Listening to your body...

For the second day in a row I've been sick. In case you're interested in symptoms, these are mine – stomach ache, temperature 101.4 degrees Fahrenheit, headache, achy bones generally feeling like the inside of a garbage can.

So I've been sleeping and eating almost nothing other than calorie-reduced cranberry juice, herbal tea, a poached egg on dry toast. Not much else. 

I've canceled my classes and that makes me feel even worse, but to be honest with you, wandering around a huge college where students are also sick, it doesn't surprise me that I've picked up something. 

Remember, I'm immune-suppressed, thanks to my kidney transplant. So I have one big strike against me to begin with, even though I've had the H1N1 vaccine. I'm too young to have had the regular flu vaccine, so who knows, that might be what I've picked up.

I've gotten into the habit of listening to my body.

Here's what I "heard."

On Wednesday, I awoke with a pounding headache – I never get headaches. I had to take my Dandie Dinmont Terriers up to their breeder/groomer for their semi-annual spa treatment. The works. This is an hour-long drive up north east of where I live. Normally beautiful Ontario countryside. Not that day. It was so foggy, I could barely read the road signs.

I decided to bring some school papers to mark with me to pass the time. Grooming, for them, involves stripping off their coats by hand, trimming their faces and ears, bathing them. This takes about a six-hour procedure. So I thought I'd make good use of the time.

But I couldn't concentrate. Instead, I curled up on a couch and slept. Every bone in my body was aching. I had the chills. My body was sending me a very clear message. 

"THERE'S SOMETHING WRONG WITH YOU!!!"

The message continued, "Perhaps you should slip into a flannel nightie and your nice warm bed with some Tylenol and go to sleep."

When I finally arrived home, that's what I did and that's what I've been doing for the last day and a half, but this bug is tenacious and won't let go. 

So, I'm cobbling out a short message to let you know that you will be not be hearing much inspiration for "Coming Out Crazy" today. For this, I am sincerely sorry. 

Health is health. My mind is okay, I guess. But with my body revolting, as it appears to be, I'm not thinking as clearly and creatively as I would like. 

There is hope, however.

It appears that the sun is trying to break out from behind the solid grey cloud cover that has engulfed this part of the world for the last few days. Perhaps that's a sign. I know I'll feel better soon.

So, for those of you to the south in the U.S.A., I hope you had a Happy Thanksgiving and today, I wish you safe shopping, if you have the strength and intestinal fortitude to brave the crowds.

No matter where you are, stay warm. Sleep well. Take care of yourself. 

Your health is your most precious possession. Treat yourself with respect. Be good to yourself. And listen to your body. During the Holidays, music, loud parties, late nights, perhaps too much rich food, too much bubbly may drown out the message your body is sending you. Nonetheless, try to listen to what your body is telling you. 

I know I've been working too hard lately. Ignoring the signals. Not good.

So treat your body and yourself, your psyche, your mind, with kindness and care. You deserve it.

Speak soon.

Storme warning...

Post Traumatic Stress has been in the news lately, triggered by the Fort Hood, Texas shootings earlier this month. We're reading more and more about suicides in the military caused by this severe, much misunderstood anxiety disorder. 

You don't have to be in armed forces to struggle with and suffer from Post Traumatic Stress – it can affect anyone at anytime.You may remember my friend who calls herself Storme. She told her story here a year ago. 

Last week, for the fourth time, she bravely faced one of my classes to tell her story of how she became a social activist. 

For three years, Storme has worked diligently to ensure that frontline workers including paramedic, firefighters and police officers, who run the risk of developing Post Traumatic Stress Disorder in their professions, can claim benefits from the Workplace Safety Insurance Board just as they can if they break an arm on the job.

Storme was raped by a superior in the back of an ambulance while on a training course six years ago. She was so severely brutalized and terrified, afraid she would lose her job and see her career destroyed, she stayed silent. She wasn't able to report her assault for 15 months. She continued dragging herself work, but inside, she was falling apart.

Finally, when she broke down and no longer could face going to work, she decided to go to the police.

"Why did you wait so long?" they asked.

