Showing posts with label disability. Show all posts
Showing posts with label disability. Show all posts

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.

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!

Rx for Joy - Joanne Shortell

Joanne Shortell took me up on my call for guest bloggers.  I am glad she did, as I learned of a blogger and mental health advocate I'd like to introduce to you.  Joanne has three websites.  Strongly Bipolar is a blog similar to Prozac Monologues.  Maevetour.blogspot.com/ is the source of the following piece.  And Servicepoodle.com gives more information about the issue it discusses.  

Rx for Joy Can Be Written by any Therapist in the U.S.


My current therapist is a nurse practitioner who can prescribe psychiatric drugs.  My previous therapist was an MSW who could not.  Both, however, could write a prescription for an emotional support animal (ESA).  A short, simple letter (see sample below) from a doctor (any medical doctor, not just a psychiatrist) or any therapist will allow a person with a psychiatric disability or a chronic pain condition to have pets in no-pets housing, to avoid any pet deposit or pet fee, and to avoid size limitations or species restrictions.  The person with the disability gives this to their landlord or co-op/condo board as a request for a reasonable accommodation.  (See link: How to Get an Emotional Support Animal.

Why should I prescribe ESAs?

The Positive Power of Being Strange


It's just too easy [in Iowa] to avoid the weirdos in our life.

First, the TED talk from one of those people who, whenever they have something to say, you want to pay attention to it. I am pleased to call Mike Wagner a friend, so I get regular doses. Here he doesn't use the language, but he's talking about the power of my favorite brain part, the anterior cingulate cortex.

Mike's shingle hangs at White Rabbit Group. The name itself tells you something. He calls it a brand altering experience.



Next, the Prozac Monologues take on the matter, a rerun from September 23, 2011

Differently Abled - More, Please

It's like he is in a world of his own. The first grade teacher, old school, same worksheets for the last thirty years, did not mean it as a complement.

Differently Abled - More, Please

It's like he is in a world of his own. The first grade teacher, old school, same worksheets for the last thirty years, did not mean it as a complement.

The mom was confused. She asked her son's Montessori preschool teachers for their take on it. They, too were confused. Then the light dawned. The way they put it was, He has immense powers of concentration. They thought he was marvelous.

The problem was, he was still absorbed by the story he was writing, when the first grade teacher had moved on from writing to math. The world he was in was not her world.

His second grade teacher recommended him for the Talented and Gifted program.

His fifth grade teacher thought he had ADHD.

People who are different get diagnosed. The Diagnostic and Statistical Manual (DSM) is all about describing the various ways we don't fit. But if you can pass for normal, you don't have a disability. If they can pick you out in that One of These Things is Not Like the Others game, then you do.

Uptown Bill's - One Candle

Okay, let me be very clear.  And let you not perversely misunderstand.  Justice beats charity any day.  The current tax structure of the United States is unjust.  At least, that is what Jesus and the Prophets would say.  Charitable people can't make up for the size of this injustice, and shouldn't have to try.  The fixed notion that we can is diagnosable.

Fair Taxes

Warren Buffett was curious and did some research.  Last year Buffett's taxable income was roughly $40,800,000.  That's after deductions.  His taxes were 17.4% of that amount.  Every other person in his office paid somewhere between 33% and 41% of their taxable income, an average of 36%.  He doesn't think that's fair.

Nobody thinks that is fair.  In fact, a lot of rich people and the Republican Congress think he paid too much.  Nevertheless, there are indeed other rich people who agree with Buffett, that they get more than most out of government services, the type of services that help them accumulate even more, and they should pay more.

I have enough to rant about without taking on tax policy.  So let me focus on the implications of our current tax policy for mental health policy.

What Jesus And Amos And Muhammed Said 

Last week I told you it is time to step up, join with others, and do what the government and the people who own the government do not have the political will to do.  Feed the hungry.  Welcome the stranger.  Visit the sick and in prison.  Those phrases come from the Christian Scriptures, Matthew 25, but were spoken by a Jew who got his religion from a long line of Jewish prophets.  We can round out the authorities of monotheism with the Muslim requirement to give alms.  For you non-theists, you have to be your own authority.

