Friday, December 31, 2010

10 Items Or Less -- Shedding And Keeping

Archetypes For The Turning Of The Year

For some people, New Years Day means the Rose Bowl.  For others, black-eyed peas.  For my mother, that was the day we were required to organize our clothes drawers.

Where did that come from?  You got me.  But it must be an archetypal response to the turning of the year.  Right now advertising is crowded with sales on organizational supplies.  If you don't know how to organize your sock drawer, surely there is one of those Dummies book to tell you how.

I just looked it up on Amazon.com.  Sure enough, here it is.

Responding, I suppose, to that archetypal imperative, I am currently recycling meeting agendas, staff reports, conference handouts and class notes, things I no longer need since I have become unemployed.

You know me.  Overboard is my middle name.  At 100.4 pounds and still shedding -- make that shredding now -- old checks with my social security number on them, I am well on the way to my goal for the week: to shed my weight in discarded paper.  I am not even counting paper clips and empty three ring binders. 

Benzos

The process is alternately liberating and anxiety-producing.  I dispose of old grudges, and then panic about what I might need after all.  I celebrate, and then I grieve.  I really did do a lot of good work.  And I left important things undone.

It is good that I refilled my prescriptions before I started this project.  Valium is my current best friend. 

Diets Are Hazardous To Your Health

I do not recommend shedding body weight as a New Year's resolution.  I say this every year, because it is one of the most common New Year's resolutions and it is wrong, wrong, wrong.  Dieting is the first step to gaining weight.  You know this.  You take this course every year and you flunk it every year.  When will you ever decide you have paid enough tuition for this lesson?

Yes, I know.  Having put the word diet in my blog, the mindless web crawlers will signal the advertising gods to place ads for weight loss programs on this page.  I do not endorse them.

I did lose weight a few years ago, which makes it thirty-five pounds easier to meet this week's goal.  I did not diet.  I repeat, I did not diet.  I changed the way I eat.  I changed my eating habits.  I still eat anything I want.  It's just the quantity and the frequency that changed.  I love my food.  I did not diet.

But this is not a dieting blog, and you can go searching for a better way to eat somewhere else.

This post is about shedding. 

Ten Items Or Less

My cognitive therapist is big on distraction.  So I watch a lot of movies.  A lot.  Many are movies that did not exist until they jumped off the library shelf at me.  A recent example was 10 Items Or Less.  Filmed in just fifteen days, it was an exercise in shedding all by itself.  It stars Morgan Freeman and Paz Vela, with Rhea Perlman and Danny DeVito in a drive by cameo.  And I do mean drive by.  They were on the set for all of fifteen minutes, during which time they asked for and received a couple of Starbucks lattes.  Then the director told them their lines.  Then they said them.  They never got out of their car.

So at one point Morgan Freeman, playing an actor, asks Paz Vela, playing a grocery clerk, If you could keep just ten items or less in your life, what would they be?  After she names her list, he names his.  That's eleven.  You just have to push it, she says.  This is the theme of her life in the express checkout lane, people who want eleven items when the sign says ten.

Later they change the exercise, If you could get rid of ten items or less in your life, what would they be?

Dinner Party New Year's Eve

I just got home from a dinner party with dear friends and we played that game, 10 Items Or Less.  We never got to the items we would get rid of.  The ones we would keep had so many stories behind them that we had to leave before we could finish the keepers so the restaurant could turn the table.

The right ten items can make a person rich enough, not only for a dinner party, but for a lifetime.

We will get to that other list at the next dinner party.

Ten Items Or Less

So that is my gift to you for the start of the new year, those two questions.  What ten items or less would you keep?  What ten or less would you discard?

Choose well.  You may not need wishes for the new year after all.  You may find you are already rich.


Winter sunrise by Stefan Mayrhofer, in the public domain 
shelves of file folders by Alex Gorzen, licensed under the
Cashier at Register by Young in Panama,  licensed under the

Thursday, December 23, 2010

Happy Christmas to my Readers



Feliz Navidad




ميلاد مجيد



圣诞快乐





С Рождеством Хрисовым




Vrolijk Kerstfeest



Feliz Natal





One Last Song -- Joy To The World
This one is signed, as well.

Friday, December 17, 2010

Holiday Shopping for Loonies and Normals Alike

Last year I got an earlier start with my efforts to help you purchase the perfect Chanukah/Kwanzaa/Christmas present.  Here are the links, one for your favorite loonie, the other your favorite normal.  The first is even diagnosis specific.  The most popular pick turned out to be a bluetooth phone for the one who talks back to his/her voices, but is trying to pass.

This year, regular readers know that I have been living and breathing gingerbread.  So this post, like my own shopping, comes late in the season -- Chanukah has passed us by.

Internet.  God bless the internet.

And what with last week's post on happiness fresh in my mind, this year's holiday shopping picks combine the two issues -- where to get what makes for true happiness on the internet.  No, really!

The Sources Of Happiness

Martin Seligman's Authentic Happiness identifies three major sources of happiness, pleasure, engagement and meaningfulness.  So here are suggestions to enhance all three for your favorite loonie or normal.

Let's address one issue first.  Life circumstances, beyond having the essentials, are not really that important an influence on the measure of ones happiness.  But poverty does matter.  If the one you love lives in poverty, go to Amazon.com's gift card section, where you can find gift cards for clothing stores, restaurants, general retail, entertainment and more.  Give us bread, but give us roses are lyrics of a working women's song from the early 20th century.  It's nice, when you are poor, to have the opportunity to choose which is the higher priority this week.

Pleasure

Well, yes.  Feeling good makes you feel good. 

On the other hand, have you seen that bumper sticker, The one who dies with the most toys wins?  That bumper sticker is an example of irony.  I hope it is an example of irony.  I am sure the person who came up with it meant it ironically.  It is possible that the person on whose Lexus SUV you saw the bumper sticker might have missed the point.  That would be sad.

