Apology?

So Robert Spitzer's Apology struck a nerve: apologies made or received, or not.  More like, Robert Spitzer's apology stuck a fork into a 220 volt socket, the nerve labeled Apology in the Clinical Setting, Or Not.

I have long been curious about this issue.  Fork in the 220 volt socket kind of curious.  I watched with wonderment as a therapist handled my complaint, which was, to me, about a life-threatening experience, steering the conversation away, time and again, from what I thought was the simplest, most natural direction, I'm sorry.

Now, I trusted this person.  Her avoidance of those words, her downright circumlocutions confused me.  My brain has long practice in making sense of the nonsensical behavior of people I trust.  So I decided there must be a rule, a therapy rule, that says a therapist shouldn't apologize, because it diverts attention from the real issue, which is about the client's mother, and not about the therapist at all.  Or something like that.

Robert Spitzer Apologizes

Robert Spitzer -- some people call him the Father of Modern Psychiatry.  In 1980 he took the DSM II, widely criticized for unreliability and lack of validity, and as editor of the DSM III, turned this obscure publication of the American Psychiatric Association into the standard reference work that defined every psychiatric disorder we've got.  It was research-based.  It listed objective criteria.  It was honkin' big, but it could be understood, not only by researchers, but also by practitioners.

Spitzer's acolyte, Allen Frances edited the DSM IV, which added a lot of information, but did not change Spitzer's basic framework for how these diseases are characterized.  Frances was a consultant for the DSM V, until he quit, basically because the new editors started to rethink things.  Frances now leads the charge against the DSM V, which has delayed its publication.  I won't develop that theme right now...

Robert Spitzer is the Man.

With Great Power Comes Great Responsibility

Trayvon Martin and Soul-Searching - Not Gonna Happen

Two things struck me about this message.

The first was the more widely quoted, If I had a son, he would look like Trayvon Martin.  There is a photoshopped poster circulating on Facebook, Trayvon included in the Obama family photo.  It brought to mind immediately the young men I know who look like Trayvon.  I don't want to write their names, fearing, like O-lan from The Good Earth, that to speak such praise as they deserve would tempt the jealous gods to do them harm.

Their mothers are among my closest friends.  I can hardly speak of Trayvon Martin in their midst.  What it must mean to be the mother of a fine young African American man.

The second was a minor note, a hidden note, one that will be forgotten, was forgotten as soon as it was said, All of us have to do some soul-searching.

We Do Not Search Our Souls

Of all the words that this shooting has birthed, all the pundits and opinions, soul-searching is not among them.

God, Tebow and the Problem of Suffering

You know, they could be right.  Maybe God is responsible for Tim Tebow's astounding success.

First, the one take away from this article:  It's not magic-thinking.  It is pattern-seeking, hard-wired into our brains, one of the things our brains are built to do.

I Am A Professional -- Do Not Try This At Home

A whole world of football fans are suddenly theologians, explaining the ways of God.  And how silly for me to caution non-professionals from this endeavor.  Everybody with a frontal cortex is a theologian.  Our brains are built to ask Why?  Everybody with an anterior cingulate cortex looks for patterns that make sense of the events of the world.  That is what the anterior cingulate cortex does.

How is this for a pattern -- A new quarterback about whose talents many have doubts delivers a win.  Somebody sticks a microphone in his face.  He gives glory to God.  Next week, he wins again.  Again he gives glory to God.  Again he wins.  Again he gives glory to God...

And what is with that 316 yards thing?

If this were a baseball player on a streak, it would be the same socks he wears each game.  It's the God-thing that makes people twitchy.  More than that.  If it were basketball, he'd be crossing himself at the free-throw line, and nobody would miss a beat.  But it's the politics of the God-thing that have raised the stakes.

Suddenly people who should know better are doing bad theology.  And people who do know better let their chains get jerked.  I don't except myself here.  Twice a day I write something snarky on Facebook, and have to delete before I post.  (It's a thing I have about public discourse on Facebook.  I try to save my snarkiness for my blog.)

At Prozac Monologues my readers can expect more than snarkiness.  I have to bend the topic a bit.  So here we go.

God Improves Athletic Performance

Really, I'm serious.

Well, in a particular way.  Anybody else have a hometown team whose weekly police report is longer than its injury report?  And the results -- Hawkeyes went where this year?  The Earwax Bowl?

These days a little clean living gives an incredible advantage in the world of collegiate and professional sports.

Now this is not about Tim Tebow.  I don't know anything about his private life.  I do know a lot of athletes flame out on dissolute living, leaving behind only fumes of what had been promising careers.

I also know that some people find their way back.

The Twelve Steps

• We admitted we were powerless over [our addiction] - that our lives had become unmanageable.

