HERE COMES GOODBYE
May 21, 2013
On resolving difficulties
May 21, 2013Somewhere I read where we resolve most of our difficulties in life by turning them into problems.
I know I have been there. All of us, I think, tend to spend too much time listening to the music on the Titanic. Our “feel goods” leave us blindfolded in the middle of onrushing traffic. And we tend to pay them a curious allegience regardless of how frequently we get hit.
Feeling better may not be the same as doing better. Next time you feel like the house is falling down around you make sure you didnt pull it down looking for a better view.
Saving home: the importance of impact
May 21, 2013Human beings need to believe they have impact on other human beings. Even when doing poorly, especially when doing poorly, we need to know our presence matters. It is for many people saving grace. Sometimes in treatment people dont hear enough of the value of their living, even with all their warts. Someone once told me their ambition was to be an ordinary person coping with extraordinary circumstances rather than an extra-ordinary person screwing up ordinary circumstances.
We must believe someone can be blessed by us. Otherwise what is the point??
If there is such a thing as wellbeing I think this must be at its core. Without it we are forever homeless. Most of the people I know who have attempted to hurt themselves in any real way have been “homeless.”
Dont just hug somebody today. Someone needs to hug you.
Be safe. Be home.
An uncertain future
May 20, 2013I have probably over-posted in the last couple of weeks. Apologies for that.
Things on a personal level continue to go poorly. No luck on finding a job and the crisis is real. In the next 7-10 days we will begin losing things. Phones and internet access will go first. There will probably be a period where this blog is no longer heard from. I hope not but it seems very likely. In a very short time the real issues like keeping a place to live will have to be resolved. Gas, food everything will be on the line. Medical care seems a silly dream right now. We will lose much. There is no way to pay. If you are a praying person I hope you keep us in your prayers. A lot of job applications are still unanswered.
I pray each day there is an answer as of yet unheard.
It seems unavoidable that difficult choices must be made. I know many others face more difficult choices. I want to thank so many people who have been so supportive in the last 6 weeks.
The richest man I ever knew
May 20, 2013The richest man I ever met was worth $400 million.
. The poorest man I ever met was worth $400 million. They were the same man.
. His grandfather had started a local business back in the Depression that in the years following had become a national power in its field. His father was close to retiring and he was next in line to the throne. I remember the day he got into an argument with his wife. He went out later that day and bought her a brand new Porsche to make up. He had everything but none of it mattered. His wife later divorced him and ended up with as much of his money as she could get.
His son had serious emotional problems and was in and out of treatment his entire adolescence. Years later I met his son again. He was no longer on speaking terms with his father and was working as a pizza delivery driver. He did get his chance to sit on the throne, but messed it up so bad that the investors bought him out in order to save the business.
You only had to be in his presence a couple of minutes to know that he was rich. It took about the same amount of time to realize how poor he was. He substituted volume for self esteem. He substituted impact for connection. He was one of the few people I knew who was always alone regardless of how many people were in the room. He had gotten Boardwalk and Park Place and had hotels on both.
In the the end though they were just plastic pieces that went back in the box. Many of us spend a lot of time and energy trying to get our own Boardwalk and Park Place and like this man forget it all goes back in the box. They go by all kinds of names: status, power, possessions, sex, drugs, alcohol, and an endless amount of other things. But basically they are all Boardwalk and Park Place. We tell ourselves that the good life is the one where we get everything that matters. What do you do the day you get everything that counts and then looking in the mirror discover the truth. You have everything that matters, but nothing you have really matter.
Rainy Day People
May 19, 2013
The DSM and the search for noble truth
May 18, 2013There has been a literal flood of words written about the coming publication of the new DSM. It seems to have been shredded from more directions than you thought there were directions. For the psychiatric bible it seems less holy and more hole-y. It seems closer to swiss cheese than holy grail.
I have started reading Gary Greenberg’s book, “The Book of Woe” and been blown away by it. I admit to more than a little satisfaction in hearing so many points about diagnosis made on this blog in the last couple of years being echoed by Greenberg. It makes me feel smarter than I am. The most striking part so far has been what seems to be the clear recognition of the people creating the DSM that there is not any way to prove validity to anything they say. It seems strange thinking to me to discover things in discussion groups and then lament the lack of evidence to prove that what you created really exists apart from your creation of it. I get the impression “this is the best we can do with what we know and we sure wish we knew more” is the basic defense given by the DSM creators. This is not the way they know things are. This is how they think things are. (Hope might be a better word.)
Greenberg says the following about his conversations with psychiatrists: “But if you ask any of them (and I have) about the DSM diagnoses and criteria…he or she will tell you they are only “fictive placeholders” or “useful constructs” the best the profession can do with the knowledge at hand…They are fully aware, in other words, that their opportunity to name and describe in psychiatric terms suffering far exceeds their knowledge.”
Psychiatry really depends on credibility. You got to believe they know before you ask. It isnt like diabetes. There are no lab results to point to. There is no insuffiency of this or that. It isnt a matter of topping off the tanks, check the oil and get back on the road. Questions, doubts, criticisms put faith in doubt. One psychiatrist calls the DSM a “noble lie”, something that actually helps people by giving them faith, kind of a plea for an unfettered placebo effect. You can drive down the road on flat tires, just not very fast or far. You can believe in them all you want, but all the driving in the road wont make the tires any less flat. The crusade for “noble truth” seems strangely absent from the DSM. It seems a fancy menu for a meal that is too often disappointing.
