Unlikable: Me Too

Poem:

I feel unlikable

It sounds young

Immature

It sounds like I’m fishing

But I feel unlikable and it is what it is

I can list my attributes

And do also remember

What others have said

In their own throws of comparisons

It is disconnected though

Me talking to myself

An echo in a cavern

Otherwise quiet

Unlikable might be better said

Disconnected

And I was created for connection

I’ll never survive any pilgrimage on my own

I’m designed to say, “Me too”

But just this

Improves my sense of company

I can’t know why

Writing it out

Makes me think of you reading it

And saying something back

Selfcare Tip: Look for connection. You are not alone.

Question: What improves your connection? Will you tell us an example of a time you turned it around; went from feeling alone to then connected?

Keep on!

Where Your Shame Is

One of my strong memories of Marcy will stay, of this Halloween. 

She was tired after her day at school. She had gone back to college to get her nursing degree. She was tired, like a shirt that had been over washed in hot water. She was the kind of tired that looked like the good emotions in her water bottle had been slurped down, and the refill was still in the fridge in her kitchen corner. At home. And she was still in the car.

These feelings started to increase and crescendo, and pretty soon she was tieing into memories of failure in her past. A young child who heard her parents yelling at each other in foul language. Marcy heard, “My family doesn’t love each other or me.” A kid who dressed poorly and Mom said, “Go change. You look terrible.” Marcy heard, “I’m an ugly kid.” A teen who didn’t get invited to the parties that she knew were going on. She heard in this, “I’m not likeable.” A young adult who watched her mother walk out on her father. Marcy heard, “I’ll never be someone worth committing to.” And now on halloween, with her daughter coming home from school, Marcy felt like a failure as a student and as a mother.

She told me about this, last week. We were in the quiet space of my office. Lamp light shone over the beta-fish hiding behind his splashing filter. 

Marcy told me, she was wilted there, in the seat beside her daughter. Saying words in effort of trying to be understood, she spoke, and she cried. At some point, Marcy realized she thought that if she didn’t go trick-or-treating with her kids, it meant she was a let-down. She wasn’t a good mother.

Not only was she someone who gets tired too easily, she was also a flake.  

Marcy threw out a few options; how to make this right for them. Then her mind opened up and processed these. She saw her inner beast let shame go. Something better in her said that she would give what she could, and discharge the rest. 

Marcy, in talking it out with her daughter, made herself vulnerable to what brought her shame. In that, she let the truth surface that she was, actually, not “a piece of crap,” after all.

Building on what our living experiences are, rather than disenchanting, they are healing. The easy fantasy that comes from comparison, from fabricated idealism, and from the personalizing of it, is destructive. We can be resilient by building on real experiences. We can be present and connected both to ourselves and others.

Brene Brown speaks on wholehearted living:  “It’s about the willingness to be imperfect, to be vulnerable. It’s about the courage to wake up in the morning and acknowledge that no matter what gets done and what doesn’t get done, that I’m enough, and that I’m worthy of love, belonging, and joy.”

Halloween will be a reminder to me of Marcy letting shame go, not identifying with the thin logic of her own self-inadequacies, and of getting into the living of it. That’s courage. That is brave.

Self-Care Tip: Start exploring where your shame is, and let your real experiences speak toward your belonging and self-value.

 

Question: In what areas of your life do you feel like you are not enough?

What has helped you discover your reality?

Please tell your story! We need to hear from you. Keep on!

False Thoughts about Getting Healthy

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Think of walking in a rainstorm. Your clothes and hair hang heavily. They provide no protection. They offer no remedy. You take a hand towel out of your bag and try to mop up your icy wet face. Wring it out and continue to wipe. 

This is like choosing to do all the psychosocial efforts in your life, but missing the biological. Until you treat the underlying illness, much of our efforts to heal are like using a hand towel to dry off in the rain storm. We think that we can get better without medication. Or, we may reject other treatment options, like ECT or TMS. We think false thoughts. 

It’s not healthy to take pills. 

I’m better than that. 

All I need is God. 

My parents would be upset, so I shouldn’t. 

If my work found out, I’d lose my job. So I shouldn’t. 

THC is better. 

Exercise is better. 

Some of these are entirely false. But some are just partly false, encased in a disconnected truth. This “rain and the hand towel” idea is not an analogy meant to minimize or bring shame to those who choose not to engage in treatment. It is not meant to talk down. Please forgive me for the crudeness and limitations. It is just meant to crack open this idea.

Yesterday, Louise commented that her physician told her taking sertraline, or Zoloft, was like taking “a vitamin for my brain”. That clicked for her! Vitamins were ok.

Question: How has your physician helped you get past not wanting to take treatment? How could your provider do better with this?

Self-care Tip: Allow healing with medical treatment for medical disease.

