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.
Happiness often shows up on the ridges of trouble. I think it was Elizabeth Kubler Ross who reflected about the beauty of canyons, formed only in harsh conditions. Likewise, happiness has a bigger edge when there is something pushing it into contrast.
Zen Buddhism speaks of life as 10,000 joys and 10,000 sorrows. I can tell you for sure you have to be asleep or die young to pass up the last half of that bargain. No choice for sorrows if you choose to live. But sometimes we seem to think of the joys as trivialities. As if This Life is Serious Damn Business, and Don't You Forget It, less you flunk the final.
Did I mention this mind-blowing Koan of DBT founder Marsha Linehan? "Whether you are walking to the 7-11, to the alter, or to the execution chamber-- in that moment you are just walking." I hated that when I first heard it. My regular "let's be black or let's be white" mind heard it as the most idiotic form of denial. Now I see it as possibility that living in the present can allow a moment of peace. There is potential for joy or disaster (or banality) around every corner, and until we get to that corner, well, we're just walking. We might as well look around and see if there is anything of interest here, where we are. And be open minded that we cannot know what for sure on which side of the list of 10,00 joys or 10,000 sorrows the next checkmark will go.
About all we have the semblance of control is what we are doing in the right now-- where we are choosing our focus, such that advance sufferings (or happiness) can wait their turns.
It doesn't take much to bring joy. This weekend alone I found comfort and pleasure in food shared with family, the new blooms in the garden, the exquisite brightness of young musicians (hit play button at end of post to here the amazing BEE EATERS). In the latter, such genius brought me also to tears. Real beauty can do that-- bring both those joys and sorrows smack in our heart in one harmonic package. It takes no more than an open and curious eye to see wonders everywhere.
Admittedly, one woman's wonder is another's horror. After a few grumbling hours spent trying to subdue the invasives from my garden, I came upon a bursting mound of baby orb weavers. They delighted me (see photo right); my companion at the time was decidedly less pleased.
After diminishing the biomass to negligible effect, I'd been considering the sell points of an all-paved yard. Seeing this clot of bristling life brought me straight out of cranky thoughts of dandelions, holly seedlings and springweed and into the present, and then a future where my garden would be delicately decorated with lacy mandalas, each with a stripy guardian. It was a happy yank up from my grumbling.
Spring's bounty--an iris jutting out from under a miniature Japanese maple, the fiery pokers, a plethora of clematis-- maybe they are worth it, even when it's hard to see my intention for all the weeds. So I'll potter around the garden, not knowing what will poke up around the next corner. And what the heck, while I'm potttering, might as well Be Happy.
I've had out-of-country company this week, so though thinking about and engaging in happiness practices (walking wetlands and beaches, dining, and roller derby), there was no blogging.
I'm still recovering. Meanwhile, check out these previous posts for quick tips on upping your level of life satisfaction. If you're a new reader or haven't seen the HAPPY documentary yet (get to the Darkside!) , some of these may be news to you. Lucky for us, happiness research has been happening for a while, and we know a few things about the non-genetic factors. They're ripe for your manipulation. Try a few and let me know the results.
Tonight was the West Coast premiere of HAPPY, a documentary by Roko Belic. Thanks to the efforts of our own Paul Turner and his lovechild Darkside Cinema, we got not only the movie, but a chat with the Academy-nominated director. He's here tomorrow as well. If you want a chance to see a man and his dream in motion, pop in for the 7 or 9 pm Saturday showing. If you can't make it then, you'll have three more weeks to be among the first to see this inspiring film on the best part of the American Dream.
After the show, I went out for some slow food and good chat with friends. We talked about times we felt in flow (more on this next post). I remembered a great night in Summit where all the requisites for my personal happiness were present: community, celebration of life milestones, family, good food, music, nature, physical activity (in this case, dancing in the barn). And recalled another beautiful evening with photographer friend Maria and her foodie musician friends, dining on four courses and telling tales of great food adventures throughout the world.
Food is as democratic a road to happiness as any. In the documentary Happy, a seriously happy Cajun family chows down on a tabletop feast of fresh crab; a few scenes later a Bushman family in Namibia shares a fresh kill. Cut to the Dali Lama, reminding us that love starts with that first suckle at mama's breast.
As screwed up as our relationship with food can become in a calorie-laden culture, food still brings us together, in celebration and grief. We comfort the sick with soup, celebrate the milestone with sweets. As lovers, we long to feed the other early on, cementing the bond with gifts of physical nourishment.
In honor of the primal need to sustain our partnerships through cuisine, I'll start this series of Happy Blogging with a recipe. This was a gift from Dennison Farms with my leek purchase last week, writ by local earthmama Wendolyn Molk (who also bakes a darn good loaf of bread and makes a great peach pie). Done by memory, so please forgive me, Wendolyn, if I have screwed it up.
So very yummy I have made it twice.
Leek Pie
3-5 leeks, cleaned and finely sliced
1-2 TB butter
4-8 oz Roquefort or Gruyere cheese (these are vastly different cheeses, and frankly I substituted with local "Oregonzola")
1 egg
1/4 cup cream or yogurt
pie crusts, top and bottom (I cheated. First Alternative Co-op has organic vegetarian crusts in the fridge section)
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Saute' the leeks on medium-low heat for 30, yes 30 minutes in the butter. If they look like they'll get too dry, cover them.
Beat the egg with the cream, throw in the crumbled/grated cheese and add the leeks. Put it in an unbaked crust and cover with the top crust.
Bake at 350 degrees for 30-35 minutes.
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Because I do not know how to leave well enough alone, I added the fresh morals I found in my backyard (sauteed til slightly brown) and a bit of nutmeg.
For additional happiness, serve with friends, conversation, reasonable social risk-taking and gratitude.
See you soon,
Jana
PS: The pic at the top is of a beet and pumpkin seed tart from lunch at the Gathering Together Farm. It was delicious.
Good intentions about spreading the happy gospel have been waylaid-- but am hoping to see some of you at the Corvallis premeire of the HAPPY documentary tomorrow at the Darkside. The director will also be attending the Saturday show. Still can't make it? Show up during the three week run thereafter.
