This & That...

It seems like ages since I last posted, or responded to your comments. I've been remiss. I apologize.

Please forgive me. I've missed you.

Although I hate it when people talk about how busy they are – because we're all busy – it seems that this is an uncommonly "wild and crazy" time.

Between Passover seders that fell this year on two of the three days I teach, plus all my marking, which is over for the time being, I have not watched any television, cracked open a book or even read the newspapers very carefully. To be honest, I don't miss the TV, but I'm feeling a little out of touch.

Except, I got a real kick out of a charming story in this past Sunday New York Times about U.S. President Barack Obama and this year's second White House seder. 

Most of all, I'm terribly sorry that I've had to neglect "Coming Out Crazy" – and you – for a few days.. So today, I'm going to play catch up and fill you in on what's happening with Angela and some other news and views. Plus, this is a short week, with Good Friday tomorrow and Easter Sunday. It's tax time, too. It means we're all working harder and faster than usual to accomplish more that needs to get done, in less time. 

Stressful, to be sure.

Next week, I plan to return to my regular schedule of two posts a week, plus commenting on your comments. Thank you for your understanding. 

ANGELA PLODS ON AS HER ECT TREATMENTS DRAW TO A CLOSE

Angela has about four or five more treatments left. Neither of us is sure if she'll be having ECT on Easter Monday, so we don't exactly know.

We speak almost daily. Yesterday morning, she was upset because there's been a hitch with her new motorcycle and she's anxious to get her hands on it and start biking the highways and byways of Ontario as spring temperatures are rising. I cannot believe it will be 24 degrees Celsius tomorrow, but that's what the weather man is telling us.

One recurring theme in our conversations is that ECT may do wonders for one's mood, but it doesn't solve all the problems in your life. And it can create others, like problems with memory – though Angela didn't complain about her memory at all yesterday.

I've been thinking about all the things that electroconvulsive therapy cannot do and was never intended to do.

Sometimes, Angela expects miracles but she's beginning to realize how much long term work she has to do with her psychiatrist in psychotherapy – in addition to the ECT. And she is willing to have maintenance ECT treatments if it is recommended.

ECT WORKS BEST IN COMBINATION WITH PSYCHOTHERAPY

"My way of thinking is messed-up," she admitted yesterday morning. "It's gonna take a while to fix. Still, I do think the ECT is beneficial. And I don't think it would be as beneficial unless it's combined with therapy."

This is true for all psychiatric treatments. And for emotional healing. Medications are much more effective in combination with psychotherapy. Ultimately, though, you have to do the work – and it IS work. Whether it's psychiatric therapy or peer support or any number of other approaches – any therapy. It's never easy and often painful. It's all about change. Transformation. I've been at it for close to 50 years and still counting. More than 20 years with Dr. Bob. Trust me, it's worth it.

Changing the way you think and perceive, changing your beliefs and your behaviour patterns is the toughest work in the world, but I wouldn't trade all those years of psychotherapy for the world. That's why I call it "my PhD in me" – though I'll never graduate with any degree. This is what recovery is all about. Those years have given me peace of mind – insight – as I hope they will Angela.

All that work is the only way to truly go into recovery. (As I've often said, you won't find insight in a bottle of pills.) It's a constant. Never ending. Because our lives are changing all the time – throwing us curves we have to deal with and adjust to. Dr. Bob and I often joke about how we'll be together until we die. "Whoever goes first." I don't view this as a weakness, either. It's a strength because change is so challenging and ultimately so rewarding. Builds resilience.

Despite the fact that we resist change, which is natural, I suppose.

CHANGE IS NEVER EASY – THERE'S ALWAYS RESISTANCE

Just look at what's happening in the U.S. and all the resistance to the new Health Reform Bill and its amendments that were passed over the last two weeks. Surgeon and journalist Atul Gawande puts this revolutionary change (for the U.S.) and the resistance Health Reform is facing into perspective in a fascinating commentary in this week's New Yorker titled Now What? 

When it comes to change, some things never change, I guess...

WHAT'S NORMAL? AM I NORMAL?

Whenever anyone, I mean ANYONE, starts talking about being normal or not being normal, I jump in and say, "What's normal? There is no normal."

Psychologist John Grohol had a nice little post about that this week on his PsychCentral blog World of Psychology that explores the question we all ask ourselves at one time or another: Am I Normal?

I don't ever ask it anymore. Instead, I view everyone as "Next to Normal" which nicely encompasses all manner of quirkiness and eccentricity and even outlandish behaviour. Extreme behaviours.

