change therapy

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when i was young, i thought for a long time that suicide was a normal, commonplace way for a person’s life to end. it was probably the most frequent cause of death i was familiar from friends and family. my earlier assessment was correct, at least partly – for example, among young men, suicide ranks among the most frequent causes of death. is it “normal”? actually, let’s forget about normal – it’s highly undesirable.

why do people kill themselves? it’s hard to speak of a single cause for a decision that has such a complex and painful pathway. one thing, however, is something that most of those who know about suicide agree on:

people commit suicide because they feel that’s the only way out.

and most of the time what they want a way out from is pain.

some of it is physical pain, mostly for people with chronic pain. cluster headaches, for example, have been called “suicide headaches.” chronic regional pain syndrome (crps, also known as rsd for reflex sympathetic dystrophy).

most of the pain is emotional pain, though. there are so many forms of emotional pain, for example

• loneliness (e.g. for seniors – older men have a high suicide rate, as well)
• shame (e.g. gambling has been referred to as the addiction with the highest suicide rate)
• depression
• guilt
• unbearable emotional/mental pressure (e.g. for people with bipolar disorder or schizophrenia)

the list goes on.

to raise awareness about suicide, there is an event on september 10 in honour of world suicide prevention day. here is an announcement:

several community partners are organizing a commemorative event on world suicide prevention day at noon on friday september 10, 2010 outside of the vancouver art gallery.

every year in bc almost 500 people die by suicide – for each of those people, there are families and communities who survive them. on september 10 people around the world gather to remember loved ones who have died by suicide, to demonstrate support and compassion for families, friends and communities whose lives are touched by suicide, and to renew our commitment to learning more about suicide prevention, intervention and postvention so we can act effectively to reduce the incidence and impact of a devastating and often preventable tragedy.

we invite you to bring a pair of shoes that can be included in a display on the steps of the vancouver art gallery, commemorating people lost to suicide. after the ceremony, the shoes will be donated to lookout emergency aid society – so please only bring shoes that are serviceable.

this is an interview with m. a bit more serious. you just never know.

i: now i will interview you, m.

m: now i’m in trouble!

i: (looks at m)

m: what are you interviewing me about?

j: men.

m: men? oh, heavens!

g: religion! there’s a good one!

i: what shall it be? men or religion?

m: religious men!

i: what about religious men?

m: well, i’ve always found them kind of interesting and crazy.

(there’s a side conversation about men in kilts going up ladders. isabella isn’t quick enough to catch the whole thing)

m: alright. mh. so. as a child, i was a catholic. we were told that the priests were very special and holy men. quite the surprise to find out that most of them were perverts, later in my life. well, maybe not most. many.

(as we’re saying this, my husband walks around the kitchen, wearing a t-shirt that says “utterly perverted”)

m: that’s probably what trigged me into this topic. g’s t-shirt. so then later i had a friend who went off to join a monastery. he was bisexual or confused, one or the other, and thought this would be a good way to sort out his sexuality, by going to a monastery. he returned a year later because he found out all the guys in the monastery were having sex with each other. no confusion there! he was pretty disappointed. that didn’t help him at all.

m: you have to ask a question! come on, interviewer!

i: so then what happened? (note the intelligent question!)

m: i just found that i was exceedingly disillusioned about religious men and the whole religious establishment. the church has a lot to answer for.

i: but this was all a little while ago. have they changed, perhaps?

m: not likely. been reading the papers lately? no, not likely. no.

i: is there anything that can save the church?

j: pure anarchy.

m: yeah! women!

i: what about the nuns?

m: oh, please! not the nuns i knew! no, i’m talking about laywomen. any organization that eliminates women from certain positions is doomed to failure. don’t your agree? (she asks the interviewer)

i: (the interviewer just types and types) (then scratches her head)

i: i have a question!

m: yay!

i: i posted something about a woman who started a church support group for people with mental health issues. did you read that?

m: sorry, i didn’t.

j: i read it!

i: does this contribute something to our conversation?

j: yes. it showed women being given the opportunity to grow in leadership and being supported in that. she was an inexperienced facilitator and was a co-facilitator to work with and it was extremely successful.

m: was that within the church?

j: yes! it was supported by a minister.

m: what church?

j: i remember her being nervous about it, then through trying it out finding it was the best she could have done.

i: it was an evangelical church in burnaby.