But I’m Not Someone Who Likes Taking Meds

pill

Presley couldn’t breath. A truck just drove through his thorax. A monster-hand was closing around his heart. He couldn’t swallow well. Was something stuck in there? Dizziness nearly dropped him, but instead of moving to sit down, like any other normal person would do, he bolted. A fire chased him. He had to escape or he would die. In the bathroom where he found himself, the mirror reflected a sweaty face and crazy eyes. Was he dying? Presley’s phone looked blurry as he dialed, 911.

Please help! I’m having a heart attack!

That was the first time this had happened. After the third visit to the emergency room over the past month, Presley was able to avoid calling 911, although still convinced he was going to die when the next episode hit. He agreed to seek counseling, where he was taught different skills to connect his mind and body, to slow his breathing down, to process, even when he was convinced he was dying.  For a time, Presley improved. It was like it never happened. He was almost able to convince himself that it wouldn’t happen again.

This turned over and over, feeling like he was going to die while losing his mind, re-engaging in counseling, thinking he was better, stopping counseling, and then another violent emotional event, thinking for sure, he would die.

It was after his second trip to the ER when he received the recommendation to schedule an evaluation with a psychiatrist. But he preferred to work through this in therapy. Presley didn’t like pills. He wasn’t someone who medicated. An olive-skinned athlete, he lived clean and didn’t believe there was much that healthy living couldn’t cure. And Presley did live clean. He ran fifty miles a week. He ate raw foods. He read his Bible.

After several months of this, his therapist, Dr. Wu, recommended he get a psychiatric evaluation. However, Dr. Wu agreed that he would continue to work with him, whatever Presley chose. (Was this the right thing for Dr Wu to do?) Presley chose, no. No psychiatrist. What would a psychiatrist do to him anyway?! He wasn’t crazy. (Except when he thought he was.)

Presley visited his primary medical physician, Dr. Belinda Jones. It had to be better than seeing a shrink!

Dr. Jones, I don’t want to take meds.

Dr. Jones, cleared him for any medical condition that might be contributing to his events. Only then was she able to convince him to try a “safe antidepressant”, escitalopram. After one pill, Presley had the worst event of his life. He’d never had any experience that was more terrifying. Presley didn’t go back to Dr. Jones, “of course.”

When these emotional tornadoes hit more frequently, he became paralyzed with fear that he would have them in public and be humiliated by them. Presley stopped going to work.  If it wasn’t for his rent, he’d never go back. But he had to. So finally Presley agreed to see a psychiatrist. …

To be continued

  • Sincerely, Dr. Q

Questions: What would you tell Presley? 

How would you like your physician and/or therapist to handle this, if it were you?

Why is Presley so opposed to taking medical therapies?

Please speak! We need to hear you.

Self care tip: Keep on! 🙂

The Path of More Resistance, and Brain Health

 

The bar hummed with the energy of human emotion.  It was one of the few places Alfred could still smoke in public. He remembered the first time he was directed to a smoking area in the airport that looked like an enclosure for zoo animals, with glass walls, and positioned in the line of traffic. What in the world?! So Alfred felt unjudged at the bar, and also pumped up.

Alfred got energy from being with people – gravitated to them like a little brother follows his big sister around. If it was the bar, or the smoke break, Alfred got energy if he wasn’t alone. He absorbed every moment, marinated in it no matter how brief. The “moment” was his forever, for however long that moment would last. He was inside the color, flavor, aroma, texture, and song. He noticed. And, Alfred grazed. Amongst ideas, people, choices, and of most anything that came into his field of vision, he chewed it up in that space of time, and then moved on without guilt. Generally people didn’t hold grudges when he moved on. Alfred was just so nice!

When Alfred was in sync with his energy, senses, feelings, and perceptions, and his wife was in sync with her own, she looked at him like he was someone she was interested in. He could make her laugh and play, whereas she was never normally someone who was playful. This was nectar to Alfred’s pollinator.

Out of sync, however, Alfred’s wife called him names when they argued. He was “flakey,” or “narrow-minded.”  And Alfred, awkward with conflict, developed the habit of escaping during those times. He did not like conflict.

Alfred began to drink a lot more alcohol. After work instead of going straight home, he’d “catch a few beers with the guys”. When entertaining clients he started joining them when he offered alcoholic beverages to his clients, imbibing during work hours. His work performance started to smell sour like his alcohol.

You can see where this is going for Alfred. When he came into my office, he reported his inability to enjoy anything, increasing hopelessness, and now when he left the bar in the evening, his mood regularly plummets, a false weight in the scale of life.

Alfred looked at me with a degree of distrust, expecting judgment. But of course, he was also coming to me for judgment – an evaluation and diagnosis, and then to present a plan for treatment.

