That is solemn we have ended,— (87)

Emily Dickinson

That is solemn we have ended,—      Be it but a play,  Or a glee among the garrets,      Or a holiday,  Or a leaving home; or later,      Parting with a world  We have understood, for better      Still it be unfurled.

Procrastination or is it Fear

From day to day it's all so strange.

What is really happening?  I mean, I do go to the grocery store for that quart of milk and bottle of capers. 

I stood in line while the mom in front of me was told to place her bike safely to the side and she couldn't take her daughter (about 8 years old) in with her because it would add to the number of the people in the store.  Today that action was acceptable.  Two months ago leaving her little girl with the woman guarding the entrance to the store would have been unthinkable.

When will things return to normal?  Will there be a "new normal?"

My observation is that I'm getting through these days with a partial awareness of the work I must do - house cleaning seems so comforting because I know how to do those tasks.  The hard work is the changed manner of staying in touch with banks and clients.

Day by day I am learning how to do old jobs in a different way.  Work is getting done but in an unfamiliar manner.

still wearing the mask

Cabin fever and how many more days of this!

I've baked.  I've  made casseroles and my freezer is almost too full for another marathon of brownies, mac and cheese and mushroom pasta.  Sigh.

Now the innovations:  that long shower that might be walking in the rain.  The risky task of cutting my bangs.  Wow!  I didn't know my hair was really grey.  There are so many self-care tasks I have completed - trimming my toe nails, doing a facial and painting (and then removing) my fingernails that strange puce.

Breathe.  Walk slowly around the interior of  my condo and watching old Astaire-Rogers films.  The good changes are that I am becoming more patient with my cooking - I am actually following each recipe closely and the results are yummy.

Breathe.  Take a nap and take the dog for a short walk.  Remember we will get through this challenge and we will actually be stronger and smarter when the restrictions have ended.

Sending virtual hugs to all my readers.

I’ve Been There

            “I just can’t go on,” the female voice on the other end of the line said. 

            “Okay.  I got it.  You feel like crap.  Are you willing to talk?”

            “Yes.”

            I then began the coaching call I have done for other clients to help them get through this darkest time.  She could only see and feel the endless pain of her depression and felt hopeless to get through another night feeling there was a no possibility of things ever changing.

            Because many of my clients live with severe depression, we have shared a look at that place that feels so interminable.  In going through this experience, they have gained some willingness to take steps to keep themselves alive long enough to call and have that conversation in which we make choices about staying alive through this night. 

            Among the issues we discuss are the chemistry of the brain that makes this pain so excruciating while seeming to be endless.  I explain that the blinding intensity of the urge to kill herself lasts approximately 20 minutes.  During that time the impulse is strong, and it is important that together we find something she (he) can do to prevent acting on the impulse for self-harm.  I suggest an abrupt change of temperature, intense exercise, or even paced breathing.  Those simple acts can take about 20 minutes, long enough to allow clients a deep breath and think about not hurting themselves.

            Why do my clients think of suicide when they feel living is an impossible burden?  What makes any individual feel that staying alive is more painful than killing him or herself?  Often the urge to take her or his life has been a recurrent thought.  When sadness or hopelessness get very strong the depressed individual often finds the thought of suicide reassuring because it is an option which takes her out of that pain.

            My work is to both recognize and accept that my client is suffering and to offer short- and long-term solutions.  Together we explore the steps needed at the moment of the call and with her or his ideas and editing, we find action she (he) can take in order to stay alive through the intensity after we end our call.  Our work is to keep her (him) alive by finding action they can take that is tolerable and works in that moment.  We also prepare for the next day in which the emotions that were driving her (him) to consider these steps may now include feelings of shame for having considered such intense self-harm.

            When I look at my clients who are or have experienced thoughts of killing themselves I recognize the enormity of their pain.  The question I consider as I aim to support them is:  what can I do to give them the skills needed to tolerate this pain?  Why do individuals who seem to “have it all” think about or even attempt to kill themselves?  Today, on the one hand, we have better tools to support individuals in pain.  We  have medication and therapy both individual and group treatment and we have support groups in many different settings.  There are spiritual counselors from various religious denominations and we are applying mindfulness tools in almost every area of a daily lives. 

