Allow me to introduce you to some people I’ve met in the past. First, please meet my 76-year old friend, Mimi. At 74, she was active in her church, minister of communion to those at home, running to meetings and luncheons, heading out to her exercise class followed by coffee and talk with the ladies. Now, she sits in her chair most days, can’t concentrate long enough to read, so she pages through magazines occasionally and frequently tells the same story over and over—or forgets things completely.
I’d also like you to meet Jackie. A professional woman who used to run her own business, hire and fire, as well as take care of a family and participate in many recreational activities. Today she struggles to organize her day, has mood swings and sleeping problems that tire her out, and rather than the 20 hour day with 4 hours of sleep it is 4 hours activity and 20 hours of rest.
Finally, let me introduce you to James, who 3 years ago, was top salesman in his region. Running, going, stretching to meet those demands as well as be dad and hubby. Then, suddenly, the phone was terrifying and the thought of leaving the house too much.
What happened? And, what’s the big deal, right? I’ve just described plain old, ordinary garden-variety Alzheimer’s and Depression right? It’s not as easy as that.
We are learning so much more about the brain. When I began in this field over 20 years ago we would have treated these from the paradigm of mental illness and taken it no further. Today, research has shown us that the brain, that gelatin-like mass under our skull, does so much more, and much more precisely than we’d ever imagined. Thus the condition of the brain itself, the way it sends messages, how blood and oxygen flow through it, and the way in which it may have been jolted in the past and impacted the present, all are considerations in the condition of someone, all extremely important.
Have you ever worked on a computer that is DOS based, not Microsoft Windows, or Apple iOS based? If you have and attempted to run a program that is Windows based on it you’ll know that you must have the right software for the program running your computer. If it’s on a Windows platform you must have Windows software, etc. Or have you tried to load a program for which your computer doesn’t have enough space? Or even better, attempted to retrieve information from a corrupted disc? Brought back your worst nightmare at the computer, huh? Well, this is like our brain.
The hardware is the structure of the brain and the protective skull that covers it. The software consists of all the electrical impulses, the neurotransmitters, the thousands of ways in which the brain communicates to allow us to move our right hand when we want to, or know which is left, or figure out a puzzle, or allows us to be appropriately angry or sad without feeling out of control. There is nothing that we do, literally nothing, that doesn’t come in some way from the functioning of our brain.
So that’s new? Haven’t we always known this? Well, not so much. We used to think it took a massive head injury that resulted in surgery and/or coma to cause difficulties later. Thus after an accident when taken to the emergency room if you could walk, your eyes reacted to light, and you sounded like you knew who you were then you were sent home deemed “shaken up but fine”. No one paid attention or related the fact that another woman I know couldn’t organize her work space, was teary for months and months, became very depressed, couldn’t remember things, and had become extremely irritable after an auto accident. Well guess what? When she was rear-ended by a semi-truck going 55 miles an hour and walked away from a totaled vehicle–she wasn’t fine. Her brain had been jolted and, think of a Jell-O mold here, had sloshed back and forth against her skull, causing trauma to the structure of the brain that can’t be seen on X-rays, CT, or sometimes even MRI. But can be seen in neuropsychological testing that allowed her to finally realize she isn’t crazy, she’s lost function in her frontal lobe that controls her organization as well as to her temporal region that controls memory. And what is more important is that all the psychotherapy in the world will not correct this. She needs specific tools to overcome the deficits and make life easier. She also needs time for her brain to heal. And the understanding that it isn’t her fault, it isn’t a moral defect, it is an injury. Thankfully, in her case, after 2 years she regained most of her abilities but still deals with difficulty in organizing and planning and has to work much harder at it than she ever did.
