Parenting

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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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Sharing Will Take You Out of Isolation

Flowers for Valentine's Day

Image by Steve Rhodes via Flickr

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

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

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

I can truly say I know how you feel.

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

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

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

Tomorrow is Valentine’s Day and Dad said,

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

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

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

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

My seven year old asked the other day,

Mommy, will Papa be alive when I have kids?

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

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

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

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

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Dad Is In The Hospital. My Reality.

Open-face helmet.

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

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

Just stick your hand in there and take the eggs.

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

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

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

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

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

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

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

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

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

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

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

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

This is my reality.  Dad is in the hospital.

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

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

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

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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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Remember Love to Feel Bigger Than Your Self

A Mothers Love. The Hand of a Child.

Image by Steve Rhode via Flickr

Self-Care Tip #175 – Remember Love.

Yesterday was my son’s birthday and today we partied over him.

How old are you?

He looks at his fingers and sees how many come up before he answers,

Four.  I’m four!

Right now, he feels really big.  He blows his lid if anyone says otherwise.  And because he’s never been above the bottom twentieth percentile on the growth curve, and because he’s four years old and the youngest of three, and because he’s so small, when he says, “I’m big!” looking serious over, yet under you with his bottle cap eyes, it’s really hard to keep straight.  But more often I do …until he loudly says,

I love you the whole day, Mommy!  The whole day!  You are my friend!

Then it’s over for me.  I can’t stay off of him.  He’s just too beautiful.  His open forwardness humbles me and I remember that it’s Love that makes us great.  It’s Love that brings us to our knees.  It’s Love, more than this stack of years, inches and knowledge that makes my son bigger than me when I forget Love.  He doesn’t.  He’s just too small to.  Four years of Love is big.

Questions:  What has helped you remember Love lately?  What has made you feel bigger than your own self?  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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Connection: It’s Medical But Still Magical

XO with Internet connection, Khairat (India)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Oh Well. That’s How Things Go.

Artist's rendering of Georgiana

Self-Care Tip#146 – Hold your wonderfuls and your non-wonderfuls together.

Oh well.  That’s how things go.

Today the kids were needing “parenting.”  Go figure.  I was trying.  About mid-day I heard,

Oh well.  That’s how things go.

At first glance you may not see its brilliance.  You may not see its hue of acceptance and texture of presence.  If you turn away too fast, you might miss the tension taking the back door out.  See?  The perfectionism is dissolving into the scum on my drinking glass that it is.  So look.  The room is crowded and for such a small statement to be noticed you have to really look hard.

Oh well.  That’s how things go.

Bits of us panic, thinking that sort of low-religion only leads to mediocrity, or worse.  But it’s not an either-or.  We can strive for excellence and still be present with what we don’t think is so wonderful.  We can include the non-wonderful in our consciousness and definition of self.  When the non-wonderfuls come around, wave, chat, take in the weather and carry-on.  There’s no crisis here.  I can see security waving excellence on.  No rubbernecking.  Things are ok.

Oh well.  That’s how things go.

I am reminded of the “The Birthmark,” by Nathaniel Hawthorne.  The gorgeous, lovable Georgiana, has a little hand print on her cheek.  A birthmark.  Her husband Aylmer, begins to detest the birthmark intensely and progressively.  It is so distracting to him that he stops seeing “her.”  In the end, it comes down to either be perfect or die.  Great story, and yes Aylmer, read my blog.

Question:  How have you made your peace with perfectionism?  How has it affected you?  Please tell me your story.

If you’d like to read another post with related information, see, “Adequate.”

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When You Are Hurting – Suffering Just Is

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

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

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

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

So no.

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

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

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

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

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

Suffering Is.

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

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Look Around to Get Strength and Perspective.

My sister and her baby.

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Self-Care Tip #145 – Look around to get strength.

I was talking with my colleague, Janice, who works intimately in the area of group homes and advocating for the clients.  I asked her to tell me something about them.

There are times when parents give up and they can’t provide.

I wrote a blog-post some time ago relating to this as I work with many families who are near this point or past it.  Taking care of ourselves can be hard enough in this world, let alone a disabled child or two, or three…  I’ve seen marvelous results from placements.   However, my blog-post, “Get in Someone’s Space” got a response that was not so complimentary.  I asked Janice about where she thought the comment was coming from.

There are a lot of good group homes but many are not.  The workers are paid minimum wage often and they are saints.  There are about 1/2 and 1/2 that are good v. not good.  They can make a lot of money potentially.  In some of the homes, the workers are ambivalent at best.  It is a job to them.  If they do care but are surrounded by people who don’t care they lose steam.  They can’t do it all.  Emergency homes are also useful to give parents a relief.

