Stigma and Me: Me-on-Me Crime

who me?

Me-on-Me Crime!

I was doing my speed walking thing on the Balboa Beach cottage lined shore. Gorgeous, it was. Fluffy thoughts were everywhere. I was purposely passing under the low hanging docks to upscale some lower body muscles. Some string bean teens with their fishing poles moved into the water’s leisurely lipping edge ahead of me. Who wouldn’t be distracted by such poetry?

Can you guess what I did? I looked up. I lost my squatting waddle.

When someone driving on the freeway slows down to look at an accident on the shoulder, we call them “rubber-necks.” What do we call someone who walks taller, someone who loses her shorter self under a low dock when “speed walking” at approximately four-miles-an-hour?

Me.

This was more painful than my three cesarean-sections. Of course, there was no anesthesia when I sped into the solid, immovable wood. I loosely figured, with physics being what it is, that I received in return the equivalent to someone slamming me with a baseball bat. I was never great at physics but I remember that Force = mass * acceleration. I am not telling you how much “maaaass” was involved, so, for the disgruntled forensic’s enthusiasts out there, we just won’t know how hard I was hit back.

As the blood was pouring down my throat, out of my mouth, down my face, and as I gargled the words, summarily “help,” to 911, I thought, “That wood was not there before, because, why would I do this to myself?!”

How are we our own enemy? I’m learning a lot about stigma these days, in preparation for a couple CME talks coming up. Stigma is a molded and remolded term, but for our purposes, we’ll say that it can be broken down into, prejudice and discrimination.

Prejudice refers to our attitudes, beliefs, and emotions.

Discrimination refers to action, what we do about it, and behaviors.

I really like this. It helps to see where “Me” plays into our own stigma behaviors toward our own selves. For example, skipping our medications on and off.  That would be, discrimination, when it is done in response to a conscious or unconscious prejudice about taking medication. Maybe taking medication induces feelings of shame or blame. Then we behave with missing pills.

Another example of stigma, is seen in our aging “baby boomer” population. Turns out, psychiatric patients are living longer too. Social workers and other professionals are admitting more and more psychiatric patients into senior facilities, e.g., assisted living, nursing homes, home health services at home, hospice, etc., and the staff at these agencies do not know how to work with psychiatric patients.  So, the senior facilities try to send these patients to psychiatric hospitals or hospital emergency rooms, and the nursing home or senior facility won’t accept them back into their program afterwards, stating “We don’t have the staff or programming to work with psych patients.”

Senior nursing home/assisted living facilities are realizing that they need to hire/train their staff to work with psychiatric patients in their senior years and that this is part of their growth as an organization and their commitment to providing quality care to seniors.

The prejudice comes from feelings, such as inadequacy, on the part of those serving psychiatric patients. The discrimination is when the patients are turned away. Everyone loses.

It’s an exciting time for senior facilities. It’s an opportunity for their staff to learn new skills and understand that with even some basic training on communication skills, therapeutic interactions, some do’s and don’ts, they CAN admit and care for psychiatric patients in these senior facilities. Everyone wins.

The most important message in learning about stigma, is we hurt ourselves any way it turns. And why would we do that to Me?

I still have a headache, three days later. My teeth hurt. And I’m not as pretty.

Self-Care Tip: Break it down – What are you feeling? How are you behaving to yourself?

Question: How have you been prejudiced and acting out toward yourself? How have you eliminated stigma toward yourself? Please tell us your story!

Keep on!

Walking in on me after my massage.

walking in on me

I never realized, until this experience, that during a full body massage, one’s “girls” seem to swell and grow,… and no, the “girls” were not directly handled.

What brought it to my attention was the door opening. That misty moment hung in the air – between the massage ending, the masseuse leaving the room, and the sheet coming off my body just before getting re-dressed. The salon’s hostess stood there and squeaked,

Oh! I sorry!

First reaction, should this happen to you, is to laugh a little. This is what you will do. “Ha-ha.” Then you will think, “What? Did I just laugh?! Oh. Those must be ‘comedy boobs.’ …Can I have my virginity back?”

And then, “Is this covered in the insurance?” 

I’m simply really glad it was not more than one lady who was at the door. It could have been a crowd. And I’m not implying any of them would have liked it either. (Boys, shush. You don’t have to remind us that a male’s response to a woman opening a door on him when he is naked is entirely different.)

But I should have known this would happen. When I was being “roomed,” the hostess wandered her facility like she was on an easter egg hunt.

Is this the place? No? Here?

Oops! I Sorry!

How bout behind this door?

Yep. You got that. She did walk in on someone else while trolling around with me. I was forewarned. Yet, did I leave? No. Rather, I deferred with, “She’s mortified. This is the bottom of her career, poor thing. She’ll never do that again! I’ll act like I didn’t notice.” Optimism rears its perky head.

During our room-hunt, we came upon a large one with many cots. It appeared to be a community massage room.

I’m all for community. Community, NAMI, connection – you’ve heard my spiel. But this was a different definition of “community.” I thought,

These massages must be cheaper.

Because who wouldn’t wonder, “Is that relaxing?!”

Again. Males are different, I’m sure, but really. All you do is smell feet. Or maybe it’s like the swingers version of massage therapy. You might not walk out with the same wife.

Finally roomed, stripped and prone, my masseuse came in. She had such “rolling-pin” strength in her one arm… “She must work out.” 

Bone…still bone. Yup. You’re still on bone.

My face went numb pressed into a doughnut, but I kept on. (I once got an award for being “The Most Tenacious.” I think I was like ten. How did they peg me?) My back was getting worked over, and I had faith, at some point, it would feel wonderful. Just like I thought no one would walk in on me and my restored, and more than, decolletage.

