Real Life; Real Challenges

Facts and Misdirection: Gun Violence and Mental Illness

gail louise Real Life; Real Challenges

I wanted to write an introduction on the criminalization of mental illness in my February posting. But there has been so much misinformation about the relationship of mental illness and gun violence in mass shootings that I am compelled to write to set the record straight. Here are the highlights of the true story on gun violence by people with mental illness.

The truth is that guns kill people and like it or not, we need effective gun control here in the US.  Focusing on people with mental illness as villains keeps us from tackling that fact, which is unpopular. Those for gun control know that we are up against the NRA and the politicians who kowtow to them.

According to research and experts on mental illness, as gathered and reported in the New York Times February 16th:

While gun violence experts have said that barring sales to people who are deemed dangerous by mental health providers could help prevent mass shootings, several more measures —including banning assault weapons and barring sales to convicted violent criminals—are more effective.

The Times also reported that Americans do not appear to have more mental health problems than other developed nations of comparable size, nations which experience far fewer mass shootings.

A 2016 study estimated that just 4 percent of violence is associated with serious mental illness alone. (National Institutes of Mental Health, National Institute of Health.)  Here is the conclusion of the study: ”Evidence is clear that the large majority of people with mental disorders do not engage in violence against others, and that most violent behavior is due to factors other than mental illness.”

A 2015 study found that less than 5 percent of gun-related killings in the US between 2001 and 2010 were committed by people with a diagnosis of mental illness.

So let’s stop being side-tracked by mental illness. Focus on the tough issue of gun control. Take on the protectors of the NRA!

Amen.

I Have Long Been Concerned …

gail louise Beyond Recovery to Healing, Real Life; Real Challenges, Shame

I have long been concerned with people who have mental illness and need care, but don’t recognize the need for treatment. Civil commitment (involuntary psychiatric care) can result if the circumstances dictate. But such involuntary care is controversial. Indeed, I have been conflicted about it for many years.

A personal experience has made me examine the issues involved with civil commitment square-on.  My father had involuntary psychiatric care when he was committed to a mental hospital in the 1950s. He always spoke negatively of the experience with feelings of anger. He was dangerous to himself at the time, threatening to shoot himself with a shotgun. One thing is clear however, as episodes of major depression reoccurred over the 1960’s, 70’s, and so on, he never sought help. He relapsed, got more depressed and Instead of getting care and treatment, he would attempt to take his own life. Surviving these suicide attempts, he would cooperate with the offered mental health care…. for a while.

In the 1950s, it was weak to be mentally ill and weak to be treated. I have always wondered whether the experience of forced care, of involuntary care, hurt and shamed my father so much that it clouded his otherwise good judgment.  Did it, finally, interfere with Dad’s asking for more help when needed?

To help me grapple with the issues, I’ve just completed reading the  book, “Committed, The Battle Over Involuntary Psychiatric Care,” written by Dinah Miller and Annette Hanson.(2016) Both writers are physicians.

In their research and writing, Miller and Hanson sought to refocus mental health professionals and others to consider this possibility: “Involuntary psychiatric care may be damaging. It may never be appreciated and the fear of forced care may prevent people from seeking help.”

The book presents a rounded picture of involuntary care. (Many times only one side of the story is featured.) I appreciated the fair handedness with which the authors addressed the issue. They interviewed former patients who had been helped as well as those who had not been helped by the process.

One of the biggest take home messages I learned from the book, was that even people who had been committed and HAD been helped found the experience to be traumatic. That was troubling to learn. Active mental illness itself is traumatic. We are talking about people living enduring a double trauma .