• We came to believe that a Power greater than ourselves could restore us to sanity.

• We made a decision to turn our will and our lives over to the care of God as we understood God.

There are more steps.  These are a start, the part that matters to a mental health blog.

However and why ever they do it, and how seriously they need to work on it, a lot of athletes and a lot of the rest of us could improve our lives by acknowledging a Higher Power.  It's a bottom line sanity issue.  People who think they are the center of the universe have their own DSM code.  It's 301.81.  But they aren't in therapy.  Those closest to them are.

No, you don't have to be a Christian, religious, not even spiritual but not religious to work the Steps.  I heard somebody used gravity for his Higher Power.  Like I said -- I am not the center of the universe is a bottom line sanity issue.

Tim Tebow's Higher Power

Again, I know nothing about the man's private life, and less than nothing about his heart.  But to the extent that his publicly professed Christianity conforms to orthodox Christianity, and by that I mean not making it up as we go along, I do believe the claim that his athletic prowess comes from God, the Creator of Heaven and Earth who delights in creation and said of it, It is good.  We have something in common here, Tim Tebow and me.  We each believe that God delights in us.  Well, I am willing to be a little less specific about the details.

If nothing else, think of this also as a comparative claim.  If he thought it was all about him, he would be at greater risk to flame out, and thereby not be able to complete as many passes as he does manage to complete.

Of course, there has to be somebody to catch those passes.  Writing now as a one-time Bronco fan, I wish I heard him say more about his receivers and his left guard.  He might make a better spokesperson for the Lord if it didn't seem like his personal miracle.

Alert: Rocky Shoals Of God-Talk Ahead

So far, I have been in the realm of orthodox theology, not making it up as I go along.

Everybody is a theologian.  The advantage of professional status is that you recognize the potential shipwreck before you get there.

Oops.  Too late.

A status update from a Facebook friend Sunday night: This is what happens when God is in charge!

Pastor Wayne Hanson, Summit Church, Castle Rock Colorado said, It's not luck.  Luck isn't winning 6 games in a row.  It's favor, God's favor... God has blessed his hard work.

So... how about 19 games in a row?  Was that luck?  What happens if the Broncos make it through this weekend and next, and Tim Tebow comes up against Aaron Rodgers, who also happens to be a stand-up kinda guy?  Not to mention one hell of a quarterback.  Will that be about God's favor?

The Problem of Suffering

I think what really drives people nuts, including a lot of Christians of the orthodox/not making it up as we go along variety, is this:

While God was blessing Tim Tebow's hard work on Sunday afternoon, 720 children around the world died of hunger.  270 people committed suicide.  Two of them, by the way, were veterans of the United States Armed Forces.

That was before overtime.  Good thing overtime was short, huh?

So on Monday morning, nearly 1000 mothers were asking, If God could help Tim complete that pass, couldn't he have paid some attention to my child?  Billions still listen for their answer.

This is not a question to be answered blithely.  We have to put football, even America to the side.

See, we have been here before, trying to find the pattern.  That is what our brains do, search for patterns, notice anomalies, then respond to new information.

There is one pattern we really, really want to find, that good is rewarded and evil is punished.  For the LORD knows the way of the righteous, but the way of the wicked is doomed.

That's from Psalms.  And to some extent, we do find evidence to confirm the claim.  Usually people who treat their spouses right have happy marriages.  Or at least happier than their marriages would be if they were out running around at night, coming home drunk and violent.

This pattern gives us a way to arrange our own behavior to get outcomes we desire, which is a good thing, and the evolutionary purpose of the development of this capacity.

This is from Psalms, too: I have been young and now I am old, but never have I seen the righteous forsaken, or their children begging for bread.

720 mothers whose children died of hunger while the Broncos pulled out that squeaker against the Steelers would beg to differ.  All you have to do is turn the channel to CNN to find that pattern disrupted.

The Bible Knows Better

Well, if you actually read the whole Book, and read it several times, over different times in your life, so you have a wider experience that helps you catch things you missed the first time round, you discover that the Bible says some other things about the ways of the righteous and the ways of the wicked.  Read Jeremiah.  Read Job.  Read the rest of the Book of Psalms.  Go do relief work in Haiti or Sudan and read them again.

The Bible records how a whole community of faith over centuries has struggled with this issue.  Sometimes the Psalm begins, O LORD, my God, my Savior, by day and night I cry to you.  And at the end, it still says, Darkness is my only companion.

The Psalms of Lament speak the truth of people who do love the LORD, who are faithful.  From Jeremiah thrown down a well to Paul shipwrecked on Malta to Mother Teresa struggling her whole life with severe depression a couple millennia later, faith does not turn out to be bankable.  My God, my God, why have you forsaken me?  Maybe the Psalms can give voice to your own experience.

