Benzos-- On My Soapbox

I hate benzodiazepines. HATE them. This class of drugs (what we know as Ativan, Xanax, Klonipin, Librium, and Valium and various others) was introduced in 1961 and sold to the medical community as "safe." Doctors then naturally begin writing prescriptions left and right and we are now learning that benzos are NOT safe. I speak from my own personal experience in working with addicts as well as from scientific research and statistics. I see people almost daily who are struggling to overcome addictions from various substances but cannot overcome the final hurdle of benzos addiction because doctors continue to hand these drugs out like candy.

Let's just lay out the facts. First of all, the manufacturers of benzos do not suggest that this drug be used longer than two weeks. Second of all, we know that long term use leads to increased tolerance (requiring more of the drug to feel any benefit), physical dependence, and dangerous, potentially life-threatening withdrawal symptoms when one tries to stop taking the drug. We also have statistics that support the fact that most people abusing benzos are typically combining their benzo with another substance, usually alcohol or opiates. This is a deadly combination.

Here are some important statistics. In 2006 the Center for Disease Control reported " Poisoning {drug overdose} is the second leading cause of injury death overall, and the leading cause of injury death for people aged 35-54 years, surpassing both firearm-related and motor vehicle-related deaths in this age group." Of these "accidental" deaths, 17% of those were related to the misuse of benzos. In 2009 in Washington state alone, benzos were indicated in 20% of accidental deaths, higher than alcohol (17%), cocaine (15%), meth (5%), and heroin (2%). Even in 1986 the well-respected National Center for Biotechnology Information (NCBI) completed research that indicated those who were depedent on benzos alone had a mortality rate 3 times higher than a control group being treated for similar mental health issues without a co-occurring benzo addiction. When the benzo addiction included the use of alcohol or other addictive drugs, the mortality rate jumped to 6 times higher than the control group.

I sat with a seventeen year-old girl this week who was begging me for benzos. She understandably wants relief from anxiety and has learned from our culture that the most efficient way to do that is to pop a pill. It breaks my heart. I also work with various other adults who struggle with enduring the withdrawal symptoms of benzos and most of them require multiple inpatient hospital stays throughout the year. Long-term benzo use has been shown to lead to an INCREASE in depression and anxiety. The abuse of this class of drugs has become a social problem, a menace to society, a bomb dropped on families, and ultimately kills.

This anger has been stewing in me for many years and the recent death of Whitney Houston really sent me into a tailspin. We do not yet know the autopsy results for this artist, but we do know both alcohol and three different kinds of benzos were found in her room. It doesn't take large volumes of these two combined drugs to cause significant depression of the central nervous system and cessation of breathing.

I believe Whitney Houston was clean from illict drugs and, thus, convinced herself she was "sober," because she was "just taking" the various benzos being prescribed to her. How do we expect people to stay clean when they are having addictive substances prescribed to them by the very people who are supposed to be helping them remain healthy? NO ONE with any history of addiction should take benzos... period. Whitney Houston should never have been given those medications. She believed she was sober and well. Our culture is ignorant to the dangers of benzos and I believe this prohibited the loving friends and family around her from knowing that the path she was on was a deadly one.

If you are taking benzos or know someone who is, these are the signs of benzo dependence (from myaddiction.com):

1. Tolerance to the medication, to the extent that the patient needs to take more to achieve the same effect; more marked when used as sleep aids, less common when used intermittently for anxiety.

2. Withdrawal begins when the medication is discontinued – may lead to taking other drugs to relieve symptoms.

3. Taking a higher dose or a more frequent dose outside of a physician’s advice. This includes taking the medications for problems other than they are prescribed for.

4. An inability to stop or excessive anxiety when considering stopping.

5.Preoccupation with acquiring more medication or another prescription – usually to meet increased need because of self-administering a higher dose.

6. A drastic change in habit or lifestyle, such as skipping social engagements or ignoring responsibilities because of the medication or the effects of the medication – embarrassment and lying may be associated with this.

I believe we should lovingly confront those we love who we know are abusing or misusing their medications. Had someone done this for Whitney Houston, we might still have her today. Please know that tapering from benzos should be done under the guidance of a doctor, due to the potential severity of symptoms. Let's wise up about this very dangerous class of drugs and spread the word that it is not acceptable to take benzos for months or years on end. We have to become intolerant of doctors who have become legal drug pushers and push for tighter regulation of this class of drugs.

Ch-Ch-Ch-Changes

I do not deal well with CHANGE. I think I've gotten better over the years, as I have come to realize that change is just part of life. Just as soon as I get familiar with one routine, something new comes along to disrupt it. Even good changes can send me into an emotional tailspin. My head is telling me that my entire family was in a comfortable routine for a little too long and it was beginning to foster complacency and boredom. My emotions, however, are screaming, "I don't care! I want to go back to complacency and boredom where it's safe!" Hubby is starting a new job, the kids are going to after-school care for the first time in their lives, my own work and exercise schedule will need to shift as a result, and our finances will need to have major adjustments.

