Wednesday, December 1, 2010

phantom limb pain

Often I write about recurring themes, in my work and in my life (or both). The writing helps me to connect the dots, so to speak and to make better sense of the recurring themes. Over the past two weeks, I have had two patients come in complaining about phantom limb pain. The one person had a hip replacement a couple years previous, and was still having occasional pain. The second person came in a couple days later, dealing with chronic pain issues. He was a veteran and had suffered some broken and shattered bones. He stated his doctor told him he had healed well and the residual pain was "phantom limb" pain, even though he had not had an amputation. He talked about the discussion he had with his physician about chronic pain, brain neurology, and "pain pathways". His doctor told him the pain would continue to subside in time, as the pain pathways extinguished themselves.
A day or so later, I had another patient come in and talk about how she needed to "let go" of past hurts and her realization that holding on to and replaying the old hurts in her mind was detrimental to her. It kept her steeped in the pain.
Pain is pain. Each of these individuals was sharing experiences related to pain and to pain pathways. In a previous post (Use it or Lose it), I wrote about brain pathways, how the brain is "wired" and how our thoughts create neural pathways in the brain. The more we "use" a thought, the more established that pathway becomes in the brain. The less we "use" a thought, the less active that particular pathway becomes in the brain.
Emotional pain can become like "phantom limb' pain. The injury and hurt occurred long ago, but we keep "replaying" the incidents over and over in our brain, reinforcing the pain pathway. Of course, I am not talking about severe trauma or abuse which results in Acute Stress Disorder or PTSD. These disorders involve hyperarousal of the central nervous system and require specific interventions to assist the person who has been traumatized. I am talking about the "normal" kinds of hurt and pain we experience in life. People deliberately hurt us for various reasons, loved ones disappoint us, bad things happen in life and we feel emotional pain.
The theraputic process allows people to let go of pain. In therapy, people are able to recognize the pain, allow themselves to fully feel it, forgive, and let go, (cut off or "amputate" the pain). Often, that process involves some rituals. People may write letters or keep a diary of "hurts", then when they are ready, they move to forgiveness and symbolically "let go" of the pain, burying the writings, or burning or shredding them. Years ago, I had a patient who wrote a series of letters to deceased relatives and when each letter was complete, he went to the grave site, read the letter, tied it to helium balloons, and watched as they floated away. He experienced such a sense of relief watching the "hurts" float up, up, and far away.
In my own life, I have nursed hurts and pains. I have "run through" hurtful situations over and over in my mind. It is interesting that it seems as if the more I entertain the thought or memory, the more the thought hangs around. Who wouldn't, if you are throwing a party and entertaining them (the thoughts)? When I decided to close that door, to acknowledge the hurt or injustice then let go, and escort it out the door, the pain subsides. I have come to see the wisdom in forgiving and letting go. No more "phantom hurt" pain. No more spectors of the past hanging around and popping up to annoy or torture me. The pain pathways have lost their strength and power. The memories remain but they don't hold the emotional impact. I have moved on.
We all have the power, and the choice, to let go and move on. Whether it be a hurtful event, a bad day at work, a betrayal, a loss, we can choose to acknowledge, then move on. We can choose not to "go down that road" again. We can choose a healing and more benevolent pathway to go down. Our pain will extinguish itself, in time. We can continue to experience the pain (much like phantom limb pain) or we can heal. We can establish new, healthier pathways in our brains.

"Have you ever been hurt and the place tries to heal a bit, and you just pull the scar off of it over and over again?"....Rosa Parks

Let's not keep reactivating old pain. Let's allow our brains to generate new and healthy.

Saturday, September 25, 2010

Use it or Lose it

As a runner, I know full well the effects of conditioning and de-conditioning. Every spring, summer, and fall, when I am established in a consistent training schedule, I run farther and faster with less effort. Every winter, as I wind down and run much less, I get consistently slower and slower and slower....When I "use it" (my cardiovascular system), I grow stronger. When I don't, I "lose it" (my fitness level).
As a therapist, I understand the power of mental conditioning, or changing our thoughts. Do you know that every time we have a thought, an electrochemical process occurs in our brain? If you could look at the brain when the "thought" occurs, you would see chemicals being released and electrical impulses carrying those chemicals between the nerve synapses. And so, a neural "pathway" occurs in the brain and becomes established. How does that thought become stronger? You "use it"- repeat the thought over and over and over and strengthen the pathway in the brain. The more you "use it" (that pathway), the stronger it becomes. Many of our thoughts are automatic. We've been thinking them for years and years and decades and they become engrained in our sense of self and how we define the world.
WE CAN CHANGE OUR THOUGHTS. When we decide to think something new, we begin establishing a new neural pathway in our brain. In order for that thought to become more "natural" or second nature to us, we have to practice the thought - create it over and over. The more we "use" that pathway in the brain, the stronger it becomes. So, when we are trying to eliminate a negative thought and substitute a positive one, the old thought (which we think less and less often) starts to extinguish itself and the new thought, (which we practice over and over), becomes stronger and stronger.

I'm working on extinguishing certain negative thoughts. The thoughts are about the world and people and how it "should" be and how I wish people were. The new thoughts I am substituting are about how things ARE. What people DO. And I'm moving more toward objectivity and noticing how things are and what people do and not judging it so much. It FEELS very different. I am noticing less stress because I don't allow the world or people to determine the quality of my moment.
When I drive, I try to "notice" what other drivers do instead of determining that they are terrible drivers. The other day, A patient shared with me her experience of having a conversation with her mother and thinking to herself "That's just how she thinks, I think differently" and noticing she felt compassion toward her mother instead of the usual anger. I have patients with panic disorders who are gaining control over their symptoms when they think, "That's just my anxiety. I've felt it before, I'll feel it again. It doesn't feel good but it's just a feeling and it will pass" instead of "Oh my God....It's happening again...I can't handle this...This is terrible"..."
The choice is about which path you want to go down. You establish the neural pathway in your brain. If you don't like where that path is going, change the thought. Many times people feel so much more empowered when they say "I choose not to go down that road". They choose a new path and practice going down that path over and over.
Use it or lose it. What thoughts do you choose to use and wire your brain to continue to produce? And what thoughts do you abandon, and what wiring do you extinguish in your brain? I choose to go down the pathway of compassion and tolerance. It feels great.

