Tell People When You Fall

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

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Self-Care Tip #171 – Tell people when you fall.

Driving today, I was slowed by a driver ahead of me.  I started to get irritated, (I know, “I can’t control this“), but then I noticed the car had bumper stickers supporting breast cancer.  In less than a moment my mind grabbed memories of faces, feelings, conversations, stories and personal experiences in my memory relating to breast cancer and I suddenly felt a sense of empathy and some sadness.  It left me a bit surprised and I reminded myself I was irritated at this driver.  While trying to tease apart these seemingly opposing reactions, I realized I didn’t care much any more about the slowness.  Mainly I wondered how there was breast cancer connected and I cared.

Providentially, Erin posted today on her blog-site, Healthy, Unwealthy, and Becoming Wise,

Falling finds friends.

I remembered the driver and you readers and thought, “It sure does.  Especially when we let others know.

My Ecuadorian sister, Joana Johnson, often tells me one of the biggest contrasts she see’s between our cultures,

connection.

I spent some time in Ecuador doing some clinical work and learning more Spanish between my second and third year of medical school.  I was rarely alone, which frankly creeped me out a little.  Being westernized, I was used to a huge amount of independence and anonymity.  I wonder who I would be if I had grown up knowing someone was always involved in my life.

You might have heard the proverb asking,

If a tree falls in the forest and no one is around to hear it, does it make a sound?

Or,

Water, water everywhere and nothing to drink.

I don’t want to be surrounded but not witnessed, connected or heard.

Telling people about our “falls,” cancer, depression, assault or what not, can feel creepy too, just like I felt loosing some of my anonymity in Ecuador.  However, I now tell myself, “It’s just culture and I can grow.  And I want to.”  Culturally in the “West,” we think of telling about our falls as whining.  That’s a misperception however and a disservice to all of us.  Telling people when we fall is not whining.  The act of telling and the act of whining aren’t contiguous unless we design them to be.

This morning when I saw those bumper stickers, it brought me into the drivers life and connected us.  We are both a little less alone than we were.  These last six months for me have been about taking down boundaries in my well defended life, and I am growing into the difference.  Thank you readers and commenters for that.

Questions:  What has telling others about your “falls” done for you?  How has your culture influenced you in finding friends?  Please tell me your story.

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

I Heart Cleaning

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

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

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

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

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

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

And as Louise Hay once said,

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

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

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

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

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

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

Playing in the Sink

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

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

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

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

I can’t control this.

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

I can’t control this.

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

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

baby elephant | playing in the water

Image by Adam Foster | Codefor via Flickr

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

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

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

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

Choose Self-Care At Your Most Elemental Level

Buchenwald-100625-14486-Schwerte-hell

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Self-Care is For Everyone, Regardless of Circumstance

Freedom from Want (painting)

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

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

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

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

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

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

Image via Wikipedia

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

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

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

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

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

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

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

“He’s Never Hit Me.” Abuse.

Self-Care Tip #163 – Name abuse when it is there.  Be a friend to yourself.

Alexandria (Alex) was crying a lot.  She was trying to divorce her husband but he wouldn’t leave.  He wouldn’t speak.  He only yelled.  He yelled at her, alone, in front of their kids, in the morning, when he came home from work, he yelled.  And he never spoke to her any more.  It’s been weeks since they spoke.  When I asked her if she thought she was abused, she said, “No.  He’s never hit me.”

Mar de Emociones / Emotional Landscapes

What do I do?  I can’t go on like this but everything I try, he won’t listen!

There are so many things many of us would tell Alex.  But would any of it make sense if she didn’t know she had rights?  If she didn’t know what was happening to her?  If she didn’t know, this is abuse.

The “Do You?” questions, per Dr. Quijada, to ask yourself if you aren’t sure if you are abused:

Do you feel good about yourself when you are together?

Do you feel scared?

Do you feel like you have choices?

Do you have effective boundaries; observed boundaries?

Do you say, “No,” and are heard?

Do you have a balance of power?

From the outside looking in, we could answer these questions for Alex.  But anyone who is or has been abused in any way knows that from the inside, answering these questions is hard.  It was hard for Alex.

Alex missed a few beats.  She didn’t want to see herself as abused.

Identifying abuse, naming it, is a start towards the other side of things.  It is reaching the peak of a hill or mountain of life-stuff, taking the view in after the fog lifts, and knowing that things are the way they are.  This is abuse.  A tangible thing.  Not the drifting mist of fights or arguments that once stalked you, leaving you bewildered and empty-handed.  Simply naming abuse is the start of empowerment.  Name it.  Name it out loud.

“I am abused.”

Alex said,

Wow.  I didn’t know that what he is doing is abuse.  I didn’t know.

After we talked about the name of what she was suffering, she talked about what she thought she could do about it, such as:

Call 911 if she feels unsafe.