Back from 3 days of art, conversation, and way too much good slow food at the coast with my WAR (women's art retreat) pals. What a happy respite from a long and weird Oregon winter.
Speaking of happiness, which we'll be doing a lot of the next few posts, a documentary on same is coming to our little burg this weekend. Here's a chance to hear the science that can help you in that elusive American Pursuit.
http://www.facebook.com/HappyMovie?sk=wall HAPPY, the latest feature-length documentary by Academy Award® nominated Roko Belic, takes us on a compelling journey across the world in search of what really makes us happy. From the swamps of Louisiana to the slums of Kolkata, deeply personal stories weave together with insights from renowned experts to provide the keys to our most valued emotion. There will be an exclusive Q&A with director Roko Belic after the opening Friday and Saturday night shows on May 20th and May 21st. HAPPY will be opening on May 20th for a three week theatrical run, and can be seen until June 9th. FOR TICKETS:www.darksidecinema.com, 541-752-4161
Not long ago, I was having a difficulty in my life. I didn't ask for it, didn't want it, and didn't like dealing with it. So I gave in to some baser impulses, and indulged my Id in being a jerk about it. I was well aware I wasn't taking the higher road, but I justified it that None of This Was My Fault, So I Had a Right. I was being the one more asshole in the room.
After a few days of this, I had a dream. I was driving a new car, and in the car was a baby. I decided it would be great fun to let the baby take a turn at the steering wheel. I was amazed its little baby legs could reach the petals. Not only that, but baby was doing a fair job of piloting the car. It wasn't a great job, but it was fun, and whizbang interesting to watch this little being move things dangerously along. Pretty soon SuperEgo started to speak up in my head. "This is insane. Babies can't drive. Someone is going to get hurt, and it will be your fault! What are you thinking?"
Just as I was thinking, "Why on earth am I letting the baby drive the car?," I woke up.
And kept thinking. Thinking that even though I was feeling all high and mighty and in the right, the path I was taking was juvenile, indulgent, and leading me only into more danger. That I needed to do the grown-up thing, whether it was what I wanted/felt like doing.
A wise Midwestern therapist once told a client to imagine she was wearing a bracelet engraved WWGD. What would a grown up do? What terrific advice, which I've re-appropriated on many occasions. We all possess the imagination, enthusiasm and boundless desires of the child, as well as the judgmental, condemning voice of the superego. The middle path is that of the adult, possessing both wisdom and compassion. The adult is able to act with restraint to its base desires. Unlike the black and white world of id and superego, the adult sees life in shades of grey. As sister social worker Janice Melland commented in the last post, this higher self can initiate "more thoughtful. nuanced response to incredibly complicated human problems."
Today I talked about the shadow self with a client-- the parts of Self that are pushed down, rejected as unacceptable by Persona. We were discussing how Americans lack a word for the middle path between Selfish and Selfish-- a Door Number Two between being a narcissist and a martyr. I am all about that middle path. I don't want the baby driving the car, but I don't want the sourpuss Senex (archetypal stern, critical and withholding judge) driving either. The baby is the gut-- all instinct and emotion. The negative Senex is Spock-- logic without feeling. Submitting to either involve indulgences or defenses.
When I am in wise mind, I ask myself: What would a grownup do? If I can get there, I can listen to both my gut and my head-- at the place they interlap and inform. And choose Right Action, a place I can stand with integrity. It ain't easy, but it feels and works much better than letting Baby drive that car.
Last night I was doing my geek thing, surfing weather blogs. I wanted to see what meteorologist Jeff Masters, founder ofWunderground.com, had to say about the spate of terrible and unusual April tornadoes that had resulted in enormous destruction across several states. I'd had a cancellation the week before, just as major storms were breaking out in the southern states. It was horrifying to watch the biggest tornado I'd ever virtually seen form before my eyes on a chaser site (severestudios.com)-- a monster storm poised right on top of Tuscaloosa. Hours later my father and I watched the same tornado come into Birmingham. We were seeing what was clearly at least an F4, and knew that meant many lives would be lost. Instead of the usual post-storm deconstruction, there was weird chatter about something big about to break on U.S. news. No one knew yet what it was-- something involving Obama, the CIA-- but even before it broke, people were guessing it was Bin Laden. And it was. It leaked before the official presidential announcement. And on the news channel, people, mostly young, crowded the Capitol Hill mall, waving flags, screaming and shouting in celebration at the news of Bin Laden's assassination. It was a happy party scene. If the sound or subtitling was off, you might have mistaken it for an enthusiastic crowd at a rock concert. Meanwhile, back in my little burg, recently named the safest US city from natural disaster, and just a few years after being named the safest town from crime, the headlines were focusing on a different story. A young man had stabbed his one year old baby and the baby's mother, killing both. The 20 year old had come here as an exchange student as a teen. During his stay he fell in love with a local girl. They were good students, and after graduation began studies at a local college. By all accounts the two were shining lights--- loved, gentle, loving. When she unexpectedly became pregnant, both appeared to devote themselves to the task of bearing and raising their child. And the community surrounded them with support. But there were apparently problems in the relationship. According to local news reports, she broke things off a few weeks ago. He became despondent. I don't have inside information. I don't know what despondent felt like for him. But I do know crazy. And by that I mean the twisted kind of thinking one can have when either through genetics or circumstance it feels as if the world has narrowed to one sharp and unbearable point. What I do know from the news is that he decided to kill them all. That he reports thinking they would then all be together in the afterlife. And that he successfully carried out two-thirds of his plan. He called 911 after the slitting of his wrists did not result in his own death. thinking he could get the police to finish what he could not. Something in this boy was broken, and it resulted in much harm. I don't know if what follows will make sense to anyone. But somehow all of this feels linked to me-- the horrific impact of the storms in the South, the celebration of a death of an enemy, and the loss of three (yes three, because there can be no good ending for this young man now) lives for no reason I can begin to understand. And it is the second time in several weeks our community has had