i grew up thinking that suicide was a completely normal way to die. some people die of cancer, others of old age, and others of suicide. the good thing is that this normalized suicide. the bad thing is that this normalized suicide.

so … let me try this …

let’s imagine you’re thinking of ending it all. you just can’t think of another way out of that thing that just seems to crush you. debts, a broken heart, a feeling of uselessness, terrible loneliness, a sense of being trapped …

how do you feel? overhwelmed, right?

can you relax just a tiny bit of yourself? just a bit … maybe your hands … maybe the way you sit on the chair …

here’s a strange question.

how does your brain feel?

yes, feel that brain. just for a moment.

sometimes it feels like it works well, doesn’t it? maybe that was a long time ago. but there probably was a time when it felt like it worked pretty well. maybe when you played with that dog. oh – dogs aren’t your thing. sorry. maybe – maybe it was when you hung out with your buddy when you were six … can you do me a favour, look for a time when your brain worked ok?

thanks.

so … i wonder … how does your brain feel right now, compared to that time when it worked well? is there a difference?

there is?

it feels a little – weirder, doesn’t it? maybe a bit cloudy? or perhaps it’s a just a bit noisy in there.

can you do me, and yourself a big favour?

i know life feels awful right now. i’d really like it, though, if you could wait with your decision to destroy yourself. please wait with that decision until your brain feels better.

if you don’t know how to make your brain feel better, stick around, please. i have a bunch of ideas we could try. and i know people who have way more ideas. they’ve worked, too. as terry wise, a woman who survived suicide, says “there are other ways to overcome pain.”

one “checkpoint” in addictions counselling is to consider “set, setting, dose”. “set” refers to mindset, “setting” refers to the physical and social setting, and “dose” refers to the type and amount of a substance used or behaviour practiced, and considerations of how set and setting affect dose. for example, if sue, who just had a fight with her parents and is upset over it (“set”), is going to a party with her friends where there is much drinking (“setting”), then before going to the party, she could think about setting a limit on how much she is going to smoke and drink (“dose”), because she knows that alcohol has a stronger effect on her when she is upset.

an interesting question here is, what is the equivalent of drinking in job search? excessive drinking is harmful. what are harmful/unhelpful behaviours in job search? possible candidates:

• using only the computer for job search
• doing many non-job search related activities on the computer during the job search
• avoidance: excessive TV watching, eating, sleeping, etc.
• distraction: cleaning, shopping, etc.

examples of helpful behaviours:

• knocking on doors
• staying in regular contact with networks
• actively limiting non-job related internet use
• learning about writing effective cover letters

mindsets – examples:

• happy, serene, hopeful, positive, etc.
• neutral, realistic, up-and-down, etc.
• negative, depressed, hopeless, angry

settings – examples:

• home (bedroom? office?)
• knocking on doors
• employment resource centre
• coffee shop

an example might be: joe is sitting in a coffee shop where he reads that job openings in his industry are rising and feels hopeful. this prompts him to phone up an ex co-worker and invite him to have coffee.

questions for career practitioners:

• would it be helpful for clients to know about set, setting, dose and how they influence each other?
• we do a lot of work around positive behaviour, a little less about positive mindset, and very little about setting. what would it look like if we turned that on its head?
• how about an exercise where we ask clients to physically visit a place that makes them feel happy?
• at the most, our clients’ lives are 12% about job search (if they spend 20 hours a week on it); the rest is other things (at least overtly; they may spend quite a bit more time thinking about it). how are the remaining 88% influencing them? what would it be like if we thought about helping there in addition to with their job search, just like sue might be helped with her drinking if she had a better handle on how to approach conflicts with her parents?

“what’s your mom’s name?” “mommy!”

“who’s that?” “that’s callan. he’s my sister. jaden is my friend.”

