Sunday, December 16, 2012

Mass Murder & Mental Illness

As the roar of reaction begins to quiet following the horror in Newtown, many media comments I have read express a demand for better "access to mental health services."

I'm not sure what that means in this case.

The biggest gap in mental health care in our country, as I have come to know it, is in in-patient hospital care. After Congress passed laws in the 1980's that down-sized state hospitals, hundreds of people were released from care. States and communities were expected to provide needed services, but in many places, such care never materialized. The numbers of homeless, mentally ill and/or addicted persons swelled, and state and federal dollars for the seriously and/or persistently mentally ill dwindled and has stayed low.

We have now have a chronic shortage of psychiatric hospital beds, and an even more critical shortage of child and adolescent psychiatrists. The cost of in-patient care is close to $1000 a day in some cities like Minneapolis. We have a shortage of psychiatrists because our medical system is controlled by the third party payer system of insurance companies, and they don't pay psychiatrists commensurate to their 10 year + post-college medical training. Fewer medical students want a job with longer training and lower pay.

If the shooter in Connecticut wanted mental health care, there are plenty of master and doctorate level out-patient counselor/therapists in Fairfield County. Family physicians are often the first level of care for mental health, and would have been able to offer referrals for counselors and medication if needed. If anyone feared for his life or someone else, state laws around the country commonly allow for persons to be held in a locked hospital ward for up to 72 hours for evaluation.

But that is all for those whose mental health is clearly disturbed and dangerous. We'd like to believe that we can see the most dangerous among us coming from a mile away. The plain truth is that we often can't.

Contemporary research into the minds of mass killers in America has shown that the majority are men who have had difficult lives and blame their pain on everyone else. They don't have a sense of their own responsibility for their lives, and when pressed even harder by some large stressor like the loss of a job or an important relationship, plan a sweet revenge upon their oppressors. These are usually men with personality disorders, people whose characters have little concern for the well-being of others. These folks make up about 10% of the population and don't seek mental health care. Or when they do, can fake their way through and get released without any improvement.

Stalin. Hitler. Mussolini. Pol Pot. Idi Amin. These men are mass murderers too. Do you think more mental health care would have solved the problem of human evil in them? No. We will always need to build a world that takes human sin seriously. That does what it can to control for access to weapons that kill quickly. That knows that evil doesn't come at us through normal channels. That remembers that evil seeks power, and that power can overtake governments, too.

We weep with those whose lives have been shattered by evil in the form of a silent 20 year old killer. For their young lives lost. But also for all who, throughout human history, have died at the hands of evil persons. Evil does exist, and it exists not outside of us, in some kind of satanic underworld of the devil. Every evil I know of is born of a bent human mind, and the continuous will to wreck vengeance, power and control of others.

We can't medicate, hospitalize, or counsel our way around human evil. Looking for relief from the mental health system is looking in the wrong direction.

Friday, November 23, 2012

ProBiotics Could Help Your Brain

I know that eating helpful gut bacteria (acidophilus, for example, found in active yogurt cultures) helps our digestion work at its best, and can improve our immune function, but little did I know that scientists are studying the effect of healthy gut bacteria on emotional resilience and mood. It turns out that good gut bacteria seem to work with the function of the Vagas Nerve, the nerve that links the brain to the digestive tract, to stimulate positive emotional function. (Check out a brief intro to this amazing nervous system giant here: Vagas Nerve.) 

In mice, this connection made mice more resilient in the face of stress and able to persist in difficult circumstances far beyond their "normal" peers. There is more than some suggestion that human emotions and mental health could be lifted by additions of pro-biotics into the daily diet. Jamie Lee Curtis (Activia!) may be absolutely right: adding yogurt or other pro-biotic supplements can make you a happier, healthier person overall.

If you struggle with mood, energy, and lethargy, it may be worth your while to give daily yogurt or a pro-biotic supplement a try.

If you'd like to hear more about this research, listen to this episode of the science radio program, RadioLab,  entitled, "Guts."  (The research about the mice is around the halfway mark if you'd like to cut to the chase.) The whole program is amazing.