I'm just saying -- Do it.  Charity is an insufficient substitute for justice.  Do it anyway.  While Facebook and the blogosphere are filling up with calls for justice, people are dying out here.

That is where I left off last week.  This week, the example I promised, one light lit against the darkness, Uptown Bill's.

Bill Sackter

Bill Sackter spent most of his life in a Minnesota state institution, placed there when he was seven, because he was mentally retarded.  He got out when he was 53, when institutions downsized and transferred care to the community.  Only there wasn't a community.  There was one social worker with a case load too large to give Bill adequate help to adjust.

Bill was on the verge of going back to that hellhole, as he called it, when Barry Morrow, a young filmmaker in search of a project met him, befriended him, became his guardian and brought him to Iowa City, Iowa.

Barry worked for Tom Walz, the head of the University of Iowa's sociology department and the kind of idealist that thrived in Iowa city in the 70s and 80s.  Except Tom is a practical man.  And he listens.  And he got Bill the kind of job that Bill could do.  He could make coffee.  He couldn't make change, but he could make coffee.  That was fine, because the social work students who patronized Wild Bill's Coffee Shop could make change for themselves.

Barry made two movies about Bill's life, starring Mickey Rooney, and Bill became a symbol of how people with disabilities can contribute to our common enterprise.

Uptown Bill's

That would have been the end of it, but, like I said, Tom Walz is a practical man.  A practical man with a vision.  When Bill died and Tom retired, Tom helped to create Uptown Bill's, a small mall of businesses owned and operated by people with a variety of disabilities, a book store, a graphics design business, vintage store, furniture repair and refinishing, and yes, Wild Bill's Coffee Shop.

Today Uptown Bill's includes all of the above, plus a music shop, home repair and maintenance business, classes on how to start e-businesses, and programming in the arts.

This is community care that works.  Emphasis on the the works.  I think it works for two reasons:

1) People with disabilities have abilities.  My dog Mazie taught me that we all come with surplus.  To lose one, or even several, leaves us with loads.  Well, we all have things we can and cannot do.  Whether we fit into the economy, whether the community is structured so we can contribute and receive, says more about the community than about us.  For that matter, our labels say more about the way the community is structured and less about us.

That is both obvious and invisible in the public arena.  But some people have eyes to see.  So a place like Uptown Bill's is possible.  People with disabilities can run our own businesses.

2) If you own the business, you don't get laid off when the funding gets cut.

Now after the manner of Hebrew poetry, I said there were two reasons why Uptown Bill's works, and I add a third.

3) There are people who do not carry the label disabled who decide to work in partnership with others who do carry the label.  They don't run the show, but they add their own abilities to the mix.  These people don't have to believe in one sort of tax structure for the United States or another, have one faith perspective or another or none at all.  They just have to want to live in a community that can receive the contributions of every member of it, without regard to labels.

Off The Grid

I write this from Costa Rica.  I live in a little fishing/tourist/beach town with enormous disparities of wealth.  Michael Jordan and Madonna own property in this part of Costa Rica, though I don't think they can see the doorway where that man sleeps from their infinity pools.  I live behind razor wire, in a middle class/working class mixed neighborhood.  Some of my neighbors make do with barbed wire.  And I watch the United States on a trajectory toward the same.  Except there won't be papaya trees growing wild up north.

When I go downtown, I see a mentally ill and homeless person who makes a living by buying a pack of cigarettes and selling them one and two at a time for a profit.  I see people who buy their cigarettes one and two at a time from him.  Because they are a pueblo.