Tuesday, August 24, 2010

Self Forgiveness - Part II

Yesterday I saw the movie "Eat, Pray, Love" and have been pondering the messages the movie brings. One of the central themes, it seems to me, is self forgiveness. In the movie, Liz is desperately trying to come to terms with the end of her marriage and embarks on this journey in attempt to reclaim parts of herself. At the ashram, she meets "Richard from Texas", who is also needing to forgive himself big time. Obviously, they learn about this process from each other.
In my clinical work, I treat people who want to heal. The themes of forgiveness and especially self forgiveness permeate the work. Central elements of self forgiveness are recognizing the impact of our actions on others, and making amends, of sorts, in any way we can. This is how we "let go"; otherwise we stay stuck in guilt.
In my experience, religion has been a strong influence in evoking guilt and self blame in very unhealthy ways. This has seemed to be a dilemma for many people. Even the concept of "grace" does little to dispel the guilt for many people. They say they are "forgiven" yet reiterate that they are "sinners" and continue to berate themselves for "falling short". Sometimes I wonder if God looks at this with tears in his eyes and says, "You just aren't getting it, are you?". We say we want to be like God, yet we hold on to self reproach and can't forgive ourselves, as God has. And if God expects us to follow his example, then he expects us to forgive ourselves.
Maybe we forget the part about making amends......and if we are angry with ourselves, how in the world do we make amends to ourselves???? Religion typically teaches us to be contrite, confess, FEEL BAD. But religion is not very good at teaching us how to compassionately treat ourselves when we screw up. And we do screw up, sometimes a lot.....
Being compassionate with oneself and forgiving oneself is major. It's a LIFE SKILL. You hear all these cliches "practice random acts of kindness", "practice forgiveness". You NEVER hear "practice self kindness' or "practice self forgiveness". It all starts with us, folks. Not in a narcissistic way but in a healing, healthy, spiritual way.

Today I had a final session with a patient, who is transferring care because of an insurance change. We talked about self forgiveness and the nuts and bolts of how she can compassionately treat herself. While she is not yet at the goal of self forgiveness, she can PRACTICE it. PRACTICE, PRACTICE, PRACTICE. Don't wait to reach the goal of self forgiveness, start practicing today. Do kind things for yourself.

One of the ways I am compassionate with myself is by being silly or goofy. REALLY. Because it lightens things, helps me to laugh at myself and let go. I stop being so darn serious about life in those moments.

So today, I think we should all practice self forgiveness and self compassion. We should all do kind things for ourselves. We should be silly and goofy. Share your experiences if you wish. I'm still learning this stuff, myself....

Wednesday, August 4, 2010

The Gift of Fear

August 4......One year ago there was a horrendous shooting at a health club in my community. My daughter was inside. Only a wall separated her from the gunman. Three women died. Three women who had homes and careers and friends and family who loved them deeply. They are irreplaceable. Many others were shot or sustained injuries from bullet fragments. Lives were changed. Everyone who was inside suffered psychological trauma, including staff. First responders experienced emotional trauma as they came upon the scene. Lets not forget family members of all affected. I was one of them. The horror of knowing someone you love so deeply may have been snatched from you in such a violent and senseless way is beyond anything I can describe. I lived that horror in the days and weeks and months that followed. I lived the emotional numbness and sense of everything being surreal. That was a year ago.

One year later....I still feel such a deep sense of sadness for everyone involved. As I sit at my computer now and write, I cry.
One year later....I am so grateful that we are not victims. At least for my daughter and my family, I can say we have moved from victims to survivors to thrivers.
One year later,I still feel the fear, but I am not immobilized by it.
God has shown me a better way...

Pain is an adaptive response. It is the body's way of telling us that something is wrong. Without pain, we often would not even know we are sick or some part of us is malfunctioning. When we have pain, the logical response is to do something about it (self care, seek medical help). It would be irrational to ignore the pain and walk around saying "ouch ouch ouch...it hurts" and do nothing.
I have come to see fear in a similar way. It is like my soul's way of telling me, "something is wrong...it is dark...the world is malfunctioning in some way...go to God" It would be irrational for me to ignore the fear, to walk around saying, "I'm afraid, I'm afraid" and not seek help.

So, I have come to be able to use fear in an adaptive way. My fear is a normal response to an abnormal, maladaptive, crazy world. I can't change the world. But I can change myself and my response to the world. I can acknowledge the fear, allow myself to feel it, but not HANG OUT THERE. I can go elsewhere. I can see the fear as an open door, and invitation to seek God, to find comfort. When I do this, God responds - an unexpected phone call from a friend, a song on the radio as I drive to work, that wonderful feeling of peace that passes all understanding...

In the past year, I have made the decision that I am not going to live in fear any longer. I can see the gift in fear and brings gifts of healing, reconnection, and compassion from it. This is how I move from victim to survivor to thriver.

Peace be with you all.

Wednesday, July 28, 2010

Fragments of My Day

Sometimes, when I can't sleep despite being so tired, I think about my day. Like today.......
I run through events, try to complete unfinished thoughts, and empty my mind.
-Breakfast with my daughters. So rare they are both home and both available. Their schedules, my schedule....So nice to have the time. In a few weeks, they will both be gone, off to school again.
-my appointments today, my clinical work....A bipolar woman who is appreciating mood stability for the first time ever, and establishing "normal" for herself...a woman struggling with feelings of betrayal and questioning if she can ever trust her spouse again after discovering he is a sex addict....a daughter, grieving the death of her mother and slowly healing as she reconnects with family and friends she had long abandoned....a single father raising a son and daughter under the shadow of an abusive mother he loathes but must still live with.....a couple who never really got to know each other because children came along quickly and interrupted intimacy...
-I had some really good fried rice for dinner...take-out from a restaurant near my office. there's some left and it's in my fridge...hmmmmm...thinking of finishing it off.
-great conversation with a friend on the drive home from work.....we talked about how God appears to us at the oddest of times and how it's so freaky but NICE when that happens..
-walking my dog on the trail at dusk. We owned the trail because no one else was out. It was quiet and a slight fog was setting in. It smelled so nice...pine needles, some sort of wild flowers.
-chatting briefly with some friends on line before going to bed.
-snuggling with my husband(and the cat)in bed.......falling asleep..........only to wake up 20 minutes later....
=oh yeah, and I'm remembering that I forgot to water the plants outside when I got home and it was pretty hot today...it's ok, they'll be fine, It was only in the 80's today, not the 90's...