 

Monday, November 12, 2012

I Need Help NOW

Several of my clients are suffering with destructive moods, relationships, jobs or unemployment at the moment.


I understand what that vortex feels like: overwhelming physical tension, unclear thinking, rushed or confused decision making, hair-trigger temper, uneasy sleep. During times like this in life, it's very hard to trust that you can find a way to hang on. The present is so unpleasant it seems endless.

When times like this come to us (and believe me, they will come to us all, at one time or another), I like to focus on two aspects of help: making the NOW better each day, and focusing o
n the small decisions we make so that we can create a more hopeful FUTURE.

The Now: There is a great deal we all can do every day to soothe our bodies and minds for optimum wellness even when in an emotional storm. They are aspects of daily self care, but few of us practice them with enough patience that they make a difference. Here are the basics I talk to all my clients about. What are you willing to work on each day to improve your own functioning?

1. Exercise. Absolutely, the most important addition to the self care tool box. The benefits of moving our bodies regularly, at a moderate level, for 30 minutes a day include lower blood pressure and blood sugar, a lowering of muscle tension, clearer thinking, better sleep. If ever there was a "magic potion" for wellness, daily exercise is it.

2. Nutrition. Along with exercise, what we eat has an immediate and lasting impact on our body's ability to get through the day with less stress. Less processed foods, less alcohol, and more real foods like vegetables, fruits, dairy, whole grains, lean meats, beans and fish will better nourish the body and brain.

3. Meditation/relaxation/guided imagery/breathing/prayer/ritual. A stressed mind and body needs to practice being relaxed. At times of high stress, the nervous system doesn't easily recover from tension. 20-30 minutes, every day, of quiet time that helps the mind quiet, slow, and focus will create a relaxation response in the body that promotes healing. Many people complain to me that they have tried meditation, breathing, or imagery and "it doesn't work." These are skills that take time to practice and learn. If you are patient, these skills can change your life.

4. Core relationships. When we are stressed by terrible strife at work, home or community, we can turn inward and neglect the other relationships that support us. We don't want to burden others with our struggles, yet it's exactly at this point we need the love and support of friends, extended family, pets, neighbors and healthy colleagues. Make time for these happier relationships, and don't spend every minute talking about yourself. Listen, laugh, relax with others. Relationships need to be balanced, even in stress.

Taking time to focus on what can be done TODAY will help lift the weight of life's struggles off your mind. Commit yourself to helping your body, mind and relationships be healthy, flexible and strong. It makes the now so much less destructive. In my next post, I'll talk about the mental skill of hopefulness that can draw us forward.

In the meantime, be well.

 
 

Saturday, October 6, 2012

We Can't Choose our Parents

It's true; we can't choose our parents.

Whatever skills or deficits they possess as people: their readiness or disinterest at caring for us, their physical and mental health, and their ability to meet basic needs for food, shelter and safety have an immediate and lasting effect on our own development. The human brain is shaped every day by the way we are cared for by those closest to us, and grows fastest during the first two years of life.

If a child is born to a parent who neglects their needs, is addicted, or who is violent, abusive or mentally ill, the effects are devastating. A human mind can be ruined if not helped and supported to develop in a healthier, more stable and flexible way.

It's also true that in America the first time a failing family may come into contact with an institution that could help it recover is with the justice system or the public schools.

In this wonderful episode of This American Life radio show, stories are told of educational and therapeutic systems that work to re-parent our cultures disordered parent-child relationships.  If you've ever wondered how schools cope, or how family and in-home therapy works, take a listen. It's great.

The American Life : Back To School, Episode 474

Sunday, September 16, 2012

Willing to Risk Again

Several times this week I have found myself talking to new couple clients about their relationships, and how hurt has caused them to feel withdrawn from their partners. Sometimes this distance has lasted for years, the human need for support, connection and understanding no longer expected from their spouse. 

One of the most important aspects of relationship repair is the willingness to risk being open to a partner who has been months or years at odds with our needs and hopes. Couple therapy at its best keeps both people focused on their individual efforts, while being confident, through actions and words in the therapy room and out, that the partner is doing the same hard work. 