Creativity and the Absurd

The ancient Israelites were sure of the pattern, that they held God's favor.  They lived in the Promised Land, after all.  Then something else happened, off pattern.  A new super power came on the scene, destroyed their temple and threw them into exile.  By the waters of Babylon we sat down and wept, when we remembered you, O Zion... How can we sing the Lord's song upon an alien soil?

When faced with the unpredicted, the absurd, the anterior cingulate cortex shifts into high gear.  Its job is to modulate emotional response, to manage the panic.  It does so by reasserting sense.

Sense can be found in two ways.

The first is to revert to the familiar.  When the brain is overwhelmed by stress, it becomes more efficient.  It shuts down brain-derived neurotrophic factor, stops learning and concentrates on what it already knows, or what it is habituated to trust.  It was the forces of evil (gays, the First Amendment...)  We are being tested, we have to believe harder...  People confronted by the absurd sometimes cling to habit, reject the unfamiliar (immigrants, head scarves).  After 9/11 there was a spike in sales of mashed potatoes and mac and cheese.  That is the anterior cingulate cortex at work, modulating emotional response.

The second way is to ramp up the pattern seeking by noticing connections that had been overlooked.

The second way is the way of creativity.  For the Israelites, the Babylonian Exile resulted in an explosion of creativity, poetry, philosophy, history, new forms of worship, the legal code, and the development of a religion that was larger than their prior notions of land=success=God's favor.  They came up with a religion that could handle exile, handle loss.  It could travel and face the future.

Their brains found new patterns.  They recognized a kinship and developed compassion, even obligation toward others who were immigrants or poor or who had lost.

America At A Spiritual Crossroads

I was approached once to be a supply preacher at a Unitarian Universalist Church during an interim.  I realized I had no idea how to do that, how to preach, if not the Gospel.  So perhaps it is inevitable that I fail my nonChristian readers at this point.

But I will do my best.

The 20th century witnessed horrors when people responded to their suffering by pulling away, by blaming others and cutting off connections, dividing nations into smaller and smaller subgroups to despise.  The brain that does that eventually goes senile.

A lot of us have lost a lot since the start of the 21st century.  And the rules have been rewritten, so we can expect more of the same.  This would be a good time to seek deeper than the theological optimism that cheered us when there was still a frontier and we could always walk away from our failures.  This is not the time to place our hopes for spiritual vindication on the thin reed of an untried and immature quarterback and Christian.  Give the kid a break.  And, by the way, give the people who are rooting for him a break, as well.  They are having a hard time, too.

The good news is that there are other patterns to be found.

The brain that remains open to new experiences, that searches for common ground, grows, creates, delights, has fun!  Ditto the nation.  Ditto the world.

Imagine that.  We are hard-wired for compassion.  And for fun.

Go Cheeseheads!

photo of Tin Tebow from tempecarnivore.blogspot.com/2011/12/hate-time-tebow-here-are-10-sports.html

Hawkeye and AA logos in public domain

Creation of Adam by Michelangelo,  1510 in public domain
The Shipwreck by Claude Joseph Vernet, 1772, in public domain
photo of Haiti earthquake victim by Lohan  Abassi, used under the Creative Commons Attribution License  
photo of UA 175 striking World Trade Center in public domain

Hey, Jesus - Happy Hanukkah!

I must be one of ten people with mental illness in the United States of America who does NOT have holiday trauma issues.  My personal desperate darkness starts each year in late July and breaks some time in late October, with mild depression fading out through November.

Thanksgiving to New Year's is pretty much my best time of year.

Nevertheless, this year I have been sad, not depressed really, just sad, as I read on Facebook the hostility that has come to be the litmus test of Christian fervor.  Evidently inspired by Fox News, Merry Christmas is no longer an expression of joy and good cheer, but a battle cry against the First Amendment and the great American experiment of freedom and tolerance of difference.

Irony abounds here.  One of my own ancestors came over on the Mayflower, as a matter of fact.  The Puritans wanted freedom to practice their religion, not anybody else's, just their own, including a prohibition against Christmas, which they outlawed in 1659.  They knew their religious history, that the holiday originated as a pagan festival, full of excess of every sort, with the thinnest wash of Christian appropriation added later to assure pagans they could still celebrate the Winter Solstice after they got baptized.

The Puritans had mellowed by 1712, when Cotton Mather, whose credentials are as Christian as you get, preached tolerance for other Christians who did want to celebrate the baby's birthday.  I do not now dispute whether People do well to Observe such an Uninstituted Festival at all, or no, he said.

