If you live in California or Florida or any climate where the seasons don't change, then you may have a hard time understanding the misery of getting a case of Spring Flu.
If you live in California or Florida or any climate where the seasons don't change, then you may have a hard time understanding the misery of getting a case of Spring Flu.
Why is it that so many people I know are having a "hideous" week, this last week of March 2009?
We're human. Not perfect. We make mistakes.
Last night, I was talking to one of my cousins. I'm the eldest of three girls. As far as I'm concerned, he's as close as any man I've ever known to being my brother. We're just a year or so apart – I'm older – and we grew up together every summer at The Family Cottage. He is one of only three people who gets away with calling me by my real name – Sandra Lee. The other two are my sister, Glorianne, and his sister, Linda Sue. Don't get me started.
The print edition of The Toronto Star is to be congratulated for brilliantly deciding to enlist the genius, wisdom, knowledge, humour, medical expertise and humanity of Dr. Rob Buckman as a regular Friday Living section columnist.
By the way, Vallenstein is a professor emeritus of psychology and neuroscience at the University of Michigan and the author of Blaming the Brain and about four or five other books on this subject. This is a man who knows of what he speaks.
The other day, I was talking to a woman who is a member of AA. What a joy. I felt instantly at ease with her and our relatively brief conversation was utterly invigorating.
There are many parallels between AA and mental health recovery. I've done a little Twelve-Step work with Overeaters Anonymous – meetings are a form of group therapy but facilitation is shared. Peer support is central to the model, especially with sponsors. It's a tried and true approach, though with food, I found it difficult because I couldn't abstain from eating. And it's the act of eating I'm addicted to, not just one type of food. I love to eat. Anything. It fills a void.
Anyway, that's another story.
"All it takes is two people to make a meeting," is a Twelve-Step saying. For those of us isolated by mental illnesses or mental health issues – and far too many of us are – just talking to one empathetic person, someone who's been there and can really listen with his or her eyes and ears and heart – is extraordinarily healing.
Part of that empathy involves "active listening" and that "active listener" doesn't have to be a medical doctor or a psychologist or a psychiatrist or a social worker or even someone with "training."
I would venture to say the number of active listening psychiatrists are few and far between. The majority aren't trained that way. Too many, today, don't see the value of active listening to be very efficient when pharmaceuticals appear to ease the pain.
You have to look elsewhere. My guess is, you can find someone who can listen with empathy and intellectually and emotionally participate in your experience very easily – if you look in the right places.
Community Health is the key. For example, at the Yale University School of Medicine, Mental Health Recovery is on the curriculum of its School of Community Health, the only such program on the continent. You would think you'd read more on mental health recovery, given the prestige of this school and Recovery's humanitarian and progressive approach to the journey of healing.
But you don't. Even though it's embedded in an Ivy League school of medicine, and was created by a man, himself in recovery from depression, Larry Davidson, Ph.D. As far as I'm concerned, Yale's program is a vestige of sanity in a world that's quietly going mad.
I'm reminded of this because tomorrow, in my "Leadership in Society" class, my students will grapple with "The Morality Quiz" – a series of dilemmas used to study human morality. Neither multiple choice, True or False or Fill-in-the-Blanks, instead, they will be forced to empathize with people in situations they will probably never experience in their lives. They will have to face a series of dilemmas used to study human morality. It's impossible to measure empathy, according to TIME magazine writer Jeffrey Kluger who wrote this November 23, 2007 cover story titled What Makes Us Moral.
Here's how that story begins:
"If the entire human species were a single individual, that person would long ago have been declared mad. The insanity would not lie in the anger and darkness of the human mind–though it can be a black and raging place indeed. And it certainly wouldn't lie in the transcendent goodness of that mind–one so sublime, we fold it into a larger 'soul.' The madness would lie instead in the fact that both of those qualities, the savage and the splendid, can exist in one creature, one person, often in one instant."
Although the interactive quiz is no longer available online, here's one of the "scenarios" used to study human morality.
It's called The Life Boat:
You're in a lifeboat with several other people. The boat is overloaded and will capsize soon killing everyone aboard unless you lighten the load by one person. One of the passengers is grievously injured and is certain to die soon, but is fully alert and aware of everything that is going on. Could you throw that person overboard, knowing that that would save everyone else and that the person would know what you were doing while you were doing it?
I could not throw the grievously injured person overboard.