It was a good day. It had the main and most important ingredients: time with family, meaningful work, great food, friends, my home and my pets.

Life is good........

Thursday, July 8, 2010

Going Home

"I will be still in an instant and go home"

For me, this is a very powerful directive. It is about recognizing who I REALLY am and why I am here in this life. The text that this statement comes from talks about that KNOWING that we all have, that we are in this world but not "of this world", that we came from another place and in our very distant memory, we have a deep longing for that place. I remind myself daily that I am NOT a physical being having a spiritual experience, but rather a spiritual being having a physical experience. "going home" is that remembering of where I came from, my Source, with whom I am still quite connected, even though I don't always recognize it in my daily flurry of activities.

When I follow this directive, everything calms in an instant.

What is the result of this "going home"?. It translates into a dramatic change in how I live the minutes of each day, the days of each week. When I "go home" I don't worry so much about traffic, and bills, and chores. In the stillness is an expansion of my awareness of the freedom I have to make positive choices. In the stillness is an expansion of my awareness of LOVE. In the stillness, I bask in gratitude. It FEELS so freeing.

Someday, for real, we will "go home". We will all die and move on. All of our worrying about this and that and money and stress and responsibilities and oil spills and everything else we all worry about will just......fade......away.....
Sometimes people come to this realization as their lives are ending.
Others are able to grasp this reality and embrace it.

We don't have to wait until we are dying to be kind to someone, to let someone go ahead of us in traffic, to hear the birds sing, to feed the birds, to enjoy the sunshine as we go for a walk, to hug a friend, to practice forgiveness, to encourage someone who seems down, to stifle an impatient desire to hurry someone along, to sing a song. In an instant, we can choose a better response, we can be still and in an instant, go home.....

We don't have to wait until we go home, to "go home"

Again, the choice is in the remembering...

"I will be still and in an instant, go home"

Thursday, June 24, 2010

Gratitude

Gratitude is something I am constantly "preaching" to my clients. I consider it a Life Skill. I can't even imagine a life without it!
So, in the practice of "practicing what I preach", I am noticing all of the daily small miracles I experience.

- Tuesday morning I awoke to a thunderstorm. I had planned to run that morning - darn. I rolled over and listened to all the wonderful sounds of the rain... so peaceful, rhythmic and calming....I realized my legs were pretty tight from all the running I had been doing. I thanked God that "there is a time to every purpose under heaven." There definately is a time to rest. I can be a slug today..I smiled and listened to the rain and caught an extra hour of peaceful sleep: NICE
-Tuesday afternoon I arrived at the office to find a newborn fawn near the front door, behind a bush. Apparently mother deer do that to newborns, leaving them in a "safe place" until they return. Those few moments of eye contact were amazing. The fawn was fearless, wide eyed and totally beautiful: PRICELESS
-Tuesday afternoon, in search of the fawn who had run into the woods after a dog appeared in our parking lot, I ventured out. Never realized how thick the patch of woods behind the office was. Geez, I'm usually in and out the back door so quickly. A wonderful midday break, walking in the coolness of the woods and the extra bonus of ripe raspberries I discovered on my jaunt. Now I have a new sanctuary in the midst of hectic days. (Never did spot the fawn):NEAT
-Texting.....I love it! I get these random texts from my daughter (the med student) who is in Tennessee on a 5 week internship. The most recent was "I almost had a baby pee on me today!" Gotta smile: TOO FUNNY
-Yesterday I remembered an interaction with a butterfly on Saturday 6/12 when my friend, Tim, passed. (See previous posting). Someone was talking about butterflies and I instantly remembered coming home Saturday, prior to the onset of the unexplained deep sadness and seeing a butterfly on the ground in the driveway. It was so beautiful and it followed me. When I stopped, it stopped, sitting on a stone. When I walked several feet, it followed. I was talking to it, telling it how beautiful it was and how much I enjoyed it's faithful company. I had sense it was there with me for a purpose. As I went back into the house, I said a loving "goodbye" to the butterfly. The deep sadness descended shortly thereafter. I like to think it was Tim, saying a peaceful and loving "goodbye" "thanks for your friendship": SMILE
-Meeting a "regular" on the trail yesterday morning. I finished my run, he was biking. He is a "trail buddy", one of the group of us "regulars" who frequent the trail. Hadn't seen him in over a year. Had a great conversation. Making new friends after losing an old friend: HEALING

Tuesday, June 15, 2010

Another Goodbye

Saturday afternoon a deep sense of sadness seemed to fall upon me. Couldn't figure it out. I had a great morning, volunteering for local 5K and 10K races, working registration and then finish line, supporting fellow runners and socializing. It was fun.
The profound sadness descended later and it didn't make sense. My oldest daughter had left that morning for a 5 week internship, out of state. I felt some sadness about missing her but it didn't explain the depth of what I was feeling. I went about the rest of my day, going to bed early, just to end the day. Sunday was much better and I forgot about the sadness of the previous day and didn't try to figure it out.

wow......This morning as I was getting ready for work, I did a quick check of my email, Facebook, etc. I subscribe to several of these "positive thought of the day" services. I felt pretty good and positive and was in a hurry, so I deleted them without reading them. This one WOULD NOT delete. I deleted it twice and it popped back up. So the quiet voice of wisdom in my head said "you need to read this one, it is not going away". So I read the positive thought, which was about being courageous and strong, not panicking, and trusting God. "uh oh".....I thought, "does that mean something bad is going to happen today?"

My morning was uneventful. I did my usual Monday morning at the nursing home. No surprises there today, no "CTB" beside anyone's name. My patients were all doing fairly well and in pleasant moods.
I had a couple hours until my first appointment in the office, so I purchased the local newspaper and stopped at a restaurant for breakfast. My breakfast was uneventful until I saw the obituary of a dear friend..............wow..............What happened to him?????????
I sat there stunned. This could not be........