Some of the disabled in placement have no family involved.  Others do.  And in those that do have involved family give their family some time to recharge while in placement.  The family can recharge and use that new energy for things like continue to “shop” further for the best fit for placement.  It can be work to find the right placement and get someone moved there.  Then after that challenge is met, families will find other struggles.  Struggles such as placement being so far that the family can’t visit or be as involved as they’d like.  They find, as we all do at some ah-ha moment(s) in life, that we can’t have it all.

Mr. Rick stated it well.

I will not be a victim while choosing my burdens.

We could also say, “I will not be a victim while choosing my benefits,” perhaps.

I understand that the topic of disabled family and/or group home placements may not interest all of us.  It may not appear at the surface to be an issue involving eternal truths.  Yet, we see that it does.  We are, each of us, not so far removed from unfair life circumstances.  From choices that look “bad and also bad.”  Or could we say, rather, that look to be choices between “one benefit and another,” knowing that we can’t have it all?

No.  We are not so far away from the single mother raising her two mentally retarded children.  We are not that distant from the caregiver with license to house five children but can’t find good staffing.  We can see the fetal-alcohol syndrome child who got what he got from birth and will live where they are until they die with staff as their family.

To my parents who can’t give any more, choose your benefits.  They are there.  To my kids who are confused by their own behaviors and emotions, to my staffers who struggle to understand the value of their jobs, to you who feel more of the burdens than the benefits, to all of us, we are the same in this.  We are each other’s “people.”  We have this knowing.

Look around.  Gather strength and make your choices.

Question:  What has enabled your perspective?  What part came without effort and what part didn’t?  Please tell me your story.

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Full Treatment Response Means a Better Future

wethree by Nancy Denomme

Self-Care Tip #140 – Push for full treatment response.  Be a friend to yourself.

Frankie was 45 now, feeling it, and feeling grumpy.  “I’m on Lexapro!” she said as if that should exempt her from her present condition.  She had teenagers.  “Enjoy these times when your kids are young.  It just gets worse!”  Frankie thought that if her kids weren’t stressing her out, she’d be fine.

Maybe parenting and other life-stressors do get worse as we progress through years.  Even if it’s true, it isn’t the point.

Frankie told me that she had felt “normal” until the last approximate four weeks when she wasn’t able to let stress go.  She was taking things personal, even when her mind knew they weren’t about her.  She didn’t like herself as much and was angry when she thought that her kids were thinking the same thing about her.  She was just a little angry.  Not like she was before she was taking medication.  “I’m not so bad.  I’m ok.  I’ll be fine.”  About 70% of Frankie believed that she was still good.  About 30% of her knew at some level that she wasn’t.

“Frankie, stress is always going to happen.  It won’t get better necessarily when your kids move out.  Life will keep the spin on.  Frankie, the difference can be in you, not life.  How you cope can be different.  Things don’t have to feel that hard to get through.”

We talked about partial treatment response and what that meant in regards to disease progression.  Depression progresses as does anxiety as disease processes.  Also, people lose response inconsistently to various treatments.  However, it is not the time to throw our hands up and say, “Bummer!  Life really is harder on me than necessary!”  It is the time to say, “This is medical.”  And explore if there are any other things we can do to improve treatment response and decrease disease progression.

Leaving ourselves partially treated is leaving a leaky pipe in the wall of our health structure.  We will worsen faster, more dramatically, and be harder to treat in the long run.  We will lose treatment options over time simply by not doing as much as we could earlier than later.

This is not to say, that if this blog-post finds you at a “later” position in life, that it is of no use.  Unless that’s how you see your future.  Which if true, I’d respond that this is distorted thinking.  Possibly secondary to the disease process and all the more reason to get treatment, again, sooner than “more” later.

I was so happy to have had this brief discussion with Frankie because it resonated with her.  Her approach to her self-care tweaked and she saw her negative emotions and behaviors were coming from her condition more than from the chaos around her.  She made friendly choices to heal.  Medically heal.

Later in our treatment together, I asked her about how her kids were.  Frankie brightened up with stories of their successes.  I asked further if they were stressing her out, and she looked at me like, “Why in the world are you asking me that!?  That’s out of left field!”  She had already forgotten that she had held them responsible for her feelings not too long ago.

Question:  What barriers have you been up against to get full treatment response?  Please tell me your story.