I could throw the grievously injured person overboard.
Think about that for a while. There is no right or wrong answer.
I've often said to people who remark on what I've endured during my life – "It's all relative." I never compare myself with others. We're all individuals. My story is my story. Yours is yours. I'm amazed at how resilient people are. And glad I've lived my life. Wouldn't change a thing. I feel I have a certain ability to walk in the shoes of some people. Not all. And this, I consider a gift.
The essence of emotional healing is listening. Empathizing. Sharing. But how do you find a place where you'll feel the "splendid" humanity Jeffrey Kruger suggests we all have within us.
Let's think like a community. All of us. Here. Right now.
As an advocate, I'm familiar with some sources of peer support – your local branches of the Canadian Mental Health Association. The Krasman Centre. The Family Outreach and Response Team. The Ontario Peer Development Initiative. These are just a few that come to mind in the realm of mental health. There are hundreds of others that serve so many "communities" of people who need a sense of connection. At times, we all do. Especially now. During these difficult days.
My public speaking has brought to light various ways in which we, as human beings, face our unique emotional issues.
Now, here, at Coming Out Crazy, a safe and supportive arena, I invite you to identify the community health centres near you. Centres of any kind. These pockets of peer support can be anywhere. Perhaps at a local park, a library book club, a coffee shop, a church or mosque or synagogue or temple basement study group, an outreach centre.
You name it, I'll print it.
Let's share the wealth of well-being.
Ultimately, all it takes is two to make a peer support group.
A week after Reading Week and it's a blur. How reality bites back. And so fast. My Queen's University keynote is now a memory, though I must admit I worry about the way young doctors are trained and how their future patients will fare. Especially in psychiatry.
But that's another story.
On the train to and from Kingston, once again, I discovered what for me is a truism.
It never fails.
I'm sitting in this Via Rail car – it could be a plane. The point is, I'll be stuck in a seat with a stranger beside me for at least two hours. There's no place to go so eventually we start chatting.
Inevitably, the question comes up.
"Why are you going to Kingston?"
"To give a speech," I say.
"Mental illnesses. Mental health issues. Mental health recovery. I'm a mental health advocate," I say.
Then, this person starts telling me his story. Perhaps his daughter had postpartum depression. Perhaps a friend died by suicide. "Without any warning. He was the life of the party. We went to him to be cheered up."
It never fails. Everybody has a story. I don't know anyone either directly or indirectly not touched by some psychiatric issue or mental disorder or addiction. But very few people talk openly about it. No one has ever initiated a conversation with me about his or her mental illness. It's not easily discussed. Or even whispered. So sad. Such a huge, heavy albatross to bear on one's own, silently. Hiding. Masked.
This doesn't seem to be changing, judging by the stunning statistic that 75 per cent of people who could be treated or helped by treatment of some kind never ask for it. Deny needing it. For any number of reasons.
Following all my presentations, people, often strangers, share their stories. Somehow, me telling my story gives them the licence to talk about theirs. It's liberating.
Having "health" problems is part of the human condition. It's life. I don't separate mental and physical and emotional and spiritual and social. They all contribute to our state of well being – or lack thereof.
My Kingston trip to speak at Queen's to the first year medical students was good. All round. Now it's history. Old news.
My friend, Tufts University psychiatrist Ron Pies said, in an email: "I suspect the students got a great deal out of hearing you, and that it will help them take a more humanistic and humane approach to their work."
Being the cockeyed optimist I am, I'll focus on that. Hope for the best. Chalk it up to experience.
On to the next!
I'm anticipating today. I may be able to return to my regular drug regime and my calm, tranquil, phlegmatic self. (Ha, ha. Were it only true.) You see, I've been overreacting a little lately. I certainly hope people who've been at the other end of my histrionics will understand.
I've learned a very important lesson with all this oral surgery and fiddling around with my medications. Next time it's necessary, I'll postpone the procedure, if I can, until I'm not working. Otherwise, strange things happen.
I've gotten through it. At last, the stitches in my mouth will come out today – maybe. And I cannot wait to be able to brush all of my teeth. It's amazing how one craves what one cannot have – like the luxury of wildly flossing and bandying my electric toothbrush all over my whole mouth.
I guess that's my message today.
Everything is relative. I have a totally idyllic life because I know where I've been and today, let's just say I'm in heaven. My smile has almost returned. I haven't gained a ton weight on a diet that denies me the joy of eating a raw carrot.
