Those Who Have Eyes, Let Them See

Yes, I said I was on sabbatical.  But I do have to write.  Like, I do have to breathe.  My facebook page this morning, somebody posted an Ernest Hemingway quote, There is nothing to writing.  All you do is sit down at a typewriter and bleed.  I have learned there is more than one way to bleed.  Teresa of Avila's stigmata, by the way, were interior.  Mine (writing) seems better than other alternatives.

So yes, I am on sabbatical.  That means I don't have to post.  I might anyway.  Oh well.

NAMI National Convention 2012

It started with Shepherd.  He stood straight tall.  Life has taken a lot out of him, including a lot of teeth.  But he stood straight tall.  I remember him as a black man, with piercing light blue eyes.  I know that's possible, a black man with blue eyes.  Maybe it isn't true in this case.  My brain really isn't that dependable anymore.  But the piercing part is the most important.  I am so glad I wasn't afraid to look in his eyes.

Sabbatical -- Summer Reading

Well, dang.  Regular readers know that every once in a while my brain goes on strike.  I can't imagine how I used to preach week after week after week.  Usually, I do a re-run or fill with some video.  But after posting something every week since April 2009, the time has come to take an intentional break, a sabbatical.

I hate to do this in the middle of a series.  I have one more post in me on apology.  But I need more than a week's recovery time this time.  So that series will have to wait until October or so.  I'll still stick up an occasional youtube.  I've got one in the file featuring Mister Rogers...

Meanwhile, I have some suggestions to broaden your blog-reading horizons.  Most are not about mental health issues.  They are the random reading that feed my mind and soul, a selection from my blog role.  Consider this my annual Summer Reading post.

First up, of course, Knowledge is Necessity.  John McManamy gave me a leg up in the blogging business, when he introduced me to his readers, as the only other blogger he knows who writes about the anterior cingulate cortex.  I think of us as blogmates.

Knowledge is Necessity is as close as you will get to your weekly Prozac Monologues fix.  The way John puts it, from God to neurons.  Not that you could mistake one of us for the other in a crowd.  For one, he's a lousy dancer.  Kinda scary, actually.  But his writing -- you'll snort milk out of your nose.  Here is my review of his new book Raccoons Respect My Piss, as well.  I am reading it a second time right now.

Second, Untangled by Dr. Kelly Flanagan.  Notwithstanding the fact that I write a mental health blog, I don't actually read many, especially not the inspirational ones.  I don't respond well to people who give me advice, even good advice.  Especially good advice.  Just ask my therapist.  But Flanagan can tell a story.  He respects the knots we tie ourselves into in a way that helps us untangle them and find a bit of freedom.

Flanagan is relatively new to the blogging biz, and rather brave, I think, a psychotherapist who blogs about psychotherapy, exposing himself to his readers' triggers.  He has managed it well when he trips mine.  Responsive, but non-reactive -- I think that's what they call it in that language of theirs.  Me, I have to choose between reactive or silent.  So I admire how Flanagan can pull off that responsive but not-reactive thing and still tell a good story.

So that's it for the mental health blogs.

Cake Wrecks.  When I need a dose of something nuts to keep from going nuts, I look at the weird things that people do with cake and frosting.  The subtitle is When Professional Cakes Go Horribly, Hilariously Wrong.  This blog is a whole franchise by now, with books, tours and contests.  The photo above is of my own cake which I did not submit for consideration, because I am not a professional.  At the cake-biz, that is.  But it gives you an idea of what you might find at Cake Wrecks.  I made this one for a guerrilla party held in the lobby of a hospital where I would commit suicide rather than be hospitalized, to celebrate suicide prevention.

My arts and crafts piece here was handicapped by a dearth of materials.  In a  fit of good sense, I had turned over to my shrink my stash of old, ineffective or intolerable and dangerous meds.  (I had quite a collection.)  So I couldn't decorate the cake with pills, which had been my intent.  I had to substitute Mike and Ike's and Smarties.  Cake Wreck cakes go way beyond this effort.