I never actually saw her. My masseuse. She came in, did her rolling pin thing and was gone. No face-to-face. The experience was difficult to identify. What shall we name this?

But you know the next part of the story. The door opened.  

I don’t have a self-care tip to share today. It could be to go get a massage. Or not. I, with what looks like a more full than empty glass, thought this experience was too rich not to share with my friends.  Keep on.

Question: When has your optimism v. pessimism steered you wrong!? Please spill. Please. Spill.

There is no self-care without Love

grieving

Reggie showed up without his wife.

The wife was a short woman.  She had some practices that usually increased the space she occupied – the smell of tobacco, the size in her chair, the volume she laughed with, her large wiry curly bouffant, and her hope-filled aura. 
“Where’s your wife Reggie?” 

Reggie had sat down with his usual socially acceptable moderate expression. 

It was common for his wife to accompany him to my clinic and if she wasn’t there, it was only for purposes of work.  She prioritized him, it was clear.  However, her work was inconsistent, money was always tight, and she would most often have to travel when the opportunities arose.  Being a temp in nursing was like that.  Reggie was so proud of her and looked at her in that mix-matched role that any relationship between one person and another always is.  In Reggie’s case, sometimes she was his parent, lover, friend, enemy, caregiver, and now, what?

If you’ve been reading this blog for long, you know I love the concept of Time.  I fantasize a little about separating Time from space and yes, at some moments, think I am all that. (Wink.)  When I asked Reggie, “Where’s your wife?” I might have done it, though not pleasantly.  Something happened there that was inter-dimensional.  Because he was transformed.  His face didn’t melt or droop.  There wasn’t a process to it.  Rather he was sitting like a normal Reggie and then he was wasn’t.  Between normal and transformed, to me, reality changed.  The between was a crack that was a different reality.  A black space without Time.

Reggie cried,

“She left me. She left me.  I begged her not to, and she did.”

Reggie’s wife had done something personal.  She went and died. 

Even when Reggie stopped crying, he looked bewildered, raw and like the faucet was going to poor a lot more.  We did get to start talking a bit about how much his wife loved him.  We speculated about the love remaining after she died. 

“I wish I knew!  I wish I knew she was somewhere good and I wish I knew if she could see me.…” 

Reggie wished he could remain connected to the love. 

During our treatment together for over a decade, Reggie complied with our medical treatment in the context of that love.  Reggie honored his wife by taking care of himself.  He even lifted up his illnesses like an offering to her.  I was struck with the concern of what kind of treatment compliance Reggie would shift to if he thought he was living without love.  I was concerned that he would not value himself, including the respect he was able to show his illness without the company of his wife’s value and respect

The way that we honor those we love and those who love us, is by honoring our own selves.

It is intuitive in our nature to believe that we can’t live without love.  Where does love go when we die? 

This brings us to another premise in, “God and self-care,”  – there is no self-care without Love.

The argument psychiatry has with the concept of Love is that sensing it, knowing it, perceiving it, is all a part of our modular brain, therefore no more than grey matter.  Thus implied that it is diminished. 

Question:  Does it diminish Love for you, knowing that our perception of Love is as mapped out as that, even able to be man-handled, turned on or off by neuronal signals? 

Please tell us your thoughts.  Keep on.

Self-care Tip:  Find Love for self-care.

Don’t Save God

saving God

A danger I don’t want to be confused by here is the temptation to save God.  I recognize I have dabbled there.  But, I am not saving God.  The agenda here is not to prove or disprove, to champion Her, or to drag any of us through the cutting edge of knowledge on dark matter. 

How much I get out of having God in psychiatry is all about me.  It’s good for me, my psyche and my self care.  I like who I am through the eyes of God, who is and who is personal.  I like what it does to me and my relationships.  This is how I see God in my life – home, biology, work, disaster, accident, gardening. 

She cannot be quantified.  If you can imagine it, God may be that and more. 

If I were a plumber, than God would be in plumbing for me.  It just so turns out that I am professionally, a psychiatrist.

Most people whom I’ve heard speak about God don’t have much that I want.  God did not employ them, from my perspective, any more than He did to me in mine.  Or the opposite is just as true.  She did.

Rob the pastor needs to do what is best for Rob. Instead, I hear Rob turfing off the disappointments in his life on God. 

Why do I do it, bring God into my self-care?  Because I want to.  Embracing that there is more knowledge than there is now in humanity, is part of Her and my relationship.

Question:  What do you want?  Why do you include or disclude God from your self-care?  Please speak!  It’s healthy for you.  It’s healthy for me.  Keep on.

Self-care Tip:  Don’t save God.  Start with Me.

God Exists and God is Personal

God and me

As there are so many views on what “God” means, and because that’s not what we want to debate here, we have a useful premise. 

God exists.  God is personal. 

Nor is our purpose to worry over the function of religion, to roll between index and thumb the business relationship between us and God, nor to tidy up the religious wars between our nations. 

The purpose here is to discuss how to be a better friend to Me, in the context of the premise, God is and God is personal to Me. 

If God is, then He is personal.  Otherwise, there is no point to God, as far as you and I are concerned.

Question:  How do we treat ourselves well in the context that God is personal to Me?  If God exists and isn’t personal, what is the point of Him?  How does working under the premise that God is and God is personal improve the way you care for yourself?  Please speak out.  We need you.

Self-care Tip:  Accept that God is and is personal to you and keep on.

