I wanted to weave some of my blog posts together into the overall fabric of my journey toward wellness.  Here it is:

Compassion

After my psychiatrist stabilized my mood, a woman with bipolar disorder came to see me in consultation.  While my mood was stable, I continued to be under the weight of crushing shame and self-flagellation.  She shared her story with me and it was remarkably similar to mine. Years of self-loathing and fleeing from her diagnosis. I felt that it was a privilege to be invited into her inner world and empathized with her struggles. Rather than seeing her as damaged, I saw her merely as being scared. Rather than seeing her as pathological, I understood her vulnerability. It was her humanness that resonated with me.

And then, what I had previously been blind to came into clear focus.  We humans can have kindness and compassion for others that we don’t often enough bestow upon ourselves. I thought that surely I could find a way to rewire the way I spoke to myself, replacing the voices of self condemnation with ones imbued with the compassion I felt toward her. This seems obvious now but back then it felt revelatory.  The pathway toward healing was right in front of me: be compassionate.

Vulnerability

We have a saying in the mental health world that growth happens when we lean into discomfort. By definition, growth is a journey where we enter an unknown world, whether we are stumbling to learn a new language, falling off our bike as a kid or taking our first dose of lithium.  Leaning into the discomfort of showing another our tender core is as challenging as it is rewarding.  Ironically, it is only through embracing this discomfort that we can find comfort.  We can’t have it both ways.  We either live behind thick walls, protecting ourselves, feeling alone, or we open up to the joy and pain in life by feeling uneasily vulnerable.  

One of my idols, Brene Brown says that vulnerability isn’t weakness.  It is our greatest measure of courage.  When we say “I love you” first, when we stand at an AA meeting and say “I am an alcoholic” or when we say “I need your help”, we are extending our hands and opening our hearts.  We humans are hard-wired to connect and being openly vulnerable is the only pathway to true intimacy and well being.  The pathway toward healing was right in front of me: be vulnerable.

Humanness

I have learned many lessons in life from the patients I’ve cared for.  Early in my career as a resident psychiatrist, I was taught an unforgettable lesson from a patient with bipolar disorder who urinated on herself.  Back then, I had no idea what I was doing. I was incompetent. One day, I was facilitating a group that was going well until a woman with bipolar disorder suddenly stood up, walked to the center of the room, stared intently at me and urinated all over herself.  I watched, speechless and in horror, as the urine trickled down her legs.  I sat in my chair mute, hadn’t the slightest clue what to do and felt publicly humiliated in front of all the other patients, the staff and my supervisors.  Since she and I shared the same diagnosis, I briefly drifted into my own thoughts. I wondered whether I was witnessing my future, one filled with hospitalizations and public urinations. 

I spoke with her later that day and in her own psychotic haze, she shared with me that the psychiatry resident who had cared for her had rotated off the unit the day before I arrived and I had taken his place.  She liked him, missed him and felt that he cared about her.  I got it. She was scared that I would leave her too.  While I have learned to express my fears in ways that don’t involve public urinations, she was making me face the reality that, in addition to our shared diagnosis, we were more similar than we were different.  We both felt vulnerable, we both felt afraid, we both felt inadequate and we both had moments when we couldn’t find our voice.  Neither of us were in control. I wasn’t always the master of my universe.  The pathway toward healing was right in front of me: embrace humanness.

Well placed faith

A few weeks ago on a bright sunny day, I was sitting in the shade of a maple tree.  As the sun slowly arced across the sky, the shadows cast by the tree moved across the ground.  Had I reached out to try to touch those darkened areas, all I would feel would be the earth beneath my finger tips.  Touching the shadows that lay in front of me would always be elusive, though they existed right before my eyes.  On a podcast I recently did, a woman asked me for advice about her son who had bipolar disorder.  She explained that for the past ten years, he would be adherent to treatment for periods of time and then he’d refuse to take his medications.  She witnessed him cycle through periods of depression and mania.  She wanted to know what advice I had for her and my answer was two words: have faith.  

How naive I must have sounded, suggesting something that could be construed as nothing more than a trite sound bite.  After all, having faith is easy to suggest, but seems near impossible to feel at times of great distress.  (The faith that I am speaking about here is not the faith that arises from religious beliefs.  That faith carries many to comforting places and is an important part of many people’s identity.  I am speaking of a different kind of faith.  A faith in a better future.)