Irony means that the bumper sticker is not true.  The one who dies with the most toys does not win.  I just wanted to make that clear.  Of the three top sources of happiness, pleasure, engagement and meaningfulness, pleasure ranks lowest on the list, happiness producing-wise.  Our mindless pursuit of it notwithstanding.

Nevertheless, perhaps the heart's desire of the person for whom you are shopping is toys.  There are all kinds of toys out there.  Almost all of them, you can find, again, at Amazon.com.  I thought they were a book store.  No, from Automotive to Watches, with books, electronics, movies and even musical instruments between.  If you know what that heart's desire is, you can probably find it there.  If you don't know what that heart's desire is -- are you noticing a theme developing here? -- gift card.

Yes, I know.  This reads like an infomercial for one particular corporate giant that is destroying local businesses across America.  But give me a break.  And give yourself a break.  Your Chanukah presents are already late.  Christmas and Kwanzaa are bearing down like a runaway train.  I don't have time to look up a bunch of choices for you.  I have my own shopping to do.  Internet.

Who am I kidding?  I can't go into stores anyway unless medicated.  Maybe you can relate.  At least I have the Rx!

Engagement

Engagement means being absorbed in the here and now, whether in family, romance, work or hobbies.  That being absorbed is the key, because the wandering mind is an unhappy mind.  Gifts that bring the family together, or send your recipient out on a date or relate to his/her interests can enhance that person's happiness.  And you can find just the gift or gift card at... what has evidently become the Shameless Commerce Division of Prozac Monologues.

Meaningfulness

Okay, all the above is filler.  Here is what I really want to sell this season.  Making a difference.  What makes for meaning is using one's personal strengths to serve some larger end (Seligman's definition.)

One kind of strength is passion.  So let's start with a question.  What is the passion of your gift recipient?

I knew an old lady once who absolutely would not deal with that word passion.  It's a wonder she reproduced.  Like Queen Victoria, she probably closed her eyes and thought about England.  Or, being American (and Episcopalian), she probably thought about The Book Of Common Prayer.

So here is an alternative for Thelma, God rest her soul, and for you if you can't relate to the word passion.  Determination.  What is the determination of your gift recipient.  What is he/she determined to support/challenge/change/make possible in the world?

Now let's go shopping for meaning.

Clean Water For Africa

Here is my passion/determination/storyThe Episcopal Diocese of Iowa has a companion relationship with the Diocese of Swaziland.  Swaziland has had a drought for a decade or so.  There are things that could be done.  But the king has about a hundred wives, and he can't play favorites, can he?  If one has a Mercedes Benz, then each have to have her own Mercedes Benz...  So who can afford to dig wells?

But then this guy in Southeast Iowa developed this technology that turns table salt into chlorine.  For $150, we could get this thing called a chlorinator that produces enough chlorine to give clean water to an entire village.

Well, heck.  I'll buy two!  (The price is now $300).


We took a lot of them over.  Now the Swazis are making them in country.  One year a mission team came back from Swaziland with the story.  An elder from one village had told them, 


Since we got the chlorinator, not one child died last year.

Not one child died last year.

I have never spent any amount of money that has ever given me and will forever give me as much happiness as those six words.

Not one child died last year.

Give your mother or your father this story and clean water for a whole village in Africa right here.  Now we are doing Haiti, too.

So that is how this year's holiday gift-giving guide is going to work, using one's personal strengths/passions/determinations to serve some larger end.

Shopping To Serve A Larger End

UNICEF

Now you can go back to those pleasures.  Do you have a friend who loves camping?  Insecticide treated mosquito nets are a bargain for $18.18, delivery included to places in Africa where one person dies of malaria every 30 seconds.

How about a friend who bakes?  High energy biscuits will feed young children in disaster sites, 1200 for a mere $49.10, again, delivery included.

You can find these and a whole assortment of Inspired Gifts for the health, water, nutrition, education and emergency needs of children around the world at unicef.org.

Heifer International

How about a gift that keeps on giving?  Heifer International provides livestock and training to improve nutrition and generate income, lifting families out of poverty.  Recipients share the offspring with others in the community, multiplying the impact of each gift.

So do you have a friend who wants a pet but is allergic?  Three rabbits, $60.  Aaahh, aren't they sweet?!  We bought bunnies for China one year.  Hunger has been wiped out in China.  Heifer International has moved on to another country.

Do you know a cowboy wannabe?  One heifer, $500.


How about a whole ark with two cows delivered to a Russian village, two sheep to Arizona, two camels to Tanzania, two oxen to Uganda, two water buffalo to Cambodia...  There are fifteen pairs in all for $5000.  For your friend who is delusional?  (Noah/end of the world/delusional -- get it?)

We are just getting started.  Knitters, a knitting basket (llama, alpaca, sheep, angora rabbit) -- $480.  Gourmet, cheeses of the world (how cool is that! heifer, goat, sheep and water buffalo) -- $990.  Homesick Iowan, pig -- $120.  Let's not neglect our vegan friends, trees -- $60.

If you are shopping for me, I have long had my eye on that water buffalo, a mere $250.



All of these are available in shares, by the way, if that fits your budget better.

Seriously.  Water buffalo. 

Habitat For Humanity

Now let's return to where this series started and my life for that last two months, Habitat for Humanity, building affordable housing by using volunteers, including those who will own - and pay for - the houses.  Whether your designated gift recipient is Martha Stewart or Frank Lloyd Wright, Habitat has its own gift catalog with everything from light switches to flooring.  One year my sister-in-law gave me a kitchen sink. 

One.org

If I haven't hit a bulls eye yet, one.org is the meaningfulness equivalent of amazon.com.  This one may appeal to the rockers in the crowd.  Cofounded by Bono, Bob Geldof, et al, one.org created a partnership of all sorts of groups working to eliminate world poverty by 2015 -- the Millenium Development Goals.