Record him.

Say the words out loud, “I am valuable and should be treated well.”

Get a restraining order.

…And other things.

Alex didn’t have a lot of extended family support, so for her, that was out.

Alex said,

I feel more empowered.  I didn’t know I could do that.

And there it was.  A dandelion growing out of the cracked cement.  Hope.  A redistribution of the unequal power.  Alex was growing a plan.

Question:  What would you tell Alex, yourself, or anyone else in her position?  How do you see words being a form of abuse or not?  Please tell me your story.

Who Are The Sick? From Here to The Moon.

Michael Jordan, Slamdunk Contest, Chicago, IL ...

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Self-Care Tip #162 – Know your need for self-care.

Question:  In FriendToYourself.com, am I writing to people who are sick?

I was speaking with Beth Jusino the other night, when she asked me this.  I thought I’d ask you in turn.  You readers might be interested in commenting.

What is mental illness?  Are you writing to people who are sick?

Beth is smart.  She’s heard of Major Depressive Disorder, Schizophrenia and such.  She didn’t ask me this question so I could read her the DSM IV-TR.  She was asking how far mental illness is allowed to go before it gets named.  And how about the space beyond?  Are there bits that aren’t named?  Does it drift along an arch between Crispy Health and Completely Ill?

What do you think?

One reason I like to write #mentalillness hashtags on @Twitter is because I have a theory that people who have allowed themselves to be named, who have accepted to any degree a need for help, who have released their history and claimed their future over and over again – well I have a theory about these people that explains why I write to them.

These people are more able to hear the knocking sounds of wanting.  These people are more available to grow.  These people accept the gift of health and any space between here and there where they find themselves, all the while pressing; a courageous forward effort to freedoms.  These people care about self-care and they know they are accountable for it.

I remember this,

It is not the healthy who need a doctor, but the sick.

It makes sense.  However, it isn’t as easy as calling a spade a spade, and not because I’m lacking honesty and directness.

I heard a variation of this analogy years ago and I don’t know who said it first.

If you ask me to compete in a slam dunk contest with Michael Jordan, competition would be over before it began.  I’d trip, travel, and carry my way to the net and not get air.  But move the basketball net to the moon, ask us to dunk and the competition is just as over.  The space of air between my shoes and the earth is not much different from the space between Mr. Jordan’s shoes and the earth when we are both shooting for a basketball hoop on the moon.

Maybe you get where I’m going with this.

What do you think?  What do you say to Beth or anyone on this?

Keep Talking

Day 349 of 365 - Self Care/Friends!

Self-Care Tip #160 – Keep talking.  Be a friend to yourself.

Lingering in the afterglow of what all of you have said in your comments over that past six months, I am distracted in the best of ways.  The comments so often complete the post.  We are a team you know.  I hope that more of you noncommenters will shuck off your shrouded lovely selves and say something to us.  Because it is not true on this blog, that casting your bread upon the water just makes soggy bread.  Nope.  You’ve all been my living examples of this.

Yesterday, Nancy wrote,

“But to associate self-care with freedom actually made me feel free today….”

I could have cried because… I just can’t say all the many reasons why she blew me away with that.  I don’t have enough fingers to point with.

Sarah,

the civil war inside of us.

Mr. Rick C. in his Blog-Jacking #2,

Folks, you have not experienced incomprehensible demoralization until you have had a Flowbee lock onto your head with the full force of a ShopVac behind it.

That one just won’t stop coming back!  The visual itself is an almost permanent gift.

Kevin Blumer keeping things light talking about stress,

I love stress I absolutely love it being busy 10 pizzas to make in 2 mins…

Some days ago, Pattyann wrote,

I think it is much easier to ask for help and receive it when we stop looking at an illness as a personal failure.

Is there any better way of saying that?

Our own articulate CarlDAugostino who shows so much interest and respect to so many of us gave me this,

I have never really heard of this “self -friendship journey” It is a wonderful concept…

Yes, you show me that I matter and that I am not alone and that it turns out, …taking care of myself has been a pretty good idea after all.  You show me that it starts (goes across a few oceans and continents) and ends with “Me.”   Thank you, all of you for that.  There are soooo many things you’ve said, (you know who you are) that have totally rocked me.   Keep talking.

Question:  What shows you that it starts and ends with you?  Please tell me your story.

Self-Care is Freedom, is Democracy, is Because We Are Accountable

authenticsociety.com

Self-Care Tip #159 – Be accountable for and to yourself.