It can feel like being open to injury. Like you are just asking for your partner to hurt you again. Many people resist, and for every right reason! But repairing such pain means turning toward your partner and feeling what you feel, expressing your hurt and disappointment, asking for what you need again, and being willing to see if your openness can be met with a similar effort of apology, repair, and affection by your partner. That's what a good couple therapist does every day with couples, with compassion, encouragement and patience. It's not a free-for-all in therapy sessions. If it is, run in the other direction. 

When deciding whether to go to couples therapy, this is one question you will need to answer: am I willing to be open again to this person, this one I once loved, and see what I feel, what they have to say, what they have experienced, and work together for new, common ground? 

Wednesday, July 4, 2012

Should I or Shouldn't I ?

In a couple of weeks I will be voted off the active clergy roster of the ELCA.

This means that the Church that ordained me no longer will consider me a pastor. All this comes about not because of any Church mean-spirited-ness or personal failure on my part. I left the parish in 2004 to become a family therapist, and because I'm not involved in ministry as a pastor any more, I'm no longer "official" in the way Lutherans understand the ordained ministry. For these 8 years, I've gotten a pass as someone "On Leave from Call." That grace has run out. So be it.

I've worked hard since 2004 to let this adult identity of mine go.
I planned to be a pastor since I was 16 ( I KNOW, right?!) and was one, full time, through unemployment and interviews, singleness and marriage, pregnancies and parenting, healthy churches and not, solo jobs and staff positions, parsonages and mortgages for 20+ years. That's one deeply held self understanding. And I'm proud of the pastor and person I was, despite my own obvious flaws and mistakes. In the end, the job was so full of politics, dissembling and distress, I threw in the towel.

I'm very happy as a therapist. I find the study of human mental health provides me with answers to questions I had been asking all my life about why people behave, believe and relate the way they do. I'm so much happier working for myself, and every mistake and every success belongs to me alone. I love helping people heal in ways I had only imagined as a pastor. I really enjoy my therapist colleagues. All in all, it was exactly the right thing for me to do.

Part of being on the roster meant that I had to be a member of an ELCA congregation. Now that I am going to be released, that no longer applies. I have been attending the Episcopal church for these 8 years, and my husband and both children were received into adult membership over the years. So that leaves me the next quandary in my spiritual journey: is it time to join the Episcopal Church?

It's a bit like leaving a family. Am I ready to join another family of faith now that I'm contractually released from my first? Is church membership even important anymore? The death knell for the organized Church in its American forms has been sounding for the last 10 years. Is being received as an official member important to the Episcopal church as it struggles to be in mission despite its own internal strife?

I'm clearly on the fence, and it's not all that comfortable up here. It's certainly not anything I had anticipated 20 years ago. But then again, not much is. 



Friday, June 29, 2012

You'd Be Proud

We put our one and only (in every sense of this phrase) 16 year old daughter on a plane to Germany two weeks ago. She has been traveling with a group of German language students and their teacher to the motherland, a trip that has been all year in the making.

It was a rather anxious start. Worst was the torrent of rain that she and I drove in from home to the Minneapolis airport. It was probably the worst rain I have ever driven in. If we hadn't had to meet an international flight, I would have pulled over and waited it out. It was as bad as night-time blizzards here in the Midwest, for those who have had that very unpleasant, life-threatening experience. It was all I could do to follow the tail lights of the car ahead of me. Poor daughter. She was already nervous, and she wisely put her head down, closed her eyes, and (I hope) prayed her way through about 15 miles of serious crazy. By the time we arrived at the airport, my head was buzzing with adrenaline, cortisol and every other emergency hormone the human body can pump out. But we made it, and so did everyone else.

They left relatively on time, but arrived exhausted and hungry in Amsterdam, and then had to drag their considerable luggage and weary selves over hill and dale, through airport, tram, train and street to their first stay, a rather nice hostel. Our daughter and I have Blackberry phones, and have been able to text at no cost internationally (RIM, you still rule, don't give up!) and that first night she shared freely the stresses and strains of the day.

