Holding Your Light

At first glance, the American celebration of Veteran’s Day may not seem to have much in common with the Hindu celebration of Diwali.  But, as Diwali, a celebration of light triumphing over darkness,  overlaps with Veteran’s Day this year, I have been thinking about the fact that many people who join the military do so in order to stand against darkness in the world (the cost of that is a story for another day).  I see these two celebrations, which seem so distant from one another on the surface, and I see the connecting thread of choosing to hold a light against the darkness.

I believe that each of us has the choice and the chance to hold our light against the darkness.  That light may be in the small choices that we make.  We can offer a smile to a stranger, or hold a door.  We can remember that everyone carries their own burden and choose to be kind.

I know that many of my clients struggle with the idea of holding a light for others, because they feel that they are barely holding on to their own light–or because others have actively pushed them towards darkness.  The idea of sharing our light when we feel as though it is scarce is a challenging one.  It requires us to trust that light shared isn’t light lost.  And when you feel kicked around–by your health, or your losses, or relationship pains–trust of any sort is a big ask.

Here is the truth that I have experienced.  Sharing light has never left me in the dark.  In those moments when I felt the most broken, I shared my brokenness.  That was all I had to share, but it connected for others. Our pain has a light too–when we share it, others can see and know that they are not alone.

So, today, I am inviting you to share your light.  It might be little and broken, but you have light. Your light makes a difference.  And our lights together can push back the darkness.

The Balancing Act of “Being Safe”

One of pieces of my practice mission is to create and hold safe space for my clients.

Coming to therapy is a big step. And it isn’t one that people tend to take unless they are facing some pretty significant disruption or pain. By the time someone is sitting down with me, it isn’t unusual for them to have been through a lot of difficult stuff. They have faced hurt or betrayal in their relationships, or they have endured significant loss. For some of my clients, those patterns of loss and hurt have repeated multiple times throughout their lives.

Read more here.

Re-Discovering Wonder

This is a not-so fabulous picture of a fraction of the exterior structure to climb and explore at the City Museum (and yes, that is an actual airplane–go ahead, check out their website, they have way better pictures than I do) in St. Louis, MO. I visited City Museum for the first time a few weeks ago, and I have struggled to describe it ever since. The best description that I’ve come up with is this: part architectural salvage, part art project, part jungle gym, part museum complete with bug specimens, part maze, part full-size Chutes & Ladders game–all amazing. I heard another visitor say, “Every time I come here, I can’t even believe that something like this exists.”

Since my visit, I haven’t been able to shake the sense of wonder that City Museum inspires. Wonder at the creative vision to begin such a place initially. Wonder at the vast amounts of time that have been invested in every corner of the space. Wonder at the improbability of the whole thing.

That has served as a reminder to me that we need to be in touch with our sense of wonder. Between the day-to-day requirements of getting through life, and the barrage of upsetting or infuriating news that we are bombarded with, it is easy to begin to feel jaded, bored, or hopeless.

Places like the City Museum, spaces where a wild, wacky, creative, larger-than-life spirit has been given free reign, function a lot like the mountains or the ocean do for me: as “wonder generators.” After I’ve been in contact with these kinds of spaces, I notice that I feel re-energized and more ready to re-engage with my daily tasks. Wonder seems to be an antidote to the anxiety and other struggles that accumulate in my daily life.

So, this week, I’m inviting you to find a “wonder-generator” of your own. If you can’t work in a trip to St. Louis, then maybe your local art gallery or city park will do the trick.

If you feel inspired to share your “wonder-generators” in the comments, you will be welcome. If you have lost touch with your sense of wonder and aren’t sure how to get it back, feel free to contact me directly for support.

Honoring Vulnerability

This year, I had the chance to participate in two fantastic panels at Stanford’s Medicine X conference. You can see the video of the panel on chronic illness and depression here://www.youtube-nocookie.com/embed/6qn7EGMzggQ?rel=0
The video for the second panel will be available later this fall. The great thing about panels is that you get an authentic discussion, a give and take that is really valuable. The tough thing about panels is that you often think about the things you wish you had said later on (maybe that’s just me).

So, this post is about those things. The things I wish I had said–in both panels. Because at the heart of all of the work I do with my clients, the advocacy I do online, and the writing I share in this blog is this conviction: [tbpquotable]We are all unique, fascinating, fallible, fragile, resilient human beings.[/tbpquotable] In spite of marketing that suggests that we should never be sad, never feel pain, never experience illness-each of those experiences is a part of being human. In spite of a culture that demands invulnerability and infallibility, we are both vulnerable and prone to mistakes.