Between Me and Thee While We Are Apart

apart

I woke up and thought, I love and am loved. I heard the birds. I recognized different songs. I know “our” birds outside our door. So grateful. The morning noises in the house, kids – This is what I pray about when I pray, “Be between me and thee while we are apart one from another.”

Every day takes us.  We go toward and away.  We connect and disconnect.  What do you hope stays close when you weave your pattern?  When you are taken into your day?

It may be a day.  It may be education.  It may be divorce, bankruptcy, or a change in condos that takes you.  It may be as simple as getting a haircut.

As hairstylist Jane said, “I see people come in here all day trying so hard to be unique, and I can’t believe that they don’t see just how un-unique they are.”  She was noticing that “unique” implies disconnect. Those of us in this condition may be grooming toward disconnectedness and missing that even the pursuit of this is inherently a connecting force between me and thee.

Let us acknowledge the connections, not fear them.

Back in the day, there was Laban and Jacob, who had shared space for many years.  When they separated, they artfully practiced connection.

Now therefore come thou, let us make a covenant, I and thou; and let it be for a witness between me and thee.And Jacob took a stone, and set it up for a pillar.And Jacob said unto his brethren, Gather stones; and they took stones, and made an heap: and they did eat there upon the heap….And Laban said, This heap is a witness between me and thee this day. And Mizpah (“watchtower”); for he said, The LORD watch between me and thee, when we are absent one from another.

Here, many centuries later, we remember our declaration of independence from Great Britain on July 4, 1776.  It is our watchtower of sorts, a time when we celebrate our freedom, beautifully crafted into what brings us together.  Freedom is not synonymous with disconnection.  It is the ability to choose, to move in and out, to live with boundaries that are made of ribbons rather than walls, to have distance and still remain close to where our heart is.

Questions:  What connections over Independence Day weekend are you celebrating?  Please speak out.  We need to hear you.

Self-Care Tip:  Let your uniqueness and freedom be a connecting force in your life.  Be a friend to yourself.

Caregiving and Selfcare

Fallen_tree2Being a caregiver is, well, …giving!  There is a need.  We respond to the need.  We give.  There is taking from what we give.

When we talk about this, some of us hear the tap, tap of a bookkeeper balancing ins-and-outs.  Tap, tap, take, take.  We feel dangerously close to objectifying what is Magical.  Objectifying what we get from giving loses at this point in our thoughts the bigger circle of love that motivates us.  Let’s acknowledge and respect that.  The bigger reasons are so worth aspiring to and treasuring.  You who believe in what is more than the numbers of our motives and behaviors, please continue to nurture us with this wisdom.  Be patient as we wander in the corners and cracks and in the places we don’t understand so well.

The point of giving, others pursuing the caregiver’s story later respond, is what we receive.  The love, the satisfaction of observing what our efforts contributed to in another’s rescue.  Perhaps, knowing we participated in saving a life.

Am I a caregiver?  Are you?  Well, maybe we think we are excluded from this category because we don’t liaison between one suffering life-being with the world around.  But are!  We all are caregivers by the definition of what is means to be living.  Living is connection.  We, each of us, are connected to the Universe and the different points from there to here where we stand.  Connection is inherent to living.  To live is to be connected.  To disconnect is to die.

This is somewhere along the philosophical thought experiment of, “If a tree falls and no one hears it, does it exist?”  I am told by those who might be wiser that it does not.  I don’t get it and what does that say about me? 😉

Observation vs. reality.

Connection is like that.  It is not perceived sometimes, and sometimes it is perceived.  This is important to Me.  To the part of each of us that is more than our senses.  More than Time and the condition of our health.  More than brain illness.  This is important to caregiving because by increasing our self-awareness of our role in connection, and thereby caregiving, we have an opportunity to increase our ability to combine the Magic of it with the “accounting ins-and-outs.”  Thereafter, we are lead to increase our transparency to others, increase our connectivity and increase our experience in Life Quality.

Magic is compatible with that which is known.  More even, they are not divided, whether we know it or not.  Magic and that which is known, just are.  We are arrogant people any way we turn the talk, of course.  None of us without agenda.  None of us without projectile pride.  But despite this, we have Grace and whether we hear the tree or not, Magic and knowledge have made allowance for us.

Caregiving comes with connection.  We give, we receive, and we do it with agendas.  Increasing our self-awareness through the process, although it feels at times like ringing out a cash register, and feels soiled by the sound of that which taking brings, – self-awareness of our agendas brings more freedom.  We are more free to give by choice rather than martyrdom.  We give without perceiving ourselves the victim to those to whom we give.  We are more free to give to our other agendas.  We are more free to consider our own needs as needs-of-value from one who is also Loved and valued, Me.

Question:  Might increasing our consideration of our “Me” increase our giving well to others?

Do you consider yourself a caregiver?  How so?  Please tell us your story.

Self-Care Tip:  Give well to yourself to give well to others.  Keep on.

What is The Difference Between Self-Care and Selfish Care

pencils

So what’s the difference between self-care and selfish care?

We hear this a lot here at, Friend to Yourself.  It is a question that can feel like an attack but also an opportunity.  Some people laugh when they say it.  Others do more of a huff.  Self-care shares with selfish care the condition of taking.  That has potential to be confusing.

Let us start with musing, what happens when we give to someone who doesn’t value themselves?  We give and give and they take and take but there lacks the receipt of value, only matter.  The person receives.  The person however doesn’t perceive the, Why?

Once there was Fred.  Fred asked Carl, “Hey man, would you please ask him for me?”

