SUICIDE ISN’T JUST ABOUT DEPRESSION

October 6, 2014Kathe Skinner, M.A., L.M.F.T. 2 Comments

(This blog was first published by Disability.gov.)

In the mega-wattage aimed at Robin Williams’ suicide everyone had something to say. But when all was said, everything went back to the way it’s always been when mental health’s the issue.

The disabled or chronically ill population often inhabits a landscape where mental health is a place of shifting sands; they know that psychological symptoms are only part of the territory. And though they might not know it, anyone else who’s ever seriously considered, or attempted, suicide has been there, too.

Reason 1: Suicide is a perfect storm. A confluence of factors accounts for an attempted or successful suicide. The biopsychosocial effect describes three separate but linked factors that make for the perfect behavioral storm.

The first, biology, talks about the genetically present markers that provide the tinder that can predict a life-ending event. Certain mental health disorders result from biological events and can’t be caused by events in our lives, schizophrenia for example. In fact, most of the diagnoses found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), are a result of nature, not nurture. (That doesn’t mean that nurture or experience can’t affect nature. For example, brain structure can actually be changed by the cumulative effects of stress).

A solid neural whack is enough to upset the brain’s apple cart and to actually affect the apple cart itself (i.e., traumatic brain injury, chemotherapy).

The psychological factors refer to how thoughts and feelings are processed into behaviors. How we think and what we think about ourselves and our world are significantly influenced by nurture and experience. Amazingly, significant amounts of emotional stress will actually change the structure of the brain – the hard wiring.

The good news is that when brain structure has been determined this way it can also be reversed. Buddha had it right when he said that we make the world with our thoughts.

Adult caregivers, or older children in our own families, are the early source of how we position ourselves psychologically. Peer groups, even one person within that group, are also influential: bullying comes to mind.

Social factors refer to what’s happening around and to us. For example, when terrorists blew up the World Trade Centers people around the world experienced significant psychological reactions that were clinically diagnosable. These are the situational diagnoses without a biological cause, although an existing mental health problem may be triggered by events.

For instance, a major depressive disorder can be brought on by grief, whether or not a history of depression exists. Trauma can be brought on by exposure, or over-exposure, to a horrifying event. That’s what happens when people are flooded with 24/7 video of disaster images, or a job involves continual exposure to disaster or tragedy.

Reason 2: Suicide is a game of dominoes. A precipitant can be found in any third of the biopsychosocial formulation, igniting reactions in the other two spheres. Reactions are ramped up as one sphere feeds the others in endless loops. Without intervention in at least one area, a body’s systems can break down.

For example, I’ve worked with diabetic clients who pay poor attention to insulin levels, diet, and exercise. This is especially true of teens. Reasons might include not wanting to be different, interference with having fun, being marked as “not normal”, or that testing is an interference. So while anxiety is part of diabetes’ medical description, that emotion may be worsened by psychological factors like negative thinking, and social factors like being shunned at school.

Reason 3: Suicide is personal. Duh. Suicide is the ultimate personal decision and action. Even if you think you’ve made up your mind about whether it’s ever right for a person to take such action, there’s always a “but what about this?” scenario. The rule that works is stated “It Depends”.

Consider these factors:

· Quality of life

· Loneliness

· Unrelenting physical pain

· Chronic emotional pain

· Persistent emotional and/or mental pain despite treatment

· Terminal illness

· Loss of dignity in living

· Fearfulness about the future

Which of these situations justify taking your own life? Do you think that one area of the biopsychosocial model predominates in a decision to commit suicide? Does seeking to die always signify depression?

In 1975 the Karen Ann Quinlan case went to the U.S. Supreme Court before the right to die with dignity for those in a vegetative state was established. It might be said that Karen Ann’s parents fought for the right to “commit suicide for her”.

The 1981 film starring Richard Dreyfus, Whose Life Is It Anyway?, addresses a quadriplegic’s right to die by refusing nourishment – a passive suicide. The film presents the moral, legal, ethical arguments that are often arrayed against individual choice. Not much has changed: decades later over 90% of states don’t allow for physician-assisted suicide, what is euphemistically called death with dignity.

