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.


Closing the Window on Past and Future

In a meeting last week with my Acceptance and Commitment Therapy (ACT) practitioner, I remarked that worries about the distant future and regrets about the remote past no longer trouble me. For instance, I don’t lie awake nights fearing old age and isolation. I don’t visualize myself slumped in a wheelchair in some nursing home, alone and forgotten. Nor do the choices that led to my lack of children and career haunt me like they once did. It feels wonderful to be freed from mental content that used to terrify and demoralize me.

On the other hand, prior to the past few days, more immediate events remained profoundly disrupting. For some reason, the window seemed to be about six months in either direction. For instance, I felt intensely frustrated by a doctor who has been treating me since January, because he views me through the lens of stereotypes bequeathed by my psychiatric record. I regret placing my orthopedic care in his hands. And part of the reason for my recent psychiatric collapse was my fear of aimlessness in the aftermath of my closing the acupuncture practice. I have no idea what to work on next, but rather than giving myself time to reorganize, I recoiled against my current lack of direction.

But why, I’ve been wondering ever since my ACT session last week, should a six-month envelope keep me captive? If I can release fears about what might happen in two decades and regrets about choices I made a dozen years ago, why not let go of next summer and last winter?

It should be easy to further narrow the window of relevance. If images of loneliness and isolation in old age no longer trouble me, when they once sparked panic attacks, why should I worry about a few months of extra free time? If the decision to move away from San Francisco and take up suburban life no longer seems disastrous, why complain about my poor choice for a new doctor?

The future and the past don’t reside in the brain. There is only the present moment, colored by traces of years past and imaginings of coming events. Both the traces and the imaginings can be consciously reshaped to serve our better purposes. For that matter, they can be left in the hidden matrix of latent neural patterns rather than pulled into current awareness.

I’ve enjoyed a new feeling of spaciousness over the past couple of days as a result of this realization. It seems to me that the difficult work of letting go of deep past and distant future makes this shift in attitude toward more immediate events rather easy. It only requires that I exercise my ability to determine what gets pulled into awareness and how my thoughts frame reality.

As often happens, a serious (though brief) psychiatric crisis forced me to reassess my mental life and update my strategies. This is the value of pain, I believe: it stimulates growth. Our task is to quit fighting and start learning.

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Finding Purpose

After nearly two weeks in the foothills near Yosemite, we returned to the Bay Area Sunday. Toward the end of the visit I was feeling discouraged, as my posts made clear.

My lack of purpose after the demise of the acupuncture business was hitting home. The book project softens that a little, but the right formula eludes me. So far the prose sounds like my least successful blogging: too wordy and intellectual. Lyrical description of the richness and lessons of my experiences may be beyond my ability.

Recent essays expressed remorse about my relationship with my father. Through writing here and after corresponding with my aunt, I eventually moved past that. But there remained a shadow of sadness.

The neck pain and the bad news from the recent MR scan weighed on me. I felt lonely, too.

In short, I was stuck in the familiar place of self-criticism, fear, and discouragement.

Then, on one of our last nights in the forest, something shifted inside. Peace returned.

Whenever I feel defeated the same phrase comes to mind: “God, help me.” This must be the most common human prayer, and although I don’t often believe the cosmos listens, I say it anyway. The words feel comforting, despite their futility. This time, to my relief, I heard a voice speak in a loving tone near my left shoulder: I’m right here!

Maybe I was half asleep and slipping into hypnogogic hallucination. Maybe my own thoughts rose to audibility. Regardless, I felt reassured. Why question the source? Whatever conscious presence exists in the universe, I’m convinced it arises from the depths of matter. It is not something separate from life; it is something integral to it. So if it shows up at all, it must come by way of ordinary neural pathways. Why distinguish between a dream, a thought, or the voice of God? If it feels divine, I choose to accept it as such and not worry about its provenance.

In the calm aftermath of that simple phrase uttered by something that cares, my sense of purpose became clear. I decided that since the material world no longer seems to cooperate with me, I might as well focus on the spiritual. I could even interpret the way the cosmos has frustrated my plans as God pushing me to commit to the mystical path. At times over the years I’ve glimpsed truth and entered resonant states of mind. Why not quit trying to achieve in the human sphere and instead seek awakening with all my heart and soul?

In truth, I’ve run out of options. I will either find relief through higher consciousness, or find no relief at all. And yes, I’ve been working toward realization for a long time, but not as my primary goal.

Writing still feels important, but I’m viewing it as a means to an end. It helps me make progress toward grounding in life, love, and meaning. It isn’t a project in the usual sense of the word, whether I’m working on the blog, the book, or my poetry. Writing is the road rather than the destination.

Deep down, I know with utter conviction that peace awaits, provided I get serious about taking the needed steps. This means abandoning striving for success. Instead, I will concentrate on taking care of my body, building my meditative skills, and healing my heart. It is time, at last, to journey inward toward the Light.

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Sadness Is No Illness

Sadness. Regret. Grief.