It was about 100 degrees Fahrenheit, which in my part of the world is considered hot.  But in Washington D.C., I considered that temperature general anesthesia.  I was breathing it in and trying hard to remain alert.  Just when I thought I could hold out no longer, I saw him.  Big and expressive, the long form of Abraham Lincoln was there, surrounded by loud irreverent people.  My brother and I were wiping sweat out of our eyes trying to keep track of our kids.  We wanted to read the Gettysburg Address for our kids, and found ourselves screaming.  The kids could barely hear the words above the disinterested rabble around us.  Despite all this, I was choking; a weepy, sweaty, nearly anesthetized but free American.

Four score and seven years ago our fathers brought forth on this continent a new nation, conceived in liberty, and dedicated to the proposition that all men are created equal.

Now we are engaged in a great civil war, testing whether that nation, or any nation, so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

Just down the corner from Lincoln is a president’s list of sites to see, informers and reminders of who we are and where we came from.  However, none of them were “my Lincoln” experience.

But, in a larger sense, we can not dedicate, we can not consecrate, we can not hallow this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us—that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion…

A couple of days ago, writing the post about how stress intersects with medicine, I remembered “my Lincoln.”  It may seem like a stretch at first but take a minute.  Self-care is a way of saying, “I am free.”   In places where life is cheap, almost without value, self-care is not much of an option.  It is because of freedom that we can extricate the meddling fingers, the invasions, and be the keeper of our own private spaces however we choose to.  It is because of freedom that we can tell people that although my brain is ill and although I take medication, I am equal. Saying that is self-care.  Saying that is possible if we take that freedom to keep our own accountability for our own selves.  Accountability is not the same as blame.  Having accountability for our freedom is not the same as being at fault for what came before freedom, nor our current conditions.

—that we here highly resolve that these dead shall not have died in vain—that this nation, under God, shall have a new birth of freedom—and that government of the people, by the people, for the people, shall not perish from the earth.

If you’re not accountable to your inner self, if you’re only accountable to your actions, or you’re only accountable to what others determine and define about you, than you are not free.  You are blamed.

Accountability is such a tender privilege.  We might lose it if we forget who we are, where we came from and our rights to freedom.  Democracy is self-care.

Question:  How do you see the relationship between self-care and your freedoms?  Please tell me your story.

Blog-Jacking by Mr. Rick C. – #2 (Do I or anyone really deserve this?!)

Hello Folks.  Today Mr. Rick C. is taking this post over….

As a person with a vast amount of psychiatric experience, I have learned the importance of watching for danger signs in others and myself.  Recently, you may have noticed, our very own DQ displaying a few atypical qualities.  Let’s take a look at her last blog.  Apparently, she has now given herself the new name of Dr. Q (any body remember that show Dr. Quinn, Medicine Woman…Hamm) and began referring to herself in the third person.  Another great blogger, xcandyxcane, does this effectively but differs from our own “little bundle of identities” by acknowledging that she is speaking in such a manner.  Dr. Q aka DQ aka Dr. Quinn Medicine Woman may or may not be aware of this.

Her blog entry seemed well written, as always.  However, she did seem a bit flustered by the fact that she got a few negative little thumb things.  Let’s put this into perspective, depressed people can be negative.  It is a key symptom of being depressed.  We are here to learn how to make little thumbs up things more often.  The fact that I picked this up and she did not, while not unusual, could be an indicator that she is not functioning at her highest level.

Finally, a sure indicator that she is teetering on the brink of collapse… the use of that oh so pointed word, “shucks.”  I can only imagine the stress and pain required to push her to such an outburst.  For these reasons, and my true desire not to watch “The Doctor Formerly Known as Quijada” spiral down to a point at which she goes on and on about flooded basements, frogs and Lebanese births, (certainly was a fun week you may remember,) I have taken it upon myself to give her the day off.  If nothing else, I’ll make her sound really professional when she returns.  Let us all keep her in our thoughts as she sits comfortably in the castle (aka future sink hole) she calls a home, self-medicating while being a friend to herself.

Since I am not a real doctor, I cannot share a heart warming narrative about the one-legged blind puppy being held by the child with such a distant look in his eyes as his mother crocheted for reasons unbeknownst to the rest of the world that came into my clinic.  However, I would like to speak up about an aspect of this blog that I am truly pleased with.  (And I’m not going to try to understand what the word “paradigm” means that she keeps using.)  As I took in the fine nuggets of wisdom that are typical of this blog, I was especially pleased with the mental image when reading the description of  “Gorgeous Candy.”  Of course, any functional male reading this immediately recognizes this fine moniker.  (There is no medical term for that, I looked.)  Trust me, Q had no idea, none what so ever.

So…. as I absorb the plethora of psychiatric knowledge, I realize, I could very well be the man who could save Gorgeous Candy.  The image is clear in my mind and I know I can help.