Here you will find more about one.org.  Here you will find the partners (Bread for the World, Oxfam, Bill and Melinda Gates Foundation, various churches, etc.)  Each one has its own focus, allowing you to find your perfect match.

And since this is my blog, after all, I will put a word in for Episcopal Relief and Development, ER-D.  When earthquake or hurricane strikes, ER-D listens to local people to determine how best to help.  Then they stay with it after the cameras move on.  For example, ER-D is still working on economic redevelopment in New Orleans.  And this is one church organization you can support that will NOT ask potential recipients where they go to church.

Joy That Lasts

So there you have it.  Without leaving the comfort of home, without even having to change out of your jammies, you can find the perfect gift, one that will give joy beyond the end of the year.

Not one child died last year.

clipart from Microsoft
cotton candy photo by Maggie D'Urbano,
used under the Creative Commons License (cropped)
child with unsafe water by Pierre Holtz - UNICEF, licensed under Creative Commons
child drinking well water by Scott Harrison licensed under Creative Commons
mosquito netting by Tjeerd wiersma, licensed under the Creative Commons Attribution 2.0 Generic license
photo of rabbits by Kessa Ligerro and made available under the GNU Free Documentation License 
Entrada dos animais na arca de Noé by Giovanni Benedetto Castiglioni, public domain
photo of water buffalo by Da and made available under the GNU Free Documentation License
GNU -- somehow seems appropriate, doncha think?  

Sunday, December 12, 2010

Happiness in a Gingerbread House


How To Be Happy

How to be happy yields approximately 450,000,000 results in a Google search.  At that number, they don't bother to be precise.  Amazon.com gets you 2914 hits in the book department.

Nevertheless, I betcha I get my own share, as I explore the specific application of gingerbread houses to research reported in The New Science of Happiness by Claudia Wallis.

Research On Happiness

Martin Seligman, former president of the American Psychological Association, started off a flurry of happiness research when he picked happiness and oddly enough, mental health as the theme of his tenure, a decade ago.  His own contribution is Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment.  More on Seligman below.

Moment-Based Happiness

color: black;"> Some
happiness research focuses on the immediate.  What are you doing right now?  And how much are you enjoying it?  Mihaly Csikszentmihalyi (no kidding) spent money on this one.  He had to develop a hand held computer device to prompt the questions at random intervals.  It would have cost less if he had waited for an IPod app.  Maybe this was the forerunner?

Taking care of my children ranks very low on this What are you doing right now; and how much are you enjoying it survey.  However, it is often cited as the most rewarding experience in a parent's life.


As it happens, raising this young man was the very most rewarding experience of my life.  That night when he was fifteen and hanging out with a friend at the mall, however...  not so much.  Not if you had asked me right then.

Happiness And Outcomes

So the outcome colors ones experience of happiness.  Daniel Kahneman studied colonoscopies, of all things.  What are colonoscopies are doing in an article and blogpost on happiness?  It's a backward approach (so to speak).  But the point is that how people feel about their experience of a colonoscopy depends on the result more than the level of discomfort or even pain.


But let's get back to the topic, happiness in a gingerbread house.  Gingerbread is a more suitable example, or at least one more pleasant to contemplate.  The roof in this photo did not break.  I had learned from that other one.



And I did NOT use a $50 bottle of single malt scotch as a wall brace, even though my brother-in-law was so moved by my story of woe that he bought me another.

">Theology Alert! text-align: center;"> So liturgical preachers who have to do Good Friday every year now have new material -- research to support why we call the day that Jesus died Good Friday.  It is because we remember how it turned out -- presented here on the left side of the triptych -- the Resurrection.
Happiness
And The Lottery -- Circumstances "> David Lykken "> Nor does knocking over a nearly full bottle of double aged single malt scotch, inappropriately used as a wall brace.  Okay, so I remember it.  It's just not very important to my happiness, not now.
Memory-Based Happiness
Seligman focuses more on remembered experience than on the moment-to moment.  He says that remembered happiness comes from pleasure, engagement (depth of involvement with family, work, romance and hobbies), and meaningfulness (using personal strengths to serve some larger ends).

My gingerbread adventure had all three in spades.

Pleasure

Way back last winter, when I first committed to this project, I knew there would be mule deer running through the trees.  There are 2000 inhabitants in Sisters, Oregon, the site of the finished project.  280 of these inhabitants are mule deer.  More move in during winter, when feed gets scarce in the mountains.  But you can tell the locals, because they look both ways before crossing the street.  I never found a mule deer cookie cutter.  These are reindeer with the antlers cut off.  I got a kick out of them, especially their little red noses and white butts.  They are to scale, by the way.

I figured the trees out early.  These are waffle cones, broken in pieces and glued back together in layers, using dark brown royal icing.  Next I frosted with tan icing mixed with coconut for texture, with not quite complete coverage, so the dark showed through in places.  Then came the green, again with the coconut.  The powdered sugar was my finishing touch.  I felt like a kid, doing a craft project with library paste.


Oh, and then there was that chimney.  The prototype used ribbon candy, nice rectangular shapes.  But I couldn't find ribbon candy at Fred Meyer in Redmond.  So I used Christmas Mix.  Think marbles in place of Legos, transforming myself from a brick layer to a builder of stone walls.  So I am insanely proud that it stands.  I am not sure, but I think it may be tall enough to meet code.

This made me happy.

Engagement 

A couple weeks ago, I reported a study on happiness and mind wandering.  Short version: they don't mix.  Engagement is the converse.  The more you are absorbed in what you are doing in the immediate moment, the happier you are.

Sex rates the highest on the engagement scale.  People pay attention to what they are doing during sex 80% of the time.  If it were higher, you know the responders would be lying.  80% seems realistic and yet still really healthy.

Okay, so this wasn't sex.  But I did hold my breath.

Sometimes my tongue even stuck out.

