The Art of Derangement

One of the discoveries in psychiatric treatment these days seems to be that artistic endeavors help us get sane.

Hell, I could have told them that.

I discovered long ago that art – in my case in the form of writing – is one of the few places on the planet that has room for unusual thinking. There is praise for being original, even if original isn’t always beautiful. I discovered decades ago that in certain artistic circles there is even a certain cachet to mental illness, since it guarantees that your points of view will not be run of the mill, and may help give others a new slant on old issues.

Of course, art is good therapy, or there wouldn’t be sand trays, drama therapy, music therapy, art therapy, at hospitals and clinics all over the nation. But it seems these days that artistic expression is also coming into its own as a way for the mentally ill to come back to themselves and connect back to mainstream reality.

Look for instance at PeaceLove Studios in Providence, Rhode Island. The founder of PeaceLove, Jeffrey Sparr, has Obsessive Compulsive Disorder and discovered to his delight that when he painted, he had no symptoms. Now he runs a series of studios and community classes dedicated to connecting people through original art. Check them out at http://www.peacelovestudios.com/about. I guarantee you will find it heartwarming and hopeful.

Closer to home for me here in California is the Peer Recovery Art Project, which operates out of Modesto. The P.R.A.P. exhibits artwork every third Thursday  at the downtown Modesto Art Walks, puts out a monthly newsletter called Renaissance, holds art exhibits at no cost to the artists, and received the 2010 Stanislaus Arts Council Excellence in Arts Award. It is described as “an art collaborative in which some of the artists may have lived experience as mental health consumers and their art may reflect that experience but the emphasis is on respect of the art,” says CEO John Black. One of the purposes of the group is to help end stigma, which is a nice thing to be doing while you enjoy yourself creating. This 501 C (3) public charity group can be found at www.peerrecoveryartproject.org, or email them at peerrecoveryart@yahoo.com, or call (209)985-0467.

And if your art is not visual but literary, you might consider submitting work for publication to Open Minds Quarterly, in Canada, or their offshoot online, The Writer’s Circle (both projects of the Northern Initiative for Social Action). They accept work from persons with psychiatric diagnoses, although all the work need not be about psychiatric topics, and have an Artists’ Loft that produces the artwork for the 8 ½ x 11” glossy magazine. Recent projects include a poetry page and a photography contest. Open Minds Quarterly has its own Facebook page, if that’s your cup of tea, or check them out at: http://nisa.on.ca/index.php?option=content&task=category&sectionid=3&id=11&Itemid=30.  You can email them at openminds@nisa.on.ca.

In California, you can probably can do a lot worse to connect yourself to art than by visiting NAMI’s site for “consumer” (that means those of us with a diagnosis) programs, to see what else is going on, not just with art but with all of their fine services. You can find them at www.namicaconsumerprograms.wordpress.com.

Meanwhile, don’t wait for anybody. Just dig out that old jar of playdough and have some fun. What could it possibly hurt? And it might help. A lot.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She has also published two romantic comedies. All three books are available on Amazon.com, Barnes and Noble.com, Kindle Editions, iBooks, and other major vendors or  you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net.

Who's Doing the Driving; Conclusion

This is the final part of a series I started some time ago about how to regain some control of your own mind. This edition is about emotions.

Emotions are important. I’m not going to say they aren’t. They help us decide what we care about, what our values are, how to weigh the relative importance of events around us.

But if we have a mood disorder, we need to understand that our emotions are not reliable guides. We need to really get it at a GUT LEVEL that emotions are actually chemical responses. They are not “you” any more than the little naggy voice in the back of your head is “you,” and if you have a mood disorder they will mislead you 90% of the time. Emotions are generated in various brain structures (the amygdala is the one I remember) in response to certain stimuli. The amygdala sets up chemicals that produce fear in situations it deems bad for survival. These responses are set in us very young. They are strong and reasonless, and they do not mature as we grow older. Emotional pain is just as strong at 35 as it was at 3. Fear is just as scary. The only difference is that through socializing and other learning, we have developed the capacity to run those feelings by other parts of our brains, analyze them, and choose an appropriate response. It may feel like it’s happening instantaneously and without our will, but there is a process, that can be interrupted.