That's the whole point about Post Traumatic Stress – you never know when it's going to hit you or what the trigger will be, she explained. Often it hits long after the "trauma" – possibly days, more probably, weeks, months, even years. Everyone is different and it's horribly debilitating.

"I spent 18 months wrapped in a blanket, fully-clothed, in bed," she said. "If I had broken an arm, I would have been fully compensated. But after an investigation, my claim was denied. I had to pay WSIB back the $10,000 they had initially paid me."

She has not yet been able to return to work after facing down The City of Toronto, Toronto Emergency Medical Services, the criminal justice system, the Human Rights Commission and the WSIB, which has denied her claim twice. She's currently preparing for a third appeal. 

"This isn't right. This has to change," she told my class. With the help of a lawyer, she contacted her MPP Cheri DiNovo and together they redrafted the legislation concerning WSIB claims to include cases of PTSD for frontline workers. At the beginning of December, it is anticipated that their Private Member's Bill will have it's first reading in the Ontario Legislature. 

Storme started alone, but she has rallied the support of the Toronto and Ontario police, fire-fighters and paramedics associations and their unions, The Tema Conter Memorial Trust, plus hundreds of her colleagues – men and women – who have experienced PTSD.

"This probably won't help me, personally," she told my students. "But it could help frontline workers with PTSD in the future. This cannot go on."

More than any lecture, any film, any text, any activity in my class, Storme's presentation brings to life the challenges of social change, how it happens and the courage it demands.

"We're going to put the word 'rape' back in the criminal justice system," she said to another one of my classes earlier last week. "It's not just sexual assault. That's too neutral."

As they left the class, each of my students shook Storme's hand and thanked her. 

Often, one student will stay behind and share her personal story. Too many times, young women will confide in Storme about how they've suffered after being raped. They don't know what to do or where to turn. A fraction of rapes are reported to police. The statistics are wildly out of sync with reality.

These young women share the horror of how their minds are shattered by the experience, a year later or several years later, often on the anniversary of the assault. Anniversaries are often their triggers. Some of these students are failing their courses because they can't concentrate on their studies, miss classes repeatedly and neglect assignment deadlines.

They hug Storme. They cling to her. They feel guilt and shame. They feel, somehow, that she's fighting for them. And she is. She's fighting for all of us.

A psychiatric chuckle...

As you know, on Wednesday, I attended a memorial celebration of the life of my husband's closest friend, film and television producer, director, screenwriter, and poet, Bill Davidson.

Actually, Marty was the M.C. I sat with about 40 of Bill's nearest and dearest, including his wife Mary, his two daughters, Wendy and Ann, and his granddaughter, Tabitha.

Tabby chose to read several of her grandfather's poems from a little collection called "A Baker's Dozen," that he sent to a very select group about eight years ago. As it happens, we were among them. 

I had read Bill's "things" as he called them at that time. They were enchanting, as I recall. Then Marty took them from me for safekeeping – I tend to misplace things – and stowed them in his office. I'd forgotten them, until Tabby started her charming recitation. One in particular stood out as being perfect for you. 

And as November is such a dreary month, especially for teachers overwhelmed with end-of-term marking, I thought we could all use a little chuckle from our darling friend Bill. 

Last evening I called Mary, and she gave me permission to post it.

I want you to know that Bill loved reading Coming Out Crazy, so I know he wouldn't mind my sharing one of his poems with you. He was a loyal member of our community.

First, these were written on a typewriter. A manual typewriter. You can tell, which makes them even more endearing. In his covering letter, he explained that he had written his poems at his cottage on Pig island near Whitefish Falls and Manitoulin Island, southwest of Sudbury. His motivation came from an old friend, retired Rutgers University psychology professor John L. Falk.

"We had been out of touch for over fifty years. To re-introduce himself, he sent me a classy, slim volume of poetry published here in Canada by Guernica Press.

"Apparently, during all his teaching years he had been writing poetry, over three thousand poems," Bill wrote in his covering letter, titled "Explanation" ... "For Sandy and Martin."

"I thought, why not just knock off some stuff that pops into my mind, for my own pleasure (and maybe for Mary, too) to entertain myself. 