Building a gingerbread house is like building a house of cards.  everything has to balance while it is going up.  Except the pieces break when they fall.  This is an exercise that requires engagement.  Your mind cannot wander.


Though I worked mostly by myself, the gingerbread houses did draw me into relationships.  My sister-in-law created Pierre here.

After the installation, I traveled the Gingerbread Trail to see the twenty-four other houses in Sisters.  I met other artists.  (No, I don't have their pictures.  I don't do pictures.)  We shared the bond of insane pride in our silly little creations.  Not to mention a thinly veiled competition.

This made me happy. 

Meaningfulness

Pleasure brings happiness.  But of the three, pleasure, engagement and meaningfulness, pleasure is the weakest.  It is fleeting, after all.  The outcome may change the emotional interpretation.  Relationships and meaning endure.

This was a labor of love.  The Gingerbread Trail is a fundraiser for Habitat for Humanity, the Sisters, Oregon chapter.  People tour the trail and vote for their favorites by putting donations into a box.  They can vote for as many and as much as they like.  Go to Sisters, Oregon before January 6th and you can vote, too.  Vote for me.  But vote for the others, as well, if you like.  The money all goes to Habitat.  It's just that mine is located at home base.

Or go here, if your travel plans to not include Oregon this month.

Habitat operates worldwide, making home ownership possible for people of limited means.  A person or family applies to a local chapter for a house.  A team of volunteers builds it.  The receiving family contributes labor.  Then they pay for it with a no-interest loan.  Then they help with the next build (or do other volunteer work, if not physically able.)

Home ownership creates financial stability and pulls people out of poverty.  Duh.  When we were in Sisters, my sister-in-law drove us past the first Habitat build in town.  She said the son has just graduated from medical school.

Go to this website to learn more about how Habitat was formed, where it works, what innovative construction technologies they use, what Jimmy Carter has to do with it, how you can give and how you can get involved.

My little gingerbread house with the snowman with attitude is helping to raise funds for another house, one for people.

This makes me happy.


So here is another piece of meaningfulness.  Most of the fund-raising for the Sisters Habitat comes from what is called a ReStore.  When you have leftover paint or wood from a home improvement project, when you upgrade your refrigerator, or replace your front door, you can donate the unwanted materials to a ReStore.  It will do three things.

  • It will recycle.
  • It will build houses with money from the resale of your donated items.
  • It will keep tons of stuff out of landfills.


The Gingerbread Trail is sponsored by Sisters' ReStore.  In keeping with the spirit, I included in my house a reindeer Pez dispenser that somebody gave me and that I intended to toss.  I donated materials I bought and decided not to use to a food bank.  I gave leftover candy to the ReStore for their snack bowl.

This also made me happy.

Now, this project did not cure me of bipolar 2.  The wheel turned again.  I expect it to continue.

But it made the good time better, while I was totally absorbed in molding a cat out of gingerbread dough and then painting it to resemble Miss Jennie, the ReStore cat.  I am not crazy about cats.  And she had to be a calico.  But she totally absorbed my attention.

I have developed a basis for future relationships.

When there are so many things I am no longer able to do, and when I am acutely aware of how difficult this project was when once it would have been easy, I will remember that I managed to do it anyway.

And I have made a difference.

It made and makes and will continue to make me happy.

flair from facebook
photo of Jacob and Jenny by Nancy German
photos of gingerbread by Helen Keefe
forest photo by Maylene Thyssen,
La crucifixión con la oración en el huerto y la resurrección, 1520
by Lucas Cranach and in the public domain

Thursday, December 2, 2010

Cognitive Behavioral Therapy -- Mindfulness

Last Week's Cognitive Therapy Technique -- Distraction

 I can't stop thinking about... [some traumatizing thought.]

So think about something else instead.

Distraction is a basic Cognitive Therapy tool.  Personally, I think it's stupid on the face of it.  The point is, I can't stop thinking about what I am already thinking about.  I am stuck on this horror movie, and somebody stole the channel changer.

Except I can change the channel.  You can, too.  You can think about something else instead.

That diagnosable gingerbread house of mine worked just fine.  It changed my channel.  How weird is that?

Here's the deal.  I think it worked is because, just like that other channel, it was all-consuming.  I had to pay exquisite attention to those cans supporting those fragile walls, whether the walls would meet, whether the pretzels would break... 

Mindfulness -- Another Cognitive Therapy Technique

 There was no room for a wandering mind on this construction site.  Gingerbread was my own personal Yoda, sitting on my shoulder, hitting me over the head any time my mind was not on where I was.  Like when I knocked over that nearly new bottle of single malt scotch holding up the back wall.  Balvenie, to be precise.

Matthew A. Killingsworth and Daniel T. Gilbert of Harvard University recently published a study on wandering minds and happiness.  The short version: a wandering mind is an unhappy mind.

“Mind-wandering is an excellent predictor of people’s happiness,” Killingsworth says. “In fact, how often our minds leave the present and where they tend to go is a better predictor of our happiness than the activities in which we are engaged.”

The researchers estimated that only 4.6 percent of a person’s happiness in a given moment was attributable to the specific activity he or she was doing, whereas a person’s mind-wandering status accounted for about 10.8 percent of his or her happiness.

The unhappy news: people spend 46.9% of their waking hours thinking about something other than what they’re doing.  That would be the average.  Me -- here and now is my worst subject in all the world.  This has something to do with a hippocampus the size of a poppy seed.  And yet so often it has that channel changer in a death grip.

Mindfulness is the non-judgmental observation of the ongoing stream of internal experiences as they arise.  Mindfulness acknowledges the hippocampus.  It just doesn't let it run the show.

Other parts of my brain deserve their say, as well.  My traumas are not here and now.  In any given moment, the odds are overwhelming that I am perfectly safe -- an objective fact.