All right, at this point, I would like to share a story about my drinking and a self-help program.  One night, after ingesting a large amount of alcohol, I decided to sit down on the couch and enjoy some television.  Interestingly, at three in the morning, there are many programs on involving various forms of “self-help” for a fee after calling and speaking with gorgeous women.  You can teach yourself to speak Icelandic in three days.  Several programs guaranteed to make you stop smoking and drinking while you do nothing.  Then – my personal favorite, the Flowbee.

The Flowbee allows you to cut your own hair with a vacuüm cleaner attachment as demonstrated by some great looking individuals.  As a result of my intoxication and the brilliant manner in which it was presented, the Flowbee sounded like an excellent idea with very few negatives.  I called just in time to be one of the lucky callers that got a discount knife set, as well.  Not so surprisingly, I was intoxicated when the Flowbee arrived.  No problem… easy enough to operate and certainly no need to watch the instructional video.  Hook it up to the Shop Vac and away I go….

Folks, you have not experienced incomprehensible demoralization until you have had a Flowbee lock onto your head with the full force of a ShopVac behind it.  At this point, as I lay on the floor trying to kick the plug out of the wall, I realized that my life was completely unmanageable and I would possibly need to go beyond the resources I had within myself.

Upon having the Flowbee removed from my head, I was fairly certain that all of my problems had been solved.  Hence, I went back to drinking.  Several years later, I would discover the twelve steps.  When I did, I was in Texas and had the fortune of becoming part of an AA group where people had no problem being honest or saying it like it is.  One of the first things that I was told, was that this is a “we” program and that if this program were to rely on “self”…. Well, based on my track record of helping myself first, I was in trouble.  Every single step talks about “we.”

Through the years, I would learn more about how important the group is to a twelve-step program.  Furthermore, the basis for AA (the first of many twelve step programs) is a movement called the Oxford Group.  This was a group that became popular around the turn of the century.  They had some basic principals that have become the basis of twelve step programs.  Key to the Oxford Group and twelve-step programs is the benefit of sharing among a group that is working this same program.  There are many tests online and other places designed to help individuals determine if they are or could be an alcoholic.  I think, for many, this test could be simplified into…. have there been times in your life that a Flowbee sounded like a great idea?

Please, share with me your thoughts.  Why are paradigms important?  When doctors self-medicate… is there a copay?

This would make even less sense if I was drinking…. Can you imagine?

No Matter Why, Where, or What Happens, Self-Care Starts and Ends With Me

Cover of "To Kill a Mockingbird: 50th Ann...

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Self-Care Tip #158 – No matter why, where or what happens, self-care still starts and ends with Me.

It’s no secret that I look at behavior through many paradigms.  Most of what I’ve shared on this blog is medical because I’m a physician.  That’s my specialty.  I’m not a physicist and don’t spend my posts on explaining how physics influences our behaviors – although I believe it does.  However, I don’t want you to think that I think behaviors and emotions exist within only the medical paradigm, even though that’s what you hear me talk mostly about.

According to Dr. Q, the roughly sketched breakdown of how stress intersects with medicine:

1.  Stress influences how we behave and feel. We “see” the stressors, and we see the emotional and behavioral responses, and we know their sources.  We know that emotions and behaviors are produced by a human.  Where else?  Anything magical or otherwise comes from Someone from another place.

2.  Stress influences our medical condition. Stress will awaken sleeping genes that carry the names of different diseases; cancer, major depressive disorder, schizophrenia, and so on.  Would those genes have awakened on their own without the external trigger flipping the switch?  We don’t always know.

3.  Because there are so many factors that influence the reasons a disease process demonstrates itself, we cannot say that it is causally related to the stressors.  Many people try to do this, and sometimes the disease’s labeled cause comes down to the jury’s decision.  But we don’t have to have read, “To Kill A Mockingbird” by Harper Lee to know that people’s opinions and judgments are biased.

4.  People try to find the reasons why.  This is natural and in my opinion appropriate.  However, where we look for the reasons for the feeling and behaviors is equally important.  Seeking accountability for how we feel and behave to come from outside of ourselves, to come from external reasons, to come from a source to fault is more often missing our chance to get friendly with ourselves.

“It just is,” as many say, and the 12-Steps would say “Surrender what is out of your control to your Higher Power.”  These are not inconsistent with owning that mental health begins and ends with Me.

Sure, there are the despicable situations of abuse, trauma, violence and other horrible biology changing events.  These are known to cause the one non-genetically related psychiatric disease process called post-traumatic stress disorder (PTSD.)  These are situations consistent with our previous post on not being responsible for our history but being responsible for our futures.

5.  Stress, other than in situations of PTSD, is not causal for the progression of mental illness.  Everyone has stress, but how we deal with it, how we cope makes the difference.  Even horrible events, such as losing ones wealth and the sequelae of it are not causal for the continuance of brain disease.

6.  Medications, lifestyle change, Love and various other therapies effectively influences the way genes express themselves, our biology, and our medical condition….