I picked up that handy little phrase after flying down to Manhattan last June for a mid-week matinee of a then-new Broadway rock musical/operetta about a suburban family coping with a mother who has serious and seemingly drug-resistant bipolar disorder.

WE'RE ALL NEXT TO NORMAL

This show is called Next to Normal and I will be forever grateful because of its integrity, honesty and respect for the complexities of psychiatric conditions and their impact on everyone they touch directly and indirectly. (We're all touched in some way.) More important to me is that it puts into perspective this rather absurd notion of "normal" – which applies perhaps to body temperature – 98.6 degrees Fahrenheit. That's about it.

When it comes to people and their personalities and behaviours and experiences, I have no idea what "normal" means. 

Do you?

Three days later, this stunningly authentic show picked up three Tony Awards, including Best Actress in a Musical for the wildly talented and irrepressible Alice Ripley, who plays the mother, Diana Goodman and sings most of the songs.

This show was slated to close in August 2009, prior to its Tony wins. It wasn't drawing great crowds. That's why I was invited to attend and comped two tickets. Instead – three days later, after scoring big at The Tony's, it started picking up steam and has continued to resonate with its audiences. The wildly spontaneous standing ovation as the curtain goes down is testimony to that. Its run has been extended repeatedly.  

Last Saturday, March 27, marked the first anniversary of Next to Normal's Broadway run. This little show that almost didn't make it has turned a profit, both signs that it's a legitimate Broadway hit.

Here's the clincher. It's an artistic and commercial hit about a most unlikely subject for a rock musical – a serious mental illness – bipolar disorder. There's even a scene during which Diana undergoes ECT, and as a result loses her memory.

I think this is revolutionary. Think of it. A major mental illness goes musical and mainstream. It's not depressing, but inspiring and uplifting. A national tour is planned for the fall. I think this is the best news of all. 

Don't you?

Have a good weekend and speak soon. I feel so happy to be back.

Dealing with holiday stress

Tonight is the first night of Hanukkah. Christmas Day is two weeks from today.

For the last three or four weeks, I've been deluged with press-releases from public relations firms all over the continent offering to set up interviews for me with psychologists and other "experts" who will enlighten me – and you – about "new ways" to cope with an old story – the stress of the holidays. 

Holiday stress has become an industry, I think. As viable and real as any retail venture offering "seasonal specials" at wildly discounted rates.

I suspect the "stress of the holidays" is a media event, to some degree. 

Charles Dickens may have had a hand it, too. 

Before I go one step further, let me be straight with you. I'm Jewish. My tradition is very different. But, I confess that I have been stressed about holidays in the Jewish calendar, like Passover and the High Holidays. 

However, I do not believe I have ever had a publicist approach me and propose I interview a psychologist about Passover stress or Rosh Hashanah stress or Yom Kippur stress or Hanukkah stress. Somehow, these holidays don't seem to generate the same calibre of stress. Maybe they did and I was too young to be aware of it. Maybe stories about how to weather Hanukkah stress run in Jerusalem Post. I don't know. 

More likely, it's simply a question of demographics. And business.

In the Western world, Christmas is everywhere. Big Business. No matter what your religion, it's Christmas and it's contagious. So, it seems, is its stress.

As I think back, way back to my childhood, I don't recall any sense of stress or anything like it. Anywhere. It was a beautiful time. 

Christmas had no religious meaning for us though we knew its origins. We went to public schools and Christmas concerts were regular annual events – and great fun. I loved singing all the Christmas carols. Still do. Especially the way Diana Krall sings them.

We were taken to see Santa Claus at Eaton's downtown Toronto flagship store (below is a picture of me at age 5, in 1953), to sit on his knee and answer the question he always asked, "And what would you like for Christmas this year?"

I was precocious. A mite like the little girl Natalie Wood played in the classic 1947 Christmas film Miracle on 34th Street. I probably lectured him on why I didn't want anything for Christmas since we don't celebrate Christmas because we're Jewish. Then, I'd tell him that my parents would probably buy me some little things for Hanukkah.

Still, Christmas was utterly magical for me. We always went to see the elaborate Christmas windows at the big downtown Simpson's and Eaton's stores. Those stores are gone and I think those delightful moveable displays are long gone, too.

They're still a tradition in New York and other major U.S. cities. Selling stuff is reserved for inside some major store, to a degree during the holidays, like Lord & Taylor in New York. But not here. 

