Welcome to the middle path

My photo
Sporadic photos and notes from a Psyche-midwife, cheerleader, anthropologist--aka clinical social worker in therapy practice. Photos are usually mine except for those of historical events/famous people. Music relevant to the daily topic is often included in a web video embedded below the blog. Click on highlighted links in the copy to get to source or supplemental material. For contact information, see my website @ janasvoboda.com or click on the button to the right below. Join in the conversation.

Saturday, October 29, 2011

A poet, a hunger, and life goes on...

 Went to see Brian Turner, Poet Laureate of New Zealand, tonight at the OSU library.  It is so good to live in a college town.  It was interesting, and sort of sad, to observe that 3/4s of the audience was grey-headed.  Poor old poetry-- competing with the World Series, and CSI, and Friday night bars.  But what a treat for those grey haired or getting there that did show up.  Turner was described in the PR as funny and unsentimental, a helpful reassurance for poetically worried sorts.  He writes about rugby, nature and our place in it, and the Human Condition.  He's delightful: unassuming, straightforward, and of course articulate in a very Kiwi mumble-y way.  Can't think of a better way to spend a Friday night.

I'm a would-be poet.  I ran a web group of poetry games, and used to have a weird hobby of making strangers write poetry for me.  I still have notebooks full of poetry by waitresses, gamblers, shoe-shiners, Welsh firemen.  I love the written word.  I don't have a lot of truck with flowery prose, but that grab-you-by-the-gut stuff--  oh, the beauty of economy in language!  Turner is good at that.  My favorites of the night were his short pieces, in which a short story was taking place in three sentences.

dreaming of food
I haven't written much poetry in the last few years.  Not sure why, but I tell people my muse done fled. Of course, after listening to a poet, I get inspired.  Maybe that muse will peek back in.   An audience member asked Turner how he knew if any of his poetry was any good.  I liked his answer: "I don't.  But I can't help writing it" (or something to that effect).  I think creativity is like that.  We put out, and we hope it resonates with someone, but even if it doesn't, it feels good to our soul.

felted daemon, 10/11
I got a call tonight from an old friend, one of my poetry conspirators back in the day.  He asked how I was, and I said "Not so bad considering".   He didn't know exactly what was under consideration. I forgot we hadn't talked in months, since before smell fled me and then Bad Smell moved in.  I told him the long story: how everything I could smell, after four months of no smell, smelled rotten.  Like nearly everyone I've told this story to he'd never heard of anosmia or parosmia.  I've acquired a whole new vocabulary this season. Stephen knows a few things about me, and he knows I loved food and olfaction.  He expressed deep sorrow for my loss, and I appreciated it, since this particular one doesn't strike most people as particularly interesting.  But I get reminded of it often-- like, for instance, tonight.  You can't listen to much poetry without hearing something about smell, and its triggers of memory and wonder. Stephen asked if I'd noticed any compensation in my senses since smell fled.  I remarked sarcastically that I can now bend spoons with my mind.  Stephen reminded me that I probably won't become a super-hero, and wondered if any of the other four senses were brighter.  I said I had been hoping that I would at least get a heightened visual acuity, but so far, no good.  Smell was it for me, sense-wise.  I've never been much of a visual person. I get lost all the time.  Touch is good; who doesn't like it?  But smell was my number one Four-D sense.  Hearing-- well, ok, I love that.  Sometimes it is 3D, mostly with nature sounds or music.  I'm slightly synesthesiac.  When I hear voices, I often have a textural association.  But smell has always, always been at least 3D for me.  And without it, the world seems awfully flat.

I had a visit from an old friend and her family a couple of months ago.  They'd moved away four years ago, and I'd not seen them in a long, long time.  They didn't know about the anosmia.  I hadn't seen their boy, now eight, since then. The dad reintroduced me to him, saying, "Do you remember Jana?  She always used to smell your head when you were little."  I teared up right away, even while reassuring him he didn't need to worry about that now.  He'd been the youngest in our circle of friend's children, and I do, or rather did, love the smell of a baby's head.

