WillSpirit

Where Will meets Spirit
∞ A Blog Devoted to Balance, Peace, and Clarity ∞

A formerly depressed physician tells stories of trauma, grief and recovery, and offers suggestions for emerging from darkness, living with mood swings, and awakening to life.








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    • 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.




The whole story.

shipwreck

I am almost sorry about yesterday. What a discouraging post! I say ‘almost’ sorry, because my goal here is to be honest about what goes on in my world, inside and out. I don’t want to hide my moods; certainly not the positive ones, but not the depressed ones, either. If I don’t watch it, my text drifts into the arid desert of analysis and logic, and away from the messy emotional compost that nourishes my more heartfelt writing. Personally, I find too much issue-dissection boring. Life is as much about what the heart feels as what the brain thinks. States such as passion, affection, sorrow, euphoria, fury, and desperation often look disorganized and senseless. If I am to be authentic, and open about my inner experience, sometimes I will sound wretched. (Another reason I’m not too regretful is that I received such nice, supportive comments!)

My feeling life gets tossed about by frequent typhoons of sadness and despair. Although the cloudiness alternates with brighter moods, including pressured winds of optimism and plans that soar high above firm ground, I never venture far from the shade. Until recently I called my storminess ‘bipolar disorder’, and my bleakness ‘depression’. At this stage in my life I find it more helpful to consider myself a bit temperamental, mournful, and sensitive, but to pitch the illness concept overboard. Whatever you name what I’ve ‘got’, however, I am never long on an even keel, and I spend a lot of time in the stagnant duldrum of hopelessness.

So if I am going to write with feeling, which makes more interesting reading than pure logic, there will be times when things sound a bit unhealthy. Self centered. Whining. Self pitying and immature. I hope the less uplifting posts will alternate with essays that climb toward ecstatic observations on the spiritual underpinnings of biology, or pieces that animate the possibility of utter contentment in the face of chaos and loss.

I could make the decision to censor ‘ugly’ material out; I could make myself always sound spiritually fit and possessed of wisdom. But I have given this thought, and my goal in this blog is to tell a story of life. Not just my own history, though that forms the basis of most of my ideas, but the larger story of life as a damaged human being. An injured person may have days when everything ‘falls into place’. On such days every insult, each wound, and the countless pangs of grief, are recognized as openings rather than cuts. The awareness blossoms that such fenestration widens the eyes so they can see more beauty, and expands the heart so it can offer more love. But most of us with hellish memories also suffer times when the vision clouds over, and the heart cramps into a lonely knot of muscle, unable to accommodate more than the thinnest stream of blood.

Even Jesus, we are told, had moments of doubt in the garden of Gethsemane. My spiritual development is as close to that of Jesus (or the Buddha’s, or Gandhi’s, or Mohammed’s) as a flea’s heart is to an elephant’s. So for me, at least, perfect and perpetual equanimity remain out of reach. I suspect this to be true of all but the most determined and fortunate of those who are raised deprived, assaulted and hated instead of nurtured, protected and loved. When children suffer overwhelming losses, they grow up with infinite feelings of want. When they are attacked, they learn to expect the worst. And when despised, they learn to hate themselves. Such lessons take a lifetime to unlearn. On the best days, one gets blessed with a radiant comprehension of life and its full panoply of emotions. One understands that joy, love, anger, and grief are just different directions that the same wind blows. One feels the uneven but never-ending currents of time, space and fate flow like God’s blood through the mind, body, and soul.

But there will also be days when it all looks like a lump. At those times the injuries seem too great, the loneliness too imminent, the joy too sparse, for life to be worth living.

I have my saintly moments. But they are not as common as my darker days. I am not offering a cure in this blog. I am not presenting my path to recovery as a method others can follow and find salvation. That would be a lie. My path has not proven to be direct and unerring in leading me to peace. My commitment to well-being wavers, and sometimes I just break down and cry.