            And we are still experiencing increasing numbers of people whose feelings of hopelessness and helplessness lead them to attempt suicide.  One of the answers to why is existential.  We are living in a world of constant change which, for many people is also a world of uncertainty and fear.  These new ideas and new policies as well as the seeming limited ability for each of us to find safety are the starting point for many individual’s pain.  How do we reach out for those personal connections that were so easy to make before our communication was impersonal electronic media?

            Why are the highest number of people who complete a suicidal action in the age group of individuals who are supposedly at the peak of their professional growth and family satisfaction?  Do we, as a culture, put more pressure on women and men when they reach a certain age or a specific level of professional growth, or do we expect people to never feel vulnerable? 

            What is missing in our culture that we are unable to connect to our friends, our neighbors, and even those people we see every day walking our dogs?  What made the fear that prevents us from making these contacts grow?  More importantly, what do we need to know in order to diminish this fear and take the risk of expressing empathy (a very important and healthy quality)?   

            Understanding that we are living in a universe of change that impacts all aspects of our daily living is an essential and fundamental tool if we are to become a healthier culture.  Empathy is both a rich and a key skill for surviving in these stressful times and it is an action we are afraid to demonstrate.  Demonstrating this quality requires both courage and a willingness to remove the mask behind which most of us hide. 

            Offering the homeless person in front of the drugstore a smile or a greeting is the first step in recognizing that we are all - all of us - experiencing some level of fear and loneliness.  This willingness to take a chance and offer contact to another person is the beginning.  How do we attack this epidemic of depression and of suicidal feelings?  By recognizing that we are all human, and we can all start our healing, with the willingness to take responsibility for our own good health.  This healing also includes recognizing that we are part of a bigger world. 

            Those phrases we hear so often, “we are all one,” “we are all connected,” are true and much too easy to forget.  As we work to lower our own pain, we can also remain aware that we do have an impact on the people around us.  It is so important to keep in mind that everyone has issues with which he or she is struggling.  Why is the number of suicides among individuals ages forty-five to sixty so high?  What happens to us as we reach those years?  Mid-life is supposed to be the most fulfilling and is the age of the largest numbers of suicides.

            Some of the answer is seen in the question:  these are the years that are identified as “the richest,” or “the most satisfying.”  We are now living the rich relationship that we have created through the years of being together, without the stress of children.   The pressure to demonstrate the achievements of our 40 or so years often feels empty.  These are the years just prior to retirement when, so the media tells us, we have reached our goals and are celebrating our lives.  And, yet, this idea is another urban myth. 

            The economic and social changes over the past fifty years have left many individuals struggling to maintain an image of success.  Many individuals have ended relationships and cut ties with family and are thus isolated in a world that does not provide the social connections enjoyed at an earlier age.  Women go through hormonal changes at this time that may exacerbate a pain of isolation created by changes in relationship status.  Men are experiencing changes that impact their professional identity.  These physiological changes can produce a vulnerability to emotional pain for which he or she is not prepared.

            Culturally, we have not prepared individuals to grow into a rich and satisfying older age.  As we stand on the brink of becoming an elder statesperson, a status that many cultures celebrate, we find that we no longer have the purpose of parenting, of career growth, and have not created another area in which to find joy or satisfaction. 

            We are finally talking about the impact of this isolation that becomes more profound in these shifting times.  We are facing changes in the community and the economy that impact our capacity to process those predictable daily slings and arrows.  Additionally, there is the demand for tolerance of the unknown for which we are not prepared.  Willingness to accept our limited capacity to understand living with these changes is an important step in caring for ourselves. 