How, she asked me, was she supposed to have faith? I told her that her faith would be well placed because of all those working every day to find cures for the many psychiatric conditions that continue to afflict too many of us.  Her faith would be well placed in the many treatments that already exist that can work wonders to stabilize moods for those with depression and bipolar.  Her faith would be well placed because so many people with mood symptoms find their way toward mental health and lead wonderful, rich lives.  Her faith would be well placed because her son had periods of time when he was adherent to recommended care, an excellent prognostic sign.  Her faith would be well placed because her son knew that he had a mother who supported him fully in becoming and staying well.  Her faith would be well placed because she loved him.  Her faith would be well placed because she was part of a worldwide community of those whose hearts were in the right place, supporting their loved ones as they walked down the challenging road of life.  Her faith would be well placed because she was not alone.

It’s so hard to retain faith in a better future during the difficult times that we face in our lives.  But when we are caught in distress, somehow we journey on believing that tomorrow will be a better day.  Even though we can’t know what our future holds for us, we take a step forward during those dark times.  Sometimes, the darkness that surrounds us can be no more than a space on the ground that is cast by a tree on a sunny day.  And here’s the thing: that shadow is there only because of the light cast down from sunshine on a bright day.  The pathway toward healing was right in front of me: have well-placed faith.

Small acts, big effects

Many years ago, there was a mathematician, Edward Lorenz who worked on models to predict weather systems.  He would use extremely exacting numbers and run his programs repeatedly, analyzing the results. One day, numbers were input that were rounded off in seemingly small inconsequential ways. He was startled to find that a very tiny change in initial numbers created huge differences in the experiments outcome. This is what we have come to call the butterfly effect. It means very minor perturbations such as the metaphorical flapping of the wings of a butterfly could influence a hurricane occurring half way around the world. That is, small acts can have big effects.

Why did you hug your daughter yesterday? What was the reason you gave your college students a pop quiz earlier this week? Why did you take your meds today? Why did you encourage your son with depression to go to his support group today? Because you wanted to show your child that you love them, you were trying to impart knowledge to young minds, you wanted to be adherent to recommended care and you wanted to help and support your son. All true, but all missing the larger point.  

We act in these ways because of the effects these actions might have not just that day but in the future. The hope that our daughters will live lives knowing love. The hope that our students will do good deeds in life with the wisdom we impart. The hope that medications and support groups will lead to ongoing wellness.  

Here’s the thing: we do these acts even though the effects might not be apparent until far down the road. Here’s the bigger thing: we do these acts even though we may never see the positive outcomes that might arise from our good deeds. Our small acts today can have big effects on others tomorrow. We can’t always see that the hug, the quiz, the meds or the support will result in anything wondrous but we have faith that it will.

Perhaps without realizing, we hope our actions will play some small part in leaving our world in a better place. So be a butterfly.  Have faith that you will usher in the winds of a better tomorrow for us all.  The pathway toward my healing was right in front of me: do small acts today and cause big effects tomorrow.

Live your authentic story

When I was little, I was sure there were monsters under my bed when I was falling asleep each night. I imagine that when my parents came into my room to comfort me, the light switch that they flicked on might have caused me to squint from the sudden harshness of the bright bulb.  Now mostly grown up, I‘ve wondered about what we see in ourselves when our lens is a bit tinged in darkness or when our lens is filled with some light.  How do we define our true selves?  

We believe that our real identity is seen when we are being authentic. I don’t think so.  Authenticity isn’t about being, it’s about doing.  Authenticity is an active choice, not a passive state.  We aren’t authentic because we feel we are an honest person.  We’re authentic because we do honest acts.

Authenticity is about authoring our own story.  It’s a wonderful thing to be authentic because we are always, at every moment, just one action away from our truest self. It is hope-filled and empowering to know that we’re in charge of our affirmations and aspirations each day.  It allows us to dream, to record our humanity and to be our better selves.  

So when it’s dark, we can see monsters under our bed.  But remember, in the dark of night, we can see the stars that illuminate the sky.  When the light is suddenly switched on, we can shield our eyes from it’s harshness.

But remember in the light of day, we can see our loved one’s smile.  I finally came to see that it wasn’t just that small acts today have big effects tomorrow, it was that small authentic acts today have big effects tomorrow.

The pathway toward my healing was right in front of me: do small authentic acts. Here’s what finally worked for me.  It isn’t that I have written my story in my blog.  It isn’t that I have told you my story.  What finally allowed me to arrive at a place of peace, acceptance and wellness is embodied in four words.  Four words that provide the compass point for my true north.  Four words that I’d ask you to consider thinking about in your own lives:  live your authentic story.  

Small authentic acts today, big effects tomorrow.  If you do this, I think you’ll flap your butterfly wings, the breeze will fill you with well-placed faith for a better tomorrow, you’ll embrace your vulnerability and humanness and in the darkness, you’ll gaze at the stars and in the light, you’ll see a loved one’s smile.  Live your authentic story.