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.


Short Term Problems, Long Term Progress

Ever feel like you’re not getting a point across?

Blog writing, at least as I practice it, is done on the fly. The essays are written quickly and revised only slightly beyond first draft. Sometimes the immediacy of the process obscures the intended message.

Many of this year’s posts have described my struggles, disappointments, sorrows, pains, and illnesses. Given that my goal is to write about life and growth using my own experience as illustration, it is only natural that setbacks prompt essays about difficulty. But the comments and emails I receive show that my larger perspective is not getting the attention it deserves.

It’s comforting to receive notes of sympathy and support. They help me feel that others listen and care. And yet, if my message was truly coming through, there would be more congratulation than commiseration.

Because the most striking fact of the past few months has been how little all these hardships get to me. Sure, I have moments of doubt and sorrow. In mentioning these, however, my hope has been to highlight the difference between how I’m responding now and how my tribulations would have affected me before. These days, I feel grief and pain flow through me at times, but my spirits stay fairly stable despite superficial complaints. In earlier years, my mind would have plunged into intractable depression and anxiety. With great relief, I’ve learned to watch life from the perspective of a deeper, broader, and more detached consciousness that doesn’t get pulled in.

I feel a clear separation between my transient emotions and my more enduring self. I can allow the feelings freedom to respond to life, but I watch them from a distance. I don’t, and can’t, take my suffering very seriously. Years of fostering meditative skills, spiritual grounding, and wise insight have led to this profound benefit. My quest has brought me to a state peacefulness I never could have imagined upon starting out.

As I work in the background on the book project mentioned earlier, I am feeling a sense of protectiveness toward that writing that seldom comes up in blogging. This larger work will demand careful editing before release. Online journaling has taught me how my unpolished language lets transient events obscure enduring truths. My book about mysticism and science needs to say its piece clearly and calmly, as if spoken from my most evolved mind; keeping that perspective in the foreground will require lots of rewriting. I hope to describe my position honestly, but with emphasis on realization rather than process.

Each approach has its advantages. I think the rawness of journaling appeals to certain readers, or else no blog would ever become popular. But the time is coming for me to clearly articulate a perspective on life that I’ve developed over decades. This can’t be done if it’s unduly influenced by the ups and downs of daily life. It needs to be written from that same perspective that is currently keeping me sane: broad, deep, accepting, and wise. I’ve gotten to the point where this viewpoint is always within reach, but it’s not always within my grasp, as recent posts have shown.

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Tales of Youth, and What I’d Like to Regain

Photo taken by Mandy on a (recent) trip to Yosemite!

At age sixteen, I planned to hike the John Muir Trail with my friend Jack (not his real name, though why would it matter if the world learned about our teenaged foolishness 34 years after the fact?). I did eventually complete the trek, but a few glitches arose. The problems started after we rode a Greyhound bus north from Los Angeles. We boarded with a number of outdoorsy types just like us, carrying bulging backbacks and bota bags, who chatted the whole trip. There were mothers holding their small children on their laps, trying to calm them as they stood on mom’s jeans, riding to homes or relatives in small towns along the eastern Sierra slopes. One or two men in faded business suits sat near the back, a lonely type I always used to see on intercity rides. Are they salesmen? Fathers working away from their families? A contingent of older folks had also boarded; they shoved shabby suitcases overhead, and leaned against the windows to nap until Reno, saving their energy for the casinos. Like them, Jack and I slept most of the way, under the influence of pills I had borrowed from the medicine cabinet of an elderly woman whose garden I tended.

We awoke to disembark at Lee Vining, a minute hamlet close to Yosemite National Park and (coincidentally) not far from where I now sit. I swiped a bottle of rum from the local general store, being an ignorant but fearless young delinquent. Jack and I sat on the shoulder of the road with our spanking-clean packs, and shared the bottle down to its last swig. As we became more and more drunk (a process aided by the the Valium we’d taken on the bus) we kept our thumbs out over the road, until a young man in a yellow Porshe at last pulled over. The car looked new, and smelled like a shoe store with all its fresh leather. Jack, being smaller than me, squeezed into the cramped back seat, and I ‘rode shotgun’ in the shiny black passenger seat as we wound our way toward the high mountains. I don’t remember much of that drive to the trailhead. It must have taken over an hour, and we arrived after dark. Our benefactor abruptly dumped us with our backpacks on the side of the road. He had figured out right away that we were tanked (how hard could it have been?), and made it clear he regretted stopping for us. Although he may have picked us up to show off his new car, by the end he probably feared one of us would throw up on the carpet.

