our friends, our husbands, our wives and kids and patients to see the elephant in the room?  My patients ask me this and I ask this of myself.

I want to feel better.  I just want to get to the bottom of this!  

Will someone please just treat what is wrong and I can move on?!

There is this implication that someone is plotting against progress to derail us from appropriate therapies, treatments, walnuts and soy milk.  Why they would want to do that, no one agrees on.

When Cincy said something to this effect in clinic, a huge shade in the shape of an elephant in the room, caught my eye and it was distracting.  I smiled at the wraith and conspired with it on how it could best gain acclaim.  I tried to explain what I was seeing to Cincy, but how does one describe an apparition?  I’ve never heard anyone do it better than Edgar Allan Poe and so I know it can be done.  I’m learning.  I needed to learn from Cincy.

Teach me Cincy.  Help me learn how to speak of these things better.

I felt like I should know that already.  But we physicians don’t graduate with a certificate in introducing elephants.

Trying to do the teaching-thang in clinic or out of clinic, if we want to get anywhere, we can’t do much if we aren’t both seeing the elephant.  Talking about solutions, about treatments, motives or anything that doesn’t redirect each of us back to that specter in some way is skipping critical development.  Counterintuitive, the immediate task at hand becomes more and more simple when there are ghosts about.

He doesn’t want me to take medication because he is afraid of what his mother will say.

Start talking about Me and not about him.  How does Me factor in to deciding on medications?

Smoking is my last vice and I’m not here to talk about it.  I’m here to talk about why I’m tense all the time.

Tension happens when our blood vessels constrict.  Tension increases when our heart rate….

Well, goodness.  You don’t want this from me now on this post.  I’m just trying to talk about that darn elephant.

When things feel complicated, when conspiracies seem to be around, when we hear ourselves naming others to explain our condition, when we avoid talking about something and when we lose Me -> reduce.  Still missing it?  Get even more basic.  Soon we’ll see the shade.  The elephant is there to help us, not shame us.  He’s there to bring us back to Me where everything starts and ends.

Question:  How has the elephant in the room improved or worsened your self-care?  Please tell us your story.

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Deliberately Setting Myself Up To Improve

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Image by samuelalove via Flickr

Self-care is about improving life, not harm.  Even though it includes doing things we don’t enjoy and sometimes hurt, it doesn’t harm us.

That’s a useful meter-stick when we wonder about something in our life.  Is this harming us?  Including people.  Do I feel better about myself when I’m with them?  Do they help me become a better person?  A better friend to myself?  Or, do they turn me toward things that harm me?

When thinking about our days activities, our choice of employment, things we put in our body, put them by this “No-Harm Meter-Stick” and see how they measure.

A deliberate check-point in my life is consistent with a deliberate goal.  …”I want to be  healthy.  Is this improving my health?”  “I want to have good self-esteem.  Does this improve my self-esteem?”  And the journey is consistent with the beginning and the end.  If the goals for the moment isn’t consistent with our big picture goals than they might not be the goals we want.  Like putting substances in our body that feel good for the moment but harm our life.  There are innumerable examples of this but you get the picture.

Questions:  What checks you when you need it?  What has been useful to remind you in this area or that to be friendly to yourself?  Please tell us your story.

Self-Care Tip – Deliberately set up feedback in your life to let you know that you are a friend to yourself.

See blog-Post:  “You” Are The Best Gift

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Where Does Courage Come From?

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

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

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

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

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

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

(WHEW!  Recovering my breath.)

Where do we find courage?

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

17th century

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

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

Where does courage come from?

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

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

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

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

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

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Self-care Begins and Ends With “Me” – Own It

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Self-Care Tip #129 – Self-care begins and ends with “Me” – own it.  Be a friend to yourself.

Yesterday we talked about connecting self-care with pleasure to make it sticky.

Today, We’ll talk more about some of the adjustment issues of why we don’t do self-care on the obvious, such as nurture vs. nature.  We’ll talk about the nurture part.  Specifically, our own not what our parents did to us.

Why don’t we stand up to our personal needs?  We don’t.  We don’t own the friendly changes that we would benefit from.

Carol who used to abuse methamphetamines and alcohol many years ago, now tells me that smoking is her only vice and she needs to have at least one.  She says she doesn’t want to stop even though her feet and hands are blue from not getting enough oxygen.

Another part of the answer is that we are so overwhelmed by the wrong we see around us.  We qualify and quantify it away, desensitized to our own needs.

“Have you seen that dietitian?!  How can she possibly give advice on weight loss when she can’t see her feet?”  And we ignore our own central fat, knowing that it has meaning.  Meaning like, we have unseen fat layering onto our central organs.  Meaning, we are more likely to develop metabolic illnesses such as diabetes.

We don’t own it.  We don’t “Just do it.”  We talk about other people and draw lines between their mistakes making pictures that we can hide our own problems behind.  We can make sense of why they are suffering so.  Yet our own problems are some sort of enigma.  Yet to be determined by science!  Open-mouthed, hands splayed in a why stance, we can’t connect our own dots.

All health begins and ends with “Me.”  Including mental health.

Find yourself again.  Amidst all the world’s needs, you still are important.  Peel off Channel 4 News, the internet, the fears about what is outside your front door, and see yourself there under it all.  Needing self-care.

Question:  How do you keep view of yourself despite the distractors?  Please tell me your story.