It was a tradition for us to be driven around the twinkling, glowing residential streets of my grandparents mid-town neighhourhood or ours in North Toronto after dark. Now we don't have to drive far. We've dubbed our street "'Las Vegas North." 

And, of course, there was The Santa Claus Parade. 

We had holidays from school. All this often coincided, depending on the lunar Jewish calendar, with Hanukkah, which had its own lovely traditions and delicious foods – like potato latkes smothered in apple sauce or sour cream. Lighting the Menorah every night for eight nights and singing the Hebrew blessings. Playing the game of Driedel, which I have never understood and still don't, with gold-foil wrapped chocolate coins, that you could eat whether you won or lost.

I remember the early days of television. My grandparents had one. I was born in October 1948. Mass marketing and advertising were in their infancy. We weren't commercialized at the age of two and three like the phenomenon of Consuming Kids today. We also weren't as sophisticated and knowledgeable either. 

I don't want to sound like an old fogey bemoaning "the good old days," but I feel sad that these holidays, which should be happy, are somehow so stress-laden.

My friend, Tufts University clinical psychiatrist Ron Pies calls them the Holiday Blues, With Some Shades of Grey in an excellent post on PsychCentral about the myths and realities of suicide and depression at this time of year, too.

So, I plan to muse about The Holidays over the next little while. Not in every post. Not all the time. It may be a cathartic activity for us. Therapeutic, perhaps. Mentally healthy.

I want to open a forum for you. Come and share some of your warmest memories of this season, no matter how you celebrate – even if you escape to the south, where Christmas is snowless and sunny, but still Christmas! 

Let us turn "Coming Out Crazy" into a place of respite from the stress of the season. Come and vent if you wish, if that will make you feel better. It's open season during the holiday season here this year.

You know me. Ever the cockeyed optimist, even as I face mountains of essay marking. I'll find some hummable seasonal music to keep me company. 

And tomorrow night, we have our annual family Hanukkah party. Mmmmmmm. I can taste those latkes!

I'm not God! You're not God! We all make mistakes!

We're human. Not perfect. We make mistakes. 

Even doctors aren't God. Though some think they are, or second to God. Take the infamous Dr. Joseph Biederman, the Massachusetts General Hospital child psychiatrist currently the focus of a congressional investigation into conflict of interest charges, known as the Godfather of the Bipolar Child Theory – for more on him and his "mistakes" read Furious Seasons. 

Philip Dawdy has been on Biederman's case for ages, scooping the mainstream press until quite recently, when Congress started its investigations. If you can believe it, this all-too-influential shrink recently went on the record as saying that if you're a full professor at Harvard, you rank above God! 

Yup. Medical doctors, some, can begin to believe they're God or close to it because they deal with life and death all the time. They don't yet create life – but they're working on it – and they can certainly save lives. They can also, however, make mistakes, errors in judgement, all kinds of mistakes, that can cost people their lives.

Psychiatrists are especially good at making mistakes. It's part of their stock-in-trade. How many psychiatric diagnoses have you been given? Count 'em. On the average most of us have at least four. Just because people don't admit to making mistakes, doesn't mean they don't make them. Or they don't exist. Or they didn't happen.

It's not like a mistake is "the tree that falls in the forest" when no one sees it fall or hears the crash. Does that mean the tree didn't fall? Does that mean the mistake didn't happen?

No way. Especially because mistakes usually ripple. Like a pond, when you throw a stone into it. Someone will hear the echo, feel the tremor, sense the backlash. Remember Newton's Third Law: "For every action, there is an equal and opposite reaction."

Doctors and lawyers and all "experts" and "super-specialists" and even "judges" make mistakes. They're human. We're all human.

Yesterday morning, my husband and I were talking about this over our 8 a.m. coffee. We were reading in print our two favourite Sunday New York Times columnists – Frank Rich is Marty's and Maureen Dowd is mine. 

They were both writing about Barack Obama and the political crisis of his presidency right now. We were talking about Obama and some of the mistakes he's made. 

That "Special Olympics" joke was a big one for me. Huge. It didn't bother Marty as much, but he doesn't have any kind of disability whatsoever. I wear hearing aids and I'm in recovery. I have a psychiatric diagnosis. In my world, people see what they believe instead of believing what they see. Many people are blinded by their beliefs. Blinkered. 

It's not always easy. So that joke really disturbed me. 

Yes, Obama was quick to apologize. 

As the late Carnegie Mellon University computer science professor Randy Pausch said in his Last Lecture, apologies must have three parts:

"What I did was wrong. I feel badly that I hurt you. How do I make this better?" 

