stigma

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God in the Space of Synthetics

Hello Friends!

I’m going to try something a little different today. I’m posting a dictation between a patient of mine and me because I think it has flow and a nucleus. (There are a few small changes made in liberty, and no identifying data.) Let me know what you think of the content.

Psychiatrist:  …And so we were talking about perfectionism, right? 

Patient:  Yes. 

Psychiatrist:  And about how you are not being kind to yourself when you expect yourself to be all healthy.

Patient:  I’m not being kind to myself when I don’t want to take this or that because I don’t do synthetics. (This is what my patient was using to describe medications.)

Psychiatrist:  I like that you used the word synthetics, because I’ve never put it in that perspective with patients, and you did that for me. 

Patient:  Well, there are non-synthetic and there are synthetic. 

There’s body recognizing things, plants, and then there are the synthetics, what the pharmaceutical companies produce. And I’m a very negative pharmaceutical company person. 

Psychiatrist:  Compare that to other inconsistencies in our life. Such as, I’m going to be all-natural, I’m only going to wear hemp.

Or take it to the point where I’m going to weave my own clothes because it’s really natural and I know exactly what’s in it. Versus saying that I’m moving forward and I’m going to take what science has offered to us. I’m wearing polyester right now. 

Or, I’m willing to take over the counter “herbs” because they don’t have the pharmaceutical stamp on it, or maybe I like that it grows out of the ground. But none of that has been governed. Aside from the “he-said-she-said evidence,” there’s often little science behind some popular over the counter remedies either. 

Let’s consider that perhaps the study data, comparing in a regulated way, one patient with another, defined synthetic agents, and then allowed my body to be its healthier self. It gave us objective data. Numbers. Sure they have their flaws and weaknesses as we learn in statistics that all does. Poke holes in it as you wish, but at least there is a degree of transparency.

Patient:  Maybe for me it’s more trust, because I feel like people are so over-medicated today. And it’s easy to write out a prescription than to really deal with the issue. 

(Me, on the sly: This view, that practitioners prescribe for reasons other than for the medical benefit of the patient, is one that I honor with humility, and stand up and listen when others voice it. Annals fill the internet search engines on it, I’m sure. I will still pick at it a little, I’m a stubborn nubby person like that.

Let us note together that the word, “easy,” in this context isn’t so kind to our person. Taking medication to treat a medical illness is often not easy. It is one of the most courageous acts in someone’s life. And this wonderful lady, who came into my scary office, was a great example of this kind of courage. She wasn’t here doing what was easy. She was giving her emotional entrails a work-over with her psychiatry venture.

This patient, whom I will name hereafter, Lady Courage, was “really dealing” with the issue, in contrast to her self-described mores. Might we suspect the insidious tendrils of “Mister Stigma” shaming her? Yet here she was… Just fabulous!)

Lady Courage: I’m more one that, “Let’s really deal with your issues, and then your mind should come around, everything should come around.” That’s how I view it, because if you don’t fix the underlying problem you’re never going to fix the problem with meds.

Psychiatrist:  Okay. But you’re willing to say there might be some inconsistencies in that right now.

Lady Courage:  Right, no, I’m not … 

Psychiatrist:  It might not be entirely false, but it might not be entirely true. 

Lady Courage:  Exactly. 

Psychiatrist:  We were saying, “I can be healthy but still have disease in my life.” 

Lady Courage:  Yes, that’s true. 

Psychiatrist:  Because I don’t have to be perfect. 

Lady Courage:  Right. And I do find that a little bit hard. But since you put it in that aspect of being, “healthy with disease,” I can see that. I probably never saw that before, because I did always separate the two, either you’re one or the other. 

Psychiatrist:  Wow. 

Lady Courage:  Yeah. 

Psychiatrist:  That’s poignant. Is that how you see God as well? 

Lady Courage:  In what aspect? Like, yeah … Well, you know what? I try to strive to walk in His ways. I haven’t always walked in His way, so I do have guilt about that, but I shouldn’t have that and I know He’s already said He’s forgotten it, He’s washed me clean. So it’s just receiving it for myself. And that just is faith. And I know then it makes me feel like I’m lacking a little faith, but I know I should be stronger. But, yeah, The Word is something that I strive to follow, and it’s hard. 

Psychiatrist:  So do you feel like God is, “either/or,” in the way He looks at you? What about the parts of you that are diseased? 

Lady Courage:  Well, no, yeah, He’s going to heal that. 

Psychiatrist:  But what if He doesn’t right now? What does that mean about who God is?

Lady Courage:  Well, He sent me here probably in hopes that you can help me to heal. He provides these avenues for us, so that we can get healed. 

(Folks! So good! Smile.)

Psychiatrist:  So you somehow think that God enters into the space of the synthetic. 

Lady Courage:  Well, yeah, I guess so, yeah. I do, okay. It’s so contradictory, but in one aspect I do take a thyroid medication that is a synthetic, but I know I have to take that and I understand it and I don’t feel it’s abusive. And I look at my blood work and I know where I’m supposed to be and how much I should be, so I feel confident. But when it comes to things like this that I’m not used to taking, and that don’t show up on labs, and it involves transforming my brain, I’m not really on board with that. 

Psychiatrist:  So when you use the word transforming my brain, I understand you’re saying that it’s making you into something different? 

Lady Courage:  It can alter your brain, yes. 

Psychiatrist:  Okay, so that’s the part I think that’s very scary for people, because they think it’s making them into somebody they’re not. But in reality the medications are there for healing who you already are. So for example, today you feel more like yourself than you did last week. 

Lady Courage:  Well, yeah, last week I was desperate and hurting and losing weight and scared. 

Psychiatrist:  And today you’re closer to who you think your healthy self is. 

Lady Courage:  I think today I’m … Yes, I’m much closer to my healthy self. 

(Q: Closer to who God is creating you to be? Closer to God’s will even?)