There are other objective facts, including that I was not always safe.  But that was then, this is now.  Remember, remember.  Keep a tight grip on this fact -- this is now.  This is when I need to focus on whether the roof meets the side wall or if there is a gap.

My misery comes from two things, then and the fear that then is next, with no room for now in between.  Like the Jewish joke, without guilt and dread, who am I?

But the odds of an unsafe event in the future are not overwhelming -- they are as miniscule as my poppy seed sized hippocampus.  My frontal cortex is perfectly able to calculate the odds.

Here and now is pretty cool.  This exact moment is a gift.  And many good things are possible in it.

By the way, that prototype served its purpose.  It taught me a lot, including the fact that it was not possible to replicate it in the one week I had onsite.



I did have a Plan B.  And not chained to my past aspirations, I decided to go to Plan B before, not after the meltdown.


I like this channel a lot better.


gingerbread photos by Helen Keefe
Harold Lloyd from Safety Last in public domain

Thursday, November 25, 2010

Cognitive Behavioral Therapy -- Gingerbread Style

First Cognitive Therapy Technique -- Distraction

My therapist said Think of something you might find enjoyable.  You don't have to do it.  You don't even have to enjoy it.  The goal is not to move your mood from 1 to 10.  Any mood change is a bonus.  The goal is simply to give you something else to think about [-- besides what I had been thinking about.]

Distraction is one of those really irritating CBT techniques.  I am traumatized and can't stop thinking about this.  Okay, so think about something else.  I pay money for this?

But my other therapist, totally different method, said pretty much the same thing.  And I was six weeks from a major project I had promised for the holiday season.  And I am not sure it would have worked except that the wheel was ready to turn from early autumn danger to late autumn hypomania.  But he did and it was.  So...

She said think about it.

I guess I overshot the mark.


Ya think?

To Diagnose Hypomania -- Pay Attention

I used to churn out 10-12 gingerbread houses each season, back in my undiagnosed days.  I used the Joy of Cooking recipe and floor plan.  But each and every one was one of a kind: a log cabin made of pretzel sticks and peanuts for the chimney, another with candy canes on the roof for a chalet effect... No, I wasn't manic.  I was excited...

It could be said I don't know when to quit.  So a simple suggestion, think about something you might enjoy instead of what you are thinking about right now, became a fourteen inch high, furnished gingerbread house.


See what I mean?  Once I decided to tile the kitchen floor with candy corn, I was gone.  Note the faucets for the aluminum kitchen sink.  And the handles on the refrigerator.  There is a fireplace hearth down there, made of a Milano cookie.  Even as I was installing these things, I knew I was out of control.  But I could not stop.

Here is a nine patch quilt, made from fruit rollups.  Plus a teddy bear on the pillows.  Should you decide to start quilting with fruit rollups, here are my methods.  Unroll them a few days in advance to dry a bit.  Don't overreach.  Let the materials tell you what they are willing to do.  Use liberal amounts of vegetable oil on your fingers and cutting utensils.  Keep the knife clean.  I recommend an exacto knife, under supervision if you have a problem with sharp objects.  Place your product between oiled sheets of cling wrap, then between sheets of paper.  Iron at LOW heat for five seconds.  Breathe.

I refer to this as my diagnosable gingerbread house.


By doubling the dimensions, I had introduced engineering issues.  I needed weight bearing walls.The closet was designed for that purpose.  I made a double wall facing the living room.  But I failed to double the wall with the door.  Two by twelve inches, it was the first piece to break.  The pretzel sticks inside the closet hold it together.


Metaphor Alert -- Community

If I were to get philosophical -- and while I bent over this project, holding my breath and waiting for icing to turn to cement, I had plenty of time -- I would reflect that sometimes things or people are created that do not have the structural integrity to withstand the pressures to which they will be submitted.  Nevertheless, they can get by with a little help from their friends, even friends that brittle themselves, like pretzel sticks.  This is the essence of support groups.  Get into one.

Some of us are not particularly unstable, but we collapse under pressures beyond normal experience.  If we don't have to bear the weight by ourselves, we can make still our own creative contribution to the whole.  The fireplace wall fell into three places.  Twice.  It stood, once it received a full back brace.  The brace is not flashy.  It is not even visible, covered by the outside of the fireplace.  But it is essential.

This is the essence of community.  Christians call it the Body of Christ.  If the house were all ribbon candy, how would it stand?  If the house were all support, what would cover the kitchen floor?

Anyway, diagnosable.  The roof also collapsed, the weight bearing walls notwithstanding, because I pushed too hard while attaching it.  Be gentle with yourself, my friends.  The stronger parts can injure the weaker.  Self-restraint is especially important where you are strong.

But we can learn from our mistakes, and turn them into more creative opportunities.  The roof went for snacks to a bible study group.  I replaced it with a lighter version.  And then I broke one side again.  This time I finally listened to my spouse, and put up just half a roof, so people could look in on that nine patch quilt.  None of us has all the answers.  And sometimes irritating advice is good advice.

Even if it is irritating.

Another Cognitive Therapy Technique -- Dialectical Thinking

Even in the midst of this craziness, I kept aiming at sanity.  My mantra was Prototype, prototype.  The point of a prototype is to make as many mistakes as possible, in order to learn, and not make the same mistakes while doing the real thing.

I was making a lot of mistakes.  Boy, was I learning.

Dialectical thinking means that life is not divided into black and white.  One can hold a painful thought and a positive one in the same brain at the same time.  That and valium got me through.

I learned not to use a double barrel aged single malt scotch as a brace to hold up a wall while assembling, like the soup cans above.  The bottle was missing only as much as is pictured here before I made that particular mistake.  Sigh.

After mopping up the nearly full bottle of scotch and as much shattered glass as I could find, it was time, it was time to stop working on the prototype.  Well, after I built the fire in the fireplace.