Carl has a childhood school friend he has stayed in contact with through the years.  Carl’s school friend, whom he used to call “Weasle”, is now Attorney at Law, Craig Anderson.  As Carl has nurtured the relationship through the years, sometimes it was easy and fun, and sometimes he nurtured it because it was just smart.  They worked in the same circles.  Once they had shared love of basketball and although they no longer meet on the court, they still meet up.  Carl saw in Craig someone worth investing in through the years, sometimes what Carl invested into Craig was intuitive and other times more deliberate.  Carl considered Craig a valuable contact.

Fred said to Carl, “I just need some information.”  How did Carl respond?  What Carl had with Craig is friendship.  However, he also has “social collateral.”

I remember when I was growing up trying to understand how much money my dad had.  I’d ask him about it, which I now realize is not completely appropriate.  He’d always tell me he was rich because of all the friends he had.  He said, “People are always the best investment.  The people you know, the friendships you have, will always bring you much more than money will.”  It was an early sight into “social collateral.”  I did not get it then.  I didn’t see the appropriate and natural intermingling of what is personal with what is bank.

Fred was asking Carl for his hard earned bank.  Before handing this over, Carl wondered, “Toward what purpose?” “What will that take from the social collateral I have?”  “What will I get from this?”  Fred had a sense of these concerns but he pushed the thoughts away.  He didn’t bring it up openly.  He asked without planning on accounting for what he was asking for.  Is Fred doing selfish care?

Let’s put Fred and Carl on the other side of this page for now.  Let us introduce Susan.  Susan is Lucy’s sister.  Lucy is known as “Floozy Lucy” amongst certain company.  Susan has rescued Lucy many times from life-threat, from financial ruin, from chaos.  Susan gives emotions, money, time, and once even her car to Lucy.  As Lucy continues to self-sabotage, however, we have a word for what Susan is doing – “enabling.”  What if Lucy valued herself more? How the dynamics between Susan and Lucy might be different.  Lucy taking from Susan would be more of self-care perhaps.

Our culture says we need to give give give and the taking is more whispered about.  It is not applauded like a big donation to the church.  It doesn’t consider what taking had to occur to allow someone at some point in their life to be in a position to give.

Over Easter this year at a small church in Corona, CA, I saw one of the best resurrection plays I’ve ever seen, including that compared to what I saw at the Crystal Cathedral years ago. The music, the props, the acting, all amateure.  However, the energy in the room, the connection between the congregation and the stage, and especially the awareness of our Higher Power was intense.  Out of all of this, what hit me the strongest was that the Judeo-Christian culturally celebrates everything about our God who sacrifices, who lives for others, who gives gives gives… but the whole point of what S/He did and does is Me.  Everything about God is His value for Me.  Without Me, that whole story is pretty mute.

Now put God in Carl’s position with Me.  Put God in Susan’s place.  Why would God want someone who gives to others but doesn’t take?  And take well, know they are a person of value.  The taking reflects quite a bit on the Giver.  The taking reflects quite a bit on the taker as well.

Take to grow your sense of personal value.  Take with increased self-awareness of your personal value.  Take to reflect on your connections well.  Take to be a better giver.

These are thoughts I’ve been rolling around.  What do you think?

questions:  What’s the difference between selfish care and self-care?  How do you take with a sense of your own value?  How does taking reflect on those you are connected to?  Please tell us your story.

Self-Care Tip:  Take to be a friend to yourself.  Keep on.

Know You Are Blessed

ulysses

 

Think of the worst of us.  Think of the worst about us.  Think of those with self-loathing.  Those with low self-awareness, the violent, and the violated, think of them.  Where is the blessing?

Blessed are the depressed and anxious.

Think of the healthy.  Think of the diseased.  The misunderstood, the ones who live miles apart from connection, who ever push like a dingy from the peer into waves and self-destruction, think of them.

Blessed are the poor and lonely. 

Where is the blessing when your real estate is brought low by the creeping up of low-life.  Where is the blessing when you get cancer just when you might retire, when your own body calls you stupid, when you lose your eyes after training as a surgeon?

Blessed are those whose bodies are dying.

Think of every corner, every shadow and open space and the turns you still don’t know about inside of your life.  Think of the unacceptable, the character you wrestle against to moderate away from extreme.  The rope you swing on and try to bring to rest, think of the grey you think you will never achieve.  This bit and chapter, this part of your construction, this surprise in how you deliver is Loved.

There is no aberration from the norm that can separate you from that Love.  There is no addiction or misdemeanor or illness or mutated cell that can lose blessing.

This is fact.  Our life is to live with it.

Blessed am I.  Blessed am, “Me.”

Question:  Where is the blessing in what you like least about yourself?  Please tell us your story.  We need to hear you! Keep on.

Self-Care Tip:  Be your own friend in adversity as in prosperity.  Know you are blessed.

Join us at, Seams of Gold!

The University Surgery Center, Department of ECT, and myself will be joining our community at Seams of Gold, where we will share life changing stories of ​resilience, restoration and hope.

Thursday, May 1, 2014  

​6:30 pm to 9:00 pm, Doors open @ 6:00 pm

“Event is Free”

PLEASE COME!  🙂

 

A Father’s Lament  contopolos

On May 29, 2010, we lost our 26 year old son, Nick, after a 14 year struggle to find long term, affordable, quality recovery and care from mental illness and addiction. During Nick’s brief life, both he and those of us who loved him were left with a fatal absence of hope while we struggled, as do many others, to navigate our society’s haphazard, fragmented “system of care”.