Psychiatrist:  In all of these scenarios, at each point we want to think, “What does this say about who God is?” If He or She, (but we will say He to simplify because it’s culturally appropriate,) is kind and loving like you mentioned, then would this belief, X, Y or Z, be true?

Self-Care Tip: Lay out our beliefs next to that standard, that premise in our life. And because we’re a lot crueler to ourselves, then we would allow other people to be, it can rescue us on occasion.

Questions: “What does this say about who God is?” Please speak out!!! …and, Keep on!

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Medication vs Drugs

I imagine some day I’ll understand why users think drugs are healthier options for them then medications.

“Doctor, I don’t think my wife will be comfortable with me adding another medication. It seems like I’m already taking so many!”

Context: Brennon is using THC “for sleep” he explains. Not recreation. It’s “medicinal.”

Boy. We are going to have to redefine what “medicinal” means in the urban dictionary vs. in the medical. 

It’s as if the masses out there are acting like it is stigma behind any opposition of THC vs. science. Folks, there may be stigma involved but it’s mostly science. THC is, 99%, not medicinal. 

My cousin is a hospice nurse and she and I were discussing this. Along the meandering conversation way, we came across, that in her field, many are taking CBD. (I know most of us think CBD is THC-free but it’s not unless it’s thoroughly governed by the FDA.) When we were in our wandering conversation about this, I imagined out loud to her, “If I were dying, I’d want to take a good trip on LSD, do a line of cocaine, and have free access to heroine. Why not?! “

My cousin politely explained that in end-of-life, most people, not apparently ignoramus blind bigots such as myself, prefer to stay alert in their last moments with their loved ones. 

That makes a lot of sense. My “free ticket” to white clouded oblivion suddenly didn’t look as appealing. I’d like that too. I’d really like to have connection with my loved ones. At any time. 

This is the effort in psychiatry as well, believe it or not. When we medicate, we are seeking to align ourselves with the patient’s agenda, toward connection and not away. Toward quality of life and not to harm. Toward hope. When we encourage to take medication, it is not to seek oblivion and isolation. Rather medication is for connection.

Brennon is not alone. Many think that medication takes us away from connection. Away from connection to ourselves by turning us into something we are not. “Doctor, I don’t want to take anything that will turn me into someone I’m not.”

Away from connection to God by taking our willingness to submit to His/Her will, away from His/Her power and toward depending on science instead, as if there is an either/or. No, there is no either-or unless we put it there. There are no dividers between science and God. He/She made them both. They are fluid to Him/Her.

Nor is taking medication taking us out of connection to our partners, nor our family who thinks medication is a cop out and whom are loaded with their own journey of self-discovery over their own self-stigma toward medication. As if taking medication makes our patients less loyal to their loved ones, thereby less connected.

It’s so layered why we think medication is worse. Even worse than mind-altering THC. Even worse, than the disabling illness, or whichever idea it may be.

Question: What is medication worse than for you?

Self-care tip: Seek connection, “even” through medical ways. Be a friend to yourself. Keep on!

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Besmirching God with My Crazy

I’m sitting here in a volunteer medical clinic for a 60K attendee camporee. It’s humid and hot and we are seeing a lot of dehydration, amongst other things. 

As a psychiatrist, I’m humming the Hallelujah chorus as I discover how much general medicine I still remember, from gout, viral rashes, respiratory and ear infections, cuts and bruises, and so forth. The group I came with teases me that if someone comes in for a cough, two hours later they will have disclosed that they were abused as a child and be swallowing prozac.  I am ignoring this implication that I am missing “the point” by treating for psychiatric needs. Ignoring and missing, at least it’s consistent.

Our theme from this camporee week is appropriate.  We have been looking at the life of David. In these, we see a whole lot of psychiatry going on, both medical/biological, and that which has to do with volition. King Saul demonstrated a sure biological mental illness. And David pretended to be crazy – call it, “acting out.”  

God put this in the Bible for some reason(s). Question: What does this say about God’s character? I mean, we certainly don’t look up to people with acting out behavior, like David. Nor do we necessarily look up to people with mental illness like Saul, either. What does this say about who God is? Why does God put this in the Bible?

The Bible didn’t describe this as psychiatric, behavioral, acting out, or general medical.  It just told the story. These ages later, we can do more with the story. Here in time, with the knowledge that the generations have given us, we could say something psychiatric was going on. But generally, despite this knowledge, we ignore the medical condition. We still talk about them with a weighted moral perspective, as if they departed from their spiritual walk in these behaviors, rather than consider the medical condition of their brains.

David is getting a javelin thrown at him while playing the harp. Patton State Hospital for the criminally insane might have housed king Saul if he were alive today. Then, David is in front of the Philistines with King Akesh, where he “pretended to be insane; and while he was in their hands he acted like a madman, making marks on the doors of the gate and letting saliva run down his beard.” (1Sam 21.) 

Dr. Martorell, a neonatologist, told me,

“I see so many people afraid to discuss problems such as depression, anxiety, other psychiatric illnesses and even family problems or abuse.  Yes, partly due to the fact that they may be judged as not having enough faith or not taking care of their health or not following certain principles.  

Primary Care Nurse Practitioner Carrie stated, 

“God and psychiatry go hand in hand I believe, but many Christians don’t think psychiatry has anywhere to go in the church. This is sad because my mom had bipolar, but nobody could help her.  She needed the ‘extra help’. The church thinks we should be able to handle it ourselves.”

You may have seen the lock-down type who says, “Keep it in the family. Don’t tell others what goes on here. It’s none of their business.”  

Dr. Martorell said, 

Our cultural or family upbringing has a lot to do with how free we feel to discuss these issues.  In certain cultures mental health problems are simply not discussed.  If it gets brought up, the family directly or indirectly tells the affected person suffering not to discuss these outside the home, as though it were some dark secret that cannot be disclosed.