In the old days, I’d have called this state of mind depression. But that word refers to a mental illness, and this doesn’t feel pathological. Rather, it seems utterly normal to feel down after everything that’s happened.

As March draws to a close, I look back on a six month run of painful events that started with my sister’s death from alcoholism on October first. The last three months of 2011 were shadowed by that loss. My first holiday season with no one else alive from my family of origin felt especially mournful. As the days shortened and darkened around my bereavement, I continued to face one disappointment after another on the acupuncture front. And just as my hopes of once again earning an income began to flicker out, the company that pays me disability insurance threatened to cut me off on false pretenses.

With all that stress, perhaps it’s no surprise that in mid-January I suffered my ruptured aneurysm and two hospitalizations. This bodily malfunction caused pain of greater severity for longer periods than I’d ever endured before, not to mention tsunamis of nausea and a twelve hour stint of nearly non-stop vomiting. Because of intestinal obstruction, I was fed intravenously for several weeks after seven days of flat-out starvation. Today, despite six weeks of normal eating and living, I still feel sorely depleted.

Not long after the internal hemorrhage, a friendship that has been important to me for years ended in a big, angry blowup that appears final. Also, during the past few months my spinal problems worsened, and now my left arm is afflicted by nerve root compression that causes stabbing pain. As a result, I can’t use that hand to carry anything much heavier than a glass of water. And the abdominal discomfort that’s plagued me for a year (and that we now know was caused by the same vascular insufficiency that created the aneurysm) is bothering me more than ever.

And of course there’s the letdown after the major manic episode that swelled, crested, and broke as my world seemed to be falling to pieces. Inevitably, it seems, energetic and euphoric states are followed by their opposites.

At the tail end of all this chaos, my cousin came to town and we held an informal ceremony for my sister at the western edge of San Francisco, where the city meets the Pacific Ocean. My wife and I owned a beautiful vintage house near that beach until December 1999. My sister visited us often there, and she loved to walk along the shore and collect sand dollars.

The memorial at Ocean Beach felt painful. First and foremost, of course, there was my grief about my sister’s passing, which I’ve had trouble facing before now: the pain has seemed too overwhelming.

But that neighborhood often makes me uneasy just by itself, because it brings to mind difficult memories. For instance, very near the spot where we spread a few teaspoonfuls of Janice’s cremains, in 1996 my wife and I watched in horror as an enormous Akita grabbed our beloved three-pound Pomeranian, biting hard and killing her almost instantly. The resulting emotional devastation ruined our weekly walks along the beach and probably fed into my hastiness in abandoning the area a few years later (see below).

Going to that beachside neighborhood feels especially poignant because before Mickey’s death I was enjoying some of the most satisfying years of my life. We lived in a wonderful city just a few blocks from the surf. I was a respected surgeon who drove to work every day along one of the most beautiful routes in California. My avocation as a figurative sculptor kept me occupied during my free time. I felt happy and proud of myself.

So much has changed since then. My neck disease ended both my surgical career and my sculpting. My mental health collapsed. We left San Francisco after I sold our beach house with little forethought during the rising phase of an extremely intense manic episode. As years passed, I tried many new careers but wasn’t able to sustain any of them. Our financial situation gradually deteriorated. And now I’m faced with many new losses that seem to echo all that escaped my grasp twelve years ago. My sister’s memorial on the sand wove my unraveled dreams into a tapestry of regret.

But change and eventual decay are what life promises, yes? Earlier tonight I was looking at a book we bought long ago, back when we lived in that unique house near the beach. It shows photos of the neighborhood and coastline dating from the mid 1800′s through the 1950′s. In one 1936 aerial photo of the amusement park that used to line the shore you can even see the house we once owned; it would have been eleven years old at that time.

What struck me in looking at those photos was how the people looked so ordinary in their happiness. Gazing out from those images were romantic couples strolling along the esplanade, boisterous families gawking at the amusements, and robust men racing out of the surf. One photograph showed a group of young women wearing swimsuits that looked like today’s scuba diving outfits; the hand-pencilled caption read: Bathing Beauties. Most of these young people were posing self-consciously for the cameras, but they all looked excited to be spending a day at the beach. We can only imagine what happened as they grew older. What joys, adventures, and successes did they find in life? What disappointments, illnesses, and tragedies did they eventually suffer? Could they have guessed that their innocent pleasure would be captured in a souvenir book and viewed a century later, long after their death? Did they ever think they would be reduced to anonymous images, historically interesting but otherwise nearly forgotten?

This is the nature of life. It buds, blossoms, fruits, and falls. As I survey the wreckage of the past six months it seems like nothing more than ordinary human history. I don’t feel sorry for myself. It would be isolating and self-pitying to call my natural sadness a mental illness. Loss and grief connect me with the global family of humankind. They pull me into the passion play that repeats itself generation after generation. The actors and scenery change, but hope, fear, joy, and grief cycle forever through their seasons, as humanity lives and loves.

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