7.  …In so doing, medications, lifestyle change, spirituality and various other therapies effectively influence our emotions and behaviors.

Question: How has your understanding of how stress intersects with with how you feel and behave affected you?  Please tell me your story.

Go Toward Mental Illness and Take It To The Floor

Sean and Cheryl: Drama on the dance floor

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Self-Care Tip #155 – Go toward the real issue.  Be a friend to yourself.

Little woman, she had pinched toes in her four-inch heals and wonder what her size has done for her.  Mindy was anxious.  Even though I wonder about her stressors, like possibly her height and the history she is telling me, I know something else.  Even though I wonder about her parenting and marital stressors, and about growing up in a small town but now living with giants, I don’t wonder what she thinks.  Mindy describes these giants as people with large accomplishments, things she would not try herself and that means something to her, but not what she thinks it does.  Mindy wanted to see how things went.  Apparently six months of this wasn’t long enough.

We could spend the next five years breaking all this up and apart and tossing it like a cranberry salad.  But Mindy’s anxiety is mostly not about the salad of life.  Mindy’s feelings are a bit about the stressors and a lot about her brain.

Mental illness is not a small thing.  We trim it down when we say otherwise.  The unfavored sister, Mental Illness isn’t spoken to much at the table.  Her more popular sisters, Stress and Life-Triggers, get a lot of the attention.

With some effort, people who once worked around Mental Illness like it was barely there take a chance and go straight at it, full charge, and swing that woman onto the ballroom floor.

I went for that dance with Mindy.  And she wasn’t talking about waiting and seeing how things went for long.  I told her, like I’ve told you, that how we feel and interpret our stressors comes from our brain.  I told her that mental illness gets worse if it isn’t treated and treated to as full a response as possible.

We weren’t talking about life stressors at that point.  We were talking about her medical condition.  Once treated, Mindy will continue to have life stressors.  We will hopefully also see however, that she responds to life stressors differently.

Question:  How do you make sense of the seemingly meaningfulness of how stress affects us with the seemingly less meaningful concept that we feel that way because of our brain and not because of the stress?  Please tell me your story.

The 12 Steps To Serenity

Ben‑Enwonwu‑Negritu

Self-Care Tip #154 – Go towards Love.

I realize that many of us talk about the 12-Steps, we know people working the 12-Steps, we even recommend the 12-Steps but have never read them through.  So here they are.  For all of us.  A wonderful walk with and towards love.

The 12 Steps To Serenity

  • Step 1 – We admitted we were powerless over our addiction – that our lives had become unmanageable
  • Step 2 – Came to believe that a Power greater than ourselves could restore us to sanity
  • Step 3 – Made a decision to turn our will and our lives over to the care of God as we understood God
  • Step 4 – Made a searching and fearless moral inventory of ourselves
  • Step 5 – Admitted to God, to ourselves and to another human being the exact nature of our wrongs
  • Step 6 – Were entirely ready to have God remove all these defects of character
  • Step 7 – Humbly asked God to remove our shortcomings
  • Step 8 – Made a list of all persons we had harmed, and became willing to make amends to them all
  • Step 9 – Made direct amends to such people wherever possible, except when to do so would injure them or others
  • Step 10 – Continued to take personal inventory and when we were wrong promptly admitted it
  • Step 11 – Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God’s will for us and the power to carry that out
  • Step 12 – Having had a spiritual awakening as the result of these steps, we tried to carry this message to other addicts, and to practice these principles in all our affairs

Question:  What do you think of these steps?  Please tell me your story.

Celebrate Your Imperfections

Perception_is_Everything_-_Rusland_Beeches.jpg

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Self-Care Tip #153 – Celebrate your imperfections and adequacy.  Be a friend to yourself.

Chrystal came in.  Years with degrees of depression pulling her up and down leave her hoping to reach euthymia (steady level mood).  Chrystal and I frequently find ourselves talking about the grief that comes with this.  But not so much today.  She was hopeful after a new medication trial gave her a week with less melancholy.

In depression, even a few hours of relief from the dark inability to feel pleasure or interest, even a few hours when hope slips in can be enough to remind us what it is about life that is worth living for.  Chrystal has stood in and out of that shard of hope many times.  Each time it returns, she turns her face into it.  Hungry.  Wanting.  Alive still.  Responding to what any of us do, as any of us would, when hope is on us.

Celebrating a little together this lovely hope, she was nevertheless aware that it might sneak off again.  She said, “We’ll see.”  I said, “We’ll see.”

And then I remembered.  “Why can’t we celebrate your flaws?  Who says we can’t?”  They have beauty.  They have depth and shape and the loveliness that comes only from pain.

Chrystal looked at me doubtfully.  “Really?  I’m not so sure about that.”