Hanson and Miller made the following recommendations:

  1. Encourage people with psychiatric disabilities to prepare an advanced directive. In the document it is possible to specify which medications are preferred, which facility one is to be admitted to, and even who should care for the person’s children during a hospitalization.
  2. Train inpatient and emergency room staff/personnel in the use of verbal de-escalation techniques.
  3. Crisis intervention training (CIT) should be mandatory and routine for all correctional officers and all state and city police forces. (Currently, these trainings are limited to a handpicked or volunteer teams of specialized officers in some locations.)
  4. Handcuffing patients who are brought to hospital by police should NOT be a standard practice..
  5. Support creation of mental health courts and pretrial diversion services to shorten incarceration times pending trial and to tie a defendant closely to needed community services.
  6. Expand use of mobile treatment teams, assertive community outreach, crisis centers, peer support services, patient directed initiatives, and a variety of housing options.
  7. Suicide hotlines should be made available to everyone and widely publicized. (Hotlines are available now but patients/clinicians are often unaware of them.)
  8. Increase efforts to detect serious mental illness in the early stages. Specifically: more training of primary care physicians and other non-psychiatrists so there is better recognition of when referrals should be made to psychiatrists. If mental disorders were recognized and treated earlier, involuntary treatment could often be avoided.

In 2018, we’ll examine some of these issues.

I appreciate your readership,

GL

On Forgiveness, part two

gail louise Learning to Hope, Real Life; Real Challenges , , ,

A lot has happened since I last posted. Joyous holidays, the battle with a depressive episode—- still lingering and touched mightily by recent family affairs, progress with workouts under direction of my personal trainer, and the severe illness and death January 31st of my beloved younger sister, Ellie. She was the first in our family of six brothers and sisters to pass. I miss her greatly.

I have been studying forgiveness and the power of forgiveness in one’s life for some time now. Indeed, I have an essay On Forgiveness on this website already devoted to the topic.   In that essay, I wrote that “forgiveness does not mean forgetting. And yet it is more than tolerating. I was startled to read that forgiveness is beyond letting go of negatives, such as anger; it is also the inclusion of positive gift-like qualities such as compassion, generosity, and even love.”

This posting is part two of my growth in understanding of this most powerful act of human reconciliation.

*   *    *    *    *    *    *

I’ve now made a little dent into the literature of forgiveness, and have learned two major facts: One, there is research to show that physical and mental health benefits come from forgiving and Two, that forgiving, learning forgiveness, is hard work. I’ll write about those benefits in this posting. The hard work of forgiveness will be addressed in future posts.

“NOT Forgiving — nursing a grudge—is so caustic”, reports Fred Luskin, PhD, a health psychologist at Stanford University and author of Forgive for Good: A Proven Prescription for Health and Happiness. “It raises your blood pressure, depletes immune function, makes you more depressed and causes enormous physical stress to the whole body.”  In this book, citing research and teaching by vivid example, Mr. Luskin shows that people who are forgiving tend to have not only less stress but also better relationships, fewer general health problems and lower incidences of the most serious illnesses like depression, heart disease, stroke and cancer.

So how does one forgive? Is it a process one can learn, something each of us might do, or a work for the saints among us only?

Forgiveness can be hard work. Robert Enright, PhD, the author of Eight Keys to Forgiveness, says: “….in its essence forgiveness is not something we do to just help ourselves. It is not something about you or done for you. It is something you extend toward another person, because you recognize, over time, that it is the best response to the situation.”  And then, Professor Enright continues:  “Working on forgiveness can help us increase our self-esteem and give us a sense of inner strength and safety. It can reverse the lies that we often tell ourselves when someone has hurt us deeply—lies like, I am defeated or I’m not worthy. Forgiveness can heal us and allow us to move on in life with meaning and purpose. Forgiveness matters and we will be its primary beneficiary.”

I’ll end this post with a brief outline of forgiveness’ process.

First, accept that something happened in opposition to your wishes and you can’t change it. What can you do to suffer less?  Then, look at your involvement with this person—simplify it.

Second, try to move past the hurt and go on. Perhaps the steps suggested below will help you progress.

