Do You Really Want to Use Mental Illness as an Insult?

I am tired to death of hearing mental illness diagnoses used as pejoratives.

I am tired to death of hearing technical medical terms that apply to me and my friends hurled as insults at political figures, used to describe weather conditions, and employed as self-deprecating comments in the context of life's little challenges.

I am especially tired to death of hearing this language in the postings of Facebook friends and in the pulpit from educated people who should know better.

Especially after I have called them on it over and over and over.

So you can imagine that my eyes perked up at a thread that addresses this issue, posted on Twitter by somebody who goes by the handle @queerfox.

@QueerFox has gone to great trouble to find adjectives for those who are challenged in the vocabulary department. They have given me permission to post their work, and I share it with you to encourage you to

Watch your mouth.

Did you mean: self-centered, egocentric, self-involved, vain, self-serving, intractable, stubborn, self-aggrandizing, pretentious, self-involved, grandiose, overblown, conceited, smug, narrow-minded, inflexible, adamant, intransigent?

Then say that, instead of narcissistic.

Did you mean: cold, uncaring, heartless, cruel, indifferent, sadistic, ruthless, merciless, evil, remorseless?

Then say that, instead of sociopath/psychopath.

Did you mean: erratic, unpredictable, temperamental, volatile, fickle, mercurial, impulsive, reckless, thoughtless?

Then say that, instead of borderline, manic, or bipolar.

Did you mean irrational, illogical, fallacious, incoherent, conceited, intransigent, obdurate, unreasonable, implacable, cussed, ridiculous, implausible, absurd, unjustified, preposterous?

Then say that, instead of delusional, schizo, insane, crazy, demented, etc.

(Not an illness, but on a related note) Did you mean: uncompromising, obdurate, obstinate, ignorant, intransigent, adamant, heedless, inconsiderate, stubborn, indifferent, narrow-minded, indifferent?

Then say that instead of deaf to criticism, falling on deaf ears, etc.

(Also not necessarily an illness) Did you mean ignorant, imperceptive, blinkered, narrow-minded, inconsiderate, oblivious, rigid, obstinate, willful, intransigent, unobservant, obdurate, unyielding, pertinacious, prejudicial, unamenable?

Then say that, instead of blind.

Did you mean anal-retentive, finicky, fussy, pedantic, nit-picky, pernickity, meticulous, fastidious, hair-splitting, puritanical, snobbish, exacting, controlling, obsessive, high-strung, uptight, queasy, prissy?

Then say that instead of OCD or neurotic.

Did you mean: melodramatic, oversensitive, delicate, uptight, clingy, theatrical, artificial, insincere, boastful, ostentatious, pretentious, attention-seeking, insecure, dependent, needy?

Then say that, instead of histrionic or borderline.

The thread continued. You get the idea.

No, this is not about being PC, where PC is your shorthand for fussy, legalistic, and not fun. This is not about the first amendment, the current justification for all kinds of bad behavior. It is about manners.

Remember manners?

So if I take offense, it is because your behavior is offensive.

In the days of manners, Monica Stoupa once slammed me against the gymnasium wall at St. John the Evangelist Parochial Grade School and said, I can tell Polish jokes, but you can't. Just like how we can tell nun jokes, but the Protestants can't.

I learned my lesson in fifth grade, and it has never steered me wrong.

Which is to say, don't bother calling me on my self-description as batshit crazy. I and my tribe can use that language. Unless you are claiming membership in that tribe, you cannot.

Here ends my lesson in basic decency.

You're welcome.

meme from

Can People With Mental Illness Become Saints?

 The day approaches - the start of Lent Madness.

What, any reasonable person might ask, is that?

Take March Madness. Mash this bracket-style competition with a list of saints, some well-known, some utterly obscure, chosen by Scott Gunn and Tim Schenk, the two members of the Supreme Executive Committee who answer to nobody. Despite years of campaigning, they still will not include Fred Rogers. But I digress...

Every weekday through Lent the reader is presented with two saints and asked to vote. Anybody with an internet connection can vote - only once - they will know. The saint with the greater number of votes advances to the next round.

Information is provided by celebrity bloggers give you a basis for your vote, introductory bios in the first round of thirty-two, odd or intriguing stories in the saintly sixteen, kitsch souvenirs in the elate eight, campaign speeches in the faithful four, and summations in the final for the Golden Halo. You can use any criteria you like to make your choice. You can enter your reasons and campaign for your favorites in the comment section if you choose.

The competition begins this year on Thursday, February 18 and runs through March 31, when the winner of the Golden Halo is crowned.

It's all good fun, or is supposed to be. If you are the sort who explodes in non-Lent-like rage when Frances Perkins, Secretary of Labor under FDR, bests Luke the Evangelist in the final (2013), then this is not the Lenten discipline for you. Otherwise, it is an opportunity to learn some church history and to ponder the notion of holiness.

