When life is hard…..

October 9, 2014 by

Life has an annoying habit of being hard especially when you are fed up with it being hard.  I know I am worn out on hard and ready for easy.  I try to remember that the difficulty of my life is not a measurement of its quality.  Sometimes I do and sometimes I don’t.

Here are some ideas about hard times:

Know how things are going. Pay attention. Too often we dont.  We are shocked when things all of a sudden seem to go poorly.  It seems like it comes out of nowhere.  And we miss so many good things.  Sometimes I wonder where I was.

Think about momentum.  Going better…..Going worse.  Bad things are less likely in going better.  Good things are less likely in going worse.  Do things on purpose that impact the momentum of your life.  A thousand things too.  None of them by themselves tip the scale but the accumulated weight of them may tip the scales of your life.  Keep a pulse on the direction of life.  What can you do differently that makes a difference.

The more effectively you deal with getting worse the less often you will have to deal with worse.  Have a plan.  Make sure it is a plan you can do, want to do, that you can tell if it works, and that you can continue to make better as times go on.  One friend told me the secret to not getting run over by a car was to learn not to stand in front of them.  See the cars coming.

Dont do life alone.  Support and be supported.  Talking to yourself is okay but as the only thing on the menu it isnt much.  Life is best shared.  It is not a solo act.  Other people have a way of seeing when you cant see, hearing when you dont listen, caring when you dont care and cheering even when you think you dont deserve it.

Do things that matter.  Live life like it means something, like it about something.  We need something to complete us.  Without purpose we paddle furiously but never get anywhere.

Learn.  From everything.  Define events by what you take a way from them.  Learn things that matter and make a difference  Even the worst of times offers a chance to learn something. 

Wait.  When you cant do anything dont.  Just wait.  Make sure when you can you do.  Some things are just survival. 

Remember feelings are not facts.  They are just hypotheses that you must check out.  They are meant to be listened to but listening need not mean obeying.  Pay attention but know paying attention means listening to more than one thing.

Life is an infinite procession of invitations:  to be angry, to be sad, to be glad, to be scared, to be proud, to care, to not care.  An invitation means you decide.  What invitations do you decide to take???  What invitations do you normally miss?

Noise.  The noise around you does not have to be the song you sing.

Count.  You count.  Nothing takes away from that.  You can ignore it.  You can act like it is not true.  You can hope it is not true.  You can try to make it not true.  But it is true.  There is a difference between the package and those things that wrap it up.  You are more than ribbon.

Life sometimes must be hard.  Sometimes it must seem too much.  Sometimes it must seem pointless.  Otherwise how would we ever know when it is not?

On what you can mean: the battle for an identity that matters

October 8, 2014 by

hopeworkscommunity:

From the archives. A good thing to think about I think.

Originally posted on Hopeworks Community:

Much of the ordinary experience of the mental health system is about identity.  We are told both who we are and what we can become in a thousand ways, both spoken and unspoken.  Often the news is not so good.

When your identity is based on what is difficult for you then much of what you prize or care about is relegated to little more than an asterisk.  I know one person who got excited when he learned about WRAP and when trying to explain it to his psychiatrist was told that he probably needed to increase his medication as he was obviously becoming more manic.    When your living is an illness everything you do is a symptom.  I know another person who told me her life’s ambition was for anyone, one single person to give her credit for being mad when she was mad instead of symptomatic.  I…

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One lifeboat on the Titanic

October 8, 2014 by

Supporters of the Murphy Bill go in great lengths to describe the problems of the mental health system.  They trot out huge numbers….310,000 mentally ill in our prisons and jails etc.  They tell us the Titanic is sinking and sinking rapidly.

But for all their passion and all their commitment they only give us one small boat to rescue survivors in.  In New York, the promised land of AOT 2000 people, 1/3 of 1% are involved with AOT.  And that is in a state that has bought in, a state that has used a lot of money and resources to make it happen.  Most states don’t even begin to use those kind of resources or serve anywhere close to that number.  1/3 of 1% is not 100%.  2000 is not 310,000.