Wonderfully, it all improved with food and sleep and she has been having a remarkable, life-shaping experience visiting Germany and her surrounds. She returns this coming Monday, and we can't wait to hear every detail she cares to share. 

What this trip also did was thrust my husband and I back to the future, being child-free for over 2 weeks, the longest we have been alone together since 1992 when our son was born. That's a long time, and I'm happy to say, it has been a pleasure to talk to each other about more than work, home and our children's lives and schedules. It's been nice to remember what it was like to live, the two of us, before children, and what, God willing, it will be like for much of the time in a couple more years when both our children will be collegians.

We're praying every day for both our children, who, though on very different paths, and very different persons, are at the center of who we are as people. We are forever different because of them. But happily, our lives didn't come to a screeching halt because they haven't been home. We are family, wherever we are. And when empty nesting comes, we're going to be alright.

Tuesday, May 29, 2012

Sunday, May 13, 2012

Attachment Parenting : You're Mom Enough Without It

The latest cover of TIME magazine (5/21/12) with the beautiful 20something mom breastfeeding her 3 year old son had me shaking my head.

What WAS she thinking taking that picture, and having her full name on the magazine cover? Ten years from now her son is going to have to face his friends when they ask him what it was like to suck his mother's breasts. Because they have proof. A million covers of TIME magazine, internet pages and downloads later. Really. The social insensitivity of that photo takes my breath away.

As for the topic, the so-called Attachment Parenting style advocated by Dr. Bill Sears, well. That, too, has it's serious problems. Let me be brief:

Attachment Theory describes the emotional or relational attachment between a developing infant and mother. It was first studied in depth by John Bowlby (and later by Ainsworth, Main, Cassidy, Hazan, Shaver, and others) in the 1950's. It posits that the emotional attachment between mother and child is the main determinant for that child's internal sense of self-in-relationship throughout life. The mother, if she is relatively consistent in her caregiving, responsiveness, and mirroring of the child's emotions, creates a "safe haven" for a developing self against the world. That same mother, as her child begins to reach out to the world beyond her, creates a "secure base" from which a child explores the world and can return to mom safely and with support for a developing independence.

This science has been studied for the last 50 years, and has developed a deep collection of research, data, and process that I subscribe to as a relational psychotherapist. About 55% of us are fortunate enough to have mothers that welcomed us to the world, sheltered, fed, changed, disciplined, loved, laughed, cried and protected us well enough that we emerged from our infancy able to approach others for support, and not worry too much about relationships. This is called having a "secure attachment" style. The rest of us, because of our mother's own anxieties, environmental stress, illness, or other issues develop an anxious, withdrawing, or mixed attachment style that we carry from childhood through adulthood at about a 75% rate.

Now, here's my issue: There is nothing in the research of Attachment Theory to indicate that mothers must breastfeed their infants and toddlers, co-sleep with them, or never put them down in order to create secure emotional attachment. Nothing. What the research indicates is that mothers who do their level best to hold, look at, speak to, and provide consistent emotional responsiveness to their child's distress, and support to their developing independence despite issues like also being a spouse, or working, or using daycare, or tending to other children in the family, or having friends or hobbies, usually produce relationally secure children. Period.

So if you love your children, are relatively secure yourself, have the most stable marriage or partnership you can create, have good health, and manage the details of your life pretty well, you don't have to give up your body, mind and self out of the fear that your child isn't getting what they need. Pending unseen catastrophes, they will, they can, and they do.

Most of all, I'm sad that mothering can feel so overwhelming to some of us that following the direction of one single doctor seems safer than following one's own common sense and the collective wisdom of the millions of mothers and fathers who have gone before us. Attachment parenting? Dump the pseudo-science and let your child sleep in their own bed. It's safer for them, and you may actually get a (mostly) full night's rest even when you're up at 3am to nurse, change or rock them back to sleep. Honest.