A friend of mine called me the other day and read a portion of The Language o Letting Go by Melodie Beattie. She read to me about the anxiety of being in the "meantime" or the middle phases of change, the waiting periods. When we go on a trip, we have to prepare, then get in the car and travel. There is a distance between one place and another. If I am travelling to a place I know well and have been to before, I may feel very excited during the travel time. If I am travelling to a place I've never been and perhaps anticipate there may be bad experiences awaiting, then the travel time is miserable. My current travel time into this new phase of life has been miserable and it must be because I am anticipating the worst! I had a dream last night that didn't seem to make any sense, but now I get it. I dreamed that I had to travel to the other end of the state and didn't want to have to make the long drive (travelling across TN is beautiful but LONG). In the dream I boarded a new-fangled train system that jets you across the state in the speed of a plane. I saw the familiar scenery speeding past me as I travelled and I was amazed at how quickly I could get there. I believe this dream was a wish-fulfillment dream. I just want to get there now and avoid all this darned travel!

Today I make the commitment to enjoy the journey. Nothing bad is happening to me on this journey. It is merely a shift from one place to another. I don't know what the new place is going to look like, but this doesn't mean I have to fear it. God is a God of change. He created the seasons, aging and growth, the shifting weather patterns, and time itself. He is in control of all things... even as they change.

Painting above by:
http://browse.deviantart.com/?qh=§ion=&q=fast+train#/d28owyi

Reflection vs. Reaction

I will offer a little self-disclosure here. Actually, I think I offer quite a bit of self-disclosure here on these pages, but anyway... I want to share a recent insight I've had. I will change the names and circumstances to protect the privacy of dear others.

I am presently in a relationship with someone where I am experiencing much tension, and this has been ongoing for some time. I also get the sense that I am actually having more anxiety and anger in this relationship than the other person, who we'll call Mr. A. This man, Mr. A, really triggers me. In fact, I sometimes find myself so annoyed by him that I uncharacteristically snap on him, become rude, and have even gotten angry enough to stomp away. Essentially, I throw a little tantrum because I get so ticked off. Just to clarify, I don't typically act like this in relationships! I'm actually known by friends and family for remaining level-headed, avoiding confrontation, and very rarely exhibting anger (even when it is probably warranted). Something about Mr. A really gets my goat, however, and I have no problem getting angry... and quick. Afterward, I always feel guilty, embarrassed at my juvenile behavior, and even more angry at him that he MADE me act that way.

It would be really easy for me to type on and on about all the horrible things this person does and how my anger toward him is justified. I could rant and rave about the rightness of my frustration and how things would be much better if he would just change. What I'm finally understanding, after a significant amount of time with Mr. A, is that he is not real likely to change. What I am now motivated to do (after many months of tension and conflict) is to examine myself.

Mr. A does seem to irritate other people as well and we have mutual friends who have commented on this. None of them, however, seem to get triggered quite as intensely as I do. What I now want to try is REFLECTION rather than REACTION. I have gotten so angry with him at times that my reaction was quick and surprised me. Sometimes I've said something very scathing, scoffed loudly at him, and various other things that surprised me. Sudden reactions. What I would like to try is to stop myself before I get to this point and take a time out. I'm not sure how I'm going to get the time-out. Most likely I'll just say, "Excuse me for just a minute, I just remembered something important I need to take care of," or I might try, "Let me take a few minutes to think on that and I'll get back with you." If you hear me saying that to you this week... well, sorry. It's better than getting hostile and sarcastic, right?

Once I get space and step away, I want to REFLECT. My reflection is what I see when I look into the mirror. I will see me staring back at me! I don't actually intend to go look into a mirror, but maybe I can examine what I am seeing within me at that moment. What am I feeling? What does this feeling remind me of? What earlier times in my life did someone make me feel this way and what was the outcome? Are those past events somehow affecting my present interaction? Most likely, yes. My reaction is so intense, it suggests that a relationship template is being triggered. This is a template that got solidified within me over time after a repeated interaction with someone very close to me. For example, some of us learn at a young age that if you show anger in your home, you are shunned and shamed by a parent, so you learn to stop exhibiting signs of anger and feel shame instead. Later in life, when we encounter someone who wakes up the "shaming parent" template inside us, we automatically and unconsciously slip into the role of shamed child who denies anger. Then we wonder why we feel so crappy every time we're with that person!

I believe that if I REFLECT rather than REACT, I am going to learn some very valuable things about myself. I hope to gain some insight about what type of issue is being triggered. I also hope that I can begin to practice some new ways of dealing with Mr. A rather than the usual red-headed tyrrant routine I've been pulling. I'm not real happy with that act lately. I doubt he is either! Almost makes me feel sorry for the poor guy... just almost but not really. :-)

I'll keep you posted on what exciting traumas I dredge up within myself!

Photo above found at:
http://browse.deviantart.com/?q=snow%20white%20mirror&order=9&offset=24#/d1k9p6n

Therapy? For Me?