Wilderness at last! In the dark and moon-less summer night we looked around and marvelled at the narrow pines silhouetted against the stars, and the flat expanse that lay between us and the forest. Taking in the majesty of the mountains quickly got replaced by our exhaustion, bordering on coma. On the cliff’s edge of collapse, we decided that rather than thrash our way into the dark groves to set up camp, we’d do the easier thing and unroll our sleeping bags where we stood. Within minutes we were passed out in our bags. Funny thing, this cop car drove by and blasted us with a searchlight. I vaguely remember their P.A. system barking something about moving our camp site. It did not sound like a bad idea, but it would have been a lot of work. So we fell back asleep instead. As you might guess, that turned out to be a big mistake. When the police returned, they had little patience with our drunkenness. It also turned out we were camping in a parking lot, which was probably what tipped off the cops that we were not too sober. Within about thirty seconds they found the fifty joints of marijuana Jack had carefully concealed in his pack. Uh oh.

For the next ninety minutes we slammed from side to side in the back of a cold steel-walled van, trying to stay perched on the single steel bench. Hands cuffed behind us, we had little chance of holding on as the vehicle roared down the twisting road toward Yosemite Valley. Once we arrived the two officers, already divided into the good-cop/bad-cop routine that I learned about later, shined intense flashlights in our eyes and told us to get out. Dizzy from the drive and the booze, and blinded by the glaring white beams, we tumbled out of the wagon and more or less landed face-first on the oily asphalt. As the cops chuckled, we writhed our way to standing positions, hands still pinned behind us. They marched is in to the little jail and spent (what seemed like) most of the night interrogating us. What they hoped to get out of two high school kids is a mystery still, but early on I confessed the location of the rest of the drugs. I should have kept my mouth shut, since I doubt they would have found the stash otherwise. They thought everything had already been located, and their search of my pack had been cursory. But the ‘good cop’ won my trust, and I decided to help him out. Their whole attitude changed after I fessed up. Both became cold and efficient, and they went through every last rolled-up sock. By the time they unlocked our hands and pushed us into the four bed cell, the pleasant stupor of near-lethal intoxication had long-since worn off. As I lay on a one-inch thick mattress staring at the underside of the upper bunk, with the corridor lighting making the room almost as bright as day, the depressing fact of our arrest for marijuana possession began to sink in. I had ample time to contemplate this giant screw-up, and what looked like the end of the John Muir Trail adventure.

How stunning the view from the front steps of Yosemite Jail! Few lock-ups let you out into a plunging chasm lined by vertical granite, with a thousand-foot-high waterfall thundering to your right as you stagger down the redwood stairs. The photo with today’s post, taken recently, reminds me of what a glorious sight opened before me as I exited the jail. Sadly, Jack’s parents were not enjoying the vista. After driving most of the night from an L.A. suburb, they seemed a bit peeved. They hammered Jack with their anger and accusations, once in a while staring at me, eyes almost bleeding with contempt. This was not fun for any of us. Jack and I had been ordered to depart the park and not return for at least a month, if ever. Jack’s folks led us to their car like executioners loading horse thieves into a gallows-bound carriage. I worked to reinforce my defences for a drive south under a barrage of criticism, but before we took off my father granted a reprieve. We spoke for the first time since the arrest as I stood at a phone booth under an enormous cedar, the morning air pungent with a scent of damp pine needles. I gazed with longing across a vast meadow the color of limes, toward sheer rock faces that loomed above me despite the distance. My father could not be predicted under even normal circumstances, so I had no idea what to expect as I told him the story. Since the police had been unable to reach him the night before, I was free to slant things to make my behavior sound pretty innocent. Those arrogant park rangers had rousted us as we slept, just to harrass us. It must have been our long hair that made them decide to frisk us. They had no probable cause. I thought it best to leave out the parts about camping in the parking lot, or how we were so stoned we could barely talk. Knowing how furious it would make my stepmother if I ruined her summer by returning to L.A., my dad only surprised me a little when he suggested I stay in the mountains. “Keep a low profile,” he directed after I told him how the rangers had banned me for thirty days. Why not just leave the park via the trail, and commence backpacking by myself? The drugs had been confiscated, so he did not see how I could get into any more trouble. (Six weeks later I would talk to him from inside the Fresno County Juvenile Detention Facility.)

