Cognitive Behavioral Therapy -- Gingerbread Style

First Cognitive Therapy Technique -- Distraction

My therapist said Think of something you might find enjoyable.  You don't have to do it.  You don't even have to enjoy it.  The goal is not to move your mood from 1 to 10.  Any mood change is a bonus.  The goal is simply to give you something else to think about [-- besides what I had been thinking about.]

Distraction is one of those really irritating CBT techniques.  I am traumatized and can't stop thinking about this.  Okay, so think about something else.  I pay money for this?

But my other therapist, totally different method, said pretty much the same thing.  And I was six weeks from a major project I had promised for the holiday season.  And I am not sure it would have worked except that the wheel was ready to turn from early autumn danger to late autumn hypomania.  But he did and it was.  So...

She said think about it.

I guess I overshot the mark.

Ya think?

To Diagnose Hypomania -- Pay Attention

I used to churn out 10-12 gingerbread houses each season, back in my undiagnosed days.  I used the Joy of Cooking recipe and floor plan.  But each and every one was one of a kind: a log cabin made of pretzel sticks and peanuts for the chimney, another with candy canes on the roof for a chalet effect... No, I wasn't manic.  I was excited...

It could be said I don't know when to quit.  So a simple suggestion, think about something you might enjoy instead of what you are thinking about right now, became a fourteen inch high, furnished gingerbread house.

See what I mean?  Once I decided to tile the kitchen floor with candy corn, I was gone.  Note the faucets for the aluminum kitchen sink.  And the handles on the refrigerator.  There is a fireplace hearth down there, made of a Milano cookie.  Even as I was installing these things, I knew I was out of control.  But I could not stop.

Here is a nine patch quilt, made from fruit rollups.  Plus a teddy bear on the pillows.  Should you decide to start quilting with fruit rollups, here are my methods.  Unroll them a few days in advance to dry a bit.  Don't overreach.  Let the materials tell you what they are willing to do.  Use liberal amounts of vegetable oil on your fingers and cutting utensils.  Keep the knife clean.  I recommend an exacto knife, under supervision if you have a problem with sharp objects.  Place your product between oiled sheets of cling wrap, then between sheets of paper.  Iron at LOW heat for five seconds.  Breathe.

I refer to this as my diagnosable gingerbread house.

By doubling the dimensions, I had introduced engineering issues.  I needed weight bearing walls.The closet was designed for that purpose.  I made a double wall facing the living room.  But I failed to double the wall with the door.  Two by twelve inches, it was the first piece to break.  The pretzel sticks inside the closet hold it together.


Metaphor Alert -- Community

If I were to get philosophical -- and while I bent over this project, holding my breath and waiting for icing to turn to cement, I had plenty of time -- I would reflect that sometimes things or people are created that do not have the structural integrity to withstand the pressures to which they will be submitted.  Nevertheless, they can get by with a little help from their friends, even friends that brittle themselves, like pretzel sticks.  This is the essence of support groups.  Get into one.

Some of us are not particularly unstable, but we collapse under pressures beyond normal experience.  If we don't have to bear the weight by ourselves, we can make still our own creative contribution to the whole.  The fireplace wall fell into three places.  Twice.  It stood, once it received a full back brace.  The brace is not flashy.  It is not even visible, covered by the outside of the fireplace.  But it is essential.

This is the essence of community.  Christians call it the Body of Christ.  If the house were all ribbon candy, how would it stand?  If the house were all support, what would cover the kitchen floor?

Anyway, diagnosable.  The roof also collapsed, the weight bearing walls notwithstanding, because I pushed too hard while attaching it.  Be gentle with yourself, my friends.  The stronger parts can injure the weaker.  Self-restraint is especially important where you are strong.

But we can learn from our mistakes, and turn them into more creative opportunities.  The roof went for snacks to a bible study group.  I replaced it with a lighter version.  And then I broke one side again.  This time I finally listened to my spouse, and put up just half a roof, so people could look in on that nine patch quilt.  None of us has all the answers.  And sometimes irritating advice is good advice.

Even if it is irritating.

Another Cognitive Therapy Technique -- Dialectical Thinking

Even in the midst of this craziness, I kept aiming at sanity.  My mantra was Prototype, prototype.  The point of a prototype is to make as many mistakes as possible, in order to learn, and not make the same mistakes while doing the real thing.

I was making a lot of mistakes.  Boy, was I learning.

Dialectical thinking means that life is not divided into black and white.  One can hold a painful thought and a positive one in the same brain at the same time.  That and valium got me through.