I feed them to my two Dandie Dinmont Terriers, Riley and Lucy, and get vicarious pleasure watching them merrily crunching away. I haven't been able to crunch on anything since Tuesday, Feb. 10. Not even a crust of bread.
And there's tomorrow. Always tomorrow. Another a new day. I love mornings. No matter what the weather. They're new beginnings. I am looking forward to a weekend of learning – finishing a course on teaching that I began last fall. Self-indulgence – a manicure. Work – marking, but there's always marking. And an exclusive party to celebrate my brother-in-law's 60th birthday. My mother is in town and she seems in good spirits. And two of my nieces who are studying in the U.S.
A nice relative mix. Family, friends, learning and a little pampering.
What a lovely, charming, engaging miscellany of activities. Best of all, I'll be sharing most of them with my luscious husband. If there is one antidote to my mental illness, my daunting psychiatric diagnosis – "psychosis linked to mania" – it's Marty. My rock. He calms me faster than any drug known to man. With just his touch. It's magical. I felt it the instant I laid eyes on him almost 10 years ago.
So you see. I live a wonderful life.
Peace of mind.
No secrets. No lies.
Last week, for the first time ever, I went to Kingston to speak to about 100 Queen's University first year medical students, the Class of 2012, during their Mental Health Awareness Week.
I was invited because of a question one of these students posed here about my ongoing campaign against the use of the word stigma. As I'm a Queen's alumna, Class of '74, she asked me to speak and I was happy to accept.
I was pretty nervous. I've never spoken to medical students before. I'm no scientist nor was I prepared to lecture. I wanted to initiate a dialogue. Engage these students. Challenge them. Get them asking questions.
After all, they're the next generation of doctors, perhaps psychiatrists. I was told that they hadn't heard one word in their classes about mental health/illnesses/psychiatry until the four 50-minute lunch time presentations last week. Mine was the last.
It went very well. I had a full house and 95 per cent of them were medical students, along with a few psychology and occupational therapy students.
My introductory remarks were short – a quick overview of my mental health history, all my different diagnoses, my subsequent kidney problems caused by 16-years of badly monitored Lithium and the fact that despite "overcoming every psychiatric indignity short of a lobotomy, I'm still here."
I was hoping they'd be open to thinking about mental health outside the medical model. Consider the recovery model. I assured them that I was not anti-psychiatry but I wanted them to hear about the possibility of change. Desperately needed change in the way medical doctors are trained. So I chose to speak briefly about recovery, the power of language and mental health and why I detest the word "stigma" – and then open the floor up to them. They asked a steady stream of good, intelligent questions, especially about labelling.
"Isn't calling yourself crazy a label?"
Sure, but I asked, "What do you think crazy means?"
"Being out of control."
Don't you get out of control sometimes?
So, we're all capable of being crazy sometimes. That's one word I think we all use. I happen to like it. In the same way the many people who are gay, lesbian, bisexual and transgendered like to call themselves queer.
I told them that I also love the word "mad" – because madness has always been part of the human condition. Long before it was pathologized into the sphere of medical/mental illnesses. Since biblical times, people who behaved irrationally or too differently were seen to have what are today considered mental or psychiatric problems.
Invariably, though, people perceived as mad were, and still are, dismissed and disregarded. Marginalized. Perceived as less than human. With no voice. And because we have no voice, change is slow to happen. No one wants to listen to us or take us seriously.
I cannot remember many other specifics about my talk – I don't use a script – my presentations are spontaneous. The students were very attentive and according to the feedback I received they found me refreshing. They were very surprised that I was so open about my psychiatric history.
This always amazes me. I have no reason to feel anything but proud of my life. With all its ups and downs.
Before my presentation, I met with Heather Stuart, a Queen's professor of community health and epidemiology. She gave a very informative and thoughtful lecture a few days before mine on "Mental Health Stigma and Health Care Delivery."
Stuart is a world leader in the field of "stigma" as it is associated with mental illnesses. She told me that only three medical students attended her talk, which is too bad because they would have benefitted enormously from her research and experience, her empathetic approach and her wisdom. She is a scientist, yet she is as passionate as I am about changing the public perception of people with mental health difficulties, their treatment and maltreatment
One statement shocked me. She said that people are afraid to come to seek treatment for their mental health problems, because of the negative stereotyping of and discrimination against people with mental illnesses.