Our society lags behind other industrialized nations regarding physician-assisted suicide. Here the rule is that the illness must be terminal with physician intervention occurring only when death is judged to be imminent. Rather than being enlightened, our nation’s religious, legal, and medical institutions are queasy at best about death, and hands-off at worst.

The result is that lots of suffering happens well before a physician provides assistance.

Reason 4: To suicide or not to suicide, that is the question. Without human resilience the rate of suicide would skyrocket. That this is true is demonstrated by people who don’t commit suicide even though they share circumstances with others who do and even though their mood is likewise affected.

In the case of minors and adults with diminished intellectual capacity, it ought to be our business. But all American institutions consider all suicides their business, acting in many ways to prevent it.

Death of any kind seems to be owned by the living, whether it’s scary or exciting or mourned or praised. The morals of the civilized world seek to prevent death at any other hand than its own. It’s a great irony that once a life is saved little energy may be expended in assuring the quality of that saved life. Society sends double messages: suicide is prevented but it all too often doesn’t accept the burden of providing for care or being respectful and inclusive to those who’ve been saved from a fate-worse-than . . .

Reason 4: Suicide can be just a matter of time. Robin Williams’ death illustrates that suicide can be the result of many factors, not just depression. He was loved around the world with an enormous talent and humanity that made a difference in many lives.

It wasn’t enough.

Robin Williams carried the burdens of Bipolar Disorder, so his death ought not to have surprised anyone who knows about the illness. It wasn’t just the depressive side that Williams’ displayed, although that’s what most news reports covered. I suspect it’s because most everyone is familiar with depression as causal in suicide. A rare opportunity to educate around the world about Bipolar Disorder, which includes periods of depression and mania, was missed.

While most everyone knows that depression can lead to suicide, poorly understood may be the role of mania, which is more than mile-a-minute speech and behavior and includes impulsivity, especially relevant here: Williams’ final impulsive act was to hang himself with his belt, not a well-thought out suicide.

Reason 5: Stress can result in suicide. Any problem in an individual’s system – chronic or acute illness, situational or inherent mental illness, social or environmental factors, the ways in which we think – can provide the potential for distress. Lots of straws have to drop into place before the camel’s back is broken.

Even so, suicide isn’t a slam-dunk.

But know this: chronic illness or disability increase the odds of being negatively affected physically, mentally and socially by distress. An already-stressed system is already part of the way there.

And while some of us are more exquisitely tuned to stress than others, it’s familiar territory for everyone. Even so, from prisoners of war, to marathon runners, to cancer survivors, many of us display a resilience we didn’t know we had.

Robin Williams was carrying financial problems, mental illness, and a fairly new diagnosis of Parkinson’s disease into an upcoming year of hefty professional commitments. Despite the affection of the world, Williams ended his life alone.

For the abundantly stressed, chronically ill, or ultimately alone, like he was, suicide may be the most understood act of all.

This blog was first published by Disability.gov.

Kathe Skinner has been diagnosed with multiple sclerosis for over 35 years, which has compounded genetically predisposed depression. She knows first-hand what suicidality feels like. Ironically, she finds her work as a Marriage & Family Therapist anything but depressing. She is in private practice in Colorado where she lives with her husband, David, and their 2 hooligan cats. Read more about Kathe at www.beingheardnow.com or ilikebeingsickanddisabled.com.

Kathe welcomes your comments and can be reached at 719.598.6232.

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

WHAT YOU NEED TO KNOW ABOUT BEING HAPPY

July 29, 2014Kathe Skinner, M.A., L.M.F.T. 1 Comment

If you’re allergic to dogs, happiness is not a warm puppy.

Metaphors about puppies, or anything else, are potentially dangerous. Even knowing where happiness — like any other emotion — occurs on the emotional spectrum doesn’t give the whole story. The only way to really know about someone else’s happiness is for you to ask and them to tell.

Thinking in deep and different ways about happiness isn’t easy. Here are some thoughts to get you started:

– Happiness has to withstand time, age like fine whiskey. Update your awareness: what made us happy then may not make us happy anymore.

– Time and distance are sweeteners; I always love those I love when I’m away from them. Be aware that both time and distance can be distorting while still sweet.

– Remembering happiness transports us to a happier time; look at the popularity of oldies music, or school reunions.