m: most of my experience has been with the catholic church and although they are evangelical catholics – maybe they’re better, i don’t know.

i: but the ones that you know … ?

m: they’re stuck. they’re totally stuck.

this is hardly a comprehensive discussion but it might open up comments for people who have had similar, or maybe completely different, experiences.

this is an entry for my participation in the 2008 blogathon, a 24-hour marathon of blogging. please support the cause and donate – however much, however little – to the canadian mental health association (vancouver/burnaby branch). to donate, email me or use this URL: www.canadahelps.org/CharityProfilePage.aspx?CharityID=d2252. you should be able to get there by clicking the link; if not, just copy and paste the link into your browser. it will take you to the appropriate location at canada helps.

thank you for visiting, reading, commenting and, if you can, donating!

i like to think about god when i wake up in the middle of the night. i had just finished deepak chopra’s new book on mohammed (review coming up soon). the many stories about the tribes, the complicated family relationships, the exchange with jews and christians, the interdependency with slaves – maybe that’s what made me come up with this idea: god is about community and cooperation. or maybe: god IS community and cooperation.

• love your neighbour as you love yourself, says jesus.
• give alms to the poor, says mohammed.
• respect your parents, says the god of the old testament.
• we are all one, says the buddha.
• do not kill one living being, say they jain.
• ren, a key concept in confucianism, is represented in chinese characters by the image of “human being” and “two”.

religions are, to a large degree, rules for living together. (i know, that’s not a new thought).

“if there were no god, it would be necessary to invent him,” voltaire said. who knows what a god is, whether god exists, and what it means for a god to exist. in my mind, these questions are often not that interesting – clearly, there are important levels at which god/gods exist.

however, i can see how it is through community and cooperation that gods could have been invented. evolutionarily, humans were desperately dependent on community and cooperation. we didn’t have the size of woolly mammoths, the adaptability of the cockroach or the fierceness of the sabre toothed tiger. huddling together, dividing labour, learning from each other as we developed tools were our only chances to survive. (banding together for raids and warfare apparently seemed like a good idea, too). building powerful rituals and stories around these communal means to survive made us stronger.

no wonder there is a god.

sometimes asking the right questions is what turns a problem around. and often making the questions as precise as possible is a good thing. i’m going to take the liberty of using one of raul’s posts. he asked, “why can’t i sometimes help the people i love the most?”  (by the way – read it. it’s quite moving.)

maybe that was the right question. and i wonder, how else could this have been approached?  let’s take the word “sometimes”. when it’s important to indicate that something doesn’t happen all the time, it’s a great word. on the other hand, there are situations where “sometimes” obscures what’s going on. in that case, it might be a good idea to ask something like

“why can’t i help my loved ones who have cancer?”

the good thing about rewriting a question is that it helps us see it in a different light. looked at it this way, i start to wonder, is this really a question, or is it a – a sigh perhaps, a sigh phrased as a question …

what, though, if it really is a question? in that case i’d like to know what the questioner is trying to accomplish, what the exact knowledge is that he wants to gain. in this case, i imagine that raul wants to help his loved ones who have cancer. so we could end up with this question:

“how can i help my loved ones who have cancer?”

this is a question that can be answered much easier, and can lead to action.

there are other times, though, when taking this rational approach doesn’t go anywhere useful or satisfactory.

“why can’t i get over my negative feelings about my father?” is a question someone (let’s call her perl) asked the other day. turning this into “how can i get over my negative feelings about my father?” didn’t have any effect. it was a long-standing problem that just didn’t want to go away. “what will your life look like once you’ve gotten over it?” produced only a lukewarm discussion; it just didn’t resonate, the possibility seemed too far away. “do you want to get over it?” is a question i asked quietly – it didn’t seem appropriate to ask at that particular point. so we were at a stalemate.

then we let go of reason. all we wanted was find a question …

“why can’t i get over my father?”
“why can’t i get my father?”
“why can’t i get it?”
“why can’t i let go?”
“what’s it like to let go?”
“what’s ‘let go’?”
“what’s let, what’s go?”

when we arrived at the last question, perl started laughing. it was a loud, free, happy laugh.