to try and fathom how someone everyone believed to be good and loving could commit such atrocities. How is it linked? Because all of these events are tragic, and none have tidy explanation. Because in each I have watched unfolding rushes to judgment from media commenters. In the cases of the tornadoes: multiple writers talked about this being God's judgment. The result of abortion being legal, or tolerance of homosexuality. I have lived in the South, and trust me, if you are looking for the churched and the God-fearing, you are going to find it there. Why on Earth God would pick Alabama to unleash wrath is completely beyond me. Vegas, maybe. But Birmingham? In the case of the young man, there was an ugly flood of racism, rants about immigration (may I remind us that we are a NATION of immigrants?) and immediate calls for the accused to be hung or shot. I understand that people are reacting to the bare facts of the crime, and it is a horrific crime. But I recoil from the early mob mentality, and especially to the calls for more violence. Similarly, while I don't mourn the death of Osama, neither am I inclined to celebrate it. For me, Bin Laden's death is one punctuation mark in a very sad chapter of world history. I don't know that I feel safer. I don't know that it was worth the 5885 American soldiers now dead from the wars in Iraq and Afghanistan. The 100,000 plus civilian deaths in Iraq alone. All I can think is every single one of those dead was someone's baby. Martin Luther King Jr said: "I'm concerned about a better world. I'm concerned about justice; I'm concerned about brotherhood; I'm concerned about truth. And when one is concerned about that, he can never advocate violence. For through violence, you may murder a murderer, but you can't murder murder. Through violence you may murder a liar, but you can't establish truth. Through violence you may murder a hater, but you can't murder hate. Darkness cannot put out darkness; only light can do that." And I do love the soldiers. Those who have been called up and served two, three, four times for a war even some of them don't get. I work with them, with their families, with their injured brains and their daddy/mommy lonesome children and their sleepless nights. And while I admire their bravery, their reality just plain sucks. There is no prettier words I can find. We want easy explanations, simple arithmetic. We want to subscribe to the Just World Theory: that if we are good, good things will happen to us, and that only bad people can do bad things. But life, and especially people, are way more complicated than that. In these last six months it seems I have seen more examples of this than I have in a dozen years. Shit happens, as they say, and it certainly doesn't pick those most deserving. So how do we make sense of it? I'll work on that one another day. In the mean time, listen to Plato: "Be kind, for everyone you meet is fighting a hard battle."
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Recently I mentioned the movie "MicMac" in a post about being different and accepted. That film featured characters with TBI (traumatic brain injury) and PTSD (post-traumatic stress disorder) as well as a few more esoteric and generic variations of the human condition, such as being super short, strong, flexible, mathematical, or mechanical.
That got me thinking of a few other movies about weirdness. No deep detail here: google/bing titles for more. But I've seen 'em and loved 'em, and maybe you will too. Mostly these are quirky comedies. There's enough suffering in the real world. And since everyone is different, each person's experience with a particular difference will also be (did you follow that?) Still, these movies can be great teaching tools for increasing understanding and acceptance of mental illness and other sorts of personal diversity.
Harold and Maude (1971): A morbidly depressed young man falls in love with a REALLY older woman. A wonderful treatise on life, love and living in the moment with a great soundtrack by Cat Stevens. This film has been a cult classic for decades.
What About Bob? (1991): An uptight psychiatrist is driven crazy, then healed by an intrusive, needy patient. With Richard Dreyfuss and Bill Murray.
Bennie and Joon (1993): Johnny Depp plays a man with social limitations who falls in love with a young woman with a schizoaffective (mood/psychotic) illness.
Amelie' (French, subtitled; 2001): Audrey Tautou is luminous as a creative oddball full of innocence; she takes joy in the smallest of life's wonders.
Lars and The Real Girl (2007): Touching Canadian film about a very socially awkward man who falls in love with a life-size rubber doll. Sounds lurid, but in fact is a tender tale about acceptance and the power of community.
The Fisher King (1991): An angry, suicidal man (Jeff Bridges) meets a joyful transient with a psychotic disorder (Robin Williams, who later falls in love with a very socially awkward woman played brilliantly by Amanda Plummer).
It's Kind of a Funny Story (2010): Various mental health issues are illustrated, including bipolar disorder, depression, and cutting. A teen checks himself into a mental hospital for treatment of his depression. Tiny revelations ensue.
A handful of others: As Good as it Gets (1997): OCD, extreme crankiness (Jack Nicholson). Little Miss Sunshine (2006): Depression, suicide attempt, color blindness, family-as-bowling-ally-in-your-head, general eccentricity Forest Gump (1994): (Tom Hanks) mental retardation/developmental disability. Garden State (2004): Depression, family and identity issues. Great soundtrack! Rain Man (1988): A young man cares for his autistic brother (Tom Cruise, Dustin Hoffman). Transamerica (2005): Transsexualism, depression, teen with major family issues (abuse/neglect). Matilda (1996): A gifted "genetic sport doesn't fit in with her couch potato parents.
OK, there's the tip of that iceberg. Feel free to send me your favorites.
Jana
As much as we are connected and similar, there are a million ways to be different. In fact, no two humans are genetically the same. Even "identical" twins will show subtle variations in their genes due to minor spontaneous mutations occurring during gestation. That's in our specie's overall interest -- some of those variations will work better in a particular current environment. Authors Barbara Kingsolver (Animal, Vegetable, Miracle) and Michael Pollen ("The Botany of Desire") illustrate how well this works in the plant kingdom. Corn and apples produce enough seeds within one generation that some will make their way regardless if the upcoming growing season is colder, warmer, wetter, drier, shorter or longer.
With weirdness (*I use this term very affectionately), the different may be genetic sports, a nicer word for "mutants". They are the quiet one in a family of extroverts, the athlete in a family of couch potatoes, the artist in the family of engineers. Or the weirdness may be contained in a gene that is passed in degrees of strength throughout some members of the family, as case of red hair. Don't think that's weird? It's the rarest hair color-- found in only 1-2% of the world's population. And much of what we use to think of as personality variations are actually pretty well cemented in genetics, including tendencies toward depression, anxiety and resiliency.