– Happiness can be a trickster. Absence does indeed make the heart grow fonder, usually brought to you by distorted reality. We want happiness so much that remembering it can be larger than life.

– The “gift giver” doesn’t have to be animate and neither does the gift, like what what we derive from picturing daybreak in our mind’s eye, or watching sunrise in the moment.

– Giving happiness to someone else requires mindfulness and presence. For example, active listening to what your child, friend, partner says, and being heard yourself are monumental gifts.

– Happiness shows externally (an ear-to-ear smile) while its meaning remains internal.

– Your happiness is unique to you; no one else has ever been happy in that precise way.

– It’s personal; no one can tell you what makes you happy. Letting someone decide for you can turn happiness into unhappiness and resentment.

– It’s a singular moment in time, that’s the reason it stands out.

– Happiness can be bittersweet; like remembering past happiness that is no longer ours. The coin of happiness has another side; in some situations, there is no happy at all.

– Happiness can’t exist in a vacuum; and it can’t start there, either.

– Happiness is an active process; changing as we change, growing as we grow.

– Happiness is dynamic: the act of giving brings as much happiness as receiving. Happiness is an endless loop, where giving begets happiness that begets the receiver’s happiness that can lead to the receiver becoming the giver where each one is giving and receiving and so on and happily ever after.

Mostly, you need to know that your happy can never truly be anyone else’s. Sharing words and thoughts and then listening and hearing each other, that’s the only way any of us ever really know what makes someone else happy.

Kathe Skinner is a Colorado-based Marriage & Family Therapist specializing in couples work, especially those for whom invisible disabiliy is a player in their relationship. Lack of happiness and poor communication are the two biggest complaints that have couples seeking her help. She knows all too well that there are times happiness seems to be hiding under a rock. What brings her happiness? Her husband David, their 2 kitties, Petey and Lucy, the people who trust her as their therapist, and lying on a pool float looking up at a clear blue sky.

Read more about her at www.beingheardnow.com

Kathe welcomes your comments and can be reached at 719.598.6232.

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WHEN A CAREGIVER DIES

June 2, 2014Kathe Skinner, M.A., L.M.F.T. 2 Comments

First published on Disability.gov

For 70 years she put up with his (sometimes volcanic) rumblings. He doted on her with diamonds, and was a poorer father for it.

The youngest of 5 much older siblings, she was babied into being passive and timid. He was a blustering bad boy who loved control; a lifelong natural at most things mechanical. He took seriously his duties as a man, a spouse, and head of the household. He didn’t brook anything that deviated from his definitions of right and wrong, a bigot in many ways. A mother and military wife who could fend for herself and children when she needed to, she preferred being cared for . . . and he liked it that way.

Both were fortunate: for much of their lifetimes, neither was chronically ill or disabled. Unless you count legal blindness, which he didn’t (though most who drove with him did). And even though she developed macular degeneration, a disease of the eye that usually leads to blindness, she could sometimes see the world better than he did.

Several years ago her macular degeneration began to impact both of them. By then, her hearing had deteriorated, too, and her world shrank. Although she rarely admitted fears (not to us, anyway) he expressed his the only way he knew how: he fixed as much as he could. He cut her food, gently guided her through the dimly-lit places they avoided more and more, lent her his arm, and searched out gizmos and gadgets he found in catalogues. He took care of her.

Last year, George left Kate.

True to his role, George had organized everything, including who his wife’s legal caregiver was to be — my husband. Now, almost a year later, Kate no longer plans on joining George in death right away and doesn’t cry for hours each night. Not that she tells us, anyway. As her vision deteriorates Kate, not surprisingly, adapts. David and his sisters do what they can from a distance of a thousand miles, mostly via phone calls and the occasional visit. Immediate support comes from close friends and a kind and caring nursing home staff.

Today, it takes a dozen people to do what George did. Even so, he can never be replaced.

None of us could live well if we spent too much time dwelling on the eventuality of death. But some of us — the visibly or invisibly disabled or chronically ill — need to spend more time thinking about the profound changes a caregiver’s death brings. Like David’s parents, my husband and I are fused by years, experiences, commitment and love. Though I’m the one diagnosed with multiple sclerosis, in truth MS is something we both carry.

