Physician heal thyself - or one another. (Mental / emotional illness)

[hagoth7]

"You lift me and I'll lift thee and we'll ascend together." (Whittier's commentary after attending a Millerite camp meeting.)

"Do unto others..."

 

Q: Do you know/love someone who regularly struggles with debilitating mental/emotional challenges, but where you aren't (yet) equipped to help them (or yourself) heal and move forward? 

Had a lengthy discussion with someone tonight, on the topic of mental/emotional health and similar struggles that impede relationships, bringing to mind Elder Holland's talk "Like a Broken Vessel", and his book "Broken Things to Mend." The discussion is also an outgrowth of a troubling/snowballing concern mentioned from the pulpit earlier this year by a pastor/friend.

Reminds me of the elderly couple in the ward/branch that my missionary companion and I rented a room from in Denmark. Decades before that, during World War 2, the husband had served in the resistance in his occupied country against the Nazis, and was captured. He suffered the rest of his life from what they did to him. (Most may be aware of the heroic role Danes played in running an underground railroad to smuggle Jews safely to Nazi-free Sweden.) As I recall, she had been a nurse, and as she explained, when they eventually married, she carefully tended to his pains every night, to help him sleep with something approximating peace. An ailment largely physical, that likely also left wounds of another kind. The man was a national treasure and a serious spiritual giant (a former Jehovah's WItness, who genuinely knew/loved the scriptures.) She was that, and genuinely an angel.

The context of tonight's discussion that I'm slowly getting to, was about an effective form of pyschiatric therapy from a pioneering trailblazer/expert in her field of mental health, that took years for her (and those assisting her) to research, hone, and distill.

The following is largely a paraphrase of the person I spoke with tonight.

The therapy was specifically designed for extremely sensitive souls, for whom traditional therapy typically did more harm than good.  It represented her life's ministry to those who are hurting the most, in a hell to *some* degree of their own making, and who regularly contemplate ending it all. So, the discussion quickly shifted gears to the matter of such therapy being largely inaccessible (both because of cost, and because very few therapists are trained in the direly-needed therapy). Her approach, DBT, has been making a difference for such people for years.

What was refreshing in her approach was that she reminded therapists that using any such imperfect approach, among/between imperfect people, that it was not an issue of *if* such a therapist was gonna make a mistake, but *when.* A frank dismissal of the otherwise-nobly-intentioned "do no harm" hubris. And her required approach of what therapists must do when making such unintentional mistakes is deeply impressive. (Constructive tangent perhaps for another day.)

So the discussion shifted back to its original intent. What if the therapy was more widely/easily accessible? What if lay people in any family or community could have access to at-your-fingertips training and tools that allowed them to minister to a friend or family member? It is said that the best/fastest way to learn/master something is to volunteer to teach it (something I know to often be true). What if people hurting could themselves opt to step forward and become such a healer? A volunteer, tagteam approach to ministry/healing.

Catholics and Shriners and Adventists (i.e. Millerites) are known for their healing work in raising up hospitals. What if some in the LDS community stepped forward into this largely-unattended breach...to minister to those hurting silently among us, and to those who might not even know or care what a Mormon is?

Thoughts? Suggestions?

Edited July 11, 2017 by hagoth7

[Jane_Doe]

It's 4 AM my time right now, and I can't sleep because of a PTSD nightmare.  

Counseling is a delicate art form, like other types of medicine.  Like any other doctor, it takes years and years of intense training to become a professional counselor, and I shun the idea of an amateurs trying to do open-heart surgery (whether that's a physical or metaphorical heart).   Such an amateur can do major damage.

On the flip side, I am a big fan of the idea of a lay people knowing first-aide, basic prevention, and when to call a professional.  In terms of mental health, things like self awareness, acknowledging good/bad/healthy/unhealthy feelings/scenarios in yourself and others.  Learning how to communicate what's going on.  Learning what is healthy and what is not.  A lot of the times being able to get help-- whether that's a friend or a needed professional-- right away really helps reduce damage taken and treat the pain efficiently.  Those are all good things.

 

I feel like I'm rambling...