I remember Someone perfect.  Last I heard, He had some pain and scars too and it didn’t change His status, value, or essence.

If we can’t celebrate our imperfections, we can’t celebrate anything because that is who we are.  Imperfect, all of us, except for One.  All of us adequate.

Adequate.  I celebrate that I am adequate today.  Adequate to live, to love, to do what I do.  “Adequate” implies a personal balance between perfection and flaws.  It implies a presence with both poles.  It does not quantify.  It does not mean that we don’t continue to grow or hope.

I’m not sure about everyone’s opinion about my self-perception, my attitude, or my effort at life.  However, I am growing surer of my own and am getting glad about that.  I’m wondering if Chrystal can celebrate her flawed self as much as she celebrates the hope of escaping her suffering.  What about you?

If each of us in turn were as pleased with ourselves as that, still hoping, still growing, still hurting, still suffering, what then?  Let’s celebrate together, alone, healthy, ill or wherever we find ourselves.  Let’s celebrate our imperfections and adequacy.

Question:  How do you live with your adequacy?  Please tell me your story.

Please Don’t Say “But”

Christopher Robin in his Disney depiction.

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Self-Care Tip #152 –  Please don’t say “but” to be a friend to yourself.

She wanted to explain why.  Her sons did not hear.  So she explained why to me.  I listened.  What I learned was…

…It is her choice.  Forget about explaining her “why.”  She knows that they can only hear themselves.  If she wants to be in their lives, she has to be with whom they are in this moment, trumpeting her failures, bemoaning their losses.  If she wants to be with them she’ll meet them there in the gutter and remember their value when she smells stench.

If you’re going to be with the sick, you can’t expect them to mop your brow with tender caresses.  Remember yourself.  If you want to be with your sons, than be where they are, apparently breathing fire and your name is the flame.  Still want to be with them?  Don’t explain why then.  Just be with them, like Christopher Robin when Poo was stuck in the tree trunk.  Just stand there until they can get out and be.  Being present.

If you say “but” it means you didn’t hear. “I’m sorry but,” is not saying I’m sorry. “Yes but,” is worse than many more obvious offenses. See the eyes roll? Hear the sighs?  Watch the words fall apart into letters that pile up like a wall in front of whatever it was that was said in the 1st place.

In some such scenarios it can be a first come first serve. Wait your turn to complain. Wait your turn to present your case.  If you didn’t get there first, listen.  And let the air fill up with all the things that someone wanted to say, and don’t open windows.  Just breath.  Just stay and breath and listen to them if you choose to.  If you choose to be a part of that person, where they are now, stay and be and breath.  Another time if and when they can be with you, you can explain the why.  Maybe they will never be able to give you that gift.  But are they worth it to you?

For her, she decides moment by moment.  You can’t give what you don’t have and sometimes she has what it takes to give that gift and sometimes she does not.  When she doesn’t, she isn’t standing beside their bodies stuck in a tree hole.   She’s off taking care of herself like she should be.  They’re still worth it to her.  And in her story, when she’s gone from them it doesn’t equal her abandoning them.  It means she can’t give just then.

For others, being gone may mean that it is not worth it.  That is fair.  It is a free choice to give a gift.  Gifts are free.  Listen or walk away. …But please don’t say “but.” No one will hear you.

And staying present doesn’t mean more than just that.  It doesn’t make you guilty by association.  It doesn’t give you a “go to jail” card.  If you don’t judge yourself that is.  Wow.  What a gift.  Standing present with the one you love.  Even when they are not being nice.  Even when they are not healthy-minded and say all manner of evil against you, still stand beside them, a witness to their value.

Nor does being present turn you into a noodle.  For pity’s sake, it means only what it means to you.  There is love.  And love is stronger than anything. …But please don’t say “but.”  No one will hear you no matter how much you love him.

And that is what this aching heart-mother taught me about presence.

Question:  How has avoiding the “but” in your dialogue affected the reception of what you’ve said?  Or vice-a-versa?

Your Personal Fight For Emotional Freedom

crochetingingeorgia.blogspot.com

Self-Care Tip #151 – Fight to be a friend to yourself.

My friend Carl, after reading yesterday’s blog-post, introduced me to this gorgeous song.  I found it on YouTube connected to a slide show of our soldiers.  Thank you to our courageous American troops fighting for the freedoms we enjoy and take and take and take.  We know that when you fight, there are losses.

We all are soldiers of sorts, fighting in life for our own selves for so many reasons.  But it’s not about the reasons or motives.  God takes care of those.  So regardless of why, thank you to all of you out there fighting for your own selves.  You who want your own emotional freedom.  The good that comes from this courageous fight ripples on the life-waves and reaches us.  Thank you.  We know that when you fight, there are losses.