Months after Nick had died, I recalled a former broadcast on CNN with a woman who had suffered enormous loss after Hurricane Katrina. The interviewer was asking this lady how, in the face of such loss, she was able to continue on and now help others. She said, “at some point, I stopped asking “why me” and began asking “what now”. That statement, in conjunction with an honest admission from my pastor that “during Nick’s life, he had absolutely no idea how to understand nor how to help us”, was what led to the “what now” of Seams of Gold community service events.

Seams of Gold is named after the ancient pottery art of “Kintsugi”. In this ancient art form of Kintsugi we find the inspiration in how we respond to the fragile beauty that surrounds us.”

Seams of Gold is a FREE multi faith, multi denominational community service event. All are invited.

We are asking that all who have been affected by mental illness and addiction as well as those who love and serve them, to come and be inspired, informed, educated and equipped. Join us, as through the prism of our tears, we pilgrimage together towards a “better day” of empathy, compassion and care for those who suffer.

Recovery is Powerful, it is Possible and it is Beautiful! 

                                                                                                                                  –  Jim Contopulos

 

The beauty of the Santa Rosa Ecological Reserve in southern California provides the backdrop for a father’s lament. Seams of Gold founder Jim Contopulos invites the viewer to join him on a journey as he reflects upon losing his beautiful son to addiction and mental illness.

“Birthed from Pain… Inspired by Art”

                                                                   

http://www.youtube.com/watch?v=VGZ1ESOlvbM

Violence and Originality for friendship

Guest Post!

…keep reading…

Image

Learning new ideas and concepts releases Dopamine, the “feel good” neurotransmitter/messenger.  I find this theory consistent with my personal experience as I am studying for the boards.  The new concepts, when I grasp them and link them to things I already know, do seem to bring a tiny packet of fell goodness.  So, as I study, i really try to capitalize on this mechanism of feel-goodness.  Maybe I can get addicted to learning.  That would be a great addiction.  I think in some ways, I already am.

Using Dopamine in enhancing our everyday life and getting addicted on life:  Creative expressions can cause release of Dopamine – proven by both science and by our everyday observations of living our life.

Gustave Flaubert, of Madame Bovary, famously said:

Be regular and orderly in your life that you may be violent and original in your work.

To me, this fits.  I find I don’t need to lead a wild and dangerous life.  I don’t need external thrills.  I get my Dopamine from being able to be violent and original in my thoughts and ideas – Quite the thrill.  The regularity and order I try to effect gives me the time and space to be just that – violent and original.

The most cutting truths live in works where the artist is violent and original.    Flaubert, of Madame Bovary, said, “be regular and orderly in your life so that you may be violent and original in your work. “. He is fiercely unapologetic in the way he worked.  I like that.  Be violent and original in one’s work, all the while freeing one’s mind to achieve that end by being regular, mundane, and orderly in one’s life.  The creative juices that thusly pulsates in the artist’s veins more than makes up for the seemingly boring and orderly exterior.

Questions:  What role has learning played in your “feel good” self?  What helps you be violent and original in a way that is friendly to Me?  How do you channel your ferocity in the most friendly way?  How has the boredom otherwise affected your quality of life?  Please comment and tell us your story.

Self-Care Tip:   Be violent and original in a way that is friendly to Me

 

Dr. Chin Tang is in his last year of psychiatry residency training, on his way to Fellowship in psychopharmacology through University of California, Irvine.  He is happily married with much adored children.

Dr. Tang says he likes being my friend because in so doing, he is more “emancipated to be as weird and eccentric” as he is, by nature, meant to be.  Dr. Tang really knows how to make a girl feel great.  Thank you, Dr. Tang! 🙂  Keep on.

How Do We Age Well?

photo

Ella Rose

In preparing for retirement, for aging, we put money away like Smaug The Dragon who knows his coin.  We imagine we will gain freedom, retain vitality, interest, and motivation, perhaps enjoy the affection of those we served through life.  But do we prepare for what is really coming?

I’ve been asked, how do we age well?  And guess who asked.  An aged man.  I tugged on my chin a little to hide my discomfiture.  After all, I would like to sit at his table and listen in on his story of doing what he had inevitably done, grown old.  I’d like to hear what he is pleased with.  And what he regrets.  I’d like to hold up the memories, like picture slides to the light, and see if I recognize anything.  Maybe something I might relate to.  Something I might more deliberately emulate.  I might feel more secure, knowing what he has done before me.  Maybe I’d think I am safe.

Remember that song,

A foolish man built his house upon the sand, A foolish man built his house upon the sand, A foolish man built his house upon the sand and the rains came a tumbling down.  The rains came down and the floods came up, The rains came down and the floods came up, The rains came down and the floods came up and the house upon the sand went splat!

(The hand motions make the song.)

But why ask me about aging?  Do I look so old already?  What the!?  Fine then.  I’d like to say, grow old continent and stock full of Botox.  Nah.  That wasn’t it.  (Mind wandering already you see.)

Or maybe, we who are aging wonder quietly if this person, or that might have a trick of doing it better.  This person wants to hold up my picture slides to the light and gather security to them.  That person wants to do more than hoard coin, and another doubts the vitality and wonders if she’d know what to do with it if it were waiting there for her after all in the end any way.  “How do we age well?”

Start with Me.

Me, where there is freedom to choose, the chance of change, the place where cause begins.  (The 3 C’s done our way at Friend to Yourself :).)