The boat doesn’t really serve the people in it very well.  It is old, has lots of holes but even if you believe it is seaworthy the real problem is not who it saves but who it leaves to drown.  Not even figuring the holes in services for those not in jail (affecting many more than 310,000) just do the math for the 310,000.  If New York is as the AOT  people claim the epitome of success and the goal of Murphy is to get something going nationwide of the same quality AOT (using the 1/3 of 1% figure) the Murphy Bill will add  1023 people to AOT.  A remarkably small boat in a big sea.

It is a model T they try to dress up in Cadillac clothes.  We need changes but we need changes for the better.

The Titanic is sinking… The seas are full and the water is cold.  No one needs to be left behind.

Governor Haslam: from Gretchen Kidd

October 8, 2014 by

hopeworkscommunity:

From the archives

Originally posted on Dear Governor Haslam:

Dear Governor Haslam,

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness – That to secure these rights, governments are instituted among Men, deriving their just powers from the consent of the governed, . . . “ – Declaration of Independence

Unalienable rights…life…

I hear lots of Republicans spouting rhetoric about the “right to life.” In a sense they are correct. All men and women should have the right to live. So, I really must question why you and our state legislature are are opposed to the expansion of Medicaid in Tennessee. Do you honestly not understand that Tennesseans—your neighbors—are DYING because you refuse to expand Medicaid? Governor, you have the facts available to you. You don’t even have to bother doing the research…

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Expert on Mental Illness Reveals Her Own Struggle – NYTimes.com

October 8, 2014 by

Expert on Mental Illness Reveals Her Own Struggle – NYTimes.com
http://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=all&_r=0
【from Next Browser】

The fundamental failure of the mental health system

October 7, 2014 by

hopeworkscommunity:

From the archives

Originally posted on Hopeworks Community:

In a fundamental way the mental health system fails to serve those in need.   This failure has in some sense been responsible for the deaths of many people, the ruined health of many more, and the ruined lives of countless others.  It has not been because of a lack of skill, commitment or effort of  those who provide mental health services.  It has not been because of some lack of motivation, insight or unwillingness to change on the part of those receiving services.  It is not the result of financial challenges or lack of availible services although both of these have drastic effects.  It is, instead, the result of the ordinary way the mental health system does everyday business.

The effects of untreated mental health issues are common knowledge.  30,000 people a year commit suicide.  Probably 10 times that amount make an attempt.  Unaddressed mental health issues have a role…

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“Dying with their rights on”

October 7, 2014 by

A reader used that phrase with me.  She felt like that was the primary attack Murphy made on his critics.  “They don’t really care about people who need help.  They want them to die with their rights on….”  I think the fear of being labeled that way is also a tool they use to pressure legislators.

It reinforces the need for positive options.  We need to be able to explain how Murphy is not really effective care and to be able to say there are better options.  We can’t let Murphy “own” care.  If we do everything we do or say sounds like people making excuses and makes Murphy look right.

We need to help people see if they buy the idea that the government can refuse to respect people’s rights “for their own good” we are opening the door to very dangerous places and that treating someone like they are less than a person helps no one. 

We need to let our legislators know we expect a system of care that really helps those that need help and it is not necessary to violate the fundamental values of this country to do so.

We don’t want people “to die with their rights on.”

We don’t want them to die.

Talking points

October 5, 2014 by

Like the last post this one is also in part an answer to some of the feedback and questions that readers have asked me.

Many of the last posts have been about the need to be for something and many people have asked very simply:  What are you for?  What would be your talking points?  This is my attempt to answer that question. 

One belief, one assumption guides everything.  People in need, people in distress should have access to services that help them to deal with that distress and need and gives them the best chance to live lives of purpose, success and connection.  Everything I believe comes from unpacking that one statement.

People in distress-  Distress is a human phenomenon.  It is part of living for everyone.  People in distress are no less people, no less deserving of being treated with dignity or respect.  They are not broken or deficient and no diagnosis, label or name they are given makes them so.  Our distress may make us more or less capable to adequately meet the demands of our life but it does not make us less deserving of being treated like a human being.