Carl, thank you.  Your personal fight, your courage, touches all of us.  What you do is self-care, is care for us, is care.

Let There Be Peace on Earth, by Gill Vince

Let there be peace on earth
And let it begin with Me.
Let there be peace on earth
The peace that was meant to be.
With God as our father
Brothers all are we.
Let me walk with my brother
In perfect harmony.

Let peace begin with Me
Let this be the moment now.
With every step I take
Let this be my solemn vow.
To take each moment
And live each moment
With peace eternally.
Let there be peace on earth,
And let it begin with Me.

(child)
Let there be peace on earth
And let it begin with Me.
Let there be peace on earth
The peace that was meant to be.
With god as our father
Brothers all are we.
Let me walk with my brother
In perfect harmony.

Let peace begin with Me
Let this be the moment now.
With every step I take
Let this be my solemn vow.
To take each moment
And live each moment
In peace eternally.
Let there be peace on earth
And let it begin with Me.

Question:  How do you see your personal fight for emotional freedom rippling into the space of others?  Please tell me your story.

One More Honest Way To Say, It Starts and Ends With Me

Hi! I am feelin so good today. At present: joi...

Image by jessica mullen via Flickr

Self-Care Tip #150 – Be honest about why you don’t like them.  Be a friend to yourself.

Today I spent with my in-laws and my own parents:  a blend of the Philippines, farm-white middle America, and Lebanese superstar.  It was tense at first but was, despite my husband’s and my paranoia (based on preformed something-or-other) nice.

When I look around at my family, I see their good features all the while remembering their not-so-good bits.  Depending on my state of mental health, the good is more apparent than the bad, or vice-a-versa.  It depends on Me.  When I am feeling confident, loved, and am doing what I like to do in life, their fabulous selves seem like the people who came to visit.  Not the ones I “walked out” on X-number of times before.  I’m sure it goes both ways, even if they haven’t typed it up for the world to read.

All of us do form opinions about each other.  You, me, or any other connection do.  We all have some level of judgment about who is holding the other side of the string.

See, I like people more when I am doing well.  Is that so unbelievable?  Well sometimes, yes.  It is more unbelievable than we first think.  It would be more believable to say, rather, that I like people more when they are nice.  Or I like people more when they do good things.  That is easily believable.

When we have opinions about people who are less than lovely, this little epiphany is there to help:  We like others more when we like ourselves more.  Introspection is useful if we know what we’re looking for.  Using this handy-dandy epiphany-tool, we might be able to get inside ourselves and see that how we feel about others is about “Me.”  It feels like we don’t like someone because they are a baddy.  But the truth is, we aren’t feeling so good about our own selves at the time.

Inversely, we might be able to do the same for others.  When they behave negatively, pull out your epiphany tool.  (It comes in many colors.  Mine is pink.)  We can remember, “Quisas!  They don’t like themselves so much now.”

What this little epiphany-tool patent banks for us is the ability to own our feelings in one more honest way.  Feeling good in life starts and ends with “Me.”  Isn’t that refreshing!?  Ah.  Sigh.  Relief.  At least we have a place to start and finish.  Me.

My mom, sweet Mom, tucked into her car about to leave today, was swelling with joy about my melting body-fat.  It was a little overwhelming for her, dear thing, and she reacted by throwing out her “gift.”

When you get to the size you want to be, I’m going to take you shopping!

I’m not going to get into all the history of my mom (whom I do love to no end) and me as it relates our “compatibility” in the arena of fashion (very little of which I naturally have) nor shopping.

I said,

Mom, just take care of yourself.  You are the best gift I could ever want from you.”

And she is.  This healthy part of Mom is.  She, that has fought so hard all these years to be healthy, is a treasure without a number.  I just want her.  And I can say that because I feel pretty good right now.  She’s always been a treasure, even when I didn’t appreciate her enough and wasn’t using my pink-epiphany-tool.  When I think of the parts of our history that are less warm and fuzzy, I think, “That’s how things go.”  And it rolls and ripples through to the space where angels fly.  A place big enough for our good and bad parts.

It all starts and ends with Me.

Question:  When is it hard to see your own role in how you feel?  Please tell me your story.

Receive When a Gift is Offered

Ms. Stephanie Cocks

Image by -kÇ- via Flickr

Self-Care Tip#149 – Receive when a gift is offered.  Be a friend to yourself.

I am totally charmed.  Sitting in the coffee-shop, and this lovely man came up and handed me his James Patterson book.  “I’m going to throw it away and thought you might like to read it.  I’m done and it was great.”  Judge and Jury looks suspenseful and I’m too fragile I think for it, but I took it anyway.  I was more charmed by the intent and character of the giver.