There are many commonly held misconceptions about therapy that I'd really like to de-bunk, but I'm going to focus on the top 4 I hear most often. Put on your big girl panties and your big boy undies, if you plan to proceed:-)

1. Therapy is only for crazy people: This has to be THE most common misconception/untruth about therapy and is most often spoken by someone who really needs therapy. First of all, what do you mean by crazy? Aren't we all just a little crazy? There is no shame in going to a therapist for help or support. If you had a disease like diabetes, you would take your medication and go to your doctor appointments without shame. Similarly, if you have experienced unforeseen events in life that have crippled you emotionally, it is good to seek the help of a therapist. It is good to take care of yourself and be seen by a professional who is trained and experienced in walking people through their hard times. Many people are blessed with genetics that predispose them to mood disorders. Then life comes along and brings out the symptoms. We go to therapy because we cannot overcome and deal with much of our emotional baggage all on our own. A good therapist is mindful of the interplay happening between the two of you and is aware that it is this interplay that is essential in you getting better! Relationship is key to healing! I personally believe therapy is especially important if you are a therapist yourself. My mind and my psyche are my primary work tools and I want them to be clear and healthy. Otherwise, I'm bringing my own dysfunctional patterns, beliefs, and feelings into the therapy relationship and acting it out with my clients-- not good. And, yes, you are doing that if you are a therapist. You are human after all, not perfect! Remember, I did warn you to put on your big girl and big boy undies. :-)

2. I don't need therapy, I just take medicine for that: I hear so many people say this. There are many wonderful medications designed to treat mental illness. I am very glad for this. In fact, I hope and pray for even more effective medications to come on the market all the time. We are in need of medications to treat biochemical imbalances that can lead to depression, psychosis, and anxiety. I also see many clients for whom the medications are absolutely an essential part of their treatment, and I know they would experience severe regression without the meds. BUT (and you knew the BUT was coming) medication ONLY is nothing more than a good start for most people. It's highly unlikely that you are going to find a medication that is going to cure it all. I see clients who find a good medication that stops their anxiety attacks all together-- GREAT! These clients feel they are better now and no longer in need of therapy. They then go on to experience one dysfunctional relationship after another, spend themselves into great debt again and again, have constant conflict with co-workers or family, etc., etc. In my own experience as a therapist, I have never seen a client who experienced anxiety in a vacuum. This is to say, they are experiencing crippling anxiety for no apparent reason, with no history of trauma, or family dysfunction that hard-wired their brain to respond in this way. I am not saying these types of people don't exist. I'm just saying that in 10 years of doing therapy, I've personally never seen it! It is possible to live without potentially addictive medications and learn to manage anxiety. Let your medication serve as a springboard that allows you to participate in therapy at an even deeper level. Remain open to the fact that there are characterological and interpersonal issues impacting your life that medication will never resolve. If you're waiting on the right medicine to come along that will finally make you feel better, you might be waiting for a long time. Medication combined with talk therapy will get you there!

3. A good therapist will be able to fix me: Many people come to therapy believing that I hold the solutions to their problems. They believe I will give them a magical answer and POOF, things will be great. They are often sorely disappointed when I have to tell them, "Sorry, my magic wand is in the shop." Certainly, there are people who need information. There are many clients who need to know more about their diagnosis. They may need to know more about the common effects of childhood sexual abuse or being the child of an alcoholic parent. This information alone can be very healing and give a person direction in how they think about themselves and the world. There are times too, when a client simply needs guidance and it is good for a therapist to provide it. Most of the time, however, my role is NOT to sit with you for an hour telling what you what you should be doing if you want to feel better. If you have a therapist who does that with you, how good does that feel? I want to encourage clients to explore themselves, dig deep inside the stuff of themselves. Together we sort through the trash, how did the trash get there, what can we do with it, what part am I playing in all the drama that goes on in my life? Good therapy also means working patiently through the ups and downs of the therapeutic relationship. Therapy means for many people that they experience warmth and a non-judgmental attitude from another person, maybe for the first time in their lives. That goes a lot farther than a therapeutic lecture. Therapy is a process of you learning about yourself, being courageous and honest about yourself, and actively working toward change.

4. I don't have time for therapy: Honey, you don't have the time to skip it. For people who are experiencing extreme stress, anxiety, chronic conflict with others, depression, addictions, and various other dysfunctional patterns, you cannot afford to continue another day without gaining some therapeutic insight. Each day that you continue on in your life engaging in the same dysfunctional patterns, experiencing the same negative and unhelpful thoughts, going deeper into dangerous depression and addiction, you make it much harder to ever extract yourself from it. You're also very likely creating further damage within your relationships that will have to be addressed and healed later as well as re-creating dysfunctional patterns in your life that you are probably unaware you are even re-creating. Good therapy cannot be postponed. It is too essential to put off until you have more time, because life will catch up with you eventually. When life and our own brokenness forces us into therapy... well, that's just no fun. Make the time now.

Rant ended. :-)

The Dark Night of the Soul

The Dark Night of the Soul is a spiritual phrase that has been used to describe the darkest most desolate phase of a person's life. During this period of your spiritual journey, you will experience immense pain, the feeling of "going crazy," falling apart, depression, anger, terror, helplessness, and complete isolation from others. Everything you once believed yourself to be is found to be no longer true. Everything you once turned to for comfort is either no longer there or has been exposed as a sham. You may feel lost, having nothing stable to lean on, not even God, because your view of Him has been shattered too. There is often also the fear that this will never end, almost like being lost in a deep dark woods, never to be found or make your way out. This is the Dark Night, Honey.