“it’s a koan!” she said, “i found my koan!”

the question doesn’t make much sense. but then not being able to let go of her negative feelings about her father after all these years of therapy didn’t make much sense either.

a koan goes deeper. it pierces through the shield of rationality – an important shield, one we are in great need of, but it’s not the level at which most of our life takes place. “why can’t i get over my negative feelings about my father?” it’s a mystery. so we went to a place of mystery.

what will perl do with this koan?

i don’t know.

where does a koan go?

this morning, i visited chitowngreg’s sunday post about gratitude. it was fabulous to see all the comments there – 48 at the time i was visiting.

and then of course my research brain got curious. what a great treasure trove to delve a little into to find out what specific things people are grateful for! i spent a few hours to analyze it a bit and cam up with a few surprises and a few things that were expected.

family was the biggest theme. i found 25 mentions of it. most of them were about children, e.g.

three wonderful children with their own uniqueness

and almost as many about spouses, e.g.

climbing into my warm bed, with my husband who loves me, and listening to the rain softly falling all night long……

then a surprise – the next category in “family” was dogs, before mothers, etc.:

for dogs who never tire of seeing me.

chitowngreg’s blog is a 12-step blog, so understandably, there were a lot (21) of expressions of gratitude about recovery and 12-step programs, like

i watched, “crazy heart”, last night. a story about an alcoholic country singer/ songwriter. made me very grateful for my sobriety and the second chance i was given.

indirectly, some of the comments where gratitude is expressed for those kinds of things would also fall into other categories such as spirituality and friends (because of the strong fellowship aspect of 12 steps). i found surprisingly few (5) for friends (“the companionship of friends”) and 4 for spirituality (e.g. “playing ave maria in a little while at mass this morning”).

i was also not necessarily surprised but perhaps “pleasantly confirmed” that those gratitudes contained none of the cultishness that 12-steppers are sometimes accused of.

another topic that came up frequently was basic needs, possibly inspired by greg’s intro to the post about how lucky most of us are. if your combined household income is over $ $26,400 a year, you’re in the top 10% of all income earners in the world. think about that. for many of us westerners, that’s mind boggling. when i think of how many people i know who are wringing their hands because they only make $25 an hour, it’s refreshing to hear this

thank god for running water!

and then there were more comments (14) about the weather/nature than there were about health (11)! that was perhaps the biggest surprise. i would have expected for health to be right up there with family. of course this is anything but a scientific research project – still, i find this remarkable, something i’m thinking of following up (maybe i’ll write one of my brainblogger articles about this sometime soon). loved this comment:

i’m grateful to have had a glorious weekend on the boat and that this afternoon there was a wonderful thunderstorm. we came back through the rain but were safe. nature in all its power!

another surprise: of all the gratitudes i looked at (about 140 altogether), this was the only one that explicitly mentioned nature.

here’s one about health:

i’m grateful today that i can think and speak in words. a dear friend is wordless after a brain hemorrhage, and it’s very hard.

other things that were mentioned more than once, with some examples, and in order of occurrence:

blogging

i’m grateful to have blogs that allow me to reconfirm i am doing the right thing in my life.

gratitude itself
people like you who remind me why i should be grateful when i’m grouchy just because its monday

personal growth

having the courage to ask “what am i going to do,” rather than sitting in pity saying “why”

mornings (that was another surprise – mentioned 7 times)

the possibilities of the whole day in front of me

also home, work, baseball (!!!) and peace.

here is the link to my final post on brainblogger on using chaos theory to understand conflict and, hopefully, see which way peace lies.  following the lead of a team of multidiscplinary researchers (psychologists, sociologists, etc.), we look at three solutions:

interrupting the feedback loop of conflict

finding commonalities

the butterfly effect – doing small things

an hommage to nancy white, one of my heroes. among a gazillion other things, i admire her for her graphic representation skills. this doodle here represents the stories of people who were talking about all the places they’ve worked.

the following is a press release from vancouver’s north shore schizophrenia society.  since no-one seems to have picked it up yet, i’m publishing it here.  it addresses the important question of when involuntary admission for serious mental illness is applicable, and the involvement of family members.

vancouver coastal, in a review of the death by suicide of marek kwapiszewski, has ducked the leading question they needed to answer: why is “dangerousness” still considered a requirement for involuntary admission rather than “to prevent the person’s… substantial mental or physical deterioration,” as spelled out in the mental health act?

what was promised by CEO david ostrow to have been an “independent” review, moreover, turned out to be not so independent after all, with senior managers under question in the review taking part in drawing up its recommendations.

kwapiszewski, 54, of vancouver, who suffered from schizophrenia, jumped off the granville street bridge to his death june 29, 2008. his sister, halina haboosheh, together with her lawyer, had made 16 different attempts to get him the treatment he needed – treatment which required involuntary admission since kwapiszewski, like many suffering from schizophrenia, did not have insight into his own condition.

instead of dealing with the factors leading to kwapiszewski’s death, the review came up with three brief items in a so-called action plan, which involved no changes or improvements in practice, nor was any fault determined although it was an obvious case of clinical failure.