Two hot tamales, cut on the bias, a couple little pretzel sticks and a sprinkling of ribbon candy crumbs.  The back of the fireplace is the inside of a mint Milano with the white frosting scraped off.

Like I said, diagnosable.

It wasn't finished.  It still isn't finished.  But the time for prototype was at an end.  The time for the real deal had begun.

To be continued...



all photos of gingerbread houses by Helen Keefe 
photo of scotch by Suat Eman

Saturday, November 20, 2010

Holiday Survival Tips for Loonies

While I am working on my entry for the Gingerbread Trail contest, here is a repeat from December, 2009.  I have reformatted and modified it slightly for Thanksgiving.  Happy Turkey! 


Ah, the holidays!  Time when far flung family members travel home and grow close around the turkey table.  Time to renew friendships in a round of parties and frivolity.  Time to go crazy?

There are stresses this time of year.  Routines are disrupted, people stay in crowded quarters, those who have reason to avoid each other are thrown together, negotiations between exes require professional mediation, alcohol is consumed in greater quantities, expectations for love and good cheer are bound for disappointment.  Loonies and normals alike need to tend to their mental health.

So Prozac Monologues supplies a handy holiday guide, with an assist from NAMI's Peer to Peer class and the University of Iowa Adult Behavioral Health department, covering the basics, planning ahead, mindfulness and quick getaways. 

The Basics of Holiday Family Survival 

Keep to your routine as much as possible.  If you can't eat like you do at home, get at least one nutritious meal every day.  If your family of origin is a little whacked, and your root chakra could use some assist, concentrate on protein (meat, fish, tofu, beans), root vegetables (carrots, beets, onions) and red stuff (beets, strawberries, cranberries, cherries -- jello does not count.)  Don't go to parties without some protein already on board.  At the buffet table, carrots.  Skip the dip, limit your lipids.  You will sleep better for it.

Remember Lloyd Bridges in Airplane?  The holidays are probably not a good time to stop sipping, smoking, snorting, sniffing...  You get the idea.  On the other hand, ultimately substance abuse is a greater hazard than help in negotiating tricky family dynamics.  So keep it under control.

Sleep -- not so easy if you get the couch in the family room.  Borrow somebody's bed for a nap.  If you anticipate a problem, I'm all for an occasional pharmaceutical assist, as an alternative to the straight jacket, which is where you may be headed if you don't get good sleep. This is true for everybody, essential for people with bipolar.

Safety -- no, you do not have to hang around anybody who is abusive.  If that is an issue, have your escape plan ready, your keys and your credit card in your pocket, your alternative crash pad arranged.

Oh, and water -- with all your meds, you are probably supposed to push water, as it is.  Even more so in the dry winter air.  Even more so when dehydration can be mistaken for hunger, leading to more cookie consumption, requiring more water.  Especially even more so with greater alcohol consumption.  Be kind to your liver.  Drink water. 

Plan Ahead

Many a family feud could be short circuited with some conversation ahead of the storm.  Which chores does the host want or expect help with?  Which chores does the guest want to volunteer to do?  In any relationship, 50/50 does not work.  You have to give at least 65.

Is there any tradition, activity, food, game that will blow your anterior cingulate cortex if it doesn't happen?  Take some responsibility for it.  Laugh about it, and let people know what it is.  And if it doesn't happen, well, that will give you material for your next therapy appointment.  You already know what your therapist will say, don't you.

How many events are planned?  Which ones can you skip?  Is there room for negotiation?  What would you like to do in a group?  When will you want to go off by yourself?  When will the one who abused you as a child be around?  Where will you be instead? 

What are your needs?  What are others' needs?  Talk to each other.  Listen to each other.  Remember, there is no Norman Rockwell Thanksgiving, except for one painting.  Which is still under copyright protection.  Which means you can't replicate it.  This is art, people.  It is not your family, and not mine, and not anybody else's, either.  Give yourself and your family a break.  Your relatives, your turkey and pie are infinitely more interesting, anyway. 

Mindfulness 

"I am here, this is now."  That is my chant, accompanied by some deep breathing, calling me out of the unhappy past and the uncertain future.  Look up, listen up, and notice.  You don't have to participate.  Just notice.


When things get especially bleak for me, I go outside, regardless of weather, and try to replace the running voices in my head with a minute description of what I see around me.  "There is a little girl.  She has pink leggings on.  Her hair is in ponytails on either side of her  head.  The woman is pushing the stroller.  The tree is a pin oak and still has its leaves.  The passing car is a Volvo.  We used to have a Volvo.  It always... -- no, that's the past.  Come back to the present.  This Volvo is dark green..."  You get the idea.

When you can't get outside, like during dinner, become an anthropologist.  Who are these people?  What do they think?  How do they treat each other?  What are their eating habits?  What happens after three beers?  You are not responsible for any of it.  You do not have to stop what you don't like.  You don't even have to like or not like.  You are simply an observer.

Mindfulness is a practice.  Practice is what people do when they want to get better at something.  Remember, if you can't pull off mindfulness every time you need it, that's okay.  You just keep practicing. 

Quick getaways 

There is one more thing you need, some handy lines to get you out of the inevitable spot.  Let's see how many of these you can anticipate.

There you are, being an anthropologist, mindfulnessing away.  And Uncle You Know Who turns to you and says...  What will it be this year?  Health care?  Sarah Palin?  What he thinks about all this therapy you're doing?  He knows your triggers like the back of his hand, because he trips them every year.  Well, write this one down on the back of your hand, "That's very interesting.  I'll have to think about that."  That one can get you out of all kinds of arguments.  Sometimes it even gets my therapist off my back.

Or there you are, seated next to the cousin you haven't seen since she tried to drown you in the pool when you were kids.  Remember, you are here, this is now.  Try, "Seen any good movies lately?"  It matters not a whit if that line is a dud, because it sets up your next line, "What do you do with your time nowadays?"