[hagoth7]

43 minutes ago, Jane_Doe said:

I feel like I'm rambling...

You're not.

43 minutes ago, Jane_Doe said:

It's 4 AM my time right now, and I can't sleep because of a PTSD nightmare.  

What is PTSD like, if you don't mind sharing?

Debilitating depression? Was there for years.

So-called manic sleep loss (or vigil), with renewed/ever-ready energy? (Check.) 

Debilitating anxiety? Been there. 

Is it anything like the latter?

Edited July 11, 2017 by hagoth7

[hagoth7]

4 hours ago, Jane_Doe said:

Counseling is a delicate art form, like other types of medicine.  Like any other doctor, it takes years and years of intense training to become a professional counselor...

Delicate. Yes.

That said, even doctors call it practice, decades into their...practice... ;0)

And such practice *has* to start somewhere.

And even *they* get it wrong, or so I once saw in What About Bob, and the things we deem funny are usually so because they're baesd on a kernel of resonating truth. :0)

If the basics of such counseling are...basic...(and they are)....and if both the facilitator(s) *and* the participant(s) are doing parallel readings in both the theory book and in the worksheets book...with such clear/documented scaffolding in place, with the scope of the unmet suffering out there, why can't laymen/women fill in where there are drastically insufficient therapists? 

4 hours ago, Jane_Doe said:

.... shun the idea of an amateurs trying to do open-heart surgery (whether that's a physical or metaphorical heart).   Such an amateur can do major damage.

What if the core principles of *that* therapy could be distilled sufficiently for a 10-year old to comprehend. Two *very* simple principles. (Which is the case.)

And what if that simple two-step dance could aid many people who need *that* type of therapy stat, who otherwise wouldn't get it? And what if they received it with the added safety net of two-deep counseling...even from imperfect laymen? (As if any doctor is perfect....no offense to their dedication and commitment.)

If a loved one is suffering terribly at length, or about to flatline, do we really gotta wait for an availble ambulance that could take months...or worse yet...a hearse, if we instead have keys to get them to the (figurative) hospital on time with a humble 2-door sedan?

While I appreciate the fear of dong wrong, and some of the good types of caution that fear can instill, what of the counterbalancing desire to do good? Based on the above paragraph, don't good-samaritan sentiments/laws kick in anywhere? At what point does perfect love gently set fear to the side?

If you know the route, and have figurative wheels, one *can* help somebody in an emergency (or in the more common previously-unmitigated chronic dilemma) get where they figuratifuly need to be.  Can't we?  (The first person in my dad's line to join the church (Swedish/Scanian) was a wheelright. The father of the family his son married into (Danish) was a coachman.)

If the road is clearly marked....and is soon to be more clearly striped...what then?

Edited July 11, 2017 by hagoth7

[hagoth7]

So if we can move beyond the trepidation for just a moment, what is wrong with a cottage ministry of people willing to reach out to those deeply hurting that some therapists don't even *want* to try to treat?

Years ago, the expert I referred to early got flack from her own colleagues at the mere mention of her attempting to help those hurting the most, the most intelligent/sensitive. those most likely to want to end it all each and every day. With some colleagues specifically saying that such people were untreatable (and they actually are, using their poorly-matched form of therapy), and that she would therefore ruin her reputation/career in the attempt.

What are we to do with a maverick Sacajawea, who shrugged off groupthink, and instead blazed a very clear/proven trail? 

Do we let her research and workbooks simply gather dust? 

 

Edited July 11, 2017 by hagoth7

[Jane_Doe]

14 minutes ago, hagoth7 said:

I can't quite relate. What is PTSD like, if you don't mind sharing?

Post Traumatic Stress Disorder is a neurological condition brought about after trauma.  Things like nightmares, being set off by certain triggers, etc.  Historically it's gone by different names, including "shell shock".  From your story, your Danish hero sounds like a classical bad case.  In bad cases, things like a caring spouse can help certainly aid the current symptoms (fantastically), but going deeper and treating the root causes (processing the trauma and it's effects) is major open-heart surgery that frequently requires years of professional help.

