Where is Your Head?

Today was a very challenging day. It was hectic in terms of handling some personal matters and it was hectic at my job at a psychiatric hospital.   I also started thinking about finally getting out there and buying Christmas presents.   Going back to bed sounded like a good idea but I was almost to my work.  

Tonight we put up the Christmas tree. I was tired as I rooted around the attic in my garage looking for the plastic tubs.  I put up the crumpled, artificial Christmas tree and did my best to get the lights hooked up.  I found myself feeling apathy because I did not care to look in the tubs at the different ornaments we had.  I found myself saying : at least the kids were enjoying it. 

As I reflect tonight, I find myself doing a Zig Ziglar "check-up from the neck-up."  I have said to myself: "Where is your head."

As I have noted elsewhere the pace of life for the average person in the western hemisphere is intense and hectic.   It is especially so for those living in urban areas.  We spend a lot of time commuting in cramped subways, trains and buses or we are stuck in heavy traffic.  We are pressured to do more with less at our jobs.  We have information coming at us from all directions that requires our response.  We get worn out and burned out and many of us value the weekend to get caught up on our personal matters and business.  Our heads are often tired from all of the intensity.

Then let us top if off with all of the holiday events and expectations.  We have to spend money on gifts to show we care.  We have to go to Christmas events to be sociable.  Combine the additional holiday stuff with our usual intense life and we are overwhelmed and probably think that going back to bed sounds even more attractive.

Let us kick it up another notch.  What if you are not feeling particularly joyful and happy this Christmas due to grief or loss?  What if you are feeling the guilt because your money and credit is tight and you cannot buy the type of presents the way you want to?   Going back to bed sounds even more attractive but it is not exactly a healthy coping skill.

Silence

In light of that, one of my favorite coping skills or coping activities in this time of year is sitting in silence and doing nothing.  While it does not solve the problems, I have found that a time of silence and stillness can be soothing.  

The problem is that it requires you to actually sit and be still.  Sitting still can be a challenge because the intensity and anxiety makes our bodies produce adrenalin which juices or energizes us and we are restless and fidgety.  Furthermore, being silent can be scary because our minds are moving really fast and with rapid thoughts can come anxiety.  Silence is essentially a discipline that has to be practiced . . . and practiced . . . and practiced because you think it holds something for you.

Forgive me for sounding like the late Henri Nouwen, but when I sit silently, I take some control of the moment. Some level of calmness happens. I feel the tension in my back and arms that I had not been in touch with because of my busyness and preoccupation and I can do something about it. I can also think spiritual or mystical thoughts or pray a different kind of prayer. I can be in the moment. I can focus.

Being in Touch with Ourselves.

I think in the rush of the holiday, taking time to be silent and ask ourselves where our heads are can be of great benefit.   But it can also be a risk. The answers to the question are not always pleasant because we might think about the pain, the grief, the loss, the regrets, and the 'what could have been's."   But it takes risk to make gains.

Where is my head now?  Hopefully in a more peaceful place than it was earlier in the day.  

Holiday Illusions: Things Are Not What They Seem

It does not seem like the holiday season here in Louisville, Kentucky USA.  It was in the 60's (Fareinheit) and it was rainy.  Yes, there are 21 more days until Christmas and it looks like a late February/early March day in terms of weather.  But it is the holiday season, you cannot judge by the way things look outside.

All of the man-made trappings are out.  Many people have decked their houses and yards in "Christmas" lights.  People are trying to get the Christmas Spirit listening to the music and watching old Christmas movies, and wearing festive holiday clothing.

The music is probably the most powerful of the different aspects of the Christmas season for most people.  The music goes everywhere and can be heard .. . in stores . . . the malls . . . and on the radio.  People sing it to themselves as they drive, and wash dishes.

I'm dreaming of what?

As I think about illusions at the holiday, Music comes to mind.  One of the all-time best selling recordings is that of White Christmas  by Irving Berlin.   The opening line is about someone dreaming about a snowy Christmas like the ones he used to know.  