"Now, I did something else to get myself kickstarted. I didn't want to poke fun of John's book, but I wanted to clearly establish my imposter credentials, my colossal conceit in pretending to write a short book of poems (things). So I claimed to have a publisher, Howler Monkey Press, and even wrote a series of reviews of my own work for the back cover."

Indeed, the return address on the manilla envelope that we received was "From the publisher's office: Howler Monkey Press, Port Hope, Ontario – no address, no phone, no email, no fax, no anything."

Imagine a big man, a commanding presence at 6-ft, 2-inches, with a broad smile and sparkly blue eyes, perched on a rock on his island, his typewriter on his lap, pounding away at his poetry. He was blissfully unwired up there.

His covering letter ended:

"I said, why not share this wacky stuff with my dear friends, Martin and Sandy, and maybe, just maybe, brighten up their day with a few twinkly chuckles. Enjoy!

"WARNING: If too painful, take this stuff with Celebrex!"

Tabitha read several of her grandfather's creations. Here's the one I think you'll appreciate most, including a few of his "advance reviews and comments"...

"A stunning disaster. A tribute to man's folly. Beats the Titantic. Sank immediately after launching." – Rear Admiral Ahab, retired skipper, Toronto Island Ferry.

"Highly recommended for infants and toddlers. From the Hickory-Dickory-dock school of poetry. Pablum for the masses." – The Brothers Grimm, professors of pornography, Humpty Dumpty Institute.

"The work of a buffoon. Forgettable, but not forgivable. His movies weren't so hot either." – Crusty McNasty, entertainment critic, The Toronto Star Weekly.

At the Annual Convention: The Return of the Fairytale Shamen. 

Based on an old English folk song.

These fellows, me thinks, 

are rinky dink shrinks, 

Willy Winky, Tom Cobly and all.

***

They're here to discuss

the probing of us, 

Uncle Siggy, Pope Carl and all.

***

They peddle their pills 

to cure all our ills,

Oedipus Rex, bad sex and all.

***

They stir up a gumbo

of cool mumbo jumbo,

bipolar, postpartum and all.

***

They unscramble our brains

for capital gains,

Lamberghinis, sunny condos and all.

***

It's buyer beware

at this sordid affair,

turkey niblits, juicy giblets and all.

***

They feed on our fear

they'll be back next year,

Goldilocks, Goosey Gander and all.

* FOOTNOTE: Proud to say, the fairytale shamen, good sports all, have asked Leonard Cohen to sing this rollicking folk song, during the opening banquet at next year's convention. If we wake him up in time. I need the royalties."

By the time Mary Davidson called me last night, I had already written another post. I'll save it for next week. It won't go stale. And I hope you don't mind this little detour from my usual harder focus on mental health and wellness.

Call it a "mental health day" post.  A break from the routine. A non-medicinal bromide. This has been a very difficult week for us. I'm glad that I was able to end it on a light note, and especially to be able to share with you the magic that was Bill Davidson. 

Speak soon and have a lovely and restful weekend. Be well and be good to yourselves. You deserve it!

Living in the "now"...

Tomorrow afternoon, we're going to the funeral of my husband's closest friend. 

Bill Davidson was the most vibrant, charming, engaging man I've ever known – robust is the word I used to describe him in a newspaper story I once wrote. He never let me forget it, either. 

I fell in love with Bill the first time I met him about 10 years ago. He and my husband met in 1958 when he was directing a wonderful B-movie called Ivy League Killers. He cast Marty, 22 at the time, as one of a gang of young, rather innocent bikers. 

Several years later, they reconnected and began a professional partnership that ripened into a best-friendship.

They simply adored each other.

Besides his outstanding career as a television and film producer and director, and screenwriter, Bill was a poet, a lover of words and wordplay. He loved typewriters, too. Then his granddaughter introduced him to one of the first generation Apple iMacs. He was hooked. His email moniker was "finefrogfilet" and he never looked back. 

He and my husband preferred corresponding by email and their messages were long and literary, laced with wit and writerly hijinks, puns and playfulness. As well, there were always these peculiar, indecipherable references to The Young and The Restless. They were both shamelessly addicted.

I've been thinking about how Bill lived. He hated replacing things – preferred old to new – and always found the most fascinating people to do his repairs. A gentle giant, gregarious and curious, Bill loved collecting quirky, odd, idiosyncratic folks and their stories, which he then added to his wide-ranging repertoire of entertaining tales. 