Sure, keep trying to turn the Titanic around.  But do something else, as well.  Our government doesn't work for us.  I think it is time to figure out how to piece together a pueblo, instead, to join with others and do what we can with each other.  One candle, one cigarette at a time.


flair by facebook.com
scales by Johannes Regiomontanus, 1512, in public domain.
image of the prophet Amos by Gustave Doré, 1866, in public domain
book cover by amazon.com
dvd image by amazon.co
photo of razor wire by Helen Keefe and used by permission
photo of cigarette in public domain 

Cognitive Deficits -- on the way to Getting My Brain Back

The speaker at our monthly NAMI meeting was tall, mid-60's, military bearing, a former ER doc who did a couple tours of duty in Iraq.  You know the type.  Only, a little less of that ER doc -- I'll call it self-assurance.

He showed us slides of the work he used to do, the before shots (which we really did not want to see) and the after shots of young people, kids he patched together at the medic stations.  He told us about the sticky dark trail running from the helicopter pad to the table, and what made it sticky dark.

His passion for his work lit the room.  We listened to stories of kids for whom he had after shots.  There weren't always after shots.

He told us about TBI's, traumatic brain injuries and PTSD and how war does damage to brains.

He was taking a break after two tours of duty, back in an ER state-side when he had the stroke.

Now it became a different story.

Stroke -- The Brain Is Part Of The Body

They told him it would be a long recovery.  Two months later, he was astounded at how long it was taking.  They told him again, it would be a long recovery.  Six months later, the frustration overwhelmed him.  His body was back, the use of his limbs, his balance, more or less.  But his brain wasn't.  And the rehab people said, This is good.  Rehab has begun.

See, we know a stroke is a physical event, something that happens inside the body.  But still we have trouble thinking of the brain as the body.  We have trouble thinking of the functions of the brain, like thinking, as physical functions.  The injured body has to rehabilitate.  We know that.  Doesn't the brain just come along for the ride?

But thinking is done by a body, the part of the body called the brain.  Thinking is a physical process, electrical charges tracing a pathway from one cell to the next, within an organ of the body called the brain.  And when the brain is injured, it has trouble performing its physical functions, like thinking.

Cognitive Deficits

This emergency medicine doctor with battle front experience can't work anymore.  He used the phrase cognitive deficits.

To illustrate, he told us about the work of an emergency room doctor.  When somebody comes into ER with a potential heart attack, there is a protocol.  There are 17 steps to this protocol.  [It might be 23 -- I wasn't taking notes.]  He told us the first step.  Check.  Then he told us the second.  The second step requires a certain mathematical calculation.  He told us what needs to be calculated, the ratio between two measurements.  [I didn't write them down.]  He knows how to do the calculation.  He can do it in 18 minutes.  The whole process is still in there, inside his brain.

The thing is, this entire 17 step protocol has to be done in 93 seconds.

So he can't work as an ER doc anymore.  His job is to do rehab for his cognitive deficits.  In rehab he is learning how to connect all the bits that are still in there.  His brain is finding new pathways around damaged areas to turn all those bits into coherent and accessible thoughts.

And I thought -- That's it!  That's my swiss cheese brain!

My Swiss Cheese Brain

I am told, now that I have lost half of my cognitive functioning, I am still smarter than 80% of the people in the room.  Well okay, between 10 and 11:30 on alternate Wednesday mornings.

All the bits are in there.  If only I could connect the dots.  I wander inside this brain like the hallways of Hogwarts, wondering what's behind those locked doors, getting caught on moving staircases that take me to places I shouldn't be, sitting cross-legged on the floor in front of the Room of Requirement, desperately requiring entrance, but not a clue how to get in.

Sometimes all the bits taunt me.  They light up like little Christmas tree lights, blink off and on.  But if I grab one, the whole chain goes out.  Other times, all of a sudden, it's back, my brain.  I can get it to take me exactly where I want to go.

You don't notice.  You don't see the day spent on a paragraph, the week that is lost when the wall will not yield.  It hurts to write.  But I don't know who else to be, if not a writer.