Which leads me to Suicide Food.  Only this blog is not about suicide.  Well, not that kind of suicide.  It collects advertising images that depict animals acting as though they wish to be consumed.  You know, like instead of the Chick-Fil-A cows, encouraging you to eat more chicken, these are the little piggies inviting you to the barbecue.  There seem to be an inexhaustible supply of these scenes to which you may be completely oblivious (I was) until you read Suicide Food, where they are rated on a scale of one to five nooses for just how sick they really are.  The folks who bring you Suicide Food are also on sabbatical.  But they have five years' worth of shrimp lounging and waving to you from the cocktail glass for you to peruse.

Finally, you can tell Shell Shock - Nell's Big Walk is not a mental health blog, because it has a beginning, a middle and an end.  An end, what a concept.  Here's the deal.  Helen and I have been thinking about the Camino, a 500 mile walk across northern Spain, from the Pyrenees to Santiago de Compostela, a pilgrim route over 1000 years old, to the place where are buried the bones purported to be of Saint James, the brother of Jesus, washed up on the shore of northwestern Spain in a boat made of stone.  My kind of pilgrimage.

In our consideration of this enterprise, we had been reading others' accounts, which are, for the most part, filled with angst and/or stupidity, slathered with pain and misery.  I mean, I thought Paulo Coehlo's quest for his sword to be the most self-absorbed little boy obsession I have ever read.

But we kept reading.  Helen was researching boots when she came upon Nell Spillane, an Irish trainer and business coach.  Nell and Frances, childhood friends, celebrated their 50th birthdays by fulfilling a vow to do the pilgrimage when they got old, which they took to mean 50.  Nell's blog is a day by day account.  Helen and I spent Lent this year, reading one post a day.  Neither of us has had the heart to finish the last few days and be done with it.  Obviously, we could use a business coach.  I am stuck 20k short of Santiago.

Frances and Nell had fun!  There are spiritual moments.  All the piety that means something to us means something to them, going to the pilgrim masses, putting beads on the wayside statues of Mary.  But it's the comfortable sort, the Celtic thing/Teresa of Avila/feel free to cuss God out/don't take yourself and your precious insights so seriously sort.  Go ahead, eat that ham sandwich (after you dust it off).  Just wash it down with some more wine.

One thing has become clear.  We will not begin our Camino at the most typical starting point, St. Jean Pied de Port on the French side of the Pyrenees.  No, we will honor our Irish ancestors and begin where they would have, outside the Guinness Brewery St. James Gate, Dublin.

Thanks, Nell.

And thanks to all my readers.  Drop in now and then this summer.  You might find something new.  But for anything that requires the frontal cortex, see you next fall.

flair by Facebook.com

book jacket from amazon.com

photo of cake by Willa Goodfellow

photo of tomb of St. James by Le Galician, in public domain

photo of Guinness Brewery, St. James Gate, Dublin by Dubh Eire, in public domain

Entitled to an Apology?

Perhaps because a central feature of both hypomania and depression is irritability, and because a characteristic of the "bipolar temperament" is a certain tendency toward an attitude of entitlement, interpersonal disputes tend to be common in this patient population. -- Ellen Frank, Treating Bipolar Disorder

Frank goes on to explain how this attitude of entitlement plays out in the clinical setting.  Unlike the usually self-effacing patient with Major Depressive Disorder, grateful for any scrap of attention, people with bipolar get irritated at imagined slights, such as when the therapist cancels an appointment, or is late.  Sometimes, the only way the therapist can maintain the therapeutic relationship is to go ahead and apologize for these imagined slights.

Yup, stick that fork in the 220 volt socket again.

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

Relapse/Maintenance - Stages of Change

Michelle Obama likes pie.  Michelle Obama likes cheeseburgers and french fries, especially when followed by a hot fudge sundae covered with peanuts.

And her mission as First Lady of the United States of America is to address the epidemic of childhood obesity.

She began this effort when her children's pediatrician noticed they were developing some issues.  That brought her own food issues to her attention.  So she changed the way her family eats.  Less fast food.  More fruits and veggies.

It wasn't about looking like a model, getting into that dress for the big event.  It wasn't a diet.  It was, and is about change, for the sake of health.

She still eats pie.  Just, not all the time.

Hypomania Goes To A Blog Party

The American Psychological Association is throwing a blog party.  Today!!  Why didn't anybody tell me about it until today?!  Maybe because they have heard about me and parties?