When we were with Bill and his wife, Mary, there was always side-splitting laughter. They had their problems – no one escapes this life without them – but Bill managed to find a funny side to those, too. He spliced his misadventures with wit and wisdom, humour and humility. He was a brilliant raconteur. Bill never simply told his stories, he re-enacted them, playing all the parts. He seemed to stop time. He was ageless and timeless. 

He was 81. 

That might sound old to you, but it's not old anymore. 

This weekend, ironically, after several years, I heard from another friend who works as a professional "permanent companion," caring for aging people, no longer able to live on their own. Right now, she's caring for a woman about to turn 101.

Ursula has no home, no permanent address, no belongings, other than her clothes and whatever else she can fit into a suitcase. She has a car, a cell phone and an email address.

She's gloriously happy.

"I live in the now," she told me. She doesn't know when her current assignment will end or where her next one will be. When she cares for people, they tend to live longer than they or anyone else expects. She befriends them and enriches their lives. 

She travels with them, cooks for them and entertains their families. She creates a warm, homey, loving environment for them and when they die, she moves on.

When I was about 13 and Ursi was 16, my mother hired her as a "mother's helper" for the summer at our cottage. She was a cute, bubbly teenager from Oshawa, where she lived with her family. 

Every summer, for years, she came back, eventually becoming an honourary member of our family.

That first summer, she remembers me at my most vulnerable, my most histrionic, my most emotional. I had no diagnosis yet. I was at the beginning of my psychiatric journey.

"It was quite hectic," she wrote in response to an email I sent with a picture of me attached, taken that first summer. "Dealing with you was on the top of the list at the time." 

Now, at 63, she's lived and married, remarried and had several different business careers. She has a daughter and a grandson. She admits she's made a lot of mistakes, but "I'm happier than I've ever been."

When I saw Dr. Bob three weeks ago, I was so stressed out I couldn't function. 

He asked me one question. "What can you let go?" 

We came up with a strategy. Since then, I've made some major adjustments. One of them is to live in the present. To stop dwelling. To do whatever I'm doing, 110% at the time.

And then, let it go. 

It's amazing. I planned a month of Wednesday morning sessions with Dr. Bob, but I only needed one. 

Something twigged. I'm relaxing. Sleeping.

What a providential weekend this was. We lost our dear, darling friend, Bill, and on the day he died, my nomadic childhood friend and helpmate, Ursula surfaced. Out of the blue. 

We're having lunch next week. We're grabbing the moment.

That's what life means to me. That's how I want to live. 

Chewing the fat about Fat Talk...

On our first week at Weight Watchers, I lost 2.8 lbs. and Marty lost 4.6 lbs. 

On our second, I lost .4 lbs. and he lost .6 lbs. – the morning after a seven course dinner the night before.

As of last Sunday, week six, I had lost 6.8 lbs. and he had lost 7.6 lbs.

So on we plod, turning every meal into an exercise in higher mathematics, discussing weighing, measuring, calculating and counting the calories, fat grams, dietary fibre and points-values in every mouthful we eat. 

He refuses to measure. I weigh every milligram. He loses like a dream. I struggle. We're doing this for health reasons. High blood pressure and cholesterol. Yesterday, we joined the Fitness Club at our local Community Centre. We're adding regular exercise to our healthier eating regime. 

I'm a Lifetime member of Weight Watchers. I've fallen off the wagon too many times to remember. Yet, even at my goal – 128 lbs. – I still felt fat. I always feel fat. That's how I see myself. Even in a size 6.

This brings me to the subject of Fat Talk. All that diet talk I was just doing? It's a form of Fat Talk. And it''s a bore. I've got to stop!

A few weeks ago, during the Second Annual Fat Free Talk Week I was so stressed out, I couldn't get my head around posting about my life-long weight problem. Or my negative body image.

Today, I'm feeling better. So, I'm revisiting this spiny issue now.

Do you know I have never met a woman who likes her body? Tall. Thin. Elegant. Beautiful. They all have some problem with the way they look.

Fat Talk promotes our collective negative body image. It dangerous.