Brain Damage

I have been writing about this stuff for years now.  Listening to somebody recovering from stroke, it finally hit me, brain damage.  I have brain damage.  The source is not the same.  A stroke kills brain cells through oxygen deprivation.  Trauma kills brain cells through chemistry, a surge of catecholamines, depression of thyroid function and hypoxia... an outpouring of other neurotransmitters, neuropeptides, and hormones... heightened catecholamine endorphin secretion with eventual depletion... the secretion of corticotrophin releasing hormone (CRH), adrenocorticotrophic hormone (ACTH) and cortisol... always more cortisol...

All of which really screws your hippocampus, seat of memory.  Here is the source of my cognitive deficits.  They say that, unlike cancer or a broken bone, there is no picture of depression.  Actually, that is not true.  MRI's show that anxiety and mood disorders damage and shrink the hippocampus.  They do have the pictures.  It is real.  It is brain damage.



Traumatic Brain Injuries, Post Traumatic Stress Disorder and severe depression all do the same brain damage.  They look the same.  By that, I mean the same MRI's.  They act the same.  By that I mean the same dysfunctions.  And, what do you know, they respond to the same treatments.  [I wrote about this in more detail back on March 28, 2010, one of my most frequently viewed posts.]

You can rehabilitate brains damaged by TBI's, PTSD and depression, just as you can rehabilitate brains damaged by stroke.  Just like stroke, some damage is reversible, some is not.  And just like stroke, expect it to take a long time.

A Long Recovery

A friend who has been my mentor through this life transition of mine told me, Yes, your brain will come back.  Give it five years.

So then my brain did its half-full/half-empty thing.

Five years -- that takes the pressure off.  I can give myself a break, and give myself time.  I can have hope.  Maybe my brain will be brilliant like my friend's brain again.

Five years -- my career really is over.  I will be too old to go back.  There is no reclaiming what I lost.  The presenter will never work in the ER again, and I will never be Diocesan Ministry Developer again.

Both.

I do tend to focus on the half empty part.

But my brain stretches out to as healthy as I can imagine, if only for a moment --

So I will do something else, instead.

to be continued...

photo of army doctor during training in Baghdad in public domain, (not the speaker referred to in this post)
flair by facebook
reproduction of hippocampus from Gray's Anatomy in public domain
fresco of The Visitation from the 14th century, Museo Matris Domini in Bergamo Italy

Mazie -- Run Free!

 Mazie came to us on August 1, 1996.

She left us on March 1, 2011

And in between she blessed us.

I wrote about Mazie a couple years ago.  She lived longer than we anticipated she would at the time.  She suffered a stroke a year ago, but recovered and went on to raise $250 in last year's NAMI walk.

Here is an edited version of that earlier post, with new bits in italics.




This dog reminds me of Mazie/Amazing Grace.  Except there are too many stars in the lower right corner of the constellation, a leg that she lost a long time ago.  Move those stars up to form her crown chakra.  For twelve of her thirteen years, people have watched her run and said, That's Amazing!

Therapy Dog

Mazie is a therapy dog.  Not officially, she never received the training.  Now she has renal failure and it's too late.  But everywhere she goes, she finds the person who needs her.  When I took her to visit the shelter during the Iowa floods in '08, she stopped to visit with each one.  After an hour, I was depressed and weary -- the start of another relapse.  I thought it was time to go.  But no, she pulled on the leash and told me she hadn't talked with that man who was isolating, sitting by himself under that tree.  And she had to hang around until the Red Cross worker got off shift, to share some grace with her, too.

People have to ponder a three-legged dog.  After a few years, I stopped making smart remarks to the same question I heard over and over. How did she lose her leg?  I came to realize that through her, people consider their own experiences of loss, and the consequences of loss, and the life she leads without even noticing her loss.