He went on to encourage a Romans 14 attitude: Good Men may love one another, and may treat one another with a most Candid Charity, while he that Regardeth a Day, Regardeth it unto the Lord, and he that Regardeth not the Day, also shows his Regard unto the Lord, in his not Regarding of it...

According to Cotton Mather, he believed in "political correctness", because he found it in the Bible, in Paul. 

The Brain And Christmas, Or At Least Something, Anything

Christian, Jew, Zoroastrian, Wiccan, Druid, "spiritual but not religious," and plain old capitalists, as the days get shorter, our pineal glands go into overdrive, pumping out all that melatonin that makes us want to hibernate.  Our brains cry out for relief.  Push back the darkness!  Light a candle!  Light a bonfire!  Wait a minute -- just a log.  Nothing in the brain requires that anybody get burned at the stake.

Regular readers know that, while Prozac Monologues is not for the purposes of evangelism, I make no secret of my Christian faith, and even defend religion and the disciplines of church membership as resources for mental health.

But not any religion.  Not what passes for Christianity but looks suspiciously like, well -- fascism.  There, I have said the word.  When the cross gets wrapped in the flag, no matter whose flag, you know that the frontal cortex is offline, the lizard brain is in charge, and somebody is about to get crucified.

Which is so not what Jesus would want for his birthday present.

I mean, the first guests invited by heaven to his party were the scruffiest low lifes of the neighborhood, who had probably been passing the bottle to keep warm that night, and some foreign fire-worshipers, for crying out loud!

Theology Alert

He came as a baby.  He came vulnerable.  He came helpless.  In the core and mystery of what Christians call Incarnation, God-in-flesh, that very vulnerability is how God tells us how much God loves us, that the great Almighty would set almighty aside in order to pitch his tent among us.

That God desires to be with us, and will pay whatever price that requires, and would indeed require, is the core of the Gospel, all we need to know that we are beloved.  We are worthy.  Knowing that, then we can exercise the courage it takes to treat others as beloved and worthy.

We can even say, to show our rejoicing for the worth that God gives us and our rejoicing for the worth that God gives our neighbors, Happy Holidays!

These days are holy, they are graced by God's presence among us, whatever days you keep.  That is what I believe.  And I hope for you that these days are happy.

Research on Vulnerability

So here is where the deep truth about God-With-Us and mental health research come together: Brene Brown, research professor at the University of Houston Graduate College of Social Work on The Power of Vulnerability.




That baby who slept in the cold and all the babies who tonight sleep in the cold call us to look deep, deep into our hearts, the hearts of our neighbors, the heart of the world, the heart of God.

Happy holidays.

painting of Announcement to Shepherds by Gaddi Taddeo, c. 1327, in public domain

mezzotint portrait of Cotton Mather by Peter Pelham, 1700, in public domain

photo of Luminaria at Lake Washington from Seattle Municipal Archives, used under the Creative Commons license

painting of Madonna and Child with Cherries by Jan Gossaert, c. 1520, in public domain

Narrative and the DSM

My therapist once picked up the DSM and said, This could be called The Book of Behaviors That Make Therapists Nervous.

An apt description.  It is filled with descriptors: adjectives, behaviors, impulses, thoughts, feelings that are all human adjectives, behaviors, impulses, thoughts and feelings.  Almost none of them are strange in and of themselves.  Almost all of them are familiar to all of us.

It's just that at some point, when these descriptors add up, somebody starts to get nervous.

Diagnosis -- Recognizing Deviation From The Norm

Manifesto: The Mad Farmer, Consumer, Blogger, Whatever

As in the days of Amos, John of Patmos, John of the Cross, it's the poets who will save us, those of us who have ears to hear.  For the rest, it's the poets who will preserve the evidence, in hope that there will yet be ears to hear.

So today, Wendell Berry's Manifesto: The Mad Farmer Liberation Front.

First, one liner note: Your mind will be punched in a card and shut away in a drawer.  In the early days of computers, data was recorded by punching holes into cards, literally, card stock, roughly 3"x7".  This was before web crawlers could find the word bread in a Facebook comment and then put up ads for kitchenware on your page.  The line in the poem, first published in 1970, is truer than ever.  The technology has simply got more efficient.

Manifesto: The Mad Farmer Liberation Front

Love the quick profit, the annual raise,
vacation with pay.  Want more
of everything ready-made.  Be afraid
to know your neighbors and to die.
And you will have a window in your head.
Not even your future will be a mystery
any more.  Your mind will be punched in a card
and shut away in a little drawer.
When they want you to buy something
they will call you.  When they want you
to die for profit they will let you know.

 

So, friends, every day do something
that won't compute.  Love the Lord.
Love the world.  Work for nothing.
Take all that you have and be poor.
Love somebody who does not deserve it.
Denounce the government and embrace
the flag.  Hope to live in that free
republic for which it stands.
Give your approval to all you cannot
understand.  Praise ignorance, for what man
has not encountered he has not destroyed.