Are we all doomed to feel Rubenesque in a thin-obsessed, air-brushed, digitally-manipulated, Photoshopped world? 

Being aware of Fat Talk and stopping it demands more than one week a year. It's a huge issue. It's everywhere. You can't avoid it. It insidiously feeds mental and emotional health issues that devour our sense of self-worth. Worse, it can be deadly. Increasingly, the lives of children and teenagers are threatened by eating disorders.

Obesity is deadly, too. Fat and Fit? How do you begin to like the way you see yourself in your mind's eye?

I'm the Queen of Fat Talk – I Fat Talk to myself all the time. Whether the scale says 128 lbs. or  242 lbs. As a chronic Yo-Yo dieter, I'm always in flux. Losing or gaining. Never maintaining. 

Fat Talk is my constant internal dialogue.  

"Do I look fat? Oh, God, look at that bulge showing. I feel like a blimp. I don't want to see that person. The last time I did, I was 40 lbs. thinner. What will she think? I look like a whale. A petite whale. I can't stand the way I look. Keep smiling, Sandy, maybe that will distract people from your hugeness."

That's what happens when you've lived for years being assaulted by external "Fat Talk."

"You have such a pretty face," people would often say to me in my youth. At 16, my father bribed me with a new car, if I'd lose weight. Another time, with a trip to New York and a new wardrobe. I dieted. Lost. Regained more. Felt worthless. Unloved. Hideous.

These days, one of my students says at the beginning of each class, "I have to ask. How much weight have you lost now? You're looking better every day." That's perfect example of Fat Talk.

Stupid me, I tell her. And the whole class. What's worse is that I feel flattered. I like it. I've been socialized and brainwashed into believing that if I'm not slim or slimmer, I'm deficient. No good. Fat and Ugly. Always "fat and ugly." 

I do this to others, too, reinforcing a damaging value I detest. 

When I like someone, I don't see extra pounds. I see the person I like. I see their eyes. Their smiles. All the characteristics I love about them. Yet, when we engage in Fat Talk consider the consequences.

Someone says, "You've lost weight. You look great!" What they're really saying is that you didn't look great before. Your value as a human being is gauged by your size. Your shape. Your thinness. That's the implication and it plays havoc with your self-esteem. 

You can't escape advertising, marketing, Hollywood, and the media. But you can devalue it. Beauty is relative. Arbitrary. Who makes the decision? 

You can become more aware and Stop Fat Talking! To yourself. And to others. You can help begin a paradigm shift. Starting with yourself. 

Change the record. Break it. Don't only comment on what someone looks like, comment on other facets of their character, accomplishments, intellect, skills, activities and abilities. Be positive about people and about yourself.

On November 2, PsychCentral launched a new website called Weightless.

It's "about well-being, not weight; about fostering body image regardless of your size. It's about exposing women's magazines and so-called experts, when they're touting unhealthy tips and promoting restrictive standards," psychologist John M. Grohol wrote in this introduction.

So now, besides all the global awareness raised by Dr. Carolyn Becker, the founder and one of the researchers of the Reflections Body Image Program and the sponsor of the Second Annual Fat Talk Free Week, you can begin to work on your own body image issues. You can begin to re-educate yourself every day.

You can start to feel good about who you are, just because you're you! 

Let's face it. The holidays are approaching.  Party Time. Socializing. Every event revolves around food and everyone wants to feel beautiful. For too many years I cloistered myself at this time of year because I felt self-conscious about the way I felt I looked. No more.

I'm starting now. Let's all start to stop the Fat Talk.  

There's so much more in this world to talk about, don't you think?

Letting things go...

Problems have a curious way of working out. With work.

Nothing happens all by itself. Timing is everything. 

Today, I'm feeling weightless. This has nothing to do with the seven pounds I've lost at Weight Watchers in the last five weeks.

I'm feeling lighter emotionally. Less stressed. Relaxed. So much so, I've cancelled this week's session with Dr. Bob.

Without going into specifics, I'm delighted to tell you that after two years of shouldering a distressing personal problem, weightier than you can imagine, it's finally resolved. 

Until now, I just couldn't process it, so it was festering and fermenting. 

Process is the key word. 