            We cannot know how to live with every new concept occurring in our environment and we certainly don’t know how to resolve the challenges presented.  What we can do is let go of the need to control those changes. For many, dread of the unfamiliar leads to thoughts of suicide.  The intensity of the emotions rising out of our loss of skillfulness leads to the urge to take some stand.  We must act in a way helps us regain the authority we feel we have lost. 

            Understanding the limitations of our power to adapt to change in our lives is fundamental to accepting.  With acceptance comes the capacity to tolerate, and even adapt, to the constant change within our world.  Change is inevitable.  Growth is optional.

            Bethany decided to take a walk.  The sun was beginning to set and, if she went down to the Palisades, just above the beach at Santa Monica, she could watch the gold and red and magenta colors slipping into the ocean.  “Will you be okay walking on that path?” I asked.

              Bethany was quiet for a  moment.  “Yes.  I’m going to be okay.” 

            “You must call me in the morning to tell me how you’re doing,” I instructed her.  “Okay.” 

            “And if you don’t call by 10, I’ll call you.” 

            Bethany was silent for a moment and then replied, “I didn’t want to go to the hospital.”

            “You are very brave to ask for help.  Call me in the morning.”

            “Thanks.  I will.”

            “I’m here.  I want you alive.” 

Shana Tova

So in preparation for the high holidays-- I contemplate the meanings and lessons stemming from resisting Lashon Hara. With the hope that this year we can create classrooms, schools, relationships, and spaces where we hear, see, feel and understand each other better than we did before. Even when we may disagree or see the world in different ways. Listening, talking, reflecting, understanding, being more thoughtful-sensitive-honest and careful with our words-- may help us do better.

Someplace to start, to work on, and to grow from. Shana Tova

Weapons: Lashon Hara
how does one speak to
another
without saying what the
other wants to hear?
how does one hear
another
without the other speaking
and looking away?
how can we see one another
when our minds are cluttered with a vision of ourselves
and there is no other?
how can they say those things
when they know the words are
heard and they see your face?
how can they listen to words
sharpened into swords?
thinking only of themselves
yet unable to see
themselves or others?
throwing out sharp words
that deafen our ears

The SHOCKING Meaning of Row Row Row Your Boat

Letting Go: Radical Acceptance

We're growing

In September two more of our therapists will complete DBT training.  We will be ready to expand including additional Skills Group sessions.

Such an exciting development to be available to create a healthy community!

Contact us (310/440-2021) to ask questions.

Treat yourself gently and breathe.

Soundtrack of my Life

The Hollywood Bowl, a lovely summer evening and a concert by Paul Simon.

And so I spent an evening totally immersed in the music that provided the background to heartbreak all those years ago.  What fun.  The music still brings tears to my eyes and the sounds still sound fresh.

The whole musical experience is a reminder that sometimes the very best experiences bring even richer experiences as it is repeated.  Listening to those songs, the classic "Fifty Ways to Leave Your Lover," and "Mrs. Robinson" had an even deeper resonance today when heard in the context of all those sad and fun events in which I first listened.  They remind me of all I have survived in moving from the youthful exuberance of the adolescent to the experience of today's adult.

Thank you, Paul Simon for reminding me of how much I have seen to reach the understanding I now have. . . . slip out the back, Jack.  Making new plans, Stan.

Take care of You

Resources for you when you're feeling overwhelmed:

What to Do If You Need Help

We have been getting an overwhelming response to this article and wanted to add a few things. The National Institute of Mental Health recommends this site. It also warns that reporting on suicide can lead to so-called suicide contagion, in which exposure to the mention of suicide within a person’s family, peer group or in the media can lead to an increase in suicides.
There are many groups that help people having suicidal thoughts. One, Crisis Text Line, inspired by teenagers’ attachment to texting but open to people of all ages, provides free assistance to anyone who texts “help” to 741-741.
If you prefer to talk on the phone, N.I.H. recommends the National Suicide Prevention Lifeline: 1-800-273-TALK (8255).