Many spiritual icons have been said to have experienced this. There is Saint John of the Cross who wrote the beautiful poem "The Dark Night of the Soul." Mother Theresa was also said to have experienced a very dark period of years, where she felt disconnected from God. This is an experience that spans across religions and ethnicities, a very human experience. For some it may last for months and for others it may last years. Many people believe that Jesus Christ experienced his own Dark Night on the cross when he cried out, "Oh God, why have You forsaken me?"  Others believe his Dark Night may have been during his 40 days and 40 nights in the wilderness when he suffered intense temptations.

The process that is occurring during this Dark Night is like a spiritual reconstruction surgery. Every piece and aspect of your Self-- your thoughts, internal constructs, foundational beliefs, feelings, and the basis for why you exist-- all of this is taken and completely shattered. It hurts like hell. This is a gross oversimplification of the spiritual process taking place, but God is essentially re-building you from the ground up. You are being given no blueprint as to how this will turn out nor even do you have the wherewithal to understand that you will survive. All you can really do is continue to put one foot in front of the other and believe that God is doing a holy work in you and you will emerge from this dark forest. You WILL emerge from this dark forest. I love this excerpt from Saint John of the Cross's poem:

O guiding night!
O night more lovely than the dawn!
O night that has united
the Lover with his beloved,
transforming the beloved in her Lover.

In looking back, Saint John was able to recognize his darkest period as an awesome journey that took him into true union with God.

I struggle with knowing what to do for someone who is in their Dark Night. Really there is very little I can do. It is their own journey, one that has to be walked out with their own courage and requires their complete reliance on a God they can barely feel. In my experience with people in this period of their lives, and from my own very profound experience, people can be really nasty during this stage. A person in pain often lashes out, can be highly inappropriate, rude, and ineffective as a parent, friend, or employee. When you no longer have even the internal human construct of good manners to hold you back, you may say and do some horrible and shocking things. I understand the inner chaos a person is experiencing and know that these offensive behaviors are not personally intended toward me or anyone else. Nonetheless, they can really cut and I wonder how much I am expected to withstand! I am beginning to understand that along with the deep compassion I feel for a person walking through the Dark Night, I must also hold a firm line with someone who is flailing about during this stage. I don't shame or guilt-trip a person for their behavior but I also am not required to tolerate or turn a blind-eye if I see someone I love engaging in harmful activities during this stage.

I'd like to re-post the first poem I ever published here on my blog. I wrote this after emerging from my own Dark Night of the Soul and offer it as encouragement to anyone who may be walking through this difficult time:

Coming Out

When you are running--
a shadow of yourself running from
and to yourself
frightened by a ghost self
in brambles the ache scratches
your body when you try to escape--
when you are running.
Just stay on your feet.
Know the darkness in its fullest
reach into the deep of the black
pour the anointing of the pain over
your head.
Keep running.
This is not night that comes and
goes in cycles with day, this
is suffering. This is
your very self at
its cellular level expanding and
constricting in its own rhythm.
If you can hear me there,
know that light will come when
darkness inks away
a self will emerge cracked
still running. It
will be blinding just as
the darkness is blinding.
Behind your forest wall
steady follow this scent
thick with heavy evergreen.

Photo above found at:
http://browse.deviantart.com/?q=dark%20woods&order=9&offset=120#/d1x790t

What's This About Sin?

The word "sin" has such a negative connotation to it. It brings images to mind of a naked man and woman in the Garden of Eden or images of sweaty preachers screaming about hell. Sin-- well, it's just so religious. Just as there is a God in heaven, there is a devil in hell, and I am certain that devil must giggle with glee at this religious connotation. It is this connotation that waters the word down and turns it into an act done only by Old Testament characters not by anyone in the year 2010.

I believe that sin is the word for that broken place inside every human being. It is from our broken and wounded places that we come up with some of our worst ideas. Just by being born human, we are born with the capacity for being wounded. Our potential gets trampled by other human beings, often unknowingly and unintentionally. Nonetheless, who we should and could have been (peaceful and connected with God) is altered into someone who is broken and forever seeking to mend the breaks with people and activities that will never really mend it. Sin. If you were born into a family system, whether that includes a Mom and Dad or a group home director, you have been altered from the self God created you to be. Welcome to the human race. You are now a sinner, just because you were born. Sin is not just the mean-spirited and/or selfish behaviors we may engage in. Sin is any thought or feeling that takes you away from the peace and connection you were meant to have with God. There's nothing religious about that!

Really, my entire blog is a blog about sin. It's about addictions, lusts, revenge, anxiety, depression, and conflict. But there is some good news! This blog is also about getting cleaned up from sin. I can be healed of my addictions and mood swings. I don't have to spend the rest of my life finding some great new strategy to finally gain peace (although there are many wonderful things we can do). I don't have to spend the rest of my life white-knuckling it through cravings and withdrawal (although there may be necessary periods of this as well).
There is a wonderful verse that keeps this all so simple, "For the wages of sin is death, but the gift of God is eternal life in Christ Jesus our Lord" Romans 6:23, The Holy Bible, New International Version. It is through a simple and effortless faith that my wounded places are healed. This is a free gift from God, an extended hand to me and a promise to be made free from my own sin. I do nothing but just believe it.