Thursday, April 19, 2012

Monogamy: It's Not for Everybody

Back in the day when I performed weddings, starry-eyed couples would come to my church office to do premarital counseling and plan their (elaborate) wedding ceremony. I guess I never stopped to consider it much, but I assumed, as did they, that the promise to be "faithful until death parts us" was seriously considered and solemnly promised before and during the wedding service. They only had eyes for one another.

Yet, I knew that about half of all the weddings I would perform over the years would end in divorce. That statistic didn't stop anybody, it seemed, from being certain about themselves. We can do it, the couple assumed. We can be each others' partner for life.

I now have been in the marriage counseling field for 8 years, and practicing full-time for 6. It's not a lot of experience, but believe me: it's enough. Enough to feel like I have a new sense of the difficulties of pledging a life-long partnership, and the challenge of not only growing and aging in some kind of parallel line with one another, but often raising children, dealing with work demands, managing health issues, sometimes moving across town or across country, or going to war, or dealing with trauma and grief.

I now think that it's pretty awesome that 50 percent of those marriages make it a life time. In fact, I think that is nearly close to miraculous.

I've been thinking about the various, very human, reasons that marriages don't make it a lifetime. And the list keeps piling up. Now, granted, my sample of the human spectrum is rather narrow, since happy couples are generally not calling me for appointments. And I do practice in a very narrow economic and cultural range in Dakota County, MN. So, that said, here are a few thoughts on the matter. I hope to write some more about it later.

1. Monogamy, sexual exclusivity with one partner, isn't for everyone. I used to think that monogamy was just a choice, and that adults could manage it. I now believe that some of the most devoted of husbands and wives suffer from sexual struggles around having just one partner for ever. And that sexual simplicity drives them to have affairs, or other kinds of sexual acting out. What I once thought of as a cop-out I now consider a simple fact of human sexual life. Not everyone will enjoy monogamy. Many people get around this not by having affairs, but having multiple marriages, amounting to a serial monogamy with several marital partners. Half of all marriages go this way.

2. When partner family of origin preferences are very different, whether around matters of alcohol, or vacations, or habits around conflict or gender roles, or religious practice, child rearing or politics, I see those habits beat out intention more times than not. The power of family habits is hard to resist.

3. Personalities are notoriously hard to change. We are individually shaped by our genetics, our nurturing by parenting, good, bad or indifferent, in families, and all the unique things that happen to us in our lives. Many people marry their partners, despite clear problems and pain, believing that they will change their partner for the better. While we do influence our partners all the time, I have never seen a marriage based on the belief that "marriage will change them" work. Never. EVER.

With all the things getting in the way of a successful lifelong partnership, I have become a person who sees the 50% success as a definitely glass-half-FULL issue. It's amazing that that many people getting married stay married, and say they are happy. If you are one of them, congratulations. You are a relationship rock star.








Friday, March 23, 2012

Thursday, March 22, 2012

The Power of Suggestion

I really want a new Etch A Sketch.
And so, it seems, do a million other baby boomers.

Amazing, the power of a familiar image, in this case, a toy, being used in political speech. Ohio Art's stock value rose 100% today.

Oh, my familiars. We children of the 1960's. Would that we could harness all our collective nostalgia, work ethic and imagination for good! We could make this economy sing!

Instead, we are paying off our mortgages, paying our children's college loans, welcoming them back home after graduation, and helping our parents stay in their fabulous retirement communities as long as humanly possible. We are this nation's backbone. And I'm proud to be one of Us.

Wednesday, March 7, 2012

So What

For all the talk in America now and forever about how spiritually diverse we are as a nation, it seems that many people have been lying to the researchers. Or just maybe have been trying to spare their mother's feelings and no longer feel they should.

Here are the surprising statistics I found as I was thumbing through my latest The Lutheran magazine (3/2012, p. 8):

  44% told the Baylor University (Waco, TX) Religion Survey that they spend no time seeking out eternal wisdom.

   19% said it was 'useless to search for meaning.'

   28% told LifeWay that it's not a 'major priority' in my life to find my deeper purpose.