That is the story I want to tell. The entire canvas, including the splattered and shredded edges that often get hidden when one uses an elegant frame. This is my life nailed to a tree. It is not hanging in the Met, or bound in the rare books section of a major library. It is a mess. But it is sometimes beautiful, often interesting, and it is all I have to offer.

My aim is not to lead people to think I always view life as a precious jewel, which I certainly don’t. Or that I am living the perfect story of recovery, which will never be the case. I choose instead to present the days as they strike me, the ideas as they arise, and the emotions as they crash over my bow.

Yesterday I was a shipwreck. Today I feel more like the transom of an ancient wooden fishing boat I once found on the beach in San Francisco. The varnish had at one time been shiny, and the wood had formed part of a stout and working vessel. What I found had turned into a labyrinth of splinters and warps and cracks. The paint that once proudly announced the boat’s name could barely be deciphered. But that piece of wood had an elegance it had never known when it was still functioning as a beam across the stern of a trawling watercraft. Time and catastrophe had etched it with a fineness that it seemed to want to share with me. So I took it home and put it in my garden.

This is my transom. It is wrecked, and not all of it will be beautiful. But I want to share it with you. Feel free to place it in some corner of your garden. Let the moss grow over it, and let the ants move in. Or burn it and toast marshmallows. It is my gift to you and to the world, if you want it. It will not always be attractive, or even inspirational, but I will try to keep it authentic.

So I don’t apologize for whining, even though I’m embarrassed. Yesterday, I was a lonely and discouraged child. Today I am an inept but enthusiastic poet. I am sometimes enlightened. I am often discouraged. But most of all, I am alive. And good or bad, upbeat or down, this blog is helping me stay that way. I pray that it helps you, too.


(I modified this post on 2009 August 28, c. 07:30 PDT, primarily in the first paragraph, but I changed a few other spots also.)

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Letter to a Friend

rippleReflection

The post I planned to write today will come later.

For the past several months a counselor practicing Acceptance and Commitment Therapy (ACT) has been teaching me to expand my philosophy, and quit struggling against my hardships. My insurance granted pre-payment for twenty sessions, and I have completed 12 or 13 so far. My relationship with this clinician started at a propitious time, and dovetailed with my involvement in Bipolar Advantage, which teaches one to take a more positive attitude toward mood fluctuations. These two influences spoke to my gathering awareness that being frustrated and unhappy with ‘the way things are’ serves me poorly. They also bolstered my resolution to wean myself off as much medication as possible, a step made more essential when I awoke to the horrific damage psychiatric drugs have wreaked on my body.

This therapist’s work underlies much of what I write about accepting life’s deprivations, acquiescing to grief, and appreciating the sublime qualities of emotional distress. Knowing that outside of the sessions this person has kept up with my blog posts, and sends me insightful comments on how they relate to my individual story, adds to my feelings of gratitude. I wrote a letter (actually an email) of thanks this morning, and ended up sketching part of my core emotional landscape. Posting a slightly revised version of my message on this site offers my audience a view of my inner milieu, while at the same time publicly expresses my appreciation. Knowing that others share your experience can be very healing. I hope that one or more of my readers will resonate with my longstanding ambivalence about life, and also my growing desire for more engagement. ACT teaches, among other things, that while we all undergo times of distress and cataclysms of sorrow, we can remain open to common joy. Even more, during those shaded times when our days feel bleak and fortune has violated all its promises, it remains possible to enjoy being alive. Perhaps it is akin to loving one’s child even as he spits hostile words at you. He may not be pleasant, but he is still an infinite gift.

