DENIAL is Not a River in Egypt

Feeling a bit like I've lost my mojo lately...

In the writing department that is. By that I mean it seems much harder than usual to find something to passionately write about. Usually politics or the frustrations of our health care system are enough to get me started but as of late the angst and fervor have failed me. Just the fact that Bush will be gone in less than a year should be plenty but I'm not feeling too excited about even that. I think I may have become disillusioned by the political system over the years, expecting more of it than it can really deliver. I no longer have any trust in the system and see the politicians mostly as actors that paint an illusion of reality for the citizens. I should be elated and jubilant for the accomplishments of Barack Obama but when I think of him I see images of John and Robert Kennedy followed by the voice of Dr. Martin Luther King, Jr. playing over in my mind. I'm not a pessimist by nature nor am I a true conspiracy theorist but I do feel that some skepticism and no gullibility diminish disappointment.

I remember the feeling when I found out Santa was a fake. Christmas was never the same. I wasn't bothered nearly as much about that cheap tooth fairy. As an adult, I questioned the validity and plausibility of the Good Book. Still haven't quite got that one worked out. We need things to believe in so that we can make some kind of sense out of this sometimes senseless existence. I've grown to define my job as helping people find their way back on track. The stressors encountered during life often lead to such derailment. Since that person may be on a different track from myself it's amazing to witness the clarity of his or her problem or situation when exploring these things with a patient. Many patients end up in treatment for the very reason of overlooking their own problems to try and help another fix theirs. I can say that at least I do get paid for it, most of the time.

I thank God for the ability to understand the dangers of denial. I've found the core of most addictions and emotional dissatisfaction to be denial of reality. If you don't believe me just asked the drinker who drinks daily or the pot head who smokes daily for years but insist on not having a problem. Or the woman wearing the arm cast and black eye who insists that "he loves me." I remember reaching my mid thirties and becoming almost irate at the cleaners for shrinking my pants. It was much easier to do that than face the fact I was eating too much and exercising to little. Psychologists call this defense mechanism "externalization." As a human being, it is much easier to just blame someone or something else than to exercise self responsibility and fix our own behavior. The longer an individual engages in externalization, the harder it is to change the behavior.

I saw an exceptionally bright 15 year old young lady earlier today who absolutely refuses to accept having ADHD. Her impulsivity has repeatedly put her in dangerous situations. A few months ago a date rape drug was successfully used on her by a 25 year old predator. Her mother who is receiving treatment for ADHD now watches her around the clock like a hawk to help her stay out of trouble. She has finished her high school curriculum at age 15 but adamantly refuses to take a simple pill daily that could help control her symptoms. She insists there is not a problem despite a gradual escalation of errors in judgment to the most recent sexual assault. Fortunately her mother recognizes the severity of her condition, even though her plan of babysitting 24 hours is in vain. This case of denial is less benign than not facing putting on a few extra pounds.

Breaking through denial is really just the beginning, which is probably the reason most of us fight so hard to hold on to and hide behind it. We know that facing reality means pain and hard work to actually fix the underlying problem. Unfortunately, each additional day of living in denial leads to more and more pain and unhappiness. In some cases it leads to injury or death. This is indeed a serious matter. A true friend will not allow one to live in denial about a behavior that is detrimental. Only an enabler would allow such. A true friend is willing to risk evoking temporary anger and hurt feelings to help another get back on track. A true friend is part of the solution, not the problem. A true friend must also recognize their own boundaries and not allow themselves to get in over their head or they could end up like the mother mentioned above. If you have a friend in need and you have gone as far as you can with them it's time to refer them to a good therapist.

spirituality and mental health

CHANGE : Final Ramble for 2007

  The time is once again upon us to usher in the new and release the old. . . 

at least in a symbolic or intentional manner. Turning such intentions into reality is quite a difficult task. After a string of failures to accomplish New Years resolutions, the very idea of changing a behavior itself can become part of the stagnation of the procrastinators world.

Most people change unwanted behaviors exclusively through a process of accepting their current state of reality and then recognition of the unwanted result of that behavior followed by commitment, will power and perseverance to reach the goal committed to. There are no shortcuts to changing behavioral patterns. Compulsions must be countered repeatedly and consistently in order to neutralize and eradicate the obsessive thought patterns that drive our unwanted behaviors. Think of an unwanted behavior as a mathematical  integer such as negative 10. The ideal desired behavior would be positive 10. Much of ones early efforts receive no psychological reward since even a major effort would not be enough to even come close to even zero.

(U R HERE)

(-10) -9 -8 -7 -6 -5 -4 -3 -2 -1 >>>(ZER0)> 

+1 +2 +3 +4 +5 +6 +7 +8 +9 (+10) (GOAL)

It has been stated that it takes 50 times repeating a bad behavior for it to become hard wired into the brain as a reflex behavior or so called bad habit. On the other hand it will require 100 times of repeating the opposite behavior in order to neutralize and reverse that bad habit. One with several bad habits cannot realistically expect any genuine change without hard work over time and commitment to rehabilitate. When people look me in the face and tell me they have made a 180 degree turn around after a few weeks it can be assured that person is quite naive or a damn liar.