Sounded good to me. With a widening smile, I pulled my disheveled and ransacked pack out of the family car’s trunk, said goodbye to a brooding Jack and his fuming parents, and trudged off into the trees. I moved quickly, before any cops noticed I wasn’t rolling out the gate. The next two weeks gave me my first taste of adult freedom. Friendships formed easily among the shaggy young drifters hanging out in the walk-in campground (no cars allowed). With our down sleeping bags stretched out on beds of pine needles, we slept randomly grouped in an open grove of ancient conifers. We all wore the same uniform: plaid cotton shirt and blue denim jeans. We ate Fruit Loops cereal for breakfast, and then broke into groups to hike, or ride the open-air trams, or maybe swim in the freezing currents of the Merced River swollen with snow-melt. We drank lots of booze, once or twice dropped LSD, smoked pot day and night, ate slices of pizza outside the Yosemite Valley store, and pretty much created a ruckus wherever we went. Every day I got an adult to buy me a half-gallon of cheap chablis, which I passed around the campfire with my new pals. That helped get me past the obstacle that as a high school kid I was the youngest and most naive of this group of youths. Most of the girls I met in the park seemed far older than me (even past the advanced age of twenty), or else they were my age but kept on a tight leash by their parents or chaperones. I lucked out, however, and managed to spend one whole night with a college-bound girl I’d met that afternoon, but in my nervousness I drank so much I passed out with my clothes on. She still seemed to like me when we awoke the next morning, fully clothed but wrapped in each other’s arms. To my chagrin, she left the park that day with her tour group. So much for my hopes of ditching my virginity in Yosemite.

I struck up a friendship with a guy named Paul, who had no fixed address and worked odd jobs when he needed cash. He latched onto the John Muir Trail idea like a tick on a poodle, and we started collecting food for the first leg of the walk. He taught me that uncooked pasta, pankcake mix, Lipton soup packs, and dry salami fed you just as well as pricey freeze-dried dinners. He helped me get rid of useless items and employ the extra space in my pack for more food, so we could go further before restocking. He showed me that you can burn a camp stove on unleaded gasoline from a service station (back then they sold gas in Yosemite Valley, and unleaded fuel was still a novelty), which was cheaper than the less toxic white gas available in camping stores. Paul made me realize that Jack and I would have smacked into problems soon after starting, given how we planned our aborted trip with such ignorance. Shorter than me, but stocky, Paul’s curly hair was so blonde it looked almost white. He only shaved often enough to keep the stubble from turning into a beard. I thought he seemed worldly and street-smart. The night before we hit the trail, I called my dad and told him I was finally launching my adventure. To my surprise, he cautioned me to be on my guard with my new friend. A few weeks later I found out he had given me good advice, which of course I did not follow.

The next morning we pulled our weighty packs up on our shoulders, cinched the waist straps, and embarked on the 211 mile trail. The first day we spent climbing out of Yosemite Valley, past the roar of Vernal and then Nevada falls. Each is a thundering column of white water that kicks up a cloud of mist. The spray drifts over the trail to either freeze or refresh you, according to the day’s weather. Above and below both waterfalls the river tumbles steeply over enormous granite boulders, roaring loudly.

The trail started out crowded with visitors, so that we had to squeeze by balky children or stomp impatiently behind older couples breathing in heavy sighs as they made the ascent. Most hikers turned around so we saw fewer people as we approached the Valley’s rim, where the terrain opened out into large expanses of granite sparkling with feldspar. I watched the snowmelt-swollen river feeding the two falls surge in vigorous currents next to the trail. The icy, clear water swept through a narrow sluice that a glacier must have carved into the massive blocks of stone that formed the mountain.