Nurse Carrie said, 

“Everyone thinks we should deal with things on our own, and we shouldn’t have to talk to people about our problems and what’s going on in our lives.”

Ironically she is describing a condition of the church of independence. Yet inherent to being a believer is the learning to depend on someone else, God. 

Nurse Carrie said, 

“Why is it with depression and such, we can’t work as a church and have medical get it done.”

Many say, ‘If you go see a psychiatrist, it’s a sign of weakness. You’re not a good Christian.’ These are the comments I’ve heard of through the years.  You should just pray, and God can take everything away.”  

When my aunt suffered colon cancer, she didn’t get medical treatment in the beginning, preferring to have herself anointed, and follow a “homeopathic” approach. Later as it progressed, she changed her mind and found it was too late. So although largely, it isn’t only in psychiatry that we misrepresent who God is, we need ask ourselves, Who is God if what we believe about this is true?

Dr. Martorell shared,

As a neonatologist, I see infants born prematurely. Their brain develops outside the womb and are simply not the same as those that develop in a dark, quiet environment listening to mother’s heart rate, free of noxious/painful stimuli inside the womb.  As much as we try to imitate a womb with our incubators we can’t provide the same care.  When these infants are followed up for years, some develop physical deficits such as cerebral palsy, blindness, the need for oxygen, and the inability to eat on their own. These physical problems are easily seen and various treatments can be provided.  They are also at greater risk for developing learning deficits, hyperactivity/inattention problems, depression, anxiety and some academic papers even suggest increased risk of schizophrenia.  The thought behind these is that billions of synapses are occurring during pregnancy and the way these synapses connect is different in premature infants.  It is also interesting to note that the brain volume preset at birth occurs during the last 4 week of pregnancy. As these children grow up they need treatment for physical problems as well as psychiatric problems they may develop.  

I realize that it is not just in our churches that we are afraid to address this issue but I see it in the families of my newborns.  So many of these moms self medicate with illicit substances in order to treat their anxiety or depression.  Our culture as a whole has neglected to look at these issues as a medical problem that needs treatment.  So many children and teens are committing suicide.  Our own “well educated” health professionals have some of the highest suicide rates and yes it is occurring in our christian institutions as well as outside.  

Nurse Carrie said, 

“In this kind of approach, people are saying S/He’s not a loving and forgiving God and S/He doesn’t understand us.  If you deal with psychiatry, you’re a sinner. Why can’t you get it done with God on your own. He’s not a loving God, saying this person is not allowed to take medication. The pastor’s describing a cruel God because he’s not allowing the person to get the help he needs.  Like if someone’s leg is bleeding and you refuse to give that person a band-aid. 

But, God is always loving. This can’t be true.

I don’t think the pastor has a right to tell the parishioner that.”

Maybe we just succumb to the awkwardness of it all.  Too awkward to talk about God in our community.  Too awkward to talk about psychiatry in our church. There are so many reasons we approach emotions and behaviors this way but in the church or outside of it, let’s consider the question, What does this ay about God’s character?

I was cleaning up a leg laceration about 1 1/2 inches long and 2cm deep. I placed the triple antibiotic ointment and approximated the edges with steri-strips, yet still encouraging the patient and her guardians to take her to the urgent care to get stitches. This wasn’t a sterile environment and our supplies were limited. While working on the wound of the young teen, I asked a few brief psychiatric intake questions. It turns out, no. She didn’t have anxiety, or depression, or psychosis. What do you know!? Not everyone does. But she and her guardians were super pleased to pray together before they left and I was blessed by them.  

God is a God of love and the kind of God that cares about all of it in all of us. S/He is kind and not miserly, discriminatory, or punitive in interest and connection to us.  

It sounds like from what i’m writing that psychiatry isn’t seen as a legitimate form of medicine in the church. Or maybe the church doesn’t refer to it, or support it.  

A friend from my group read this post and responded. 

“We hear a lot about emotions and behaviors in the church, and related directives. We don’t hear however about where emotions and behaviors come from. 

I hear, ‘just pray more,’ or that I am lacking in faith. The people in the church get defensive, as if they have to defend God. And that’s not it. Honestly, it’s not complimentary to me that they think I’m insulting God. They are in a way attacking my spirituality. But I know God is helping me and He’s here with me. But I’m still this way. I still feel this way.

There’s a taboo that mental health and disorders all get grouped into this one cringeworthy word, “Crazy.” We’re almost protecting God from crazy by staying away from it in the church. We forget about the sin factor. The separation between us and God. The loss of connection. The word crazy isn’t very nice. So if we say crazy and we say psychiatry and God, it’s almost like we are besmirching God.  

Self-Care tip:  Ask, and ask again, What does “this” say about the character of God? It comes back to “Me.”

Question:  Do see the Bible and your church talking about psychiatry? Where and how? What does it say about who God is? 

Keep on!

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Get You Some of That – Medical Treatment for Medical Illness

…Continued from yesterday.

Cole_liveCole Swindell – Get Me Some Of That

Why do I feel so horrible when I start a treatment that is supposed to help?

Medication treatments for depression and anxiety, and some other brain illnesses, often worsen how you feel before you feel better. I can’t tell you how many patients have told me that if they had known this before, they never would have stopped their mediation(s).

Yesterday, our post discussed a Dr. Jones and Presley.

Presley fired Dr. Jones when after following her directive, he subsequently experienced an extreme panic attack. Dr. Jones may not have done anything wrong in her treatment recommendations. Presley was just an individual, as compared to a “number on the curve” of treatment responders. Escitalopram, the medication discussed as an example yesterday, (one medication option out of many), may have been dosed at an initial amount that Presley’s body couldn’t handle “straight out of the gait”, so to speak. But likely, if he had started at a lower dose, maybe ½ or even ¼ of the tablet, and then waited for his body to accommodate to the medication. Then Presley would have tolerated it. Presley would have tolerated slowly increasing the medication if approached, rather, piece-by-piece of a pill. I’ll even joke with patients,

I don’t care if you lick the pill. Just get on it.