The term distress is used to convey the idea that misery or unhappiness is a human issue.  It may have physiological aspects.  It may have interpersonal aspects.  It may have emotional or cognitive aspects.  It may have spiritual aspects.  But the important thing about any of these aspects is how they effect us as human beings.  This is a distinction largely lost by those who have a vested interest in believing that the aspects of human life that concern them are more important than anything else and the determinant of other aspects of life.  It is much more convenient and much easier to cut people up into pieces and somehow believe those pieces are the real reality of those people.  People are much more than the description people give of them.

Should have access-  To have access means you have a choice.  You can either say yes or no, but you can say.  What you choose matters. 

Part of access means having the ability to say yes.  One of the major things that means is having the resources, the insurance or whatever you need to use the services you need. I live in a state that has not expanded Medicaid and statistics say over 80,000 people with mental health issues, needs or whatever term you prefer to use have no access to the services they need for help.  They cant say yes even if they want to.  In terms of impact I believe health care reform, meaning access to services, is the most fundamental mental health care reform there is.  It literally astounds me the Rep.  Murphy preaches about the need for more services in one and then in the next breath is against medicaid expansion.  It is hypocrisy of the worst sort.  Anyone who blames someone for not making use of some service and who would deny that person the ability to access that service is simply wrong. 

Another part of access is the things you want to say yes to must exist.  Another great hypocrisy of Murphy is that he makes no mention of the fact that over the last years in this country that state after state has drastically cut their spending on mental health services.  Available services for many are skeletal at best and in some cases less than that.  To try to explain  the current problems in the mental health system without any reference to that is simply stupid and unrealistic.  Murphy’s idea that somehow the “worried well” use too many resources that people with “real problems” need is a cheap effort to blame the people who seek help for the unwillingness of state and federal governments to provide the adequate help they need.  It is like telling starving people that their greatest problem is that the person sitting next to them is eating too much. 

People should have the ability to say yes, something to say yes to and finally they should be encouraged and empowered to make those choices.  A well functioning system would encourage people to move towards as much independence as possible.  At some points that might not be very much.  People’s needs vary at different points in their lives.  But still it is theirs to chose.

To services that help-  The quality of services is just as important as the quantity of them.  We do too many things because we are used to doing them or because people who do them have a vested interest in continuing to have them done.  The mental health system should be honest.  It should not be about territory or status.  If it works it should be done regardless of whose sensibility or philosophy it offends.  If it doesnt work it should not be done regardless of whose territory or status is threatened by the prospect of change.

Every person should be informed by that honesty.  They should know a realistic appraisal of the risks and the benefits of anything that is recommended to them.  Again choice means little if it is not informed.

Them to deal with that distress and move towards living a life of purpose, success and connection. It is about life getting better. All of us live with a reality we will not surpass but it doesnt mean life cant get better. Part of being human means having a sense of purpose. It means feeling like who we are and what we do matter. Part of being human means enjoying some sense of success or effectiveness in living. It means developing the skills that enable us to make life a better thing. And finally part of life means connecting to others. Caring and being cared for, knowing that we matter to others and that others matter to you and no difficulty or problem we have need of necessity make that impossible. Life is not just a matter of survival but of the opportunity to thrive. My thriving and your thriving may not be the same. But that is okay. The testimony of the lived experience of thousands and thousands of people living with the most severe distress and hard circumstances is that life can and does get better.

The Murphy Bill violates all of that. It reduces people to diagnostic labels and removes long standing protection of their rights and welfare. It doesn’t take the issue of access seriously. Instead it substitutes coercion and blames the victim. And finally it doesnt take the issue of independence and transformation seriously instead believing that for people in distress realism means accepting they will never move past that distress, It replaces the notion of recovery and transformation with one of management and dependence. It would deny people choice and try to make that denial a foundation of what the mental health system should be based on.