So, let’s go back to the individuals you met earlier. First, back to Mimi, our 76-year old with “Alzheimer’s”. The doctors for a year and a half said it was just “aging” when she complained of not remembering everything. Possibly true. And then there was a surgery with aftercare mismanaged by the surgeon and a cardiologist, a physician, and mental health provider who all deemed her depressed. Eventually, 6 months later she was diagnosed and treated for the pulmonary embolisms that were impacting her ability to breathe and eventually her heart so that very little oxygen was getting through her body. Now, we have a woman who has had mood problems in the past, but her memory, moodiness, ability to initiate and concentration are all poor. Why? The brain needs oxygen which it didn’t get it and these damaged pieces can never be regained. So, Alzheimer’s? Likely not from the brain scans and MRI’s already done. Oxygen deprivation to her brain, highly likely. Reversible? No. In her case she’s not gotten worse, fortunately with oxygen flow restored, her symptoms stabilized and with help from her family she is able to live with her husband well.
Remember Jackie? The previously successful “superwoman”? She had hit her head numerous times throughout life in sports injuries and domestic violence. She did okay, had some problems, but managed. But then came a sports injury that left her significantly impaired for a few days and gradually her overall functioning reduced and she needed more and more support from staff. Eventually the coping became too much, her mood took a huge dive, and her ability to work became compromised. Just depression? No. Just a personality disorder? No. Significant damage to temporal and frontal lobes, some parietal dysfunction, and both her hardware and software have been impaired.
Finally, James, no major head injury. But he has a genetic background of bipolar and major depression. The software is corrupted, and the stress of managing on a corrupted software program became too much. Much as your computer starts freezing when a patch or some other fix is needed, he also froze. And it’s been a long way back to speed with medication and life management changes and dealing with pain in his emotional past. Not just depression, but bipolar disorder.
We can’t be too careful when it comes to evaluating ourselves, our loved ones, and our clients in terms of hardware and software deficiencies. The 76-year old woman had family members who kept asking questions, and asking for new doctors, and pushing hospital staff to reconsider what they found to be obvious. Eventually the answer was found, but not before the damage was relatively severe. We must be proactive in evaluating people and not just settle for the easiest, the quickest, and the least difficult explanation when the “fixes” for these diagnoses are not helpful. We must demand our health providers keep looking and search for the answers. And you deserve to understand your brain and your loved one’s brains. It may never happen to you or a loved one, but we don’t know what we’ll be given to deal with, do we? As Mrs. Gump said, “Life is like a box of chocolates…You never know what you’re gonna get”. If you are interested in learning more, any of the following books are great references and fairly easy reads on the basics of the brain. Then you too, can advocate for someone — or perhaps for yourself.
The Brain that Changes Itself by Norman Doidge
The Whole Brain Child by Daniel Siegel and Tina Bryson
Change Your Brain, Change Your Life (Revised) by Dr. Daniel Amen
CDC Website for Sports and Children – Heads Up Program at http://www.cdc.gov/headsup/youthsports/index.html
Quite often I work with people who are experiencing grief and loss in their lives. I’ve dealt with the loss of my own parents among other losses, but until this past month I had not had to deal with the death of a beloved dog of mine. True, a year ago a friend who rents a room from me lost her 14-year-old dog, and that hit close to home as I’d come to love that furry friend. And earlier this year a dog for whom I’d been the surrogate mom for a number of years and then become my sister’s loved furry friend died. And that left a hole. But in late October my boy, Punky, died at the age of 13 following a rapid decline from liver cancer. Diagnosed one day, gone the next. And with his death I came directly, shockingly, abruptly, and painfully to the beginning of learning to cope with the loss of my dear companion and co-therapist. When I’ve worked with others who have struggled with coming to terms with the loss of a pet I’ve had compassion for their loss. The symptoms, to many people’s surprise, are much the same as any loss, and often as or more significant than the loss of a friend or family member. Why? Because the pet companion offers a more unconditional love than many of us humans are capable of with each other. A friend put it in this way recently to me, “I don’t think it’s any mistake that dog and God are spelled with the same three letters and are mirror-opposites in spelling.” Also, often the pet, as was true with Punky, was a witness to my life and activities. I was fortunate enough to also work with him for years. So we had a regular routine and joint comings and goings. He could predict nearly my every move. This is true for many pet-lovers of any length of time, there is a sync to our lives and activities and the loss of this is a unique loss to other types of loss. One step in healing is often to memorialize our fur baby in some way. I chose to write a letter to Punky that expressed my feelings about him and our life together. Here are a few snippets from it:
You walked into my life unsought.