So, I wish I had said these things:

• We need to give our doctors and other health care providers permission to experience and claim their own pain, fear, sadness and vulnerability.
• We need to talk about the amazing learning potential in our mistakes.
• We need safe space (in our heads, in our workplaces, in our training environments) to have moments of vulnerability.
• We need to counter shame and unrealistic expectations.
• We need to challenge the damaging perfectionism that pervades our healthcare system.
• We need to respect the courage it takes to admit when you are hurting, or scared, or depressed, or anxious.
• We need to support one another’s humanity more and better.

The statement I made that was tweeted the most was about the need to decrease stigma around depression and other brain health struggles–both in medical patients and in medical providers. In order to decrease stigma, we need to increase our understanding that vulnerability is a fundamental human experience AND our compassion and empathy for the pain and difficulty that vulnerability can bring.

I’ve been having a conversation about vulnerability with the #MedPsych tweetchat community over the past week. We’re continuing that conversation tonight at 9:30 pm ET. You are welcome to join us.

Being Brave

One of the things I love about psychology is the chance to routinely sit with really brave people. These aren’t necessarily the folks who do dangerous jobs or who would be recognized as “brave” outside of therapy. In fact, many of my clients believe that they are ordinary, or broken in some critical way. But the truth is, we are all broken. Most of us who have lived long enough have been broken in some critical way at least a few times throughout our lives. I know I have. Being brave isn’t about painting your face blue or rushing into battle.

Being brave, at least in my book, is allowing yourself to sit down and face your own broken pieces. To come to terms with the pain that you have lived through–or are living through. It means having the courage to acknowledge that, alongside your brokenness, you also have some fantastic qualities, things that make you interesting, worthy and meaningful in the world.

Because we live in a culture that tells us we aren’t all of those things. In fact, our society likes to celebrate someone interesting and then tear them down when their brokenness & humanity show up, along with their talent. So, when you take the time to face your pain, and then to discover the strength underneath it, you are being courageous and counter-cultural.

Being brave includes being willing to cry, or shout, or question. It isn’t some fake front. It means standing up and owning your imperfections, acknowledging your struggle, and still finding joy and making beauty anyway.

Every person who chooses therapy is meeting my definition of bravery, just by walking in the door. Because the work that we do here is hard. It can get messy. And it’s not how you normally interact with people. (Who else do you know who buys her tissue by the case?) Coming here is an act of courage. Imagine what else you can do, now that you’ve gotten in touch with your inner brave person!

How have you been brave recently? What do you want help in finding your brave for? Feel free to share in the comments. Oh, and for some bravery inspiration, here is Sara Bareilles performing her fabulous song “Brave.”//www.youtube-nocookie.com/embed/QUQsqBqxoR4?rel=0

You can be amazing
You can turn a phrase into a weapon or a drug
You can be the outcast
Or be the backlash of somebody’s lack of love
Or you can start speaking up

Nothing’s gonna hurt you the way that words do
When they settle ‘neath your skin
Kept on the inside and no sunlight
Sometimes a shadow wins
But I wonder what would happen if you

Say what you wanna say
And let the words fall out
Honestly I wanna see you be brave
With what you want to say
And let the words fall out
Honestly I wanna see you be brave — Sara Bareilles

Play Outside: An Earth Day Reflection

I don’t normally do a great job of keeping up with all the various holidays and points of celebration. But Earth Day is near and dear to my heart. And not for any deep political reason. Earth Day is special to me because it reminds us to look outside and celebrate the amazing planet that we live on.

I am an outside girl. Even as a kid who just wanted to be left alone with my books, I wanted to be left alone with my books while I was perched in the crook of a big old tree. Some of that is a reflection of many family summers spent camping and playing outside. Our vacations almost always included (still do, actually) lots of hiking and visits to beautiful parks and trails.

There has been plenty written about the possibility that our kids might be experiencing an over-scheduled, over-stimulated, electronically padded nature deprivation.

I think that adults are at risk of nature deprivation too. We all need the experience of fresh air, or spring flowers, or the sound of wind in the trees. It touches something deep inside us. For me, it fills those places that are longing for some peace and quiet.

I’m going to keep this post short & sweet today. My Earth Day gift to you is an invitation: get outside! Put your toes in the grass, plant a seed, walk in the park, watch the birds, smell a hyacinth. . .you get to pick, just enjoy a few moments of connection with nature today. I bet you’ll feel a tiny bit renewed too.