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Feeling Human. Get to Work.

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Some days, I feel more human than others.  Today was one of those days.  “Chalk full,” as my Aussie-friend says, with stuff.  Started when I got up with the usual dishes, laundry, breakfast and such.  Thankful for it you know.  Means we’re living here.  Moved on to the car dealership to get some work done on my mom-van.  They said thank you and promptly shuttled me and my 3 small children to the mall.

Spending time with kids at home can be too crazy for me on a good day.  Spending time with the kids, without transportation, in the mall 3 days before Christmas….  Words cannot describe it so well.

Four hours later, the shuttle came back for us to collect their $730-some dollars.  I said thank you and drove my kids home.  This was around 2:30pm.

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We found our basement flooded.  Really flooded.  It is 9:41 and I just sat down.  My basement is now mostly just wet.

I am tired.  But still grateful.  I fell a little more in love with our house today, thinking, “I will do this for our house.”  “Home.”  (Myuaaah!)

You can yell at things and sometimes people you love and it doesn’t have to mean you love them any less.  A bang-up fight in fact can make the bond even stronger.  I fought with my home today.  My fingers are numb.  My back hurts.  After the rain I can fix the original sin causing the flooding.  However, I imagine that because it is still raining, I’ll have to do this again tomorrow.  There’ll be more fighting.  More love.

The thing that got me through today most of all, was the commonality.  Work.  Work just has to be done.  So human.  To live is to work.  There is no emotion attached unless I put it there.  Work is.  There is a lot of life satisfaction when we do it and don’t get all personal about it.  Don’t dance around, away, negotiate it.  Get it done and or don’t.  Either way, you get what you worked for.

Self-Care Tip #139 – Get up and live.  Work it.

Question: When have emotions, issues, temperature gotten in the way of your work?  Please tell me your story.

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Things Will Always Be About “Me”

Common Clownfish (Amphiprion ocellaris) in the...

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Self-Care Tip #138 – Stay aware of “Me” to be more present with them.

The second thing I learned from Toastmasters is that no matter how good I get at doing the 1st lesson, in my eyes, things will always be about “Me.”  No matter how skilled or self-aware or Mother-Theresa I become, “Me” won’t disappear.

Mother Theresa, by the way, did exactly what was congruent with her temperament.  Doing what she did for others tied her in more closely than ever with them …her.  Doing what she did naturally only made her more present with herself, her own journey, her own awareness of self and at some point with others.  There is a symbiotic relationship so to speak.  Remember Nemo and his home in the sea anemone?

Doing well for myself and for others is not a problem of effort towards altruism or other saintly motives.  It’s a matter of biology.  More than ever, I believe in hard-wiring.  Acting like it isn’t about “Me” is boring and even irritating at times for others to watch.  Even when we are trained actors or Toastmasters in this case.

When we say that the acts of heroism someone did was temperamentally congruent, it takes a little shine off.  Would you still call Mother Theresa a saint if you knew this?  How about “Me?”  That shouldn’t make it any less wonderful, what we do in life when we do it this way.  Yet the sense of enchantment gets a little fainter.  It’s a shame because who we were made to be is magical.   Doing what we do best by design is what our personal angels might have a hand in, I think.

If we can’t keep sight of ourselves, of “Me” while still seeing who’s around, there might be something medical going on.  No one wants you to disappear.

Question:  How do you keep it about you even while remembering that it isn’t?  How do you live symbiotically?  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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When You Are Hurting, Remember Why You Want To Live, And Live For That

 

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Self-Care Tip #133 – When you are hurting, remember why you want to live, and live more purposefully for that.

My daughter has a viral upper respiratory infection.  She is laying on the floor in her sleeping bag that has the stuffed puppy dog head for a pillow.  She just wants to be near me today while I work.  She wakes up and coughs, I check her out and dose her if she’s febrile.  She goes back to sleep.  Awakens.  Trundles up to drink some mango juice, water, eat 3 noodles, comes down again and lays there, pink in the cheeks, red eyes and chafed upper lip.

Sometimes when one of the kids is sick they stay home if I’m here.  It usually stresses me out but I’ve been getting better at believing more that we can take what comes and still get the work done.  Today, in-between patients, I laid down beside her.  Face-to-face.  She leaned in, opened her eyes and smiled!

She is one of the most delicately framed little people I know.  My nuclear family has never had small bones so this must be from someone on my husband’s side.  My daughter swung that tiny arm, warm with fever over my neck, put her face on mine, and fell asleep.

