Tag Archives: Mental Health

Why am I still here?

“Why am I still here?”

I hear that a lot. Perhaps you do, too.  The veteran who survived a firefight that took his friends; the person who woke up in the hospital to find they were the only survivor of a car crash that took their family; a survivor of a natural disaster that took many lives.  Many adults, perhaps most, have had such an existential episode. I’ve been in car accidents that could have killed me; survived acts of violence that could just as easily have tipped over into lethality, lived through serious illness. None of those are particularly unusual, and only mentioned to underscore the point.

“What do I live for now? What ought I be doing?”

That’s a tough one, yet it is the question every believer is tasked with as the subtext of life every day.  There is some chatter among the media that presuming that one’s survival is in God’s hands is some sort of unusual perspective. It is not my intention to speculate on any particular person’s interpretation of what that means. For those who find it perplexing, I hope to offer at least this Christian’s perspective. God never wants evil; it takes our free will for that to happen. Many of us wrestle with trying to figure out why God allows bad things to happen. Allowing something is not the same as wanting something, that’s for sure; every parent has to learn that lesson, fairly early on.

You may want your toddler to go to sleep. You may want that very, very, very eyes-burning-with-exhaustion much. But you have to allow the reality that the toddler will keep on singing songs, or whining, or coming out to complain. (If you do anything to “make” a child sleep, whatever adult is aware of it is required to report that to child protective services). C.S. Lewis does a much better job of explaining this particular point.  God, of course, chooses to allow or not. I’m not going to understand why because I am not God. God creates everything and I can do not a thing, even catch a breath, unless God wills it.

Our job is to figure out what God wants from us in each emerging situation, whether the situation itself was His will or not. For believers, every breath is a gift; there is no guarantee of another. Pondering what we are to do with these circumstances and assuming God has a preference in terms of our choice of action is not a big stretch.

So, for a Christian, God did not want Corey Comperatore to die in gunfire, protecting his family. It was not God’s will for the gunman to shoot. Mr. Comperatore clearly discerned his purpose was to protect at all costs. He had, apparently, discerned this over and over until his reflex towards self-sacrifice looked “automatic.” That seems to be a sign that his formation into the nature of Jesus Christ, the nature of complete self-giving, was something he had truly embraced.

And now, everyone left behind must discern what God asks of them in this new, tragic circumstance. Over the course of years and months, his family will each have to discern how to restructure life and find a different path forward. Friends and neighbors will need to discern, ongoing, how to provide friendship and support when the months pass and the spotlight of media attention fades.

The question doesn’t necessitate a tragedy, such as an accident, tornado or an attempted assassination. It is a perennial question: every person mourning infertility, every widow, widower, and bereaved parent.  Adolescents are supposed to wrestle with it; the elderly are, too. And all along the way, it is the question every thinking person ponders when transitioning to a new stage of life. We ask it at those times, too, that are both joyful and sad; a child grows up and successfully leaves the nest: mission accomplished; but what is my purpose now? Retirement comes; well, then what? What is your purpose now, beyond a vague sense of perpetual recess?

Being Christian means striving to be conformed to the nature of Jesus Christ. That means seeking not just to avoid being “bad” but attempting to do God’s will in every situation.  Is it “bad” to spend an entire lazy weekend afternoon with a pot of tea, a good book and a handful of chocolate? Especially on the Sabbath? No, lemon ginger tea and Lady Gregory’s book of Irish folklore, edited by W.B. Yeats, don’t make the list of “do-nots,” but the entire afternoon? When a friend needs a caring ear or a letter? When a nagging thought keeps intruding with that starts with, “I really need to reach out to…” maybe the “not a bad thing” needs to step aside and yield to the “better thing,” a “because” for the moment.

And, when you’re wrestling with the big questions of life, the little “becauses” become a path through the dark places.

I Just Needed to Vent about That

Back in my running days, I once reached mile 18 in a marathon when I noticed the blood coming through my running shoes. “Didn’t you notice?” I was asked. I said, no, not really, as I changed socks and went back to the run. You might think I have the pain tolerance of a superhuman, but that’s not the case at all. First twinge and I am on the phone with my dentist’s office, where everyone knows me by first name. Discomfort comes in categories and for me, blisters, in the context of a marathon, were in one category and dental pain in an entirely different one.

This issue of categories of discomfort intersects with the variety of responses to life’s pains and problems.

“I just need to vent.”

“Sorry – I’m just going to vent.”