Ask the questions that have no answers.
Invest in the millennium.  Plant sequoias.
Say that your main crop is the forest
that you did not plant,
that you will not live to harvest.
Say that the leaves are harvested
when they have rotted into the mold.
Call that profit.  Prophesy such returns.

 

Put your faith in the two inches of humus
that will build under the trees every thousand years.
Listen to carrion - put your ear
close, and hear the faint chattering
of the songs that are to come.
Expect the end of the world.  Laugh.
Laughter is immeasurable.  Be joyful
though you have considered all the facts.
So long as women do not go cheap
for power, please women more than men.
Ask yourself: Will this satisfy
a woman satisfied to bear a child?
Will this disturb the sleep of a woman near to giving birth?

Go with your love to the fields.
Lie down in the shade.  Rest your head
in her lap.  Swear allegiance
to what is nighest your thoughts.
As soon as the generals and the politicos
can predict the motions of your mind,
lose it.  Leave it as a sign
to mark the false trail, the way
you didn't go.  Be like the fox
who makes more tracks than necessary,
some in the wrong direction.
Practice resurrection.

from The Selected Poems of Wendell Berry

And your homework for this week, gentle reader --

What does it mean to Practice resurrection?  What tuition will you pay?

Johannes der Evangelist in Patmos from a triptych by Hans Memling, 1479

photo of punched computer card by Litrefs used under the Creative CommonsAttribution-Share Alike 3.0 Unported license

photo of Immortal Tree, Humboldt Redwood State Park by Jan Kronsell, public domain

photo of fox from US Department of Interior, public domain
book cover from amazon.com

Souls in the Hands of a Tender God -- Again

A month's worth of travel + new medication = time for a rerun.

This one has something to do with my NAMI Convention reporting.  It's a book report on Souls in the Hands of a Tender God.  I met the author, Craig Rennebohm at the Convention's presentation on FaithNet. 

First we pause for a word about FaithNet:

NAMI FaithNet is a network composed of members and friends of NAMI. It was established for the purposes of (1) facilitating the development within the faith community of a non-threatening, supportive environment for those with mental illness and their families, (2) pointing out the value of one’s spirituality in the recovery process from mental illness and the need for spiritual strength for those who are caretakers, (3) educating clergy and faith communities concerning mental illness and (4) encouraging advocacy of the faith community to bring about hope and help for all who are affected by mental illness.

NAMI FaithNet is not a religious  network but rather an outreach to all religious organizations.  It has had significant success in doing so because all the major religions have the basic tenets of giving care and showing compassion to those in need.

Next year's NAMI Convention will be in Seattle, Craig's homebase.  He set himself a goal of enrolling 132 congregations in FaithNet as part of bringing NAMI there.

One bit of feedback to Craig, if he's reading:  Congregations have a particular skill set that would be very useful at a NAMI Convention -- ushers and greeters.  Just a thought...

Meanwhile, with a few images added, from January 6, 2010 --
 
Souls in The Hands of a Tender God

Rush Limbaugh says that he experienced the world's best health care in the United States of America, and it does not need fixing.  I am glad for Rush that he was staying at a resort near a world class hospital for coronary care last month.  I imagine he has insurance to pay for the hotel-like accommodations, the angiogram and several other tests that failed to find the cause of his chest pains.

Given his public platform and his wide influence on American opinion and public policy, I wish Rush would expand his experience of health care in the United States of America.  He could shadow Craig Rennebohm for a few days to find out how health care works for other people.  Craig is the pastor of Pilgrim Church (UCC) in Seattle and, as part of their ministry, "companions" persons who are homeless and mentally ill.  With David Paul, Craig describes their quite different experiences in Souls in the Hands of a Tender God: Stories of the Search for Home and Healing on the Streets.

One Nation, Two Health Care Systems

The emergency personnel got Rush to the emergency room like snap!

That's not what happened to Sterling

Over months Craig built the trust of this man who camped in the church courtyard, surrounding himself with trash to protect himself from the evil spirits.  Finally, when the trash included highly combustible materials, Craig convinced him to go to the hospital.  Winter was coming.  The mental health professionals (MHPs) who showed up said they couldn't take Sterling in, because he was a voluntary patient.  They only picked up involuntary patients.  Sterling accused Craig of betraying him and fled the scene.  Craig couldn't find him until a month later, when he read of a homeless John Doe who died of exposure.

Rush was examined for days, still hospitalized, after they already knew he was not having a heart attack and not in immanent danger.