The difficulty with mood disorders is that our brains were set on OVERKILL, sometimes at a very early age (that setting can be adjusted somewhat by the right medicines, but it’s rarely a complete solution). Think of it as having your stereo locked in at a very high volume. The emotions are so big, and so loud, it is hard to notice anything else.  For instance, with an anxiety disorder, just about all the incoming data gets labeled as “dangerous,” and the chemical response of fear gets slapped on almost everything that happens. The whole world feels dangerous, and we worry and stress and perhaps start withdrawing from all these risks.

But if we understand that this is not our  soul’s true response to the world, but an overdose of chemicals, we can delay our fearful reaction until the chemical overflow stops. That takes about 90 seconds. In only 90 seconds, the chemical floods our bloodstream and then, if we don’t buy it or hook into it, passes out of circulation. After that, it’s possible to choose some other reaction, using the same analytical parts of our brains that helped us learn not to scream when we are hungry.

As I counseled once in a previous blog, your best bet with oversized emotions (such as rage) may be to do NOTHING until the chemical surge passes and you actually have some choices again.

Don’t let just one or two parts of your brain boss you around. Stop, see who’s talking, and decide if you want to listen. Don’t let it be up to the primitive parts of your brain stem. You can still go with your first instinct, if you want to. Just decide for yourself.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She has also published two romantic comedies. All three books are available on Amazon.com, Barnes and Noble.com, Kindle Editions, Nook books, and other major vendors; or you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net

The View from a Pit

I am indulging myself this week by posting a relevant piece of my creative nonfiction. Thanks for reading.

I remember being drunk and suicidal. It is like crouching in the bottom of an old, dry well, a deep one, maybe a mile down. You don’t know how you came to this old abandoned farmstead anyway, you didn’t see the covered pit, and now you are trapped and wounded and thirsty and no one has a rope long enough to save you.

The real problem is not the pit. It’s not even the broken leg you got when you landed. The problem is the view. It’s small and dark. You can hardly see any sky at all, just a little pinhole. And sometimes it’s night and there’s nothing to see. And you get to thinking maybe the sky is a charade; maybe it’s not really up there and not really as blue as you remember and not worth climbing for since as you can see it’s only two inches wide.

You start believing it’s not worth the effort to climb out. Even if you did, you would still have a broken leg. And you would still be lost on an abandoned farmstead, still hungry and thirsty and alone. It’s just too far to medical care and warmth and comfort – especially if there is no sky.

So what we need in the bottom of the pit is someone who brings the blue sky with them. Someone warm and alive who convinces you that the sky still reaches to infinity, even if you can’t see it, and that under that sky there is still room for you. Someone who will be there with you when you climb out of the well.

Bless all the people who descend to the bottom of the pit when ropes don’t reach. Bless those who bring the blue sky with them, in their eyes and in their voices, for they are better than drink or food or even ropes and ladders. They show us there’s something up there. They give us a reason to climb.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She has also published two romantic comedies. All three books are available on Amazon.com, Barnes and Noble.com, Kindle Editions, and other major vendors, and you can order them from your local bookstore. Or visit her web page at www.lafruche.net.

 

Take an Animal Break

I was going to talk this week about emotions. But I’m going to take a break to advocate for a grand old institution: the live-in pet.

My morning was lighted up today by the kitten - almost cat - who lives in our house. She will reach her first birthday in just a few days. She plunks herself down on the bed in the mornings, rolls so her stomach is up, and waits for me to do my stuff, in perfect trust and faith. Sometimes she purrs before I even get started.