Speaking as to my personal story (and no this is not remotely a sensitive topic), I was severely sexually abused as a little kid.  Growing up it was major nightmares/headaches/flashbacks, lack of trust, severe and sucidical depression, being unable to talk about it, and.... I'm trying to find the right words here.... for example, most kids/people like surprises- like a surprise birthday party.  My gut reaction was to tackle the well-meaning surprise giver, pin them to the ground, hold a knife to their throat, in my head screaming "don't you dare touch me!".  I'd have chronic major nightmare of "fire and lightning dancing".  I'd play games with my toys, trying to make sense of it all- trying to comprehend.  I'd always know where the exit is, and instinctively a mental list of how I could defend myself if necessary.  For years that was just my world.  I didn't know anything different, or how to express what I was going through.    

Nowadays, I've been through lots of therapy/prayer/mediation/etc and consider myself healed now, and vast majority of those symptoms are gone.  I processed through things.  But every couple months I'll have a bad nightmare of a predator and can't sleep afterwards.  Frequently my husband is great at calming me down, but today it's 4 AM and he's completely zonked.  So here I am messing around on forums, passing time.  

To reiterate again-- this is not remotely a sensitive topic for me.  To the contrary, I find that speaking about mental illness is very important to de-mystify/de-stigmatize what's going on.  People can only seek treatment if they know that it's there, and feeling not alone makes a world of difference.  And people do experience different things differently, so experience vary.

[hagoth7]

This is kinda how I view the doctor in question.

Now the person I spoke with tonight has been suffering deeply for years. More than I will go into here. And hasn't been able to afford treatment. And was recently rejected for funding to get such treatment because, in the eyes of gov't officials, he was deemed too intelligent. (And he is *extremely* intelligent.)

Yet...the intelligent sensitive ones are the very ones the expert in question fashioned a new form of treatment for, which has proven effective for years...helping people pull out of their own private hell.

 

What then? 

Edited July 11, 2017 by hagoth7

[hagoth7]

26 minutes ago, Jane_Doe said:

Post Traumatic Stress Disorder is a neurological condition brought about after trauma.  Things like nightmares, being set off by certain triggers, etc.  Historically it's gone by different names, including "shell shock".  From your story, your Danish hero sounds like a classical bad case.  In bad cases, things like a caring spouse can help certainly aid the current symptoms (fantastically)

Thank you for sharing. I wish you peace.

26 minutes ago, Jane_Doe said:

...but going deeper and treating the root causes (processing the trauma and it's effects) is major open-heart surgery that frequently requires years of professional help....  

The type of therapy (DBT) that I'm referring has been helped mitigate PTSD with war veterans.  And although it can take years, it's a matter of repeating the same two-step in lessons over and again, and then repeating each such lesson every 6 months or so...akin to our 4-year Sunday School manual rotation.

Wash, rinse, and repeat such lessons until healing is in place, and new, empowering habits emerge from the ashes. 

26 minutes ago, Jane_Doe said:

...I find that speaking about mental illness is very important to de-mystify/de-stigmatize what's going on.  People can only seek treatment if they know that it's there...

But *is* the treatment there? In my state, it isn't. With millions of people, last time I checked there was only one therapist available...as a part-time gig.

He doesn't have the bandwidth to treat  a fraction of locals needing his help. And that drastic shortage reportedly ripples across this country, and likely across others.

And if such a person gets misdiagnosed or shoehorned into getting more traditional therapy, instead of the kind specifically forged to free them, it worsens their state *considerably.* Digging them deeper into their pit.

Do we simply wait decades during their chronic, life-threatening suffering, *hoping* that enough 18-year-old high school graduates will be mature enough to opt to pursue such a career path?

Or...?

26 minutes ago, Jane_Doe said:

...feeling not alone makes a world of difference....

Agreed.

And agreed.

 

When the therapeutic help isn't there, for years on end...do you see a better option(s)?

Thoughts?