"Three quarters of people in Canada and worldwide who meet criteria for mental health diagnoses do not receive care," she said.
In 1998, when I first started publicly presenting my story, putting these issues of stereotyping and discrimination out in the open, that figure was 66 per cent. Now, it's 75 per cent. What's happened?
That's the subject for another post.
Stuart was very receptive to my ideas about problematic use of the word stigma. As I see it, that word is part of the problem.
As well, she said that in terms of change, "We know contact counts. When we put people with mental health problems with those that don’t and allow positive interaction, we can see the difference that it makes. We need to do that. More contact. And we need to focus. We shouldn’t be going about spraying the public population. We need to target groups. Here are some groups that can be targeted ... worthy of targeting. Understanding what they need is the important way to proceed: School, police, health care workers."
I say, start with the health care workers, especially the doctors.
Especially the doctors who are training doctors in medical schools.
Medical school curricula must be revamped so that health is considered. Physical, mental, emotional, spiritual, social. Holistically. Surely health is more than absence of disease. Yet, healing and doctoring by today's standards are very different.
Today, we are a series of body parts and systems. Medicine is so specialized and technological that the essence of the person seems lost. That's where complementary medicine, and other schools and approaches to health have so much to share.
Not in today's medical schools, where one model is taught. The biomedical model. Not the recovery model. Doctors are scientists. Psychiatrists are neuroscientists.
What about our minds?
Nothing in medicine is purely objective – writes psychiatrist Ron Pies in his fascinating essay "Psychiatry Clearly Meets the 'Objectivity' Test." According to Dr. Emmanuel Persad, psychiatry can be an intellectually vigorous and rich specialty if talking therapies are a mainstay of its practice. If they aren't, I would think psychiatry must be boring as hell.
How can the neurosciences – biochemistry, pharmacology of the brain and nervous system – help people with issues that relate to their life experiences? Their traumas? Their minds?
Brain disease? No way.
Drugging people is a quick fix that doesn't always work well. It can help, but pharmaceuticals can also have serious side effects. Without the insight that can only come, in tandem, with psychotherapy, the neurosciences are only a partial fix. They're only one set of tools in a therapeutic tool box filled with many other potentially more effective tools. Certainly, handing out drugs without any human, therapeutic support isn't the only answer.
You need to have an open mind. That was my parting shot to these future medical doctors.
An open mind.
Yesterday, during their first-ever Mental Health Awareness Week, I gave a keynote to approximately 100 Queen's University first-year medical students, plus several psychology and occupational therapy students.
And it all started right here with a comment one of my posts at "Coming Out Crazy"...
I plan to tell you all about it – but not today. I'm exhausted.
Next week, I promise to fill you in:
* On the fascinating discussion that followed my talk – titled "Coming Out Crazy" – what else?
* On the warm reception I received from these doctors and educators of the future and their reaction to what I had to say – which challenged what they're learning about "health", which seems to neglect the synergy between the mind, the body and the spirit.
* On spending a fascinating hour prior to my talk with Queen's epidemiologist Dr. Heather Stuart, a world renowned researcher in community-based mental health care. She's also co-founder and co-chair of the scientific section on Stigma and Mental Disorders for the World Psychiatric Association. On Tuesday, she delivered a talk, as part of this series, on "Mental Health Stigma and Health Care Delivery." Dr. Stuart is currently scientific adviser to the Mental Health Commission of Canada's Anti-stigma: Campaign.
It was a whirlwind trip. I was in Kingston for 25 hours.
It was also a trip down memory lane. I attended Queen's from 1971-1974, where I graduated with a BA in English and Drama, was the entertainment editor of the Queen's Journal and was a stringer, writing theatre and film reviews for the Kingston Whig-Standard, then a fine old Canadian newspaper, founded in 1834 as The British Whig.
When I worked there, the family of Robertson Davies owned the Kingston Whig-Standard.
By the way, my psychiatric diagnosis during this time was schizophrenia. Just thought I'd throw that in. I did not have one psychotic episode during my Queen's years.
But I digress. Next week, you'll hear all about my Queen's and Kingston adventure.
Have a great weekend.
My dear Ladies and Gents,
Today, I'm going to address mental wellness – and an intriguing discovery I've made during my two and half terms teaching a course called Leadership in Society at Seneca College of Applied Arts and Technology.