How did she come to be a therapy dog?  We don't know the before story.  We only know the after, the kindness of a farmer who went out of his way for an injured stray, a no-kill shelter that is very picky and does home studies before they let people adopt, a vet and staff who treat her as a queen, the strangers who are drawn to her and, I believe, bring their own need for gentleness to the gentleness with which they approach her.  And she responds in kind.

Disabilities And Heaven?

Will she get her leg back in heaven?  I don't think so.  On earth, her only handicap is that she can't pivot to the right at a full run without falling down.  I think her one wish for heaven is to lose the leash, so she can do what she loves to do, run like the wind in three quarter time.

I knew somebody who was born with a foreshortened arm.  It ended at the elbow with a stump of a hand.  She always bristled when some religious person reassured her she would be whole in heaven.  She said she already was whole.  And she was.

Maybe what heaven will fix is our lack of imagination.

Loss And Heaven?

What does it mean for those of us with mental illness to be whole in heaven?  All the life experience that makes us who we are includes the experience of mental illness.  Will we lose that?  Who then will we be?

All the loss in this world -- a friend is reading a midrash of Exodus.  In midrash, the rabbis explore the meaning of Scripture through story-telling, expanding and deepening the levels of the text.  In one interpretation of the burning bush, initially Moses refused the call to go free the Israelite slaves in Egypt because -- what about those who died while building the pyramids and were buried in the walls?  Who would let them go?

To Lose One's Memory

A psychiatrist once tried to reassure me about Electro-Convulsive Therapy, ECT.  She said that usually the only memory loss is of events immediately preceding the treatment.  And usually people are so unhappy before treatment that they are glad to lose those memories.

It was not a convincing argument.  Such an argument would be abhorrent to somebody who is JewishI am not, but it is abhorrent to me, too.  To forget is to lose one's people and one's self.  I don't want to forget.  I don't want to lose any of it.  It is part of me, even the pain.  I guess I want for it to mean something.

No, I don't.  I don't want God to explain it.  I want to ask God to answer for it -- like the Holocaust survivor who insisted he be buried in his Auschwitz uniform instead of the traditional Jewish winding sheet.  He wanted to stand before the throne of judgment wearing the evidence that would itself say, who is judging whom?

To Be Found

Maybe what I really want, for Mazie, for those lost in the walls of the pyramids, and in the ashes, and for those who are in such pain that they want to lose their minds, for all of us, is to be found.

Good-bye, sweet Mazie.  Run free.

Mental Illness -- Stigma or Sexy?


Full confession time.  You may have noticed that I respect copyright.  I use images in the public domain or with permission, and don't use pictures where permission has been denied.  Which sometimes is a real bite.  The Des Moines Register...

I don't have permission for this one yet.  I ripped it from a site where you can purchase bracelets to support nkm2.org.  So I urge you to help me atone for my sins, while I write for permission.  Go to this link and buy one.  They have those cute little loony birds on them.  And you know how I love loony!

nmk2.org is Joey (Pants) Pantaliano's bid to make mental illness as cool and as sexy as erectile dysfunction.

Really.



Okay, it hasn't gone viral yet.   But Harrison Ford with one earring is kinda sexy.  It's a start.

Mental Illness Awareness Week -- One Year Later

A year ago, Prozac Monologues was just crawling, six months old.  I was new to this disability experience.  And NAMI Johnson County was new to me.

I am not sure how Della McGrath decided I was literate.  Maybe I had given her my card, and she read some of the blog.  But she asked me to speak at a candlelight vigil, to remember those who have died from mental illness, give courage to those who hope to survive it, and support to those whose loved ones did not.

The great thing about NAMI -- if able is always part of the contract.  So I could say yes, even when we were using sedation in place of hospitalization.  And hope for the best.

As it turns out, God gave me a window, and I was able to say what is written below.  It is reposted from October 3, 2009.  It is a bit out of date.  Once I was on disability, I could explore and admit to a better diagnosis, bipolar II, in place of major depressive disorder.  Bipolar is a disease with more stigma than vanilla depression.  And hardly anybody has ever heard about bipolar II, so they think the worst.  But now that I wasn't working, stigma didn't matter so much.  And I could let myself take the best bipolar II medication.  I knew its side effects would make my job impossible.  But that didn't matter anymore, either.