Doctors have known for a long time that pets are good for the mentally ill, and if you have even a tiny bit of money in your budget for cat food or dog food – or bird or rat or lizard food, for that matter – I would urge you to get one. Some places which otherwise don’t like animals will let you keep one if you have a note from your doctor showing that a pet will help improve and stabilize your condition, or words to that effect. The love and trust of a pet is a valuable thing, and its response to you, and your knowledge that you are taking care of a living creature, are very health-encouraging things.

I think pets are a sort of energy-transformer in a living package. You give them your emotions. You pet them when you’re sad or bored or play with them just to try to feel better – and you do. It purrs or it woofs or it tiptoes over your hand, and you DO feel better. It turns your weeping into a cheep of contentment. For one thing, if your mind is a very complex and painful place, it is entirely soothing to watch a beast go about its instinctual and simple behaviors without (presumably) the kind of angst we are stuck with. Just having someone – a living presence – there in the room when you come home is a sort of blessing. Mental illness is often a very isolated and lonely place. Having company is a good thing. Company that doesn’t get tired of you or complain or tell you to just buck up and shut up and FIX your life, as people so tiresomely do. Your pet accepts you as you are, period. Even a hamster on its wheel or a lizard on its rock  is a living presence that accepts you as part of its life.

Of course, the flip side of this is that you have to provide for its care, even if you are flipping out. Food and litter or cedar shavings or what have you are minimal provisions, and if you don’t feel you can provide them regularly, then pets are a bad idea. Killing your pet rat by neglect will not make you feel any more sane. And there is the spectre of occasional veterinary needs, though many of the standard surgeries and immunizations are provided for free, or very cheaply, by the ASPCA. But if you check on local service organizations, you may find – as did a friend of mine in San Francisco – that there are even groups  that will help pay veterinary bills (I believe this one was called PAWS). Perhaps most importantly, find someone nearby who will agree to take care of your animal at short notice if you need to go to the hospital or anything else wild goes down. This kind of planning will also go a ways toward reconciling your landlord to a live-in animal – he doesn’t have to worry that it will end up on his hands.

If all this is too much, you might want to stick with plants. Living things are good. But they don’t make those cute little sounds.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She has also published two romantic comedies. All three books are available on Amazon.com, Barnes and Noble.com, Kindle Editions, and other major vendors, and you can order them from your local bookstore. Or visit her web page at www.lafruche.net.

Who's Doing the Driving, Part II

In my last blog I talked about learning to recognize when you were in an altered state. Now I want to suggest you scrutinize the inside of your brain a little. What part of you is doing all this crap to you, anyway?

Jill Bolte-Taylor, in her enlightening book My Stroke of Insight, talks in depth about what it was like to come back to full functioning after a brain stroke. She says something very interesting. She says that eventually she noticed that there was a “storyteller” coming back alive in her mind. This storyteller function would weave various events and sensations together into a narrative, where A led to B led to C, and the meaning was D. She found it amusing, she says, until she realized that this part of her brain expected her to believe everything it said. And she probably would have, if she hadn’t managed so long without it.

This “storyteller” is the voice that talks to us all day long. Everybody has one. Most of us think this is the real “me,” since we have never been without it and it never shuts up. It’s important to understand that this is NOT all of you, nor is it the “real” you. There are other parts of your personality which are calmer and better informed (for instance, the parts accessed in meditation or hypnosis). Even more to the point, it’s important to recognize that when you are mentally ill, the storyteller is at least partially broken.

It sees causes and effects that really don’t make sense. It uses faulty data. It jumps to conclusions that the facts don’t support. Without any warning, and for no reason we really understand except that it’s partly chemical, it may suddenly jump the tracks and decide that the crabby people you’ve met today are really all trying to kill you. Just for example.

