Dear Readers,
It has come to my attention that the Recommended Reading link is not always working. My apologies. I am working to fix it. In the meantime, here is a copy of the list:
My most recommended books are the ones by Bruce Perry, a child psychiatrist. He has two books: The Boy Who Was Raised as a Dog and Born for Love. His ideas have formed the basis of my own treatment. To grossly simplify his theories, if a child has a trauma at a young age it does not necessarily matter what they consciously remember or how they feel about it years later. If a child has a trauma before the age of five, when the brain is still forming, and essentially does not have the opportunity to run around and explore the world and act like a child, it can affect the way the brain forms. That can affect things later, even if the child receives good care afterward.
I had a severe physical illness just before I turned three. Dr. Perry blasts many professionals for not recognizing the effects early trauma can have on people. In my case, most people did sort of suspect that my illness was at the root of my problems, but no one could really figure it out.
According to Dr. Perry, people in that situation need stimulation and skill-building aimed at the age they missed it, not their current chronological age. In my case, I needed to figure out what skills I had missed and come up with ways to obtain them. That has been the most helpful approach I have encountered in my life. I needed to build skills one at a time, and it took a while. I am still working on some of the more advanced skills. I will write more about some of the details of what I did later. For now — read the books.
Some of the other books about mental illness I really like are:
The Center Cannot Hold by Elyn Saks. A powerful story about a woman with schizophrenia and her (successful) struggles to build her life and career.
The Quiet Room by Lori Schiller and Amanda Bennett. This book is somewhat dated (although a new edition with an updated epilogue was published in the last few months), but provides a very informative view of exactly what is going on in a schizophranic person's mind.
Girl, Interrupted by Susanna Kaysen. Ms. Kaysen discusses her own hospitalization in the 1960's with some of the questions we frequently face today: How much of this is me and how much is my meds? What is the real problem and the solution?
Danger to Self by Paul Linde. A very interesting book by an emergency psychiatrist. People with psych problems often complain legitimately about ER services, and it can be helpful to see the opposite perspective.
Saturday, March 23, 2013
Thursday, March 21, 2013
Coping With Outside Stress
This letter was originally written the week Osama bin Ladin was killed:
Dear Tony,
I will admit that the events going on in the outside world can leave us shaken.
We build a foundation very slowly, piece by piece, around our understanding of the outside world. A surprise announcement like the one we had this week — even good news — can seriously disrupt that foundation.
Many people would admit to some of the same feelings, but I think some of our feelings are stronger.
One of the central tenets of mental illness is an inability to handle and process our feelings appropriately. We work on building that, but sudden events can throw them out of control.
That being said, I do not a lot of advice to give. Except to be aware of it, and realize that it might affect your mood and energy for a while. You might need to make some accomodations for that.
Sometimes in the past I needed to put my own progress aside to deal with events in the outside world. I cope by reading as much as I can handle about the subject. Some people I know cope by shutting the news out as much as possible. I am not advocating either method. I am just letting you know.
Dear Tony,
I will admit that the events going on in the outside world can leave us shaken.
We build a foundation very slowly, piece by piece, around our understanding of the outside world. A surprise announcement like the one we had this week — even good news — can seriously disrupt that foundation.
Many people would admit to some of the same feelings, but I think some of our feelings are stronger.
One of the central tenets of mental illness is an inability to handle and process our feelings appropriately. We work on building that, but sudden events can throw them out of control.
That being said, I do not a lot of advice to give. Except to be aware of it, and realize that it might affect your mood and energy for a while. You might need to make some accomodations for that.
Sometimes in the past I needed to put my own progress aside to deal with events in the outside world. I cope by reading as much as I can handle about the subject. Some people I know cope by shutting the news out as much as possible. I am not advocating either method. I am just letting you know.
Monday, March 18, 2013
Where To Start
Dear Tony,
To start, work on one thing. Only one.
Look at yourself honestly and figure out something you can do. It may not be what you most need. I need to emphasize that: Start with what you can do, not what you most need.
For me, I needed to learn to communicate. For most of my life I could not express myself in a way that people could understand. I could not figure out the rhythms. I would explain too little, and people would misunderstand. I would say too much, and people would not be able to follow along. To converse, you need to tailor what you say to the other person. You need to follow cues about what s/he is thinking and feeling. All of that was way ahead of me. Like many people with mental illness, I had difficulty making friends. Even more important, more than once I was seriously harrassed and could not report it because I could not communicate.