It bills itself as a fundamental reform and reforms nothing. It preaches about evidence based practice and then offers us psychiatric hospitalization. It criticises the mental health system and says it is based on unsound principles and then in one of its major provisions says that forcing people to be part of the very system it tears down can help them to solve their problems. It preaches about removing federal authority and then seeks to provide more of it. It talks about hundreds of thousands of mentally ill in the jails and then proposes solutions that cant even begin to address the needs of the amount of people left in the cracks. It is dishonest and fraudulent and in the end betrays the people it says it is trying to help.

It is a collection of bad ideas supported by other bad ideas. It is time for our voice to be heard. You have heard what I would like to say. What would you add?

On figuring what we are for: defeating Murphy

October 5, 2014 by

I have gotten a lot of comments on the last two posts I have made.  My point was basically that the Murphy Bill could best be defeated by our articulation of better options.  It was fine to say he was wrong but it was better to say he was wrong because something else was better.

Virtually everyone who responded agreed.  They all felt like saying no was not enough and wouldn’t be effective in the long term.  The best way to say no was to say yes to a better option.

Past that though feedback varied.  Many people thought it unlikely that any agreement would ever be found that most people could support.  They felt like many people would simply not compromise on what they thought and anything approaching unity was impossible.  Because of that they were doubtful of what we might accomplish.

Others were encouraging.  They were hopeful of finding common ground especially if people realized that lack of a common ground might result in a Murphy Bill becoming a Murphy Law. 

Another 10-15 people saw things a little differently.  What follows is my understanding of their position.  There were differences among them so this is not exactly what anyone said.

“It is important to advocate for a better option and it is important to have talking points that clearly explain that option.  But some people simply will not agree and that is okay.  There are different ways to get to the same place.  What is important is that a lot of people share their opinion on the Murphy Bill.  Legislators will in the end make their own judgements about the options presented to them.  Some people’s opinions may be dismissed as irrelevant or unrealistic.  Others may touch a cord and move someone to action.  Don’t worry about trying to control what you can’t control.  Build the common alliances and positions you can.  There is strength and impact in unity but in the end everyone has a right to their own opinions.  Wish everyone well that opposes this Bill rather they see things as you do or not.  You don’t need everyone to agree with you and because of that those who disagree with you can never hold veto power over your position or actions.  Invite others to act with you but respect those who choose to go their own way.  As many voices as possible need to be heard.”

Like I said the last option is my summary of what many people said, but I have to admit I see a lot of things in that option I like.  Common agreement with some folks is not likely.  We have handcuffed ourselves feeling like we have to have that agreement to move forward.  Perhaps we can not act as one because we are not one.  I like the idea of seeking the widest consensus possible but accepting the idea that behind our common opposition to Murphy there are wide differences on how to move forward and leaving it to each individual what they are willing to buy into.  We can share talking points but each person in the end must make their own choices.  What is important is that as many people as possible act.

On the danger of no voice: losing to Murphy

October 3, 2014 by

My last post talked about the need to be for something that can be presented as a better alternative to the Murphy Bill.   It argued strongly that simply saying no was in the long run not going to be enough and actually played into the hands of those supporting Murphy.  You can argue against Murphy’s solutions but in the end you lose if you ignore the issues and problems he identifies.  You don’t sound like you are shedding light on the problem.  You sound like you are advocating blindness.

Since the post I have received a lot of feedback agreeing with me.  Everyone seems to realize that you really want to make a difference you must be for something better than what you argue against and be literate and compelling in your presentation of that.  Murphy is really good at caricaturizing people who can’t or don’t as obstructionists against real changes.

But the question that almost everybody asks is the same.  What if we can’t agree?  What happens if we can’t agree on our voice?  Do we not have enough differences amongst ourselves to make it unlikely if not impossible we will agree to anything.  I share the concern.  I don’t know the answer.  I would like to think that Murphy would be enough of a unifying threat as to move people past differences, but I am honestly not sure.  And I wonder what will happen.

I can think of several possible outcomes.