A large segment of the population staggers under a burden of emotional agony. If that were not so, investors in pharmaceutical stock would not be so well rewarded. No doubt people have always been afflicted by almost unbearable feelings, but in this era of education, abundance, sanitation, and comfort, I believe we can do better. Not that the pain will go away, but perhaps our appreciation of day-to-day reality can increase. Imagine a world where even in the midst of wage-slavery and fears of violence people relished being alive. Where they accepted their pain to the point that they had energy to fight against injustice. Where financial and material trappings became less important than human relationships and creative expression. The way to achieve this vision lies in opening up, ‘sharing experience, strength, and hope’ (as they say in Alcoholics Anonymous), and collectively learning how to thrive in the midst of a challenging world. I try to do my little part by deconstructing my rusted and creaking mental mechanisms to a behavioral health audience, and handing on the tools and lubricants others have provided to help me get things running more smoothly.

This therapist gives me much in this regard. I publish this letter as a public statement of gratitude, with the prayer that programs and messages such as ACT will propagate outward into our culture, like the rings stretching away from a pebble pitched into a pond. Where the surface of my depression once looked as solid and impenetrable as a pane of glass, ACT shows that all pain has depth and rhythms, and that I can learn, grow, and even enjoy myself while exploring these textured realms. Of course, the ideal often lies beyond my grasp. My ability to take such a philosophical stance, and savor the warm sensation of blood pumping from my wounds, depends on practice and motivation. But I have been fortunate to meet someone who has had the patience to sit with me as I bleed, until I understand that unlike the blood that flows through my body, the blood of the soul is infinite. No matter how much I hemorrhage, I will always have the vital spirit to go on, if I choose. So much better than my previous experience in the mental health world, where the philosophy has always been to apply pressure and tourniquets. Sure, drugs can slow the rivers of emotion, but once you tighten the tourniquet the limb goes dead.

I place the letter here because it is more personal and less intellectual than much of what I write. I want to allow people to get to know what I’m really going through, rather than always hiding behind a facade of philosophy, analysis, and weak attempts at lyricism. Fact is, I am making progress, but slowly. I see the path ahead, but have yet to walk most of it. This message shows one footprint along the trail.

Dear [M],

I’m glad that my last blog post provided, at last, some good news in regard to my mental state.

Contemplating death as a solution has always seemed reasonable to me, given how my mother checked herself out of life as I watched. In the suicide hotline we always ask about prior suicidal behavior; I’ve only made a few weak attempts, none of which had a high likelihood of lethality. But suicidality has become a part of who I am. Even twenty years ago I was pretty sure I would some day kill myself. Obviously I have not, and may never, but I no longer feel alarm about thoughts of destroying myself. I think that attitude helps me support people who call the hotline in crisis.

On the other hand, I respect that such talk upsets others. I wish when in my worst moods I could censor my statements better. In particular, it is hard on Mandy to know how often thoughts of death go through my mind (not that I talk about it all the time, but it only takes occasional mention to make the problem apparent). Accepting that life brings pain, and that pain can be endured or even seen as a kind of beauty does not automatically translate into a desire to keep experiencing it. I am OK with that disconnect, but I am not so pleased that my ambivalence about life pollutes the happiness of those around me.

Back to today. Bottom line is I feel better, and happy to keep going. I truly do have a commitment to stay around for Mandy, and I would never leave my dogs unprotected. I even look forward to the future, no matter what it brings.

Thank you for paying attention, and supporting me as I work out a philosophy and mind-set that will carry me through the last several decades of my life. I need to have some kind of framework to both endure and see positive aspects to further declines in health, increased physical pain, and the probable loneliness that await me. Having a deteriorating neck that hurts all the time, and threatens the integrity of my spinal cord, plus knowing how few close relationships I have other than my marriage, does not give me a rosy picture for the future. I appreciate that ACT is not about convincing myself that my fears are unfounded (they aren’t), but rather gives me at least a glimmer of hope that I can survive the struggle. There is even that astounding suggestion that no matter what happens, my future can be enriching and full of adventure.