The unwritten subtitle of this course and the actual subtitle of the text is For College Students Who Want to Make a Difference.
You may be wondering – what is going on here? What has this to do with "Coming Out Crazy"?
Please suspend your willingness to disbelieve for a minute while I stretch William Taylor Coleridge's theory a bit. You'll get my drift. Trust me.
This weekend, I was immersed in marking the online journals my 42 students write, based on questions I pose. This is a private blog. They don't see or comment on each others' posts. It's their opportunity to have a private dialogue with me.
Many of my questions are reflective, yet reference the text either directly or obliquely. (That way, I know they're reading it.)
Many of these students chose this elective thinking they would learn how to boss people around.
If they do the work. Follow the course mantra – Woody Allen's: "Ninety percent of success is showing up." They have a good chance of getting excellent marks – which matters enormously to them.
They also learn something entirely new in an academic setting. Self-awareness. Teamwork. Empowerment. The power of Listening. The difference between ethics and morals, values and beliefs. And how good it feels to help others.
They develop, evolve and walk away from this course with a sense of "community" and the personal gratification that comes from the work they do in and outside the classroom – which matters enormously to me.
They're required to do 20-hours of volunteer work (for 30% of their final mark) – outside all their curricular activities – with any agency or organization they choose, as long as those agencies or organizations are not for profit.
The majority – about 95% – are either International students or from vast, delightfully diverse backgrounds. It's amazing how much I learn from them.
This is a Community Service course – and I love Barack Obama's take on it. After all, he's first and foremost, a community organizer.
The classroom is a community. The college is a community. Out there, in the real world, many of these students belong to other communities – ethnic, religious, political, neighbourhood, familial, friendship, sports, hobbies – the list is endless.
Leadership in this course is for Social Change – a process everyone can learn and participate in.
Three major skill sets are stressed – teamwork, communications and self-awareness.
I noticed some amazing insights reading my students' journals. The question that sparked these insights concerned their personal strengths and weaknesses – self-awareness.
Many of my students – ages 18 and 20 – wrote so thoughtfully about what they perceived to be their personal strengths and weaknesses. They opened up about feeling excluded when they first moved here from their native countries, knowing no English. They wrote about the personal pain they felt when kids in school treated them like outcasts, because they seemd so "different."
I also asked them to reflect on how they overcame those feelings.
Invariably, they wrote about one person reaching out. Perhaps a very sensitive teacher, or another kid who had similar experiences. Always, it was someone who listened and held out a hand of hope.
This was universal. Even for Canadian-born kids in new schools. Most interesting was how they all found ways to overcome those painful feelings, which relate to being perceived as "different."
We're all different.
I think mental illnesses are all about "difference" – being perceived as a little too different.
And mental health is about feeling included.
Generally, as a society, "being different," or perhaps a little "too different," is difficult to accept. It's easier to alienate, isolate, shut away, turn a blind eye, ignore, stay ignorant, or even fearful.
The history of "madness" – the term "mental illness" is relatively new – goes back to the beginning of time. It's about powerful perceived difference. French philosopher, historian and sociologist Michel Foucault described "mental illness" as the "Leprosy of the 20th Century."
We're all feeling the stresses of the Recession. Exhaustion. Longer hours. Heavier workloads. Uncertainty. Now is the time for community service – a great tonic for these stresses. Pressures. Gloom and doom.
I don't just preach this stuff. Seneca asked me to develop this course because of my history of community service, particularly my mental health advocacy. I'm giving a keynote at Queen's University this week and writing an article for a scholarly journal inspired by this blog!
It feels great.
Want to get over depression? Anxiety? Consider committing to a good cause.
Drive for the Canadian Cancer Society or deliver Meals on Wheels. You'll discover it's not the "driving" that feels so good, but the relationships you develop with the people you drive and deliver meals to – and the people administering these essential services.
You get much more than you give by involvement with community organizations dedicated to making positive, meaningful differences for the Greater Good.
Like Habitat for Humanity – a favourite among my students.
This "work" lifts your spirits. Gives you a sense of belonging. Inclusiveness. Empowerment. Purpose.
A natural high. You feel connected. Less alone.
It's mentally healthy. For you. Everyone.
Thought I'd share that with you on this beautiful, bright, sunny, soon-to-be Spring March day.
Take good care!