I didn't know about me and parties.  I didn't figure it out until I discovered I have bipolar II.  -- Not bipolar I.  Everybody knows about that kind of crazy.  Bipolar II is -- well, you never know what you're going to get.  Sometimes what you get makes you the life of the party.  Sometimes in a good way.  Sometimes it makes you crazy productive and successful at work.  That is why it years and years to get a bipolar II diagnosis.  Nobody goes to the doctor because they feel great, are having fun, and are the apple of the boss's eye.

Sometimes the family member knows about the evil twin.  But chances are, the doctor doesn't ask the family member.

Raccoons Respect My Piss

I don't know that for a fact.  Actually, the piss in question is John McManamy's piss.  And he has the experience to back his claim.


Nor do I have any recollection of how I discovered McManamy's blog, Knowledge is Necessity, and from there, his enormous set of resources at McMan's Depression and Bipolar Web.  But as it happens, my entry into McMan World was Skunk -- the blog piece from August, 2009 that inspired his new book's title, Raccoons Respect My Piss, available in kindle format and now in paperback.


Since I asked John's permission to steal Skunk, which I guess means I didn't steal it, we have become what I call blogmates.  He most graciously gave me a leg up in this business, plugging Prozac Monologues in its infancy on his own blog.  Since then, we often find we are captured by the same curiosities at the same time -- as he puts it, God, neurons and everything between.

NAMI Camino - BDNF Meets 5K

Exercise and learning new things -- two of the most powerful tools in the Recovery Toolbox.  They came together in my NAMI Camino, April 28, 2012.

NAMI Walk/NAMI Camino gave you the set up.  NAMI Johnson County held its annual walk/fund-raiser last week, when I was in Costa Rica.  It would be my fourth and last time participating.  But I would be in Costa Rica!  Inspired by the San Diego Walk in 2010, when a battalion in Iraq ran while San Diego walked, I decided to do Johnson County's Walk long distance -- though I would not be running in full battle armor and in the heat of the day.  My extra effort was confined to carrying a laptop to record the event.

With the following results:

So what follows is a series of installments, stopping at each kilometer marker.  This series shows you what you can do with Photo Booth, Youtube, not much skill, and a willingness to experiment.  Everything is reversed, left and right, which won't confuse you unless you are trying to read t-shirts or street signs.

Preparation/Action - Reprogramming Your Brain for Healthy Eating

Some days Facebook just breaks my heart.

Last week a friend who is trying to change his eating habits because, well frankly, his life depends on it, posted a complaint about his breakfast smoothie.  He gave the recipe, and yes, it was nasty.  So one of his "friends" said she would bring over some donuts.

Another friend posted, I have the best husband! He brought me home an Oreo Blizzard.  Her life doesn't depend on it yet, because she is younger.  But it will.  She is on her way.  SAD, the Standard American Diet is an addiction and addictions are progressive.

Real Mental Health Advocacy - We Have Begun

Okay, so I just blew away this week's post.  Sigh.

Instead, I will honor the people in Chicago, who have tried every form of education, conversation and persuasion they could devise to convince Mayor Rahm Emanuel not to close six of the city's twelve mental health centers.  Finally, they staged an occupation.  For seven hours, they held the Woodlawn Mental Health Center, while Occupy Chicago gave support from outside the clinic.

They are my heroes.

Read the remarkable details here.  The videos seem to be missing from the text.  Here is the link to the story as recorded in stages on youtube.

NAMI Walk/NAMI Camino

I started a new project today, researching the route for my NAMI Camino.

I Walk For The Mind Of America

April 28 will be my fourth Walk to raise funds for NAMI (National Alliance on Mental Illness).  I have been most gratified by the support from friends who help me give back to this organization that has made such a difference in my life, and hundreds of thousands of others.

History Of NAMI

Since its founding in 1979, by a bunch of uppity Wisconsin women who said There is no such thing as a schizophrenic family; we did NOT cause our children to have this devastating BIOLOGICAL disease, NAMI has been a beacon of light, education, advocacy, and support first to families and then to persons living with mental illness.

My History With NAMI

In my case, Peer to Peer, a 10 week class helped me to understand, come to accept, and learn skills to live with my illness, whatever they think it is this week.

Project Implicit and the State of One's Soul

Remember, Dumbledore said to Harry, It is our choices that show what we truly are.

Project Implicit

So did you do the homework?  Did you try any of the Implicit Association Tests?  Do you still want to read my blog?