The year since has not been an easy one.  But I am still here.  And so, amazingly enough, is Prozac Monologues.  You, dear readers, give me a life that begins to replace the life I lost to this illness. 

DSM 5 and Mood Disorders, Part I -- What's at Stake

Earlier this month, the American Psychiatric Association released the long awaited proposed revision of their Diagnostic and Statistical Manual of Mental Disorders (DSM-5).  It is available now for public comment, with an anticipated publication date for the final version in May 2013.  To call this the Bible of Mental Illness is to overestimate the significance of the Bible.


The DSM was first written to give clinicians and researchers a common vocabulary and a common understanding of the various diagnoses of mental illness.  John McManamy has related this history on his blog Knowledge is Necessity.  I refer you to his thorough account, found in the links at the bottom of his post. -- [Hey, John -- I recognized your image for "Few Surprises."  It was one that I considered for this post!]

The way the DSM works always reminds me of a Chinese menu.  For example, if you have one symptom from Column A and at least five from columns A and B, for over two weeks, you have Major Depressive Disorder.  You can upgrade your core diagnosis with specials offered alongside the basic menu.  These lists of symptoms provide a common vocabulary and simplify diagnosis, so that family practitioners commonly diagnose depression and prescribe antidepressants, without referral to psychiatrists.  This practice provides a boon to the pharmaceutical industry, which markets heavily to family practitioners.  If patients had to see a psychiatrist to get a prescription, fewer people would take antidepressants, since there is greater stigma attached to treatment by a psychiatrist, psychiatrists are in short supply in many parts of the country anyway, and health insurance plans provide inadequate coverage for psychiatric care. So family practitioners prescribing for depression sells more antidepressants.  Big Pharma wants to keep the DSM simple.

Over time, even as therapists have become more eclectic in their therapies, the sequence of DSMs has more narrowly defined the illnesses which therapists treat, adding more specificity.  The DSM gives a numerical identifier for each diagnosis, along with decimal points after the numbers to indicate variations and severity.  Health insurance companies rely on the DSM to determine coverage.  If you don't have a number, you don't get reimbursed.  But they have become concerned about the multiplication of diagnoses, raising the number of claims.  Health insurance companies want to limit the number of diagnoses and limit the number of people diagnosed.

Nonsense and the Anterior Cingulate Cortex


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

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, if you flipped the image so that it faced 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 the pattern. Confronted with anomaly, the ACC goes to work.

"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 am filling out disability applications, I am again at a crossroads, and again, instinctively, I 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.

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.

"This person loved me; this same person abused me" -- two memories in conflict. Put them together, they cause pain. They call it dialectical thinking if you can 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 becomes quiet if we engage in dialectical thinking? I wonder. Does it can 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. 

image of brain from NIMH 
artwork found at Glocal Christianity

Hello, my name is Willa, and I have a mental illness

I try to post more often.  The last week has been spent in a story so stereotypical that those readers who have or have tried to get disability benefits will find it banal.  And until it has an ending, I can't tell it in Prozac Monologue mode: reflections and research on the mind, the brain, depression and society. I am not reflecting yet.
So I tempt fate with the following.  Si Dios quiere, God willing -- I will say the following at the opening of Mental Illness Awareness Week Sunday, October 4, 6:30 PM, at the Anne Cleary Walkway, University of Iowa Campus, Iowa City, Iowa, a candlelight vigil to remember those who have died from mental illness and to support those who hope to survive it.

Hello, my name is Willa and I have a mental illness.

Hello, I am the Reverend Willa Marie Goodfellow, an ordained minister, an Episcopal priest who has served congregations, campus ministries, and diocesan staff in Iowa for 27 years. And I have a mental illness.

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