  • Acknowledge that you have been hurt. Talk to a few close friends to explore your feelings and obtain a sense of perspective.
  • Make a commitment to forgiveness.
  • Start with small things. Start by trying to forgive modest slights by people who have done you harm in life.
  • Recognize your “grievance stories” and gradually deemphasize and replace them by thinking of your own positive goals.
  • Focus on facts rather than emotions. Attempt to understand what led the person to the hurtful behavior. Bless you.
  • Try not to take things personally. Many offenses were not deliberately targeted to hurt you personally, but were byproducts of other people’s own selfish goals.
  • Forgive those you love. The most important people to forgive are those close to us.

( Find these steps in Terrie Heinrich Rizzo’s posting The Healing Power of Forgiveness, 2006 )

Christmas 2015

gail louise Real Life; Real Challenges ,

Living with Major Recurrent Depression at the Christmas Holiday Season

It crept up. Tearing up, opening floodgates of sadness set amid the bright lights and cheer of family and, yes, even happy memories. Heavy sighs out of nowhere. Head bowed down in folded arms. Troubling thoughts, felt perhaps amid Christmas chaos and exuberance. Hiding the fears and sadness; not wanting what seemed to be another episode of depression to reoccur. Not again, not this holiday. No, not to me and especially not …… to my family.

I’m lucky now. I understand and my family understands recurrent major depression. We pretty much go on as usual at Christmas time, depending on my comfort level and the family’s needs. No one puts the pressure on! That is, the pressure to perform, the pressure to act happy and to make others feel happy. There is a calm unchallenging acceptance of the depression I am experiencing. Flowers, good food, hugs, prayers, kind humor all help. But best of all is that quiet acceptance. No one tries to change me. I can partake in as much of the holiday festivities as I am able with unfettered support. I love my family and they love and unconditionally support me, warts and all. I am lucky.

I am very grateful and thankful.

It is December 27th and our family Christmas celebration is Saturday, January 2nd. As grandma and grandpa, Jim and I will host the special day. Because my depression is peaking in advance, (I think), my husband and I can plan how to lighten the day to make it transpire more easily. I’ll be wrapping the gifts today while listening to the Packers game on the radio (and wearing a number #3 Seahawks football jersey!). What food can be prepared ahead of Saturday will be so done. I’m going to try to replicate my mother’s famous and delicious escalloped potato recipe to serve them with the baked ham. I’ll ask our adult children to bring the appetizers. Whole Foods Market will furnish the salad, rolls and cookies. I’ll make the pies ahead: Tradition plus convenience!!!

Jim is pretty special as he does the cleaning and the outdoor decorations. Together we choose seasonal music we love to play in background while we work and while we entertain.

I feel much better already. It is no coincidence that I do feel better, that is, less helpless and depressed than I did an hour ago. A lesson learned, taking action to counter depression is much better than stewing about it. Writing this has put my mind to use in a very productive way. I like to think that balance was restored to those neurotransmitters by the creative process.

If someone you love suffers from depression during the holidays, please be respectful. Together find out what would work the best for the holiday celebrating that you wish to do.

Thanks and Happy New Year!

On Forgiveness

gail louise Learning to Hope, Real Life; Real Challenges , , ,

One aspect of my illness that I’ve struggled with for many years is forgiveness – forgiving the people, events, and even the institutions where I have felt anger, humiliation and pain.

Why do I struggle and feel so strongly about this? A level playing field must be found among friends, family and providers to nurture communication, comfort and a new beginning. Imagine setting aside blame while acknowledging responsibility. Think of deeds being forgiven and the tangled web of the past losing its ability to shape our future.

Just what deeds am I thinking of forgiving? Sadly, they are all real, and the ability to forgive them will not come easily. People with mental illness many have experienced being abandoned when ill, or we may remember restraints and seclusion. We may have experienced involuntary commitment, deep humiliation, or poor care resulting in severe symptoms that led to years of mistrust toward caregivers. For many family members, deeds that need forgiving may include their relative’s antagonistic behavior, violent acts or threats of violence, sexual infidelities and indiscretions, verbal abuse, or unreasonable demands or careless spending sprees which left the family in debt.