This is how they describe what they are doing:

Project Implicit represents a collaborative research effort between researchers at Harvard University, the University of Virginia, and University of Washington. While the particular purposes of each study vary considerably, most studies available at Project Implicit examine thoughts and feelings that exist either outside of conscious awareness or outside of conscious control. The primary goals of Project Implicit are to provide a safe, secure, and well-designed virtual environment to investigate psychological issues and, at the same time, provide visitors and participants with an experience that is both educational and engaging.

The variety of topics include attitudes toward age, race, disability, ethnicity, mental illness and others.  The tests are constructed to bypass thought, commitment, decision.  They dive deeper into what is known as the lizard brain, the part that evolved before reason, and that simply reacts, by setting one to tasks that have to be accomplished faster than the thinking part of the brain thinks.

Project Implicit is well aware that we may not like what we find in the lizard brain. I don't care for what I find in mine.  But it is important information, for two reasons.

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.

Dopamine - Can't Live Without It

Dopamine -- It's what gets the lab rat turn to left at the T, race down the hallway, make a flying leap at an 18" wall, snag the ledge with its little claws, and struggle over to fall to the other side and win those four food pellets.  If you artificially deplete the lab rat's dopamine, it will turn right at the T and settle for the two pellets lying on the floor.

Dopamine -- It's what got you out of bed this morning and to work on time.  Or if your dopamine levels are depleted, you pulled the covers over your head, while your spouse pleaded with you to go back to your therapist.

Dopamine -- It's what got you out of the house early to redeem that two-for-one mocha coupon at your favorite coffee shop on your way to work, and as long as you were there, might as well order that banana chocolate chip muffin.  Bananas are good for you, right?  Or if you just never got into the habit of that particular coffee shop, and it's not on the way to work, and you really like the French Roast you have at home anyway, then your dopamine never got you fired up, and the coupon went to waste.

Changing Food Habits - Contemplation and Preparation

Do you have any idea how complex the neuroscience of your food habits are?  Cinnabon, Chili's, General Mills, et al know way more about your brain than you do.  David Kessler, former FDA Commissioner, pediatrician and Dean of Yale and UC San Francisco Medical Schools, tells the story in The End of Overeating: Taking Control of the Insatiable American Appetite.

Neuroscientists know how the salt/sugar/fat triple whammy messes with the brain circuitry, taking offline the I have had enough now sensors and replacing them with More, please.  Reward centers, neurotransmitters, HPA axis, limbic system, operant conditioning -- they are messing with you.  Neither your meds nor an aluminum foil hat will protect you.

My Food Autobiography and the Stages of Change

This is not a post about dieting.  If you are looking for the quick fix for the upcoming wedding, reunion or beach vacation, move on to the next page on Google's list.

Before life so rudely interrupted, I was doing a New Year's series on the Stages of Change.  Since then I have rewritten my profile, reflecting on change as a theme.  I don't particularly care for change, but I am fascinated by how people manage to pull it off.  And I am astounded that at age 54 I changed a basic health practice, that being my eating habits, and have maintained that practice for six years.

Let me repeat.  This is not about dieting.  Who wants to DIE-t?  This is about changing the pathways inside your brain, retraining it, creating new synaptic connections that serve you better than the ruts (automatic reflexes) your thoughts and behaviors now travel.

Not in one leap.  One step at a time.

Grief/Depression IV - Not the Same/Maybe Both

So a woman goes into the doctor's office, three weeks after her husband died. I got through the funeral just fine. But now I feel awful. There is this ten ton weight on my chest. I'm exhausted; I don't have the energy to wash the dishes. I'm trying to pack up my husband's things, and I am too weak to pick up his shoes. I can't eat. Sometimes I get hit so hard with this wave of anxiety, I think I'm going to throw up.

What are the chances the doctor will say, Of course you feel awful. These are all very natural symptoms of grief. You just need time. But if you still feel like this a month from now, call my nurse and set up an appointment. What are the chances the doctor will not pull out the stethoscope and listen to her chest?

Answer: It depends on whether the doctor is stupid.

Or a psychiatrist.

These are classic symptoms of heart disease. There is significant overlap between the symptoms of heart disease and the experience of grief. But there is no Bereavement Exclusion for a diagnosis of heart disease. Instead, family physicians and cardiologists take the time to examine whether the person presenting these symptoms may have both.