When slowly titrating a medication, it allows the individual’s neurotransmitter receptors to down-regulate whilst the agent floods the receptors. If there is a neuron targeting another neuron, there’s a baseline balance in time. There is a baseline understanding between these neurons. An agreement, of sorts. “I’ll sit here and receive your messages,” (neurotransmitters, or chemical messengers such as serotonin, norepinephrine, and/or dopamine). “I’ll then carry those messages on your behalf to their intended recipients,” (such as the amygdala or hippocampus). But then this person artificially takes a higher quantity of these messengers, for example, by way of medications, and floods the system. The receivers, (or neuroreceptors), have to adjust to this to establish a new healthy baseline. 

In this initial time of treatment, when 1st introduced to the increased neurotransmitter-load, (ex: as released by a tablet of Escitalopram), there can be a negative response, such as panic and/or depression emotions. We call this, “initiation side effect’s.” Once the neuroreceptors get used to the new load, then the response improves. 

After accommodating to the new pharmacology, the brain is allowed to experience the blessing that comes from treatments, and heal.

Some individuals are outside of the curve and cannot tolerate the standard initial treatment dosage, like Presley was. Some are inside, and can without much difficulty. The point in treatment, though, is that the person just needs to get on it.

Get on treatment. However you do it. You have to make the treatment work for you, an individual, in your own way. The prescriptions are there to serve you. You aren’t there to serve the medications. I like to analogize Jesus’ statement,

The Sabbath is there for man, not man for the Sabbath.

Make it yours as an individual and reap the benefits; the blessings inherent there. (See Mark 2:27). 

If you don’t get on the treatment, you won’t get better. Anything less than this will be inadequate. It’s like drying water off your face with a hand towel while still walking in a rainstorm.

What is your agenda in treatment? List it. Write it out. Then, go get you some!

Outside a medical approach is like flicking water off in the context of a rainstorm. If your agenda is getting to your healthy self. Get out of the storm and get dry. Then go get it. 

You have a medical condition. Treat it with the assistance of a medical professional. 

I don’t go to a plumber to help with my electrical home repair. I don’t go to an accountant or a church counselor to treat a medical one. 

The plumber, the accountant, the church counselor are what they are. This is not minimizing their efficiency in their own fields of excellence. But why do we seek care in psychiatry from those who haven’t studied this? From those who are not experts in this? Maybe stigma keeps us away from psychiatric care. Maybe misinformation directs our search for mental health treatment elsewhere. 

Self-Care Tip: Get you some medical therapy for medical illness.

Question: What are further concerns you may have about taking medications? How would you prefer your medical providers to work with you? Please tell us your story. 

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But I’m Not Someone Who Likes Taking Meds

pill

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

Please help! I’m having a heart attack!

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

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

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

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

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

Dr. Jones, I don’t want to take meds.

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

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

To be continued

  • Sincerely, Dr. Q

Questions: What would you tell Presley? 

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

Why is Presley so opposed to taking medical therapies?

Please speak! We need to hear you.

Self care tip: Keep on! 🙂

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The Sins of the Fathers, and Mental Health

 

“We know the Bible speaks of sins of the fathers passing to the 3rd and 4th generations while God imbues his kindness and mercy far beyond that to those who love him and keep his commandments.”

Rosa had no experience in the world of mental health, or so she thought. She had spent her formative years studying the world through the perspective of her church and interpretations of the Bible. As you know, there is a lot in both with a lot to say about emotions and behaviors. However Rosa was taught and modelled that these were moral issues and not biological. An either or, verses, part of the same thing. Could we call it sequent variants, maybe something like genetic alleles? Or maybe something better to describe this is out there, rather than an either or.

Rosa Leticia Montoya, at this point in her development, with her own overwhelming emotions and her husband’s plummet into dark moods, felt forced into considering mental health. She did not want to go there, but here in the space of losing control, not trusting herself or Carl any more, and before she was willing to say she didn’t trust God, she was doing what was a last resort. Considering that she was going crazy was the only thing this chaos could mean.

Before she completely surrendered to the idea that biology was behind this sinister change, she had to ask, “Is this because of our parents?” She had spent her life trying to untwist the bad choices her parents had made and the consequences those choices had on her life. Drugs, alcohol, and cheating were what she had grown up with. Quietly. Hiding it in the church. Rosa there, praying a lot to live well and be forgiven. Praying that bad thoughts would go away. Praying to depend on God and not on herself, as seen through her perseverating worries ever since she was a child. Worried and worried. Not speaking of the wrong Bible-breaking life her parents wore like underwear beneath nice tailored clothes. Would she ever be forgiven? Would she ever stop sinning?

So she asked me, “What do you think?”

That’s a lot to work with as a psychiatrist. So I did what most of us do. Ran to the shelter of medicine. Whew! But there is the added benefit that God created medicine, psychiatry, and all that there is in my tool bag worth working with.

Even so, there was only so long that I could avoid the topic of God and His punishments, per her perspective. It came up every visit.

If you believe in God, at some point within your discovery of mental health, this question will come up. Rosa is not alone. Are the emotions and behaviors gone amok, such as seen in anxiety disorders and depression, secondary to moral weakness? Living with “too little” dependence on God’s power? Is it this? Or is it an “either or”, with our biology? …a matter of cellular grey matter composed of DNA-expressing pathology? And is this something evil woven into my DNA because of what parents did? Well, I’ve spent 30-some years in school and now 15+ years in practice in this space and am still trying to understand.

I’m wondering if you would help me articulate this. It’s fundamental for us in self-care. It’s not possible to be very friendly to ourselves with the dissonance.

So in our self-care question today, please answer us. What is the relationship between “the sins of the fathers” and biology? Please speak!

Self-care Tip: Pursue kindness in your belief systems toward yourself.