1.  The coalition against Murphy falls apart due to internal squabbling and ends with people reduced to pointing fingers at each other.
2.  Efforts to come up with an option to Murphy fall apart and we rely simply on being against Murphy and hope that is good enough.
3.  Murphy unifies and a common alternative is developed.  People who may have a lot of differences find enough common ground to make a unified stand.
4.  Efforts to reach common ground fall apart and several groups start their own campaigns.  The consensus is that it is okay to be against the same thing for different reasons and the hope is that the cumulative impact of different voices will make a difference.

The scary thought is not just that Murphy wins but that we help him to win.  There are many questions to be asked.  Murphy is a bad Bill and the chances to beat it are real.  But it sure seems easier to beat something when you have something you would like to win.

Being for a better mental health system: On the new Murphy Bill

October 2, 2014 by

The new Murphy Bill will soon be amongst us.  And the battle to define who is really in favor of a better mental health system will soon enter a new chapter.

The message of the supporters of the Murphy Bill is really pretty simple.   We have a terrible mental health system, many people receive inadequate services.  Many receive none at all.  We are for a better mental health system.  If you are not for us you are not for a better mental health system.  Much of their message has been to share stories of those they say are hurt by the system and to claim their proposals would help those being hurt.  They rely heavily on statistics about people with mental illness in jail.  They say those that oppose them don’t really care about the people being hurt and oppose them generally for selfish reasons and because they have a monetary reason to oppose change.  They tend to try to frame those who disagree with them as lacking integrity and honesty.  They don’t worry about opposing messages so much.  Instead  they try to destroy opposing messengers.  They portray themselves as lonely warriors fighting against a dark conspiracy.  And they are wonderful salesmen.

Their genius is in their effort to capture an issue that has relevance and emotional impact to the legislators they talk to in such a way as to identify themselves as spokesmen for those people who have watched their relatives or loved ones  fall between the cracks of a system that too often seems to have a lot of cracks.

When people criticize their proposals as being coercive and not respecting the legitimate rights of people receiving services they caricaturize those criticisms as being given by people wanting to weaken the power of professionals and being totally out of touch with the reality and enormity of the problems thousands and thousands of people face.  And to the degree the caricatures hold the people who support the Murphy Bill are able to use the complaints about coercion as evidence they are being opposed by dangerous people who don’t really want to change a flawed system.  And, as I said before, they are positively gifted salesman.  The real question is to what degree enough legislators will buy their argument.

The weakness of those who oppose the Murphy Bill is that they are not nearly as clear about what they support as they are about what they oppose.  I have written about this before but it is so crucial.  The Murphy folks would use that as evidence that critics are not for real change and would leave crucial changes ignored.  And they try to use that as further proof they own the issue.  They are for real change.

The solution is simple.  Those against the Murphy Bill must present themselves, not as being against change, but for better change.  They can not let the Murphy people own the issue.  They must have a better option and that option must be presented in such a way that it is credible and compelling to legislators who in the end will make the decision.  I think you could make a strong argument that in the end Murphy will be defeated by an alternative Bill or he will not be defeated at all.

The same old Murphy Bill may or may not be the new Murphy Bill.  And it may pass.  I may be very wrong and hope I am but I really question rather or not the same old opposition will be enough.  Historically opponents of the bill have had a hard time agreeing on anything but their opposition to the bill. It will be hard to find legislators to agree with them if they don’t find a way to agree with each other.

Tennessee ahead: The coming of mental health season

October 2, 2014 by

The early projections are not good.  Tennessee governor Bill Haslam is, asking for budgets to be prepared with a 7% cut from last year.  We should know in the next couple of weeks what is likely to happen.  Peer support centers are near the top of the cut list I would imagine from the little bit I have been told.  Whatever is ahead is not good news.

There is a major battle to expand Medicaid in Tennessee.  A peculiar form of chaos would be to substantially increase the amount of people people eligible for services at the same time you sure substantially cut services.

Mental health season in Tennessee approaches.

What makes life better

September 30, 2014 by

If life is about momentum then two sets of factors are important.