Grief/Depression III - Telling the Difference

Once, when I was seriously under and still headed down, a friend said to me, There have been times in my life when I was sad, so sad I couldn't imagine being any sadder. But it seems that what you and others with depression are describing is a whole different level that I know nothing about.

See, that's what would be helpful, instead of, I know just how you feel. I remember when [fill in the significant loss]... I knew that he knew times of deep sadness, because I knew some of those times, and because he is a person is thinks and feels deeply. And listens deeply. Everyone should have such a friend.

It was Social Hour. We were in a corner to protect me from all those people being social. I leaned against a wall, because I was very tired. I guess the wall gave me the idea. I said, Yes, there are times I have been so sad I couldn't imagine being sadder. It's like the sadness became a wall I could lean against, because I was so tired. But Depression IS different. Imagine if the wall gives way. Imagine there isn't a limit. You lean and the wall gives way.

Grief/Depression II - Rise in Rates of Mental Illness

Are we really getting sicker?

A New York Times article, When does a broken heart become a diagnosis? sells papers with its usual technique - latch onto a fringe element and substitute good writing skills for substantive analysis.

I am all for good writing skills, and perhaps stumble in the same direction at times. But depression is my beat. So God willing and the brain permitting, I am going to beat this bit to the ground. Two weeks ago I discussed three contexts for the discussion, the cost of health care, the scientific value of the DSM and the hobby horse of the author featured in the Times article. I promised more contexts to come.

Are We Getting Sicker? - Context IV

James Wakefield's thesis is that we are turning natural human emotions, (the ones we want to get rid of, because they are unpleasant), into a diagnoses. His beat is depression, as well, but the Times is on this bandwagon with autism and no doubt other diagnoses to come.

Well, I grant some validity to the concern in general. Is it shyness or Social Anxiety Disorder? Is it artistic nonconformity or Attention Deficit Hyperactivity Disorder? Is it the sleep disruptions of normal aging or Overactive Bladder Disorder? Was it all those wings, doritos and beer you guzzled Superbowl Sunday (and most Sundays), or Gastroesophageal Reflux Disease?

For When Your Therapist Goes on Vacation

I have two therapists and they were both on vacation the week I got home from my mother's funeral and all those issues and all the family and all those issues.  And still on vacation the week after that!  My brother-in-law subbed - thank you, Darryl - with the following email.  I offer it as a resource for when your therapist picks a lousy time to go on vacation.

For extra entertainment value (my entertainment, anyway), I have identified which one I hear Michael telling me with >>, and which ones I hear Liz telling me with **.  One of them regularly irritates me.  I'll let you guess which one.  I have to keep both, because the double-teaming seems to help.

Wisdom Learned From the Seat of a Tractor

Your fences need to be horse-high, pig tight, and bull-strong.

Grief? Depression? Both?

The New York Times reports this week on a proposed change to the definition of depression for the Diagnostic and Statistical Manual (DSM) V. Asking, When does a broken heart become a diagnosis? it raises the specter that normal grief at the death of a loved one could be classified as a psychiatric disorder.

An estimated 8 to 10 million people lose a loved one every year, and something like a third to a half of them suffer depressive symptoms for up to month afterward, said Dr. Jerome Wakefield, author of The Loss of Sadness. This would pathologize them for behavior previously thought to be normal.

Okay, before we get our knickers in a twist -- oops, too late. Knickers in a twist is the current US national pastime. Nevertheless, there is a larger context here. Several, in fact.

DSM Context I - Follow The Money

In Memoriam - Mary Kirigin

This is one of my favorite photos of my mother, standing next to my sister Mary.  That smiling mouth agape, as if to say, Can you believe what I get to do now!

I am writing on Monday, in the few minutes before I head over to the Pato Loco for the memorial service, to be followed later by a funeral in Utah.  Not sure about my publication schedule for the next few weeks, and taking personal privilege with the topic.  It's your blog, my doc once said.  So it is.

Mama was a survivor, in the real world, not reality TV world sense of the word.  She was also a public person, and I learned from her how to set a public face, mostly a competent face.  Privately it was more often harried, the face I see in the mirror, more every day.