The treatment plan was short this day. Go to alcohol rehabilitation. Telling Alfred that there was nothing else we could do for him until he engaged in a rehab, was nerve-racking for me. (I never know how a patient will respond after similar directives like this. Sometimes they are not kind. Especially when talking about their substances or addictions, of any sort.)

Alfred stood up, a bit like a mechanical man, thanked me for his contact referrals, and left. I thought that was the last time I’d get to see him. It’s impossible not to hope for the best.

The deal with brain illness is that the treatments I am able to offer in an outpatient setting are ineffective in this context. Other stuff going into the body hits those brain receptors, turning genes on and off, like Wile E. Coyote in the back country. It would be enabling the mal-behavior if I diverted our focus onto anything else. Even so, like so many in the company of users, it is wilting not being able to offer more.

About two months later, I was completely surprised when Alfred came back sober! He told me he did just what we talked about, and rehabilitated. More surprising though, was his statement,

Thank you for refusing to treat me. You saved my life.

Alfred was still married, and yes, the marriage was still volatile. But he wasn’t plugging his ears and disconnecting from his wife with alcohol. It was a start. And Alfred still had restarts available to him.

We did end up starting psychotropic medication and psychotherapy, with which Alfred continued to heal.

I am humbled by Alfred’s courage to pursue rehab, the path of more resistance, and recognize that I should never underestimate the same courage in others when they present similarly.

Self-care tip:  Taking the path of more resistance may bring just what we are hoping for.

Question: What have you done courageously? Where has it taken you? Please tell your story!

STOP! DON’T STOP! The quandary inside of us when deciding to take medication

Everyone says “Hi” to my dog, Timothy… Way more than to me. Silence.

Is it the springy fluffy hair, I wonder? They walk up, even speed, out of an unseen shadow without inhibition and rub him down. He is pleased every time, to say the least. Do I regret all the painful laser hair removal treatments I got years ago? Hm. I am half Lebanese after all and few really know how much fur I really came with.

(Curly-cue.)

Steve came looking for help. I spied him in the hallway before clinic. That’s always a little awkward for some reason. Running into someone out of context. Like we both are caught out of costume and the curtain just pulled up. (Gotcha!)

His strings pulled in, an inner tension, apparent even then. He looked susceptible to emotional or physical attack when we caught each others eye. I could see him wondering if this was “her”, his psychiatrist. What was he expecting?

When patients come in for treatment, it’s comparable to anyone acting on a realization that they’re vulnerable, asking help from a stranger. It can take immense courage.

Part of this understanding is what contributes to the awkwardness of meeting in the hallway, out of context. We are both a little undefended there.

So what would bring a person to do this to themselves? It doesn’t sound pleasant when put this way – vulnerable, asking help from a stranger.

Steve had a wife, kids, a job, a house, and a pet. Inside this bubble, Steve didn’t think he had reasons to feel the way he felt. He looked for them and felt stupid because everyone told him how good he had it. Nor did Steve see reasons to behave the way he behaved. He described his story, a rolling out of his life, like that of a hand stitched carpet. In it, we saw together that he had anxiety then, and then, and then. He had coped well mostly, until he hadn’t. Then he would spend some time falling out of circulation and incurring losses. Then he’d recover and forget. He’d forget that worse patch and redefine the lines around the man. Then again the lines would smudge, he’d get anxious and irritable beyond “control”, grapple within the darkness of the white noise, which panic brings, grapple for reasons why the anxiety came again. His identity would be so threatened, the suffering, the feedback from everyone around him would pull on him, that the lines of his person frightened him into treatment.

There Steve was. Timothy at his feet with his puffy furry head in Steve’s lap. Steve asking for help. At the same time as asking for help, he would also refuse, stating caution.

“I don’t want to change myself.

I like being the person who gets things done so well.

I like accomplishing things.” (He thought it was his anxiety that allowed him to do this.)

It reminds me of the, “Stop! Don’t stop!” that I’d tease my brothers with when we were kids.

People think that taking medication changes who they are. Understand that in order for this to be true, that would mean medication changes DNA code.

“Doesn’t it change my brain chemistry?”

Let’s say that were true, that medication changes brain chemistry. Still that isn’t changing your DNA. The DNA is what gives a person “personality,” or, what many of us say, “Who I am.”

After getting laser hair removal, I didn’t change my DNA, but I don’t have as much hair. When my kids were born, I checked, and sure enough, DNA…. They’re gorgeous! Wink. (That’s done with one heavy cluster of eyelashes around my dark Lebanese eye.)

Question: What are your fears about taking medication?

If you have taken medication, how did you see it affected your identity?  What happened to who you call, “Me?”

Please SPEAK! We need to hear you. Keep on!

Self-care tip: Self-care means taking care of yourself even at the biological level. It starts with “Me.”