That's not what happened to Shelly

Shelly was seven months pregnant, with bronchitis and in a state of euphoria and grandiosity.  Craig brought her to the ER.  But she wasn't a good faith voluntary patient.  They believed she would check herself out so she could go accomplish her mission.  She didn't qualify for involuntary admission, because she wasn't a danger to herself or others.  What about her baby?  What about her bronchitis?  Bring her back when she develops pneumonia.

Karl Is A Vet

Karl's story is the clearest example of how health care in the United States of America is not working just fine.  Karl is a vet.  He was arrested for resisting arrest for vagrancy.  He just remembers being attacked, and later that the people in prison were poisoning him.  He was transferred to the hospital for two years, then back to jail to be released, no money, no meds, nothing but the clothes on his back.

Craig had been alerted.  He was a total stranger when he met Karl at the jail that morning and took him to breakfast.  Karl couldn't compute the question, White or whole wheat?

They continued to a clinic, where Karl couldn't understand or fill out the two-page form.  Since he wasn't in immediate danger, they sent him to the Department of Social and Health Services to apply for SSI.  Craig helped him with the six-page form there.  The social worker discovered he once received benefits.  So he had to get a statement from Social Security.

Social Security noticed Karl was receiving veterans benefits.  Next stop, the Veteran's Administration.  But the counselor there said they were a PTSD program and didn't take walk-ins.  He sent them a mile away to the Federal Building.  His file was in another state, so they had to get it transferred.

Meanwhile, the file was on computer, and said he was getting 50 cents a month, which was going to the hospital. (They could look up the information, but couldn't give him a copy until the file was received in a few days.)  Craig said, He's homeless and needs medication right now.  So he was sent to the VA hospital, then to the outpatient clinic in the bowels of the hospital.  Several kind strangers helped Craig find the way.

To get help at the outpatient clinic, Karl had to be admitted through ER, where they determined his illness was not service-related.  The waiting list for outpatient treatment was six months, and he might not get in, because he had been hospitalized only once.  The social worker suggested they try the clinic where they had started the day.  By now it was 6:30 and the clinic was closed.  They covered miles that day.  Karl spent the night in a homeless shelter, still not able to remember Craig's name.

That's where I will end the saga, though it is still several days from completion.  Small wonder that 83% of psychiatrists want a national health insurance plan, a higher proportion than any other specialty.  So many of their patients are homeless.

At Least I Have Insurance
 

And I thought I was having a hard time.  I have boatloads of people to help, support and advocate for me.  My salary is continued while I fill out applications.  I have a roof over my head and continued health insurance.

Most of all I have Helen, who asked me all the repetitive questions over several days, monitored my capacity, and terminated the work each day, usually after twenty minutes when I was getting overwhelmed.  My phone has been set to mute the disability company whose questions put me over the edge.  She screens my messages.  This process turned me into a pill-popping wreck last fall, and though my memory is not what it used to be, I do know my helper's name.

Rush, the system works well for you.  But not for the rest of us who live in the United States of America.

A Different Way

I commend to your reading Souls in the Hands of a Tender God by Craig Rennebohm with David Paul.  Craig uses his stories to help us see the face of Christ in these abandoned ones, and to frame his theology of God and what it means to be a human being in the sight of God.

We cannot make the journey alone.  None of us.  We are made for life together, made for community.  Those of us blessed with health and wealth may be tempted to forget that.  We may want to believe that we are self-made and assume that we have succeeded through our individual merits alone...  Illness - and especially mental illness - confronts us with the unavoidable truth of our frailty and finitude.  Illness underscores our fundamental dependence on the love and help of others...

Companioning

Craig describes the work that his community is doing, "companioning" people who are mentally ill.  Companionship can be described in terms of four practices: offering hospitality, walking side by side, listening, and accompaniment.  Let's consider these in detail...

And he tells the astounding story of a very different kind of system in Gheel, Belgium.  I will tell you about The Miracle of Gheel next week.  There is a different way to do this.

photo of Rennebaum from http://mentalhealthchaplain.org

photo of toast by Ranier Zenz and used under the terms of the GNU Free Documentation License

US-GSA-USAServices-Logo.svg Logo of the USAServices program, a program to help other government agencies with online communication, managed by the General Services Administration is in the public domain etching of Sysiphus by Max Klinger, 1914, in public domain book jacket from amazon.com  woodcut of Road to Emmaus by Julius Schnorr von Carolsfeld in public domain

 

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 Jewish.  I 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.

The Road Map For Loonie Liberation

First they ignore you.
Then they laugh at you.
Then they fight you.
Then you win.

This is a preview of next week.  Me -- taking a mental health break.

photo of Mahatma Gandhi in public domain

10 Items Or Less -- Shedding And Keeping

Archetypes For The Turning Of The Year

For some people, New Years Day means the Rose Bowl.  For others, black-eyed peas.  For my mother, that was the day we were required to organize our clothes drawers.