The pear I really want to be eating
Sometimes now I go a day or two without thinking so strongly of what I miss.  I do think I have learned a few things about loss and grief and acceptance.  But I miss smell.  And tonight, writing this, I am thinking mostly about my hungry belly.  I came home from work peckish, and could find little I wanted.  I came home from the poetry reading ravenous, and could find nothing tolerable. The parosmia puts most foods off-limits. The upside:  I've lost my "kummerspeck"-- a great German word that translates as "grief bacon", and means the weight you gain after a loss.  I gained 15 pounds following a couple of significant losses a few years ago.  I now weigh less than my driver's license record of a few years ago.  On the other hand, I'd take back the pounds to be able to enjoy a delicious meal of fall's bounty.  But there you go.  We don't get to choose our cards, as they say, only how we play them.  I am trying to learn grace in the game.  It's a slow go some days.

Back when I cooked food, and liked it, and was the poetrix for the word game group, we had an assignment to write a recipe into a poem.  Click here to read my Gumbo recipe on the wonderful Very Bad Poetry website.   It's bad poetry, but good gumbo.

Off to dream of eating something satisfying...
Jana

Monday, October 24, 2011

The Incredible Heaviness of Being: Braving The Stigma of Mental Illness

Kay Redfield Jamison wears many distinguished hats.  A PhD psychologist, she is a tenured professor of Psychiatry at the prestigious John Hopkins school of medicine.  She's been honored by Time Magazine as a "Hero of Medicine", and is the author of at least two international bestsellers and over a hundred published research articles.  She's had dozens of  fellowships, lectureships, and national awards.  She's received the MacArthur "Genius" Fellowship.

She also has, and she will be the first to tell you this, a serious mental illness.

Dr. Jamison first became ill with Bipolar Disorder as a senior in high school.  In her conservative Episcopalian family, mental illness was not discussed, and if anyone noticed how she was floundering, it wasn't remarked upon.  But she noticed.  She noticed the long periods of high creativity and energy followed by the much less tolerable periods of complete, abject and suicidal depression.  The story of these, and her later complete psychotic break and serious suicide attempt, are charted in vivid and heartbreaking detail in her books "The Unquiet Mind" and "Touched with Fire:  Manic-Depressive Illness and the Artistic Sentiment". 

It's unusual for a PhD (as opposed to an MD) to be offered a professorship in psychiatry.  But that rarity pales in comparison to the level of support her employers at John Hopkins gave her for being "out" with her illness.  In an unusual display of wisdom and compassion,  her mentors allowed her to continue to pursue her work after her first major break and hospitalization.  And her direct supervisor urged her to use the experience of her illness to teach and write.  As a result, we have what has been called the classic textbook on Bipolar illness (then called Manic Depressive Disorder), countless research studies, and an example of human courage exemplified.  If she had been dismissed, marginalized-- if she had her license to practice revoked (none of these are unusual situations in our culture, when ignorance is faced with illness)-- we would have none of these great works, which have done much to encourage understanding and treatment.

But it is not only the compassion of her employer responsible.  It is her courage in saying:  "Yes, I have an illness.  It is genetic.  It is not my choice, but it is my responsibility to manage".  Her bravery has had a profound effect in showing people that "different" is not always hopeless.

Dr. Jamison would tell you, as she did the audience of several hundred at OSU tonight, that having BP  is not an easy path. In fact, (and I disagree with her, but I don't have her direct experience to effectively contradict) she says that having a mental illness is "99.5% bad".  As in my last post, I strongly believe that it was her experience of the illness and her ability to humanize and integrate it that led to some of her greatest gifts.