Play with the idea that your storyteller cannot always be trusted. See if you can find a deeper voice within you to consult. I once asked a very wise schizoaffective woman what she had gained from mental illness, and she said, “Now I know which voice to listen to.” Practice separating from this storyteller, or ego voice, if you prefer to call it that. At any point, while it is saying A and B mean C, stop and question it. Try a phrase like, “Do I  believe that?” or “I don’t have to listen to you” or even just “What if that’s not true?” You don’t have to do a knee-jerk rebellion and change your mind. Just start noticing that it is talking to you, and look a little deeper for other choices.

Since I’ve been working on this, an interesting thing has happened to me. My storyteller, tired of being questioned, sometimes recites nonsense rhymes. It seems just as happy to be chanting, “Higgity, piggity, diggity, figgity” as it used to be to beat me up all day with its endless criticisms.  It just wants to be talking. What does that tell you about the true importance of that voice’s opinion? Sometimes I feel very silly with these jingles going through my head. But it beats the hell out of what I used to have to listen to, so I’m not complaining.

Next time you feel an altered state coming on, or even just a crummy mood that you don’t want to indulge, you can say, “Hey, I don’t think that’s true,” or something to that effect. You can get a little bit of a grip on yourself again, a little distance and perspective. Every little bit helps.

The goal is to be able to look at yourself as if you were looking at someone else, and say, “This doesn’t make sense.” Then you can do something about it.

Next week: Emotions as chemical reactions.

Deborah is a speaker and author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She has also published two romantic comedies. All three books are available on Amazon.com, Barnes and Noble.com, Kindle Editions, and other major vendors. You may also order them from your local bookstore. Or visit her web page at www.lafruche.net.

Who's Doing the Driving? (Part I)

A couple of months ago I was giving a speech (my first) on mental health skills. Planning it, I had to ask myself: what is the single most important skill the mentally ill can learn?

Answer: learn how to tell that you have entered an altered state (psychosis, panic, mania, etc).

Now, this is not simple. If you think of the altered state of dreaming, you notice that while you are dreaming all the impossible things that happen make perfect sense to you. It is only when you return to waking life and try to describe it that you find the logic and chain of events don’t work. But there are some people who can occasionally, while in the dream state, say to themselves “This is a dream.” That is similar to what I suggest we develop. It is an inner ability to detach, just a little bit, and see ourselves.

This is not a replacement for taking your medicine. This is more a way of dealing with those ‘breakthrough’ symptoms that so many of us live with.

There are enormous advantages to understanding, for instance, that you are having a panic attack or hearing voices that are not there. Once you know, you can take action: call a doctor, take a pill, get off the freeway, go in your room and close the door, whatever your personal experience has taught you is effective. This minimizes the damage. If you don’t know you’re not in ‘standard reality’, you will keep bumping up against other people’s reality, and that could end in a screaming fight or the police station or other unpleasant places. You will then be at the mercy of what other people – maybe strangers – decide to do about it.

So here’s how you learn to catch yourself. This is a practice that develops over time, it is not a quick fix. At the end of each day, review the day briefly to yourself and ask something like, “How sane was I today?” or “Did I have symptoms today?” Go over the day and see any place where maybe you lost it a little (or a lot). This is not the time to beat yourself up. This is the time to analyze calmly. Zero in on the incident. What did it feel like? How did it feel or sound in your head? What was going on with your body? Were you all tensed up? Were you overwhelmed and shaky? Did you have a headache or anything else that was noticeable?  Is there something that you say or do every time that happens? Really go over that experience in your mind and then compare it with whatever your personal version of ‘normality’ may be. How are they different? Can you get a feel for that? Would you recognize it next time? What could you do next time that would be helpful?

If you do this nightly scan for awhile – not criticizing yourself, just looking for information – you will start to find repeating patterns and sensations that are familiar. These can be your “clues” that you have gone over the line and need to take rescue measures. After some time, you may even start to notice triggers. Do you always end up sick if you do x? Do you suffer if you overdo y?  You’ll start to understand some of what sets you off, or just generally makes things worse. I do not mean that we always have external triggers or “reasons.” Sometimes  there’s just an arbitrary chemical surge in your brain, and you have to deal with it. But you can learn to avoid some of the unnecessary stressors in your life. You can begin orienting your activities away from those triggers.