Where did that come from?  You got me.  But it must be an archetypal response to the turning of the year.  Right now advertising is crowded with sales on organizational supplies.  If you don't know how to organize your sock drawer, surely there is one of those Dummies book to tell you how.

I just looked it up on Amazon.com.  Sure enough, here it is.

Responding, I suppose, to that archetypal imperative, I am currently recycling meeting agendas, staff reports, conference handouts and class notes, things I no longer need since I have become unemployed.

You know me.  Overboard is my middle name.  At 100.4 pounds and still shedding -- make that shredding now -- old checks with my social security number on them, I am well on the way to my goal for the week: to shed my weight in discarded paper.  I am not even counting paper clips and empty three ring binders. 

Benzos

The process is alternately liberating and anxiety-producing.  I dispose of old grudges, and then panic about what I might need after all.  I celebrate, and then I grieve.  I really did do a lot of good work.  And I left important things undone.

It is good that I refilled my prescriptions before I started this project.  Valium is my current best friend. 

Diets Are Hazardous To Your Health

I do not recommend shedding body weight as a New Year's resolution.  I say this every year, because it is one of the most common New Year's resolutions and it is wrong, wrong, wrong.  Dieting is the first step to gaining weight.  You know this.  You take this course every year and you flunk it every year.  When will you ever decide you have paid enough tuition for this lesson?

Yes, I know.  Having put the word diet in my blog, the mindless web crawlers will signal the advertising gods to place ads for weight loss programs on this page.  I do not endorse them.

I did lose weight a few years ago, which makes it thirty-five pounds easier to meet this week's goal.  I did not diet.  I repeat, I did not diet.  I changed the way I eat.  I changed my eating habits.  I still eat anything I want.  It's just the quantity and the frequency that changed.  I love my food.  I did not diet.

But this is not a dieting blog, and you can go searching for a better way to eat somewhere else.

This post is about shedding. 

Ten Items Or Less

My cognitive therapist is big on distraction.  So I watch a lot of movies.  A lot.  Many are movies that did not exist until they jumped off the library shelf at me.  A recent example was 10 Items Or Less.  Filmed in just fifteen days, it was an exercise in shedding all by itself.  It stars Morgan Freeman and Paz Vela, with Rhea Perlman and Danny DeVito in a drive by cameo.  And I do mean drive by.  They were on the set for all of fifteen minutes, during which time they asked for and received a couple of Starbucks lattes.  Then the director told them their lines.  Then they said them.  They never got out of their car.

So at one point Morgan Freeman, playing an actor, asks Paz Vela, playing a grocery clerk, If you could keep just ten items or less in your life, what would they be?  After she names her list, he names his.  That's eleven.  You just have to push it, she says.  This is the theme of her life in the express checkout lane, people who want eleven items when the sign says ten.

Later they change the exercise, If you could get rid of ten items or less in your life, what would they be?

Dinner Party New Year's Eve

I just got home from a dinner party with dear friends and we played that game, 10 Items Or Less.  We never got to the items we would get rid of.  The ones we would keep had so many stories behind them that we had to leave before we could finish the keepers so the restaurant could turn the table.

The right ten items can make a person rich enough, not only for a dinner party, but for a lifetime.

We will get to that other list at the next dinner party.

Ten Items Or Less

So that is my gift to you for the start of the new year, those two questions.  What ten items or less would you keep?  What ten or less would you discard?

Choose well.  You may not need wishes for the new year after all.  You may find you are already rich.

Winter sunrise by Stefan Mayrhofer, in the public domain 

shelves of file folders by Alex Gorzen, licensed under the

Creative CommonsAttribution-Share Alike 2.0 Generic license.

Cashier at Register by Young in Panama,  licensed under the

Creative CommonsAttribution 2.0 Generic license.

Happy Christmas to my Readers

Feliz Navidad



ميلاد مجيد



圣诞快乐




С Рождеством Хрисовым




Vrolijk Kerstfeest



Feliz Natal




One Last Song -- Joy To The World
This one is signed, as well.

Good Friday Reflection

American Tune by Paul Simon, sung by Art Gunfunkel and Paul Simon 

These all died in faith, not having received what was promised, but having seen it and greeted it from afar, and having acknowledged that they were strangers and exiles on the earth.  For people who speak thus make it clear that they are seeking a homeland.  If they had been thinking of that land from which they had gone out, they would have had opportunity to return.  But as it is, they desire a better country, that is, a heavenly one.  Therefore God is not ashamed to be called their God, for he has prepared for them a city.