I try to tell my daughter about this.  When someone offers you a gift, just accept it.  It’s not so hard.  Say thank you and in doing so, give them the gift of giving and receive the gift of receiving.  It’s powerful for both parties.  The ability to receive isn’t always natural.  It’s something I’ve tried to understand my whole life.

Well, I didn’t catch the name of the book-man but we chatted despite lacking that social etiquette.  He saw my blog-site on my open computer screen and discovered my background in mental health.

“I have problems,” he said.  “Really I do.”  Maybe he was used to people not believing him and added that to add emphasis.  “I have anxiety.”  “Oh.”  I said.  “That’s torture.”  “It is!” book-man said.  “We don’t choose our emotions!  I used to think we did, but we really don’t!”  I heard it from the source.  Speak it book-man!  We don’t always choose our emotions.

We didn’t talk long.  He walked off before I could offer too much.  Maybe it was the anxiety that called him away.  I felt sad and happy.  Sad, because his suffering connected with me.  Happy, because of all the people in here, he and I connected.

Connecting with people any time any where is a small bit of the supernatural.  It’s not something that we can distil, put in a tube or slide under a microscope.  It’s not something that obeys even the excellent paradigm of temperaments.  It comes both expectedly and unexpectedly.  It comes deliberately through labor and through chance.  An airborne-something from the spirit world.  This is not to say that the natural isn’t also family, the dear child of the supernatural.  It’s just that there is a unique charm in the unknowing.

And so the book-man and the unknown connection stays with me even now after he is gone.  His anxiety, his reaching out, his generosity, the Me drawn into his space and he into mine.  I am receiving and he gave.

Thank you Great Supernatural and Natural God for this.

Question:  When do you connect despite the anxiety of being in the position of receiving?  Please tell me your story.

Emotions: The Physical Gift We Can Name

Leprosy hand affected fourth digit

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Self-Care Tip #148 – Identify your emotions, navigate, and get help.

Mad.  And when Mia was angry she wanted to go eat.  Nervous.  When she was nervous she wanted to go eat.  Like a wire with a current, she couldn’t stop her thoughts from moving and moving.  Although eating soothed her in less than a shard of a second, it was also followed by self-loathing.  Self-loathing brought on more eating and then purging.

Sitting in my office, Mia said it was like she was looking at herself from the outside in and the self on the inside could hear the, “Stop!”  Demands, petitions, and begging to stop came from the other Mia, who was loosing her command-authority in a scary-fast way.

How often we hurt ourselves but blame a trigger, an emotion, a person, or an act of malice.  If only we could say, “Put the offense down and take two steps back.”  But sometimes we can’t.  It’s easy to piously say, with habits and cassocks or soutane (French for traditional priest’s attire) in place, “Don’t make decisions based on emotions.”  It’s easy to say, “Be objective, we can’t trust our emotions.”  But if emotions are what we use to interpret the world around us with, if that’s all we have, what can we do?

Emotions are ideally the color, texture, perfume, music and salt in our physical self.  Emotions are our spiritual sensory system.  Not being able to trust them is a big loss.  Being blind, deaf, anosmic (can’t smell,) unable to taste, and numb would make it really hard to interpret the world around us too.

Paul Brand, MD, coauthored with P. Yancy, “Pain:  The Gift Nobody Wants.”  This book uniquely tells Dr. Brand’s story of working with lepers in India.  Leprosy is a disease that causes a person’s nerves to stop working so they lose their sense of touch and subsequently can’t feel when they hurt themselves.  A once harmless thing like bumping a finger for example, is extremely dangerous.  Lepers can’t feel the pain, and so don’t accommodate for it and protect themselves. You can imagine that bumping a finger but not reacting to it leads to tissue damage when it is done over and over, until one day the finger falls off.

Dr. Brand is right.  Pain is a gift.  And so are emotions.  Including emotional pain, if serving as intended, to protect the individual and not self-destructive things such as bingeing and purging.  The purpose of this post is not to get into what binging and purging is.  That’s just an example of behaviors that might grow out of emotions gone amuck.  Emotions that we used to trust.  That use to tell us who is a friend and who is an enemy.  Emotions that used to know who’s side they were on.  Emotions that forget their own like that can be just as extremely dangerous as leprosy is to our tender fragile fingers.

The purpose of this post is to flatten the mountains of understanding between here and there.  Between understanding that emotions are as physically important as anything else, such as the spinal cord.  The purpose of this post is to furthermore say what to do about it once we can 1) identify the problem and 2) get past the stigma.  Mia did the eating and purging stuff, but she also asked for help.  3) Ask for help.

Lepers have still so few options to help their disease.  Us with emotional illness are very blessed because we do.  We have medications, psychotherapy, coping skills, miracles, and more.  We have a lot.

Question:  How do you define the space between emotions and other “real” medical illnesses such as diabetes?  How do you navigate around stigma?  How do you ask for help?  Please tell me your story.