You captured my heart in a moment.
So swiftly, surely, unblinkingly.
A little fuzzy pooh with eyes
That warmed, snuggled in, said so confidently,
“You’re mine. Take me home.”
And I did.
You grew, you jumped, you ran.
You, dearest Punky, taught me searching is ok.
Laughter comes from simple actions.
Joy comes with love.
You also taught me, dearest Punky, love means terror for your safety,
Sacrifice at the most inconvenient of times.
Confidence it would all somehow work out.
As my co-therapist you helped me to wait,
To slow down, move carefully.
Sometimes my clients grew not
From my actions or knowledge or words.
But from you. Your unconditional regard.
You often drew them out –
Helped them relax. Then let me work.
I miss your gentle, soft kisses, my dear Punky.
Your tongue that licked so gently to say
“I love you” and “Good morning! Let’s go!!!”
You going up from floor to foot stool to couch.
One fluid movement.
Through you, Punky, my ability
To give love goes on.
Dearest boy, run pain free now.
You can see Punky had much influence on me. I hope to use this to urge anyone grieving the loss of a pet to reach out. Talk to a friend. Make a memorial of your own to your pet. Count the ways you’ve been loved and loved and feel the loss. Honor that relationship. Just a dog? A cat? Another pet? No, I think not. Honor your companion and all that means to you. Only through working through your feelings and dealing with all the small and large changes their passing has brought to your life can you be free to love again. If you need help most humane societies, the ASPCA, some hospices (like Hospice of the Valley), and other related places offer grief support materials and groups. It’s ok. As we know, our friend is free to run in health and we will be free to love in health again.
(Punky worked side-by-side with Dr. Beth for most of his 13 years. Many clients have also grieved his passing as they have learned of it given the special work he did and love he offered. Dogs and other animals are used in many forms of therapy including psychological, medical support, occupational therapy, and equestrian therapy for special needs as well as emotional healing. If you would like to help non-profits who provide such work check your local area.)
I have heard two definitions of psychotherapy I’d like to consider. The first one was in a newsletter of my friend and colleague, Dr. Robin Dilley: “a journey into one’s self to help facilitate a deeper awareness about one’s self while developing a passion for living”. The second definition was provided by a psychologist working for a very large managed care firm in town: the process whereby change is made in symptoms that can be measured and that is a result of interaction between a therapist and a client. He went on to state that ideally this should be quick and not a journey on a path but rather a trip down a super highway. Hmm.
I suppose that there is truth in both definitions although those who know me can probably guess that I align myself much more along the lines of Dr. Dilley’s definition than that provided through managed care. Do we want to settle with getting rid of the stuffy nose or do we want to live a life that is challenging, health producing, and joyful? Now the truth is that our insurance policies don’t always pay for the second. After all, the insurance contract is not a personal growth policy but rather a contract that agrees to provide services to return a person to their prior level of functioning.
I urge you not to settle for your prior level of functioning. We only go through this life once, and it is our choice how we live it. To live at your prior level of functioning means that you don’t take the opportunity to grow spiritually, emotionally, mentally and psychologically. It means you do choose to stay where you are. If you are on the pathway then you are choosing to see the ground beneath your feet, smell the air and the flowers around you, hear the sounds of the birds and the animals that are scuttling about. If you choose the super highway you get a fast trip with no smells, few sights and the blare of the other vehicles and their horns blowing.
This year, you can choose the pathway. In her book, “The Invitation”, Oriah Mountain Dreamer speaks of the invitation to live, to grow, to experience life. Much of what she suggests is part of the psychotherapy adventure: “I want to know you can live with failure, yours and mine.” — It is as we face our failures and our successes with another that we learn how to live with them. Psychotherapy provides this opportunity. “I want to know if you can get up, after the night of grief and despair, weary and bruised to the bone, and do what needs to be done.” I would add, can you also stay in bed when you truly need to and take care of yourself? So often we take care of others but ignore ourselves.