Knowing and understanding that most people don't exactly freely choose to be/think/behave as they do can go a long way toward relaxing our attitudes towards them. You can stretch this one as far as you like, depending on your belief system. We don't get a choice about being tall or short, born here or in a third world country, to rich or poor or a single or unhappy parent. The most useful advice might be to remember you don't get to choose the hand you're dealt, but you can choose how to play it.
Or like the guy in this video-- maybe someday you'll meet someone who not only gets you, but helps you figure out how to turn that difference into a strength.
weirdo photo of weirdo
statue from weirdo
friend's weirdo home
Don't feel like you exactly fit in? Join the club.
For a country that celebrates individuality and independence, Americans sure have trouble dealing with differences. This culture is market-driven. There's money to be had convincing you that you aren't quite right, but hey, we can fix that if you buy this car, wear this brand, live in this zip code.
Marketing works by preying on common insecurities and the biological need to identify with a group (read: safety in numbers). Even outliers look for their herd. Witness the popularity of "alternative" fashion chains in American malls.
Still, people who are on the edges of bell curves of ability, appearance, gender, creativity and cognitive styles-- to name just a few of our lovely genetic variabilities-- find self-acceptance difficult. The internet helps. Never had an interest in sex, be it bi, straight, gay or otherwise? Googling "asexuality support" brings up over a million resources. Wondering what to serve at your Chinese-Italian wedding in a French speaking province? There's a link for that.
Despite this glut of information, I meet dozens of people a year who feel like no one will understand their crazy intrusive thoughts, the depths of their sadness, why it is so hard for them to organize their day or how it is they feel like a phony after 10 successful years in their field. They feel weird, ashamed and alone. Even if they have heard about other people with the same problem, they are sure theirs is somehow more shameful, more repulsive and that they are more personally responsible for it.
Visible differences present other challenges. While people in the previous examples may worry that everyone knows their difference, if you are biracial, albino, missing a limb, scarred you don't have a choice but to have that difference reflected back to you on a regular basis. Biracial clients tell me that "What ARE you?" is the most tiresome question they hear. " Human," is the response many wind up giving in exasperation.
Persons with physical challenges such as cerebral palsy tell me they get tired of being addressed as if they are retarded, and persons with cognitive challenges such as retardation tell me they get tired of being treated as if they are children. Children tell me they get tired of being treated as if their thoughts and feelings aren't valid. And on and on.
Here's the deal. We ALL have our stuff. Some of it is private, some public. Some of it, like learning differences, depression and OCD is usually invisible to others. Other variables, including physical challenges such as vision impairment and paralysis, are all too obvious and can block out the individuality of their bearers.
And yet under all the labels-- crippled, crazy, queer, whatever-- is a person. A person who reflects, cries, dreams, fears, longs, creates and loves. And if you can't relate to that, well...
You're really different.
I think the reason it's a big deal for some of us is that we are so bombarded with "why can't you just..." "All you have to do is..." and other statements that suggest we should just "be normal," that it is a never-ending reminder that we aren't like "normal" people. And that is a big part of where the depression comes from. We can't "just..." get over it or let it go or whatever "normal" people are able to do. When someone understands that, and accepts us as is, that is the best form of therapy there is. It lets us feel like, even though we may not be "normal," we are legitimate and real and worthy.
Great comment. Especially this line, which bears repeating: When someone understands (us) and accepts us as is, that is the best form of therapy there is.
Normal. Now there's a concept that has caused more than its share of troubles. Let's remember that any distribution of traits will spread, averages-wise, across a bell-shaped curve. Even on the dropping off sides of that curve you are still talking within the range of "normal". And even on those edges, differences may not be significant in the long run. The baby that walks at 9 months (my girls) and those who walk at 16 months (me and my son) are both on the outside of that "normal" middle lump of the curve (10-15 months). Guess what? We were all running at age 2.
We cause so much grief with our desire to categorize. Judgment (as differed from discernment, which is more about wisdom than measurement) makes us feel better or worse than others. Neither of these positions is good for us, decreasing either our compassion or our self-esteem.
I am so glad to live in a generation where we have at least a few positive and culturally visually role models for gay and lesbian youth, persons with physical differences, stay-at-home dads and executive moms, and so on. That wasn't true when I was growing up. The information age can connect persons with the rarests of differences.
But we haven't come far enough. Many of our culture's worst slurs and curses reflect our negativity towards differences in gender, mental and emotional functioning, and sexual orientation. Although we are quick to display pink ribbons in support of sufferers of breast cancer, we remain in enormous denial to the choice aspects of mental dis-ease. We blame the victims. We stigmatize anxiety and depression as personal weaknesses, increasing isolation and shame for those suffering.
It's impossible to truly know another's experience. I remember not getting why an obviously bright student of mine was such a crappy speller and made so many mistakes in his grammar. I didn't get that dyslexia had little to do with other areas of intelligence and thought he was just being stubborn or lazy. I was a great speller back then (don't call me out-- spell checker and years out of school have had their way with me) and figured everyone else could be the same. We often think the world works the same for others as it does for us. Think about color-blindness. No matter how sure you are that there are clear differences in blue and green, someone else's eyes may see no difference there at all. Which of you is "right"? Whose experience is not reality?
In a previous post I talked about an author who described our experiences thus: "It's as if we are all looking at the world through long, thin aluminum tubes, and thinking everyone else, with their own tubes, is seeing the same view". We are born into these tubes. If the only language we've heard is English, of course Chinese is going to sound strange and harsh to our ears the first time we hear it. What we need to figure out is that our language sounds just as foreign to those not speaking it.
We need to expand our vision. The next few posts will talk more about being different in a culture that loves the norm.
"I feel so ashamed." "It's ridiculous I should be so unhappy. Others have it so much worse." "I shouldn't be so weak".
These are common comments in my office made by persons in the throes of depression. Because it is a mood disorder, and because people assume moods have causal links to what's happening in their lives, depression leaves people bewildered when they cannot link the feelings to situational events. Even when they can, the other common depressive ruminations (guilt, hopelessness and helplessness) reinforce a very personal responsibility for the symptoms. "I feel like a burden." "I should be able to handle this." "I'm broken."