 

A Day for Connection?

What stories could you share?

Earlier this month, I shared a post that was inspired by a StoryCorps story. The StoryCorps project has been active for ten years now. In addition to their mobile recording studios that travel the country, StoryCorps has also created what they call the “National Day of Listening.” The goal of the National Day of Listening is to remind us that anyone can be a curator of history. Today, you are invited to sit down with someone who matters to you and have an informal interview with that person.

The tagline on the National Day of Listening’s website is “Ask great questions. Share great stories.” I have not had the chance to actually be in a StoryCorps booth, but I do come from a family of wonderful storytellers. And while we might be in the “never let the truth get in the way of a good story,” variety, our stories are still an important way that our family history is remembered and shared.

These stories ground us. They tell about the things that matter most, or the things that were the funniest. They remind us that we aren’t alone in the world.

I’ve written before about stories, especially in the context of patient stories. And when I hear about projects like the National Day of Listening, I find myself hoping that many people will choose to stop in the middle of the holiday rushing about and sit down to share a story.

Stories allow you to connect and to see new sides of the people in your life. Stories allow room for healing and change. And they create a chance to make space for engaging with one another in ways that are outside of our normal habits and routines. For example, I learned last night that my dad, who was an avid reptile fan as a kid, used to leash his pet lizard to the Christmas tree, where it would proceed to eat the popcorn and cranberry strings. This gave me a brand new perspective on my grandmother–I had to reconcile her formidably clean house with pictures of leashed lizards.

I know that this is a busy, busy weekend for folks. I still have my big holiday meals to prep for myself. But I hope you take the invitation offered by the National Day of Listening project. I hope that you reach out to someone who matters to you and ask for a story. And maybe share a story of your own. You don’t need to record it, or write it down. Just listen to one another.

Not sure how to get the conversation started? The National Day of Listening has suggested questions on their website.

Want to share a favorite story here? Go for it!

What Hands do You Hold?

“I want you to know that if you need me to hold your hand, I’m there.”–Paquita Williams

I listen to NPR–a lot. I know, I know, that’s not really a shock, since I use NPR references in lots of my posts as a way to back up the fact that I’m essentially a nerd. And on Friday mornings, NPR works with the StoryCorps project, highlighting a story every week. This week, the story happened to be about a friendship that has developed between a subway rider and a subway conductor in New York. The story is only two and a half minutes long, and as I listened, I was struck by the statement I used in the introduction.

Conductor Paquita Williams talked about a moment in her own life where she didn’t get the compassion and support she was hoping for. There was a moment of choice for Ms. Williams. She could have chosen to dwell on the failure of the other person. Instead, she chose to use that moment to guide her own behavior and responses, placing upon herself the responsibility of making sure that those around her receive the compassion she didn’t.

This is a moment that all of us will face (often more than once). We will be confronted by insecurity, selfishness, grouchiness, thoughtlessness or just plain mean behavior. We can choose to let that negativity in. We can allow it to shape how we think about ourselves. We can allow it to trickle forward into how we respond to others. Or we can do as Paquita Williams has done.

We can choose to offer forgiveness to the person who didn’t or couldn’t meet our need. And this isn’t a turn-the-other cheek and allow bad behavior to continue kind of forgiveness. This kind of forgiveness is an internal experience of accepting that someone else’s bad behavior is not our fault or responsibility. It unhooks our self-worth from their behavior. This forgiveness allows others to fail because they are human, not because they are responding to some flaw or lack inside of us.

And then we can choose to use that moment of our unmet need to remind us that those around us need contact and compassion too. That even our small gestures, like making eye contact, offering a smile, offering a hand–those have the power to change the course of someone’s day. When we reach outside of the insecurity, sadness, loneliness, heartbreak, stress or frustration that we are experiencing and allow ourselves to connect with others around us, we can change the world. One hand at a time.

Please know that when I’m writing this, I’m not trying to minimize the pain you may be experiencing. I know that pain is real, and heavy. Instead, I hope that Paquita Williams reminds you, as she reminded me, that we can all reach out a hand. That we don’t lose that power, even in our moments of darkness.

Who has reached out a hand to you? When did you get to offer that support? Please share.

Empowered Patients, Engaged Physicians: Bridging the Patient-Physician Divide

I am seeing a theme emerge in our discussions about healthcare. I hear it in my office; during the Medicine X 2013 conference; in a comment on my last post about my experiences at Medicine X; in the #patientchat TweetChat this week; in tweets that I have seen for the cHealth 2013 conference and the British Columbia Kidney Days. The theme is this–that empowered patients often feel as though they are engaged in a struggle with their medical providers to be taken seriously, to be treated as a member of the team, to be heard. And I have had my own patient experiences that have shown me that this isn’t just a patient feeling–it is an actual experience.