Psychotherapy provides time and attention for our own needs and it is through taking time for oneself that one becomes available to others in a truly free and honest manner. Thus so, one can be seen in pain and not need to hide.
“I want to know if you will stand in the center of the fire with me and not shrink back” is a superb description of the group experience one can have through psychotherapy. The women’s groups I have had the privilege of facilitating have born out women choosing to stand in the fire with others and bearing testimony to the pain and the growth.
“I want to know if you can be alone with yourself and if you truly like the company you keep in the empty moments”. Ah, the most profound and deeply felt successful therapeutic experience will allow you to say “YES” to this experience.
I would invite those of you currently doing your own therapy to examine your journaling, your heart, your soul to see if you are walking on the path or whether you’ve stopped to enjoy a piece of the scenery. Is it time to move on? Take that next step? Then ask your therapist for assistance with this. If you have been considering taking such a hike, I invite you to call and schedule an appointment with me. If you are already walking down this pathway, enjoy the walk and know it will lead you to further peace, further ability to stand in the fire, and deeper, more meaningful life experiences. As Oriah Mountain Dreamer says, “I want to know if you will risk looking like a fool for love, for your dream, for the adventure of being alive.”
As I reflect on my summer, and on what the next 3 months will bring, I want to move through the last quarter of the year peacefully. There are changes that always come in the fall; although schedules get back to normal in September with all back in school it is quickly followed by holiday time and the schedule that gets even busier than normal. And yet autumn is my favorite time of year, by far. I enjoy the hope of spring, the relaxation of summer, the meditation and new beginnings of winter. But fall is when my heart and being are calmest, the feel of the season flows deeply in my being, and the smells, sounds, and sights are most meaningful and enjoyable to me. Fall is home, it’s family, it’s love. Spiritually it’s a time of balancing light and dark, letting go, and deeper understanding that nothing is permanent. Think about nature: we are moving to more balance between sun and darkness, the leaves are falling from the trees, and we learn that even what we enjoy in the summer flowers and play must end as we move forward.
As we face the changes in the season (granted, more slowly in Arizona), it’s a time to take stock. What are you holding onto that might be better let go of in your life? In speaking of letting go recently with someone I noted that we often think of it as a one-time action, like letting go of a balloon. While letting go is actually more of a process when it comes to the psychological and spiritual realms. When a loved one dies, for example, there are twists and turns in letting go of the person as they were here, and adjusting our life patterns accordingly. Or when we leave a career, it’s an action of walking out the door the last time, but we still must integrate into our lives the new career or job or retirement. There is more than the one moment in time.
What are you in the process of letting go of? How are you being asked to recognize the impermanence of something in life? Where is balance off in your life?
Here’s a simple journaling exercise to do around this topic:
Consider and write down your answers to the above questions. Or, if writing isn’t your thing, draw a picture to represent it.
Include in your writing, or picture, words and colors and shapes to represent how you feel about this change or loss.
Next, write or draw a picture to represent the ways in which this release might be beneficial to you.
Find an object to represent this change you are moving through, this period or experience or person or whatever it is that you must let go of in your life.
Finally, put this object in a meaningful place to remind you of the letting go you are in the process of. Let this encourage you to allow this to happen a moment at a time, a day at a time. It takes time for a leaf to fall, allow yourself time to let go of the leaf in your life.
I believe if we face this fall with such action, and using our spiritual resources to encourage and help us to take the steps needed in letting go, we will reach winter in December and be ready for the new beginnings of January. Don’t rush this fall. Inhale the pumpkin and cinnamon smells, enjoy the early morning or evening walks that are a little cooler, decorate a part of your home with fall leaves, pumpkins, or corn husks, and spend some time each day breathing in the depth and wisdom in the letting go. And as you do so, remember:
Autumn . . . makes a double demand.
It asks that we prepare for the future–that we be wise in the ways of garnering and keeping. But it also asks that we learn to let go–to acknowledge the beauty of sparseness.
by Bonaro Overstreet