As a psychiatrist, it’s easy for me to think first of the biology of aging of course – brain health over time and to recall that the brain is connected to rest of the body.  I could tell this aged man that he’ll be wanting to get oxygen to his brain at night and use his cpap regularly.  I could speak of motility and exercise, of caloric intake and sleep hygiene.  We might spend some time on medical care for psychiatric illnesses common in again, depression, dementia, anxiety, and so forth.  We might speak of the inevitable process of losing friends and family, aging past a child or losing pets.  But as many so often remind me, psychiatrist’s only have the truth that their perceptions allow.  😉

A dear Obstetrics and Gynecology specialist told me the other day that she has become more convinced than ever that the processes of coming into the world and that of leaving the world are the same.  Having delivered countless souls into life, she has been marked, as if the luminescence of so many branded her.  She carries the knowledge of their entry and of those who have already died.

I remember my niece who died at 9 years and 28 days.  Not so old.  Not so aged.  Some how we think of death when we think of aging, not when we think of nine-year-olds.  However my niece did age well.

I suppose aging is like any system, as strong as its weakest member.  The wonder is that if we believe in aging, we believe our lives run on a line, on Time, which is after all, a human construct, a philosophy and based on Magic. Aging well as implied by my OB-gyn colleague, is looking at it from both ends, looking at what is in between, and looking at what is outside of birth and death.  Aging well includes exploring the essence of Me, what bit of Magic came before Time and before zero and numbers and philosophy turned into math.

How do we age well? Does aging imply disease? Aging is linear. They’re different but definitely paired… Help me on this?

keep on.

Bearable Disappointment

Guest Post!

Read on 🙂

We’re aware as smart single women that we can’t expect perfection.

But life still manages to throw us curve balls.

Maybe once you’re into your mid-thirties,

it shouldn’t be called dating,

it should be called waiting for the other shoe to drop.

Why is it always something?

Unless you’re in a problem free relationship with TiVo.

– Sex and the City

 

Despite the fact that the mention of TiVo dates this quote (remember TiVo?!), it still rings true. And you don’t need to be in your mid-thirties for it to apply. Any woman, or person for that matter, who has dated for a length of time knows the meaning of this quote in his or her bones.

You meet someone. It is electric. You connect over so many things. His father passed when he was small too. She loves Quentin Tarantino movies as much as you do. You both want to travel the world with nothing but a backpack. You share a love of fine wine and cooking extravagant dinners.

Before you know it you are sailing off in a sea of hormones and dreams of a future with this new, amazing person. You spend time at work day-dreaming of all the romantical things the two of you will share and your heart skips a beat when you see a new text/call/email.

You are twitterpated. Crushing, hard.

The intensity of these new-love emotions makes you feel as if this person is your destiny. This is deep and something you have never felt before. He is “the one”. You are ready to introduce her to mom.

Suddenly all of your hopes and dreams come crashing down, shattering into a million smithereens.

It could be any number of different things. “Deal breakers” are different for everyone. Prince charming could have said:

  • “Well, I am a musician, but it’s more of a hobby right now. I work at Big 5 to pay the bills”
  • “I live with my mom”
  • “I don’t actually have a college degree. I said I did because I’m only 20 credits away”
  • “I’m impotent”
  • “I have a daughter”
  • “I don’t want to see you anymore”

Sigh.

At the very least you are disappointed. You might feel devastated. Even worse, you might consider throwing your standards out the window to start a relationship with this individual anyway.

Let’s get real and break it down.

Getting real: You don’t know this person. Really, you don’t. You feel like you do because of the adrenaline, dopamine and serotonin running through you. It is also very likely that you have projected a huge, unrealistic fantasy onto them that has no basis in reality. That whole engagement speech you dreamed he would be reciting on bended knee? Yeah, you made that up in your head. The home-cooked meals and coffee dates with your mother you thought she would be making? Also fiction.

It is so easy to become disappointed and exhausted by dating, and life in general, when we live in the future instead of the present. When we live in the future we set ourselves up for disappointment and hurt feelings.

If you feel wounded by your dating life, only you can change that.

Be present. Make reality your friend.

Being present: Don’t wait for a partner to make your life happen. Enjoy every day. Plan trips. Have fun. Be grateful for everything you do have. You have so much! I keep a gratitude list on my phone that I add to and read when I am feeling sorry for my single self.

Making reality your friend: By realizing that that the initial excitement of dating a new person is not a promise for the future, you will save yourself a lot of heartache. People are often not who you perceive them to be (this is usually not their fault). And while it is frustrating when individuals misrepresent themselves, that is part of the dating game. Have compassion for people who don’t feel comfortable being up-front about who they are, and move on, (without them!).

Putting all your emotional eggs in one basket is your decision. Allow a potential partner to earn that over time. Let them demonstrate through actions who they actually are and that they are trustworthy. As the song goes. “You can’t hurry love, you just have to wait.”

Also realize this disappointment you feel is not personal. It is not a reflection on you. You are worthy of love. Have hope and stay positive. Remain grateful.

Be soft. Do not let the world make you hard. Do not let pain make you hate. Do not let the bitterness steal your sweetness. Take pride that even though the rest of the world may disagree, you still believe it to be a beautiful place.

– Kurt Vonnegut

Question:  How have you and do you endure well when disappointed?

Self-Care Tip:  Remember that this disappointment is not personal.  Keep on.

20140224_182909Jessica Adams:  I am a science teacher in Southern California who thinks about relationships, human health, love and of course science. I am passionate about doing what is right for kids and personal growth.

 

Trying to explain, temporary memory loss in ECT

rain gauge

I’m trying to help explain, “Why temporary memory loss in ECT versus loss of memories prior to ECT?” It is “friendly” to understand our treatment options and dispel stigma, starting with “Me.”  Please let me know if this effort is helpful in any way. 🙂

Community opinion of ECT, largely influenced by the media rather than data, has a very hard time believing that the memory loss is of new memories, (or imprinting memory, ) during the course of the index trial; not memories before ECT, not memories after the index trial is done, not memories when maintenance ECT is going on.  