Of course, this does not work for anxiety reactions. If you hide from everything that scares you,  you will soon be living in the broom closet. For anxiety problems, you are better off facing these things in small doses, one by one. But you are still better off recognizing your reactions when they happen. Naming things takes some of the fear and strength out of them. You can say to yourself, “oh – this is not me, it is my disease.” That gives you a little power over it.

Over time, this kind of self-monitoring will help you to live life with fewer outbreaks. Or you can recognize them sooner, and head them off at the pass before they get too extreme. It’s worth the time and effort you put in to make a more functional, peaceful life – and believe me, your loved ones will appreciate fewer storms as well.

Next week we’ll discuss some other ways to catch on to what your brain is doing.

Deborah is the author a one self-help manual, Is There Room For Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness.  You might also like to explore her award winning comic romance novels set in the 1800s in England. See Amazon.com, BarnesandNoble.com, Kindle, or Apple's iBookstore.

Affordable Health Care Update

I attended a lecture Thursday night on the status of the Affordable Care Act (health care reform) that became law in March of 2010. There was a lot of interesting information, not all of it new, that I think anyone with a mental health challenge ought to know. We do, after all, have a chronic condition that requires regular medical care, and the bills can be a lot higher than we can afford.

You probably know that there is now a sort of exchange where people with pre-existing conditions can go, but do you know how to find it? Go to www.pcip.ca.gov (in California), or call 877-428-5060 Monday through Saturday. I’m sure they can give you information on out-of-state sources to contact, as well.

Here’s a quick summary of the provisions active so far: lifetime coverage limits have ended, no pre-existing conditions are allowed for children under 19, coverage can’t be dropped midstream, and Medicare (which many of us are on) has eliminated copays and deductibles for preventive care. So if you need a checkup or a mammogram and you don’t have money, go anyway. Also, parents can keep children on their insurance to the age of 26. Those are a few of the more important items.

Now here’s a rundown of additions for 2011: Most important for Medicare Part D beneficiaries, there’s a 50% discount on brand name drugs during the infamous “donut hole” period (which won’t be eliminated till 2020). Also, Medicare payments are supposed to now be connected to quality outcomes – so you aren’t given just the cheapest treatment whether it is right for you or not. The speaker I heard also claimed that access to long term care at home and in the community is increased, and that community health centers are expanded. What that looks like in real terms, I don’t know. Also, insurance must use 80 to 85% of your premiums ON HEALTH CARE.

Some of the things coming up:

2012   - a voluntary option for long term care insurance

2013   - increase of payments for Medicaid primary services. Increase of Medicare

doctors and nurses

2014   – Insurance exchanges come online for individuals and small businesses.

-       Discrimination due to pre-existing conditions or gender ceases.

-       Medicaid is expanded to everyone below 133% of the poverty level, which right now is $29,000 for a family of 4.

-       No more annual limits to coverage

2020   - Medicare Part D “donut hole” terminated

I also understand that ultimately on the California State Exchange insurance will limit out-of-pocket expenses to a maximum of $11,000 in any calendar year. So you won’t get wiped out by one big injury or illness. I don’t know what year that becomes law.

You can find out anything else you need to know at the new federal website: www.healthcare.gov (or in Spanish at www.CuidadodeSalud.gov).

And if you’re already stuck with a big bill, get help here: www.hospitalbillhelp.org

All this information is courtesy of the Unitarian Universalist Legislative Ministry of California, which can be reached at www.uulmca.org or 916-441-0018. I’m sure they’ll be happy to refer you to out-of-state sources.

Good health to all, and I’ll see you next week.

Deborah is the author a one self-help manual, Is There Room For Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness.  You might also like to explore her award winning comic romance novels set in the 1800s in England. See Amazon.com, BarnesandNoble.com, Kindle, or Apple's iBookstore.