The irony of it all is that Irving Berlin was jewish.   He did not keep Christmas as a child . . . he kept Haunukuh and even while as a secular jewish who was not observant, he did not keep Christmas during that time either.   From the different sources I could briefly piece together, he wrote a song for the Christmas market because it would sell.   Yes, he made a lot of money off of it. 

Don't get me wrong, the song was a morale booster to American troops during World War II. It made them think about getting home for Christmas.  However, the point is, at its basic nature, the song is an illusion--the composer simply composed something and it did not appear to be from his heart.

Music has this surprising power over us to change our emotions.  We get sad with songs and we get happy with sons.

Considering Hope: Real People Do it.

In keeping with the first Sunday of Advent, I have been mindful of the concept of "hope."   Hope is one of the themes of Advent.   I think that "hope" is rarely something contemplated or reflected upon the average person's life.

The meaning of the word.

I am not being original in this but according to Webster, hope is a feeling that something wanted is possible, and confidence.   Hope is looking forward to the future and does not look backward to the past. 

When Do We Hope?

It seems that we hope when we are not in a good spot.  We tend to hope when we are not feeling good, miserable, or are anxious.  Maybe something bad is predicted or expected to happen (such as a employer laying off workers or the "Fiscal Cliff") and we desire an exception to occur.  Maybe a loved one just died and a piece of us hopes that we are in the middle of a bad dream and we will wake up and the person will be there (this is part of the denial stage of grief).  

We tend to engage in hope when we are not in control.  We hope when an object, outcome or action is to happen sometime in the future.  We do not control what happens tomorrow . . . no one knows what happens until it happens. 

Sometimes we hope for something that we cannot get a clear timeframe on when something is to happen.  Many hope and wait for the love of our life to come.  Some of us hope for a job.  Some of us hope for the promotion we have worked so hard in our current employer.  

Sometimes we hope for the impossible against our better judgment.  This usually includes hoping for acceptance from your critical parent.  Maybe it is hoping that Aunt Phyllis will at least smile and be nice at the holiday and not find someway to make a scene at your holiday gathering. 

When Do We Give Up Hope?

People give up when they are depressed or when they feel that they have been hoping for the wrong thing.   It can be bad and then again it can be good.

When someone is depressed, they feel stuck and possibly suicidal . . . and give up hope.  Only when they start to feel hope do they recover.   I have had many depressed patients who had given up hope and feel that they were up against a big black wall.  By accident, years ago I told one patient that I offered them a message of hope and that they could get better.   When that patient was being discharged from my program, they said that my offering of hope helped them begin to recover.  (You bet I started making that statement a habit.)

On the other hand, sometimes we discover that we are hoping for the wrong things.  We find that we are waiting for something that is not going to happen.  We then surrender to the reality that it is not going to happen.  We grieve and make a choice to move on.  (I wonder how many people have gone to Hollywood and then went crawling back to their hometown in humility that their dreams were dashed?)

In reality, many people still keep some of their unrealistic hopes in corners of their minds.  Many hope that the estranged family member will return and apologize.  Many hope that they can become a celebrity.  Many hope that their lottery numbers win.  I think that it is part of human nature. 

The Spiritual Hope of Christmas

While I have not particularly sought to proselytize, I will say that if you are looking for hope in Christmas, then you probably need to examine the situation you find yourself in.

Christmas is a celebration that is more theological at its core than anything and part of the theology of Christmas is the spiritual hope for the world.  In making a general, theological statement, the world is a fallen place where bad things happen, and Christ is the redeemer to save it.  Jesus Christ is the hope of the world.

Sometimes we become mindful of how bad we are as people. We think about all of our bad points and how evil and rotten we can be . . . and have been.   That is when we can be open to looking for hope in deliverance.  The Bible tells us in a number of places within its pages that God loved us first in sending Jesus to earth to be that deliverer, and in him we can have hope and can be made renewed and clean. 