[tbpquotable]In all too many situations, it is an accurate perception that patients are rushed, dismissed, and discouraged from speaking up.[/tbpquotable] Patients have spent too much time watching conferences and summits in which the patient experience is represented by someone without a primary patient identity.

I agree with the frustrations that I have heard expressed. I have lived them. I believe passionately that patient voices should be at the core of professional and academic conferences. If we aren’t talking to our patients (or, in tech-terms, the end user), we are talking in an echo chamber. We need to be reminded of why we chose these helping professions. We need to hear where our hopes for good care are falling short of patients’ needs. We need to hear about the small things that work.

I have to admit, though, I am a little concerned about the divisiveness that I have heard arise. So many of my face-to-face clients have had difficult experiences as patients. They have complex chronic conditions that don’t submit easily to a diagnostic label. They have had to struggle to be heard. I want that struggle recognized. But the relationship-builder in me doesn’t want the struggle to be recognized by casting patients and physicians as opponents. I want to see relationships like the one between Michael Seres and Marion O’Connor (check out the great video below) recognized as normal, instead of extraordinary.

I want the many passionate, caring, engaged physicians to be connected with the many passionate, caring empowered patients in a proactive, cooperative way. I want to think and talk about how we can connect, and build bridges, and encourage one another when we hit obstacles. I think conferences like Medicine X, communities like the #BCSM Community, spaces like Talk About Health or WEGO Health, and chats like #patientchat are a wonderful start to that bridge.

I want to be part of the bridge. How about you? What else can we do? Where are the points of connection?

More Alike that Different–Redux

Another Medicine X-Inspired Reflection

For those of you reading who didn’t attend or follow Medicine X, and are ready for me to get back to my normal blog topics, I apologize. The experience of attending MedX was overwhelming and exciting and occasionally challenging–and I process those kinds of things by writing. But take heart, this post is both a reflection on things I learned at the conference and a reach back to something I have written about before–at the heart of things, we are more alike than we are different.

One of the things that I most appreciated about the three days of Medicine X was the deliberate effort to bring different identities and roles into contact with one another: patient with physician, designer with consumer, technology experts with technology users, academicians with practitioners. And one theme that I heard throughout the conference was a growing awareness that the experiences we share are deeper and broader than the experiences that distinguish us. Many patients, who had been accustomed to focusing on the communities of others who shared their diagnosis, noted that patients with other diagnoses seemed to be telling stories that felt closely parallel to their own. Physicians who had been firmly grounded in medical practice talked about learning about the power of good questions and close listening–key tools of mental health practitioners for decades. I could see patient’s eyes widen during one-on-one conversations and my panel when I brought up the point that, eventually, doctors are patients too.

And this reminded me of the summary I use to describe my practice: “help at the intersection of physical and mental heath.” Training models and insurance reimbursement have tried very hard to draw clear lines of separation between physical health and mental health. (If you’re not sure about this, just talk to anyone who has run into separate plan management, deductibles, and co-pays for “behavioral health.”) That separation has always felt artificial to me–and anyone who hangs out with me long enough will eventually hear me make a passionate argument for the fact that health is a big umbrella. And it doesn’t help anyone when we allow artificial separations to treat us like we are different.

We share common human experiences of joy, loss, excitement, struggle, achievement and pain–no matter what our job title or diagnostic category is. I love Dr. Daniel Siegel’s concept of interpersonal neurobiology, which he defines as this:

Interpersonal neurobiology is a field that draws on all branches of science – and now it even draws on other ways of knowing, like the arts, literature, and music, as well as the contemplative practices of meditation and even some insights from wisdom traditions and the contributions of religious practices, which are all about the process of being human. We try to learn, from all these different ways that people have been exploring, what it means to be human and to answer some fundamental questions. — Dr. Daniel Seigel

When I read things like this definition, I have a great deal of hope that we will do better and better at understanding that we are fundamentally more alike than different. I think this understanding is what will allow us to push forward and create better systems for health and health care. I think that respecting the wisdom and unique knowledge that we each bring to the table, while acknowledging our shared human experience, is what creates change. I saw some of this at Medicine X, and I hope to see more in the future.

What do you think? Is there something to this “more alike than different” track? Or am I missing a key concept?