“the ‘action plan’ should have been called an ‘inaction plan,’” NSSS president herschel hardin commented. “it was as if a review had not taken place.”

the so-called action plan was presented to haboosheh and the north shore schizophrenia society, which made the original submission in the case, at a meeting july 26, in vancouver coastal’s boardroom.

the first item, to facilitate a discussion to consider development of an operating definition of “deterioration,” makes no commitment to ultimately do anything, and is highly questionable to begin with in any case. nor does it apply to the kwapiszewski case, where the deterioration was quite clear and substantial.

the second and third of the three items were bureaucratic filler, not representing anything new and showing no grasp of what the problem was.

the review also completely missed two other crucial factors in the case: the failure of vancouver coastal staff to involve the sister, halina haboosheh, as an integral member of the treatment team, following best practices, and the concomitant failure to share clinical information with her. if that had been done, marek kwapiszewski might well be alive today.

it was also learned that the items were not the independent work of the external lawyer and psychiatric consultant hired to undertake the review, but were a consensus arrived at with senior community mental health managers and, possibly, vancouver coastal’s risk management officer. in effect, they had a veto over what would be presented.

as well as forfeiting the review’s independence, this meant that a major shake-up of senior mental health management, called for in NSSS’s 2009 submission, could not even be addressed. instead, the primary subjects of the review, as NSSS considered them, were parties to the review’s outcome.

in response to vancouver coastal’s items, NSSS has presented four recommendations of its own to vancouver coastal and has asked ostrow and his board for leave to speak directly to the recommendations at a board meeting.

for more information, please go to the NSSS media center.

i am still intrigued by the question of the relationship between work, mental health and peace. it is interesting that this relationship is hardly ever explored, not even the relationship between the workplace and peace. however, here and there i find a little nugget. one of them is giving peace a chance: organizational leadership, empowerment, and sustainable peace by gretchen spreitzer at the university of michigan at ann arbour. here is her finding:

we started the paper with the question – can business organizations contribute to sustainable peace? our initial explorations provide some fledging support for our hypotheses that participative leadership practices and employee empowerment can foster more peaceable conditions. how? in simple terms, we suggest that business organizational leaders can give employees opportunities for voice and empower employees to have more control over their work. from these more participatory work practices, employees will be exposed to some of the key characteristics of peaceful societies. when people get a taste of empowerment at work, they may then seek opportunities for empowerment in civic and political domains. in short, business organizations can develop collective agency so people believe they can intervene in civic and political life as well, leading to more sustainable peace.

the idea that business organizations can be a sort of olive branch for peace rather than just a harbinger of excess and exploitation is attractive. too often, it seems that companies seek to have a positive impact on communities through corporate philanthropy or corporate social responsibility. while these initiatives can be impactful, they are often expensive and can been outside the mission of the firm. this research suggests that business organizations can have a positive influence on peace through their everyday practices around participative leadership and empowerment. while not meant to substitute for more formal philanthropic efforts, this research indicates that business practices affect more than employees and the firms they work for. they can also impact the communities of which they are a part. business organizations can create models of peaceful societies which can ultimately move societies toward more peaceful outcomes. even when financial resources are scarce and impede corporate philanthropy, business organizations can still make a positive impact through participative leadership and empowerment practices. business organizations can do good for peace by creating good business practices. ultimately, it’s a win-win outcome because the business organizations benefit from these progressive management practices while societies benefit from having models for peace.

do you know an organization that embodies these values? have you ever worked in one?

