A RITUAL THAT DOESN’T WORK.

resolution

Who came up with this idea, anyway?

Blame the Babylonians and Romans who used their new year to reaffirm allegiance to the gods as well as to lesser but still powerful mortals like kings or emperors.

Much later, in 1740, John Wesley developed a religious alternative to holiday partying.  These watch night services were held as a renewal of the covenant with God.

Resolutions ran with a powerful crowd.

Ironically, less powerful are today’s resolves, which are about inwardly personal behaviors rather than loyalty to something greater than ourselves.  Resolutions about mental health and wellness concerns like partnering, parenting, drinking, drugging, smoking and eating are peer- and culture-expected but given lip service.  In an attitude of predetermined failure, resolutions about important behavior changes are almost expected to be broken and quickly forgiven when they are.

Promises expected are promises unkept.

That’s how I feel about New Year’s Resolutions.

Besides, I think most of us change not because we’re supposed to, or even want to, but because we choose to, sometimes for not-very-good reasons.  Change is something much greater and often tons more weighty and harder to handle than a New Year’s resolution.

Those choices and changes can’t be scheduled for a certain day, like January 1st.  That’d be about as meaningful as marriage vows made in an arena full of other couples.  If that’s anything like the resolutions actually kept, about half of those couples are headed for a split after only a month together.

Sitting here at the end of December, I’m in solid company:  According to a 2013 CBS poll almost 70% of Americans don’t make New Year’s resolutions at all.

I just hope none of them were married in an arena.

Kathe Skinner is a Marriage and Family Therapist in private practice where she specializes working with couples looking for change within their relationships.  She and her husband David live in Colorado with their two change-aversive cats, Petey and Lucy. 

copyright, 2014, Being Heard, LLC

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

CASTING A SPELL: EASIER THAN YOU THINK

Casting a spell is done by the lovers among us; no exorcism needed.   Anyone who’s had a broken heart knows words and potions don’t work anyway.  And, unless you’re a crazy cat lady, the likelihood of being under the spell of a lover’s words is far greater than being eID-100183804nchanted by a black cat.
Loving someone calls out parts of us untouched by anything else. Loving and being loved is the genesis of trust, fearlessness, safety, vulnerability.  Linking to another calls for courage, and hones our concept of “forever”.  Falling under love’s spell is the only time we’re wholly, nakedly, ourselves.
There’s no doubting there are parts of love’s enchantment most of us would choose to do without.  Being vulnerable, for instance.

It’s so scary that most partners would rather fight, go silent, resentfully acquiesce, or run away rather than connect.   We think that connecting with the one we love calls for us to “give ourselves over”, “lose” ourselves.  And that that person will, with malice aforethought, mistreat us.

Holding ourselves back from our partners, investing the bulk of our emotional energy in children, jobs, or pets may seem a safe way to cope.  It’s not.  Actions may seem to be reasonable when they’re really frantic, reactive, and irrational.  The result is disconnection.  It’s alone-ness, alright; one that’s soul deep.

Being by yourself and being in a relationship isn’t always unhealthy, though.  In fact, the bulk of who we are is lived individually, as it should be.  The relationship itself stays healthy when there is a communicated, mutual understanding of, and confidence in, the “us-ness” that bridges one to the other.

Successful relationships are overlapping, not pancaking.  A well-designed spell allows each partner to breathe.

Take John and Mary, for instance.  To him, being alone means time to decompress after work, diddling on the computer or watching the news.  For Mary it’s a long, hot, bubbly soak spent with a trashy novel, candles . . . and no kids.

Are we now too busy to spend time re-casting love’s spell?  Too dour to be delighted in loving and being loved?  So impersonal that we let our thumbs wirelessly communicate our needs?

Is casting a spell a lost art?

A passionate lover of the season of beauty and decay, Kathe Skinner is a Marriage & Family Therapist specializing in teaching couples how to be safe and vulnerable at the same time.  She lives in Colorado with her husband of 28 years, David, and their 2 hooligan cats, Petey and Lucy.  Black spirit cats Squeak and Winston Bean never felt safe on Halloween.
 
© 2014, Being Heard, LLC
Image courtesy of 9comeback at FreeDigitalPhotos.net
 
 

SUICIDE ISN’T JUST ABOUT DEPRESSION

suicide wordly

(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
 
©  2014, Being Heard LLC
 

WHAT YOU NEED TO KNOW ABOUT BEING HAPPY

Funny couple

 

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.

©2014, Being Heard LLC

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WHEN A CAREGIVER DIES

bigstock_Old_Couple_Holding_Hands_2041049     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.

DSC_4482-K&DKathe 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.

© 2014, BeingHeard LLC

7 TRUTHS ABOUT COUPLES THERAPY

computer screen choosing loveJunk.

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