To improve my communication skills I needed to focus on just putting my thoughts into words. Only that. Not eye contact. Not my volume or tone of voice. Not my body language. I needed to go back and work on the basics of communication.
That was the only thing that worked for me. After a while I was able to work on eye contact and my other issues. It took a while to reach that point. But I did learn to communicate better.
To start, work on one thing. Only one.
Look at yourself honestly and figure out something you can do. It may not be what you most need. I need to emphasize that: Start with what you can do, not what you most need.
For me, I needed to learn to communicate. For most of my life I could not express myself in a way that people could understand. I could not figure out the rhythms. I would explain too little, and people would misunderstand. I would say too much, and people would not be able to follow along. To converse, you need to tailor what you say to the other person. You need to follow cues about what s/he is thinking and feeling. All of that was way ahead of me. Like many people with mental illness, I had difficulty making friends. Even more important, more than once I was seriously harrassed and could not report it because I could not communicate.
To improve my communication skills I needed to focus on just putting my thoughts into words. Only that. Not eye contact. Not my volume or tone of voice. Not my body language. I needed to go back and work on the basics of communication.
That was the only thing that worked for me. After a while I was able to work on eye contact and my other issues. It took a while to reach that point. But I did learn to communicate better.
Wednesday, March 13, 2013
Finding Limits
Dear Tony,
Do the best you can.
Don’t strain yourself. Making these changes and trying things that you haven’t done in a long time (or never before) is enormously stressful. If you add to that by demanding that you reach certain limits, routinely do something at a specified time or for a certain length of time, you are going to burn out.
A large part of this is discovering what you can do, what your limits really are. People’s limits change from day to day (sometimes from minute to minute), are sensitive to moods and outside events, and frequently are not known in the beginning. People recovering from mental illness are even more sensitive to such issues. Your best work today may not be your best work tomorrow or the day after. Do the best you can at any certain point. Concentrate your efforts on not pushing too far and not burning out.
Do the best you can.
Don’t strain yourself. Making these changes and trying things that you haven’t done in a long time (or never before) is enormously stressful. If you add to that by demanding that you reach certain limits, routinely do something at a specified time or for a certain length of time, you are going to burn out.
A large part of this is discovering what you can do, what your limits really are. People’s limits change from day to day (sometimes from minute to minute), are sensitive to moods and outside events, and frequently are not known in the beginning. People recovering from mental illness are even more sensitive to such issues. Your best work today may not be your best work tomorrow or the day after. Do the best you can at any certain point. Concentrate your efforts on not pushing too far and not burning out.
Sunday, March 10, 2013
Setbacks
Dear Tony,
I haven’t written in a while because I have had some of my own setbacks which I needed to deal with.
Setback. That doesn’t make my current project a failure. It doesn’t mean that I need to permanently restrict my activities or make drastic changes. It means exactly what it is. Set. Back. It usually means I need to take a few steps backwards, need to slow down, need to lie low for a little while. Need to regroup. It depends of the project, of course, but it usually only lasts for a week or so. Then I try again.
So why did it fail? For me, the most common reason is that I simply moved too quickly. I took on more than I can handle and I needed to withdraw and rethink my current duties. That isn't a failure. Or I was doing too many things with my current project and my other responsibilities. Or I wasn’t as prepared for the next step as I thought I was, and I needed to go back and rebuild myself some more. Or some crisis came up, and I couldn’t handle anything new.
Taking on new projects requires a lot of energy. Often I need to make my life as stable as possible and I need to withdraw from some other activities. I need to just concentrate on doing the first step, and then I need to rest. Sometimes I need to give the same attention and focus to the second and third and fourth step, too. But eventually I will grow accustomed to it. And if I don’t, then I need to step back and figure out what happened. If I need more time or a smaller step. But I usually learn something and make some progress.
I haven’t written in a while because I have had some of my own setbacks which I needed to deal with.
Setback. That doesn’t make my current project a failure. It doesn’t mean that I need to permanently restrict my activities or make drastic changes. It means exactly what it is. Set. Back. It usually means I need to take a few steps backwards, need to slow down, need to lie low for a little while. Need to regroup. It depends of the project, of course, but it usually only lasts for a week or so. Then I try again.