I don't have much to add to information about Bipolar that colleague and expert on affective disorders psychiatrist James Phelps has not already said, much more brilliantly than I could.  If you've not visited his website, I urge you to do so.  (If you or someone you love has BP, get his book as well).  I would add a bit to Dr. Jamison's speech, though.  I'd add that there are some effective management techniques other, or in addition, to medication when folks with affective disorders aren't significantly impaired or completely disabled by their affective differences.  You can read about these on Dr. Phelp's site.  I would take issue with calling those without BP "normal", because I just haven't met anyone who truly fits that description-- we ALL have our stuff.  I think her point in repeatedly saying "mental illness" was to get across that these impairments are not any more chosen, or morally suspect, than having asthma or cardiac disease.   And the outcomes of not treating this illnesses are profound:  50% of persons meeting criteria for Bipolar Disorder attempt suicide.  10% succeed.  That's a very lethal illness.

See also:  http://www.janasvoboda.org/search/label/depression

In some ways, it is easier than ever to get treatment for affective and other dis-eases of the mind.  You can google, ask your MD, look in the yellow pages.  In other ways, it is harder than ever.  There is still a lot of stigma and ignorance about illnesses and differences that affect our minds and behavior.  And even though literature reports that  lifestyle changes and therapy support are as effective or increase effectiveness over medication alone, insurance often won't pay for counseling.  Certainly not everyone has insurance.  Your local NAMI chapter can help you find resources and support.  If you are a student, contact your education counseling center to see what low-fee or free services are available.  If not, call your local mental health center (God. politicians and voters willing that you still have one).  If all else fails, call a crisis line.  There are many you can find on the web.

Here are two: 
1-800-SUICIDE
1-800-784-2433
1-800-273-TALK
1-800-273-8255

Wednesday, October 19, 2011

The Imprisioned Voice

Drove to Eugene late Sunday night to visit gifted photographer/friend Maria.  I don't often have time in the car, and I forget to listen to the radio at home.  NPR was on the dial, with Krista Tippet (Speaking of Faith in the old days, and now hosting the more inclusively titled On Being) interviewing a biologist and Big Cat conservationist.  I was distracted and couldn't focus on the interview the first half of the drive.

I noticed the guest had a slight stutter-- so slight I wasn't sure I heard it until the third or forth time.  In the second half, I came awake, as biologist and explorer Alan Rabinowitz revealed that his love of cats started because watching them at a zoo was a rare respite for him as a child.  Rabinowitz was afflicted with severe stuttering as he developed language-- so severe that he was effectively electively mute until adulthood.  Friendless and locked in with a voice powerful but seemingly unable to be tolerated, he related to the tigers, lions and jaguars that paced their cages, made impotent by their environment.  His parents did their best to help, and sent him to psychiatrists and speech therapists.  At the time, stuttering was seen as a behavioral rather than neurological issue.  The therapeutic emphasis was on getting him to knock it off, which only made things worse.   When he was 18, his parents found a speech clinic which taught him to be a "fluent stutterer"-- to accept what was true about him and work with it.  It worked.  He is now an international speaker, and his voice-- for the animals, for conservation, for himself-- is a powerful and effective one.  As a child, he watched these powerful cats pace in their cages and said to them, "I'm going to get us out of here."  He has devoted his life to finding and preserving places for this animals to express their powerful voice and their genetic heritage.

Krista Tippet is a wise and compassionate interviewer, and has talked with many people over the years whose wisdom, like Dr. Rabinowitz,  was similarly hard won.  "When you talk about what helped you... becoming a fluent stutterer rather than denying it...It reminds me about what I hear about hearing and wholeness... that in fact being a whole person is about taking in whatever our wounds are and our fears are, and  integrating them into our identity... it's the work of a lifetime."

The story gets even more profound. In 2002, Dr. Rabinowitz was diagnosed with CLL (Chronic Lymphocyttic Leukemia), which has no cure.  As Krista pointed out, mortality is not at all special, but most of us manage to avoid looking at it while we are still living our full lives.  Yet even though hearing that living in the field, with its exposure to dengue fever, thyphoid, malaria and other illnesses, was likely to shorten his life, he decided that his mission was so important to his identity he would soldier on.  "Have the courage to live", said Robert Cody.  "Anyone can die."