Thank you for speaking with us! Keep on!

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NPR interviews Kitty and Michael Dukakis

In an interview with Kitty and Michael Dukakis, journalist Katia Hauser explores the benefits and risks of electroconvulsive therapy (ECT) in treating depression. Kitty shares her first hand experience with ECT and the ways it changed her life, and Michael provides the perspective of a family member.

Dukakis interview

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The Perfect Doctor – Healthy With Disease

looking

One of the difficulties we have in talking to psych patients is realized with the dawning truth that we are not curing anyone.  Working in those conditions of not curing, you both, patient and psychiatrist, have to come to terms with each others’ agendas.  The physician says, “(‘I’m a failure.’)  I can’t cure anything.”  Now eye contact is even tough.

“If I don’t look them in the eye, some other emotion will surface and they’ll stop crying.”

Rachel was crying and crying hot and hard in the emergency room.  She was unable to stop the lava flow.  It was bewildering to her.  The people around her shifted their gazes.  Those who didn’t, looked angry instead, as if to say, “Pull yourself together, Woman!”

Psychiatrists have the advantage perhaps to these others in the lobby and receiving rooms and gurney shelves. Supposedly psychiatrists can grip and tug at the corner of the large sweater that is human behavior and say, “Emotions and behaviors come from the brain.”  They can imagine, if not entirely believing at a visceral to cognitive level, that the person they observe is responding to symptoms of what is happening biologically, at a cellular level. When they are tempted to avert their eyes, or look back impatient with the messy emotions, they can say, “This is medical.”  Impatience with emotional chaos from psychiatrist to patient, is equivalent to the ER doc saying to the trauma patient, “How dare you bleed in a public area?”

When someone cries on the medical unit, you may hear, “Nurse! Call the psychiatrist! There’s an emotion on the ward!” Later when things are calm, I walk out and they say, “Doctor!  You’re amazing!  What did you do?”

“Well, I bit off the head of chicken and sacrificed a goat on the patient’s chest.  Then I said, take this pill and everything will be as it should.”

Luckily I have several chins now, and when I gesticulate, their quiver contributes to me looking very capable. As if I could cure something.  I don’t know much about art history but, The Thinker, a bronze sculpture by Auguste Rodin, is probably what that Frenchman’s psychiatrist looked like when they both came to terms with the fact that psychiatrists don’t cure anything. (Heresy.) At least he got to get nude while he did it.

Talking to psychiatric patients can be that difficult.

There are studies on patient satisfaction that demonstrate that patients don’t like us when they think we give them bad news.

You see the predicament here, don’t you? So, some of the difficulty the world at large may be having with talking to psychiatric patients is that we have distorted perceptions of good and bad news. We may have difficulty with our own humanity, frailty, infirmity, and seeing it out there “without a scarf on” for decency, is a hard reminder.

We will never be cured of so many things. All of us. And the best we can hope for…

What is the best we can hope for?

(We are all gluttons and all hope for many unpublishable things but please! Just humor me.)

Say: “I hope to be healthy with disease.” There. Now we will all speak better to each other. It all starts and ends with Me.

Questions: Have you ever had difficulty talking to a psychiatric patient? Have others had difficulty speaking with you? Why do you think that is? What could help? Please tell us your story.

Self-Care Tip: Hope to be healthy with disease. 

(I bet Carl D’Agostino could make an excellent cartoon with this rich irony to work with! That’s right Carl! You heard me! Maybe a blue ribbon with a hole in it?… Ah heck. I’m sticking with practicing psychiatry and leaving the toons to you!)

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NAMI: National Alliance on Mental Illness

Hello Friends,

I’m enjoying this all too fast passing time at the APA annual meeting in Toronto. What I am most enjoying is the education, the community and connection with new and old friends, and the reminder of what this is all about – you and I. In honor of us, I’m “pressing” this excellent post from our national advocators and stigma-fighters at NAMI.

NAMI: National Alliance on Mental Illness | NAMI: The National Alliance on Mental Illness.

Check it out and let me know your thoughts. How does this resonate, or not, with you. We need to hear!

Be well and keep on!

Q

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Media Used Educates

media

Me:

Jasmine, I’m so honored to collaborate with you on this important post juxtaposing the various ways media shapes stigma and your own testimony.

Guest Post from Jasmine:

I love old ads, Victorian, retro, apothecaries…  not only are they works of art, but are full of the funniest jokes.

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It would be a lot easier to laugh at the ad agencies if it wasn’t for the fact that we buy it.  These ads are proof that our health depends on our willingness to look at more than media.  Just because we read it on the internet, see a commercial on TV, it doesn’t mean it’s the right path.

I look at my bottles of pills.  “Of course it’s safe, otherwise they wouldn’t be aloud to sell it in the grocery store”, I think to myself.  Or, “they must be okay because my doctor said so.  Somebody would have gotten in trouble for it by now, if it was bad”.

That kind of thinking gives away our power.  We are no longer responsible when we make it everyone else’s fault if something bad happens to us.  Even if the doctors and companies get sued, it is Me who will suffer the most.  There is nothing more important than our health.  How can we deal with life when we are distracted with health issues?  How will we treat people the way they deserve, when we’re not feeling well?

The point is that what we see in popular culture isn’t there to educate us.  It is there to entertain. Or make a sale.  Or push its other entrepreneurial agenda.

media

I’m trying to focus on smoking because there is no way anyone could deny they hurt you in some way.  Pills are different because there is a different mindset with that, and I’m saving that for another day…  But smoking clearly isn’t healthy.  My dad was one of those people who smoked 1-3 packs a day and said that it’s a myth that people are getting lung cancer from cigarettes.  He jogged everyday and worked out… with a cigarette in his mouth.  If he was alive, I would like to ask him if he thought he would be a better athlete with more stamina if he at least didn’t smoke while working out.  I know the times are different and we know more now than we did back then… But I smoked enough cigarettes in my day to know that I would hack up a lung every morning and had a regular cough, until I quit.