I learned not to use a double barrel aged single malt scotch as a brace to hold up a wall while assembling, like the soup cans above.  The bottle was missing only as much as is pictured here before I made that particular mistake.  Sigh.

After mopping up the nearly full bottle of scotch and as much shattered glass as I could find, it was time, it was time to stop working on the prototype.  Well, after I built the fire in the fireplace.

Two hot tamales, cut on the bias, a couple little pretzel sticks and a sprinkling of ribbon candy crumbs.  The back of the fireplace is the inside of a mint Milano with the white frosting scraped off.

Like I said, diagnosable.

It wasn't finished.  It still isn't finished.  But the time for prototype was at an end.  The time for the real deal had begun.

To be continued...

all photos of gingerbread houses by Helen Keefe 

photo of scotch by Suat Eman

Hope and the Play of the Week

I am up to my earlobes in ribbon candy, pretzels and gingerbread right now, a holiday project gone diagnosable.  I have been working for several weeks now on the prototype of a gingerbread house that is yet to come.  If this one stands.

I hope I can post pictures of the finished product.  They could go in my file.

Meanwhile, I have scavenged a video from a Facebook friend.  It reminds me of my very favorite poem in the whole wide world.  My congregations know it by heart, they have heard me preach it so often.

Listen to the mustn'ts, child.  Listen to the don'ts.
Listen to the shouldn'ts, the impossibles, the won'ts.
Listen to the never haves then listen close to me...
Anything can happen, child.
Anything can be.

-- Shel Silverstein

Come to think of it, the gingerbread house, the poem and the play of the week all have this is common.  They are matches, held up against the darkness.

Here's hoping you some light.

Nonsense and the Anterior Cingulate Cortex -- Redux

This traffic monitor should read YOUR SPEED 60 MPH.  But I couldn't find that image.  I suppose creating it would not be a good idea.  So this image will have to do.

If you are traveling too fast when you hit the pothole, you break your suspension.

So I am taking a break while we try to balance the GAMA and glutamate in my synapses.  Here is a slightly modified rerun of an oldie but a goodie.  I think it addresses the current phenomena of the Tea Party, the growing rigidity of those whom it threatens, and the retreat of the rest into reality tv.  If I didn't make so many connections like that, my brain wouldn't hurt so much.  Then again, Prozac Monologues wouldn't exist.

Nonsense and the Anterior Cingulate Cortex -- November 7, 2009 

John McNamany put the thought into my head, the New York Times tickled my fancy and a blog new to me gave me the art work.

Function of the Anterior Cingulate Cortex

Finally, it's Anterior Cingulate Cortex Week!  This lovely portion of the brain is found in the limbic system, located just above the center, about where Iowa would be and extending into western Pennsylvania, if you flip the image so that it faces right, as I did here.  Like a true Midwesterner, the ACC modulates emotional response.  A hard-working manager, the ACC handles motivation to solve problems and anticipation of tasks and rewards.  It also monitors for conflict, things that don't make sense.  The brain is unhappy when it cannot detect a pattern.  Confronted with anomaly, the ACC goes to work.

The Absurd Stimulates Pattern Finding Behavior

"Researchers have long known that people cling to personal biases when confronted with death... In a series of new papers, Dr. Travis Proulx of University of California Santa Barbara and Steven J. Heine, a professor of psychology at the University of British Columbia, argue that these findings are variations on the same process: maintaining meaning, or coherence. The brain evolved to predict, and it does so by identifying patterns.

"When those patterns break down — as when a hiker stumbles across an easy chair sitting deep in the woods, as if dropped from the sky — the brain gropes for something, anything that makes sense. It may retreat to a familiar ritual, like checking equipment. But it may also turn its attention outward, the researchers argue, and notice, say, a pattern in animal tracks that was previously hidden. The urge to find a coherent pattern makes it more likely that the brain will find one." [Benedict Carey, New York Times, October 5, 2009]

To test whether confronting the absurd leads to pattern-searching behavior, they had twenty college students read Kafka, The Country Doctor, a story that is urgent, vivid and nonsensical.  Does anybody who is not in college ever read Kafka?  Anyway, after reading the story, they were given a task, to study strings of letters that did not form words.  They were then shown a longer list, and asked to find the strings they had seen before.  The letters did have patterns, very subtle patterns.  And the students who had read Kafka did better at this task than another twenty who had not been exposed to the absurd, 30% better.  With a Kafka-stimulated ACC, they were primed to find the patterns.