My friend Tim was first a colleague, then a friend. We "grew up " together in the early days of our careers, cutting our professional teeth together. We shared our hopes and dreams and supported each others efforts. We cheered for each other, each step along the way and encouraged the other when one of us was discouraged. Then as we both progressed in our careers, he moved across the country and our contacts were briefer. We would meet each summer when he was in town visiting family for a few weeks, and usually during the Christmas holiday as well. Gosh, I was just thinking the other day that I haven't seen him in over a year. He never contacted me last summer and the summer flew by. In late August, I got a frantic phone call. He had seen THE PICTURES in The Denver Post, of the horrendous shooting (I have mentioned in previous posts), and he wanted to know if we were all ok. I called him back, missed him and left a voicemail message, reassuring him we were all ok. You know, that was the last time I heard his voice. He sent me an email in the past few months, about an honor he had received, and I quickly emailed back with warm congratulations and NEVER HEARD ANOTHER WORD FROM HIM.

As I sat in my office this afternoon, I pulled up his obituary online and checked info on the arrangements his family had set up. I read the online condolences......I offered my condolences and memories online and started to cry and cry...That reality hit me, that he was gone and we would never talk again, never laugh together until we cried again, never insult each other again, never encourage each other again, never share a meal together again, never worry about each other again.....no more ever agains, NO MORE AGAINS....wow....

This afternoon I was talking with a friend at work and she was consoling me. When we talked about the "positive message" I received this morning, the one that would not delete, I stated, "maybe that was a message from Tim". My friend commented further, "Maybe that was Tim telling you not to fear, have courage and continue on"......Her words ECHOED in my mind and I had that eerie moment of KNOWING. Tim was with me in the profound sadness Saturday (the day he passed on). He spoke to me this morning in the annoying "positive message" that would not delete, that didn't seem at all positive to me in that moment. He was saying, "I'm ok, have no fear, be courageous, do not panic.....life goes on......"

This evening I will go to the funeral home, because I want to say "goodbye" in that way. I know I will cry, a lot. I will likely laugh too, with his family and other friends as we remember how crazy he could be.

I believe that Tim said his own "goodbye" to me, in his own way - in the sadness of Saturday, and in the encouragement of this morning's "message".

This one is certainly going to take some time.......

Monday, May 31, 2010

Writing a New Story

I just finished Donald Miller's new book "A Million Miles in a Thousand Years". For me, reading Don's work is an experience. His writing stays with me, long after the book is finished. I have been very contemplative while reading it and have read it very slowly.......not wanting the book to ever end.......but it finally did, this evening. I had one short chapter left and I resisted reading it......but the end finally came. So, as I have been reading it over the past few weeks and digesting it, I now am wanting to write about the messages it has given me.

In the book, Don talks about not "having a life", recognizing that his life is boring and that all he does is sit on the couch and watch tv. He begins to learn about the elements of "story" and decides to incorporate story into his life, and thereby creates a much more deep and meaningful existence. In his words, "I've wondered, though, if one of the reasons we fail to acknowledge the brilliance of life is because we don't want the responsibility inherent in the acknowledgment. We don't want to be characters in a story because characters have to move and breathe and face conflict with courage. And if life isn't remarkable, then we don't have to do any of that; we can be unwilling victims rather than grateful participants".
I've been thinking about my own life and I have to admit, I have few regrets. I have always lived my life in a quiet but daring kind of way. I believe it goes back to a scrape with death at age 21, when my appendix ruptured not once, but twice. I laid in bed, post surgery, for two weeks with tubes everywhere, and nothing but time on my hands, to think. (Back then, there were no tvs in hospital rooms). And the doctors told me it was a miracle, I was very lucky to be alive, that no one's appendix ruptures, seals over, and after a month of all that poison in their system, to have it rupture again, and live to tell of it.......And I was sick and afraid and I laid in bed and thought and thought and thought......What would my life have meant if I died at 21? I hadn't accomplished anything, I hadn't even graduated from college yet.....I didn't even really know who I was and what I was meant to do or be........And those thoughts continued on as I continued to recover and to eventually return to college and graduate, and marry, and go back to school, and live my life........always with a sense of awe and wonder and PURPOSE. That medical emergency turned out to be a turning point for me.
So, as I have been reading and pondering Don's book for the last couple of weeks, I have been noticing "people who move and breathe and face conflict with courage" and the images have become like a collage....each its own beautiful picture to me, and all together, a powerful statement. I'd like to share a few of these:

-my 92 year old nursing home resident, who said goodbye to me, knowing intuitively that she would not see me again. She took advantage of our last visit together to let go of some feelings, to forgive some people, and to say thank you and goodbye to me! She came to the realization that she had a life well lived.
-my friend, who at age 48, ran her first marathon. She ran it with purpose and yes, she did complete it. I am so proud of her.
-a woman, who at age 58, decided to "get off the couch" and create a life that involves more than work and coming home and watching tv. She is going out and trying new things and finding happiness in ways she never expected.
-my daughter's friend, Gabrielle, who right now, today, is in New Orleans, spending her summer helping victims of Katrina. She writes about the daily joys and struggles and hopes and fears, in her blog. She went there knowing no one and is facing significant hardship. She learns something new every day.
-my oldest daughter, who is about to complete her first year of medical school. Being a physician and serving the underserved is her passion and her calling. It has been a difficult year, as is expected, but for her especially given that she left home and moved to a new city and started medical school THREE DAYS after being at a horrific shooting scene where three women died (as mentioned in my previous posts).
-an established health care professional who is pursuing his passion for music by writing and performing, "putting himself out there", and thereby facing many fears.
-a young woman dealing with the grief of a siblings suicide and struggling to bring good, purposeful action out of the tragedy.

These are each snapshots of courage. All of these people are just "normal" people. They all "got up off the couch" and started living in a more purposeful way, even if it was just to complete the final days of their life (as with my 92 year old patient). They are unwilling to be victims of a situation but are finding purpose. They have decided to "write a better story".