Obama learned an important lesson about his "slip of the tongue." Something we all do! They're thoughtless. And sometimes not so innocent. They can be cruel. They cut deep.

Tim Shriver, Chairman of the Special Olympics in his gracious televised reaction to Obama's "sincere" apology for the joke he made on "The Tonight Show with Jay Leno" at the expense of people with special needs said, "Words hurt. Words do matter... and this is a teachable moment." 

Let us all learn from the U.S. President's mistake.

Think about that much misinterpreted, misused, misunderstood word, stigma. You know I find it foul and confusing. Hurtful. Let this teachable moment be a wake-up call for all of us to be more respectful with the language we use when talking about people with psychiatric, mental and emotionally traumatic problems, conditions, disorders, difficulties, addictions and troubles.

Sadly, you cannot take back hurtful words once you've said them or they've slipped out. I detested that joke, but I still believe Obama is a brilliant man with enormous empathy, the potential to be a great president and to make positive changes for the greater good. Even to help repair a very badly broken economy. 

I also believe that the other half of mistake-making is to be forgiving. 

At 9 a.m., Marty turned on our favourite TV show – CBS Sunday Morning and guess what! 

Host Charles Osgood, the epitome of his name, announced "this week's cover story" – headlined "Ooops" – Make No Mistake: To Err IS Human" – all about the human bent for "getting it wrong," for "misconstruing and misinterpreting," for "misreading and confusing," for "mixing things up and miscalculating," for "assuming and blundering and omitting and miscalculating."

And why. Based on a new book, Why We Make Mistakes: How We Look Without Seeing, Forget Things in Seconds and Are All Pretty Sure We Are Way Above Average by Joseph T. Hallinan, former writer for The Wall Street Journal, Pulitzer Prize winner and past Nieman Fellow at Harvard University.

I take a different approach to mistakes. Hallinan can tell you why we all make them. A good night's sleep can help you avoid them, but we all know that sleep heals.

I'm going to muse on why we should celebrate them. 

Look up human in the dictionary. As an adjective, it means mortal, fallible, weak, frail, imperfect, vulnerable, susceptible, erring, error-prone as well as compassionate, kind, understanding, sympathetic and approachable.

Some coincidence, eh? I didn't even watch the whole segment. I'll catch it later. I just ran up here to my iMac and started writing. There is method to my madness for wanting to write about not being God and mistakes. I've made so many, lately.

At the same time, I love mistakes, even though I feel awful when I make them. I take them very seriously. I want to disappear off the face of the earth. They have enormous impact on me and on others. I try very hard to right my wrongs. I try even harder not to make the same mistake twice. 

They are the best learning tools we have. When I tell my students that, they think I'm crazy. (Of course, we know, they're right! ;-)

God doesn't make mistakes. God is perfect. That's why God is God. We cannot understand God, because that's what makes God, God. If we could understand God, we'd be God, too.

In our house, we view God in several ways. Among them, as "Good Old Dad" and as "DOG" spelled backwards.

Religion has nothing to do with it. Nada. I learned this from one of my students recently.

As for mistakes, as I mentioned, I'm an expert at mistake-making! A veritable genius at it. I have made so many mistakes, I could write an encyclopedia of mistakes.

 

Last year, I taught four classes in one day, pinch-hitting for a professor who was having surgery for cancer. I was teaching her classes – and a subject I had never taught. On the first day, I taught from 8 a.m. until after 5 p.m. My two classes and her two classes. Eight hours of teaching in one day. A first for me.

I was so exhausted at the end of the day I was a little wound up. That's my nature. I'm intense. I stormed into my Chair office. Paula Gouveia hired me – knowing all about my hypomanic "nature." I announced, "This is the worst teaching day of my entire life."

Without hesitation, she said, "No, this is the best teaching day of your entire life because you'll never forget this feeling and you've learned so much. You've learned that you can do it."

She was right. I've never forgotten that moment, that day and those feelings. Maybe I am a better teacher because of it. I'm still learning.

Paula is now Dean of Arts and Sciences at Humber College.

All I can say is, thank God for mistakes.

–––

P.S. I haven't forgotten my promise to review  Elyn R. Saks' best selling memoir The Center Cannot Hold, My Journey Through Madness (Hyperion, 2007) but as I am hardwired into news, I wanted to pick up on the timeliness of today's subject. I hope you don't think I've erred in so doing.

The Mood Disorders Association of Ontario is another great place for Peer Support. Thank you, Leslie, for Sharing the Health.

Have a great week. Speak soon!