Questions:  How do we tell people what to listen to?  Not just listen to other dramatic people and what we want to hear… not kid ourselves and run away from the real solution, whatever it may be?

-Jasmine (I’m 39, a wife, a mother and I’m cRaZy!)

 http://lakeelsinorelife.com 

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Self-Care Tip:  Use media material for entertainment and look in better places for education and counsel.

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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.

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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.  

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Work Hard at What You Must – Stigma

Late... Again ?

I was late again for my exercise group, Kaia F.I.T.  It almost kept me from going.  Being late is embarrassing!

Being late is a misunderstood disease.  A syndrome.  I am pretty sure there is a formal diagnosis that the DSM-VI (Diagnostic and Statistical Manual of Mental Illness) will have for it.  Difficulty with being late will get its own ribbon.  I do not know.  Maybe yellow after “The Yellow Wallpaper” by Charlotte Perkins Gilman.  I will tie yellow ribbons to my hair, shoes, car, and get a yellow-ribbon pin for my shirt on behalf of myself and all those with like-affliction.  Stigma toward those of us suffering with this condition will diminish.

(I am really hoping Becca, Rene, Alyssa, Maria and all other Kaia coaches across America are reading this so that I, and those who suffer like me, will not be further socially abused, nor get the government involved.)

Now, in celebration of diminishing stigma of any kind all around the world, I am reposting, with gratitude:

“Why I Wrote The Yellow Wallpaper” (Charlotte Perkins Gilman)

Many and many a reader has asked that. When the story first came out, in the New England Magazine about 1891, a Boston physician made protest in The Transcript. Such a story ought not to be written, he said; it was enough to drive anyone mad to read it.Another physician, in Kansas I think, wrote to say that it was the best description of incipient insanity he had ever seen, and–begging my pardon–had I been there?Now the story of the story is this:

For many years I suffered from a severe and continuous nervous breakdown tending to melancholia–and beyond. During about the third year of this trouble I went, in devout faith and some faint stir of hope, to a noted specialist in nervous diseases, the best known in the country. This wise man put me to bed and applied the rest cure, to which a still-good physique responded so promptly that he concluded there was nothing much the matter with me, and sent me home with solemn advice to “live as domestic a life as far as possible,” to “have but two hours’ intellectual life a day,” and “never to touch pen, brush, or pencil again” as long as I lived. This was in 1887.

I went home and obeyed those directions for some three months, and came so near the borderline of utter mental ruin that I could see over.

Then, using the remnants of intelligence that remained, and helped by a wise friend, I cast the noted specialist’s advice to the winds and went to work again–work, the normal life of every human being; work, in which is joy and growth and service, without which one is a pauper and a parasite–ultimately recovering some measure of power.

Being naturally moved to rejoicing by this narrow escape, I wrote “The Yellow Wallpaper,” with its embellishments and additions, to carry out the ideal (I never had hallucinations or objections to my mural decorations) and sent a copy to the physician who so nearly drove me mad. He never acknowledged it.

The little book is valued by alienists and as a good specimen of one kind of literature. It has, to my knowledge, saved one woman from a similar fate–so terrifying her family that they let her out into normal activity and she recovered.

But the best result is this. Many years later I was told that the great specialist had admitted to friends of his that he had altered his treatment of neurasthenia since reading The Yellow Wallpaper.

It was not intended to drive people crazy, but to save people from being driven crazy, and it worked.

__________________________________________________

SOURCE: The Forerunner, October 1913.

Awesome, huh!?

Self-care tip:  Work hard where you must.  Stigma is as stigma does.  Keep on.

Question:  Where is stigma attacking you?  What are doing with it?  Please tell us your story.

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What would brain illness look like

Look Mommy! Look at my note!

 

crinkledShe pulled out a crumpled treasure.

See?!

It was a white paper. Blank. I paused with the, “I’m very interested,” and, “I’m a good Mom to whom you want to divulge your innermost thoughts and secrets to,” expressions on my face. I am you know. All that. Sniff.

Another mystery maker, handy, said,

Where’s your pen?!

She was getting agitated. I did not get it. I was less of a P.I. than she had hoped. She had a non-P.I. mom. Just great.

A third wheel rolled in and stuttered out,

You need the pen, Mommy! You need it! You need the light!

I noted the multiple exclamation points hovering about and knew the sand in the glass was almost out. Communication needed to be received or my three secret agents were going to increase their level of effort. Be warned.

I am an emotions-Jedi after-all. I sense these things. The Force is strong in me, still, young Padawans.

Then, there it was. Under the blue penlight, shown the hidden messages.

No. I do not remember them. Just the sense of them. And…

And, I thought it was a super illustration of how brain illness is there but not generally seen.

I am sure this was disconcerting to my investigative kids, who had dreamed I would do what they wanted with my life and thoughts. I wish they would just let me be me! (Flipping hair.)

Brain illness does not get as much air time as cancer. It is not as obvious as a withered hand. Nor a rash. Nor a big outcropping of plantar warts seeded across the soles of our feet – brain illness is not.

Brain illness does not engender connection easily because not everyone has the Force in them. Not everyone is a Jedi like you and I. It does not have the advantage to connection as a name tag illness. Brain illness does not wear itself on our visage like an invitation to others to embrace us in shared experience.

Where is the Light?

Right. In us. We are the light. We are what brings awareness to this secretive suffering. We are secret agent Jedis. Yes. Exclamation point. Exclamation point. Exclamation point.

Questions: What would brain illness look like if it was visible?

How has brain illness become more of a shared experience? How can it?

Please tell us your story.

Self-Care Tip: Share your experience.

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Allow yourself to transcend the naming of your symptoms

French political cartoon of French cardinal Je...

Mental illness, diseases of the mind, behavioral disorders or however our community allows it to be named, it is all inadequate.