This story forms a diptych, and one main panel of it happened as I attempted to cross the granite sluice through this muscular flow. For today, I want to skip ahead to the first night Paul and I spent on the trail. We set up camp in a grove of conifers stunted by poor soil layered on top of a hard pan of rock. That evening, as we sat with a Boy Scout troop around a toasty campfire (back then hikers were still allowed to burn open fires), we heard a loud thrashing and the sound of breaking branches. By the flickering light of the blaze I spotted a bulky shadow under the tree where I had suspended my sac of food. We all stood up, but only I rushed into the grove to find that my bag, and only mine, had been swiped by a bear. I had dutifully suspended it from a branch but underestimated the reach of a bear extending on its haunches. As an unrepentant petty thief, I suppose it served me right to get robbed by a wild animal. But it did not bode well for the success of my trip if I ran out of food in the first twenty-four hours, especially if it wasn’t me that consumed it.

I was young. I was stupid. I took off after the lumbering bear. It looked like it moved slowly, but that illusion came from its gigantic size. The animal’s gallop rapidly outstripped me as I sprinted in pursuit, screaming and throwing rocks. The moon was full by this time, two weeks after the dark night when Jack and I camped in the parking lot. So I dashed through the open forest in pursuit of the bear’s gigantic contour which I only glimpsed now and then, shouting at full volume. Somewhere along the way I pulled a thick branch into my hands, and I brandished it like a baseball bat. If I had caught the bear, if it had waited for me, or if it had headed back my direction, I would have swung that branch at its head. Which probably would have been my last living act. Luckily for me, after the bear paused to rip open the sack and rummage its contents, it loped onward and disappeared into the trees. Badly winded, I was relieved to see my food containers and torn ‘stuff sac’ scattered on an open face of rock the size of volleyball court. I gathered up my items: a can of spam had been punctured by the bear’s fangs; the box of pancake mix was ripped and dampened with slobber, but still held most of its powder. Cans of evaporated milk had rolled into crevices unharmed, but the beast had ripped open my box of brown sugar and licked out every single crystal. And I never saw the dried salami again.

Why did I take the time to put this really long story on my blog? Especially when I know that few people have enough interest to read all the way through such lengthy posts. As I said, this tale actually forms part of a diptych. The second part is short, and tomorrow or soon after I will publish it on the site. Both anecdotes show my courage as a teenager, and how blind I was to my own vulnerability. I suspect young soldiers at war have similar ‘bravery’. Generals count on their troops to act with little caution when engaging the enemy. I would have done well in a war, until my brashness got me killed.

I am different now. Very timid about risk, and ever-mindful of consequences. One advantage of my former bouts of hypomania, which medications no longer allow me, is that I would lift my blanket of caution. I would recover some of my adolescent wildness, and its creative impulses. As I pull myself out of my decade-long pit of despair, I want to recover some of that bravery. I’d like get reacquainted with that young man, who chased a three hundred pound fanged and clawed wild animal through a moonlit forest. Who never worried that the bear could have sliced his gut open with a swipe of its paw. Stupid, yes. But also bursting with vitality. Better to be alive in one’s heart and a bit foolish, than be dead in one’s soul and ever-so-wise.

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What A Lifetime of Therapy and Self-Help Hasn’t Taught Me

AACA Cartoon

What does it take to transfer understanding in the rational part of the brain to the emotional part? The number of years I’ve spent in therapy, or support groups, is vast. Here’s a partial list of the therapy:

  • 15 sessions with a court-ordered counselor when I was sixteen.
  • 12 sessions with a PhD psychologist in college, after a suicidal gesture atop the campus bell tower.
  • 180 sessions with another PhD psychologist, who called himself a behaviorlist.
  • 20 sessions with a counselor in medical school, as I went through a divorce.
  • 24 sessions with a Jungian analyst.
  • 150 sessions with a psychiatrist during residency, who mostly had me talk about family-of-origin dynamics.
  • 250 sessions with a psychiatric nurse who specialized in recovery from child abuse
  • 20 sessions with a counselor who practiced sand tray therapy, among other things.
  • 2 psychiatric hospitalizations, of 12 days and 8 days.
  • 300 sessions with a psychiatrist who took me (again) through family-of-origin dynaymics
  • 100 days or so in intensive outpatient treatment.
  • 20 sessions or so with a social worker specializing in Cognitive Behavioral Therapy) CBT and mindfulness.
  • 12 sessions with a social worker specializing in Acceptance and Commitment Therapy (ACT)–ongoing.
  • Recent sessions with a social worker to deal with history of sexual abuse, and how damage from medication brings that up. (long story to be dealt with in another blog)

And here’s a partial list of the support groups:

  • Support group of medical students weekly for 18 months in medical school, then occasionally for 2 years.
  • Alcoholics Anonymous since 1987. Countless meetings.
  • Alanon since 1988. Countless meetings.
  • Adult Child of Alcoholics meetings weekly for one year while living in Manhattan. (These groups were often hard to take)
  • Adult Survivor of Child Abuse meetings weekly for two years.
  • An eighteen month intensive group therapy for child abuse survivors.
  • Numerous meetings, sporadically attended, of other 12-step programs (e.g., debtors anonymous, sex and love addicts anonymous, etc.)
  • Weekly meetings of a dual recovery group for 2 years ’06 to ’08.
  • Weekly meetings for people with a history of problems with prescription drugs, ’06-’08.