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every month i delve into the buddhasphere to come up with interesting tidbits in buddhist writing. this time around i was interested in the concept of right action.

the poem we start out with today is the famous shin jin mei poem

the perfect way knows no difficulties
except that it refuses to make preferences;
only when freed from hate and love,
it reveals itself fully and without disguise;
a tenth of an inch’s difference,
and heaven and earth are set apart;
if you wish to see it before your own eyes,
have no fixed thoughts either for or against it.
to set up what you like against what you dislike -
this is the disease of the mind:
when the deep meaning of the way is not understood
peace of mind is disturbed to no purpose.

thanks, tricycle!

right action and the death penalty

i’m including this one because the writer draws a (perhaps tentative) conclusion that is different from my own; it’s important to me look at a diversity of points of view. also, it’s fitting to start with this one because “do not kill” is almost always cited as the first exhortation in the teachings about right action. i like the simplicity of it, similar to hippocrates’ basic idea, “first do no harm”. here is an excerpt of the post dying for killing:

one of the most important things the buddha taught was “do not kill.” it’s commonly accepted as the first precept. so, buddhists clearly do not believe that it’s right to kill, to take life. as the buddha did not teach, “do not kill except in the following cases…”, it’s commonly accepted that all killing is wrong. this is why many buddhists are vegetarians, peace activists and conscientious objectors.

isn’t it amazing how something so straightforward can be treated with such confusion? because here’s where i start wavering.

right action and the body

here, in fact, is a translation offered by a buddhist from malaysia about the buddha’s teaching. it is interesting how in the west, the idea of right action is usually linked closely to ethics whereas this section clearly is concerned with what one does with one’s body:

and which, friends, are the 3 kinds of bodily moral behaviour in harmony with the dhamma? here someone, stop all killing of living beings, abstains from injuring living beings; with rod & weapon laid aside, gentle and kind, such one dwells sympathetic towards all living beings.

avoiding the taking of what is not given, one refrains from stealing,what is not freely give. one does not take by way of theft the wealth and property of others, neither in the village nor in the forest. abandoning abuse of sensual pleasures, such one gives up misuse in sensual pleasures. one does not have intercourse with partners, who are protected by their mother, or father, or mother and father, or brother, or sister, or relatives, who is married, betrothed to another, who are protected by law, in prison, or who are engaged to other side.

that is how there are three kinds of bodily moral behaviour in harmony with the dhamma… such is right action!

right action, teaching and fun
this excerpt here from back to buddhism illustrates why it can sometimes be difficult to find interesting posts about buddhism – many buddhists just don’t bother to stick the label “buddhism” onto all they write.

i really don’t think it’s necessary to categorize something as buddhism or not-buddhism; after all, there is really not much difference between the two. when i write about racism, i am writing about right mind. when i write about teaching, i am writing about right action.

so let’s see what he says about teaching.

in all my classes, whether they are english or computer science or meditation, i make a concerted effort to make sure it is fun. in fact, i try to make class silly. the class has to be fun for me and it has to be fun for my students. if we are not having fun, we are not learning.

… after lunch is the most difficult time to teach. to counteract the drowsiness of my students, i knew i would have to really knock the lesson out of the park.

it’s relatively easy to act out the verbs – walk, shout, am. it’s also not so hard to point to nouns and dress them up with adjectives. even adverbs are not so hard to impersonate

however, acting out through and at and with is a bit more of a challenge; toward was nearly impossible.
we made it through prepositions i had planned. salt played a big role in the lesson. the salt is on the table, above the table, under the table, with the glass, behind the glass. there was a combination of horror and laughter when the salt went in the glass.

right action, software and the mundane. oh, and green living

at first glance, this post on buddhism and software selection (first found on another malay buddhist blog, buddhist bugs) seemed a little lightweight. well, it is, just like the book they suggest, what would buddha do? nevertheless, there is something intriguing to seeing buddhist teachings applied to something so seemingly mundane (and yet very important for businesses, just like not stealing and not cheating). after all, if we don’t apply the teachings to the mundane, what’s the point?

and if you’re in the mood for more lightweight reading, go to mother nature news and read about the book what would the buddha recycle? once again, it’s easy to raise our highbrow eyebrows but let’s be honest – isn’t light and fluffy material like this that sometimes provides the entrance to more profound learnings?

right action and inaction
buddha’s pillow has a number of posts on right action, like this one on responsibility:

many of us choose inaction in stressful or frightening situations. this is not practice. inaction in the presence of conscious choices of right vs. wrong actions is irresponsible to oneself and one’s world.

right action and social responsibility
more on responsibility.  here`s an interview at shambala sun about social action:
goodman: kittisaro often quotes ajahn chah as saying, “if it shouldn’t be this way, it wouldn’t be this way.” yet we live in a world of great suffering. how do you reconcile ajahn chah’s teaching with the buddhist precepts of “right speech” and “right action”?