There is a saying where I come from that "You can't bullshit the bullshitter." Associating with chemically addicted individuals on a daily basis has helped me to realize the profound truth of this frank metaphor. Over the years I have grown to accept being the poster child for adult ADHD. I'm not ashamed of this anymore than I would be ashamed of being diabetic or asthmatic. I even share this with my youthful patients often as a means of helping them feel less stigmatized for receiving treatment. I believe that if they recognize my accomplishments then they too will realize that they could do the same. Dr. Ed Hallowell, Author of "Driven from Distraction" and fellow ADHD sufferer is an excellent resource for any reader interested in learning more about the positives of ADHD.

Stubbornness is one of the keys  since this trait is characteristic of the ADHD. I've used mine to prove the things I can accomplish instead of what I shouldn't be able to accomplish. Preparation + Opportunity are the keys to success. When working in the prison environment I met many who used their stubbornness in a manner that was counterproductive and illegal. Practicing that behavior created habitual patterns so strong that most individuals had it hardwired in their brains that the whole world is wrong and that they are just misunderstood. Out of thousands I may have met a handful who accepted responsibility for their crimes. I know comparing ADHD to Adult Antisocial Behavior is like comparing apples to pears but it helps to highlight the crucial catalyst of free will in an individuals outcome. Without a desire to work for the change that is desired that change will not occur. 

Procrastination and disorganization attract negative karma and thus unhappiness. Taking on too much are the seeds of procrastination and disorganization, so limit setting is often the key to improving ones productivity and self esteem. Work on one problem at a time until that problem is solved, then move on to the next problem. This can be more easily taught to a child than an adult. Adults are more prone to learning things the hard way since they are more hard to contain than children. Mix in a little drug abuse and you may as well forget it. As a doctor my limit is set at crack addicts. When one has fallen to the depths of smoking crack there is even little that God can offer them so who am I to offer them help. A few have survived and made it back from this hell but I know that it was done mostly through their will to survive by facing the truth and having something worth fighting for. If an addict sees you in an enabling role you can only hurt them more. Cut them loose.

For 2008 I plan to follow my own advice and see what happens. As always I wish to thank everyone who found my journal worth a few minutes of their time to read over the past year. I wish you all a most Happy and prosperous New Year in 2008. 

spirituality and mental health

Holiday Thoughts

 Had another birthday on the 14th.

To me it was just another day. I think birthdays were invented so everyone could have at least one day out of the year to feel something special. The Christmas Holiday has always seemed to overshadow my birthday, meaning that there is already enough to celebrate. I also sometimes think that even Jesus' Birthday seems to be upstaged by the commercialization of Christmas. I hate seeing people depressed because they lack the funds to buy for their children all the things on their list. A list that is essentially programmed into their minds by corporate America. Maybe the tragic circumstances of the lead poisoning associated with the toys in China will wake some people up. My parents talked about getting a bag of fruit and nuts on Christmas morning and being happy to get that. The real joy came from the thought and not so much the cost or designer name on the gift. We all love to receive nice things but I still believe there is more joy in giving than receiving, from a purely spiritual perspective. True love is fueled by giving and making sacrifice for others. Is that not what the word Christ really represents since he made the ultimate sacrifice.

Sometimes I'm sickened by spoiled kids. I do not condone violence by any means but it sometimes gets difficult to block out the thought from my mind of what good a few pimp slaps might do for the child with the audacity to talk back disrespectfully to adults or call his mother a bitch or worse with relative ease. Of course it is usually the fault of the parent for letting the situation get so out of control in the first place without seeking help. No need to blame the teacher, preacher, or doctor at this point. Enough of this, I'm beginning to sound like my age.

I'm preparing for 2008 to be a spectacular year. I want the last 2 years to serve as examples of a place I want to try avoid going in the future. We all need to bottom out from time to time in order to re establish our bearings and rebuild on solid ground. Adversity tends to test our true limits and just experiencing the reality of survival serves as a re affirmation of faith and a source of personal growth and strength.

I opened a new office 2 weeks ago. I knew for some time that a change was in order. From a personal standpoint I realized that I could never be happy working for someone else, for any amount of money. It was a bit tempting, however, to think of just going to work 9 to 5 daily and taking a night or 2 of call a week and then simply pick up a check at the end of the month, taxes paid, insurance paid, benefits paid... That was hard to turn down. I also had to consider that you never get something for nothing. I'm not selling my soul yet. I'd rather take the opportunity to learn from my past mistakes and preserve my ability to operate autonomously. I understand that the current health care system has the deck stacked against me and favors the corporate models including managed care and pharmaceuticals but that could change once the American people awaken and realize what a bad deal they have received over the past eight years. I believe a time is at hand for change and that one day a private practitioner will be allowed to deliver care not to just a select minority but to anyone truly in need and actually be paid for it without having to split the money with an undeserving third party. If things don't go as I would like in the future I still will probably refuse the "if you can't beat them, join them" model. I think I'd rather just get out of health care all together and find another way to make a living than be a part of something I don't feel good about. Moving to another country isn't out of the question. That may sound crazy but that's just how stubborn I can be when I feel strongly about a principle.

Oh well, enough ranting for today. If I don't make it back to the keyboard by the holiday, I wish all my readers the Merriest of all Christmases and Happiest of all New Years. Thanks for your interest in my blog.

spirituality and mental health