Monday, December 27, 2010

Proceed as the Way Opens

Proceed as the way opens.  It's an old Quaker saying.  People in the mental health community, particularly caregivers, tend to spend a lot of time banging their heads against stone walls.  Recently, this old Quaker proverb has come at me again and again.  This kind of synchronicity is always a sign to me that God is trying to send a message.  So I am trying to force results a little less and follow an emerging path much more. 

Reflection is necessary to attain the discernment to do this, often accompanied by journaling.  Running your thoughts past a wise friend and Biblical guidance also are needed, especially when it looks as if you are about to make major life changes.

A while back,  I wrote down a list of five questions to ask myself daily to see how the way is unfolding.  Unfortunately, I didn't write down the source. This is not original to me, and, if you recognize it, let me know who came up with it. The five questions are:

  1. Where in this day did I feel the presence of God working in my life and in the world?
  2. What in this day seemed like it was a part of my leading?
  3. What made me believe that?
  4. How does that leading fit into my personal and spiritual life?
  5. What did I do today to feed my spirit or move me ahead on my spiritual journey? 
 See you on the way!

Friday, December 24, 2010

Are we there yet? Not hardly

So where are we in dealing with mental health and brain-based illnesses as we enter the 11th year of the 21st century? Pretty far from good, in my opinion.

The best single summary from 2010 is "Within Our Reach: Ending the Mental Health Crisis" by Rosalynn Carter, who has been a blessing to those with mental illnesses for 35 years. After giving some chilling facts about the number of mentally ill people in prison (40 percent of people with serious mental illness end up in contact with law enforcement and the justice system at some point) and what happened to the stabilized mentally ill after Katrina when they could not get their medicine (can you even imagine?), she ends with hope: research and recovery. Here's Rosalynn Carter talking more about this.

The National Institute of Mental Health reports that 95% of what we know about the brain was discovered in the past 20 years. Hopes for a single-shot cure for some of the illnesses have deteriorated in recent years, but the research is pointing the way, especially toward early discovery and intervention to prevent the most severe brain damage.

In that light, the journal Biological Psychiatry has reported that simple brain scans can help to predict the onset of schizophrenia in people ages 16 to 25 who have no symptoms but do have a family history of the disease. Schizophrenia, which affects 1 of every 100 people, is associated with a dramatic reduction in brain tissue. Everyone has brain tissue shrinkage beginning in early adulthood. (Surprise!) But the people who will eventually get schizophrenia have this shrinkage at an accelerated rate, concentrated in the parts of the brain that control personality, decision-making and social behavior.  More about this is found here.

So, if you or your children are at risk of schizophrenia, you apparently can now find out whether it is en route. (Frankly, I'm not real sure that I'd want to know.)  On the positive side, early knowledge can lead to early intervention . Young people who are treated immediately during their first psychotic episode generally respond and some never become ill again.  The longer it goes, the worse it gets, evidently. So, on that cheery note ...

Rosalynn Carter closes her book by talking about the true needs of the mentally ill: a home, a job, a friend and the respect due them as human beings who have, through no fault of their own, a serious illness. These things bring, to borrow a phrase, the audacity of hope. With this, people with mental illness can participate in their own recovery. Hopefully we won't have to wait until the 22nd century to see it happen.

Sunday, December 12, 2010

Advent Reflections: Learning Patience

Leaping into the Christmas spirit ... sometimes even before the Thanksgiving meal ... robs the soul of Advent, the season of waiting. This is a particularly appropriate time for those of us who take care of people with schizophrenia and other disabilities. We are learning patience the hard way.

Wikipedia says patience is studied as a "decision-making problem," both in evolutionary psychology and cognitive neuroscience.  Do you get your small reward in a short time or hold on to get your bigger reward after a longer time? To me, patience is what you develop when there may not be any  reward at all. At least in this lifetime.

If you believe, as I do, that the purpose of suffering is to make you more like Christ ... then you look at the lessons of waiting in this Advent for signposts of how to grow. Clearly my tendencies to sarcasm and snarky remarks are not part of the improvement plan. I am not at my best in Advent.

One of my Advent books is "Living in Joyful Hope" by Suzanne M. Lewis. She remind us early on in her wonderful meditations that Advent began when God was "not confined by limited possibility" and sent an angel to speak with an impoverished young woman in backwoods town.  The angel's message was of a miracle that would involve, in the end, terrible suffering.

We don't know why things happen. We don't know why some people get well, sometimes miraculously, and others do not.  We do know, as I am frequently reminded in my prayers, that not one single prayer, not one act of love, goes wasted. This Advent, again, we are waiting.

And the miracles do come. We were nearly killed last night when my husband pulled out of the church parking lot in front of an oncoming car. I'm still not sure how the car missed us. And a message that a healing would take place turned out to be for my husband and me, rather than for our children. Much appreciated, but I still want the children healed.

So we are waiting.  In joyful hope, as much as possible.

Sunday, December 5, 2010

Dialectical Behavior Therapy: One Earth-Shattering Crisis at a Time

"Just take it one gigantic earth-shattering crisis at a time."

- A plaque in our bedroom

As we recover from yet another crisis at our house, my husband and I are practicing mindfulness. You know: Stay in the moment. You are OK right now. Breathe in, breathe out, move on, as Jimmy Buffett suggests in one of my favorite songs. Adding mindfulness to our toolbox of coping skills has been a blessing, and it's certainly been supported by our centering prayer practice and the gifts of recovery.

What I didn't realize until now is that mindfulness is also a very important component in a useful new therapy for people with bipolar disorder, borderline personality disorder and other conditions that result in dealing with very intense emotions. The therapy is called Dialectical Behavior Therapy. I'm reading a workbook about it ... basically because I bought it for someone else who doesn't want to read it. (Yes, I am caregiver in recovery for co-dependency. Why do you ask?)

"Don't Let Your Emotions Run Your Life: How Dialectical Behavior Therapy Can Put You in Control" by Scott E. Spradlin is a solid self-help workbook. My friends who are psychiatrists and therapists would be sure to point out that a workbook does not therapy make. But it's still interesting to me that observing and describing emotions in a nonjudgmental (i.e. without self-loathing) manner can help people who are predisposed to be overwhelmed by them.

The workbook urges us to let go of worry thoughts and "shoulds/musts/have tos." Just notice the thoughts and the feelings. Then focus on one activity, thought and feeling at a time. It says, "Do you best to handle the things that come your way, using your skills wisely and giving each activity your best shot."

That's good advice not only for people whose strong emotions tend to envelope them in crises, but for those who find themselves repeatedly cleaning up after them.