thanissara: at some level it’s obviously true—it can be no way other than it is right now. however our actions in the present condition the future.

buddha didn’t just sit there and say, “oh well, the world is at it is.” he acted. in fact he tried three times to prevent a war between those in his home country of kapilavastu and the king of kosala. yet he wasn’t able to stop the bloodshed. he had to accept that this was a karma he couldn’t alter, but it didn’t mean that he didn’t try. on leaving the area, it is recorded that his beloved attendant ananda asked him why he was so sad, to which the buddha replied that his people would be massacred within the week.

right action, therapy, living in the now and values

the smart buddhist, written by a therapist, has all kinds of choice morsels on offer. here he touches on a sensitive point for me, the idea of being value neutral as a therapist:

the experience of living in the present, paradoxically, can tempt us into experiential avoidance all over again, just in a new form. it’s quite possible to trade escape from the now for escape into the now. the recent enthusiasm for mindfulness and acceptance in the west needs to be channeled properly or we risk creating just another form of western self-indulgence. by themselves, mindfulness methods as they’re often used in western psychotherapy don’t give sufficient attention to the organizing influence of purpose in human life. in the spiritual traditions from which such practices were drawn, “right action” is specified through ethical principles. but western therapists are encouraged to take a value-neutral professional stance, and not direct our clients to any particular belief or “right action” enjoined by a religious or spiritual tradition. nevertheless, we still can help our clients gain access to their deepest aspirations and turn a life lived in the present moment into a life worth living.

right action and rightness

in the last little while, i’ve come across a number of situations where people understandably got a little itchy at the idea of rightness, for example in the comments on my post about trying to come up with a definition of mental health. what’s with this right action, right thought, etc.? part of this comes precisely from the doctrine of value neutrality that many of us been exposed to – in therapy for some of us, but definitely in science. historically, this is also (paradoxically) connected to the very fabric of democracy and human rights, for example when it comes to religious freedom. it is useful, then, to look at this idea of rightness. dogen sangha gives a bit of insight here:

there is none among the many kinds of right that fails to appear at the very moment of doing right. the myriad kinds of right have no set shape, but they converge on the place of doing right faster than iron to a magnet, and with a force stronger than the vairambhaka winds.

(even though each of milliaeds rights do never have any kinds of decisive form beforehand, and so there is no right, which exists before at the present moment, and at the same time there is no right, which continues its existence to the next moment. right is always exists just at the present moment, and such a present moment continue at every moment.)

right is a simple fact, which occurs just when it is done at the present moment, therefore it is perfectly impossible for right to exist at a different moment other than at the present moment at all.

right action and musicianship

we started with the art of poetry, let’s end with the art of trumpetry. here is a beautiful piece at macfune about musicians and right action

what, then, of the moral commitment of the musician? what is it to be a trumpet player? certainly we can differentiate between the hack who puts some plumbing to his lips every once in a while and the truest artist whose spiritual being is not separate from the physical processes inherent in performance. the difference is morality. the difference is how one lives one’s life, not how one thinks idly about right and wrong but how one acts.

(side note: nothing is still, nothing is constant, nothing exists from one instant to the next: all we are is action. there are no nouns in this universe, only verbs. all nouns are categorical statements that limit and defy the constantly changing nature of phenomenal existence. “i” should be understood as a verb, not a noun.)

right. so the musician is, like all artists, exploring the fundamental question of human existence: the moral question. when we listen to miles, coltrane, glenn gould, to the cleveland orchestra playing beethoven (!), or to any other great musician, if we pay attention we can hear a profound moral question posed.

i remember reading somewhere or other that the key to understanding jazz is to hear the hidden social message: in the softest, most intimate ballad are the seeds of a profound sadness, and in the most joyous, swinging celebratory bop number is wild rebellion, lurking just beneath the surface.

if you’ve made it this far, thank you! come again next month, on september 15, or read some of the other buddhist carnivals.

on tuesday i had the honour of hosting the #mhsm (mental health and social media) chat. that’s a weekly one-hour conversation about mental health on twitter. the topic we discussed was mental health and addictions. it was very lively, and perhaps the biggest topic was self medication, a topic that sprung up within the first few seconds and just kept coming back. here are some of the things that were said. the categories i chose are not mutually exclusive – they just make it a bit easies to see some of the patterns.