It is challenging to look at spiritual matters.  Life in the 21st century does not lend itself to spiritual reflection.  We are very busy people in the western world who tend to be driven to produce and be busy and not think about the spiritual.  We become numb to most matters of hope, and we only end up hoping when our expectations crash.   It is usually when our expectations crash, and when logic fails that we are open to the spiritual and the miraculous.  We hunger for something that knowledge just cannot fill, and that is the spiritual part of us.

Hope.  Real people do it.

I'm Dreaming of What?

It does not seem like the holiday season here in Louisville, Kentucky USA.  It was in the 60's (Fareinheit) today and it was rainy.  Yes, there are 21 more days until Christmas and it looks like a late February/early March day in terms of weather.  But it is the holiday season and you cannot judge by the way things look outside.

Despite the weather, all of the man-made trappings are out.  Many people have decked their houses and yards in "Christmas" lights.  People are trying to get the Christmas Spirit listening to the music and watching old Christmas movies, and wearing festive holiday clothing that sits in their storage tubs the rest of the year.

The music is probably the most powerful of the different aspects of the Christmas season for most people.  The music goes everywhere and can be heard .. . in stores . . . the malls . . . and on the radio.  People sing it to themselves as they drive, and wash dishes.  Music has a way of bringing on feeling and emotion and can make people laugh or people cry.

I'm dreaming of what?

The power of  music leads me to think about how powerful illusions and false appearances at the holiday can be.  One of the all-time best selling recordings is that of White Christmas  by Irving Berlin.   The opening line is about someone dreaming about a snowy Christmas like the ones he used to know.  

The irony of it all is that Irving Berlin was jewish.   He did not keep Christmas as a child . . . he kept Haunukuh and even while as a secular jewish who was not observant, he did not keep Christmas during that time either.  Christmas Day was actually tough for him because his son died on a Christmas Day in the 1920's.    From the different sources I could briefly piece together, he wrote a song for the Christmas market because it would sell.   Yes, he made a lot of money off of it. 

Don't get me wrong, the song was a morale booster to American troops during World War II. It made them think about getting home for Christmas.  However, the point is, at its basic nature, the song is an illusion--the composer simply composed something and it was not real or personal.

Being Real

I think that coping during difficult holidays means looking at what is real and what is illusion.  I am not suggesting that everyone be skeptics, because if someone is not having a hang up  about Christmas and the holiday they should continue doing what they are doing.  However, checking out whether or not you are chasing an illusion can be of value if you are dealing with pain, so you might feel less pain or maybe even feel good. 

The primary Illusion in this case mean that Christmas is supposed to happen in such a way also known as

perfect. 

 In Cognitive Behavioral Therapy it means that a person suffering such distress in such a way is focusing on the "shoulds," "musts," and "oughts."    Perfection is unattainable and does not happen.

Who says that things should be a certain way?  Sometimes it is a powerful person in our life.  But most of the time it is us and what we are choosing to think.  We have the power to say what should happen and what should not happen.  People judge themselves needlessly against the illusion. 

Giving up the "should" often means surrendering and grieving that the illusion is not going to happen.  But giving up the "should, must or ought," can also be liberating.  The liberation comes from not feeling that the holiday has to meet a standard that is merely an illusion and not real.

If you are grieving a loss this holiday, your holiday does not have to be perfect.  It may feel numb and surreal.  Things may not exactly taste as good as they would other holidays.   You may choose a scaled down menu. You may turn on other music instead of listening to Christmas music, and it is all okay because you are grieving.   Grieving is a necessary part of life so we can move on.

For many, Christmas will still be painful and hopefully there can be less pain when people get real and stop chasing illusions that things should be perfect. 
 

Hoping for Inner Peace in a time of discontent

Yesterday was the first day of Advent.  While I was doing the nursery with three, four, and five year-old children there was a sermon going on related to Advent.  Yesterday was supposed to be the Sunday of "Hope."

From time to time I consider the concept of hope.  It is a looking forward to an expectation . . . something that is supposed to be good in your eyes or at least good for you.  We have all kinds of hopes . . . some are little and some are large. 