Now, you would think that after all that I would not spin out because my blog-stats dropped. But I did. So how do I take all the knowledge that I really do have about codependence, abandonment issues, self-esteem, acceptance, etc, and make myself well? How come it is so easy to know something with my mind but remain completely clueless in my heart? Is there anyway to transfer the knowledge? Can I build some kind of high-speed data connection between the two parts of my brain that deal with these things? (Aside: Don’t you just hate brain/computer comparisons?)

The only solution I can find is looking for improvement (‘progress, not perfection’ is what they say in AA). Yes, I did crash and burn about the web statistics, but I pulled myself out of it pretty quickly. I was even able to see the humor in my response. That is much better than ever before. What’s more, I opened up about what was going on with me, reached out for help, and was rewarded by many kind messages from those who’ve been reading my posts. (And this was true even though I’ve only been doing this with any regularity for 3-4 weeks; a real testament to the kindness of those who read mental health blogs.)

Thus, I look for signs that my emotional skills today are more honed than yesterday. But I am still puzzled about why I’m so dense. Therapy ‘should’ help the emotions. The unconscious ‘ought’ to learn, but mine obviously did not. Or maybe it sometimes learns, but other times forgets. One way or the other, I find my theoretical understanding far surpasses my practical application of what I know about how to be healthy. Hence, I find it easier to give advice than to live in a state of emotional balance and spiritual connection. It would be easy to blog about all the stuff I’ve been told, and never mention that it only works for me half the time. But that would not be honest, or fair, or helpful to others or to me. So here I am, admitting that the simplest things still trip me up, even though I was fortunate enough to have good insurance, the resources to pay for what insurance would not, and to live in an area with a surfeit of recovery and therapy groups.

I’ll end by asking if anyone knows some tricks for taking cognitive understanding, and turning it into emotional maturity. I am anxious to grow out of this phase and into something more enduringly healthy.

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Meltdown as Mentor: Examining Insecurity

Note: the attribution for photos can be found by clicking on the image. Most are used via Creative Commons license, as is indicated in my footer. But it does not hurt to state it up-front occasionally.


moving van

It helped so much to get such kind comments after I blogged about my discouragement. How wonderful that the blogging community (at least in the mental health realm) is so supportive.

Today I worked at putting fixtures back up in our bathroom, after Mandy painted yesterday. It took the better part of a day to get it all restored to order. That normally would be fine, but I really wanted to write something extra interesting today. I wanted to show how much it meant to me that people responded, even as I thought no one was coming around anymore.

I like to look at meltdowns like the one just ending, and ask what can be learned. I already mentioned the problem with being too sensitive. The other issue that I see is the ever-present fear of abandonment. On another page of this site I placed the recent essay I wrote about my last memories of my mother. Watching her fade into deepening depression, and then die, left me with a sense that even those who love me (and I know my mother did) cannot be counted upon. Then I think about all the moving we did as I grew up (every year until I was ten), and the fact that I would go spend the summers relatives who would be really nice to me, but then force me to return to Los Angeles to be assaulted by my ‘evil stepmother’. So the idea that anyone will remain in my life seems pretty unrealistic.

Hence, I am always ready for the inevitable disappearance of those who matter to me. The surprising thing is that in the short time I’ve done this blog, having people read my little essays has become very important.

I could walk away with some growth here: 1. a sense that even people I’ve never met care; 2. a realization that feeling abandoned because my site statistics dip is not too healthy; 3. knowledge that I have found an activity that’s important to me, after years of little enjoyment of anything. (I could also add: 4. a reminder that to some extent I am still stuck in my childhood.)

So in the end, a valuable experience. Thank you to all who read this: you have helped me rediscover joy.

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