Happy Year of the Monkey

Monkeys are creatures of humor and surprise.  Perhaps those are the traits that will dominate this year.  I can already sense that all the uncertainty of coming events are presaging fun and surprise.  I will have a lovely and surprising visitor from Ireland in April.  A chapter I wrote for a book on working with individuals with Borderline Personality Disorder is being published and there is more travel on the horizon.

All of these changes demand the discipline of getting enough sleep (when???), eating healthy meals and keeping up with my yoga practice.  I have the preparation for classes that takes several hours for each class, then I have the preparation for seeing my clients and I have those basic tasks of paying bills, walking the dog and (argh) cleaning house.

My goal for the next months is to get sufficiently organized  to manage all of those tasks and still have the fun that is required for the year of the Monkey.

Lights in this Challenging time.

Dear Friends,  tonight is the first night of Chanukah. In Hebrew it's called the festival of lights.  With all that's happening in the world, we can use some light now.  There is an old Chanukah song that describes how we as a collective for good can triumph over dark times. Banu Choshech Le Garesh.  Literally, we have arrived together  to chase away the darkness. Here are the words in Hebrew: 

בָּאנוּ חוֹשֶׁךְ לְגָרֵשׁ
בְּיָדֵינוּ אוֹר וָאֵשׁ
כָּל אֶחָד הוּא אוֹר קָטָן
וְכֻלָנוּ אוֹר אֵיתָן
סוּרָה חוֹשֶׁךְ הָלְאָה שְחוֹר
סוּרָה מִפְּנֵי הָאוֹר

Here is my translation adapted for our days:

We have arrived together to chase away the darkness that surrounds us
each of us in our hands has a light from our internal flame
each of us alone and by ourselves are a small but bright light
but when we join together with purpose we are a powerful and towering light
that illuminates a path through the opaqueness and uncertainty ahead
so the darkness will flee from the faces of our radiant lights

May your latkes, jelly donuts, and singing fill the world.  May our lights shine a bright path ahead.

Happy Chanukah

Peace in the Time of Terror (part 4)

“We want to respect you. Because of a lack of understanding on our part, we have not been skillful at showing our respect, our care I or you, and we have been caught in our own situation of suffering. Please tell us what is in your hearts. We want to understand your suffering. We want to know what mistakes we have made for you to hate us so much.

“We ourselves do not want to live in fear or to suffer and we do not want you to live in fear or to suffer either. We want you to live in peace, in safety, and in dignity because we know that none of us will have peace until all of us have peace. Let us create together an occasion for mutual listening and understanding, which can be the foundation for real reconciliation and peace.”

Peace in the Time of Terror (part 3)

“To resolve our current dilemma with terrorism we must be like this doctor. After our leaders have inspired confidence in Americans and proved that, as a country, we have the capacity to listen and understand, we can then turn to those who are considered to be terrorists. Our leaders can address them with loving speech.

“We know that you must have suffered and hated us very deeply to have attacked us. You must have thought that we want to destroy you as members of a religion, as a race, as a people. You must have believed that we embody evil, that we don’t recognize your religion a nd your spiritual values. We are sorry that you suffer so much. We want to tell you that it is not our intention to destroy you as a people, as a race, or as members of a religion. It is not our intention to i-eject your spiritual values.

(more in part 4)

Peace in the Time of Terror (part 2)

“God does not take sides. Jesus, Buddha, Allah—all the great beings speak of compassion and inclusiveness. We should not believe that we can be peaceful by eliminating the other side.

“A doctor wants to destroy the malaria in a sick person, not destroy the patient himself. Terrorists are human beings who are sick with the virus of terrorism. The virus you see is made of fear, hatred, and violence. You can be a doctor for a person with this illness. Your medicine is the practice of restoring communication.

“But if a doctor cannot talk to a patient, if the patient refuses to cooperate, then how can the doctor help? If the patient refuses the doctor’s help, doesn’t trust her, and fears the doctor maybe trying to kill him, he will never cooperate. Even if the doctor is motivated by a great desire to help, she cannot do anything if the patient will not collaborate. So the first thing the doctor has to do is find ways to open communication. If you can talk to the patient, then there is hope. If the doctor can begin by acknowledging the patient’s suffering, then mutual understanding can develop and collaboration can begin.