Lying there, thinking I’m so glad I could do this for her, suddenly felt wrong.  It flip-flopped over in my mind and I realized that I was glad.  But for me.

Having her near me while I work is a connecting force.  To both of us but maybe more for me.  My family has been exchanging this virus for 2 weeks now.  It hasn’t been hell but it has not been a delight.  Yet here I find myself delighted.  I wonder how long I’m going carry this gladness around.

Come what may in this world, it is these surprising moments that convince us about the rest.

In psychiatry, I’m required to ask each patient if they have thoughts of wanting to die.  Then I ask, “What do you want to live for?”  That catches some people off guard and I’ve gotten looks that could defend anyone in war.  But we aren’t at war and eventually they tell me why they want to stay alive another day.

At some level we all answer that question even if indirectly.  Everyone suffers.  If I were asked, my daughter’s smile would be on my list.

I am often amazed by good things that come out of bad.  Knowing that, gives hope.  But it also gives purpose and we can choose to angle ourselves more purposefully towards that rather than passively.  We can choose to live for the reasons we think worth living for.

My husband prays, “God please turn my posture toward you today.”  I’ve always loved that.

Question:  Why do you want to stay alive?  What are you living for?  Please tell me your story.

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The Process Of Coping With Triggers Such as Anger Includes Awareness

Two people in a heated argument about religion...

Two people in a heated argument about religion when Mahmoud Ahmadinejad spoke at Columbia University. Click the audio button found above and to the left to listen to them. (Photo credit: Wikipedia)

Self-Care Tip #132 – Awareness comes over and over again when you are a friend to yourself.

A reader posted in response to yesterday’s blog, When Someone Is Afraid Of You, You Don’t Have To Be Afraid Of Them. Just Be,

Sometimes it feels like any negativity dirties me up forever. I have a really difficult time dealing with any of the more negative emotions…. I am not sure how to “just be” with respect to those emotions…it always feels like anger whittles away my soul. Any ideas for coping through the times when we get really angry?

Taking care of ourselves requires awareness.  Just seeing it for what it is.  Being tuned in.  Having that degree of knowing.  Insight.

Awareness is sort of like “I love you’s.”  When we hear them, we might need to hear it again 5 minutes later.  There are no available stock options.  If the love doesn’t keep coming, than problems start.  Same with awareness.  We restore our own awareness how best we can, over and over again.  It slips and when new feelings come up, it may seem like it never happened.

My dad came over a week ago and spent the day with me and the kids.  The joy of just being able to spend a whole day with him was unique.  It was a different company than when he visits for an hour or on a timeline.  This day was all ours.  He left his car, and his cell phone behind.  He rode with me and the kids, sans detractors.  We were relaxed together.  Present.  There was a lot more time of just sitting quietly doing our thing but sharing even in silence our own selves.

Today he called, “To check on the tribe.”  He reminded me that it had been “just” a week since we spent that time together.  In my business of filling cereal bowls, the office, picking up dirty kleenex, training our dog where to poop – our time with Dad seemed like a long time ago.  I told him half jokingly, “Dad, we aren’t a bank account.  You have to keep coming.  You don’t accrue interest on what you put in.”

So is our own self-care.  It’s not that we are starting from scratch every time we take a bath.  It’s more that when we get into the flow of caring for ourselves inside and out, it becomes a regenerating, constantly investing rhythm that may at some times take thought and at others just happen because that’s who we’ve become.

One step of coping is that regenerating, repeating, purposeful process of awareness.  Our reader’s question about coping with getting angry put simply, requires awareness.  Because coping is soooo much more than just that, I’m sure it is too simple but it’s a start.  From there, come other bits of coping.  But without awareness, hmm.  Not much is going to happen.

Question:  What is your process of coping with triggers such as anger?  Do you think about it or is it cued subconsciously?  Please tell me your story.

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Go Toward The Pain To Get Connected

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Audrey came in looking fresh.  Better than before for sure.  She had an aura that brought to mind the moment just when tearing off wrapping paper.  It was nice to see her.

I am doing better.  I’m able to let more of the little things go, like the house doesn’t bother me as much when it’s not clean.

She was more able to do self-care with less forethought.  What did take her by surprise though, was her guilt.  She could see that it was inappropriate but insight didn’t entirely remove what shouldn’t be there.  She said these thoughts and feelings were something her husband likely never struggled with.  She didn’t think he was worried about her home doing dishes when he was at work.  However, the reverse for her was true.  She gave a coughing laugh.