As we age and tire, slow and re-prioritize, both of us have to remember that though we plan to go out holding hands as star-crossed lovers, the truth is more mundane . . . and likely. Whoever is left to mourn, cared-for or caregiver, what needs to happen is the same:

1. Plan now. The outcomes might look different, but the grief will be the same.

2. Get your house in order. You don’t have to be a survivalist in order to be prepared with legal, medical, financial, and personal concerns.

3. Create your own family. Gather together people who care, no matter what the will says.

4. Get outside each other. Get perspective from someone trustworthy and caring who’s outside the mix — minister, counselor, or therapist.

5. Express yourself and your needs clearly, often, and appropriately. Consider what to say and who you say it to. Sometimes being blunt can be hurtful; at other times necessary. Some people are better prepared to bring a casserole or help with housekeeping than to see you cry. Try out your voice to a journal, or pay a therapist or counselor . . . they can be skilled and trustworthy allies.

6. Keep in touch with others. It’s unfair (and shortsighted) to place the burden only in one place — like with your son.

7. Have someone to talk to, starting now. Clergy, therapist, physician, friend, partner, family can help you sort out what to say and how to say it. Think of yourself as a nuclear reactor. Keeping it to you guarantees one of two outcomes: shutting down or exploding.

8. Join a group of those experiencing what you are. There’s no substitute for having someone “get it”. Don’t believe me? Try talking to someone who doesn’t.

Kathe Skinner is a Marriage & Family Therapist and Certified Relationship Specialist specializing working with couples, especially those for whom invisible disability is part of the mix. She has been diagnosed with multiple sclerosis for over 35 years. Kathe and her husband David hold Communication Workshops in Colorado Springs and are both Certified Instructors for Interpersonal Communication Systems. Along with their two hooligan cats, Petey and Lucy, they live along Colorado’s Front Range. Find out more about Kathe and David at http://www.beingheardnow.com and read Kathe’s blogs, ilikebeingsickanddisabled.com and couplesbeingheardnow.com.

7 TRUTHS ABOUT COUPLES THERAPY

March 13, 2014Kathe Skinner, M.A., L.M.F.T. Leave a comment

Junk.

That’s the name I give to those reams of paper already printed on one side, fit only for recycling. The remains of old binders of stuff from grad school account for this week’s batch of junk paper for my printer. Like a paper I’d written almost 20 years ago: Assumptions, Approaches and Issues in Marital Therapy: A Personal Definition.

Amazingly, what I believed then, minus the naïveté and lack of experience, is largely the passion and promise of what I believe today:

1. Ease the pain. Right off the bat, a therapist’s job is to give a couple hope about the future, no matter if it’s separately or together. A therapist’s first role is to soothe heart hurt, restore faith, and normalize anger. The hard work can wait for later.

2. Children’s and pets’ behavior is about you. Overstated, but you get the point: Misbehavior, theirs or yours, is a symptom and not necessarily the cause. When you want things better at your house, start by working on the big boys and leave the small fry alone.

3. You’re driving the bus. Where we go is yours to decide; my job is to help you get there. A good travel agent doesn’t tell you where you want to go; you tell the agent. Think of me in that way, gathering information then putting a package together that gets you on your way, lending a hand when problems along the way.

4. I’m not immune to the issues you have. Part of my skill is being able to tune in to your problems. Although I’ve often been there, done that, I may see in your struggles things I have yet to resolve in my own life and relationship. In the that’s called counter-transference, and all therapists are touched by it.

5. For each step back take 2 steps forward. The family system we grew up in, and how relationships worked within it, predict behavior in our relationship now. Think of it as an individual version of “driving the bus.” Called individuation or differentiation, couples therapy looks hard at each partner’s ability to separate from those automatic behaviors we learned about ourselves and relationships so long ago. Remember that it takes two strong individuals to make a relationship work.

6. Without Action, Knowledge is wasted. Put another way, “So what’re you gonna do about it?” The whole aim of coming to therapy is “behavior change” and not just “changing your mind.” Those are things for me to know and you to learn.

7. Crisis = Opportunity. Going into marital therapy, or any kind of personal work, is an adventure whose outcome is largely unknown. What I do know is that when things come to a head tremendous opportunity for growth exists when things burst. Relationship is dynamic and as individual as each of you and the two of you together.