In closing this post, I will again quote Donald Miller, who says it far better than I ever could, "We have to get up off the couch and turn the television off, we have to blow up the inner-tubes and head to the river. We have to write the poem and deliver it in person. We have to pull the car off the road and hike to the top of the hill. We have to put on our suits, we have to dance at weddings....."

Monday, May 17, 2010

goodbye

Today, one of my nursing home patients said "goodbye" to me. She is 92 years old and tells me she is dying. She stopped being able to eat. She says her system has "stopped functioning" and she knows she is dying. She shared all kinds of feelings of sadness and loss. Then after "unloading" all of this, she said she felt better. She has a strong faith and this is a comfort. She thanked me for listening and caring. As we parted, she quietly, once again, said "goodbye - I know I won't see you again"......
It's so odd, I have worked as a therapist for 30 years, and no one has ever said "goodbye" in that way before. There are lots of goodbyes, many times for very good reasons - people heal, are doing much better, and move on, not needing the support any longer. People move geographically. Sometimes people leave without saying goodbye - they quit coming in for appointments, or they are doing fairly well but terminate prematurely, without saying a proper goodbye. Or they die - suicide, overdose, or they are sick and die. But in these situations, no one has ever said "goodbye" to me before they left. If it's a true desire to suicide, they don't tell me, they don't tell anyone, they just do it. The overdoses are always accidental - people do the same thing over and over and don't die but who knows why on that particular day they die.......and when people are sick and dying, they don't usually know that it will be the last time we meet, or if they know, they don't tell me.
So, today, my lovely 92 year old friend said "goodbye". What a special moment it was for me. You know, there's this part of me that wanted to scream "NO!!! don't be silly, you're not dying!!!!".....but she is 92 years old and she's no longer eating and she had a very powerful and moving dream about dying and is at peace.....So I didn't scream the thoughts that a part of me had.....I held her hand and listened and sent her love. And, in that final parting, when she once again affirmed that this really was goodbye and she would not see me again.....it was as if time stood still, for just a brief few moments......It felt so odd yet moving and purposeful.......Every day I learn from others. Today is a new lesson, a lesson about being in a sad and odd and moving moment and not trying to "fix" anything.....just being there with someone.....and feeling and accepting.

Monday, April 26, 2010

h o p e

Hope is something we sometimes feel in a BIG way, like a flashing neon light, very warm and welcoming, inviting us to something better. Other times, it is like a tiny spark, barely visible.....

I have been thinking about hope recently, probably for a couple reasons. Of course, in my work, I see people daily who seem sometimes bereft of hope. I always have to remember that by the time people end up in my office, they have already been struggling for months and years and sometimes decades. They have tried everything they could think of, and have often been to doctors and therapists in the past. No wonder they are frustrated and feeling hopeless. So, some days, at work, it feels as if I am immersed in hopelessness.....

I have been thinking about hope also because it is spring, my favorite season! And, I have been planting seeds! I do this each spring and I am like a little kid and still find it so fascinating. I go to the store and purchase the seeds. Then I go home and plant the seeds in soil in pots and set the pots on my deck and water them and WAIT AND SEE......I check them every day to see WHAT IS HAPPENING....I read the label for the "expected growth date" and am so excited when they start to sprout in 3 days verses the 7-10 days that it says on the seed pack. And I keep checking and checking every day because the little seeds ACTUALLY GROW and KEEP GROWING and become these beautiful, delicate and unique flowers!

I was watching tv Sunday morning, or really I was flicking through stations, and caught part of Joel Osteen. I like Joel a lot and I think that in many ways, his message is all about hope. Maybe I'm taking his message on Sunday out of context because I did happen onto it in the final 5 minutes but here's what I took from it - It matters what we do with hope. Sometimes we have just a small h o p e, but don't let it die because it is so small, we can also nurture it and see what happens.

This morning as I checked my pots on the deck and the growing sprouts, I was amazed to realize that the hardiest sprouts are the ones which were tiny, tiny, seeds. They looked like tiny black specks of dust and when I placed them in the soil, a part of me wondered "will these really become beautiful flowers?". And, the bigger seeds, the ones that were the size of small peas, have barely sprouted!

So, now I'm thinking - hope is hope. It doesn't matter if it is a huge flashing neon sign HOPE, or a tiny spark, barely visible
h o p e. It's what we do with it that matters.

I know I have followers and invite comments. Tell me about your experiences with hope!

Thursday, April 15, 2010

Death and Taxes

Some life lessons keep returning to us OVER AND OVER AND OVER. I like to see them as "gifts", opportunities to learn and grow and become a better person. Death and taxes are kind of like that - unavoidable and they keep returning to us....

April 15........the day we dread, the day we agonize over........So, like many people my mind has been preoccupied with INCOME TAXES. How much do I owe???? It's the same process every year, worry, worry, worry....how much do I owe?????
It's also April, the month that my sister passed. It's only been four years, so naturally I have been preoccupied with her passing, the anniversary date, DEATH.
DEATH and TAXES.....Wonderful things to be preoccupied with.....

I was talking with some friends recently and we were talking about how the "worry", whatever it is, isn't the real issue. "We never really worry about that which we think we are worrying about". The superficial worries - taxes, tests, deadlines, etc will keep coming and going in life. There will always be something to worry about. The deeper issue is the difficulty trusting LIFE, or our source, or GOD. We had this really interesting discussion about how if we have internal peace, the external stresses stop being a "worry". I have a friend, Joe, who we can always count on to say "It's really very simple, but it's not EASY". Isn't a lot of life like that? Changing our thoughts, our perspective sounds so simple but it is anything but easy.

The taxes are an easier thing to deal with - they are going to keep coming around again and again and again. Every year we pay income taxes, every time we buy something, or see road construction "Your tax dollars at work"....Here's my change in perception - I also like to see children able to go to school and be educated, people without health insurance receive care, beautiful parks and recreation areas. I feel privileged to be a part of paying for this - "MY tax dollars at work". It FEELS so different when I think about it that way.

Death is a more difficult thing to deal with. I lost my mom when I was 22, and my dad when I was 29. When I was a kid, I lost uncles and aunts. Losing a sibling is an entirely different experience. You expect to lose your parents some day, you often lose relatives when you are growing up. But a sister....you just think "well, SOMEDAY, one of us will die first but that won't happen until we are OLD"......