In the end, something that is hoped for is supposed to bring a sense of fulfillment or pleasure or peace.  Your emotional inside should feel positive and not negative. 

Here at the end of 2012 we have all kinds of worries and discontents.  In many of our countries the economy is doing badly.  War persists in several locations around the world.  The news brings us all of it and Marshall McLuhan's global village brings us a sense of insecurity.

Combine the feelings of insecurity and discomfort with Andy Williams singing, It's the Most Wonderful Time of the Year, and you are experiencing a contradiction.   The feeling of worry and discontent can increase some to make one question personal sanity: Is something wrong with me?

 Defining and Finding Inner Peace

I think for the purposes of this blog, inner peace simply defined is an absence of anxiety, a sense of fulfillment, a sense of security, and a feeling of confidence that you have a grasp on things.    Inner peace does not make everything better.   Inner peace allows you to see a big picture and tolerate the distress and be able to be still. 

A warning is noted here: I can find my own inner peace.  I cannot find yours for you.  I cannot get you over your hump . . . there are no freebies here. 

First, I think that people as a rule do not pay attention when they have inner peace.  They only know when they feel absence of peace or emptiness.  Some of that emptiness comes when there has been a loss that one had centered his or her life around such as a marriage or career, or significant other.   I have found a useful exercise to include asking:

What do you feel like when you are not feeling empty?

For at least now, some people have to ask the question:

What good is your worry doing you?

I have known, colleagues, patients, acquaintances and family members to stay anxious out of a belief that it is the wise choice.  They are the type of people who say "I hope you're right?"  They will stubbornly hold onto their anxiety and be "basketcases."  They hang onto their worry and anxiety out of some need for control . . . they at least feel they are doing all they can do . . . maybe.

A risky example: Me

For me, I find my sense of inner peace first in my faith.  I note that God offers peace throughout the Bible.  Jesus told his disciples in John 14 that he gives peace--not as the world gives.  I have to surrender from time to time and ask God for peace because I am not always going to find it within me.

I also find peace in my non-religious beliefs.   I found that I had been holding negative assumptions that were actually making me feel wretched. When I stopped trying to mind read the thoughts of others and stopped  dwelling on the past I actually felt more peaceful.  Keeping my mind on the present has a remarkable way of faciliting serenity and a sense of order as I can only do something now--not yesterday nor tomorrow.

I must say that as a human I am not a perfect model of inner peace.  Like all humans I have my worries from time to time. 

As I look at Christmas and seeking the feeling of peace, I do find that I am dependent on something larger than I am.  I sometimes need not to look just at the babe in the manager but also at the courage of a guy named Joseph who learned that the virgin he committed to came up pregnant, and he listened to God in his dreams and acted in faith.  He made the obedient choice to stay in the relationship.  I get the sense of peace that it is okay that I as a human have tough choices to make where there are risks and some emotional suffering because that is life.   Sometimes with the risks come affirmation in strange ways that include

• some strange shepherds barging in on your and your wife in the middle of the night telling you a wild story of seeing angels in the middle of the night sky.  

• eight days later seeing some old guy holding your baby up and saying some prayer to God that he can now be dismissed in peace because he has seen the salvation, and then some old lady making a prophecy about your baby 

• two years later seeing some astrologers coming in with Gold, Frankincense and Myrrh followed by another dream telling you to get out of town because Herod is wanting to kill your son.

The Bible does not give Joseph's emotional state through this story line, so I can only imagine that Joseph saw his big picture that there was something larger working.  It hurt and was humiliating in the beginning, but there were all kinds of acts of God after the fact that affirmed God was present and working, even in possible emotional pain. 

I do not know what the future holds, but the Christmas story does have all kinds of complicated side bars to look at.  I think that it shows that God is not naive of how complicated our lives are and can be.  God is there and he will give people to those who ask for it.

Holiday Grief: Depression.