I look back at what I’ve written here and almost laugh at myself: this is how I think when my mood is more or less good (although I’m realizing my spirits are not as upbeat as yesterday). I don’t know how you feel about getting saddled with me for twenty sessions, but it has helped me that you have been so understanding. And I am thrilled that there is at least one person reading my blog who really ‘gets’ what I’m writing about. Of course, it’s not surprising that you do get it, since you taught me much of what I’m saying. What’s nice is that you’ve taken the time to read how I’ve been thinking about the acceptance philosophy. (You’ll note that I don’t do much with commitment, at this point. I need to more fully commit to staying alive before I can talk with any authenticity about fidelity to values, etc.)

To try to end on a positive note, I am highly motivated to search for reasons to stay alive, and to be glad I am. I want to build something more than a stoic fortitude to not abandon Mandy. Writing helps me feel good about breathing and thinking. Knowing that you (and hopefully a few others) find what I produce interesting makes it even better. In the end, creating something attractive and worthwhile out of tragedy and sorrow has been the task of artists throughout the ages. After decades thinking of myself as primarily a scientist, I now see that creative expression will be my salvation. That requires the knack of appreciating the heavenliness of heartache, which you and ACT have taught me.

Thank you.


(I modified this post on 2009 August 15, c. 17:45 PDT.)

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Death’s gift of Life.

Mountain Lion Picture comes from National Park Service via Wikimedia

Yesterday my post took too much time to tell a story too far off-topic; the main subject is meant to be behavioral health. Even though life-history, spirituality, and psychology overlap, I plan to keep mental health the central stream. Yesterday’s final paragraph said what the entire memory/story had been driving toward: remember how excited we were as youths? Wouldn’t it be nice to regain some of that passion? Even if it also meant making some silly mistakes? Or taking some risks?

Not long ago I concluded that to a large extent, for me, fulfilment depends on passion. Life begins to look dull and pointless when everything feels lukewarm. There needs to be an occasional volcano, or some lightning storms, or comets racing across the sky. Maybe feeling a lava flow’s heat scorch my face, or listening to the roar of a tornado from across an abandoned field would do me good. Over the past decade, my mental health clinicians inculcated me with a sense of fragility. Last year at this time friends were going on a trip to experience three-day ‘vision quests’ alone in the high desert. My therapist and psychiatrist convinced me that doing so might make me depressed. Wouldn’t want that.

But what if I had taken the challenge, and then became depressed? Couldn’t I have learned from that, just like my ‘manic-psychosis’ in 2000 brought me ecstatic spiritual enlightenment? The time has come to quit handling my psyche like a wounded dove, and let it step forth as a muscular mountain lion (we have those around here), alert and voracious.

Today’s post extends the theme a little further. It is not as short as I’d hoped, but it completes the diptych. Having made the point that hazards are the price we pay for feeling the thrill of life, I now walk myself back to when I stood in the currents of danger, and gazed at death’s face. Yesterday’s post laid the groundwork for this closing anecdote. Here is the stage setting:

With a recently met friend, a sixteen-year-old kid (me) starts a hike of the 211-mile John Muir Trail in California. (Check out this JMT link for photos of what the scenery looks like in the High Sierras). The first day they make the steady climb from Yosemite Valley (elevation 3966 ft/1208 m), past two waterfalls, to an area called Little Yosemite Valley (elev. 6100 ft/1860 m). In this region, the river that feeds the waterfalls runs through smooth channels carved in granite by nature’s forces. The icy snow-melt water moves swiftly, but the granite sluices are so smooth-walled that the liquid travels without gurgles or waves or white water. Pure and fresh, it does not carry debris or obvious life forms. The stream looks perfectly transparent, and only the shifting reflections and refractions of sunlight hint at the deep and powerful currents.