This was a powerful and moving interview, and there is much to be learned from listening to it.  I encourage you to take the time.  Find it here:   http://being.publicradio.org/programs/2011/voice-for-the-animals/

Many of us have voices that long to be heard.  Find your voice, and use it.  Your wounds are part of your history.  Own them.  They are part of your power.

Related links on stuttering:  http://www.stutteringhelp.org/
http://www.asha.org/public/speech/disorders/stuttering.htm
http://www.youtube.com/watch?v=Lj2IsxxCSS8

If you've not seen it, The King's Speech is a powerful film in which the protagonist stutterer finds and uses his voice.  

I'll close with a poem by a voice for the inarticulate:  Mary Oliver.

The Imprisioned Voice

Driving to Eugene on a Sunday night to visit gifted photographer/friend Maria.  I don't often have time in the car, and I forget to listen to the radio at home.  NPR was on the dial, with Krista Tippet (Speaking of Faith in the old days, and now the more inclusively titled On Being) interviewing a biologist and Big Cat conservationist.  I was distracted and couldn't focus on the interview the first half of the drive.

I noticed the guest had a slight stutter-- so slight I wasn't sure I heard it until the third or forth time.  In the second half, I came awake, as biologist and explorer Alan Rabinowitz revealed that his love of cats started because watching them at a zoo was a rare respite for him as a child.  Rabinowitz was afflicted with severe stuttering as he developed language-- so severe that he was effectively electively mute until adulthood.  Friendless and locked in with a voice powerful but seemingly unable to be tolerated, he related to the tigers, lions and jaguars that paced their cages, made impotent by their environment.  His parents did their best to help, and sent him to psychiatrists and speech therapists.  At the time, stuttering was seen as a behavioral rather than neurological issue.  The therapeutic emphasis was on getting him to knock it off, which only made things worse.   When he was 18, his parents found a speech clinic which taught him to be a "fluent stutterer"-- to accept what was true about him and work with it.  It worked.  He is now an international speaker, and his voice-- for the animals, for conservation, for himself-- is a powerful and effective one.  As a child, he watched these powerful cats pace in their cages and said to them, "I'm going to get us out of here."  He has devoted his life to finding and preserving places for this animals to express their powerful voice and their genetic heritage.

Krista Tippet is a wise and compassionate interviewer, and has talked with many people over the years whose wisdom, like Dr. Rabinowitz,  was similarly hard won.  "When you talk about what helped you... becoming a fluent stutterer rather than denying it...It reminds me about what I hear about hearing and wholeness... that in fact being a whole person is about taking in whatever our wounds are and our fears are, and  integrating them into our identity... it's the work of a lifetime."

The story gets even more profound. In 2002, Dr. Rabinowitz was diagnosed with CLL (Chronic Lymphocyttic Leukemia), which has no cure.  As Krista pointed out, mortality is not at all special, but most of us manage to avoid looking at it while we are still living our full lives.  Yet even though hearing that living in the field, with its exposure to dengue fever, thyphoid, malaria and other illnesses, was likely to shorten his life, he decided that his mission was so important to his identity he would soldier on.  "Have the courage to live", said Robert Cody.  "Anyone can die." 

This was a powerful and moving interview, and there is much to be learned from listening to it.  I encourage you to take the time.  Find it here:   http://being.publicradio.org/programs/2011/voice-for-the-animals/

Many of us have voices that long to be heard.  Find your voice, and use it.  Your wounds are part of your history.  Own them.  They are part of your power.

Related links on stuttering:  http://www.stutteringhelp.org/
http://www.asha.org/public/speech/disorders/stuttering.htm
http://www.youtube.com/watch?v=Lj2IsxxCSS8

If you've not seen it, The King's Speech is a powerful film in which the protagonist stutterer finds and uses his voice.  