Edited July 11, 2017 by hagoth7

[Jane_Doe]

Speaking just my experience here--

For years I never wanted to go to a therapist- for some stranger to "get inside me" (as I viewed it as a rape survivor).  I feared quite deeply the they would find me irreparably broken and have me locked away, or (worse) they would get close to me.  So for a decade I tried to treat myself.  I did a lot of good- reigned in sucicidal depression, reined outward symptoms, walled off the flashbacks, etc.  To use a physical analogy: I successfully bandaged up to wounds and stopped the outward bleeding.  But it was beyond my power to stop the inward bleeding, and I was indeed still bleeding, even if you couldn't see it on the outside. 

Come college my mental "bandages" broke.  I was completely bleeding out, sucicidal, not sleeping, and starving myself.  Seeing a therapist was completely not an option in my mind ("stay away from me!"), but I did reach out to a few friends-- one in particularly.  It... on one hand I didn't literally die, but on the other hand she did MAJOR damage.  She/we meant well, but we had no idea what we were doing.  Not just one mistake, but years of major ones.  

I REALLY should have been into a professional.  That's not to say that professionals don't make mistakes (far from it!) but part of a professional's training is knowing how to read vital signs and to realize when someone is flatlining.    We (my amateur friend and I) didn't know that.  We metaphorically flatlined me, and thought "well maybe if we just try harder the same thing will work", so we pushed the flatlined harder and harder.   It was incredibly destructive then and for months afterwards.  I needing major healing from that "healing".  Yes, professionals make mistakes, but they are better equipped to realize that things were a mistake and deal with the fallout.  

Again, I'm against amateur surgeons here.  Not against first aide responders and education (I'm a huge fan of that!).

[Calm]

There are two definitions of the word "practice.  It is best not to confuse them.

"the actual application or use of an idea, belief, or method as opposed to theories about such application or use.

"the principles and practice of teaching"

synonyms:application, exercise, use, operation, implementation, execution

2. repeated exercise in or performance of an activity or skill so as to acquire or maintain proficiency in it.

"it must have taken a lot of practice to become so fluent"

synonyms:training, rehearsal, repetition, preparation; More"

[hagoth7]

4 hours ago, Jane_Doe said:

...Seeing a therapist was completely not an option in my mind ("stay away from me!"), but I did reach out to a few friends-- one in particularly.  It... on one hand I didn't literally die, but on the other hand she did MAJOR damage.  She/we meant well, but we had no idea what we were doing.  Not just one mistake, but years of major ones. 

Understood. And I meant well as a father...but did an extremely poor job of things. Better training/support for someone with my shortcomings would have been beyond helpful...for me and especially for them. 

When there is a current shortage of direly-needed DBT counselors, and when that paucity of supply may not improve until some future generation,  what course of action do you suggest instead, for those in crushing pain now?

Edited July 11, 2017 by hagoth7

[hagoth7]

3 hours ago, Calm said:

There are two definitions of the word "practice.  It is best not to confuse them.

<---sometimes riffs on wordplay, tongue-in-cheek, to illustrate a point with a hint of wit (or as some might say, half). 

<---needs to use emoticons more often for greater clarity of intent.

Edited July 11, 2017 by hagoth7

[Jane_Doe]

1 hour ago, hagoth7 said:

When there is a current shortage of direly-needed DBT counselors, and when that paucity of supply may not improve until some future generation,  what course of action do you suggest instead, for those in crushing pain now?

If you're asking me to fix the healthcare system, that's beyond my expertise.

[Calm]

1 hour ago, hagoth7 said:

<---sometimes riffs on wordplay, tongue-in-cheek, to illustrate a point with a hint of wit (or as some might say, half). 

<---needs to use emoticons more often for greater clarity of intent.

It is an old joke that really annoys me, emoticons would have made it worse.

[hagoth7]

59 minutes ago, Jane_Doe said:

If you're asking me to fix the healthcare system, that's beyond my expertise.

1. I'm not asking you to fix a beauracracy. It's obviously not solely about you. Or me. It's about a surprisingly large number of people among us who are living their own hell...and simply don't know where, beyond self-medication or self-abuse (temporary relief that deepens the problem), to find lasting relief/healing. Where Can I Turn for Peace meant a lot to me during the years when such things were deep trials for me.