Hardest for me to learn has been that I can never want change more than my clients do. You will be (and ought to be) the trump card, driving force, bus driver, agent for change, mover and shaker.

What I know is that all of my skill, compassion, and knowledge will never be enough to right a boat when the passengers have jumped ship.

Kathe Skinner is a Marriage & Family Therapist, Coach, and Relationship Specialist who, for almost 20 years, has been in private practice along Colorado’s Front Range. She has been diagnosed with multiple sclerosis longer than most relationships she sees and specializes in working with couples where invisible disability is part of the relationship mix. Kathe and her husband, David, teach Couple Communication Workshops where participants get a peek at how this team manages a marriage where 2 very different personalities see things from 3 perspectives – and where class-goers learn to do the same. Workshops are offered throughout the year. Get the schedule and learn more at http://www.BeingHeardNow.com.

Image courtesy of Vichaya Kiatying-Angsulee/FreeDigitalPhotos.net

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©2014, BeingHeard, LLC

IT TAKES TWO TO DO-SI-DO

February 14, 2014Kathe Skinner, M.A., L.M.F.T. Leave a comment

Doin’ the do-si-do’s impossible to do by yourself.

I spent lots of years hanging out with girlfriends or not hanging out at all, which was more likely to be true. Most times, none of us even had someone who filled in for love. I’m not ashamed to say there are times I would’ve settled – my need for affiliation was that great – at least for awhile. Although I did draw the line at that Mafia guy.

Being un-paired suggested to me that who I was was unacceptable; someone whose standards, suggested Mom, were sometimes too high. This time she was right.

The upshot was a 10-year marriage I never wanted and that didn’t work, anyway.

And when, post-divorce, I found someone to love, conundrums followed double-behavioral-messages and I was as heartbroken and needy as if I were one of those women who stand uncomfortably on the periphery of social situations. How humiliating that, when I bought myself a dozen roses to make him jealous, he knew no one else had done that but me.

If you haven’t been there, done that, and are newly-bummed by Valentine’s Day, here are some thoughts:

1. Scoundrels are plentiful. Scoundrels will always be scoundrels. Scoundrels become scoundrel-ier the more you like them.

2. Singles gatherings are very sad. While such encounters are billed as “fun”, they never are. They’re too often a forum for people to tell their bad/sad story. While good forums for social science researchers, mixers like this can suck the breath out you for weeks.

3. Visit the zoo. Animals who live in enclosures have other fish to fry so they’re not upset when your dump truck of emotions backs onto their turf. Just don’t dump on their food.

4. Develop a mental solidarity with women who become collectors of cats. Every cat-loving woman I’ve ever met understands how this happens, and is comforted by knowing that homeless felines are plentiful if all else fails.

5. Diet only if you want to. A hungry person is a grouchy person, not at all lovable. By the same token, if you’re ashamed of evidence of those ice cream orgies, remember that a shamed person often lies.

6. Going to a bar is noisy, phony, expensive, sometimes dangerous but often depressing, especially when your friend gets hit on and you don’t. People sucking up the bar scene are generally alcoholic, shopping for a good cut of meat, or both.

7. At the first sign of abuse run. Fast and far. Never look back.

8. Everything you’ve ever heard about kissing frogs is true. These days you really can get warts.

9. While the world feels like Noah’s Arc. fact is that with the divorce rate at 50%, out there’s a pretty big pool of people rejected by someone else. And they’re yours for the taking.

10. A clean bill of health is as important as it was to have a passport in Nazi Germany. The consequences are about the same, too.

Pairing up is about lots of things, many of which we have no control over, like the biological imperative to reproduce our species, and to protect what we create. Humans are meant to affiliate; we’re social animals who rely on, and need, each other. The herd is enormous – 7 billion and growing.

The odds are in your favor.

Kathe Skinner is a Marriage & Family Therapist and Relationship Coach who’s been in private practice for the last 17 years. She works especially with the invisibly disabled. Kathe finds real-life adventures in Front Range Colorado, where she lives with husband David and their hooligan cats, Petey and Lucy. Neither of them has square danced since they were in 6th grade. Learn more about Kathe & David Skinner and the Couples Communication Workshops they teach at http://www.BeingHeardNow.com and be sure to keep visiting Kathe’s blog at ilikebeingsickanddisabled.com. P.S. Pass it along!