You've heard me use it often. It's a driving force in my life. Everything we do, I think, is process-oriented. Talking therapies have taught me how to process. My husband often accuses me of psychoanalyzing him and everyone else. Not true. But, I admit, my modus operandi tends in that direction.

I try to live in the present, but old records keep playing and even the work I do in my psychotherapy at times runs at odds with my deepest instincts. I feel I'm listening to the cross talk of two voices in my head – reason versus emotion. They argue. Never agree. It's dizzying.

We're such complex creatures psychologically, which is why pills aren't the only way to deal with emotional or psychiatric issues. They're not that simple. Medications may numb our feelings for a while, but they don't resolve root problems.

I was harbouring a lot of pain. It was distracting and debilitating. So, over the last few weeks, somehow I was ready and able to begin to try working things out. 

And now, the problem is gone. Over. No more pain. Old chapter closed. New chapter opened. I let it all go and learned so much through the process.

It's all about interpersonal communicating without getting emotional. It takes time to reach that place in your head and your heart to be able to discuss your real feelings and your pain without an overlay of toxic emotions – resentment, mostly anger – without taking things personally.

With Facebook and texting and email – all toneless – this deeper level of interpersonal communication seems to be waning – like the art of conversation – the ability to express your feelings openly and directly. My friend and sage, psychiatrist Ron Pies hints at this trend in his recent essay on the current narcissism of our age. 

As far as communication goes, it's the listening more than the talking that oils the process. Empathic listening. Active listening. With your ears, your eyes and your heart. For some reason, maybe maturity, the other day I was able or willing to listen more than spout or shout – and remarkably, my two-year stand-off smoothly sorted itself out. No fuss. No muss.

On the same day, coincidentally, one of my favourite bloggers, Therese J. Borchard who writes an eclectic, spiritually inspirational and often surprisingly practical blog called Beyond Blue, posted a piece on PsychCentral's World of Psychology called 5 Clues You Should Be Letting Go of Something.

It really hit home. I was guilty on almost all five counts. I discovered that the answer to "letting go" is to be willing to change. To take action. Sounds simple, but change is probably the toughest thing anyone can do. 

Ironically, this is one of the models I teach in my "Leadership in Society" course at Seneca. It's well-explained in the text, Exploring Leadership for College Students Who Want to Make a Difference.

The essence of leadership is change. 

This model is called "Knowing-Being-Doing" or "Knowledge, Attitudes and Skills" or "Head-Heart-Practice." The U.S. Military coined the phrase "Know-Be-Do." 

Knowing – "Know thyself" – means knowing yourself and others, how change occurs and how and why others may view things differently than you do.

Being – means being open to differences and valuing other perspectives. 

Doing – means you must act. Take action! Practice listening skills, coalition building, interpersonal communication skills and effective conflict resolution.

My favourite Barack Obama-ism is his habit of listening carefully, actively, and thoughtfully to people from all sides of any question and then admitting honestly, "I respect your point of view and your opinion, but I'm afraid in this case, we're going to have to agree to disagree."

Whenever I use this approach, conversation doesn't stop. It continues and flows – because it's respectful.

Everybody wants to feel respected. 

Most of our interpersonal problems stem from communication problems. Lack of listening. Which leads to miscommunication and compounded problems.

Between communications and miscommunications, messages are confused. Emotions flare. Anxieties. Anger. Both blinding. And Bingo! Feelings bruise. Communication breaks down, or stops entirely.

That was the life-lesson I learned this weekend when I was able to resolve my problem and to let it go, at last. 

It felt extraordinary. That's why I'm floating right now.

Be well and thanks for listening.

Fort Hood: Psychiatrists & Stress...

No one will ever know exactly what snapped in the psyche of U.S. Army Major Nidal Malik Hasan, but something surely did. 

How else can you begin to fathom why this highly-trained medical doctor and psychiatrist started blindly shooting innocent young soldiers at close range on yesterday afternoon at Fort Hood, Texas – the largest military base on U.S. soil.

I'm not making excuses for his unspeakable behaviour. But what happened? Was he sleep-deprived? Why? This is bewildering so many of us.