So why did it fail? For me, the most common reason is that I simply moved too quickly. I took on more than I can handle and I needed to withdraw and rethink my current duties. That isn't a failure. Or I was doing too many things with my current project and my other responsibilities. Or I wasn’t as prepared for the next step as I thought I was, and I needed to go back and rebuild myself some more. Or some crisis came up, and I couldn’t handle anything new.
Taking on new projects requires a lot of energy. Often I need to make my life as stable as possible and I need to withdraw from some other activities. I need to just concentrate on doing the first step, and then I need to rest. Sometimes I need to give the same attention and focus to the second and third and fourth step, too. But eventually I will grow accustomed to it. And if I don’t, then I need to step back and figure out what happened. If I need more time or a smaller step. But I usually learn something and make some progress.
Friday, March 8, 2013
Facing Trauma
Dear Tony,
I know you have some serious trauma in your past which you think about often. I do, too. The majority of people with mental illness do. How it affects our illness is difficult to understand.
Facing this has been difficult for me. Often it is difficult to think about. If I try to write or say precisely what happened I fall apart. I can only deal with little pieces at a time. Even now.
That does not mean I can't improve.
One serious issue is the guilt surrounding my trauma. I wasn't totally innocent. I did do some things wrong. Often, when people wanted to help me, they implied that I was pure and innocent. Or that what happened vastly outweighed anything I had done. But my guilt was still in a ball inside of me. I couldn't release it. I wasn't even sure I should. If people said I was innocent, I felt that ball pressing against me.
I wasn't innocent. I did do some things wrong. I just felt like I had been sentenced to a lifetime of hard labor for a misdemeanor. I think that is common.
Don't let go of your sins -- you have probably realized by now that you can't -- but try not to dwell on them either. Try to think about what you can do. What would make you feel better now? Do you need to find ways to atone or do you need to heal yourself overall for now? Do you need to start to work through what happened directly or do you need better ways to protect yourself? Each person is different. No one can answer those questions for you.
I know you have some serious trauma in your past which you think about often. I do, too. The majority of people with mental illness do. How it affects our illness is difficult to understand.
Facing this has been difficult for me. Often it is difficult to think about. If I try to write or say precisely what happened I fall apart. I can only deal with little pieces at a time. Even now.
That does not mean I can't improve.
One serious issue is the guilt surrounding my trauma. I wasn't totally innocent. I did do some things wrong. Often, when people wanted to help me, they implied that I was pure and innocent. Or that what happened vastly outweighed anything I had done. But my guilt was still in a ball inside of me. I couldn't release it. I wasn't even sure I should. If people said I was innocent, I felt that ball pressing against me.
I wasn't innocent. I did do some things wrong. I just felt like I had been sentenced to a lifetime of hard labor for a misdemeanor. I think that is common.
Don't let go of your sins -- you have probably realized by now that you can't -- but try not to dwell on them either. Try to think about what you can do. What would make you feel better now? Do you need to find ways to atone or do you need to heal yourself overall for now? Do you need to start to work through what happened directly or do you need better ways to protect yourself? Each person is different. No one can answer those questions for you.
Wednesday, March 6, 2013
Starting to Change
Dear Tony,
I know that changing things is very difficult. You just need to start something. Anything. Anything that you can do right now.
The first step is almost always the most difficult. Once you have started, you will be able to move on and go further. You will see more possibilities, more things that you can do. But just taking that first step is the most difficult.
Chances are you fuction better at certain times or in certain locations or under other very specific conditions. Accomodate that as much as you possibly can. Change is difficult enough at first. Make it as easy on yourself as possible.
Don't be worried about failure. In my experience, almost nothing is a complete and total failure. New changes usually succeed in some way, even if it is not the way you most want. Even if you do fail, think it over and consider what happened. You probably did some things right, and you need to realize and build on that. And if you can figure out what went wrong, than at least you know what to avoid. Or what you are not ready for right now. And then you can make changes and try again.
Also, do not think about the long-term plan for now. Just do whatever you can do. Obviously, later on you will want to be careful that you are moving in the direction you want to move in. But for now just make any positive change you can. In order to move in the right direction first you need to learn how to move.
One more thing: Taking the first step is very difficult, and you will need to take care of yourself when you do so. I usually need more food and sleep when I am beginning to do something new. You may need to find some other activities you enjoy. Call it a reward. You've earned it.
Good luck!
I know that changing things is very difficult. You just need to start something. Anything. Anything that you can do right now.
The first step is almost always the most difficult. Once you have started, you will be able to move on and go further. You will see more possibilities, more things that you can do. But just taking that first step is the most difficult.