Hebrews 11:13-16

The Bible, Revised Standard Version

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

Permission is granted to copy, distribute and/or modify this

document under the terms of the GNU Free Documentation License

The Miracle of Gheel -- Humane Treatment for Mental Illness

It was seventh century Ireland.  The Queen died.  King Damon's grief was so deep that it moved into depression and then psychosis.  He thought his daughter Dymphna was his queen.  Rather than submit to his advances, Dymphna fled to Belgium, to the town of Gheel.  But her father followed.  When she again rebuffed him, he killed her, cut off her head.  Dymphna was buried in the local church.

Six centuries later, her coffin was found during renovations.  Signs on the coffin demonstrated her holiness.  She began to be venerated.  Cures of the sick were attributed to her.  She was canonized in 1247 as the patron saint of the mentally ill.

Okay, here the one last bit of unrecovered Catholic in me demands to be heard, to note Rome's fascination with girls who prefer death to rape.  Even as a nine year old, that made me uncomfortable.

Moving on.  People came to Gheel for healing.  Many brought family members who were mentally ill.  Sometimes they left them there.  The priest housed these abandoned ones next to the church.  When the job of caring for them became too much for him, townspeople started bringing in food.  They built a hospital in the 14th century.  When it was full, the real miracle of St. Dymphna occurred, or rather, began.  Townspeople took some of the patients into their own homes, reserving the hospital only for those most ill.

All across Europe, people with mental illness were thought to be possessed.  They were exorcised, tortured and burned at the stake.  But not in Gheel.

Imagine it!  A psychotic foreigner commits a terrible deed.  But the townspeople do not close the borders.  No, they open their homes.

And they still do.  Through plagues, wars, revolutions, recessions, depressions, during the Napoleonic "Reform," when all the mentally ill people in the country were ordered into one big hospital, during the Nazi occupation, with their "final solution" for mental illness, during the latest reform when the U.S. of A. was/is dumping all our mentally ill people out of the hospitals, onto our streets and into our jails, the people of Gheel developed and continue genuine community-based mental health care.

Today, there are 700 foster homes for 1000 people with mental illness.  A person will enter the hospital for evaluation and stabilization.  S/he meets the psychiatrist, psychologist, nurse, social worker and family practitioner who staff one of the five neighborhood community mental health centers.  Each of these staff people spends half a day each week in the hospital, so everybody gets to know everybody.  The potential foster family and patient meet at the hospital, then over tea at home, then over a meal, then over a weekend before placement.  Outpatient care, medication monitoring and therapy continue at the neighborhood center.  If possible, the biological family participates in the treatment plan.

Once part of the family, the person shares in family activities, chores and church.  The church doesn't have special bible studies, services or programs for the mentally ill.  They are fully integrated, regular readers, members of the choir, ushers, etc.

What if the person's symptoms flair?  "We say s/he is having a bad day."  Because the person lives in a family, not on the streets or alone in an apartment, problems are caught and addressed early, not after getting fired or evicted or arrested or in a bloody mess.  If needed, s/he can go back to the hospital for a while.  In fact, the hospital is not the place of last resort.  When the foster family has to go out of town, say, for a funeral, the person can stay at the hospital.  There is continuity of care.  There is care.

Three years ago I wrote a chapter for Deep Calling called, "If This Were Cancer."  I detailed all the ways that hospice patients receive the support of others, and that people who have suicidal depression do not.  "If this were cancer, there would be casseroles..."  I imagined the total collapse of care for the mentally ill, under the weight of our crazy health care system.  In fact, it's happening as I write.  I imagined that the Church would step in to meet a desperate need, to create hospice for the mentally ill, as the Church originally created hospice and hospitals.  I claimed that the Church has the resources to organize for such care on a local basis.  It has the faith to imagine such a thing, the love to cast out fear, and the values to demand it.  I will have to rewrite that chapter.  I didn't know it had already been/is already being done.

I am ever so grateful to Janet, whose last name I don't remember, who gave me Souls in the Hands of a Tender God: Stories of the Search for Healing and Home on the Streets by Craig Rennebohm, the source of this story.

Lord God, Who has graciously chosen Saint Dymphna to be the patroness of those afflicted with mental and nervous disorders, and has caused her to be an inspiration and a symbol of charity to the thousands who invoke her intercession, grant through the prayers of this pure, youthful martyr, relief and consolation to all who suffer from these disturbances, and especially to those for whom we now pray. (Here mention those for whom you wish to pray.)

We beg You to accept and grant the prayers of Saint Dymphna on our behalf. Grant to those we have particularly recommended patience in their sufferings and resignation to Your Divine Will. Fill them with hope and, if it is according to Your Divine Plan, bestow upon them the cure they so earnestly desire. Grant this through Christ Our Lord. Amen. 

Dymphna's feast day is May 15.