Grief has to happen and is a natural process, it's not dysfunctional to cry and feel such intense pain. As we work through grief, some of the "gifts" start to appear. We think about the person, their characteristics, what they loved and hated, what they stood for, how they lived their life, what made them angry, all the goofy and silly things they did, their imperfections and their passions. And we laugh and we cry and we HONOR them. I feel it is an honor for me to honor my sister. Four years later, I am very much into honoring her.

I feel honored to have had her as my sister. She was 12 years older than me, she was my big sis and she was there for me, in a very real way when I was very young. As I grew up, she continued to be there for me. I don't like to think about how my life would have been or how I would be different if I never had her as my sister.....

I honor her by continuing on in my life, remembering all her goodness and passing it on......Since it is four years later, I have been able to see "gifts" in the loss, much as I have seen in her life. One of the gifts is the renewed awareness of the fragility of life and the decision to embrace each moment. I am very much more in the NOW than I have ever been. Another gift is greater passion to help others. She lived her life serving others and when I am feeling burned out, I draw strength from her example. Another gift is a more relaxed sense of myself. My sister could REALLY be silly and was so much fun. I loved that about her!

Because of my faith, I know she is not gone. She has moved on to the next phase of existence. I know that love does not die and our love REMAINS.

My challenge this month remains to feel what I feel, to see the gifts in all of it. My income taxes are paid, my life goes on. I honor my sister in very real ways and I EMBRACE all that she has taught me about life...

To my sister, Barb, THANKS SO MUCH for who you are and what you gave. Love you!

Monday, April 5, 2010

Self Forgiveness

Seems to me that self forgiveness is one of the most difficult things to do. I admit I have difficulty with this, as do many, many people. It is not an uncommon problem. Why is it that we have such incredibly high and unrealistic standards for ourselves? We can forgive someone else twenty times over before we forgive ourselves. We have so much more compassion for others than for ourselves.
Today, I learned that one of my favorite patients at the nursing home passed away. I had the honor of meeting him last summer when the referral showed up on my clinic list one day. He was youngish for the nursing home (mid to late 40's). He was there because of kidney failure, secondary to diabetes. The first time we met, he told me he struggled with self forgiveness. He had regrets in life. Specifically, what he shared with me was that he had not watched his diabetes and had poor self care until his condition became so bad he was confined to the nursing home. Now, he was so angry with himself for not taking better care of himself. And, now it was too late to do anything to reverse the damage that had been done. We talked about his relationship with God. He said he believed God had forgiven him. So, then we talked about his relationship with HIMSELF. He was really tough on himself, with all his "SHOULDAS". So I listened while he talked. I don't even recall exactly what I said to him, but the message was self forgiveness and that if God forgives us, who do we think we are to not follow this example?
After that first meeting, he was more at peace. At subsequent meetings, he told me he had FINALLY forgiven himself. His anxiety diminished some. Each visit, I listened while he talked. He had a nice Christmas with family. Little did I know when I last met with him that it would be our last meeting. I asked again, how was he doing with the self forgiveness and he reassured ME that he was still in a good place with that issue and had long forgiven himself.
Today, when I walked into the clinic to pick up my schedule, I saw his name with "CTB" beside it. The first time I ever saw that notation, I asked a nurse "What does this mean? Does it mean Confined To Bed? Because if it does, I can go to the patients room to see them". And the nurse gently told me, "No, that means "CEASED TO BREATHE"........
CEASED TO BREATHE.....or rather, died........So, I saw his name and CTB and I walked back to my office and took a deep breath and shed a tear, before I had to take my first patient and dive into my schedule.....It was a very busy schedule today, which was probably good because I didn't have a lot of time to think.
As I left later in the morning, I walked to my car, in the beautiful sunshiney, warm day and again, I thought about him. I felt happy for him that he had found peace. I thought about his courage in what he was dealing with. I felt some wonder at his ability to forgive himself. I realized I had learned some more about self forgiveness from him. As the old adage goes, sometimes the student is a teacher and the teacher his student..........Thanks 'R" for being my teacher and for being a role model for me. God Bless and rest in peace.

Monday, March 29, 2010

Resurrection

It's Easter week. I have to admit, I never really liked Easter much. As a kid, I LOVED the chocolate. My mom used to buy only the good, expensive stuff, no cheap chocolate for us. But, that's about all I ever liked about it. I HATED getting dressed up and going to church. I remember one particular Easter when I was in high school that it snowed. I mean, it really snowed, probably at least six inches and we COULDN'T GO TO CHURCH. I believed it was my best Easter ever.

Today, I'm still not a great fan of Easter and I just have been realizing why. For me, it's never been something I could use in a PRACTICAL way. Like, it's a GREAT story and there's so much that's GREAT in it that I can and want to incorporate into my daily life - love, forgiveness, grace, sacrifice, redemption......what's not to like about any of that?

Resurrection...now, there's something that seems much more PRACTICAL to me. So, in light of what I have been blogging about (internal change and self-correction), I am focusing on internal change this week - internal resurrection. I want to keep working on changing my thoughts, away from separation and back to oneness.

When I see the Easter images, I will think "I too can change, become more loving and accepting, and let go of (or die to) my old ways of thinking". Sometimes I "don't know what to think", or I want to change the way I think. So, I ask God to help me to think differently. It, at times, is my mantra - "God help me to change my thinking...God help me to change my thinking...." As a therapist, I know the power of changing one's thoughts - cognitive behavioral therapy is effective and I use it a lot in my clinical work. So, personally, when I suspend my own thinking for even a few moments and ask God to "change my thinking", this opens a door and fresh thought enters. Not always immediately, but if my mantra remains "God help me to change my thinking...", then it always happens, a new, more sane, loving thought emerges. It's one of the daily miracles I experience, when I choose to focus on RESURRECTION vs MY thinking.

So, when my thoughts change, then my life changes. I don't act the same ways, I am calmer and more at peace. Caroline Myss, in her book "Defy Gravity" states, "There is no such thing as absorbing the power of a truth and having your life remain the same". Thank you Caroline for these thoughts. Thank you Jesus for the promise of resurrection.