Now for the story: After we reached this area above the falls, I noticed many people were camped on one side of the river, and none on the other. It seemed sensible to me to cross the flow, and set up our site away from the masses. I looked for a place to traverse, and settled on a spot where the stream widened to forty or fifty feet (12-15 m), but was only about four to six inches (10-15 cm) deep. At this location the water was sliding down the face of a hillside of solid granite. The expanse of ash-colored rock looked as big as a hockey rink, and formed a steep grade as it leaned against the mountain. Its surface dipped slightly in the middle, forming a shallow depression where the river spread out to became a flat, flowing sheet. Broad and smooth, the channel introduced no frothing or white water. All I saw was a layer of perfectly transparent water, moving quite fast, but only as deep as a full sauce pan. It looked like wading across would be no problem; the spot seemed like the perfect ford.

I led Paul to the place I’d found, and started to step in. Without explaining why, my hiking companion hung back and just watched. With no hesitation, I waded with confidence toward the other side. Not paying much attention, I made it ten feet (3 m) or so into the flow before realizing the hazards of my action. First, the granite surface felt almost as smooth and slippery as ice. My feet seemed ready to slide right out from beneath me. Second, the water carried far more force than I expected. Although the stream was only inches deep, my standing in the middle of the flow created an obstacle that brought forth the water’s hidden power. By blocking the current, my body caught the river like a sail catching gale-forced wind. A wave of boiling turbulence climbed my leg to mid-thigh, and I had to lean hard into this wall of water to keep it from knocking me over. It felt like a linebacker was slamming into my lower body. Finally, I looked downstream, and saw that this broad sluice ended at a jumble of angular boulders the size of compact cars. Huge flags of water sailed into the air where the river smashed into the rocks, and the roar sounded just like the waterfalls we’d passed coming up the trail. After crashing over the granite blocks, the water gushed into what looked like a small, deep lake. The surface of this icy body of water bubbled in whirlpools and eddies that spread away from the inlet. That I had not noticed the chaos and danger where the granite channel poured into the pool below shows how little I had thought through my plan.

rapids

With a sudden flash of clarity, I realized the danger of my situation. For the first time in my life, death stared at me with its frozen eyes. Almost like watching a movie, I could imagine my feet slipping out from under me, and could almost feel my hands claw at the glassy granite surface as I slid down its face at shocking speed. I felt the shove of the water driving me toward the boulders, and imagined my bones cracking hard against them. My head jerks against my neck like a doberman on a chain, my legs snap like dry sticks, and I fly into the water as if I were a bumblebee in the jet of a garden hose. I land face down, then writhe against my clothing and the icy water, trying to turn over. I am sinking and freezing at the same time. My arms don’t work right, and my jeans feel like lead blankets wrapped around my legs. I put every ounce of my waning strength into holding my breath, but my lungs are already screaming. After just a few more clock-ticks, I can’t hold it one more second, and against all my willpower my chest bursts, forcing me to blow out air, and suck in water. Ice-cold liquid floods my mouth then slams against my throat. My larynx clamps tight in a gagging spasm, and my chest heaves, both choking against the liquid, and wrenching in gasps for oxygen. Every muscle in my body cramps like twisted rope as my lungs fill with a column of cold, cold water. Then a kind of peace descends. In an oddly calm way I think, “So this is what it’s like to drown.” The screen fades, and then turns black.

As this imaginary scene flickered in my mind, I kept my body motionless, as if paralyzed. By leaning into the massive wave breaking against my lower body, and not shifting my feet by even an fraction of an inch, I was holding my footing. But how could I possibly get back to dry rock? I was no more than a quarter of the way across the river, so heading forward was not an option. I turned cautiously, looking to see if Paul had suggestions. He sat an a flat rock far away from me, looking in my direction but talking to a pair of young women who had their backs to me. I noticed some strangers watching my predicament, and moving toward me as they recognized my danger. But no one could help. Even if they’d had suggestions, I could not have heard them over the thunder of water blasting against rocks.