The 12 Steps guide us through this healing. Step One: We admitted we were powerless over others, alcohol, food, narcotics, sex and love, SIN. I cannot heal myself. Step Two: We came to believe that a power greater than ourselves could restore us to sanity. There is a power that can heal what I cannot. Step Three: Turned our will and our lives over to the care of God as we understood Him. I love the kindness and the room for error in Step Three. We've all got such clouded understandings of God. Our God view has been distorted by misguided Sunday school teachers, by negligent fathers or abusive mothers, by rule-bound and shame-based churches. I don't know that my own distorted views will ever be made clear, but I just have to believe one thing about Jesus-- I can turn my will and my life over to Him and He'll take care of this sin problem. I can believe that!

Photos above found at:
Adam and Eve
Helping Hand

Intimacy: Do It Afraid

A reader recently asked for some specific tools in learning to tolerate intimacy. Intimacy, the sharing of your genuine self with another and experiencing the genuineness of another, can feel wonderful and also very scary. In those simple moments of intimacy, one can feel so vulnerable. When we expose our soft spots, there is the risk of that fragile place being crushed by another. This is especially true for those of us who have been crushed in the past. Having offered entry into your true self and having it trashed, one can become cynical, even downright phobic of trying again.

Being a 12 Stepper, I hold a firm belief in a Higher Power and my Higher Power is God. I believe God desires for us to have intimacy first and foremost with Him and there is a holy place within us reserved for God alone. Beyond that, I also believe he desires for us to enjoy intimacy with other trusting people, and God offers continual comfort and healing for the times we will be hurt by others in the process. Being intimate always requires the risk of being hurt or disappointed, and the reward is always worth the risk. Yes, you will be hurt. It's just part of the process. You will survive and heal from these hurts.

Here are a few tools for those of you who are ready to remain open to the wonderful gift of intimacy but often feel afraid and want to pull back:

1. Simply Be Present In moments of intimacy (whatever that might be, conversation, quiet times together, eye contact, sex, etc.)when you feel the anxiety begin to rise, simply remain present. Stay in the moment and just observe it. Notice the sights and sounds of the moment. Simply observe them, identify them (i.e., my husband is wearing blue, the TV is on in the other room, my left knee aches). Sometimes identifying the simpler components of a moment can reduce the anxiety of it. Let the pressure of the moment recede while you identify these smaller components.

2. Breathe and Soothe When the anxiety begins to rise, take a deep breath in for as long as you can hold it, then release for as long as you can release it. Take several of these belly-deep breathes and speak in a soothing voice to yourself inwardly such things as "I am OK right now," "these moments are good for me and my partner," "nothing bad is happening right now," "I am just fine, I can do this, this is good." Relax, breathe, and soothe yourself with kind words. Talk yourself gently through it. You have to learn to tolerate the moment rather than escape it. When you don't escape the anxiety, you find that it reaches a peak, then begins to recede. After you have tolerated and talked yourself through the anxiety, you can gain confidence over it.

3. Daily Alone Time with God I say daily because you probably need this frequent practice if intimacy is difficult for you. How do you expect to feel OK sharing deeper parts of yourself with another when you cannot even experience those deeper parts when alone? Sit quietly with God and feel his acceptance of every single part of you. As you learn to feel OK with all of you, then you will grow more comfortable sharing that with others. It takes a little time and patience with yourself.

4. Practice Be willing to put yourself in situations of intimacy that make you uncomfortable. These are wonderful opportunities to practice. Don't worry about whether or not you are doing it "right," only be proud of yourself for continuing to try. Pat yourself on the back and cheer yourself on, "I am so brave doing this. So many people never show this kind of willingness to grow, but I want more intimacy!" And this is true, many people struggle with this step-- practicing. It's just too hard, so they make excuses for why they cannot go on that date, excuses for why they need to work a couple hours late rather than go home to the wife, make excuses for why they cannot talk with family when they do come home.

These 4 strategies are loosely based on Dialectical Behavior Therapy (DBT)pioneered by Marsha Linehan. I use these strategies with clients coping with many different types of anxiety.

Photo above found at:
http://gemini-soul.deviantart.com/favourites/#/d1dqgwk

Being Humam 101

It's been a little while since I've come here to blah onto the page. This is such an effective and useful coping tool for me, I should come here more often. I hope that I do. I've got lots of ideas, inspirations, and recent events floating around in my head that I could write, but I often give my own sweet self this advice, "First thing's first and one thing at a time." Ok, well, I kinda melded that statement based on good things I heard at various Alanon meetings. :-)

Let's talk about being human for a little while. Why is it I keep forgetting that I am a human being? I absolutely do this and work with families and children who do this. I do not want to just BE. I want to be DOING something. I want solutions and an action step to work on. Just tell me what to DO and I will fix anything. This is my hope, but not at all the way my Creator made me to function. I was created with these annoying things called feelings that seem to have no other function but interrupting my attempts at being a Super Hero. If I just wasn't feeling so overwhelmed I would be able to attend one more meeting and keep people happy. If I just wasn't feeling so angry, I could do your job for you again today and keep the peace. But, no, being human stops that every time.