Stress has been uppermost in my mind this week and if anything illustrates the staggering power of stress on the human mind, body, spirit and soul, surely this horrifying catastrophe does. Thirteen people died. Twenty-eight others are seriously wounded. Hundreds of families and friends are in shock and grieving, desperately in need of counsel and support. A whole country is mourning.

Perhaps Major Nidal Hasan desperately needed but didn't have any support because of the nature of the harrowing emotional demands of his profession. 

Surely, what happened to him to cause him to act out as he did had to be related, in part, to the mounting stress, anxiety and fear he must have been feeling at the prospect of his imminent deployment to Afghanistan on November 28.

But I have another thought.

Remember, he's a psychiatrist specializing in "disaster and preventive psychiatry." Post Traumatic Stress in a specific demographic – veterans of war.

He has been treating soldiers returning from intense, active combat in Iraq and Afghanistan – shattered emotionally, spiritually, mentally and physically – after fighting in these two endlessly gruesome, fruitless wars. When his patients unburdened themselves on him, confided in him, vented on him, where did this single, 39-year-old man go to get help for himself. How did he manage to shoulder all that pain?

How do psychiatrists deal with stress?

"Doctors, who ought to be in the best position to help the public, are not distinguished by their own ability to help one another or themselves," psychologist and prolific writer Kay Redfield Jamison wrote in her groundbreaking book Night Falls Fast – Understanding Suicide, published in 2000.

"They are, to start with, twice as likely to kill themselves as other people are," writes Jamison, who has lived with bipolar disorder since her teens and has seriously attempt suicide. "Doctors, more often than not are left alone to struggle with their suffering. Many find it hard to ask for help, or, indeed, to acknowledge needing it: they are trained to be independent, to be accountable for decisions that cost or save lives, and to assume an undue portion of the miseries of others. They function within a closed system that too often discourages seeking treatment ..."

I'm sure the military would be especially tough here.

This morning, I sent an urgent request for help with this question to my muse, friend, mentor and polymath, Tufts University clinical psychiatrist and professor of psychiatry Dr. Ron Pies. He answered quickly, admitting candidly that he didn't have "any profound or learned comments, except to recognize that mental health professionals and physicians of all stripes are under extraordinary levels of stress, a great deal of the time."

He wrote to me, understandably briefly, because he was "on the road," as he often is, adding that "without prejudging anybody, I think it is fair to say that the horrific shootings at Ft. Hood represent a terrifying illustration of how one's emotional turmoil can be fuelled by a specific set of environmental factors. If not detected early, and followed by timely clinical intervention, the results can often be tragic."

Then Dr. Pies added a more personal perspective.

"I have always found it important to have many interests, supports, and creative outlets, beyond my profession as a psychiatrist. I always worry about colleagues who say, "Psychiatry is my life!" and who spend every waking hour thinking about nothing else. 

"Balance and perspective are great stress-busters, and I have always found these in areas such as literature, philosophy, and creative writing. Others will find relief and solace in sports, music, or spending time with family. 

"The important point is that all of us need to find ways of monitoring our levels of stress, and to provide ourselves with fulfilling activities that help us achieve emotional balance."

So, I leave you with these wise words on stress from my dear friend, Dr. Pies. 

Think balance. Perhaps that's what was lacking in the tragic, tormented life of U.S. Army Major and psychiatrist Nidal Malik Hasan. Who will ever know for sure?

This, however, I do know. 

From now on, every weekend, my husband and I plan to take a few hours to do something for ourselves. Nothing major. A movie. A walk in the park with the dogs. Just a little something to divert ourselves from the ongoing pressures of our work – we both teach at community colleges.

Because nothing. No job. No deadline. No pressure. No virus. Nothing is worth sacrificing one's emotional, spiritual, physical and mental health and well-being. One's psyche. One's hope.

Take care and enjoy this brisk, November weather!

Speak soon!

Stresssssssssssssssss!

Until last week, I had no idea how mentally, emotionally and physically debilitating stress could be. Good stress. Bad stress. It doesn't matter. Stress is distressing.

"If you get the H1N1 virus, there is a very good chance you'll die," my kidney transplant coordinator told me on the telephone early last week. "It's so fast."

It wasn't available yet in Toronto. No one was dispensing it. 

"And the rules seem to be changing every day," she added.