“Look, I don’t need any advice – I just need to sort of verbal vomit this stuff.”

Lots of ways to say it, but the short form is “vent.” As in, blow off steam, let off a bit of pressure. It sounds like a good idea, right? I mean, holding all that in can’t be good for us.

And neither, as it happens, is merely venting for the sake of venting. With a caveat.

That caveat is the situation in which someone really is in a painfully difficult situation in which there are no tenable options except to endure it. Consider, for example, the pain of the spouse who is caregiver to their dying husband or wife. They have already accepted the help of Hospice or palliative care; friends and family have stepped up. But the loneliness, the grief, the pain and exhaustion still are there. This is a person who can benefit from some venting to a compassionate listener who isn’t going to give them silly advice or trite encouragement.

Then there are all the rest of us.

Venting, in small doses, here and there, might be helpful. It stops being helpful when it becomes some sort of permanent coping mechanism, perhaps even seemingly a part of the personality.  Consider the coworkers who deal with unhappy work situations by commiserating over drinks or takeout week after week but never find the time to look for something better. They keep the level of discomfort just within tolerable levels by venting and indulging in bonding-in-misery.  Perhaps it’s the person for whom griping is a personality trait: anything is fair game. They confuse unmet whims with discomfort. Real discomfort has a very useful purpose.

Discomfort lets you know there’s a problem. Sometimes the problem is serious, and sometime it isn’t. Elite athletes, including very dedicated amateurs, react to pain differently from the non-elites.  An elite athlete will disregard non-critical discomfort and stop on a dime if the wrong sort of twinge – something a non-athlete might not even notice – suddenly starts. That’s why a marathoner will be surprised at their bloody socks at the end of a race but would have stopped a workout if there was a fleeting not-right sensation in the back of the knee.

If you’re a “venter,” maybe it’s worth reflecting on if you are habitually venting – like a beginning exerciser who thinks every stitch in their side is an emergency. Or are you more like a semi-regular exerciser, who can tell the difference between serious and nonserious discomfort, but would like an excuse to hit the snooze button and go back to sleep- so you vent instead of taking constructive action? Perhaps you keep venting in its place: very occasionally, but mostly for the times when options are very limited.

Please share about the day with your loved ones, including the joys and frustrations. Just realize that if the same frustrations keep being aired, that something in the situation needs reflection and change – whether it’s the circumstances or the approach to them. After all, in a year, or two, or five, do you want to be having the same conversation about the same problem?

Mom Wisdom: See, I wouldn’t like that

My mom has much wisdom, and it is often compressed into a succinct statement. One such statement is the beautifully versatile, “See, I wouldn’t like that.”

It is a thoughtful, personally disclosing and completely nonjudgmental response to all sorts of statements and behaviors. 

A distant relative has gotten an uncomfortable looking piercing. See, I wouldn’t like that, having a hole in my lip. But it’s not my lip.

Another family member is an avid hunter, while she is a vegetarian. See, I wouldn’t like that. But I’m sure it’s good to save money on food and of course the poor animal had at least a better quality of life while it lasted than those poor animals trapped in commercial stalls.

An elderly family member is planning a hiking and camping trip in the mountains. Well, good for her, but I wouldn’t like that. I’m sure she’ll have fun.

She will not pretend to agree with an opinion to keep the peace; she will not be abrasive or confrontational about it, either. She will not pretend that she, too, would want to skydive or travel someplace with large insects or otherwise engage in activities that she finds unappealing. She will listen, ask lots of questions, show genuine interest in the topic, seek to understand the other person’s enthusiasm, be encouraging and may also remark, well, see, I wouldn’t like that.

We have, to some extent, adopted this expression. Even when making an observation about something, such whether to go to the local First-Friday concert when the music is not a genre we enjoy, no criticism is necessary, just the agreement that lots of people will really enjoy it but, see, we wouldn’t like that.

I wonder what changes would ripple out if more people, instead of criticizing others for thinking or doing differently, the first stance was that respectful curiosity followed by a personal reflection that has nothing to do with whether the other party is “right” or “wrong.”  The alternative is a world where people fight or even cut one another out of their lives for matters that are more personal opinions than principles and too often, too little effort is made to find some common ground. And, see, I wouldn’t like that.

Why Ask Me That? Third in a series on questions in the therapy room

Someone who is struggling with anxiety just wants to feel better. It’s understandable; anxiety feels awful. The physical symptoms, so often hovering just below full-blown fight-or-flight; a mind that won’t rest, a brain that hops from topic to topic like a rabbit in a vegetable garden. Add to this the fear that so many people have when they come to therapy:  will the therapist tell me I’m crazy?