(More in part 3)

Peace in the time of Terror

“Man is not the enemy”, Thay has often reminded us.
“Our enemy is hatred, anger, ignorance and fear.” The roots of terrorism are not to be found in religious philosophies or unfamiliar cultures, but in misunderstanding, fear, anger, and hatred.
“Terrorists are human beings who are sick with the virus of terrorism. The virus you see is made of fear, hatred, and violence. You can be a doctor for a person with this illness.”

From Thay’s book Calming The Fearful Mind:

“Some people commit acts of terrorism in the name of their values and beliefs. They may hold the idea that others are evil because they don’t share these values. They feel justified in destroying their enemies in the name of God. People who engage in this violence may die with the conviction that they are dying for a righteous cause. And isn’t our country acting out of the same conviction when we kill those we define as threats? Each side believes that it alone embodies goodness, while the other side embodies evil.

“Fear is another root of violence and terrorism. We terrorize others so that they will have no chance to terrorize us. We want to kill before we are killed. Instead of bringing us peace and safety, this escalates violence. lf we kill someone we call a terrorist, his son may become a terrorist. Throughout history, the more we kill, the more terrorists we create.

“Across the globe, people suffer from very much the same things: social injustice, discrimination, fear, and fanaticism. Fundamentalism is very much alive in countries around the world. Many people believe that they alone are on the side of God, and they behave as if they are the only children of God and the lives of others are not as precious. They want God to bless their own country above all, and not to bless others who they feel represent evil. But to think that everything the other group does is evil and everything we do is good, prevents us from understanding the values of others, and from recognizing their suffering and fear. Instead of making us stronger, our unwillingness to listen keeps us vulnerable and afraid.

(more in next post)

Reflection on the High Holy Days

Given all that is happening globally this year, humanity collectively has lots more to do to bring the world to a better place. A reflective poem for Rosh Hashana (this Sunday eve):

My reflection

When I look into the mirror
I see the face of millions
looking back
at me

When they gaze at me
some may be able to see the reflection of
those who might care enough to look back
at them

And when they see me in them
And when I actually see them in myself
we both will know that our core images and essence
though slightly different-- in meaningful ways,
are really the same at the center

As I align my image with the other
And as they align their source with me
we will one day look into our mirrors
and see who we really are

finding that life worth living

All the little nasties seem to happen at once.  Insurance companies hanging up on me, clients not showing up,  and everyone else wanting their own chunk of change. Taxes here, office rent there, and the tea box in the office is empty.  Oh, yes, the dog needs his rabies shots.

Those are only the financial stressors. I know they will stabilize - and I will get through this money crunch. I am able to stay focused and keep the worry within tolerable bounds. I remind myself, when I start chewing on those fears that at this very moment, I am okay. I keep breathing. I take another deep breath, and take the dog out for a walk.

Believe it or not, it does help. I recognize the things I can control, accept the things I cannot change and see the difference between the two. It's what people in 12 step programs call the serenity prayer and what I call radical acceptance.

hawaii was wonderful wish I were still there

The yoga, the food and the warm days and nights!

If only to be back there right now.

Now, if I can get into this site, I will be putting chapters from my book on "Depression? the last help you'll ever need" up here.

Needless to say, google does NOT make it easy to access my accounts.

Keep breathing.  I'm still around when I can get into this site!!!

Ahh, end of term and off to the warm beaches

Yes!  I am flying away to the big island tomorrow.  I have never been to Hawaii and not only am I going to this beautiful place, I am going to a yoga retreat.

What a wonderful way to heal from the continuous stresses of the now ending semester.  Sometimes the therapist truly must take good care of herself.

A week of quiet, healing yoga practices in one of natures most wonderful gifts will serve well to set me back on the path to being ready for another new year.

I am sending positive energy and good thoughts to everyone as we head into 2015.  I encourage myself to think kind and loving thoughts to move me into strength in the new year.