self medication to deal with life’s stressors
1:02 am floridlymad: [addiction is a] coping mechanism to life’s stressors gone wrong…
1:03 am floridlymad: @JoyFull_deb YES. a girl i know w/crack addiction once told me it’s her only joy left in life…
1:04 am GermanInAlabama: From my uneducated view I would say oftentimes attempt at self-’medicating’ and means of forgetting about probloems
1:48 am twitertwotter: If addicts r using drugs 2 self-medicate we need to find out why and help them learn to cope with it and move forward from past trauma
1:06 am NAMIMass: Sometimes people don’t want to take prescribed medications but think it’s ok to drink or take illicit drugs to feel better
1:18 am twitertwotter: I think an important thing that gets missed in addiction is in many cases the underlying trauma

self medication to deal with mental health issues
1:02 am JoyFull_deb: Yes !! Addiction (whatever kind) can be used to self medicate mental illness.
1:04 am petequily: @moritherapy society often doesn’t take mental health seriously & pays the cost in self medication / addictions & other MH conditions
1:05 am EatsShootsEdits: I used to self medicate before I came to understand my illness and get stable on meds
1:08 am hollymclennan: @moritherapy i see the conx btwn mental health + addiction when ppl don’t get the help they need + self-medicate.
1:08 am floridlymad: addiction to certain substances can trigger (or worsen preexisting) psychosis, which may or may not persist even after *quitting*.
1:17 am perthtones: We now know cannabis is effective on a range of depressive disorders, ketamine being trialled for bipolar – legal/illegal is abritrary
1:47 am icantican: My hx of drinking problem w/ alcohol was directly related to self medicating my symptoms of depression, blips of mania, anxiety, ADHD
1:08 am EatsShootsEdits: at lot of people self medicate long before they know they have a mental illness. our minds seek comfort sometimes it is drugs first
1:23 am twitertwotter: Many addicts use marijuana and other drugs to medicate their hyperarousal, that can be a result of PTSD or overactive flight/fight

self soothing
1:26 am twitertwotter: Treatment definitely needs to address mental health issues, coping mechanisms, affect regulation and self-soothing techniques
1:51 am twitertwotter: People who drugs to feel better, or to forget, or to escape. That is self-medication. They do not know how to self-soothe.
1:53 am NAMIMass: @twitertwotter Not all addiction is about self soothing. We’ve talked about self-medicating substance abuse for #mentalhealth issues
1:46 am moritherapy: if addiction is about self soothing, then it doesn’t matter that much what the substance/behaviour is
1:57 am NAMIMass: @moritherapy I’m not sure I do agree. I’m not thinking of them at same level. I think of self soothing as less than self medicating
1:54 am moritherapy: @NAMIMass self soothing and self medicating very similar, wouldn’t you say?
1:56 am moritherapy: @NAMIMass but if you talk to health care ppl, self soothing/medication will NOT be #1 for them

self medication and ADHD
1:08 am petequily: Smallest # of addicts with #ADHD in clinical journals I’ve seen is 20%. But only 5% of pop. has ADHD http://bit.ly/7cXP8
1:10 am petequily: Study 35% of Cocaine Abusers had #ADHD http://bit.ly/4vRuoi #selfmedicate #mentalhealth
1:25 am petequily: I know of people who had undiagnosed #ADHD & self medicated w/ one addiction, stopped it & started & stopped multiple other addictions
1:44 am petequily: Study 33% of Alcoholics had #ADHD 65% of Drug Users Had ADHD http://bit.ly/b4EwqG #addiction
1:47 am petequily: @unxpctdblessing well by telling other people about how he self medicated his #ADHD w/ pot you may save others from same exp.
1:54 am asdquefty: With ADHD or depression, substance abuse can be obtaining artificial motivation.

stories of self medication
1:03 am JoyFull_deb: I watched my sister “self medicate” for many, many years….
1:16 am MelissaMashburn: my brother is a vet and almost lost his license because he was self medicating with xanex and writing his own scrips.
1:39 am MelissaMashburn: I used internet games to self medicate
1:40 am unxpctdblessing: @petequily I agree. He had been self medicating since he was 14 years old. I knew he used when I met him but had no idea the extent.
1:44 am MelissaMashburn: For me the addiction to an internet browser game, was away for me to self isolate, and self medicate