No; no, I won’t tell you that, but I am probably going to annoy you with a lot of questions that may seem to be irrelevant to your suffering. My paperwork asks about your history, decade by decade; your losses; job satisfaction; health issues; your alcohol and drug use; your prescribed medications; your exercise and sleep patterns. I ask about screen time, social memberships, supportive relationships. I ask a lot of questions, and I can tell who thinks those questions are irrelevant by who leaves them unanswered, handing me incomplete paperwork and acting surprised when I follow up on the many blank places.

All these questions are important, and here’s a short discussion on just a few aspects and the explanation.

Your sleep patterns, and any difficulties, can both contribute to, and be worsened by, anxiety, stress and depression. If you need more, or better sleep (and most people do), figuring some ways to improve your quality and quantity of sleep can help across many categories of your life: focus, memory, energy, stress level, and mood. When these improve, relationships can often improve, as you might expect when you can pay attention and be less cranky.

If you have major health conditions that are not properly managed, these may contribute to problems with sleep, anxiety, or mood. For example, poorly managed diabetes, besides being physically very dangerous, impacts focus and mood. I would refer you to your physician to see if there are problems that require medical attention.

Social isolation is a recipe for loneliness and depression. Social media use tends to make this worse – something that seems weirdly contradictory. Lonely people eventually withdraw, and this creates more loneliness, isolation and possibly anxiety and depression. We need to explore ways to enter back into activities with others.  From my guidance counselor days: children who are isolated suffer. If you ask a child if s/he has friends, and then ask him/her to name those friends, and there is a flash of hesitation, you know you are dealing with a child suffering social isolation. Just so, adults who cannot identify some supportive relationships and what is good about those relationships is an adult who is emotionally isolated.

I ask questions that make sense to me; if they don’t make sense to you, please ask why I’m asking. Thanks!

Why Ask Me That? Part 2 of a series on questions in the therapy room

Very often, as a therapist, I observe to couples or family members in the therapy room that they are having separate conversations. They think they’re having one conversation, but they are not; the communication wires are crossed and each is addressing what they think the other means, and not what the person actually means. This happens, too, in clinical settings.

Take, for example, my friend “Anna,” (not a client), in her 70s, long-married, who very precisely answered her long-time physician’s query about her sexual preferences with, “Paul Newman, James Garner, and Errol Flynn.”  Hilarious – but not the answer anticipated for the question being asked of her.  Anna discussed this with friends and family later, and wondered, “Why ask me that?”

Her question has merit for two reasons. First, simply because time is scarce. Many people complain about the lack of time with their doctor to discuss their concerns, their symptoms, the confusing test results, the sometimes scary, “What’s next?” (I don’t; I have a great primary care physician.) In Anna’s case, a long-time patient is asked what seems obvious to her and not given an explanation of why it is being asked, while other people feel shortchanged at the time available to discuss the growth on their thyroid or the troubling change in their bloodwork.

Second, her question reinforces how important it is for all of us in the health-related fields to explain why we ask the things we do.  I ask, in the initial paperwork, about friendships, sleep, health problems, job satisfaction, etc.  – things clients sometimes think are irrelevant to what brings them to counseling. I don’t think they are irrelevant; I think that these are essential aspects of well-being, and understanding more about the client’s world helps me to help the client. I state this in the paperwork, with a brief explanation about how understanding a client’s habits, strengths and support systems gives us information to build solutions that fit that particular client.

So perhaps the moral to the story is for healthcare providers to explain why we ask the questions we ask.

And perhaps another moral to the story is, ask those questions very precisely. Because sometimes people will answer exactly the question we asked, and not the one we intended to ask.

Why Ask Me That? Part 1 of a Series on Questions in the Therapy Room

“It’s a lot of paperwork.” 

Yes, I agree, it is. And all that information is helpful and useful for me in what I presume is a shared project: making positive change in some aspect – or many aspects – of that client’s life. 

The number of people who simply skip sections, as if they were optional, or not relevant, is significant. This gives the opportunity to have some conversations about those questions, and their relevance.

For example:

If someone routinely shortchanges their sleep, health problems will develop. In the short term, irritability (which tends to mess up personal and work relationships), less efficient short-term memory (ditto), distractibility (ditto) and impulsivity (mega-ditto) are possible contributors to whatever the primary complaint may be.  So maybe we should address that, too!