Speaking of which, can people with mental illness become saints? Well, obviously, Church calendars of saints are filled with visionaries (Bernadette), people with stigmata (Francis of Assisi), and extremists of many sorts (Joan of Arc). Some of them would be diagnosable in a modern age.

Except for the really big names whose oddness gets obscured by good PR - here's looking at you, Francis and Joan - the diagnosable saints tend not to fare well in Lent Madness. The comments in these competitions are telling. It's a self-selected electorate. They often express a disdain for legend, which disqualifies most of the pre-Enlightenment competitors. They tend to prefer the do-gooders. As a consequence, people who are diagnosable rarely make it past the first round.

I have written about two of these, Margaret of Cortona and my favorite, Christina the Astonishing, patron saint of therapists. Did Margaret have an eating disorder? Was she a cutter? I don't know, but people who rejected her didn't like her extreme fasting and self-disfigurement. Did Christina suffer from delusions? Her family went to the extreme of breaking her leg to keep her at home.

Does mental illness disqualify one from sainthood?

Let's talk about Florence Nightingale and the 1991 General Convention of the Episcopal Church. It was a hot one, not just for being held in Phoenix in July. People were testy as the Church began to talk about sex. So that was the atmosphere in which we considered adding six people to the calendar.

The commission that nominates additions to Lesser Feasts and Fasts had been charged to come up with some names other than the same old, same old, nineteenth century clergy. Specifically, they had been asked to include women and lay people. They presented a slate of six, four women, including Bridget of Ireland and Florence Nightingale, and two men, the founders of Gaulledet University. The House of Bishops stripped the four women off the list and recommended to the House of Deputies the two nineteenth century clergy.

Their reasoning? I can't remember the other two women. Bridget, they didn't like because she was legendary. Was she really a Christian or a Christianized version of the ancient religion? Of Florence, one bishop is reported to have said, Didn't she go a little loony in her old age?

The House of Deputies was not happy. Imagine Mitch McConnell and Nancy Pelosi voting the same way on anything. The equivalent happened in the unanimous vote to restore Bridget to the list and return the measure to the other House, where it finally did pass.

What was with Florence? There were mutterings and suspicions about the real reasons for her rejection. But after further investigation of her old age illness, (and assurances were made that she was not a little loony?), she made a comeback in another year and made it onto the Episcopal Church's list of Holy Women, Holy Men.

And then in clear vindication of her character, Florence Nightingale went on to win the arguably more prestigious Golden Halo in Lent Madness 2017.

This year's bracket is fairly obscure. Until we get into the bios, I don't know if it offers any fellow loonies as candidates. I wait for the Church and for church members to recognize mental illness as a life condition in which some of us strive to follow Jesus as best we can, sometimes heroically, sometimes in ways worth emulating, sometimes as examples of faithfulness to our Lord Jesus Christ. Calling some of us saints does not mean, God forbid, that anyone wants to be like us, even in holiness of life.

I wait. But I don't hold my breath.

Lent Madness widget from
Perkins icon from
needlework of Christina the Astonishing created by Cookie Scottorn, used with permission
more of Scottern's art can be viewed at

Help! How Do I Talk to My Delusional Cousin?

Consensual reality has taken a real beating lately. Fake news, alt facts, conspiracy theories, Russian Facebook bots... Sure, we'd all like some civil discourse. But what do we do when we can't even agree on what is true?

Delusional is a big word to throw around, especially when you are trying to stay in some sort of relationship with friends or family whom you believe, frankly, to have gone over the deep end. Does it really apply to this situation? Or is the use of the word a lit match in a room full of gasoline?

Let's start with some clarification. The Diagnostic and Statistical Manual (DSM-5) defines delusions as
 fixed beliefs that are not amenable to change in light of conflicting evidence. Well, that sure sounds like what we are dealing with.
Delusions are taken as indicators of a mental or physical disorder. But before we go making armchair diagnoses, consider how powerfully our minds cling to ideas that are demonstratively false, the fear of spiders, the hope in lottery tickets, trickle down economics. Let's exercise some restraint and some humility here.

What follows are techniques used in the field of mental illness that may prove useful to communication across the reality divide between people who care about each other. They do not presume that the other person suffers from a mental illness. They do not presume that you have your head screwed on straight either. Actually, how great it would be if both parties agree to use best practices for talking with somebody who is delusional!

The first recommendation follows directly from the definition. Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. As a consequence, it is utterly pointless to present evidence that will "prove" the delusion is false.

You have already experienced this. Whatever evidence you present is either discounted because the source is unreliable. Or it is absorbed into the delusion with an alternative explanation.