Many people feel depression at the holidays, grief is looked to as one of those causes.  Depression at the holidays can be for many reasons that include Seasonal Affective Disorder (SAD) and a spontaneous episode of medical or non-medical reason, but grief is a big culprit. 

I think that when it comes to deciding the cause of depression at the holidays, it comes to the decision of the sufferer.   Many people who are depressed dwell on and reflect about grief, loss, and regrets, but it does not necessarily mean the grief is the cause.   It usually takes a bit of discussion and hearing the story, but getting to the intended topic, this post will talk about the grief stage of depression and how depression is connected with grief. 

The Stage of Depression

When it comes to the depression stage of grief, a person realizes that there is no bargaining and that they are stuck--the loss happened and there is no going back.  In the death of a loved one, the bargaining usually seems to be short.  In terms of a relationship-loss you see that the relationship is done, the marriage is done, the divorce is final.  The depressed phase can go on for a long time. 

With depression, there is a diminished functioning. The feeling is dark. There is a hole in your life.  You do not feel like doing anything and nothing sounds good. 

One example of the depressed phase was a couple I knew who lost an adult child in a car accident did not answer the phone for a long time. They just were not up to talking to people.  

A second example was a woman who had her mother as her best friend then lost her mother.  She not only lost her mother but she lost her friend.  She had no one to talk to.  She had a need that was not being filled. She was stuck in depression. 

Eventually, this stage ends if the person is able to start exploring and find a way to move on, and heal.  A person moves to acceptance and finds a way to live again and find a way to meet needs.  I plan on talking about moving from depression to acceptance in the next post or two. 

Being Stuck in Anger as a Cause of Depression. 

One other connection between grief and depression has to do with anger.  If you cannot handle the emotion of anger and happen to be either one of those who live in denial, or guilt, you will likely eventually feel depression because you will get worn down.  

Over and over again in my career I have met children and adults who have said "if only I had . . .."  They have blamed themselves over and over again for a negative outcome such as a death or other loss.  They assumed what the truth was . . . and the assumption was merely an assumption where the alternative was never, ever going to be learned; if the alternative did happen, there was no guarantee the loss was going to be prevented.   Part of my work as a counselor has been to allow them to tell their story and then look at the truth, and then forgive themselves for being human who can never know everything.  

A second scenario that I have heard over and over again is people who just cannot allow themselves to be angry.  They are afraid to be angry.  The images of abusive family members combined with low self-esteem just make anger to feel like a sin.  Maybe they were just too codependent and had no time to get angry because everyone needed them.  I essentially have had to encourage this type of person that anger is okay and that they likely needed to take a ride on the wild side and allow the feeling . . . anger will not mean that they will go out and start a world war, nor did it mean all else was going to be put on hold. I am not sure how successful I have been in these cases. 

What are we suppose to do with this? 

I have concluded that feeling depressed is okay especially when you have identified that you are grieving.  Feeling depressed is going to be a part of life and a task was going to be feeling it.  

If you are going to be depressed, you had probably be civil to the people who care about you.  I think that there is no shame in feeling depressed when the rest of the world wants to deck the halls, rock around the Christmas Tree, and roast chestnuts over an open fire.  You are not necessarily being a jerk  . . . unless you really are being one. 

While there is a general desire to withdraw and stay to yourself,  being healthy should be a priority.  Taking care of yourself and seeing that you are eating and exercising and trying to keep your mind engaged in something is appropriate.   Also, you may have to push yourself to be around people and stay off to the side quietly and let the merry ones be vicariously merry for you when you are depressed. 

Suicide is NOT Okay nor a Solution to Problems.

For the record, there are two types of depression: clinical depression and situational depression.  I have been discussing more of a situational depression.  However, depression can get to be of a clinical nature where a person's functioning level declines that includes 

• inability to sleep,
• eat too much or not eat anything,
• concentrate,
• take baths,
• be around people,
• enjoy anything
• and take care of personal affairs.

The depression can include feelings that all is meaningless, and there is nothing to live for.  A depressed person may give consideration to the following suicidal thoughts:

• Others would be better off without me.
• I don't want to be here.
• I want to die
• I want to commit suicide. 