These thoughts are symptoms that arise from the disorder.
When one has a fever, one doesn't usually think "I shouldn't be so hot." A person with Type 1 diabetes doesn't tell themselves or their doctor "I really should have my pancreas under better control." But when our brains are screwing up, we take it really personally. We confuse our mind/soul/personality with our brain. And we think we are supposed to be in charge of it.
The brain is an organ; a very complicated one. It interlinks with a intricate endocrine system over which we have little conscious control. That system tells our body such things as "wake up", "be energetic", "get drowsy". In his Feb 2011 New Scientist article "Days of Wonder", Roger Highfield charts the mysteries of the complicated chemical factory that is our human body as it goes about an average day. From the moment we wake up, when perifornical orexin neurons start our day by alerting the sympathetic nervous system to get going, to the time we ready for sleep and the dark triggers a chemical dose of drowsiness to quiet the system, hundreds of complex biological processes are happening. Like Japan's nuclear power plants, there are dozens of redundant mechanisms to prevent the inevitable mishaps from collapsing us. And like Fukushima, sometimes there are enough failures of those mechanisms that there are catastrophic results.
In depression, there is many potential failures (or more benignly, design issues) that can happen. As psychiatrist Jim Phelps explains (buy his book already!), "A big part of depression is a single gene."
A person no more chooses to carry this particular gene than the one for say, hairy knuckles or that one that makes your pee smell funny after you eat asparagus.
Other things that can increase likelihood a person has a depressive episode are as varied as season and latitude,daylight savings time (!), hormonal changes (pregnancy and postpartum, menstrual cycles, and menopause for women), and medication (including some you'd never think of-- even certain antibiotics, such as Cipro). The linked list doesn't include antihistamines, which seem to cause depressive symptoms for me. Every body is different. If you notice you have a consistent negative response to a medication, consider reporting that to the FDA here. These anecdotal reports add up and make a difference if there are enough of them. I remember back in the day it was commonly thought that there was no such thing as a withdrawal syndrome for folks on antidepressants. It wasn't until enough people complained to FDA and doctors that they were having serious issues that guidelines for slow tapering of SSRIs became common.
A more obvious causal relationship can be made for depression in a person who has been through one or a series of traumatic or stressful events. Even then, it is likely the physical response of the body's bombardment with stress chemicals that explains the lethargy, mental fogginess and emotional reactivity of severe depression, not just the psychological effects.
How can you mediate the body's reaction to these difficulties? There are a few straight-forward paths to wellness, whether your symptoms are aches of the physical or psyche:
Practice good sleep/wake habits to support the endocrine system's ability to do its complex job.
Minimize late night light and get a reasonable amount of daily fresh air and sunshine.
Eat well: adequate nutrition is essential for good mental health.
Exercise is neurogenerative. There are dozens of studies showing its benefit to mental well-being.
Social connection is very predictive of happiness. Depression encourages withdrawal. While reflection is good to a point, don't isolate. Find ways to increase community. If you are too shy or depressed to go out, at least go online, and find a support group/chat where you can connect with others.
Count your blessings. Pay attention to what is going well in your life and keeping a journal of gratitudes.
Address the unproductive inner focus by finding ways of being in service.
Find and practice ways of giving your life meaning.
Develop a spiritual discipline that supports compassion to self and others.
Learn to recognize depressive cognition (thoughts) as symptoms rather than reality.
Minimize your exposure to avoidable stresses as you would to secondary smoke.
When stress is unavoidable, learn ways to decrease its impact through Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, meditation, prayer, focused distraction, creativity or other means.
As always, click on highlighted links for more information.
Friday a week ago I listened in sad silence to storyteller Alton Takiyama-Chung tell of Japanese Americans interred by our government during the war. A week later I was surfing the internet following a lecture at university, checking up some references given by the speaker. During the lecture I had noticed the screen shaking a few times, and wondered if the time if we'd had a small tremblor. I remembered this as I was online and hit my bookmark for the USGS earthquake map. It showed a massive 8.9 quake had just hit Japan.
At first I thought the site had been hacked. Earthquake magnitudes are measured on the Richter scale, in which every 1 point value represents an increase of 10 times the amount of energy. Michigan Tech's site for young seismographers gives this simple explanation: "Think of it in terms of the energy released by explosives: a magnitude 1 seismic wave releases as much energy as blowing up 6 ounces of TNT. A magnitude 8 earthquake releases as much energy as detonating 6 million tons of TNT." I'm thinking it must be hoax. An 8.9 earthquake would be 700 times more powerful than the one that hit Haiti.
I switched to BBC, and watched in horror as the events of the earthquake and ensuing tsunami unfolded. Unlike technologically poor Haiti, coverage of the destruction was immediate. Hundreds of videos of the quake and the wave were posted, some as they were happening. I couldn't turn away. For hours.
I wrote an immediate email to the two Japanese highschoolers we had hosted from Tokyo a couple of years before. I was relieved to get a response from Yasu a few hours later:
Good evening.
I’m sorry for delaying in my mail.
Damage in my country is more awful.
However, I do not have the problem.
Please relieve.
I was in the school during the earthquake.
So, I came home walking from there for three time.
But, the house is far and there is a friend who stayed at the school,too.
Thank you for worrying.
I want to meet again.
The next day, all the way here in America, one of Oregon's own was washed out to sea photographing the wave's arrival from Japan.
For Whom the Bell Tolls
No man is an island,
Entire of itself.
Each is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manner of thine own
Or of thine friend's were.
Each man's death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.
--John Donne
We are all connected. No matter how different we seem or pretend to be, we connect in our ability to suffer and to care. We are here to be here, to love and ease the paths of others and give meaning to our birth and life.
It is heartening to see the governments of China and Russia-- no friends, historically, to Japan-- sending relief and rescue crews to the stricken country. Our own country, less than three generations ago locking up its citizens of Japanese heritage, is providing assistance and support in many ways. We all live on one planet. We are more alike than different.