The best way I can explain this, (and this is my own Dr. Q effort,) is that the memory loss is related to mechanical issues, like a cork in a bottle.  Think of a rain gauge, for example.  After it rains, we see on the gauge that it rained 2.3 inches last night.  We uncork it at the bottom, and all the rain water flows out until the rain gauge is empty.  We let the water out. The rain gauge may fill again when it is recorked.

The electrical stimulus and subsequent seizure to a brain cell is like the process of uncorking the rain gauge.  The natural process of the brain is to “recork” after a stimulus, be the stimulus pressure, magnetic, chemical, or in this case, electrical, and let the cell fill back up each time it happens.  The recorking process happens all the time in our brain, (in vitro,) after natural stimuli act upon a cell, be those natural stimuli pressure, magnetic, chemical, electrical, or another.  

ECT is a medical therapy that uses the basic recovery methods of our own physical design and perhaps, this is one of the reasons it is so effective.

Unless the cell has that inside content, it cannot lay down new memories.  The stimulus and stimulus response does not damage the cell.  They empty it. The response is mechanical.

This idea also works to help understand why the memory loss is most often temporary rather than long-term.  The cells replenish between treatments.  It is a cumulative effect, so the closer the treatments are, the more the degree of memory loss.  As the time between treatments increases, the recovery time is so brief, that the patient doesn’t notice memory loss.  The patient is able to imprint memories without difficulty.  The rain gauge, we could say, has its cork in for longer periods of time.

Question:  Have your choices toward treatment ever changed based on dispelling your own stigma?  Has information and greater understanding of your treatment options ever specifically improved your self-care?  Please tell us your story.

Self-Care Tip:  Use information and greater understanding of your treatment options to improve your self-care.  Keep on.

And Then Stigma Disappeared

scarlet

Discover Your Sweetness – Value, That is To Say.

This historical post above is what I will start tonight with when we meet at NAMI.

The blooming sense of value that comes when we pause to appreciate our imperfect selves, our abused selves, diseased, pecked at, and unrighteous selves, this we can trust more than the who believes she serves altruistically.

I remember the Scarlet Letter by, Hawthorne, and wonderful dirtied Hester.

But, in the lapse of the toilsome, thoughtful, and self-devoted years that made up Hester’s life, the scarlet letter ceased to be a stigma which attracted the world’s scorn and bitterness, and became a type of something to be sorrowed over, and looked upon with awe, yet with reverence too. And, …people brought all their sorrows and perplexities, and besought her counsel, as one who had herself gone through a mighty trouble. …with the dreary burden of a heart unyielded, because unvalued and unsought,—came to Hester’s cottage, demanding why they were so wretched, and what the remedy! Hester comforted and counselled them, …at some brighter period, when the world should have grown ripe for it, in Heaven’s own time, a new truth would be revealed, in order to establish the whole relation between man and woman on a surer ground of mutual happiness. 

Once we value ourselves, much of stigma disappears.  There is a coming together of that which is “perfect” with that which is imperfect, flawed, “unvalued and unsought,” and we can see the disease in others and not demand perfection in them either.

Everything starts and ends with Me.

Questions:  How has stigma touched you?  How have you, do you, deal with it?  What helps you?  Please tell us your story.

Self-Care Tip:  Let the imperfect come together with the perfect in you, to deal with stigma in others.

What Are Our Treatment Options in Psychiatry?

choosing

I go through this almost every time I see a new patient.  I often hear that this is all they really wanted, “To know what my options are and that I’m not choosing something way out there.”

First off, most treatments for psychiatric brain illnesses are not done with intention to cure, but rather to restore health and increase quality of life.  Healthy is not the same as disease free.

This applies to all the treatments listed here.

1.  Hospitalization:

Inpatient – 24 hour locked unit, voluntary and involuntary, little psychotherapy, and daily physician care.

Partial Hospital – Day Hospital that runs during business hours such as 9AM-3PM, voluntary only, includes intensive psychotherapy, and weekly physician care.

2.  Counselling/Psychotherapy:

Talk therapy and exercises of various forms.  May be with physician or nonphysician.

3.  Stimulation Therapies, such as:

Deep Brain Stimulation (DBS) requires brain surgery to implant an electrical stimulation device in the specific brain area, controlled by a device implanted in the gut. Effective, but higher risk.  Least time consuming for maintenance care.

Transcranial Magnetic Stimulation (TMS) – The patient sits in a chair with a magnet at the head’s surface that uses magnetism to stimulate the brain for treatment, 1 hour a day, 5 days a week for various weeks, according to the patient’s need and funding.  Few side-effects.  Time consuming.  Not as effective as DBS or ECT but comparable to some medications.

Electroconvulsive Therapy – Uses electricity to stimulate the brain, inducing a short seizure for treatment.  Considered safe and of low risk.  Most effective.  Response is speedy.  Few, and mostly temporary side effects.  Does not enter into the body systems.  Less time consuming.

4.  Medications:

Chemicals for treatment in the form of pills, liquids, injections, patches, powders, vapors, gases – enter into the body systems causing physical side effects that, as with any treatment, must be weighed against the benefits.

Pills – generally taken daily, which is a challenge to treatment compliance, and activate internal conflict and personal stigmas.

Injections – generally done in a clinical setting, bimonthly or monthly.

5.  Aerobic exercise 50+ minutes, 5 days a week.

6.  Sleep hygiene.

7.  Diet

8.  Alternatives – such as over the counter herbals, naturalistic supplements, meditation, spiritual, acupuncture, acupressure, massage, or no treatment.