Mental illness, is a stale description.  It has sat in the open community air, over the many years when our awareness grew too slowly, when stigma and ignorance gave it the old cold frost-bite.  It reminds of me of the, Confessions of Georgia (Anne) Nicolson series, by the most hilarious Louise Rennison, When Georgia Anne says, “Have you gone mental?!,” in one-thousand-and-one ways.  There is just so much sniffing and eye swirling around the term.  I do not mind Georgia Anne using it at all.  It is fresh in her mouth.  It is not, however, winter green in ours.

Dr. Thomas Insel, Director of the National Institute of Mental Health, states that these terms are “impediments to progress.”  He uses the term, brain disease, as a way to diminish barriers to scientific investigation, hopefully leading to earlier detection and treatment.

Others, however, challenge even this term, brain disease, stating that it is premature and narrow.  The illnesses that demonstrate emotional and behavioral pathology involve more than brain and mentum.  They include the magic, the internal/external stressors, the arguments and the weather.  They include the intersecting paradigms that make us who we are, often referred to as the biopsychosocial model.  These, “Others,” argue that it is presumptuous to name pathological symptoms of emotions and behaviors with, “brain disease,” until we know what the brian does in the first place.

Questions:  But what do you think?  Are the terms we use more impediments to progress than they are tools toward?  Do you have any recommendations?  How have these terms affected your life?  Please tell us your story.

Self-care tip:  Allow yourself to transcend the naming of your symptoms.  

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I Am A Poster Child For Sinners

IMG_4706 Leather pants

I am a poster child for sinners.

Sitting with a respected mentor, a leader of women in medicine, I couldn’t stop myself as usual from playing with the ideas of being a friend to yourself.  She caught on quick with where I was going and I felt wishes winging in.

I wished I could have practiced with her, have had her for a peer, a voice in the room that gets me, a mind that might even have resonated and crescendoed the healing process that comes from being a friend to Me.

Oh that guy is as stiff as they come!  She knew.

He always made me feel like I was a poster child for sinners.  …And I knew I loved her.  It wasn’t just me.

Sometimes, remembering that “it’s not just me” seems like reciting folklore.  The longer that Time clutters up between real encounters with like-minded folk, the more magical the thoughts brew of being chosen to suffer, I am alone and I am special for what hurts me.   However, perhaps a good this or that can come out of even things such as these (insert, “human connection.”)  Is that so much to ask?  Do I really have to sacrifice a chicken on a full moon over whitened unicorn bones to make it happen?

In becoming a Friend to Yourself, we know there are many times when living with not much more than our better choices for company is almost more than that stringy thin young muscle of self-care can sustain.  But know this.  Just when you think you might collapse, the Truth that “you are not alone” will wing in.  More than a wish or a perception of reality, “you are not alone” is Truth.  Something great comes to us, like,

I am a poster child for sinners.  

Stigma comes from ignorance after all and in being a friend to Me, well, our community has undeveloped awareness about it.  Some who don’t know that everything starts and ends with Me feel threatened, angry and even verbally aggressive toward us.  But, just when we think that the whole world is touched with ignorance and cruel responses except for Me, we find Thee.  (Yet another variation on the  quote by a Yorkshireman –  “Everyone in the world is quite mad, except for me and thee.  And sometimes I have my doubts about thee.”.)  Me finds Thee, just in time.

Suddenly we see ourselves for the stud-muffins that we are, courageous and in company.  Leather pants may be included if you like.

Self-Care Tip – Remember the Truth – you are not alone, even in being a friend to yourself.  Keep on.

Questions:  How’s your company these days?  Do people ever treat you like you are a wrong-doer for loving yourself?  How does that go over?  Please tell us your story.

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Celebrating Your Courage Will Connect You With Your “Me” and With Community

Veterans Day

A seriously cool veteran was cruising Old Town today on his Harley with about fifty American flags affixed in mysterious ways to his bike and person.  I cannot figure how, but those flags were not going anywhere he was not.

I had forgotten today is Veterans Day, even though my kids were all home, off from school, properly running amok.  This man, in his leather skins and industrial number of stars and stripes, reminded me.  As we approached each other from opposite sides of the street, I saw him nod to another biker passing him by.  His nod was enough to say, “Hello.  You are not alone.  I am not alone.  We connect by this brotherhood.”  I watched him in my rearview mirror and immediately dialed my dad, of course.   “Happy Verterans Day.”

Sometimes we do not wear our history as confidently as this cool vet.  How messy that would be, right?  Imagine a world where people used their hard-earned losses as a tool to empathize with themselves and others.  Where people’s pain was used as a force to connect with their Me and with others.  How tiring to receive nods, to accept judgments and applause, as it may be.  Right?  Company can be a burden.

This is my guess as to why not many of us speak up about what electroconvulsive therapy (ECT) has done for us.  We hear about the miracles of medication therapies from first person reports, heck, even second, third or tenth hand.  We do not hear much about the miracles of ECT.  Instead, we hear the sound of quiet or else hopeless barbarism.

I was talking with a patient, Carla, about ECT as an option for treatment, and we laughed that we are anesthetized for a colonoscopy for much longer amounts of time than we would if we had ECT.  They seemed like such funny things to juxtapose.  The convulsion lasts around thirty seconds and you are done.  There are no broken bones.  No tongues bitten through.  There are no chickens sacrificed on anyone’s chest.  Carla had never heard about the physician-patient who had undergone thirty-six ECT treatments as a patient, whose morbid melancholia resolved and who later returned to practicing medicine in full capacity.  Why would the physician tell people about his history?  What kind of nods do you think he would get?  What patients would be willing to go to him for medical care?  Carla had not heard about the gamers, computer programmers, the nurses or anyone from the functioning productive public who had the courage to fight for themselves by choosing ECT.