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INVISIBLE DISABILITY GOT YOU SIDELINED THIS WINTER?

February 9, 2014Kathe Skinner, M.A., L.M.F.T. Leave a comment

Even if I walked away, I wouldn’t be able to walk very far.

For those of us who are disabled, invisibly so, preparing for weather that turns wintry follows a simple self-care rule: stay inside.

As multiple sclerosis has progressed in me, simple tasks loom large.

Accumulation of simple tasks makes negotiating my environment literally hazardous to my health.

And I’m not alone in what can happen:

Impaired mobility. “Give me something to hold onto, like a railing, or a walker,” I said confidently, “and I’m good to go.” This from a woman who managed the unbelievable – falling down and taking the shopping cart with her. Not just with her, on top of her. The same woman who stepped off a sidewalk and fell face-first on her rollator into Chicago traffic.

Adding ice, snow or both increases the danger, whether I want it to or not. Cold temperatures stiffen already-Frankenstein-like limbs, reduce feeling, and can even shut down body functions altogether. For me, any extreme of temperature, hot or cold, and I look and act like a zombie.

Impaired senses and abilities. When it’s cold, the body’s heat is centralized to protect the core. Extremities function poorly, if at all. Try counting change at the grocery store, or picking up something you dropped. Even bending over is dicey and can result in a tumble. Even worse? Getting up again.

People with breathing difficulties may struggle, even with little or no exertion. Arthritis sufferers are crippled all the more. And the head-injured’s thought processes slow. way. down.

Anything already stressed responds negatively to even more stress. Think of the knees of someone overweight: when chubby becomes obese, knees already weakened break down when more weight is added.

Of course not everyone will have such a dramatic response to arctic-like conditions, but some will. For me, balance and strength, ability to write, well-being and fatigue, mood, motor skills, bladder control, cognitive functions, like word finding, are some of what fall to unacceptable levels.

It’s just plain dangerous. A wheelchair-bound client of mine was hit by a bus when the driver’s vision was impaired by a snowstorm – he didn’t see her crossing in front of the vehicle. My massage therapist suffered brain damage when she hit the pavement after slipping on ice in the parking lot.

Our focus on independence may cost us, like the guy who refuses to leave when the flood waters rise. Thinking about who picks up the pieces doesn’t cross our minds.

Can you afford to get stranded for hours?

Can your heart or lungs hold up to strenuous efforts to free your car from a snow bank? What happens when your body’s attempts at staying warm mess with your blood sugar? Or the stress of the whole ordeal brings on pain and diarrhea?

I have a highly polished ability to ignore what I don’t like. I especially don’t like staying home on those arctic days when others are doing ordinary things, like going to work. This is true even though experience tells me how I’ll hurt my body, mind, and self-esteem by ignoring how the m.s. in me behaves in harsh conditions.

Instead, control what you can. Don’t know about you, but I already know what happens when I ignore what that is.

Kathe Skinner is a Marriage & Family Therapist and Relationship Coach working especially with the invisibly disabled. She looks for real-life adventures in Front Range Colorado where the environment’s sometimes restricted by weather extremes. Currently, she’s cleaning up her home office while groovin’ to the oldies. A pirate’s treasure is stacked on the floor; who knows what she’ll find in all that paperwork? Learn more about Kathe Skinner and the Couples Communication Workshops taught by Kathe & David at http://www.BeingHeardNow.com

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THAT GIRL KEEPS FALLING ON HER BUTT

January 29, 2014Kathe Skinner, M.A., L.M.F.T. 2 Comments

My balance, isn’t.

So when I head straight toward the bushes at the entrance to my building it isn’t surprising.

Bushes are a trigger in picturing my first (and only) experience as a new MSer in an MS support group. Recommended by my neurologist, the group experience was meant to help me cope with the way-past-due-diagnosis of my disease.

Instead, it freaked me out.

Walkers, wheelchairs, canes, crutches – and me, invisibly disabled, in high heels looking at a future unable to wear them.

Big time downer.

Especially when a guy lost his balance and landed on his butt in a bush. That he laughed it off was horrifying.

I understand, now, the reason he laughed. Not only is laughing at the faux pas around the commonplace common, but situations that elicit that kind of response are also all too common.