I'll close with a poem by a voice for the inarticulate:  Mary Oliver.










I was profoundly moved by this interview, and I hope you will take time to listen to it.  

Wednesday, October 12, 2011

Back in the Saddle Again

Just returned from a wonderful visit to Wales and England.  It was a true vacation---few to no responsibilities, and gone long enough to settle down and Just Be.

I love my job, but we all need time to be off duty and refresh our perspective.  This trip was a gift from my sister and her husband; my job was to show up and enjoy.  What a gift that was.

We spent our first two days in a village a couple of hours north of London, where the average house was 400 years old and the streets resembled alleys.  Weather and company were sunny and warm.

Time in Wales was rhythmic and slow in the best sense of the world.  We stayed fairly close to the family home as to be available for the gracious meals of the matriarch and the zingy one-liners of the patriarch.  Yet each day we saw amazing places-- castles and gardens and stone-age settlements.  Day one was a pilgrimage to Dylan Thomas's writing studio and boathouse on the south coast.  The walk is punctuated with poetry and inspiring vistas.  I collected beach glass that I've convinced myself are from ale and whiskey bottles Thomas pitched from his writing perch on the cliff above.

London was hustlebustle in comparison, and the smells, or rather The Smell, overwhelming at first.  My anosmia transmogrified into parosmia just a few days before my trip.  I now get one smell and it's horrific:  think offal dipped in toxic waste then burned.  It's triggered by such seemingly unrelated scents as coffee, soap, and salsa.  Also perfume, garbage, fuel and just about every ten feet of an urban environment.  I used all those skills I preach about here to cope-- acceptance, targeted refocus, mental math-- and it worked pretty well most of the time.   Eating was the hardest part, especially in restaurants where every pound paid was a gamble.  I found fish and chips tolerable and ate more this week than I've had in 10 years.  To your left is a sample of what I couldn't eat, so merely lusted after.

Tate Modern Art Musuem provided good targeted refocus and I especially enjoyed the Dadaist and Surrealist works.  They had a nice room of Rothkos for soothing contemplation.  Other highlights:  walking along the Thames in the evening before theater, watching a well-acted play, wandering in the London library, and a great meetup with a writer for lunch.

Coming from a small town to a metropolis that size means lots of people watching.  While walking in the city, I decided to experiment with eye contact.  In most urban environments that's the province of the aggressive or insane, so percentage of return was low.  Whether the person I passed was a child, elderly, rich business person or homeless looking, I looked into their eyes.  If they looked back, I usually smiled.   My thought was:  Each of you is someone's child, who was loved or deserved to have been.  It was a powerful experience.  No one shouted or glared at me; many smiled in such an open way it was almost heartbreaking.  That happened more with the poor/homeless than the business people.

In the past months I have been thinking a lot of the importance of community.   And despite it's virtual prevalence and all our connections (Facebook, emails) we are more isolated than ever.  In Llandeilo, Wales, population less than 2000, at least four pubs have shuttered their doors since my visit ten years ago.  More than a bar, pubs are the UK's town halls and churches, where business is conducted, families connect, problems identified and resolved.  Now some 50 pubs a week are closing throughout the UK.  Some have histories going back hundreds of years.

In the US, it's our libraries and independent bookstores and diners that are going away. Places where we used to while away some time, breathe a little, meet with friends.  Single-screen movie theaters are a thing of the past, but the multiplexes aren't doing that great either.  Live music events don't attract like they used to; people are content to buy (or steal) their music off of the net.  Old venues fold and with them a piece of our history and the exoskeleton of our community.

This week's homework:  Get out a little.  You don't need to cross the pond to find connection and renewal.  Take some time to support a local institution you want to see survive.  Ask a few friends to join you, and remember how nice it is to see familiar faces.

Meanwhile, if you need to relax, here's a Welsh lullaby: