About These Blogs

Welcome to "Beyond Mental Illness." This site was created to give advice to people who have a psychiatric history and now are working to re-build their lives. It is definitely possible for people with psychiatric histories to have meaningful lives with important contributions, and these pages are designed to give suggestions on how to do so.

There is minimal discussion of medication here. Medications can be an important step for some people, but they are only one step. Medications can help mitigate some symptoms, but they cannot do everything a person needs. The author hopes to give suggestions on filling other needs people with mental illness have.

Right now the blog has two composite characters. One is Tony, a young man who has recently been released from the hospital and is low-functioning. The letters addressed to Tony are here on this page.

The second character is Kayla, who has been stable for a while but needs advice on taking next steps and moving forward. The link to Kayla's letters is: beyondmikayla.blogspot.com.

The author recommends people interested in mental health consider reading the following books: http://beyondmentalillness.blogspot.com/p/recommended-reading-list.html.

Thursday, May 30, 2013

Intrusive Memories

Dear Tony,

I would like to write about what I have learned about dealing with intrusive memories.

All of the following is just my experience. I can't speak for anyone else.

Intrusive memories are memories you cannot rid yourself of. They keep pressing against your skull and can become very upsetting. I knew that these memories were not worth being so upset over and that I should just forget about them. But we do not have the ability to control our thoughts and emotions as much as any of us would like. Try as I might, I could not rid myself of them.

Most of my intrusive memories are of things with did legitimately upset me. They were genuine injustices. But they were not the worst injustices in the world or even the worst injustices I had personally encountered. I understood that as well, but I still could not rid myself of them. I finally realized that these memories must have had some deeper meaning to me. They were not significant enough in their own right to be bothering me as much as they were.

I started looking back in my past at some situations which had deeply bothered me when I was younger but did not bother me nearly as much now. I tried to figure out what had changed and when they stopped bothering me.

Often those memories bothered me because at the time I couldn't understand them. I was young and naive and had considerable difficulties understanding the nuances of situations. I had been in trouble for behavior which I honestly did not understand was upsetting people. As I grew older, I was able to look back and better understand how my behavior appeared to people. Often those other people had done things wrong as well. Conversations and social situations are extremely complex, and frequently there are multiple small times when things went wrong (especially if there were more than two people involved). Once I was able to sort out precisely where I was wrong, where other people were wrong, and exactly what happened, I was able to gain some control.

When I had that basis of understanding, I was able to heal from the trauma. Healing still did not happen quickly. Think of a large physical wound. Even if that person receives the best medical treatment for that wound, it will still take a while to heal. Much of trauma is like that.
That approach worked for earlier intrusive memories. It helped me heal from more recent intrusive memories. But it was not enough on its own.

I eventually learned that my more recent intrusive memories reflect a skill I am still lacking such as effectively fighting back against being screwed or explaining I misunderstood earlier instructions. I did not have the social skills to succeed at the time, and I still lack those specific skills today. That is why I am still haunted by these memories. I am subconsciously bothered by the fact I still don't have these skills.

I am working to specifically develop them now, and the memories are starting to lose their intensity. Not quickly. But gradually they are not bothering me much more than other bad things that have happened.

Saturday, May 25, 2013

Reminder - Two Principles

Dear Tony,

I would like to remind you of the two basic principles which helped me improve. I have given you and Kayla specific suggestions based on what worked for me and what I have learned reading and talking to other people. But my advice for you is based around two central premises which I would like to review:

1. Do what you can do, not what you need. I guarantee you, you will be much better off in the long run doing whatever small, silly, trivial thing you can to improve your life right now than you would be waiting for the large things you really need and sitting and suffering while you wait. Do anything you can. For right now, don't worry about the direction you are going in. Just do anything. In order to move in the right direction, you need to first learn to move.

2. Don't wait. Don't wait for anything. Don't wait for the things you really need. Don't wait to understand your illness. Don't wait for the medications to work. Of course, you should talk to your counselor if you have any questions about your medicines or diagnosis. But don't wait to change things. The longer you wait, the longer you are going to be sitting and suffering.

Friday, May 17, 2013

Cleaning

Dear Tony,

I would like to write a little bit about cleaning. I don't mean looking back and re-evaluating things and finding ways to improve yourself. I mean simple, undramatic and unemotional housecleaning.

I know keeping your living space clean is difficult for many people with mental illness. You are well aware your place is a mess, and it is embarrassing to have people over. Sometimes you try to clean it up, but it does not last. More often you are well aware you need to clean, but it is very difficult to organize yourself to do so. I have been there plenty of times.

My advice on cleaning is basically the same advice I have given you again and again: Start with what you can do, not what you need.

For me, establishing a routine is key. Even now, I can usually clean either (1) by a rigid impersonal schedule that does not take into account special events or unusual occurances or (2) only on special events or unusual occurances. I eventually figured out that in cleaning it is better to do it on the rigid impersonal schedule.

Start with establishing a schedule for one cleaning chore. Ideally, it would be something which impacts your day-to-day life such as washing dishes or doing laundry. Figure out a certain time - either a day in the week or a time in your daily routine - when you can comfortably do this chore. Focus on doing it then. At first it will probably be difficult, but eventually it will simply become part of your schedule. If you miss the chance to do it on the set time don't worry about it. Simply resume your plan the next set time it comes. Chances are that is still better than doing it sporadically. Once you are used to doing that one chore on a set schedule, you can start to add other chores.