The thing therapists think you are supposed to say to survivors is Wow!  You are so strong!  Me, I don't care for that line.

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

The Stages of Change and Weight Loss

Continuing the thread from last week, the average person in the US dies sooner than the average person in forty-nine other nations of the world.  Our higher death rates are linked to our astounding rates of overweight and obesity.  People with severe mental illness die even earlier, 15-25 years earlier.  We have the same life span as the people of Sudan.  The same things kill us as kill everybody else, heart disease, stroke, diabetes, cancer.  They just kill us sooner, because even more of us are overweight and obese.

Side bar: I have growing difficulty using the term mental illness, because I think the term leads to an artificial bifurcation of mental and physical illness.  The weight issue is a case in point.  Most psychiatrists accept the biological model of mental illness, that our diseases are brain diseases.  Nevertheless, most consider the physical aspects as outside their purview.  As a consequence, the part of our disease that is going to kill us does not get treatment.

Weight issues are a case in point.  Psychiatrists hand us prescriptions for medications that cause ballooning weight gain and off the chart cholesterol levels along with the pro forma reminder that we won't gain weight if we don't eat more than we expend in energy.  So all we have to do is eat less and exercise more.

This kind of help doesn't help anybody, regardless of mental status.  Here, as in any other aspect of our recovery, we are on our own.

Weight Loss Programs - Hah!

The temptation is to buy the promises of the commercials that flood the airwaves each New Year.  Here is the deal.  These promises are less verifiable than the ethically-compromised promises of your medications.  But what studies that have been done indicate a relapse rate of at least 50% weight regained within a year or two.

Bottom line, diets don't work.  You have to change your life.  And to change your life, you have to change your brain.

Luckily, you can change your brain.  You just have to understand how.  You have to take the time that it takes.  But you can change your brain.

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From Thursday, June 30, 2011 and edited a bit: 

Habit and the Stages of Change

I have been writing for several weeks now [June, 2010] about this mass of electrical activity inside our brains, dendrites and nerve endings, meeting at synapses, passing their spark from one neuron to the next, creating -- what?  A wink, a whisper, a sensation, the next big brainstorm.

Most of these connections could be called, in the widest sense, habits.  By habits, I mean that pathways get used over and over, form patterns, become familiar, channel us to certain outcomes.  Most bypass the frontal cortex, requiring no thought.  Like breathing, smelling, salivating at the cinnamon.
 

Most of the remainder are still automatic.  But with effort, they can be brought to consciousness where the frontal cortex could interfere, and a decision made.  Like blinking.  Or picking up the cookie somebody brought to the meeting.

What if you don't want to pick up the cookie?  Okay, you really do want to pick up the cookie.  What if you want to not pick up the cookie anyway? 

How Do You Change A Habit?

You're gonna take more than one step.

Last week, I put some numbers out there, the Wahls diet.  Nine cups a day of vegetables and fruits.  I broke it down for you: 3 cups leafy greens, 3 cups cruciferous veggies, 3 cups intensely colored.

This food plan helped Dr. Terry Wahls reverse her secondary progressive MS and get up out of her wheelchair.  It could help you reduce your symptoms of heart disease, lung disease, asthma, hypertension, depression, obesity, bipolar disorder, diabetes, Alzheimer's or Parkinson's.

If you have, or are tending toward any of these chronic diseases, you have already heard your doctor/mother/spouse tell you that you need to improve your diet.  Dr. Wahl's book, Minding My Mitochondria tells you just how much and why. 

Nine cups a day of vegetables and fruits:

3 cups leafy greens
3 cups cruciferous veggies
3 cups intensely colored

Stages Of Change 

So there is your canyon.  Here are the steps, more than one.  Several, in fact.  The steps are known as the Stages of Change.

The Stages of Change model appears all over the place lately.  This article from the journal American Family Physician uses the Stages to help physicians help their patients, something more effective than Just do it.  A Youtube search yields results for addiction recovery counselors, life coach trainers, weight loss clinics.

Different sites number the stages differently.  Some say Precontemplation is Stage 0.  Some give Relapse its own number.  Some add Transcendence, whatever that is -- said the priest who gets cynical when quasi-religious language gets used for the purposes of self-improvement.  Whatever we are supposed to transcend, evidently it is not our desire to improve ourselves. -- But I digress.