“grandma, who’s that in the picture?” “the father.” “what’s his name?” “i don’t know. jack, maybe?” “no, that’s not jack.” “michael?” “no, not michael.” “is his name gordon?” “noooo! not gordon!” (that went on for 10 minutes, to ever-increasing amusement)

and the most interesting one:

i poke him in the belly. he giggles.
me: “who’s that?”
him: “that’s my belly!”
me: “that’s fabian!”
him: “no, that’s not fabian. i’m fabian!”

he’s not his belly. that’s something i’ve been thinking about quite a bit these last few months. to what degree am i my body? my mind? my soul? my ideal version is that it’s all me. i am my mind and my toenail. but it’s so easy to split it all off, and especially from the body. when i say “my feelings” there is a different connotation, a different implication, a different understanding from when i say “my knee”. there is a tacit understanding, often, that i am indeed my feelings but my knee is something that is owned by me, subservient to me. which of course raises the question of who “me” is (that’s material for another post; suffice to say that i quite like what matthew says here, informed by buddhist thich nhat hanh).

these thoughts about identity come to the fore even more now that i am taking a course in focusing. part of this is to go inside and acknowledge/describe a “felt sense” – processes, feelings or sensations that are experienced in the body. a suggestion in focusing is to describe such a sense like in this example:

i notice there is something that feels sad.

what’s curious is how my body reacted to that distancing. there are a number of layers: “i notice”, “there”, “something that …”; even “feels.” it is very different from

i am sad.

my body didn’t like the distancing.  the challenge i see before me is to use the various distances, rather than judge them. i know how very useful it can be for my clients to distance themselves from their feelings, to contemplate the possibility that they are not their feelings, and/or that they are not dominated by their feelings. if that can be useful for them, then clearly i might find some use for it as well.

fortunately, one of the core philosophies of focusing is that wherever the focusser wants to go is right. so there is not party line for me to tow; i don’t HAVE to use the distancing, i CAN use it. that makes me much more amenable to playing with it …

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?

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.

gifted relationships: on being “too much” to the right of the curve

for most of my life, finding friends and work that honored my intensity and intelligence wasn’t an issue for me.

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make my psychotherapy plain, but with a twist
by tom ellis, PsyD, ABPP on july 23, 2010

jon allen’s post “is psychotherapy going to POT?” is spot on in terms of describing the quandary faced by psychotherapists and their patients with respect to the double-edged sword of “prescriptive therapies.”

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my hopes for mental health camp UK

the moment i spotted MentalHealthCamp toronto i wanted to help make it happen here. years ago i was a volunteer MIND mental health advocate in the old hackney psychiatric hospital (a former workhouse) which was a schooling in one side of mental health services. now that i’m an accidental digital innovator i can see the huge potential in a mashup of mental health and digital, which i can’t really put better than the MentalHealthCamp toronto mission statement :

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dr. khalid sohail, a psychiatrist by profession has been passionately writing for the last two decades. his collections of poems, stories, travelogues, novellas and essays have been published in english, urdu and punjabi. his writings are an attempt to share his humanistic philosophy of life. he summarized his views in his book “pages of my heart” in the following words:

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edge: getting at the neuroanthropology of morality
edge has just posted a new seminar, the new science of morality. you get lots of access to interviews, links to papers, videos, exchange of views, reactions from the press, and more. quite stimulating.

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calling all social change geeks: it’s netsquared camp vancouver

a month from now, on saturday, august 14, i’ll be attending vancouver’s first NetSquared camp, a day-long event for people who work at the intersection of social change and technology. the goal of the event is to build skills and capacity through peer learning, and invites the participation of “nonprofits, activists and social entrepreneurs [along] with their friends and allies in the world of technology and communications.”

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study shows possibilities for predicting how patients will respond to antidepressants

in a study of an experimental treatment for major depression, pretreatment testing to probe the function of a specific brain center predicted how patients would respond to ketamine, a medication that can lift depression rapidly in some people. the work suggests it may be possible to develop ways to use such assessments in the future, not only to better understand depression, but to guide treatment choices for individuals.

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effective confrontation

basic principles to remember:

the 30 second rule: the first 30 seconds in a confrontation, or your response to being confronted, will determine whether or not productive dialogue will even begin.