Save your breath.

The rest comes from Xavier Amador. Amador is not my go to person for understanding people with schizophrenia. But he does give good advice for dealing with delusions. He outlines a four-part strategy: 

  • Listen, reflectively with respect and without judgment. Hear the other person out. Ask questions to make sure you understand the position, not questions to challenge the position. For example: Do you think the Secretary of the State of Georgia falsified the vote totals? or Do you think the Secretary of the State of Georgia certified accurate results? There may be some nuances here that you are missing. Don't go beyond the broad strokes. Just make sure you know what the issue is.
  • Empathize strategically with emotions stemming from the delusions. For example: That would feel really disturbing or My position must feel really frustrating to you.
  • Agree where you can. For example: Every legal vote should be counted and People who commit crimes should be prosecuted.
  • Keep the relationship going with things that you do share. For example, my family members don't respond to each other's political posts on Facebook. But we like each other's photos, jokes, positive news.

I am not suggesting that this strategy will heal the national divide. That is way above my pay grade. As long as there are no threats of violence, this is simply a holding pattern to allow friends and family to hang in with each other until things sort themselves out and consensual reality makes a comeback.

May it be soon.

How Will You Get Through This Week?

Self care is not my best subject in the best of times. I can establish a routine, get up, eat breakfast, go to work, walk in the afternoon, and so on. I can hang on to good habits, eat a healthy diet, wear amber glasses at night. But that place in the list where I am supposed to do something for myself? Here is how that goes:

    Therapist: What will you do for fun this week?


Okay, so what will YOU do for fun this week? (Clearly, I could use some ideas.)

And now there is this insurrection. How did that word work its way into daily conversation?

After the year from hell, here we are again, discovering even lower circles than Dante anticipated. The world is indeed exceeding the limits of my medication.

But dear reader, I am also thinking of you this week. I want you to be well. Well, as well as you can manage.

Have you made a plan? I think it will help to make a plan.

Here is mine: 

  • I will not go anywhere people gather, not even grocery shopping. We're eating out of the pantry.
  • I will treat myself gently. I have set low expectations for productivity and am moving everything on my to do list to next week. Activity is good. But we'll see how it goes.
  • I will stay in touch with friends. We can gather on Zoom. It has been enormously helpful to me this week to talk with people I love. Remember the people you love, or even like a little bit. Check up on them.
  • I will pray the serenity prayer every day. In the first phrase, "Grant me the serenity to acknowledge what I cannot change," I have been visualizing myself riding the top of a wave. I don't have to engage the wave, which I cannot control. I just have to ride it.
That's the plan. I could probably add some more items. Yeah, I need to put something fun on it. But refer to the second item. This is enough.

Take care of yourself this week. And if you figure out how to have a little fun, let me know.

What Happened to My Bipolar Brain and How Do I Fix It?

The most troublesome statement in Goodwin and Jamison's Manic Depressive Illness may be this: "Complete symptomatic remission does not ensure functional recovery." This is no small problem. For some 30% to 60% of patients with bipolar disorder, simply treating their mood symptoms is not enough to help them return to a full life.

There’s a third pole that needs to be addressed for that to happen: cognitive symptoms. These often persist even when patients are euthymic, and they range from problems with memory and attention to more subtle deficits such as picking up on social cues and making wise decisions. 

Chris Aiken's article, Eight Ways to Improve Cognition in Bipolar Disorder, opens with these paragraphs. Ironically, what Aiken calls troublesome, I find immensely reassuring. My experiences are real!

Several years back, my pension fund paid for a three-day psychiatric/psychological evaluation of my disability status. I went in with a diagnosis of Bipolar NOS. I thought that PTSD also fit. The pension fund wanted a second opinion and a prognosis. The shrinks asked what my goals were.

I wanted to know what had happened to what I called my Swiss cheese brain, my difficulties with concentration, reading comprehension, memory, word-finding. I was losing track of my thoughts in the middle of sentences. The day I messed up the buttermilk pancakes, an old family recipe, my wife was seriously concerned.

Well, they asked. But I wasn't footing the bill. So...

They ran their regular battery of tests, determined that I didn't have dementia, and that I was pretty smart. The good news is, there is nothing wrong organically, they said. Their conclusion: the cognitive difficulties were all dissociation, caused by my trauma history.

Okay, yes, dissociation is one of my best skills. But it was like I was an Olympic athlete who had gone for a post-injury physical evaluation and been told, You ran a five minute mile. That's really fast. Nothing wrong with you.

True, I was really smart. But I used to be brilliant smart. And the difference between before and after my brain blew up meant that I could no longer pursue my goals. I could not get my doctorate. I could not finish projects that were important to me. And in a variety of small and large ways, I just wasn't very good company anymore.