Chances are you fuction better at certain times or in certain locations or under other very specific conditions. Accomodate that as much as you possibly can. Change is difficult enough at first. Make it as easy on yourself as possible.
Don't be worried about failure. In my experience, almost nothing is a complete and total failure. New changes usually succeed in some way, even if it is not the way you most want. Even if you do fail, think it over and consider what happened. You probably did some things right, and you need to realize and build on that. And if you can figure out what went wrong, than at least you know what to avoid. Or what you are not ready for right now. And then you can make changes and try again.
Also, do not think about the long-term plan for now. Just do whatever you can do. Obviously, later on you will want to be careful that you are moving in the direction you want to move in. But for now just make any positive change you can. In order to move in the right direction first you need to learn how to move.
One more thing: Taking the first step is very difficult, and you will need to take care of yourself when you do so. I usually need more food and sleep when I am beginning to do something new. You may need to find some other activities you enjoy. Call it a reward. You've earned it.
Good luck!
Learning to Heal
Dear Tony,
I have gone through some difficult periods myself recently. I would like to reflect on some of what I learned.
You need to fix your life as best as you can. Change is very traumatic at first. You need to have as much stability as possible before trying to change anything. Too much change can backfire quickly. Major changes involve an extended period of down time where you need to keep the rest of your life as stable as possible.
I tried to do too much, pushed too hard, and grew depressed. I essentially shut down for a while. I needed to rest and stop pushing myself more than absolutely necessary. I stopped trying to eat well or exercise more. When you are depressed, just eating anything at all can be an accomplishment, and I stopped there. I stopped trying to clean my apartment or do anything really productive. I just rested for a few days.
And it worked. I feel a lot better now. Although I know I still need to be really careful about my limits and to concentrate on my new job and not push myself to do much extra.
A friend of mine who had a chronic physical problem once told me that the body needs extra energy trying to heal. That if she strained herself or had a complication she needed to rest more and eat more to let her body heal. I think that is true for mental health as well as physical. If your mind or your body is strained, then you need to give it something extra to recover.
I have gone through some difficult periods myself recently. I would like to reflect on some of what I learned.
You need to fix your life as best as you can. Change is very traumatic at first. You need to have as much stability as possible before trying to change anything. Too much change can backfire quickly. Major changes involve an extended period of down time where you need to keep the rest of your life as stable as possible.
I tried to do too much, pushed too hard, and grew depressed. I essentially shut down for a while. I needed to rest and stop pushing myself more than absolutely necessary. I stopped trying to eat well or exercise more. When you are depressed, just eating anything at all can be an accomplishment, and I stopped there. I stopped trying to clean my apartment or do anything really productive. I just rested for a few days.
And it worked. I feel a lot better now. Although I know I still need to be really careful about my limits and to concentrate on my new job and not push myself to do much extra.
A friend of mine who had a chronic physical problem once told me that the body needs extra energy trying to heal. That if she strained herself or had a complication she needed to rest more and eat more to let her body heal. I think that is true for mental health as well as physical. If your mind or your body is strained, then you need to give it something extra to recover.
Healing
Dear Tony,
I know you are sick. I know that is very scary. I have been there before.
Try to relax and calm down. Try to just rest at first. This is most likely temporary. Your life will grow better in time.
When you are sick, you need to heal. You need to relax and let both your body and your mind heal yourself. No one can do that for you. People may be able to help you with that, but you really need to heal yourself.
Healing is not the same as treatment. Healing is much more than taking medications. Healing is fixing your mind, your body, and your life so that you can live as fully as possible. Medication is only one piece to that. For some people it is essential, but it is still only one piece of improving. The true healing rests with you.
Rest at first. When you are sick you need rest. Then start to figure out ways to heal.
I know you are sick. I know that is very scary. I have been there before.
Try to relax and calm down. Try to just rest at first. This is most likely temporary. Your life will grow better in time.
When you are sick, you need to heal. You need to relax and let both your body and your mind heal yourself. No one can do that for you. People may be able to help you with that, but you really need to heal yourself.
Healing is not the same as treatment. Healing is much more than taking medications. Healing is fixing your mind, your body, and your life so that you can live as fully as possible. Medication is only one piece to that. For some people it is essential, but it is still only one piece of improving. The true healing rests with you.
Rest at first. When you are sick you need rest. Then start to figure out ways to heal.
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