The reality he must’ve experienced then is one I now share. Today I laugh, too. Because it’s truly comical at times and also because laughter is socially reassuring. “It’s alright, folks. I’m alright. Nothing to see here, move along.”

Knock wood, I’ve yet to experience anything dire in my navigational mistakes. Embarrassment to be impaired in public is what hurts. Most of us don’t know what to do in a situation like that. I put lots of effort into looking unimpaired, but when I catch sight of myself in a shop mirror, the reality of how I walk, for example, isn’t normal at all.

When I use an assistive device, a rollator in my case, parents scold their children for staring. I’ve yet to hear mommy or daddy use the opportunity as a teaching moment to talk about disability; rather it’s “don’t stare” before hurrying away. No wonder society hasn’t made much progress in accepting the disabled community who, except to children, remain largely invisible.

Recently, Disability.gov blogged an article about steps to take when being newly disabled.

It’s worth a read, especially if you’re not.

Specializing in couples work, Kathe Skinner is a Colorado Marriage & Family Therapist and Relationship Specialist. She works especially those couples where invisible disability is present. For over 10 years, she and husband, David, have been Certified Instructors for Interpersonal Communication Programs . Find the schedule for their next Couple Communication Workshop at http://www.beingheardnow.com© 2014 Being Heard

HAVE SEX OR DO LAUNDRY?

January 24, 2014Kathe Skinner, M.A., L.M.F.T. Leave a comment

No brainer, right? But for many women, it’s not as stupid a question as you’d think.

The 21st Century may see a socioeconomic shift in favor of women, e.g. more upper-level management positions, more business owners, greater control of wealth.

Success comes at a price; working harder for longer hours upsets the already teetering balance among personal, relationship, and family demands. Another price? Women are just as likely to experience heart disease as men.

For decades men have steadily increased the amount of time they put into housework and childcare. Even so, the reality in most families where both partners work still reflects a scale that’s less than balanced. And while the workforce is trending toward containing equal numbers of men and women, that increased role doesn’t usually reflect other, needed, social changes, like equal pay, daycare, maternity leave, or scheduling flexibility in attending to family needs (like staying home with a sick child).

Women as breadwinners are another phenomenon of the new century’s economic downturn. That kind of role-shift between partners rocks a boat already sinking with the weight of household needs – who does what? How long before hunting dust bunnies pales in comparison to hunting mastodons?

It’s a 24/7 job, no matter who does it and whether the family knows it or not, holding fast is everyone’s job. While men may be able to put sex toward the top of the pyramid (at times even the tippy top), most women are still in the burial chamber, getting the mummy ready for bed.

Fact is, too many married women look to their partners to lighten the loads of laundry, not for sex.

In this context, how does a willingness to do some horizontal exercise together move up in your list of must-do’s?

Talk Together. Remember how it was when your relationship began? You two talked forever. It worked then; why not now? Remember that part of what makes your marriage exciting (and sometimes turbulent) are your differences.
Mourn. Be brave; acknowledge that some hopes and dreams are no longer attainable or even reasonable. Holding on can pull you both down. Move forward by dreaming in a different color.
Say it Out Loud. No one knows what you’re thinking unless you say it out loud. You may have always expected your partner to be a mind reader, thinking “If they loved me…they’d know.”
Re-Prioritize. And share the list with your partner. Working toward workability takes two. Are you tired of seeing his clothes on the floor? Does he get crazy when your hair’s in the drain? Negotiate a win-win; it’ll save you both time and aggravation.
Negotiate. Working toward workability takes two. Are you tired of seeing his clothes on the floor? Does he get crazy when your hair’s in the drain? Negotiate a win-win; it’ll save you both time and aggravation. Be sure to follow through.
Delegate. Neither of you is superhuman. Trying to do it alone hasn’t worked, has it? Too many women excuse children from sharing in home tasks. This often untapped resource can learn, starting as early as age 3, responsibility, ownership and pride. And you catch a break.Cluttering our days with unreasonable expectations and unspoken needs is so much less necessary to our happiness – and health – than being together. So what’s stopping you?