You can help. Donate to relief agencies such as AmeriCorps or Doctors Without Borders. Check out CharityNavigator.Org to find reputable sites. Make your dollar count: those cell phone donations cost more and take up to three months to process, since the agencies have to wait on the money from your paid bill. Pay by check or directly by credit card to the agency. Even a few dollars can make a difference.
Here's a video of Alton Chung performing a few minutes of his poignant story of a Japanese American soldier during WWII.
I received a note from a reader this week:
"As someone who suffers from anxiety/panic and the resultant depression that goes along with those, I find it very frustrating that therapists, and even psychiatrists, really don't understand what this is like. I mean, yeah, they understand it academically, but not from having the actual experience. What do you think about this?"
What I think is that it can be very frustrating to feel your experience of reality is being questioned by someone else who doesn't get it. But I'd add that if I had been through everything all my clients have been through-- cancer, horrific abuse, war trauma, loss of a limb or ability to walk or everything I owned in a house fire for just a few-- I don't know that I would be able to practice. On the other hand, I've been through some things. And I think most people with some compassion and insight know what it feels like to be scared, hopeless, furious, or any of those other intense emotions. They might not know exactly what it feels like to have a panic attack, just like your physician may not know what it feels like to have a heart attack. But they've seen plenty. They should still be able to treat you effectively. I don't mean that to sound snarky. I think it helps a lot to talk to someone who has been through your particular experience, just to know more certainly that you're not alone in what you are experiencing. That's why I often refer clients to peer support groups or give them articles from people who've been there.
The best practitioners I know fall somewhere in the range of "the wounded healer", as Jung calls it. They've been through enough hardship to understand that life isn't all roses. They've seen and felt suffering on a level to take it seriously. They can relate, if not to your specific dilemma, to the suffering it causes. Suffering is inevitable if you live long enough. I don't think they need to have directly experienced a particular symptom to understand the effects it can have on you or how to help you address it.
That aside, I remember with big chagrin being a young, childless family therapist and telling people with authority how to handle their kids or marriages. I remember at 25 becoming frustrated with a patient addicted to anxiolytics (medication for relief of anxiety) and telling him he really didn't have a thing to be anxious about, beings as he was not doing diddly squat with his life. For me, getting some more life experience was humbling and helpful. The older I get, the less black and white my thinking becomes-- and thank goodness. I still think I was helpful, most of the time. I also think at times I was a more than a little clueless. I appreciate the clients who called me out, saying, "I don't think you are really getting this." I appreciate the varieties of human experience, and the gift my practice gives me of having more of them vicariously than any one life could hold. Each year I feel my heart expanding in compassion, and "that little aluminum tube through which we all look at the world, thinking all others are seeing the same scene through their tube", enlarging.
Bottom line: if you don't think your therapist gets you, tell them. Be ready to own your own shist, so to speak. We are, in other wise words of Jung, "dirty little projectors", often unconsciously foisting our own shame and defensiveness onto the other. Look clearly at that first. Be curious and open to information as well as clear as you can be of your experience and your interpretations of it. Be willing to let go of your assumptions if they really aren't in line with your caregiver's intention. Give it a little time to see if maybe you are just dealing with vestiges of resistance. Even bad habits are afraid of dying.
If after honest conversation, reflection, deep listening for understanding and curious compassion you feel unheard, disrespected or just plain mis-matched, remember this is your nickel. You can vote with your feet. You can and should discuss your reasoning and even ask for a referral to someone that could be a better fit.
Nobody can be everybody's everything (and if say they are, run). I don't make it with all my clients. Earlier in my career I saw this as a big failure. But then I read a passage in a book on the Zen of Falling in Love that shifted things for me. It was something along the line of, "you may have chosen a perfectly outstanding apple, with stellar apple qualities. But if you want a pear, you're not going get what you what." Now you have to choose-- learn to deal with pear-ness, or go out and find an apple. There are deficits, benefits and chances for growth both ways.
But if you feel humiliated, harassed, dismissed-- and you've discussed this to no positive outcome-- ask for a referral or ask others you trust. Finding a good therapist isn't much different from finding a perfect pair of jeans or shoes. You might have to shop around and try a few before you find what really works for you.
Like most therapists, I have been in therapy. Sometimes for a few short sessions for a tune-up or problem solving, and sometimes for longer when I needed to dig to get at some perspective or to process something heavy. I have met with perfectly delightful clinicians who frankly were not what I needed at the time. Sometimes I needed a handholder and got an asskicker; sometimes the opposite. I like very active therapy, and the smile-nod-how-does-that-make-you-feel sessions make me feel crazy. Maybe that would have been a good thing if I'd stuck around longer to find out, but at my age I have some clear ideas of what helps and what doesn't, and I can get close to that level of feedback from my cat. We all have our preferences.
On the other side of the couch, I may move way too fast and feel aggressive to a client who wants much slower, gentler and contemplative experience. It's not a bad way to work; but it isn't the way I work. In such circumstance, I may suggest they'd find the therapy experience more comfortable and valuable with someone who practices in a different way. When I refer out like that, it isn't a rejection of the client. I am truly hoping to find a better match so progress can be made. I have to get my ego out the door and do what's best for a unique individual.
The take home, as they say, is "know thyself." This includes knowing your strengths and preferences and warts and defensiveness. Bring your whole self into the office. Ask for what you need . You still may not get it, but it sure as heck improves the chances. And speaking only for myself, I love it when clients throw me a little education about their diagnosis, recent research on it, and area resources. I do my best to keep up, but as a generalist, there's no way I'm going to know everything.
Thanks for the thought-provoking comment. Hope to see more of these inquires as we continue muddling through the middle path.
PART ONE: CHANGING YOUR FOCUS
Remember losing a tooth when you were a kid? How you could hardly leave that hole it left alone? How big it felt, how you couldn't stop fiddling with it and poking the space where the tooth used to be with your tongue or finger? Maybe for a while it drove you crazy. Maybe for a while it was all you could think about.
And then after a while, you forgot about it.
OK, depression is not much like losing a tooth. The link here is the idea that when you pay a lot of attention to something, it occupies a lot of space in your mind.