If you are extremely extroverted and are working remotely and living alone, you have created a perfect petri dish for restlessness, depression, and dissatisfaction. Those are psychological and emotional factors that create problems across domains. Deliberately arranging adequate real interactions with others will be essential to meeting that basic need.

If you don’t have five or six people who you can identify as part of your social support system, such as friends, family, a mentoring colleague, etc., there may be a heightened risk for depression and anxiety.  That doesn’t mean you confide personal problems with all those folks; you might have someone who provides support and encouragement in career-related areas, some people you can pray with, people who you play sports or exercise with and enjoy lighter conversations.

There are no questions on my paperwork that are not rooted in helping the client and me have a grounded understanding of the client’s strengths, struggles, and emotional resources for making positive change. Just ask me.

Detour Ahead. There. And there.

Look carefully. Yep, that’s a detour sign, pointing to the right at the T-intersection. And yes, across the street is another detour sign, pointing left. There are, as it happens, only two ways to choose here – right or left. Both appear to be detours. To where? From where?

A quarter-mile away, the road crews who neglected to pack up these signs (months have passed) also left behind a Detour sign with an arrow pointed up, as in, go straight ahead. That particular sign has been moved back and forth, one day pointed north, then south, and, most recently, either whimsically or horribly, as if the detour was to crash through someone’s side fence into their backyard.

Pity the unsuspecting rideshare driver who has to figure all this out. Eventually, there will be road work in our area again and we’ll all stupidly ignore the first detour signs, because we’ve learned to regard orange signs with arrows as signifying nothing.

There you go: life with crazy detours and places where there seems to be no right answer. At least, there seems to be no easy answer. It can be hard to know if a detour indicates something to be avoided or a relic or even a ruse.

Anyone new to the neighborhood would be stymied by the mixed messages, while the people who know the origin of the dueling detours shrug and ignore them – or, in some cases, get annoyed and move signs across the street.  There’s a clue: when a detour arises, ask questions; see how other people are responding to the apparent detour, and why.  On occasion, I see, in stores, the relics of the social distancing recommendations of 2020, those half-peeled away stickers on terrazzo floors. Like the road-sign-weary denizens of my area, shoppers ignore signs that used to be treated as if they’d come down from Mount Sinai.

There are detours that make sense, like when there’s a big hole in the road. No doubt you’ve gotten your share of detour signs from life. I’ve had mine. Some have kept me from disaster, and some turned out to be less about danger and more about someone else’s fears or agendas.  I’ve heard about many – and about so many people who figured out which detours were legitimate, and which were either relics or ruses.

Wishing you good adventures, and the wisdom to know relics from ruses, as well as to never be the person who puts up fake detour signs for others.

To Ink or Not to Ink

To ink or not to ink: that is the question.

Not my question, but a lot of people debate this. Perhaps they are considering the latest news: the research showing a significant increase in the risk of blood cancers with just one tattoo. That seems worth attention.

Sometimes, people planning a tattoo want to talk about it, the image and the expected arguments from friends or family. We might discuss the option of wearing a piece of jewelry with the same design for a year straight – no exceptions – or the benefit of a trial run with temporary tattoos for a few months.  Perhaps pulling out a particularly unflattering photo, with a hairstyle and clothing you thought looked great at the time, and facing it every day for a year or so would provide a tap to the brakes. Most often in these conversations, I simply listen, ask a lot of questions, and offer my personal explanation as to “why not.” There are three significant reasons.

On my phone, I have a photo of memorial bricks that rest in Europe, with the names and deportation dates of family members who died in Auschwitz in 1944.  They would have been tattooed by the Nazis, each with a unique number, for the obsessive record-keeping for which the Third Reich was known. Out of respect to their memories, no ink.

I can’t think of any sort of decoration I wouldn’t tire of, sooner, probably, rather than later. A look at my hair and fashion choices in old photos makes that spectacularly clear. Due to the likelihood that I will someday find my décor of the day regrettable, no ink.

Finally, the two most significant factors in my life, my faith and my marriage, are too important to me for tattoos. Both deserve a deliberate, mindful choice – every day, every moment. The crucifix I wear is by choice, never mindlessly or without reverence for its meaning and the demand placed upon me, however poorly I may live out that demand. The wedding ring is deliberate, a clear statement of, I love you, I choose you, each day. Never indifferent, never nonchalant: to wear these things is a daily action verb.