I like this site, which is the source of the graphic above, even if the author does use that word Transcendence that made me twitchy there for a minute before I got back on track.  It works through the stages from the perspective of the person who is making the change, not the person who wants somebody else to change. 

Crossing Canyons/Building Bridges In My Brain 

Dr. Wahls calls it a diet.  I don't diet.  Who wants to DIE-t?   Each chocolate chip cookie left on the plate represents a little death.  A diet is a temporary interruption.  When it ends, you go back to your life.  But there is nothing temporary about the nutritional needs of my mitochondria, without whom there would be no life.

I'm into changing my brain.  In that mass of electrical wiring, some potentially healthy pathways are blocked by the detritus of dead dendrites.  Other destructive pathways are carved into canyons of well-worn automatic responses. 

Changing my brain will take time.  It is taking decades.  It will take at least another blogpost. 

And The Word Became Flesh 

Question: What do the Stages of Change have to do with Prozac Monologues? 

Answer: Words.  The Stages of Change use language to shape the brain.

Language is one kind of pathway from neuron to neuron.  It connects electrical impulses from the autonomic systems, the olfactory nerve, the amygdala, through the hippocampus (memory and emotion) and the anterior cingulate cortex (pattern seeking) and into the frontal cortex (conscious thought).

Language is how all this electrical activity gets turned into meaning.  It is where the brain and the mind become one. 

The Stages of Change include a process of changing our patterned thinking about food.  And thinking is how we move from one stage to the next. 

Dr. Wahls writes about synergy, how exercise and diet work together to heal her myelin and reduce the symptoms of her MS.  I'm thinking the same process works for changing habits, particularly food habits.  Each new behavior reinforces the preceding thought that moved you to the new stage.  That repeated behavior patterns the thought that will move you to the next stage. 

Meanwhile, what you are eating while you are trying to make any change matters.  Your mitochondria need the right materials to build the dendrites that form the new pathways.  Like lunch for the road crew.

So don't try to skip stages.  And don't skip broccoli.

One of these days I will write my own food autobiography, my trip through these stages.

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Back to New Year's, 2012 

Pre-Contemplation 

The good news is, you have already moved past Stage One, Pre-Contemplation.  I presume you have moved past Stage One.  Pre-Contemplation is when you don't really think you have a problem. And why would you still be reading this post if it wasn't your problem?  So you have already made progress! 

Contemplation 

But don't try to jump that canyon.  Don't go from I have a problem to New Year's Resolution: no more cookies.  It is January 3rd, and that resolution is probably already in the toilet.  We are not talking about the New Year here.  We are talking about your life.

One step at a time.  Make a list.  Make it as long as you can.  Why do you want to change?  What difference would this change make in your life?  Go deep here.  Screw those little graphics with the magically shrinking ladies that show up in your Facebook sidebar.  What is at stake for you?  This is no longer a game.

Read that list every day.  That will help the re-patterning process.

That is enough for this week.  You have homework to do.  I have my life to get back to.

Happy New Year!  Happy Long Life!

No New Year's Resolutions - Change Your Life December 29, 2011 -- Overweight is a major health issue, the largest contributing factor to early death for people who have mental illness.

My Food Autobiography and the Stages of Change March 8, 2012 -- Pre-contemplation and contemplation.

Changing Food Habits -- Contemplation and Preparation March 15, 2012 -- Reviews The End of Overeating by David Kessler and introduces the brain science of the sugar/salt/fat trifecta.

Dopamine -- Can't Live Without It March 23, 2012 -- The brain science behind habit formation and an experiment to try.

Preparation/Action -- Reprogramming Your Brain for Healthy Eating April 26, 2012 -- How to change a habit.

Relapse/Maintenance -- Stages of Change May 24, 2012 -- Review and finishing up the series.

photo of salmon in Ketchikan Creek by Wknight94 and used under the terms of the GNU Free Documentation License 
photo of Women Working at a Bell Telephone Switchboard from the National Archives and Records Administration and in the public domain

photos of Hatherton Canal in Staffordshire by Roger Kidd, Coal Creek Falls by Walter Siegmund, Glen Canyon by Sascha BrückJeff Kubina used under the Creative Commons Attribution-Share Alike 3.0 Unported license.

Stages of Change graphic was created by Todd Atkins, who placed it in the public domain