I have a thoughtful book of essays that is helping me sort through many questions about forgiveness. What is forgiveness between us? Why forgive? And where to begin? Exploring Forgiveness, edited by Robert Enright and Joanna North, contains a forward by Archbishop Desmond Tutu of South Africa that states:

“Forgiveness is taking seriously the awfulness of what has happened when you are treated unfairly. It is opening the door for the other person to begin again. Without forgiveness, resentment builds in us, a resentment which turns into hostility and anger. Hatred eats away at our well being.”

What I am learning is that forgiveness is not pretending that things are other than they are. It is not cheap. Robert Enright and others write that forgiveness does not mean forgetting. And yet it is more than tolerating. I was startled to read that forgiveness is beyond letting go of negatives, such as anger; it is also the inclusion of positive gift-like qualities such as compassion, generosity, and even love. Joanna North insists that forgiveness is hard work, and that:

“Forgiveness is not something that we do for ourselves alone, but something that we give or offer to another. The forgiving response is outward-looking and other-directed; it is supposed to make a difference to the wrongdoer as well as to ourselves, and it makes a difference in how we interact with the wrongdoer and with others.”

Learning how to forgive includes understanding both the perspective of the injured party and that of the wrongdoer. When we begin to separate the wrongdoer from the wrong which has been committed; we also begin to see the person who has committed a particular wrong. Healing can then occur to the person injured and to the relations between the two parties.

It is my hope that in the year to come we can learn, as people with mental illnesses and as family members, to speak not only of understanding and empathizing with the other, but also to explore issues of forgiveness. “Without forgiveness there is no future,” Bishop Tutu declared.

Let us create a good future.

About Partnerships … thinking about enhancing care and support within them

gail louise Beyond Recovery to Healing, Learning to Hope, MajorDepression, On Support, Real Life; Real Challenges , , , , , , , , , , , , , , , ,

46 years. That’s how long my husband and I have been married.  And it was 50 years ago when we first dated, a sweet memory today.  Jim has always been the very kindest, most fun and interesting man I know.  Our kindness toward one another is a key to our relationship, especially when the water wasn’t so smooth due to effects of mental illness on my thoughts, feelings and behaviors.

My partnership is our marriage.   It is the most supportive aspect of our lives together.  It is, it turns out, quite a bit stronger than mental illness.  Yours may be another partnership – marriage is not the required word, but supportive is.  How do we support our partner without being overwhelmed?  How can we be supported without having to feel we’re a burden?  I don’t have all the answers, but we do have some suggestions here based on our experience.

To Tell or Not To Tell – Discussing self-disclosure

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I’ve been reading summaries of research on stigma-busting that lay it on the line. Publishing facts about mental illness, as for example, how treatment helps people live successfully, does not assist in alleviating stigma. Highlighting the stories of people with mental illness who have achieved significant accomplishment, does not curb stigma either. What does work is for ordinary people to get to know ordinary people with mental illness personally! For stigma-busting and awareness and acceptance of mental illness to happen, individuals with mental illness need to be able to safely self-disclose or identify that they have received mental health treatment. Both peoples need to get acquainted and know each other. Nothing breaks down barriers like good communication. Acceptance and trust can be built up by direct experience of the other. But someone has to take the first step. Will it be you? Should it be?

I want to talk about the role of self-disclosure in advocating for people with mental illness. I am hoping to reach out to you especially if you have a mental illness yourself or are related to someone who lives with mental illness. [Continue reading the article under Real Life; Real Challenges]

From Shame – Moving Toward Healing

gail louise Beyond Recovery to Healing, Brene Brown, PhD, MajorDepression, Real Life; Real Challenges, Shame , , , , , , , ,

During the recent half decade I have been so fortunate, as Brene Brown* describes, to have completed the journey from the “not being good enough” shame struggle to believing and knowing “who I am is enough.” Shame from having mental illness has left me. Shame from being related to other people with mental illness has left me also. I have been graced.