I wonder if that explains the college student's propensity to read Kafka in the first place.  Not to mention all those posters by Salvador Dali on dorm room walls.  The college student is at a crossroads, and has to puzzle through the animal tracks of his/her life, to discern the pattern, the call, the next direction.  These representations of the absurd stimulate the part of the brain needed at this developmental moment, just as caffeine stimulates the system before the exam.

I graduated from college at loose ends, with the Episcopal Church still discerning the patterns that would allow for the ordination of women.  That was a few years off, and I wasn't ready to commit to a vocation that might not be received.  But I didn't read Kafka.  Instead, I decided to read everything that Kurt Vonnegut had written up to that point, a modern day Kafka.  Kafka-lite, if you will.  Today, as I fill out disability applications, I am again at a crossroads, and again instinctively, am drawn to Vonnegut, whose body of work has grown since 1975.  Evidently I am stimulating my ACC and boosting my pattern/meaning/coherence finding abilities, priming myself to discern my next direction.

Patterns and the fMRI

Oh boy, I found another fMRI experiment!  There is a study in the Journal of Pain (what a title!) that discovered, when people were prompted by pain-related words to remember painful autobiographical episodes, the fMRI machines showed that it was -- you guessed it?! -- the anterior cingulate cortex that lit up.

Dialectical Thinking -- On Not Blowing Out Your ACC

This person loved me; this same person abused me -- two memories in conflict, absurd.  Put them together, they cause pain. They call it dialectical thinking when you hold two seemingly contradictory ideas in the same head at the same time.  But dialectical thinking is a highly developed skill.  Before anybody ever suggested to me that I could employ it to reduce my pain, I spent (and still do spend) enormous amounts of energy trying to make sense of events that were absurd.

Some of us had Kafka-esque childhoods.  I wonder, does the ACC become quiet if we engage in dialectical thinking?  I wonder, does it blow a fuse if we don't?

If you are searching for Christmas gift ideas for the Prozac Monologues blogger, an fMRI machine would certainly be well received. 

photo of traffic sign by Richard Drdul, Creative Commons  

Attribution-Share Alike 2.0 Generic license.

image of brain from NIMH 

Obama inauguration photo taken by

 Petty Officer 1st Class Chad J. McNeeley, USN 
and in the public domain 

Shadows

Thom is a long-time fellow traveler and now both a Facebook friend and Prozac Monologues reader.  He regularly posts on Facebook the latest segment of the ABCs of Spiritual Literacy.  Last week's entry was on Shadow.  Well, that hits me where I live.  My thanks to Thom for leading me to this post. 


This website presents one spiritual practice at a time, each in a similar format.  First it names what the practice enhances (in this case, wholeness) and what it balances (Pollyannaism/projections).  Then it moves to the Basic Practice and Why This Practice May Be for You, with links to books, films, art, prayer, imagery, discussion questions...


So here is the story on Shadow:


The Basic Practice:
The spiritual practice of shadow encourages us to make peace with those parts of ourselves that we find to be despicable, unworthy, and embarrassing — our anger, jealousy, pride, selfishness, violence, and other "evil deeds."


Kinda reminds ya of a therapy session, doesn't it?


University professor, author and fellow depressive, Parker Palmer is my favorite resource on shadow.  His book Let Your Life Speak has vocation as its central focus.  By "vocation" he means the call to be one's true self, not the self that one finds virtuous.  Ah, but the journey to the true self is treacherous.  He got there himself by traveling the road of depression.  He quotes Annie Dillard:


In the deeps are the violence and terror of which psychology has warned us. But if you ride these monsters down, if you drop with them farther over the world’s rim, you find what our sciences can not locate or name, the substrate, the ocean or matrix or ether which buoys the rest, which gives goodness its power for good, and evil its power for evil, the unified field: our complex and inexplicable caring for each other, and for our life together here. This is given. It is not learned.

(from Teaching a Stone to Talk)

Palmer continues: Why must we go in and down? Because as we do so, we will meet the darkness that we carry within ourselves—the ultimate source of the shadows that we project onto other people. If we do not understand that the enemy is within, we will find a thousand ways of making someone “out there” into the enemy, becoming leaders who oppress rather than liberate others. 


In his chapter on Leading From Within, Palmer writes of what makes people leaders, five virtues or strengths of leaders, and the shadows associated with each of these forms of light.  This is how I encountered Palmer, when I was creating a formation process for spiritual leaders in congregations.  We examined five virtues, things we all wished/hoped we brought to our leadership, their shadows and what we might find if we ride the monster down. 