You know those cartoons where someone stubs his toe so he bites his thumb? It doesn't make much sense that adding pain could subtract from it. But what's effective isn't the addition of a new pain, it's the distraction from the original one. When we use a focused distraction, it's not that the pain isn't real. It's that we are choosing to focus our minds and energies elsewhere. This is part of the thinking behind all that complicated breathing they teach in Lamaze to control pain during childbirth. There's some neuroscience and other physiology there too, but the simple part is: it's hard to pay as much attention to pain when you are trying to remember all those patterns to the choo-choo breathes.
In the quirky and beautiful French film MicMacs, protagonist Bazil deals with his depression and PTSD by reciting obscure history facts to himself when triggered. He's practicing a form of Cognitive Behavioral Therapy. As the name implies, CBT aims to change thinking and actions from nonproductive or destructive patterns to those that support health.
When we are depressed, we ruminate-- obsessively mull over negative thoughts. The original thoughts are spontaneous; we can't control them. But by repeating them over and over in our mind we create neural bridges that strengthen them. What we hear over and over (even from our own in-the-moment-distorted minds) seems believable. At minimum, we wear a groove that we can now slide more easily down. If you've ever studied music, think of it like chords or scales. No one is born knowing how to play a C chord. You learn it, and at first you have to think about it. On the piano, C E G: white keys, each with a black between them. If you've practiced them often enough, you can form the chord with your fingers even if the instrument is nowhere in sight. If you now pretend to play a D chord, you know that middle finger moves up, to hit the black note in the middle of the chord. You don't really even have to think about it. After a while it becomes automatic.
Thoughts can be like this too. We have a spontaneous thought, such as "Life sucks." Let's say we don't know exactly why we are thinking it. If we start ruminating about it, being the problem-solving and pattern seeking people we are, we can probably come up with some evidence to support the thought. Because we are sorting for supportive evidence, we disregard or fail to look for exceptions to the thought. After a while, the evidence we've selected comes easier to the fore. After a longer while, it comes automatically. And because it is so present, so pervasive...
We believe it.
One way to deal with depression is to question the thoughts and the narrative we use to support them. As mentioned in a previous blog on Obsessive Compulsive Disorder, everyone has crazy thoughts. The difference in folks with OCD is they pay attention to them. Say you are driving down the street and you think, out of nowhere, "I could serve my car into that oncoming semi." Who knows where that thought came from? Maybe you saw a movie where it happened, or heard a news story, or maybe you just had a random "brain fart." Most people who have that thought might be momentarily disturbed. They think, "Where did that come from?" But the next minute they resume thinking about the burrito they are off to get, or singing along to the radio. People with OCD have a different reaction. They think, "How could I think that? What sort of monster am I? Does that mean I want to do that? What if I DID do that? What if I can't control wanting to do that?" They go over and over the scenario. Maybe eventually they can't even drive, because they are afraid of having the thoughts or of acting on them.
In depression, minds can get sticky in a similar way. Our task is not to control the original thought, but our responses to them. We can do this in many ways. Focused distraction-- intentionally turning the mind to something else-- is one. Singing, paying attention to sensory detail, doing math-- it hardly matters what it is as long as it's a less harming thought. See Managing the Monkey Mind for more on this.
As AA says, it's simple, but not easy. Just like scales, learning a new skill takes time and lots and lots of practice. If you have depression, you've had lots of practice in negative thinking and narratives that support why you feel so crappy. And as noted in the last post, it's not that you aren't really feeling that crappy. The point is the way you are addressing it can change, and that change can do you good.
CBT has been found to be as effective as antidepressants in alleviating depression. Other CBT interventions and more on how it works coming up-- stay tuned!
Meanwhile, here's a positive thinking song from Gloria Gaynor: dance it out.
If you are one of the rare few that hasn't had at least a two-week case of the blues, it can be hard to fathom what it's like to be in the maw of what Churchill called his "Black Dog"-- a companion both familiar and dangerous.
Depression comes in all shapes and sizes. There's dysthymia, a sort of a profound negativity and sour or melancholy disposition that's hung on for two years or more. There's major depression, which can oddly enough be mild to severe, and in the latter form be accompanied by psychosis. In kids, the chief symptom of depression can be irritability. There's cyclothymia/bipolar two ("soft" bipolar) in which low moods alternate with normal or expanded ones. Then there's Bipolar One-- what used to be called Manic-Depression, in which the highs can be WAY more damaging, accompanied as they often are with delusions of grandeur, paranoia, and really out of character behavior. Read the last few days' infotainment news to see examples of a current celebrity demonstrating many of those symptoms. (Note: you can't diagnose based on news reports. Said celeb may also be showing symptoms of heavy amphetamine use or even a brain/thyroid tumor. But's he's doing a bang up job of illustrating the non-stop energy and grandiosity of someone in the throes of a manic illness).
The chief features of garden variety depression are the low moods, cognitive cloudiness, ruminations and withdrawal from activity. Depression is a biological illness, not just a "thinking" problem. (Don't forget-- your brain is IN your body). Stomach issues are very common-- did you know your stomach is a second brain? Other aches and pains increase as well. Some of this may be strictly physiological, but some of it is an offshoot of the cognitive changes that occur when we are depressed, specifically ruminating thoughts.
Rumination means focusing too much on distress, its causes and its consequences. Marni Jackson's book, "Pain: The Fifth Vital Sign," gives a vivid example. The author is happily biking down a country path, enjoying the sun, the company, the ride, when she feels something hit her mouth. Suddenly her world temporarily collapses into a very small place: she's been stung by a bee, and she's no longer thinking about the beautiful day, her family, the bike ride. She's in pain, and that's all there is in the world for a time.
Depression is often like that. A pain so intense, so overwhelming that it knocks the importance of everything else out. Alternately, it can be a numbness that completely blocks the possibility of feeling joy. In either case, the depressed mind mulls over and over the pain or numbness, searching for reasons and filling in the narrative with explanations of deservedness, hopelessness. helplessness-- the cognitive triad mentioned in the last post.