One of the most striking trends in religion statistics in recent decades is the rise of the Nones, people who checked "no religious identity" on the American Religious Identification Survey. The Nones went from 8% in 1990 to 15% in 2008. 

So, while America grows increasingly vocal on the edges of the religious landscape, there appear to be lots and lots of people, young and old, who are opting out of the conversation completely. Somehow the core issues of faith like belonging, meaning, forgiveness, renewal, love and compassion, have not been compelling or important enough to draw people toward the discussion.

So what? I'm not very excited about a secular culture. Despite all the problems that religiosity and diversity bring (and I could go on and ON about that), our life in America has been immeasurably enriched, challenged, and improved by the influence of faith on daily life. Just a few examples spring to mind, institutions and events that were driven by religious values: the establishment of colleges, the building and staffing of hospitals and nursing homes, the abolition of slavery, and the provision of food shelves, homeless ministries and chaplaincy to prisons. These are key aspects of American life may or may not ever have happened without people of faith sacrificing and organizing around the life principles of love for the neighbor, and compassion for the sick, poor and suffering.

If those of us who remain connected in some personal way to religious communities need to take anything away from these current statistics, it may be that we need to do a better job speaking, living and working out of our core principles. We may have been doing lots of stuff in the past 25 years, but it doesn't seem to have captured the imagination of our children, our next door neighbor or the college student across the country. And why should we?  So that these disconnected might have a real chance at hearing why we think faith is central to life in the first place.

That this is not all there is. That Love created the universe. That we're in this together. That we hurt each other, and yet we can repent, forgive, even start over. That we all belong to God. I don't want anyone to miss out on this 'eternal wisdom' because it saves lives from despair and emptiness. So what? That's what.




Tuesday, February 7, 2012

Friday, January 27, 2012

Why I'm a Moderate

When it comes to politics, each side of the American major two-party system holds certain beliefs about everything. Including, but not very explicitly, human beings.

Conservatives (Republicans, Libertarians, etc.) seem convinced of the power of the individual. In this worldview, people have unlimited possibilities if they/we just try hard, sacrifice, invest, produce, invent and risk. The human person is strongest as the independent "I" who may contribute to the general welfare, but only because of personal choice and acting out of personal moral or spiritual values. The conservative man or woman buckles down, works hard, and enjoys the fruits of their labor, contributing to the general welfare in limited (roads, bridges, national defense) ways. Success? Well, you deserve it because of hard work, luck, or some other feature of your life. At'a boy! Think Warren Buffet, Ayn Rand, Ronald Reagan and Margaret Thatcher.

Liberals (Democrats, Green Party, etc.) are focused on the welfare of the whole, particularly those whose life experience, health, social status, age or race makes them vulnerable to fewer advantages in the classroom and marketplace. In this worldview, the whole needs protection from the individual run amok; the individual meaning someone Anglo-European, privileged, educated, and middle-class. The environment, exploited by industrialization, needs protection and renewal. Women, children, people of color, the sick, impoverished, and aged, perpetually disadvantaged by the economic system of the last 200 years, deserve legal protection and help from the government of the whole. Think Barack Obama, Al Gore, Hillary Clinton, and Ralph Nader.


Here's why I'm between the extremes: because human nature is imperfect, and both of these polarized views of people and communities are true. We are both ingenious and productive AND careless and profoundly selfish. We need all of us working at our personal best as well as joint efforts for justice, economic opportunity, education, and health care. The very best of American politics is an effort to balance out these perspectives on the human condition. Our extremist rhetoric of the last few years is an exhausting waste of all our time.

We need a government that is committed to hard work and effort as well as the common good. The vast majority of voting Americans know exactly what I mean, and can't wait for common sense to infuse politics. Won't that be a glorious day. 






Sunday, January 1, 2012

Spiritual Reflections: Warm weather could be sign of a larger problem

My newspaper column from Saturday. All the mild weather has had me thinking...and worried.

Spiritual Reflections: Warm weather could be sign of a larger problem: After the winter we had last year, snow as high as our shoulders at the end of the driveway, cold that froze lakes hard and early, this winter’s non-start is a strange reversal. A dry Thanks...