The first shadow-casting monster is insecurity about identity and worth.  This monster is hidden by an extroverted or outgoing personality that hides its insecurity by creating settings where others are in the disadvantaged or less powerful position.  If we ride the monster down, we find that we are loved and valued simply because we are children of God.  We do not need to make others feel less so that we can feel worthy.


Well, let me pause right here and notice my own projection.  I can name half a dozen people to whom this applies, without pausing for breath.  It is harder to stay with it long enough to find this shadow in me.  I invite you, as I name the other shadows, to take the step deeper, to look within rather than without. 


A second shadow inside many of us is the belief that the universe is a battleground, hostile to human interests.  The strong competitor turns others into enemies that weren't there before the competitor's fear of losing created them.  Palmer asserts that death and loss are part of a circle of life, that harmony is the deeper reality, and that this spiritual truth could transform our lives and our institutions.


A third shadow common among leaders is “functional atheism,” the belief that ultimate responsibility for everything rests with us.   Those who take on the responsibility for making every good thing happen ourselves often end up with burnout, depression, and despair, when we learn that the world will not bend to our will and we become embittered about that fact.  When the load becomes so heavy that we have to drop it, then we can receive the gift of community, in which we trust that each will give and each receive. 


Palmer's fourth shadow within and among us is fear of the natural chaos of life.  Those who are organized can become rigid, imprisoning the organizations we lead, rather than liberating them.  Following the monster down, we learn that chaos is the precondition to creativity: as every creation myth has it, life itself emerged from the void. Even that which has been created needs to be returned to chaos from time to time so it can be regenerated in more vital form. 


The last shadow is the fear of failure or death itself that keeps the successful leader from letting go.  The best leaders in every setting reward people for taking worthwhile risks even if they are likely to fail. These leaders know that the death of an initiative—if it was tested for good reasons—is always a source of new learning.  The monster takes us down to the place where we can learn that death does not have the final word.  It is the source from which new life can spring.


So many of these shadows participate in depression.  Before we get to Annie Dillard's matrix... which buoys the rest, the monster takes us through the darkness that depressives know too well.  Here we touch a question both quietly pondered and hotly debated.  Is there anything good about depression?


Palmer's point seems to be that going through the darkness is how we get to the light.  His personal story is one of finding his true vocation after depression deprived him of what he thought he should be doing.


Depression, like pain, can be good, if it is used for what it is good for -- telling us that something is wrong -- that we are hiding our insecurities at the expense of others, that our combative attitudes deprive us of peace, that we have false expectations of ourselves and others, that excessive control has stifled our creativity, that our fear of death is preventing us from being born again.

Those who ride the monster down have stories to tell to the rest.  We believe there is a link between our depressive personalities and our depth of thought, understanding and feeling.  We can rattle off the names of authors, poets, musicians and artists who have struggled with mental illness and sometimes lost, Hemingway, Scott Fitzgerald, Woolf, Mary Shelley, Plath, Whitman, Handel, Cobain, van Gogh, Ansel Adams, O'Keefe...


I have a friend who responds to this question with anger -- there is nothing romantic about this terrible disease that destroys minds and sometimes those who suffer from it.


It is time to distinguish between depression and Depression, one the feeling common to all thinking and feeling people, the other an out of control extreme that is caused by and causes further brain damage.  The Shadow is not the latter.  It is part of the human experience.  Everybody benefits by becoming mindful of its place in their lives.  While the disease is overrepresented among artists, perhaps every true artist rides the same monster down to find the truth expressed in his/her art.


I wonder, how often does the disease interfere with artists' creativity?  According to Ernest Hemingway who was there, when T.S. Eliot and F. Scott Fitzgerald were being wrestled to the ground by their personal demons, they were not writing.


I was going to say, "putting to one side the works that were not created because their creators were dead..."  But I can't say that.  We can't put suicide to one side.  That is the romantic garbage of which my friend speaks.  It calculates the value of artists for what they give us, their utilitarian purpose, not for their own sacred selves.


In my own experience -- my books lie unfinished, out of reach of this brain that the Grim has gone through with a paper punch for the last five years.  It takes me a week's effort to write a blog post, two sentences at a time.  The Shadow is something else.  It calls me to my self.  It shows me that I am of value, even with a brain that has holes in it, even if I have to lay down my work in formation of spiritual leaders, even if my books remain unpublished.  It brings me to the place where I am held in the hands of a tender God.


Even if I am still fighting it all the way down.
 

Photo by Victor van Werkhooven

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