My patients with whom I discuss ECT have concerns.  You have concerns.  Much of the world is concerned.  There are reasons.  ECT has improved farther than Jack Nicholson’s report on One Flew Over The Cuckoos Nest, though many of us were alive when his movie was first viewed.  The distance we have come in refining the practice of ECT is out of proportion to the distance in time from when ECT was not much more than sticking your finger in a socket and getting voltage in a continuous sine wave for therapy.  Is it shameful being connected to that history?  Is it too soon to say, “These are the ancestors I claim?” You know what to do with shame.

There are few medical specialties that gather as many opinions as psychiatry.  Yes.  Well there are even fewer medical treatments that are found in the company of so much frothing opinions than ECT.  No wonder we are quiet.  No wonder we are concerned.

So, although we veterans of ECT perhaps have not spoken up in our community, although we may not tear up at ceremonies for what our courageous self-care has done for our country or understand how we fit in, although we may not hang flags or tattoo it into our skin, we are courageous important citizens in company.  We are heroes.  Maybe not as cool in leather, but we are where we are because of those who have come before us and for what we have carried on.  We have suffered and died and lived and we are connected.  We have community and we are not alone.

Happy Veterans Day.

Self-Care Tip – Celebrate your courage.

Questions:  How do you celebrate what others think is shameful but you know is not?  What have you found in doing so?  What has gaining your community done for your ability to celebrate?  Please tell us your story.
Series on ECT:
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Consider the Barrier Stigma Plays in Your Ability to Take Care of Yourself

Esther... The Girl Who Became Queen DVD Cover

I am just going to come right out and say it.  I have been trying to be clever, a Queen Esther toward her King and Hamon, on behalf of the people she loved.  (Yes.  I am Queen Esther in this story.  You can play her in another one.  Maybe tomorrow.)  I have been talking about treatment options for brain health and it is just not going where I was trying to take us – ECT.

ECT, my friends.  Electroconvulsive Therapy.  Many people see this as an extreme option for the dire, filtered out treatment failures.  That is an ugly description but I believe pretty close to what we have culturally got.  Many of you have told us how you escaped receiving electrically induced convulsions.  You hid from the boogie man and lived to tell us.  (There are chemically induced convulsions but we have more control of the convulsions through electricity, so that is the standard of care.)  Others have testified that it destroyed them with a catalog of specific and nonspecific complaints.

Interestingly we have not heard from you who have received ECT.

Come out, come out wherever you are.

Stigma perhaps hides you, and we can understand why.  Stigma toward ECT is like stigma toward anything – pretty off topic and hurtful.  Although it is improved by education and empathy, it is not fun challenging it “alone.”

Tonight I am not going to talk about the pros and cons of ECT, but to say that you are not alone.  You who are in treatment or have been in treatment or are considering ECT – would you tell us what you know, personal or impersonal?  There are many of us who would benefit from your education and empathy.

(What would that do to stigma?  What would that do for us?)

It would be wonderful to hear questions any of you have, as well, and anything related to ECT that you would like to share.  Please tell us your story.

Self-Care Tip – Consider the barrier stigma plays in your willingness to receive treatment and to connect with others.

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Become a Better Friend To Yourself In and With Your Culture

"Energy Crisis!" ...

Image by Toban Black via Flickr

A barrier to getting friendly with ourselves might be our culture.  The inverse of course could also be true.  ‘Takes culture to design the flavor of our homes and habits, our communities and the energy between us and them.  Think, TV in the bedroom, alcohol tasters offered to children, books or the absence of books on the floor and shelves.  Think religion and diet, family meals or take-out.  The way we deal with shame.  Culture is a gate-keeper for many of us.

We could call our culture, the way we live together at home, the balance between each family member and the flavor of emotions there.  Culture might be layered, wrapping us from one balance of energy into another into another creating our own galaxy between each point of light.  In any room, if we look we can find culture.  In any space outside, there is a flavor telling us how to maintain the balance between me and thee.

I don’t know if sociologists look at culture this way yet, but I hope they will.  With all that observing, data gathered and surmising, I hope they study how the individual can be a better friend to herself in “this” culture.  And then I hope they tell us.

Becoming an active designer of your culture is not always easy.  But it is friendly.

Questions:  How has your culture introduced you to your friend, “Me?”  How have you been able to develop a more friendly culture for Me to live in and grow in?  What’s still keeping you?  Please tell me your story.

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Emotions – One Part of The Multi-Paradigm Weave That Makes Us Who We Are

Immanuel Kant developed his own version of the...

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Yesterday we spoke about the emotion, happiness, as it connects to and does not connect to spirituality.  Traditional western religions squirm  or  more, disagree when they hear this.  Everything is spiritual in their school of thought.  However, as our understanding of where emotions and behaviors come from, we have happily disentangled ourselves from the stigma and judgment that comes from the way many people have (mostly unwittingly and often without intended malice) abused us with mental illness.

I know that I have also been in this crowd of prejudiced.  Coming out of that has been fun.  There is still so much that I think I see clearly but don’t, as it is for us all.  The growth we’re talking about is part of the high adventure that brings pleasure to life.

To say it plainly:

  1. Emotions come from the brain.
  2. Emotions are not always directly chosen as we can’t directly choose the way our brain works.
  3. Emotions are what we use to interpret the world around us.
  4. Emotions don’t have intrinsic moral value.  Morality is bigger than the way we feel.
  5. Emotions are not constant between us.
  6. Emotions are a sense.  We’ve called them the Sixth Sense.  Senses are subjective and not objective.

How does this fit into your biopsychosocial model of how you see yourself?

Biology.  Psychology.  Socially.

How does it influence the way you befriend yourself?

How might this influence stigma surrounding emotional illness?

Emotions are just one of the many things that make us who we are.  Many many things.  As we tease these bits of ourselves apart, it is not the same as denying the multi-paradigm weave that makes us who we are.

Self-Care Tip – Enjoy your emotions but don’t put your life on them.

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