WillSpirit!


∞ Where Mental Skills Heal Mental Ills ∞

A former physician writes about mental health and recovery using insights from life, science, and spiritual practice.








  • Red_Exclamation_DotDisclaimer
    • Dear Visitors:
      Although I trained and practiced as a physician, my background does not include formal instruction in psychiatry beyond basic medical education. This journal presents ideas about treatment philosophy, but must not be considered therapeutic advice. Abrupt changes in one's psychiatric medications can trigger profound cognitive, emotional, and physical symptoms, including suicidal thoughts and actions. Consequently, pharmaceutical agents should not be increased or decreased without supervision by a mental health clinician.

    • ON THE OTHER HAND, your brain belongs to you, and your opinion counts. If you decide that changing your medication regimen will serve your best interest, then I believe your providers have an obligation to help you try to achieve your goals. I want everyone to be educated about their options, and do what will be most helpful for themselves. No one should feel pushed around by dogmatic and/or limited viewpoints, whether those of psychiatrists, anti-psychiatry advocates, or myself.


Rising Up Again After a Fall

One day in kindergarten, the teacher taught us how to cut a circle out of construction paper. We were making cards, or posters, or something, and we each needed a red round. She started with a square piece of paper and cut off the corners. This led to an octagon, and she cut the corners off that. She continued cutting the increasingly obtuse angles until she held a pretty circle in her hand. It was obviously an efficient method, perfect for five-year-olds.

But I wasn’t buying any of it. The method looked too mechanical, too slow. Why not just cut the shape freehand? Which is just what I did. Or tried to do. Instead of a four-inch diameter circle, I ended up with a two-inch ragged pear. It proved impossible for me to cut a circle by eye; no matter how many times I went around it with scissors, my creation looked anything but circular. The teacher, rather smugly I thought, used me as an example for what happens when you don’t follow directions.

I have always had a hard time doing things the way everyone else does. I’d like to blame my father’s ranting against “the establishment,” but it seems unlikely that his politics were to blame for my contrariness in kindergarten. My refusal to follow normal patterns probably contributed to later career misadventures, relationship difficulties, and health problems. It would have been so much easier to choose the field of study I enjoyed rather than one that seemed more impressive. My life would now be richer if I’d focused on raising a family rather than neurotic fears. My health would be better if I’d never wasted time with marijuana, alcohol, and so on.

Some people seem blessed from an early age with knowledge of what’s important in life. A good friend of mine in college happily pointed out pregnant women, because he was so interested in starting a family. Nothing could have been further from my mind at that time. He now has three delightful offspring, and I have none. Other friends chose careers they felt passionate about, and some have achieved significant success as a result of their healthy decisions and years of perseverance. I, of course, find myself in retirement at age fifty-three.

So there has been a price to pay for nonconformity. Many prices, in fact. But today, it makes more sense to focus on what was gained instead of what was lost. By operating outside the mainstream, I’ve learned that life can be valuable even if it doesn’t follow the healthiest path. I’ve found that although a family and satisfying career no doubt help one find satisfaction, they aren’t essential. Even in the midst of pain and disability, life remains fascinating and often beautiful.

So although I’m prone to break down and often feel discouraged by my fate (which I admit to having shaped by my own choices), I spring back soon enough. And each time I rise up from despair I feel less tainted by it. Learning that the mere process of living is enough, no matter what goes wrong or how much it hurts, is of inestimable value. It leaves me ever more certain that I will weather whatever destiny may hold in store for me.

You have a right to be skeptical after my last essay. How can someone who entertains suicidal fantasies claim resilience in the face of hardship? My only defense is to say that resilience doesn’t imply that one is upright and rigid like an obelisk. Instead, it suggests the suppleness of a sapling, which can be flattened nearly to the ground by blasts of wind, but then springs upright once the storm clears. Having been knocked down countless times by circumstance, I now feel confident of my ability to bounce back.

And let me emphasize that this has been a learned skill as much or more than an ingrained trait. In younger years a single perceived rejection could lead to weeks of self-contempt and withdrawal. Nowadays I can ride out debilitating pain, humiliating treatment by a new doctor, utter cluelessness about my purpose in life, and still feel fairly happy to be alive once I get the initial tantrum out of my system.

Whence this ability to find satisfaction in the face of discomfort? It came from meditation, introspection, writing, and practice, practice, practice. Luckily, life has provided me many opportunities to develop a talent for rising up again after pain, disappointment, and despair knock me down.

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Personality Problems & Self-Hatred After Childhood Trauma

Hieronymus Bosch: "HELL"

Almost a week has passed since I last posted something on the blog. I’ve been engaged in a pitched battle with some of my worst demons. Trying to survive. Living minute to minute. That sort of thing.

Seems like I should check-in with everyone. I haven’t the courage to look at my web-stats, but even though I’m sure the number of visitors is way, way down, I know there are several readers who do care. I want to reassure them I am still kicking, albeit less strongly all the time.

I’m pretty much out of ideas for how to get out of this pit, which mostly is one of very low self-esteem. I don’t mind the anxious, sad, and angry feelings like I used to. But I am sick of my personality and see little chance of change…

About half my therapists have been willing to give me the diagnosis of a personality disorder. Of those, at least two seemed to enjoy slapping me with that accusation. Of the ones who have held back, I suspect there has been a sense of not wanting to further lower my opinion of myself, or further anger me, or somehow make things worse. One psychiatrist said she thought there might be a difference between ‘borderline’ characteristics that are reactive and defensive, but not necessarily integral to the personality, and true BP disorder. That seemed like a nice way of saying that I sure look like someone doomed to eternal conflict with others, but maybe there’s a small chance I can improve.

One of my curses is being so self-aware. I can see all the hostile and counterproductive things I do and even understand why I do them, but I can’t seem to stop. I’m not someone who puts the blame on others or thinks that if only people around me would cooperate I’d be fine. I see myself do and say the most appalling things sometimes, and yet I have no more ability to redirect my actions than I would of turning a train running on a straight track.

The sad thing about so-called ‘borderline personality disorder’ is that it mostly results from childhood abuse. So you get rejected and mistreated as a child, then grow up into a confused and mistrustful adult who invites rejection and mistreatment. The only way I can manage self-forgiveness is to recognize that almost anyone who lived through a childhood as traumatic as mine would turn out just as badly messed up. Perhaps a few abused children escape without major personality flaws, but most suffer with rage, shame, and mistrust. I suspect close to half end up imprisoned, on the street, or dead.

So just surviving, remaining outside institutions, and having one close relationship must be counted as a kind of success. There was a time when I could point to my surgical career to prove I had beaten the odds. But time has mocked that victory. So now I just try to be OK with making it from day to day, sustaining a marriage, and continuing my efforts to improve. I think some would question how hard I try (“If you really wanted to change, you could”), but I know how many years I’ve spent in therapy, how many groups I’ve attended, and how many books I’ve read. I didn’t do those things just to piss off people who tried to help me. I really wanted (want) to improve, but somehow couldn’t get past all the obstacles. Just because I built the many of the barriers myself does not mean they aren’t there.

This was supposed to be a one-paragraph check-in to let others know I’m still alive and fighting. It ended up a rant on my current despair. I hope it somehow helps others feel less alone. At least I feel that way, even if all my readers have long since gone.

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