Then there is the open-ended "How about them Hawks?" Or Vikings, or whatever.  Do a little research ahead of time, so you know a team near the person you are addressing.  For the sport challenged, here is a starting point: it's football season.  And if that line is a dud, follow with... are you with me yet?...  "What do you do with your time nowadays?"

When you want to escape the person or the room, there's:  "Excuse me, my drink needs more ice; I'm going out for a smoke/some air/to make snow angels;" and, "Do you know where the bathroom is?"

And when you have had your limit: "I really must go.  Thank you so much for dinner.  Happy Thanksgiving."  With a normal host, I mean really normal, not undiagnosed normal, you don't need to explain anything.

If the host is in the "undiagnosed " category, then try: "My puppy/probation officer/Nurse Ratchet is waiting up for me."  Or, "I'm sorry, suddenly I'm feeling flu-ish."  You can play the flu for all it's worth this time of year.  Or even, "Oops, my meds are wearing off.  Gotta go!"

Sometimes a simple "I'm outa here" works.

Make yourself a crib sheet, and these few lines will help you navigate a wide range of social situations.

Do you have anything else you want to recommend to fellow readers?  Make a comment!

Families -- you gotta love 'em.  At least you can laugh.  It works better if you do.  Happy Holidays!

Our (Almost Traditional) Thanksgiving Dinner photo by Ms Jones and licensed under the Creative Commons Attribution 2.0 Generic license
Sleep and his half-brother death byJohn William Waterhouse 1874
photo of dirty dishes by User:Mysid and in the public domain
Autumn by Vincent Van Gogh
photo of Margaret Mead by Edward Lynch, given to the Library of Congress

Friday, November 12, 2010

Hope and the Play of the Week

I am up to my earlobes in ribbon candy, pretzels and gingerbread right now, a holiday project gone diagnosable.  I have been working for several weeks now on the prototype of a gingerbread house that is yet to come.  If this one stands.

I hope I can post pictures of the finished product.  They could go in my file.

Meanwhile, I have scavenged a video from a Facebook friend.  It reminds me of my very favorite poem in the whole wide world.  My congregations know it by heart, they have heard me preach it so often.

Listen to the mustn'ts, child.  Listen to the don'ts.
Listen to the shouldn'ts, the impossibles, the won'ts.
Listen to the never haves then listen close to me...
Anything can happen, child.
Anything can be.


Come to think of it, the gingerbread house, the poem and the play of the week all have this is common.  They are matches, held up against the darkness.



Here's hoping you some light.

Thursday, November 4, 2010

Weighing Costs and Benefits Part V -- Down and Dirty Algorithm

SE + NE + $$$ + STG + TR = STC.

E#PT X NSR = STB.

STB TO STC = ODDS OF SUCCESS


There it is, the Prozac Monologues Down And Dirty Algorithm, to weigh your costs and benefits for medication or any other treatment for any mental illness, or any other medical condition, for that matter.  Click on the first and second lines.  They will take you to the posts that develop the formula.

Can you believe we finally made it?

We started with the:

Manifesto of a Lab Rat. 


I am a Lab Rat.  Yes, I am.

The Manifesto begins there.


It continues: 
 
If I am a lab rat, I will be a free-range lab rat.

What I mean by free-range lab rat is this: 

I insist that I contribute more to this enterprise than my body.

Your doctor tells you to weigh your costs and benefits, but gives you no way to do so, other than insufficient information + gut + desperation = noncompliance, if you don't come up with the same answer as your doctor.

What we need is an algorithm: logical rules that we can apply to objective data to solve a problem.

This algorithm does not exist.

So as an interested party, a very interested party, given that my body is the test tube, I decided that my contribution to this chemistry experiment would be the algorithm.

The problem we want to solve is this:

Do I Want To Put These Chemicals Inside My Body?

This task has continued over several posts this fall, interspersed with a few sick leaves and vacation days.  Click on costs and benefits to follow the whole development.  (The first post is at the bottom, dated August 19, 2010).

What To Do With The Algorithm

The resulting algorithm can be applied not only to the chemicals you put in your body, but any other form of treatment as well, talk therapy, aerobic exercise, yoga, Chinese medicine, acupuncture, even aroma therapy, should you choose.

You can compare the results of the cost/benefit analysis of different treatments, and do the same with various combinations, when you can find the numbers.  Which admittedly, you cannot for any of these that do not get Blue Cross Blue Shield reimbursement.

There are numbers out there for talk therapy and aerobic exercise.  But doctors do not usually use the word therapy for anything other than chemicals or electro-convulsive therapy (ECT) or any of those new-fangled electrical interventions.  That is the context in which you are told to weigh your costs and benefits.

For the most part, I have used antidepressants as examples.  One out of every ten people in the United States is taking them right now.  So this would be the most common application, among psychotropic medications.

It was helpful to look at chemicals as I developed this algorithm, because they are the form of treatment with the greatest costs and greatest variety of costs:





dizziness and confusion,





insomnia and fatigue,



weight gain, irritability, sexual dysfunction,  irritability.




So this is what you do when you use the algorithm to weigh your costs and benefits -- you compare two numbers, STC (Short Term Costs) and STB (Short Term Benefits).

And how do we get those numbers?

Remember,

SE + NE + $$$ + STG + TR = STC.
E#PT X NSR = STB.

The abbreviations increase the confusion quotient, and thus make it look scientific.  Here is a translation:

Side Effects (SE) plus Not Effective (NE) plus Money ($$$) plus Stigma (STG) plus [lack of] Trust (TR) are your costs (STC).  These costs are based on the reasons people give for discontinuing their medication.

Efficacy Given The Number of Present Trial (E#PT) times How Many Would Not Experience Spontaneous Remission Unless They Took the Medication (NSR) are your benefits (STB).

Did you like my illustrated tour of the previous posts?

And Where Are We Supposed To Get Our Data?