What are the risk factors (behaviors, situations, relationships, emotions, attitudes, and ideas) that tend to be precursors to things going worse? What predicts bad times coming? What makes bad times and problems more likely?

What are the protective factors? What (behaviors, situations, relationships, emotions, attitudes, and ideas) build capability? What makes positive outcomes more likely? What builds resiliency in difficult times?

Do what you do when life is going better. Things that make you stronger increase your chances of living successfullly in life and more likely to coping when you are not.

Doing things that are good for you won’t prevent life from having problems. Nothing does that. Much is beyond control. But it may make it less like likely and more likely if there are problems you will deal well with them.

You may or may not be able to control whether or not you have problems in life. But everything is better if you do all you can to build solutions into the fabric of daily life.

Recovery vs. Disease Management: The Core of the Argument

September 29, 2014 by

hopeworkscommunity:

rom the archives

Originally posted on Hopeworks Community:

  •  Recovery  believes that individuals matter.  No degree of impairment or difficulty makes them matter less.
  •   Disease management believes that the disease or diagnostic label is the most important thing about anybody.
  • Recovery believes that if an individual is important then what is important to him is important: his thoughts, feelings, goals, aspirations, interests, hopes and dreams.  No amount of impairment or difficulty makes this less true.
  •  Disease management believes that many things that an individual values are a creation or result of his disease.  It believes that these things do not have as much validity as they do for people without a diagnosis.  It believes the most important thing is symptom management.  What is most important is not that people are people, but that they are “diseased.”
  •  Recovery believes that if an individual is important then what is most important is what he chooses for himself and not what…

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What I believe

September 29, 2014 by

These are some of the fundamental ideas and values that have guided Hopeworks Community over the last years.  Most of them have been the subject of multiple posts.

People should be able to make their own choices about their own life.

They should have choices that matter.

They should have access to the knowledge, skills, and support that enable them to make the best choices they can for their own life.

They should have the ability to change those choices as life dictates or circumstances change.

Nothing that anyone is called or limits makes them less of a human being, broken or deficient in some fundamental way.

All of us have limits.  There are some things that will not change and some things we will not be, but the capacity for change, for life getting better…..for hope is real and not based on groundless wishing or pollyannish thinking.

People can and do thrive under the  most challenging of circumstances.  Dont give up on anyone.

People who live difficult lives can be successful in their endeavors…..connected in their relationships…..and live a life of purpose and meaning.

Man is a biological, social, emotional, historical, cognitive, spiritual and relational being.  Any system of  thought that reduces man to one of this dimensions or that tries to say that one of these dimensions is more fundamental or the cause of others distorts what people are.

A biological, social, emotional, historical, cognitive, spiritual, or relational fact is most important in the way it manifests itself as a human issue and the misunderstanding of this causes great harm.

Life is largely a matter of momentum.  Things that are more likely to happen, all other things being equal, tend to happen more often.  A major secret to being in control of your life is understanding how to control the momentum of it.  Bad things can and will always happen.  That is what it means to be alive.  But we can affect the difficulty with which they occur.

People learn.  Experiences have the opportunity to teach us important things that make the experiences after them better.

Meaning matters.  In choosing what we make of things we make likely what they make of us.

Many people are ordinary people dealing with extraordinary circumstances and we so often do not acknowledge their courage or give them the credit due.

In any circumstance some people are doing better and some people are doing worse.  The people doing worse can learn from the people doing better.  Lived experience matters.

Every person has times where they are doing better and times when they are doing worse.  As much as you can do better things on purpose.

Support is essential.  People who dont support others normally find it hard to find people who support them.

Taking care of yourself does not mean living like you are the only important thing in the world.

Accepting what you cant control gives you the capacity to control the things you can.

“What happened” is the most important question you can ask anyone.  Helping people to cope with injury is more often than not the key to really caring.

Feelings lie.  It is often not as bad as it feels.  It is often not as good as it feels.

There is no real explanation for tragedy.  It just is.


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