I do!  I feel bad when he does the things.  It doesn’t make sense.  If he wasn’t washing dishes when I was working he’d just be watching TV.  But I still feel bad.

For her, working her job, taking her jogs, and attending Mommy groups were all in a grey category of “extras” for life.  Not necessary but bonuses she was spending their retirement on.  However, despite this, she looked the champion she was when saying,

I still am able to take care of myself.  Even though those thoughts come.

Audrey, by thinking about, talking about, and materially man-handling these thoughts, she was able to join her personal journey.  These things became connecting forces in her life.  They drew her closer to her family and not away.  Resentment dissipated and she was able to take part in her available positive emotions and thoughts.

It could have been different.  It had been different at other times, before medications and other positive deliberate choices in her life.  But it wasn’t now.  The could-have-beens trickled away together, the other near misses that sometimes we know about and sometimes we don’t.  There they go…

Going toward the pain in life, not averting from it, is a connecting force in our lives.

Question:  What have you been avoiding?  What has it done for you when you went toward the pain?  Please tell me your story.

Self-Care Tip #124 – Go toward the pain to feel connected.  Be a friend to yourself.

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“You” Are The Best Gift

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Self-Care Tip #123 <–> Take care of yourself.

Before I was found by my man, my brother Vance Johnson used to tell me, “Become the woman whom the kind of man you hope to marry some day would want.”  It was one more thing that helped keep my focus off of searching for boyfun-friends and on to living my life.

Of course it doesn’t end when we get what we want.  When we stop growing, we stop living – as Sarah said in the blog-post, “You Are Enough.”  Regardless of where we are in life, we are responsible for being the person that the people we want in our life want to be with.

Many of us deteriorate under the guise of service, employment, obligation, parenting, care-giving or whatever reason.  We neglect ourselves and then give that battered up self to our hopes and to the people we love.

Don’t be misled.  If asked, those very people we are serving would say, “Just take care of yourself.”  If you don’t believe it, reverse it.  What do you want to say to the over-extended people you love?

Jennifer who is a stay at home mom, tells me that she feels so guilty when she takes time to go for a run.  She laughs, saying her husband wants her to go.  He comes home and tells her, “Go!  I’ll watch the kids.”  Yet she still feels bad.  She thinks about her husband’s long day at work and the kids moods, their needs, what she could do for them, and she can barely force herself to leave.  Once she does, she says she always feels great about herself and them, and comes home having more than she did before to offer.

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Taking care of ourselves, is giving the best gift to the people we love.  “Me.”  Taking care of ourselves might be the most selfless thing we could do.  It keeps us connected to our life journey, which by definition includes keeping us connected to the very people we love.

Keep on!

Question:  Where are you in your journey?  Taking care of yourself, connected, disconnected?  How does it affect those you love?  Please tell me your story.

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Toughing It Out! …Is Not What You Think.

Mental Health of our Military

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Self-Care Tip #114 – Tough it out.  Be a friend to yourself.

Trying to tough it out is good it’s just not what most people think.

Many people think that toughing it out means staying med-free and getting through melancholy, anxiety, emotional chaos with gritted teeth.  They gather a degree of commendation from weathering out the behavioral and emotional problems until they either feel better or don’t.

This is not the kind of toughing it out that I’m calling worthy of our life efforts.  It is in fact the opposite.  Toughing it out is doing what may be socially and culturally counterintuitive.  Getting medical care sooner than later.  Not waiting to see what will happen before getting medical care if it is indicated.  Believing the medical data, the physician you trust, the knowledge that mental illness is medical, biological and often PROGRESSIVE over time.

Waiting means you are getting more ill on a cell level and at higher risk for your future and waiting is not being tough.

Toughing it out is digging into your courage bank every day to take that pill when you feel ashamed of it.  Toughing it out is fighting for your brain’s future.  Toughing it out is sacrificing what ever you need to, to give your loved ones and yourself the healthiest you possible.  Even if that means talking yourself into it, going up against your fears, ignoring prejudice, ignoring opposing recommendations from your favorite sources.

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This calls for thick skin.

Candace tells me she still intuitively can’t believe this, even though her mind tells her it is true.  She takes her medication but it still hurts a little every time.  Like she’s betraying herself.  Like she must grieve for herself.  Candace says the apparent calm, decrease in anxiety, improved relationship with her children, and the flowering hope eases her inner psychic pain.  Candace is drawing strength every day from the growing evidence of health.  Candace is tough.

Question:  What are you getting tough with in your life?  How do you do it?  Please tell me your story.

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