Questions:  What do you think of your options?  What do you choose?  And why?  Please tell us your story.

Did I miss anything?

Self-Care Tip:  Get informed about your treatment options.

Lupita Nyong’o Speech on Beauty – W-O-W! And, thank you.

“…and my mother again would say to me you can’t eat beauty, it doesn’t feed you and these words plagued and bothered me; I didn’t really understand them until finally I realized that beauty was not a thing that I could acquire or consume, it was something that I just had to be.”

This woman gets us. Friend to yourself. Keep on.

The Energy in Stigma, Yours for the Taking

unicorn

There are nothing like lightbulb jokes in the operating room to make you plume your feathers.  The other day, my nurse “enlightened” me with them.

How many psychiatrists does it take to change a lightbulb?  One, but the lightbulb has to be willing to change.

How many surgeons does it take to change a lightbulb?  One, because while he holds it, the world revolves around him.

How many nurses does it take to change a lightbulb?  If it’s during shift change, no one will touch it.

That is as far as we got, but please share yours, especially if related to psychiatry :).

Lightbulb jokes are common, clean, dirty, and fairly ageless. It does not take the brightest lightbulb in the room (Teehee!) to know that they are so because they capitalize on stereotypes.  Stereotypes, likewise, are widespread, and fairly ageless.  Even in something as objective as brain disease. i.e., The brain is carbon matter, a human organ, mushy grey stuff. The brain gets sick like any other part of the body, human organ, and people bits. Brain gets diseased, people behave and feel diseased.

A primary care physician’s assistant, “PA,” was sharing with me the other day about how she deals with stereotypes when she approaches patients who need treatment toward brain health.

I tell them about all the executives and professionals who get treatment ‘because the stress gets to them and they have nervous breakdowns.’  Then they don’t feel so bad about accepting treatment because they associate themselves with these successful people.

Stereotypes can be positive, negative, or neutral.  Everyone has them.  We clinicians, patients, grocers, those who want nothing to do with medical care, and even executives and other professionals (smile) have them.  But what, in dealing with stereotypes, is friendly to Me?  It starts there.  With Me, one little, or largely valued Me.

We stereotype ourselves and maybe that is why we stereotype others.  For example, this struggle of what to call illness of the brain is common, widespread, and fairly ageless. A Menninger Clinic blogger wrote eloquently about it recently, “Does reframing mental illnesses as brain disorders reduce stigma? by JON G. ALLEN, PHD.”  Most pithy, I thought was this,

…we should be skeptical of the view that regarding psychological problems as brain disorders will abolish stigma. Although the disease model decreases blame, this shift comes with a cost: It increases pessimism about recovery and might also contribute to perceived dangerousness.

I have never forgotten the Spiral Dynamics idea that in the magical level of consciousness, there is a sense of being disempowered. “Perceive dangerousness” is magical. Behind negative stereotypes, there is magical thinking.  We give over what is not to be given and take what is not to be taken.  We have fear.  We feel victimized.  We lose what is freely our own.  Disempowerment is terrifying. There is a lot more stigma out there than there is information but giving stigma and/or negative stereotypes power is our own choice.

A fellow blogger wrote to me how he approaches it,

Change brain illness to mental illness. Our problems really are brain illness from physical dysfunction but I can accept that my psyche is sick easier than my brain is sick.

Stereotypes may scare us but they can also inspire.  It is up to the individual, to Me, how to respond.  As in lightbulb jokes, we who are targeted by stereotypes can take pride in them.  They are not the same as “stigma” although there is overlap when negative.  Stereotypes can be neutral or even something to be proud of.

How many psychiatrists does it take to change a light bulb? None–the light bulb will change when it’s ready.

How many psychiatrists does it take to change a lightbulb? None. It’s their job to help people find their way in dark places!

There is nothing like the kind of energy in stigma and negative stereotypes to inspire us.  Such force, such Magic, these can get the punk in any of us to love who we are.

I used to be quite turned off by the beatitudes thinking I was supposed to want to be a wimp, and couldn’t quite make myself do it.  Now I realize, being a wimp is just what it is.  The blessing is what is inherently available to Me in my “condition.”

1 Now when he saw the crowds, he went up on a mountainside and sat down. His disciples came to him, 2 and he began to teach them, saying: 3 “Blessed are the poor in spirit, for theirs is the kingdom of heaven. 4 Blessed are those who mourn, for they will be comforted. 5 Blessed are the meek, for they will inherit the earth. 6 Blessed are those who hunger and thirst for righteousness, for they will be filled. 7 Blessed are the merciful, for they will be shown mercy. 8 Blessed are the pure in heart, for they will see God. 9 Blessed are the peacemakers, for they will be called sons of God. 10 Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven. 11 “Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me.

Questions:  How have you been able to use stereotypes and stigma as something toward friendliness in your life?  

What have you found is inherently blessing you from where you find the condition of life to be?

How might you use the energy in them toward being good to yourself?  Please tell us your story.

Self-care tip:  Use the energy available in Magic to empower you, rather than disempower.  

What are you up to?

Image

Hello Friends,

What are you up to?

Lately, I have been working on getting our ECT book done.  I am spending more time with the kids, exercising less, quilting more, and eating tons of fruit as it is always in season and “going to waste” (which guts me to see) around our little property.  I am still listening to tons of books from audible and I think that my portrait would show me anywhere anytime with earbuds in.  It must annoy others. …What was that?

Let us know what you are doing.

Be a friend to yourself.  Keep on.