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coaching at work magazine – mark on a difficult case
mark mckergow is featured in the current issue of coaching at work magazine (http://www.coaching-at-work.com). in the troubleshooter column, a difficult case is presented and expert responses are sought. here’s the problem:

international online training program on intractable conflict
conflict research consortium, university of colorado, USA

non-violent struggle
the problem with the use of violent confrontation strategies is that they quickly escalate to the point where the parties’ only concerns are victory, vengeance, and self-defense. in these cases, the moral arguments of people who are being unjustly treated become irrelevant. what matters is that they have used violent strategies and their opponent is, therefore, justified in a violent response. this problem is complicated by the fact that both sides are usually able to argue that the other side started the violence.

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eight steps for workplace confrontations
one of the challenging things about working in a team environment is that there are times when people behave in ways that we find unproductive, offensive, or hurtful.  when we ignore these feelings the relationship can suffer as our resentment festers.  yet fear at confronting others can prevent us from taking positive action.  today’s post contains a checklist you can use to determine if a confrontation is appropriate, and if so, how to move forward.

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the missing ingredient in most social media strategies
what is the missing ingredient in most strategies i’ve seen? actual strategy.

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expressive writing for the treatment of gay-related stressors

according to research published in the journal of consulting and clinical psychology, writing about stressful or traumatic events related to one’s sexual identity may be an effective treatment for gay-related stress.

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forms in english haiku
keiko imaoka
japanese haiku have been traditionally composed in 5-7-5 syllables. when poets started writing english haiku in the 1950′s, they adopted this 5-7-5 form, thinking it created a similar condition for english-language haiku. this style is what is generally considered “traditional” english haiku.

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gogyōka (五行歌^?, literally, “five line poem”) is a form of japanese poetry invented by enta kusakabe (草壁　焔太） in 1957, in an attempt to escape the constraints of haiku and tanka poetry.^[1] unlike traditional japanese poetry, gogyōka has no mora or syllable requirement for the length of its lines, which is instead governed by the duration of a single breath. the only defining rule of gogyōka is that the poem should be five lines long. in addition to japanese and english, gogyōka have been written in french, chinese, arabic, tagalog, korean, and latin.

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on being chronically absent : “calling for my soul, at the corners of the world, i know she’s playing poker, with the rest of the stragglers”
i have always been an absentee.  sometimes by choice, sometimes by chance. i still do all of my work, and put great effort into it.  but i have never been keen on always attending class.  sometimes i feel that the time is better spent working from home, getting much more done. some classes i never want to miss, and am sad when i do.  i don’t play hooky, like i must admit – i did quite often in elementary school – but at times absenteeismt is necessary. sometimes i need “mental health” days off.  actually, i find it ridiculous that this isn’t expected at the “workplace”, since it has been found that most “sick calls” are due to feeling mentally worn out, than due to being physically ill.  if you get the flu, go home, best that you not spread it!  i feel the same is true of mental exhaustion and the need to get away for a while – a short leave of absence is simply necessary for one to “perform to the best of their abilities” (what any employer assumedly wants – accuracy, efficiency, obedience…, but when you  try to suppress the negative energy that fills your disposition, it spills out onto the people you are working with, and for (diners, students, etc.)

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the rise of the psychopharmaceutical industry 1987-2010
written and submitted by mary ackerley ***md, mdh

mary beth ackerley md is a harvard and johns hopkins trained board certified psychiatrist. she now practices holistic psychiatry.

robert whitaker’s brilliant book anatomy of an epidemic asks a simple question.why , if psychiatric drug treatments are so efficacious, has the number of people on disability for mental illness more than tripled in the last 25 years? most doctors and researchers answered this question by stating that the numbers have increased simply because we are diagnosing more people with mental illness. in response to this stereotyped dismissal of his data, robert began to do more research on the efficacy of known psychiatric treatments. and then, while poring through the psychiatric scientific literature on treatment effectiveness for the last fifty years he found an even darker question beginning to emerge. “is it possible that psychiatric drugs are actually making people much worse?” could it be that far from “fixing broken brains” the drugs being offered actually are worsening, and even causing, the very illnesses they claim to heal?

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any thoughts on this?