I only recently realized I had made this journey. I understand now how much shame – and my growing resilience in the face of shame – had influenced the course and depth of my mental illness through the years.

It didn’t happen, this journey to being shame-free, automatically. I happened to want to do what is recommended for building shame resilience for other reasons; I wanted to help others cope with mental illness. Often, as part of my work, I told my story of family and personal mental illness. I didn’t realize then, twenty five years ago, how much nurturance I would receive from assisting others.  My story of the power of shame and how I arrived at healing from shame follows …. [Read the Full Article]

 

*   Brene Brown, PhD, LMSW   Audio lecture, 2012: Men, Women & Worthiness, The experience of Shame and the Power of Being Enough.  Available on CD at Soundstrue.com  PO Box 8010/Boulder CO  80306.

Real Depression; Real Men: “Because you have to deal with it. It doesn’t just go away.”

gail louise MajorDepression, On Suicide, On Support, Real Life; Real Challenges, These Illnesses , , , , , , ,

This post’s title is taken from a video clip “Real Men, Real Depression” featuring Patrick McCathern, 1st Sergeant, US Air Force, Retired, and available here on The National Institute of Mental Health’s website.

Depression in Men often manifests itself differently. What ails men may not be recognized by them or their family or friends as depression. It may be mistaken as a sleeping problem or a digestive problem … or a character flaw. When a man has depression he has trouble with everyday life and loses interest in anything for weeks at a time.) He may be irritable, feel very tired, and lose interest in his work, family, or hobbies.

The tricky part of depression in men: They may not want to recognize, talk about, or acknowledge “it” or how they are feeling. (Please see my entry on Male Depression under These Illnesses in the menu section of my website for life experiences with my father’s depression.)

The quiet truth about depression is that it is very, very painful, and unending. And although women with depression more often attempt suicide, men are more likely to die by suicide.

HOW CAN I HELP A MAN WHO IS DEPRESSED? (Recommendations from The National Institute of Mental Health):

  • Offer him support, understanding and encouragement. Be patient.
  • Talk to him, but be sure to listen carefully.
  • Never ignore comments about suicide, and report them to his therapist or doctor.
  • Invite him out for walks, outings and other activities. If he says no, keep trying, but don’t push.
  • Encourage him to report any concerns about medications to his health care provider.
  • Ensure that he get to his doctor’s appointments.
  • Remind him that with time and treatment, the depression will lift.

MEN WITH DEPRESSION ARE AT RISK FOR SUICIDE. IF YOU, OR SOMEONE YOU KNOW IS IN CRISIS GET HELP QUICKLY.

Call your doctor or 911 for emergency services.

Call the toll-free, 24-hour lifeline, National Suicide Prevention Lifeline

1-800-273-TALK (1-800-273-8255)                  TTY: 1-800-799-4TTY (1-800-799-4889

People with mental illness want to succeed as parents

gail louise Chronic/SeriousMental_Illness, MajorDepression, Parenting, Real Life; Real Challenges , ,

Parenting. I know that when my son was born, and I had serious depression, I was overwhelmed by the thought of taking care of a newborn, the rest of the family, the home, meals, …..the whole shebang. No one in my health care team thought of arranging for assistance for me or even meeting with me. My extended family assumed once the baby was born the depression would correct itself and, with the joy of the new baby, I would manage fine.

Actually the terror of my anxiety level worsened. I was sure I would do things wrong. The depression worsened.

My children are now ages 35 and 40. They are well and we are doing well with each other. I couldn’t be more blessed as a parent. In fact, now I am a Grandparent to two children, a boy and girl who are 5 and 9. Their birthdays are coming up and celebrating grandchildren’s birthdays  is an awful lot of fun!

I’ll discuss some things I would have done differently when my children were born in a second post.