They ought to be provided to you by your doctor, who has told you to weigh your costs and benefits.  Except for money, stigma and trust -- you have to come up with your own odds that you will quit taking your medication because you can't afford it, you are afraid for your reputation, or you do not trust your doctor.

They ought to be provided to your doctor by the drug reps.

But they are not.

So you have to do your own research.

I think the algorithm would make a fabulous app.  The numbers could be regularly updated, from the latest research by scientists not funded by the companies that sell these chemicals.

I claim copyright, by the way. 

Long Term Costs And Benefits Are Missing

Notice that I refer to short term costs and benefits.  Some will object that I left out good reasons to take meds: the difference that meds make to how quickly another episode occurs (relapse rate), how long various approaches take to work (time to remission), how medications affect things like brain mass, suicide risk.

Others will object that I left out good reasons not to take them: the possibility that medication might accelerate the natural progression of the disease, the possibility that the diagnosis is off and you will flip into mania or hypomania, liver damage, the consequences of weight gain, such as heart disease and diabetes, suicide risk.

Someday I will do a post or two on that suicide risk issue.  There is a lot to say about that.

Well, this algorithm is complicated enough and took five posts already.  This one has that i-Pod potential.  The one that includes all those other issues will take more gigabytes.

STC versus STB give you the odds.

Once more I repeat, they do not give you your decision.  There are additional personal factors that influence or even override logical rules, objective data, and problem solving.

Personal Factors:

You have used up your sick leave, your vacation time and your family leave for this year and next, and your boss will fire you if you don't start taking meds.

Your wife has issued a similar ultimatum.

You can't get out of the loony bin any other way.

You are desperate.

You have the knife to the wrist.

Like I said, it is your decision.  I am merely your humble servant.  Who does occasionally buy a Powerball ticket.

How Does The Algorithm Work?

Let me give you a personal example.

When I first took Prozac, Eli Lilly's website said that it had helped 70% of the 55,000,000 who had already taken it.  I didn't know anything about spontaneous remission or the effect of which trial this was.  So STB = 70.

Meanwhile, none of the side effects (SE) reported went above the 15% range; the odds that it would not be effective (NE) were 30 out of 100; it was already generic, and I could afford it ($$$); stigma (STG) was not an issue for me; and I had total trust (TR) in my doctor.  So STC was 15 + 30 + 0 + 0 + 0 = 45.

That meant (with the information I had) that the odds for Prozac were 70 to 45 in favor.  And I could put off therapy.  No brainer.

Next up -- actually, five keep trying's later, we had moved on to a psychiatrist who prescribed Effexor.  Crazy Meds says: for deep, despairing clinical depression that needs to respond to the standard tweaking of the three most popular neurotransmitters, Effexor XR (venlafaxine hydrochloride) often pulls people out of the abyss.  By then, the deep, despairing abyss -- that would be me.

My doc said I get good results from Effexor.  She didn't say how good results translated to a number,.  (That's case studies, by the way -- not research.)  But she did tell me to weigh my costs and benefits.  By then I knew that most antidepressants have about the same effectiveness level, which I took to be around 40%.  I didn't know it mattered that I was on my sixth go round.  Odds for benefit, STB = 40%

She also gave me the usual side effects, because I asked.  Since insomnia was a major issue for me, and we had run through a number of sleep aids, she said that the insomnia risk (SE) was 15%.  Not effective odds (NE) would come in at 60 out of 100.  Since she didn't ever answer phone calls, and I knew I couldn't stop this med without help tapering off, and I was wary of her by now, I grilled her on how to discontinue without her help.  Trust, lack thereof, (TR) was in the 40% range.  STC was 15 + 60 + 40 = 115.

With Effexor, my odds were 115 to 40 against.  Not so good this time.  However, desperation overcame gut instinct.  So I kept trying.

The rules of the algorithm work, but the results are only as good as the objective data.  What if I knew then what I know now?  Without going into the whole story, and by tweaking numbers actually available: 

Prozac -- 

STB = 40 (E#PT) X .8 (NSR) = 32.
STC = 30 (SE) + 60 (NE) + 0 ($$$) + 0 (STG) + 20 (TR) = 110. 

110 to 32 against.  I still had issues with therapy (nothing to do with any therapist I have ever known, by the way).  And being over-educated, I am on the compliant side.  So I would have given it a shot. 

Effexor --

STB = 10 (E#PT) X .8 = 8.
STC = 34 (SE) + 92 (NE) + 0 ($$$) + 0 (STG) + 95 (TR) = 221.

221 to 8 against.

The numbers for Effexor come from the STAR*D study, and were available at the time I started taking it.  But I didn't know that.  STAR*D's original conclusion was that after two antidepressants have been tried, subsequent results are dismal, and more research for better medications should be a priority.

Since then, a jillion articles have been written about how STAR*D was a lousy research design that cooked the books in way favor of the chemicals at every step, starting with the selection of subjects.  Click here for my posts that reference STAR*D.  But Google it for for what the scientists say.

Anyway, 221 to 8 against -- I would have given it a pass.  Even I could tell the books were cooked.  And I got so much better after I went off it.

And So The Manifesto Of A Lab Rat Concludes

Of course, your results may vary.  Just remember, it's your test tube.




flair from Facebook
Photo "Tired Man" by graur codrin
Photo "Angry Father" by Akapl616.  Permission is granted to copy
under the terms of the GNU Free Documentation License
i-Pod family photo by Matthieu Riegler, licensed under
the Creative Commons Attribution 3.0 Unported license.png
photo of Warren G. Harding in public domain
photo of woman pointing taken by David Shankbone,
used by permission under the Creative Commons 
Attribution-Share Alike 3.0 Unported licence and modified
photo of prozac by Tom Vasco and is licensed under
photo of effexor by Parhamr who has placed it in the public domain
photo of John LeCompte of Evanescence by Samuel Lang,
permission to copy and modify granted under GNU Free Documentation License