Here is what I have learned about humanness-- If I try to push myself beyond my own reasonable capacity, it will always end in depression and anxiety. It might take a few months before I wind up there or even a few years for some people, but it never ends good. I cannot deny myself of basic human self-care for extended periods of time and think there are no consequences for that. By basic human self-care, I mean we take care of our bodies. We eat healthy, avoid excesses of all kinds, sleep, and get routine medical care. But I also, and especially, mean taking care of our feelings. Our creator gave us these beautiful, fragile, and indispensable feelings that are there for our own good. Although our feelings are not FACTS, they are ours, completely and utterly ours. It is not weak to have feelings nor is it weak to attend to them the same way I would attend to my body's needs.

I want to clarify that I don't mean I coddle my feelings. Caring for them means I first acknowledge that they are present! Feelings become loud and dangerous when routinely ignored. Then I listen to them and hear where they are coming from. Honestly, for me, that usually settles them down pretty quickly. Our feelings are our friends. Our feelings want to let us know when we are being taken advantage of. Our feelings want to let us know when there is a hurt that needs to just spill for a little while. Our feelings are there to act as friendly guides, especially the uncomfortable feelings like grief, anger, and loneliness.

When I ignore the friendly and helpful feelings of grief, anger, or loneliness, they evolve into the crazed and unhelpful feelings of depression and anxiety. How many times do I need to ignore my feelings and watch them turn into depression and anxiety before I finally get it? If I could count how many times I've done this in the past, it would have to add up into the thousands. I am HUMAN and it is good to have feelings and respect them. Today I will choose to honor even the uncomfortable feelings because I love myself. It may have take 30+ years, but I finally figured out how to derail some depression and anxiety!

Photo above found at:
http://browse.deviantart.com/photography/?q=being human&order=9&offset=24#/dt1ydn

Post Traumatic Stress Disorder, Part 1

I've been thinking about the fact that I specialize in treating Post Traumatic Stress Disorder (PTSD) but have never written about it on my blog. I'm not sure why that is exactly. I think partly because I'm afraid that once I get started talking about it, I won't be able to stop! I also worry that I will begin to get long-winded and technical in my discussion of PTSD and lose many of my readers. I think it's important to begin my discussion on this and trust my ability to rein myself in as needed. Thank God for "edit posts" option. Here goes...

What is PTSD?
Well, first of all, for any of you who are unfamiliar with PTSD, let me define it for you. I'm going to define it according to "professional standards," but will put it in everyday terms. A traumatic event is one in which you fear that either yourself or another person is going to be seriously injured or killed. Many people face events like this but do not develop PTSD. Post-Traumatic Stress Disorder develops when, after the traumatic event is over, you continue to feel like you are still experiencing it. You may re-experience it through intrusive memories or flashbacks of the trauma. You may have nightmares of the event or at times literally feel in your body as if the event were happening right now. Also with PTSD you will go to extreme lengths to avoid situations or people that remind you of the trauma. It is common that we sometimes experience these types of symptoms immediately after a traumatic event, such as losing a loved one. The difference between a normal stress reaction and PTSD is that in a normal stress reaction, these symptoms tend to dissipate after one month. Also, in a normal stress reaction, you tend to maintain some level of control over your response and your life is not shattered irreversibly after the event. For example, you may face a horrifying event and be really shaken up about it for weeks afterward. Over the course of the next few months you find that you are able to leave your home, continue with work, and the anxiety does not rule your life. With PTSD, it is not uncommon for people to not experience any symptoms until months or years after the event occurred.

These are the technical criteria for PTSD:

1. A person is exposed to a traumatic event and has a response of intense fear, helplessness, or horror.

2. The traumatic event is persistently re-experienced (i.e., intrusive memories, flashbacks, nightmares, intense distress when exposed to cues or reminders of the trauma, etc.)

3. Persistent avoidance of people/situations related to the event (i.e., unwillingness to discuss the event, inability to recall details of the event or maybe extremely sharp memories of detail, withdrawal from everyday living and people in general)

4. Increased arousal, that is, "hyped-up" behavior-- you may be hyper-alert, on edge, on the watch, difficulty falling asleep or staying asleep, irritable/angry, difficulty concentrating, exaggerated startle response

5. The duration of these symptoms last longer than one month and cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning."

How Does PTSD Happen?
Our brain is an intricate road map of neural pathways. There are happy and pleasant pathways in our brain and then there are some terrifying (though life-saving) pathways as well. An example of this is the fight or flight response. We've all most likely experienced having our fight or flight pathway being activated. Your heart rate accelerates. You go into survival mode. You may freeze up and feel unable to speak. You can feel every hair all over your entire body stand on end. Or you may turn into someone you don't recognize and display tremendous strength or ferocious aggression and fighting back. It's a critical part of our human make-up that we have this response. It keeps us alive in many terrifying situations and has for eons now.