It becomes a big concern when someone starts to think of a plan as to how they are going to kill themselves. Some people ponder overdose, firearms, car accidents, stepping out in traffic, and jumping.  Some people are passively suicidal such as by drinking with their medication and failing to manage a chronic illness such as diabetes or blood pressure.  Some people try to be subtle such as by getting into fights and getting a law enforcement officer to fire at them (often called suicide by cop). 

Despite the different countries and states that have approved physician-assisted suicide, it is the opinion of this writer that suicide is not okay.  Even though we all will die one day, our job is to live, and I hope you are reading this because you want to live and live as well as possible. 

If you are entertaining thoughts of wanting to die, I would encourage you to hang on.  There is always something to live for and there is always a reason to live.   There are people who care and value you.  

Even religious people get depression---it is not a spiritual failure.  Situational depression can wear down on a person to the point where medication and/or treatment may be needed regardless of faith or fervor.  

If you go for treatment to professionals, you are not going to get a shocked look, nor are you going to get shamed.  Mental Health professionals see depressed and suicidal people all the time.  They (including myself) are interested in being professional and respectful, and in delivering effective services to help people recover.  

I would encourage you to talk to your clergy, find a professional or go get an assessment at your nearest psychiatric hospital. If you live in the United States you can call the National Suicide Prevention Help Line at

1-800-273 TALK (8255)  

 or the SAMHSA Referral line

1-800-662-HELP (4357). 

I hope that this helps. Leave a comment if you have questions. 

Holiday Grief--Bargaining . . . it's not just for shopping

I have been reviewing grief at the holiday.   The third stage of Elizabeth Kubler-Ross's model of grief is "bargaining."   Bargaining is a way of trying to regain control.

Typical Bargaining

When we are bargaining we are trying to find a way

•  to regain what once was 
• or to regain control.

From my experience we don't bargain so much when there has been a death, but people tend to bargain when there has been a break-up or divorce.

The bargaining can be quite complex.  At its simplest, two people such as a couple who has broken up  bargain between each other over the long term whether reunification is possible.   An example of a more complex situation is a kid bargaining between his or her parents and attempt to reunify his or her parents by acting out or trying to arrange for family gatherings.

The bargaining usually ends in depression when the bargainer realizes that the bargaining is done and the toothpaste cannot be put back into the tube.  It is hard to stop bargaining because of the loss of investment. There is a piece of you and me in the loss that cannot be recovered and thus bargaining can surprisingly last a long time.

It has been my experience that people are not necessarily aware that they are bargaining.  On numerous occasions I have heard clients tell their story and it is evident that they are invested in bargaining . . . and have been for a long time.  They present the situation of being stuck in conflict with the estranged or ex-spouse/partner/significant other.   The standard line is to suggest that they are bargaining and they stop engaging in that bargaining behavior.  The result is not necessarily going to provide liberating relief, but it likely exchanges one toxic pain for pain that is antiseptic and cleansing

What it might mean for the Holidays

I think that bargaining at the holiday may include trying to get the family to engage in old traditions that had involved deceased loved ones or estranged family members.  This kind of bargaining may mean trying to regain the nostalgic good feelings and sense of belonging that old traditions brought.   If mom had been responsible for Christmas and she is now gone, you may find yourself trying to bargain with other family members about how to celebrate Christmas.   You may find yourself talking to the wall when it comes to your other surviving family members because they are just not ready to have Christmas.

If this is your case, you may find that you will have to create your own Christmas in a non-traditional way. You may find yourself engaging in different activities to celebrate and keep Christmas.   I would say that despite the awkwardness, experiencing Christmas in different ways can provide some sense of fulfillment and meaning despite losing the former sense of belonging that was had with family.

Closing Thoughts

This has been a brief discussion of bargaining as a stage of grief.   It is a difficult step and it usually results in only more pain.  Ending the bargaining does not guarantee that you will feel better, but hopefully less pain. Stay tuned.


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