I don't have to sit around and wait for the resurrection to "happen" for me some day (when I die and go to "heaven"). I can live the resurrection every day by taking responsibility for the quality of my thoughts and changing them. BIG PROJECT - wish me luck, and say a prayer.....

Friday, March 26, 2010

Healthcare Reform

I'm not a political person although i have strong views about healthcare reform. Lately all of the debate about the recent approved healthcare plan has me livid at times. It actually "hurts my heart" at times when i hear the opposition. This has been my experience - many of the people I know who voice opposition are clueless about what actually goes on every day in the real world with health care. They sit in their big houses with their nice jobs and new cars and great health care plans and say "What's the problem?" or, they recognize there is a problem but they say "Why should the government get involved?"
Every day i see people fall between the cracks. This is what I see on a daily basis - working class people whose employers offer no healthcare benefits, working class people who can't afford to purchase healthcare because of the high cost, people with healthcare who still can't receive care because of high copays, people with insurance who have no or ridiculous prescription drug benefits so they don't take life sustaining medications because they can't afford them, people who lose jobs and can't afford cobra,people who are excluded from coverage because of pre=existing conditions, on and on.....
Why should the government get involved? Why not - someone has to FINALLY do something!!! If insurance companies and Big Pharma wanted to self correct and alleviate some of the issues, they would have done so DECADES ago. They have no interest in fixing the problems because that would eat into their HUGE profits.
I though maybe when some of the recent legislation was enacted restricting pharmaceutical companies from some of the questionable marketing practices, we would see more drug samples coming into physicians offices, to dispense to people without coverage. Less pens, cups, stickie notes, and other marketing paraphanelia, and more product to patients. has this happened? No, actually the opposite has occurred. Drug reps bring fewer and fewer samples. We used to be able to give medication samples to people without coverage, now we can only say "IF the drug rep brings it in and IF we have it." I have seen "Patient Assistance programs" offered by drug companies become more restrictive, so that, for example, a family of four with a combined income of 23,000.00 a year is considered to have "too high" of an income to qualify. The industry creates these highly restrictive guidelines that few people can in reality meet and then say they have social conscience because they offer "Patient Assistance Programs".
What hurts the most, i think, is that people JUST DON"T GET IT.

So, then I turn inside and look at ME and say 'What is it about me that I am seeing in this issue?" and "Why does this bug me so much?"

In my past, as a child, the big people in my life, who were supposed to take care of me, JUST DIDN"T GET IT. They were clueless in many ways about the needs of a child. I think I'm over that but it still strikes a chord when I see this in the world.

I've always been an advocate for the downtrodden, those in pain, the misunderstood. Maybe it just hurts me more than the average person to see the social inequalities and injustices. Maybe that's ok. Probably that's a really good thing. It makes me good at what i do. It makes me more compassionate. Rev. Robert Schuller used to say "Turn your scars into stars". We can always bring good from negative, if we CHOOSE to.

Over the past couple days, as I have been pondering all of this, I have decided to look at this differently. I have decided to look at the people who represent to me, the "other side of the fence" in regard to healthcare reform, as my agents for internal change. Their "cluelessness' represents to me an opportunity to self-correct, to be more compassionate, to soldier on in "being the change I wish to see in the world". I can be annoyed with my perception of their lack of understanding, or I can move beyond this and love people, all people more. I'm working at it....wish me luck....(and say a prayer for all of us).

Sunday, March 7, 2010

More on Forgiveness

In a previous post, I talked about forgiveness, as a process. I shared with readers that my daughter was at a shooting scene. Given that forgiveness is truly a process, this process continues on.......

A couple weeks ago, I was talking with a friend about THAT NIGHT, the night of the shootings. She had not known what happened and was asking questions. It got me to thinking..... She told me later that she googled some things and found the pictures and that they were horrific.......I had not seen the pictures since they were published, so I googled some myself, and THERE THEY WERE. I started to cry, it was like a river.....I cried for the victims of the shootings. I cried for ALL the victims, living and deceased,and their families. I cried for my daughters. I cried for myself. I cried that we live in such a crazy world. I cried for ALL OF US. It felt so strange to be crying now, months later but then I realized I was crying the tears that I could not cry back then, because back then it was JUST TOO REAL.

Life has gone on, for everyone. I wonder about the women who died, their families, and how do they just go on? I think about the people I saw that night, and talked with, some who were inside when the shootings occurred, some were family members, like me. For my family, it has impacted us all, in different ways. My daughter is healing and has the wisdom to strive to bring good out of all of this. She will NEVER be the same but she is making sure that is in good and positive ways.I am so proud of her.

Last night THE DREAM reappeared. I am running around locking doors because I have to keep my family safe. Running, running, locking doors over and over because there are people with guns who are coming to harm us. This time, the dream was a little different and more hopeful. This time, there were other people running around with me, finding me hiding places, helping me to lock doors, acting as sentries. This time the dream progressed to the end, and the threats were gone, and we were all safe. Sigh. That's the way the real story ended for me and my family, but not for the three women who died.......

Forgiveness is an ongoing process.....

Wednesday, March 3, 2010

Ron=God

I met an interesting man the other day. I was sitting in the waiting area at my doctor's office and he entered the waiting room as well and smiled, as he looked into my face and stated "you have a pure heart". He told me his name was Ron and after awhile of rambling on and on to me about himself and his religious experiences, he finally sat down next to me. Since I am a therapist, this sort of thing doesn't usually bother me - I meet all kinds of people and am very accepting of "kookiness". I admit I only half listened to his rambling but with amusement enjoyed his delivery and the kindness he was exhibiting. He talked about the saints and miracles and his catholicism and most importantly, his relationship with God. Near the end of our encounter, right before I was being called back to my appointment, he handed me a card of Jesus carrying his cross - it's really very pretty, with a shiny gold border and a shiny gold halo around Christ's head. Then Ron said to me "God wants you to know that you worry way too much. You are a Mom, it's natural but God wants you to know not to worry". I kindly thanked Ron and wished him well and walked back to the exam room. As I sat there waiting for the doctor to arrive, Ron's kindness was on my mind. Do I think he was a kook? Who knows, and it didn't matter to me. I was not the doctor in this situation and he was not the patient. I was not evaluating him, I was just another person, making a brief but touching connection with him, and accepting the gift of encouragement he had to offer.
So, since then, his words ring in my mind. When I start to worry, I hear the voice of God, thru Ron saying "You worry too much!!!"I carry around the golden Jesus card and keep it in my appointment book. I pull it out and think of Ron at times, then I smile. I remember the kindness of a stranger. Isn't this what Christianity is all about anyway - It's about loving others, being kind, offering love and encouragement to one another. To me, it's not so much about the BIG things we do but the every day kindnesses we share. Mother Teresa said "We can do no great things, only small things with great love". Was this a synchronistic event meant to encourage me at a low moment? I like to think that it is. Thanks God, thanks Ron.