Things go awry if this fight or flight response gets activated when there is not actually any terrifying event occurring. Someone with PTSD who has a history of physical abuse from a parent may be triggered into fight or flight years later when someone in the grocery store bumps into them roughly by accident. A child who was sexually abused in a bathroom may continue to experience intense anxiety about going to the bathroom years later. A war veteran who saw a friend killed in combat may continue to experience a feeling of hypervigilance and anxiety at the sound of loud trucks or booms. When someone has PTSD, their brain continues to categorize many events as "danger," when, in reality, there is no present danger. This categorization is not under control of the person and happens too quickly to be stopped many times. Once the woman in the grocery store was bumped by a stranger, the brain quickly perceived this event as life-threatening and activated a neural pathway of "high alert." Once the neural pathway is activated, it's like a loop with no end. She's driving on this pathway that just goes around and around with no exit.

As you can imagine, this is a miserable way to live. Often people with PTSD are going through their everyday living being triggered by voices, scents, perceived threats or sounds. These people are unaware themselves what is happening within them, not understanding what just triggered intense anger or anxiety. Many people with PTSD have no clue that they symptoms they are experiencing have anything at all to do with a traumatic event that likely occurred years ago. Or, if they do have some suspicion that their present anxiety is related to event(s) from the past, they are not fully aware of the extent to which their very personality is being shaped by fear and a need to avoid.

There Is Hope
PTSD does not have to be a life-long disorder. There are good and effective treatments for PTSD that are backed by research. The most effective treatments for PTSD aim to help people access helpful and positive neural pathways in the brain, when triggered, rather than falling into the fight or flight loop. This is what is being done in narrative and cognitive behavioral therapies that create positive and helpful pathways then, through repetition, link them with the traumatic event and triggers of the event. Eye Movement Desensitization and Reprocessing (EMDR) is a type of therapy that literally retrains the brain through the use of eye movements to access helpful networks in the brain. I love EMDR and use it often in my practice. It often brings immediate relief to those suffering with PTSD. I have personally seen countless children and adults suffering with PTSD go bravely through treatment and lose their diagnosis. I have watched these people begin to experience relief from symptoms within weeks and months of treatment. If you have PTSD, you do not have to suffer or self-medicate for relief (this is another blog post!). There is treatment available to help you. I believe the human mind wants to heal itself and sometimes it just gets stuck. It is good to seek the assistance of a trained professional to help the broken record get un-stuck and get you back on the right track.

Photo above found at:
http://m-a-e-e.deviantart.com/art/trauma-125461377

Intimacy? Why?

I am having some meandaring thoughts about intimacy-- so bear with me while I try to organize them here! I was thinking about what intimacy is, how it happens, and why we are so reluctant to have it. First of all, intimacy is when two or more people come together and CONNECT. Intimacy can happen between spouses, friends, parent and child, or most any relationship. Each person brings a real self into the moment with the other person who brings a real self. What I mean by this is that I am in touch with my thoughts, feelings, and values, and come into relationship to share them openly, willingly, and honestly. The other person(s) does this as well and a magical thing happens-- intimacy. Intimacy is not enmeshment, which means we come together and I lose myself in whoever I fantasize you to be, and you lose yourself in whoever you fantasize me to be. When we are enmeshed, we lose ourselves in other people. When we are intimate, we bring what we have and ultimately always find more of who we are. In true intimacy, I can say "no" when I need to and can respect the other's "no" as well without falling apart.

Intimacy does not happen without practice. I believe developing the capacity for intimacy is just as crucial as language development. Also, like language, intimacy is best learned at an early age. We can learn intimacy and new languages later in life, but it is always more difficult. Our brains are just primed to get these things very early on! Intimacy begins at birth... the touch, smells, and sounds of our caregivers. We cry and they meet our needs. We explore the world and caregivers look on lovingly and encourage us to try new things. We make mistakes and caregivers may critique, offer advice, or support. In all these ways, and many more, we learn who we are and how to share our budding selves with others without fear.

So if intimacy is all that and a bag of chips, then why the hell are most of us running scared when it comes to getting intimate? Well, fear is always based on fear of loss. Thank you, Dr. Howard Lipke, for giving me this wonderful insight this weekend! The fear can be a loss that already happened and fear wards off the sadness and grief of the past loss. If you experienced true intimacy with someone, then lost that person, being intimate with another can trigger those painful feelings of loss. The other type of fear of loss, is fear of a future loss. For example, we may fear that if I become intimate with you, then I will lose myself. Often adults who experienced physical and/or emotional abandonment as children fear intimacy for this reason. They fear that if they share who they really are, then you will not want to be with me anymore and leave, just like others have before.

Love addicts have often experienced both enmeshment and abandonment. In their world, these are the only two options. The love addict experiences enmeshment as a wonderful union, a supernatural connection, when the addict is truly FOUND in the other person. The love addict is able to experience a self through the eyes of the other person. This is terribly exhausting for the object of the love addict's affection.

The love avoidant often fears intimacy due to strong fears of potential abandonment. The love avoidant ultimately wants to be admired and maintain a sense of control. Love avoidants will pursue a love addict (who often appears in distress and in need of a hero). The love avoidant comes onto the scene, saves the day, then wants to bask in his/her bravado. When the love addict begins to actually seek identity through the love avoidant, the avoidant fears that intimacy may be approaching and intimacy means you will see I am really not a supernatural savior. True intimacy could also mean that you see the real me and abandon me, as others have before. Thus, the love avoidant does what avoidants do best... well, avoid! Run! This sends the addict into a desperate chase, which only makes the avoidant run harder. You see the pattern.