Once you have started improving your day-to-day life this way, the next priority is sanitation. Often keeping your space sanitary involves more difficult and more demanding chores (cleaning floors, cleaning bathrooms, etc.). Again, chose one chore - maybe the one that is easiest for you - and figure out a time in your routine when you can do that. Focus on doing one chore at a time. Keeping your living space halfway clean is better than not keeping it clean at all.

Cleaning effectively is a legitimate skill which takes some knowledge and considerable practice. If you honestly do not know how to do these chores, I can understand that it might be embarrassing to ask people. There are a number of books about how to clean effectively. There should be some available in the library. Even if you have done these chores in the past, it takes some time to grow used to them and to learn how to best do them in your specific space. It takes some practice before it becomes part of your routine. If you try to do too much at once you could grow overwhelmed and shut down.

One final note: This is just cleaning and keeping your space sanitary. Don't even try to make things organized and attractive. Worry about that later.

Saturday, May 11, 2013

Traumatic Memories

Dear Tony,

I would like to write a little about dealing with traumatic memories.

Some memories fade over time. Time heals most wounds. But some wounds become infected.

If the memories do not fade by themselves, the next step is to determine whether or not they are still connected to emotion - if having these memories triggers feelings. You need to base that on whether or not these memories are upsetting you now, not how much they upset you at the time or how much they do or do not upset other people. If the memories do not upset you now, just deal with them as best you can. Chances are they would be more work to control those memories than is worth it. Also, for now you are probably better off obsessing over those memories than obsessing over real traumas in you past. One caveat: If you are having flashbacks of trivial incidents for years which have not faded, then chances are they do mean something and you would need to explore what.

But to be honest, if you are having constantly recurring memories they probably are genuinely upsetting you now. You need to figure out a plan to deal with them.

For me the most effective method has been - if it is at all possible - going back and visiting the physical location of the trauma. Do not let anyone push you do so before you are ready - you will be retraumatized. You need to work your courage to go back to the place which can take months. I usually try to go back at least two or three separate times. I have always gone alone and taken the time to work my feelings out. But that has proven to be the best method for me.

I personally am still working on ways to process trauma when it is not feasible to return to the physical location. I have sometimes found that composing letters expressing some of my thoughts and feelings can help. Don't mail them. I usually don't even need to write it out, but I need to figure out precisely what to say. Sometimes coming up with some symbolic action can help as well.

Wednesday, May 8, 2013

Steps

Dear Tony,

I want to remind you that you need to go one step at a time.

I have come a long way since I was hospitalized. But I needed to do it piece by piece. If I tried to go too far, I would crumble. Recovering from mental illness is about a million small steps. In my experience, there are very few big steps.

I think of it as building a foundation. When you are building anything, literally or figuratively, you build one brick, one nail, one small piece bit by bit.

You can do impressive things, but you need to do them a little at a time.

Monday, May 6, 2013

More on Changing Yourself

Dear Tony,

The leader of my Toastmaster’s group characterizes the club as “a comfortable place to try uncomfortable things.”

That idea of establishing a comfortable place is critically important. And often overlooked.
When you are doing something uncomfortable (which, when you are starting out, probably means any new step), you need to make the rest of your life as comfortable as you can. That means anything you can reasonably control — physical space, time of day, food, noise, etc. Trying a new step is difficult enough. Trying a new step on top of dealing with normal annoyances is usually overwhelming.

For me, it helps to choose the exact time and place and plan the details in advance. If something goes awry, I will reschedule. But I plan exactly what I am going to do before, during, and after the step.
When I am starting, I can’t compensate for any variation whatsoever. If things don’t go as planned, I usually need to wait. When I am just starting out, I completely lack flexibility. When I have done the step a few times and are more used to it, then I can begin to tolerate some variations or surprises. But when I am starting it needs to go exactly as planned.

After I finish that first step I am usually exhausted. No matter how small the step is. I need to relax and do something to reward myself. I need to recognize that these changes are difficult and I need to make other accommodations in my life.

Change is not easy. But it is possible.

Wednesday, May 1, 2013

More on Dealing with Pain

Dear Tony,

I want to expand on what I wrote in the last post about having feelings.

The first feeling you have is pain. That is to be expected. I have really genuinely had some very bad things happen to me, and I would bet you have, too. Of course you feel pain. It would not be healthy to suffer and not feel pain. As I said, pain can sometimes be a good thing. It means that you are still able to have feelings. Some of the sickest people just go numb.

Once you start having feelings they come in out of control. They can come flooding back. There could be a minor feeling about a minor upset that just refuses to leave. They become mixed with each other. For a long time, I would focus and emphasize with small issues while ignoring larger ones. No one has been able to adequately explain feelings. Every conscious human being sometimes wishes s/he had the capacity to turn his/her feelings on and off the way we turn a television on and off. We don’t.

When my feelings started flooding me, I had to sort it out. This took just about every spare minute I had (and then some). I had to consider, dwell on, and analyze every feeling which I had. This was not because I really believed every feeling I had deserved such contemplation and expression. I simply lacked any sort of triage system.

I was eventually able to understand and start to triage most of my feelings. I know I could not have done it without all the contemplation. There are no shortcuts to that I can suggest. Just lots and lots of practice of recognizing your feelings and (as much as possible) figuring out the root causes. It was definitely worth it, and it was definitely necessary to my recovery. But it was admittedly extremely laborious.