I had no choice but to back up. With barely perceptible shuffles, I crept my feet backward bit by bit. Time seemed to stop. My body ached with the tension of resisting the pitiless column of water shoving against me, at the same time as moving my feet and legs with surgical precision. I could not make the slightest misstep, or my hiking boots would lose their tenuous connection to the slick granite, and I would die. I knew this one fact with absolute certainty. At no time in my life have I been more aware of every muscle in my body. At the precipice of extinction, my mind had more connection to physical reality than ever before. Daydreams, distractions, future plans, regrets, and every other extraneous mental action left me. All was focused on moving just the right way to survive. For someone who has contemplated suicide with clock-like regularity, at that moment I was fighting for my life with every cell and particle of my being.

Have you guessed that I inched my way out of that situation without catastrophe? Maybe my predicament was not as dire as I thought. I have not been back to that area since, so perhaps the granite was not as steep as I picture it, the water not as fast, the boulders not as big. It does not matter. On that day I saw my death with the same clarity as I see the computer screen right now. At age sixteen, this was when I first met mortality. As should be clear from the story I told yesterday about chasing the bear, which happened that very night after my aborted river crossing, the need for caution did not sink in right away. In fact, I continued to make wild and risky decisions for a few more years. But the way was now prepared for me to some day ‘settle down’.

I am quite settled. Domestic and cautious, I try to make careful decisions, and not wreck things by acting rashly. I made poor choices in the run-up to my breakdowns ten years ago, and that further cemented my anxiousness to avoid mistakes. Not that I don’t do stupid things. I can’t help it. But I do not take risks that I can forsee.

So the binary story of today and yesterday is now complete, and they arrive at more or less the same conclusion: I have learned to play it safe at the expense of simple play. I don’t let loose and just see what happens. I don’t ‘throw caution to the winds’, as exciting as that phrase always sounds to me. Dulling the knife-edge of passionate impulse may be necessary, but it is also sad.

Of course, there are those who refuse to get in line. They hang-glide at 15,000 feet. Or scuba dive deep into labyrinthine underwater caves. Or fly over rough dirt on motorcycles, hurling off jumps without looking first to see where they might land. Thrill-seeking probably brings that exact sense of death’s nearness that I experienced back at age sixteen, in the middle of a freezing river. That so many pursue such adventure shows the value of it. For my part, I am so cautious that violent accidental death is unlikely. More probably I’ll succumb to boredom. If I don’t change.

I don’t plan to take up rock climbing. The most dangerous thing I’m likely to do is hike around our house in the mountains near (is it really a coincidence?) Yosemite. Doesn’t sound too scary, except for the mountain lions. The cats have many deer to eat in this region, and being well-fed are not likely to attack adult humans. Still, I have to admit, it feels just a little thrilling to take the miniscule chance of getting eaten by a carnivorous wild animal. Perhaps that would be better than dying in a nursing home in thirty years. As I intimated in the story of the river, my first brush with death was also, in a strange way, my first contact with life. Just as you can’t see a white object unless you have a dark background, you cannot feel truly alive until you shake the hand of the reaper.

Death and life. Yang and Yin. They depend on each other, define one another. Death would have no meaning if nothing were alive. And life feels less significant when we lose touch with what makes this moment in history special. This instant, this second is ours, and there are only a finite number. If we lose sight of our ultimate fate, we risk devaluing our brief afternoon on this planet. How sad to spend a short life wanting to die, for instance. Death is not far, and obsessing about suicide makes no sense to me anymore. At age fifty, I finally ‘get it’ that my time is limited; until recently I had forgotten what those seething, frozen waters taught me at age sixteen. Suicide is a way of escaping life, but in a way, so is excessive caution. Right now, for me, risking more is a way of dying less.

This turned out longer than I planned. I also fear it sounds trite and obvious. I lay no claim to clairvoyance or unparalleled insight. All I know is that recovering my youthful zest for life seems vital to me right now. After ten years of fearfulness, introspection and self-pity, I want to recover bravery, a forward view, and self-confidence. The time has come to crack open the chrysalis, and emerge into the next stage of my adulthood. That requires stepping out of my protective shell, and into the heated embrace of fate.


(I modified this post on 2009 August 9, c. 06:40 PDT.)

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