Specializing in couples work, Kathe Skinner is a Colorado Marriage & Family Therapist and Relationship Specialist. She works especially those couples where invisible disability is present. She and husband, David, have lots of practice re-prioritizing retirement in interesting economic Find the schedule for the next Couple Communication Workshop at http://www.beingheardnow.com

‘TIS THE SEASON TO LOSE BIG CLUMPS OF HAIR

December 17, 2013Kathe Skinner, M.A., L.M.F.T. 1 Comment

“God bless us, every one.”

I think Tiny Tim got really chilled waiting in line on Black Friday.

And Cyber Monday.

Come to think of it, somebody told me he was at the mall the other day, too. Amazing, since he hit the deck real hard when he lost a tug of war over some on-sale Levi’s. Gotta give him credit for gettin’ back on the horse.

Poor guy.

We had coffee at his house the other day. I didn’t say anything, but you shoulda seen the place. Like Santa’s workshop, but no ho ho ho. Bags from Macy’s and Target and Aeropostale with who-knows-what in ’em. Honestly, I don’t think Tim even knows.

Tim told me he couldn’t resist. “So what’s left over’ll go into the storage locker with last year’s stuff. No big deal.”

I don’t wanna say anything, but he seemed a little stressed. Okay, okay, a lot stressed. Nasty nightmares, even when he could sleep. Way overspending. I gotta say, the marriage ain’t lookin’ so good, either. Vicky’s back at her mother’s; said she just couldn’t bear to hear one more ***damn ring-a-ling-ling. What? I didn’t tell you? Tim sat on a bag of bells, didn’t notice, and they somehow worked their way into…well, you know where. Actually a nice sound when he moved; a little muted, but what the hey.

All that shopping, gotta be listed somewhere they talk about sicknesses. But you know Tim; can’t tell him anything.

If you ask me, I think all this joy and peace and fa la la la la is killing him.

So, hey, me and the missus, we’re gonna do this 90% off warehouse sale. Gonna go early. Like before the sun’s up. Wanna come?

Kathe Skinner is a Marriage & Family Therapist and Certified Relationship Coach. She has a small stash of presents for somebody-in-the-future but has considerably whittled down her holdings. She’s a firm believer in the concept of ceasing all manufacturing of giftable goods, believing everyone should recycle stuff by shopping at one big garage sale. She and husband, David, live in Colorado with Petey and Lucy, kitties who leave little presents for them all year round.

THE RORSCHACH WENCH.

December 12, 2013Kathe Skinner, M.A., L.M.F.T. Leave a comment

I keep a book in my office and if I had a coffee table, it would be on it.

It’s red, with a coffee spill down the front that’s dried into a Rorschach-kind of thing. Nifty for it to be in a therapist’s office.

Inside, dozens of clients have written their “should’s”.

It’s not instructive to describe what they said; more than likely, their self-flagellations are the same as yours. What catches the new subscribers is how similar their self-flagellations are. Put another way, there’s nothing special in their dysfunctional thinking.

Back when I was exploring how should’s get perpetuated, I was stunned and amazed to find myself described in the exact words I’d always used in describing my neuroses (notice I used the plural). Admittedly, there was disappointment in seeing myself laid out like some common Rorschach wench. I suspect that others, too, hold their depression, anxiety, mania, whatever, as a sort of badge of differentiation from others.

For others, as it was for me, depression is powerful; it was the coin of my realm and the way I bought into the realm I inhabited growing up. Depression can get attention, especially when nothing else seems to. That can be true in a marriage where one partner exists with an invisible disability. And just like for the kid who acts out, it’s attention of some kind, even if it bears a high price.

Being a therapist, consequently, has been double-edged: one edge cuts through the dysfunctional thinking, the should’s, the irrespective unfairnesses; while the other is sad to see those defenses so cut down. What I do in my office forces me to be embarrassed at my own mental laziness. Being depressed is hard; so is being anxious or manic.

But hey, it’s hard even when you’re not.

Kathe Skinner is a Marriage & Family Therapist and Relationship Coach in Colorado Springs, Colorado. She comes by depression naturally as well as artificially and has recently added anxiety, for which she can thank multiple sclerosis. Petey and Lucy, the two hooligan cats Kathe and David share their lives with, are too annoying to let depression settle too quietly in their home. Kathe and David get out of the house by teaching partners the communication skills their relationships need.

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