Another barrier to true intimacy is that many people are completely out of touch with their own thoughts, feelings, and values, and therefore, cannot possibly share them with someone else. How can I bring anything to the table, when I have no clue what is in my pantry? This is true for both addicts and avoidants, and why the first step to any recovery is development of a self. I guess what I am realizing then is that true intimacy always happens first with self and Higher Power before it happens elsewhere... what a concept. Sometimes meandering takes us to nice places.

Photo above found at:
http://millesime.deviantart.com/art/Two-Women-3-32709018

Writing as Therapy

I recently had a comment from Glenda Beall, a fellow blogger at Netwest Writers ( netwestwriters.blogspot.com ). I love her blog and hang out there quite frequently just for the sense of writers' community I get there. Glenda pointed out to me how she too has felt writer's block during times of happiness. I mentioned this in an earlier post, and I couldn't agree more that writing is a form of therapy.

I do a writer's workshop once a week at Vanderbilt's Adolescent Psychiatric Hospital. This project is made available through Nashville's Youth Speaks organization. This pulls together my two greatest loves, psychology and creativity. I find that the troubled children there are highly creative, cooperative and open to the writing process. I enjoy them every week and find such inspiration in their courage to share honestly. Although I work with lots of great poets who also help facilitate this writing group, I believe I am acutely aware of the personal struggles of the adolescents there because of my experience in counseling this population for many years now. I enjoy them so much, and I am always thinking of both writing skills as well as tools that will help them cope with the many traumas and stresses they face in their young lives. I thought I might share some of those with my readers.

Processing an Emotion

One skill I teach the teens is how to take a feeling and squeeze every drop of sensation from it. I encourage them to describe in great detail the thoughts, body sensations, colors, and images associated with it. A common exercise we do is giving the emotion 5 senses. For example, if anger had a taste, what would it be? What color is anger, what would it feel like in your hands? Often we hold intense emotions in one side of the brain with no connection to positive neural pathways or even words! This exercise helps to make emotions more bearable and work them through.

Dealing with Obsessions

Another skill I teach the adolescents is how to "write out" an obsession. Often these children are plagued with anxieties or worries. I ask them to imagine that they have literally been eating whatever is the target of their obsessions or anxieties. If they ate this particular thing, what would we see running from the corners of their mouths? What would other people think or feel when seeing this? How did it feel to swallow? The kids love this exercise. One girl wrote, "There is no pain like mine. I have been eating your last words to me."

I believe our writing puts to words the pains that are often indescribable. I cannot tell you about the depth of my hurt, but I can describe the cold hand clenched around my throat, hoping to take my life. Bringing these feelings into being through image and sound puts them into a safe container. Writing about joy engages the same senses, but joy is not often a feeling that was forced into suppression, nor does it require safe placement. Joy is safe, and I'm more accustomed to writing about the forbidden. Joy, I feel it but am still learning to write it!

Picture above found at:
http://lavidamesorprende.deviantart.com/art/Writing-at-the-beach-8919736

Suffering is Optional

Why is it that once someone begins suffering, they never seem to stop? I'm not talking about going through some hard times or hitting a few unlucky bumps along the way. I'm talking about enduring abuse, abandonment, neglect, anxiety, chaos, you know, that kind of suffering. I'm noticing a pattern where those who have made suffering an art, often began honing this art at a very young age. By the time I see these people in therapy, whether they are teenaged or an adult, the suffering has become part of their personality. To suggest there is a life otherwise is blasphemy and almost insulting.

Even those who finally have the light bulb go on and decide they want the suffering to end sometimes have difficulty walking it out. Going from a life of suffering to walking in sunshine, smiling, finding the positive, making lemonade out of lemons... well, it's HARD. I have a client who has known suffering that some of us cannot fathom. She is an adult woman now, struggling almost daily with panic attacks, worry, abusive relationships, and tensions with her children. She has supports in her life that others don't. She has a good treatment team, a good job, and a nice home. Much of the crazy in her life is of her own making. My heart just goes out to her watching her hurt herself this way and I told her, "You have suffered enough. It's time to have a great life now. You deserve it. It's ok to start your great life." I think she's starting to get it.

Today I shared a rubber band with her. She and I put a colorful band on our wrists like bracelets. I explained to her that though she had no control over the crap that has happened to her for her much of her life, this is no longer the case. Starting today it was time to find the good. I asked her to flip that rubber band on her wrist every time she has a negative, critical, or anxiety-provoking thought. After snapping the band she would then say, "God wants me to have a GOOD life and today I choose that GOOD life." I agreed that I would do the same.

I agreed to do this primarily to give her a sense of support and connection with another person. What I didn't expect is how much this exercise has affected me. I have popped my own wrist about 20 times already today and by gosh, I think I'm really beginning to believe it... God wants me to have a GOOD life and today I choose that GOOD life.

Pain is unavoidable, suffering is optional.

Photo above found here:
http://jakrak.deviantart.com/art/Bands-20510905