While loss and tragic circumstance can lead to depression, they aren't necessary as explanations. Brilliant, beautiful, gifted and successful people suffer along with and sometimes as much as those who've been beset by real-life horrors. Sometimes that can make it even harder. "Why are you so miserable? You have a wonderful (fill in the blank: spouse/career/job/family/life)". Such statements are no more helpful than telling an amputee that s/he shouldn't have pain in an absent limb. It doesn't matter whether it looks like there's a reason-- the pain is very real. Blaming one for feeling it only makes it worse, adding guilt to the burden.
But like the amputee, the migraine sufferer or the victim of losses, intense focus on the pain does nothing helpful either. One must find that strange balance between denial and indulgence-- acknowledging the pain, addressing it where possible, and bringing focused attention to something besides its insidious, hypnotic insistance that it is all that exists or matters. Remembering that acceptance is not the same as approval, we can work on being a compassionate witness to our emotional state instead of consumed by it,
Next blog: cognitive approaches to managing depression.
Depression. The Black Dog. The Emotional Flu. The Blues.
Along with anxiety, mood issues are a major source of discomfort for folks with the Troublesome Trifecta: Big Feelings, Big Radar and Big Processers.
Depression is nothing new and, at least in its more common appearance, nothing rare. Most people will go through periods of sadness in their lives when energy and concentration lags, thinking is cloudy, and the future looks dim. It's normal following the loss of a loved one, illness, catastrophe or other sorts of regular life hardship. Time and emotional support will usually be enough to address these dips into dark places. Jungians say aspects of depression can be a strange sort of gift: the slowing down, withdrawing and going into one's thoughts can offer opportunity for rest and reflection. Depression can be Psyche's way of expressing dissatisfaction with Ego's choices and a chance to think about what soul truly needs.
What's known in the biz as "clinical depression" is another matter. This sort of emotional upheaval is so intrusive and persistent that the sufferer's life is affected in multiple ways. Work, relationships and physical health are disrupted. Levels can vary from mildly incapacitating to life-threatening, and the sadness may be recurrent, with periods of remission and relapse. There appears to be a strong genetic component. In families with histories of mood disorder there may be generations of substance abuse: perhaps markers of attempts at self-medication.
Symptoms of clinical depression as listed in the DSM-IV include sadness (you knew that one, right?), loss of interest in previously pleasurable activities, sleep disturbance (too much/little), fatigue both physical and mental, clouded thinking and inability to make a decision, weight changes (loss of appetite is usually more significant than gain), thoughts about death and suicide, and the triple-threat-thoughts of helplessness, hopelessness and guilt. Again, most everyone has some of these, some of the time, for a bit. But for persons with clinical depression the symptoms persist, aren't necessarily related to anything happening in the outside world, and interrupt functioning on one or more levels.
The thinking can be the worst part. Depressive thinking feels Very Big, Very True, and it's a liar. It says: You're worthless. You've always felt this bad. You'll always feel this bad. You're a burden. The worst outcome of the lies of depression is suicide. Depression can be a fatal disease.
In Japan, the colloquialism for depression is "kokuro no kaze", which translates roughly to "when the soul has a cold." Prior to a major marketing campaign by big pharma, depression wasn't much discussed in Japan, but the idea that one's soul could feel weak, leaky and lousy resonated with a lot of people. Likening it to physical ailment rather than a character defect lessened the societal stigma, and inquiries to the medical profession about how one could address depressive symptoms immediately and dramatically increased, as did sales of antidepressant drugs.
In the US, antidepressants are at the top of the list for most prescribed drugs; some studies say nearly 10% of the US adult population currently take them. Ads for antidepressant therapies are ubiquitious. You can't flip through five pages of most pop magazines without seeing dramatic before and after pictures of hapless, then happy souls. The symptoms described in some ads are general enough that most anyone could relate on a bad Monday. Such campaigns have inspired numerous parodies. Click here to see one from the satire newsmag The Onion. Reprinted as fact in a few web sources, it was apparently so close to actual ads that outraged readers couldn't tell it was in jest. I want to be clear: antidepressants have made a significant and positive difference for many persons with depression. There are also concerns about their overuse, effectiveness,side effects and limitations. Medication is one approach to treatment of depression; we'll talk about that and other interventions in a future blog.
There are many authors who believe the high rate of medical intervention for depression is a result of overpathologizing these unavoidable life events. I think it's a little more complicated than that. Changes in American life, from technological and environmental to social, may all play a part in rising reports of depression. Probable suspects are abundant. Artificial light and poor wake/sleep cycles (not to mention environmental contaminants) mess with our hormonal systems. As a nation, we eat a lot but are often poorly nourished. We are too busy and we are much too stressed. We don't sweat enough to work out all those fight-or-flight chemicals our brains pump out to deal with those stressors. And we don't have nearly the social supports we had before we all moved so often, worked so much, and dropped out of networks (churches, clubs, coffee circles) where we could ask for and get support.
Psychiatrist Jim Phelps, a specialist in mood disorders, has been mentioned several times in my blog for good reason. If you want a lot of great information on depression, its causes and treatments, check out his website or order his book Why Am I Still Depressed?. He takes very complicated information on the genetics, neurology and treatment of mood disorders and makes it understandable and interesting. You'll notice he talks a lot about Bipolar disorder. Don't let that scare you. Dr. Phelps makes a convincing argument (supported by leading researchers in the field) that most depressions are part of a spectrum of mood issues called "soft" Bipolar or Bipolar II, where periods of low mood are accompanied or interspersed with anxiety, irritability and other symptoms. His site includes information on medical, therapy and lifestyle treatments with known positive benefits for addressing the symptoms and causes of depression.
The most important thing to know: depression is real. It's a full-body illness, with physical, social, cognitive and emotional effects. It is treatable and recovery happens. Don't let it run you. The WHO commissioned the video below. Share it with others, and pass the word that the Black Dog doesn't have to have the last word.
Admittedly, one woman's wonder is another's horror. After a few grumbling hours spent trying to subdue the invasives from my garden, I came upon a bursting mound of baby orb weavers. They delighted me (see photo right); my companion at the time was decidedly less pleased.