Wednesday, January 27, 2010

FORGIVENESS IS A PROCESS...........

Living in an unsafe world......how do we practice forgiveness in an unsafe world??
Forgiveness seems so theoretical and how do you apply it IN REAL LIFE?

I've been pondering this alot lately...because....over the summer, a deranged madman tried to kill my daughter. He actually killed three women and lucky for me and my daughter, and all the other people who escaped "unharmed" (physically). But not so lucky for the others. How do their families put together the pieces and forgive, if they do at all?
You know, you see these heartwarming stories on The Today Show, about radical forgiveness.....people who have lost family and friends to murderers and they forgive.....So, theoretically, I think....yeah, that is good, it is healing, it makes sense. Until it almost happened to me...and my family....

FORGIVENESS IS A PROCESS.......

I start to forgive.....the therapist in me kicks in and I understand why people become so desperate. Then something reminds me....of HIM, that awful night....I go back there and I feel numb.....

FORGIVENESS IS A PROCESS......

I become impatient and less tolerant of others. This is not like me. I entertain negative thoughts about others instead of self-correcting.

FORGIVENESS IS A PROCESS.....

I start to calm down, think it through rationally, return to "life as usual". Now the nightmares have returned. Two nights ago I had to get up out of bed. You know when you have the dreams that you can't shake? You have to get out of bed and clear the foggy feeling? I had some hot chocolate and went back to bed. Still the dream images haunt me......In a building, this time it was a warehouse, danger is coming, coming, coming and I am locking the doors over and over and over. There are people with guns and I HAVE TO LOCK THE DOORS TO PROTECT MY FAMILY. This time I was using huge, thick beams to barricade the warehouse doors......

FORGIVENESS IS A PROCESS.

When I am overly emotional, and can't sleep, and am distracted in my work because of HIM, the DERANGED GUNMAN, I feel less numb and more angry (for brief moments), and I want to scream at him..."HOW SELFISH COULD YOU BE?????"

FORGIVENESS IS A PROCESS.

Forgiveness, of course, is an inside job. It starts with me. It is a conscious choice and an active decision. I am going with it, I am IN THE PROCESS of forgiving. It's better some days than others....It works in layers....some progress, the more reactivation of the HORROR OF IT ALL, then there's another opportunity for forgive, ONCE AGAIN.......

FORGIVENESS.......IS.......SUCH.......A.......PROCESS.....

Thursday, January 21, 2010

The world is a picture into my self

I've been focusing alot lately on projections. Here's what I do (and hate that I do)...I have these automatic thoughts about someone I see or know or interact with, like "You're a jerk", or "she is fat", or "what an idiot!". Sometimes I entertain those thoughts. Sometimes I catch myself and say "wow...I hate that I have that thought", then I change it to something compassionate. But, what works best is to look at the projections, or rather to LOOK INSIDE MYSELF. It's not fun or easy. So I ask myself, "what is it about myself that I don't like that I am seeing in that person?" wow...there's almost always an internal knowing. That's what I can work with then. I try to see my annoyances and "judgements" of others as "gifts", opportunities to self-correct, to grow as a person, to heal.
Yesterday I had the realization that I am having many more annoyances and impatience with people, and many more judgements than I usually do. So I realized it was time to beef up my looking inside. I see the picture on the "screen" (event or observance or interaction in the world), and I remind myself that the picture on the screen is a projection into myself. So I watch the movie in a different light - it is a STORY OF MY INTERNAL LIFE.
Example: Yesterday I went to see my holistic practitioner. he is a very kind, caring person but he sometimes has this edge of irritability to him. As I was driving home, I thought about this some more. I thought about our conversation and his judgements of others and realized he was reflecting to me my own recent increased concern about my own judgements. wow...what I focus on and struggle with is played out right in front of my eyes!...it is like watching a MOVIE OF MYSELF. I recalled that times that I am not struggling with judgements, he can be his usual self and it doesn't particularly bother me "that's just how he is, that's just an aspect of his personality, that's not the total person" is how I think of it at those times.
I keep realizing that I have a choice in every moment - To externalize and judge, or to self correct and heal. Neat.

Monday, January 18, 2010

I can change my mind

I'm an expert at changing my thoughts - I'm a therapist and I am a survivor. As a therapist, I teach people how to change their thoughts and that by changing their thoughts, their experiences of life change. I am also a survivor, having grown up in a dysfunctional family. My mother was bipolar and unmedicated. My father coped with her insanity by withdrawing into workaholism. So, many many of my internal childhood experiences were of loneliness and I became an expert at a very young age at changing my thoughts. It became second nature.
When I was a kid, I changed my thoughts by saying "I don't love you, I don't need you, I don't need ANYBODY". As an adult, I learned to change my thoughts by saying "I love you, I need you, I love people". It was reprogramming. It took time.
Advance to today.....I see every day as a miracle because I see the miracles in each day. It's fun, it's like doing magic or rather, seeing magic occur right in front of my eyes.
So....I'm thinking if I write about the everyday, mundane and not so mundane experiences, I have a running log of my experiences finding the magic, the miracles in every day. Some days it may be my musings and wonderings, other days it may be my rantings and ravings, other days simple experiences. My challenge to myself is to find the magic in all of this. And, in part, the magic transpires when I change my thoughts......Here we go......