Now, those reasons may make no sense to you. Maybe they seem silly or irrelevant to your situation. Perhaps they do; but perhaps they are worth a conversation with someone as you, or they, make decisions about permanent records of this particular spot in place and time.  

Social Contagion

(This post mentions eating disorders, self-harm, substance abuse and suicide. Please reach out to your local emergency services if you or someone you know is struggling with any of these!)

When I was in 9th grade, I unwillingly, and briefly, attended our parish’s very small Catholic Youth Organization meetings (CYO.  The group comprised mostly boys, all altar servers, who played ping pong and pool with our associate pastor, a well-meaning middle-aged priest from Poland. The only other girls were the type of enmeshed best friends that are normal at that stage of life. Their shared passion was Bay City Rollers. They put together, in that era of typewriters with ribbons and no internet, a monthly fan newsletter with some success.  Life would have been oh, so easy, if only I could have mustered enthusiasm for the boys from Edinburgh.  I tried. But, despite the social costs, a Dylan fan I remained.

Go ahead, laugh. But you have faced the challenge of social contagion, too. You may even now be wearing a style of clothing you don’t actually even like. It’s just what’s “in.” As a teenager, you wore the right clothes, or pined after them; you strove for the right hair style. You wore the trendy colors even if they made you look ill, and were anxious for the approval of your peers.  It’s not just kids who follow the crowd; every married person knows that when your spouse’s friend circle comprises mostly divorced people, there may well be trouble ahead.

Over the years, we’ve seen waves of societal concern about the risks of contagion. Were young people teaching each other to cut or burn themselves (1990s), how to purge or starve themselves (ongoing since at least the 90s), how to get a so-called “high” from household items? Could a teen’s suicide lead to copycat attempts?  The answer to all of these is, yes.

Children now are not gifted with preternaturally adult-style brain development. The ability to sound sophisticated by parroting what you’ve read or heard is not the same as an adult brain with a well-developed executive function – something that takes into the early to mid-20s to acquire.  Your kid is not any more resistant to peer pressures of even the subtle type than you were when you were screaming in excitement over a band because all your friends were.  As it happens, they are more vulnerable, because peer pressure can surround them wherever their cell phone works. Odds are, you were free – as soon as you were off the school bus, there was some space for other influences to counterbalance the noise of adolescents striving to show their individuality by being as much like their desired group as possible.

Notice the vagaries of the teenage years: they move from music star to music star, aesthetic nomads in lockstep. No one wears jeans; then they all wear jeans. The games, the accessories, even the car you drive falls under the anxious eye of a child who wants to fit in.  It’s important for all of us to be attuned to the various social pressures to conform, because we want our young people to survive, and thrive, throughout these very turbulent times.

What’s in your backpack?

I was speaking with someone reluctant to make any sort of commitment to a small change in the routine. Things were not going well for my friend, and the future seemed murky. With no clear picture of “where the journey is heading,” taking any first step seemed imprudent, my partner in conversation asserted; it would be better to wait until the “where” is sorted out in life before making a concerted effort in any direction.

One reasonable response to that is, there is no “standing still” in life: attempting to stand still just means things around you will change while you pretend you can hold your position.  See how that works for you standing in the ocean. Maybe that seems trite; the whole “you never step into the same river twice” trope that is, as it happens, absolutely true.

Another way of looking at my friend’s dilemma is this: no matter where my journey is going, some items always go in the backpack. I may not always need the water purification straws, or the sleeping bag rated for freezing weather, but I always need underwear and socks. I always need a spare pair of contact lenses and sunscreen. I always need a small Bible. I always need chocolate and my thyroid medicine. Even without knowing where, or when, I’m going, some things can go into the backpack.

No matter where your life journey is taking you, wouldn’t it be helpful to have a better quality of sleep? More physical energy?  A firmer sense of what your values are, and why, and what the implications are for daily life? A little less messiness in the closet or refrigerator or your car? Less weird clutter and mysterious crumpled papers in that one drawer? Some better thinking habits, whether it’s taking on a phobia or developing your capacity for focused attention?

Even if you’re feeling really stuck – a lot of pressures, an unhappy job situation, the first year or so into significant grief – perhaps there is one small thing you can do first– something you can “put into the backpack” – without a clear picture of where you hope to be heading. And, as you’re putting those essentials into your pack, perhaps the mystery of the next few steps on the journey will begin to come into focus.

Happy trails –