The power to name our suffering is, as Greenberg says, an awesome one. It is a fair and necessary question to ask whether or not human suffering can or should be medicalized. He who sets the terms of the conversation controls the content of that conversation.
When it gets to the point that our distress is nothing but a symptom of what is wrong with us you have to wonder a little bit about the demise of common sense in the face of psychiatric progress. How can the meaning of my distress be evaluated apart from the context of my life. “What happened?” seems a more meaningful question than counting how many symptoms I have off some list. If you dont believe meaning matters then you ignore what makes me most human. To know of me is not to know me.
I wish there was something like a DSM for recovery, a chronicle of what works in what conditions for people. I have often thought that being solution oriented and trying to solve problems more effectively are not the same thing. If we put a smidgeon of the time into solutions we have put into problems we might be shocked. Thousands and thousands of people in all kinds of circumstances can give truth to that.
How can a “noble lie” be the foundation of any large endeavor?? Some promises just dont deliver as advertised and the history of mental health in this society is one of promise after promise found wanting and discarded.
Perhaps the most noble truth might be to celebrate that truth matters, that it is okay not to know, that humility is a strength and not a character flaw and base what you do on the dignity of those you work with and that they ultimately must make their own decisions about life and to know people can and do with regularity find the path to a better life no matter how serious the distress they face.
DSM-5: A Manual Run Amok
May 18, 2013To a very, very good friend in very, very bad times
May 18, 2013
When stupid cures
May 17, 2013I met a lady the other day who said she had bipolar disorder. She had cured the bipolar by becoming a drug addict. Her arms, her legs…..everywhere was literally littered with the track marks that testified to the choices she had made.
She told me that she had an infinite capacity for stupidity. She could convince herself that anything made sense….anything she wanted. She had borrowed money from her son for a fix. He said “Mom if I give you this money isnt it the same as giving you the drugs….” She cried and begged. He gave her the money.
She is going into detox. She says it is the first time for real. She says soon there will be nothing left to save. She is afraid maybe all ready too late.
We talked for a long time. Maybe most of us have a similar relationship to stupidity. She is ready to try. Her son loves her and stands behind her. She is terrified of the pain ahead. But most of all she is terrified of herself.
I cant wonder how often many of us try to cure life with stupidity. I wonder why it is so easy to believe what we want is good for us and so hard to believe that what we need is worth the effort.
On being carried
May 17, 2013I struggle. A lot.
Many good things have happened in my life and continue to happen. But many hard things remain hard and maybe always will be. Somedays balance seems so hard to find. Later I am normally appalled at my foolishness and how I let things that are not so big become gigantic but it does little good to beat myself up. Maybe all of us need to learn to forgive ourselves for being human. I dont think you can try so hard you are not.
Community is such a necessity. Many times we seem content to let it be a place of masquerade where people meet to tell each other how smart they, how rich they are, how important they, how loving they are, how right they are…… Sometimes we think others are our best opportunity to try to convince ourselves we are what we hope we are.
Community is about being cared for as we are. Sometimes it is about being carried and about carrying.
I know sometimes I need to be carried. It is good to know when you are confused, scared and beaten down that no matter how lost you feel you can be found in the arms of others.
The violence of realized potential
May 16, 2013To tell someone that they need to accept the fact that they have realized their potential and they need to accept the reality of that is often an act of unintended violence. A friend described how it worked in her life.
She had struggled with physical disability and mental health issues her entire life. She had known many tragedies and catastrophes, but had also known many victories. Life was often hard, but it had not stilled her heart. She thought she had much yet to do. She saw no final verdicts or terminal pronouncements she needed to abide by. Her family, out of love, wanted to protect her from her disabilities and ended up trying to save her from herself. And they never understood why she seems so much to want to be only protected from them.
“Even if things are hard and even if some things will never change it doesnt mean I cant. My circumstances may limit me but they dont define me.”
She has a family passionately in love and passionately at war. Her kids are adults and they dismiss her hopes as a symptom of her problems. She is “just mom.” They would run through a brick wall for her but prefer she be careful about trying to open doors. Hurt feelings abound on both sides. Both wonder how the other can be so ungrateful.
I think of all the times people that experience mental health diagnosis as the end of possibility. I wonder how many families have self destructed trying to help each other. We so easily lose each other behind the labels that define who we supposedly really are.
Like a boat with mast but no sail
May 15, 2013I feel like a boat.
With masts.
But no sails.
In water deep and rolling.
With wind and rain.
Anchored above.
As if concrete and steel.
And immune to hope or wish or thought or effort.
Waiting for push or pull or escape from a moment that seems a forever tick in a clock frozen and sleeping.
Melody and song seem covered and quieted in molasses moments that seem deathly sweet.
I wait.
For dawn, for difference for evidence of new land ahead.
I tell myself there is movement even when I see or hear none.
No moment is alone from other moments and sails are often there and not seen.
The storm lies (they always do)
For they are only of the moment.
However fierce and loud.
And I hold tight to the faith of new seas.