Great. 

I couldn't talk my family doctor's receptionist into giving me the seasonal flu shot. At 61, I'm four years too young. 

Then I explained that I really needed to be vaccinated against H1N1 because I'm one of the high risk groups – I take three powerful immunosuppressant medications to ensure my body does not reject my transplanted kidney.

In 1991 I went into "iatrogenic" acute endstage kidney failure and lost the function of my only kidney because the psychiatrist who had treated me for 16 years for my mood disorder had neglected to monitor my Lithium levels properly. I had the kidney transplant in 1994. I have virtually no immunity to H1N1.

I made an appointment for the H1N1 vaccine. I'll have to wait until December to get the seasonal flu vaccine. This past Monday, right after my class at Seneca's Markham Campus, up in the northern end of the GTA, I jumped into my car and drove all the way downtown to Mt. Sinai Hospital.

Arriving at 2:50 p.m., I'd never seen my doctor's waiting room so crowded. All the receptionists were wearing masks. People of all ages were seated or milling around, including pregnant mothers with young children in tow. 

"We're running about 45 minutes late," my doctor's receptionist told me. "There's only one nurse and she's doing the best she can." 

Talk about stress. I couldn't wait to get out of there and within 20 minutes, I had my shot and was back outside, walking towards the underground parking garage. 

I live with a psychiatric diagnosis on the bipolar spectrum called Hypomania. In my case, it's rare and serious, but I handle it pretty well. I never get depressed, but wow, do I get high. To the point of psychosis. Mania. 

It can be frightening sometimes because I can tell when those curious little manic ideas slip into my consciousness. It takes me a minute to realize that I'm fantasizing, a little delusional. 

That's why I'm also in Recovery. I've worked so hard at processing my mind for 49 years in psychotherapy that I have spot-on "insight" that Dr. Bob admits he's rarely seen in anyone he's treated.

That doesn't mean I'm invulnerable to stress. Or that stress cannot trigger my grandiose thinking. Sleeplessness. Quirky judgement. The key is, I am prepared for it and work very hard to keep it in check.

On Friday, October 23, I had lunch with a colleague. It was my birthday lunch and we "dined" at the Flint 'n Feather, the modest dining room at the college's main campus. All during lunch, little delusional thoughts kept flickering in my mind.

"I bet she's planned a surprise birthday celebration for me... I bet the whole staff of the Faculty of English and Liberal Studies are going to burst into the dining room singing "Happy Birthday, dear Sandy... I wonder when... " This thought keep flickering in and out of my thoughts.

I couldn't concentrate on our conversation because of this intoxicating feeling that something wonderful was going to happen. 

It did.

My friend treated me to my salad and fruit!

At Seneca, a melting pot of more than 20,000 students – many from all over the world – you can sense everyone is a little on edge. More than the usual mid-term angst. It's filtering into my classrooms. This week, I've held two de-stressing sessions. Open dialogues. "Show and Tell" sessions. Opportunities for the students to "evaluate the teacher," for a change. 

Anything to help them unwind and, as my late father would say, "hang loose."

Lately, I'm not sleeping consistently. Sleep keeps me sane and stable. I'm bouncing around my mood spectrum from my normal, which is always slightly elevated to exuberant to flying around the rafters to back to my invigorating normal. 

That's why I'm seeing Dr. Bob every Wednesday for the next month. I saw him this morning.

There's so much going on. Stresssssss. I feel tingly. I have to go easy. I'm running up stairs instead of taking the escalator. I'm walking at twice my normal pace. I'm waking up two hours before the alarm goes off in the morning.

This is all stress. Good stress. Bad stress. It doesn't matter. It's debilitating. 

"Why worry when you have no information," Dr. Bob said this morning. "As soon as there's enough vaccine available so everyone can be vaccinated, things will die down. In the next few weeks. You'll feel better."

Right now, the H1N1 flu is great news story. There's an old saying about news.

"Good news is snooze news."

Too bad. We could use some good news right now. It would help ease the emotional and mental effects of this bad news story that feels more contagious than the flu.

Relax. Take a deep breath. Take good care of yourself. Sleep. Stay informed right here at Healthzone.ca.

Speak soon.