A speaker at a NAMI meeting described the consequences of his traumatic brain injury. And though I had not experienced a TBI, some of what he described matched my own experiences. I decided to treat my brain as though it were injured and needed to heal.

And it did heal. Not entirely, but it got a lot better.

  • First, I adjusted my expectations. A friend with similar experience recommended that I give myself five years to recover.
  • I gave myself rest, started following every good sleep strategy out there.
  • I improved my diet, less red meat, more veg.
  • I changed my meds. The people who did the evaluation recommended that I take small doses of Valium throughout the day prophylactically. It has never been addictive for me. But after a few months, I couldn't tolerate the brain fog anymore. My pdoc agreed that I could drop it.
  • While lamotrogine helped slow down my rapid cycling, it didn't slow it much. Nor did it relieve the depression enough for me to tolerate the word-finding issue. I was a writer, taking a med that took away my words? So I dumped that, as well. Eventually, once relatively stable, I found other meds that help me maintain that stability, including fish oil and CoQ10.
  • My wife found behavioral strategies for reducing the dissociation thing, like getting my clear attention and making me to write it down when she wanted me to remember something.
  • And I keep trying to take that pause between stimulus and response to let my frontal cortex catch up to my ever-alert amygdala. That one is hard, but an important social skill.

A number of these are strategies that Dr. Aiken recommends. This article was written for doctors, but in an accessible way that patients, even those who are no longer brilliant, can understand. He has recently joined Jim Phelps at Psych Education, a website jammed with information for patients about how to live a bipolar life to the fullest. Go there. Spend days there. You will The website is filled with what your doctor never bothered to tell you.

You can do better than you're doing right now.

May we all have doctors who pay attention to our quality of life and who help us pursue our goals.

How Does the Mind Learn? The Neuroscience of the Way of Love

This month I have been posting at Batshit Crazy Preacher instead of Prozac Monologues. It's a series of daily reflections for Advent, the Christian season of preparation for Christmas. Watching and waiting, not so much shopping and decorating. Lots of people are posting images and reflections on social media for #AdventWord. But me, well, you could expect that mine would have a Prozac Monologues flavor, regardless of the venue.

So in case you don't follow both blogs, here is the link to one of my posts in which I explain the neuroscience behind a particular spiritual discipline. Not meditation, mindfulness, breath prayer, those typical crossover exercises that regulate cortisol. No, I'm talking about learning, at the cellular level, complete with my drawing of a neuron.

Blessings, all.

Prozac Monologues Moves to Batshit Crazy Preacher

Advent is the season of spiritual preparation for Christmas. The idea is to slow down, not speed up. Spend some quiet, reflective time. Remember the reason for the season... Honestly, I think about setting up an Advent wreath, that sort of thing. But our candle holders broke. They broke years ago. I guess I'm just not into the candle thing.

Most years, the closest I get to Advent wreaths, calendars, whatever, is a box of twenty-four wee drams of Scotch from Master of Malt. I know, I know, Scotch is not what your psychiatrist recommends for your recovery toolbox. At least it usually take me well past the twelve days of Christmas to finish the thing.

Anyway, this year I found a practice that does spark my imagination, #AdventWord. It is an international community of prayer that you can enter in whatever way appeals to you. There is a daily meditation to read, based on a different word every day. Advent Word, get it? The ones so far this year are tender, deliver, strengthen, earth, rebuild, fellowship, and glory. People post photos on Twitter or Facebook, or scripture passages, or songs inspired by the word. You can get a poster with spaces to color in each day. You can doodle, decorate the word, or draw whatever comes to you. When it's finished, it's supposed to remind you of a stained glass window. The whole project lets you do whatever prayer style works for you.

I used to make gingerbread houses during Advent, (see last week's post). But that got just too hypomanic. Nowadays I write. Writing has long been my primary spiritual practice, especially when I was writing sermons. Today I do so much writing and speaking related to the book, I have taken a break from preaching. But I miss it.

So I started posting a reflection on the word of the day each day at my other blog, BatshitCrazyPreacher. These reflections have been a mashup of my two passions, mental health (or my lack thereof) and my quirky take on things scriptural. Oh, and I post my sketch, too.

Good golly, every day! This activity threatened to replace gingerbread on the hypomanic trigger list. But, hey - not my first rodeo. I know to jettison at least some things when there get to be too many things. That is my rather roundabout invitation to you to check out BatshitCrazyPreacher this season, because that is where I will be doing my thing, instead of here.

While I have your attention, I also invite you to follow me on Twitter and Instagram @WillaGoodfellow. You can also check out other offerings for this AdventWord thing on both, using the hashtag #AdventWord.

Happy Holidays!

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