2. And proposing an end run around the inertia to meet that need...a solution, an outreach, which could promptly fill the gap, even if imperfectly.

3. Essentially, the intent of my meeting last night was to review the materials, and explore the viability of generating online training and discussion forums and outreach groups elsewhere for any who feel a desire/call to ramp up and minister in such a way. Even more so if a generic you is hurting, and feel that by lifting others, you can better master the new habits needed to *find* healing. (Teaching sometimes is the quickest way to learn/internalize/master.) If not, fine, that other person and I may simply proceed alone for his/my purposes.

4. And...inviting any who have other (or better) solutions/suggestions to *please* speak up.

After seeing WW last night, I've tried doing nothing about such things...for years, And now prefer to step forward and do *something.* If you don't feel such a thing applies to you, I won't *at all* insist that's the drum you should march/dance to today. 

Edited July 11, 2017 by hagoth7

[thesometimesaint]

8 hours ago, hagoth7 said:

You're not.

What is PTSD like, if you don't mind sharing?

Debilitating depression? Was there for years.

So-called manic sleep loss (or vigil), with renewed/ever-ready energy? (Check.) 

Debilitating anxiety? Been there. 

Is it anything like the latter?

PTSD isn't exactly like Clinical Depression. Though it can sometimes result in loss of sleep.

SEE https://www.bbrfoundation.org/faq/frequently-asked-questions-about-post-traumatic-stress-disorder-ptsd

[hagoth7]

39 minutes ago, Calm said:

...that really annoys me...

I do that sometimes. Unintentionally.

I hope your afternoon is better/brighter. 

[hagoth7]

22 minutes ago, thesometimesaint said:

PTSD isn't exactly like Clinical Depression.

I know.

PTSD,  anxiety, depression, mania, etc.  different maladies with some occasional overlaps.

 

My intended point being that *some* of these things are effectively transformed/transmuted/healed through DBT....And DBT counselors/facilitators are currently few and far between.

If any have the desire to serve in *that* field, please give the word, here or privately.

Edited July 11, 2017 by hagoth7

[hagoth7]

And it just so happened to have for the surprisingly first time come across Danny Gokey's song Better Than I Found It, essentially the scout camping motto. His song helps express my wish considerably better than the written word can.

[rpn]

The two so far research proven effective interventions for PTSD are cognitive behavior therapy (CBT) and EMDR.   (Propranolol research is showing promising results, but still in trials.)

You can get CBT online (though many therapists claim they do it and few actually do it with fidelity).   One resource is https://ecouch.anu.edu.au/welcome which started as an experiment to see whether online CBT could be as effective as in person.   There are others:  I'm told that BYU health clinic provides CBT through a contract that provides it in home, for instance.

From google (not vouch for authoritativeness): "Dialectical behavior therapy (DBT) is a specific form of cognitive-behavioral therapy. DBT seeks to build upon the foundation of CBT, to help enhance its effectiveness and address specific concerns that the founder of DBT, psychologist Marsha Linehan, saw as deficits in CBT."

Edited July 11, 2017 by rpn

[thesometimesaint]

On 7/11/2017 at 11:56 AM, hagoth7 said:

I know.

PTSD,  anxiety, depression, mania, etc.  different maladies with some occasional overlaps.

 

My intended point being that *some* of these things are effectively transformed/transmuted/healed through DBT....And DBT counselors/facilitators are currently few and far between.

If any have the desire to serve in *that* field, please give the word, here or privately.

I've been retired from the clinical setting for a while now. But I still keep up. Most therapists will gladly give you a referral to someone in the area, if they themselves don't have that specialty. 

[Tacenda]

In answer to your question in the OP Hagoth7, yes, my brother. I think he is a sociopath. He's the brother that was homeless for a short time, and an alcoholic. He's been like this for years, in and out of work, and in jail here and there. I was able to get him into a wonderful rehab up in the mountains, cheap too. And he got an incredible job after the 90 days, with a work truck that had am interlock system that the DMV required given his past with alcohol violations. He even got his son on the job to work with him, he's a Glazier. 

The other day I got a message from a girl he's been dating for a short time that he knew from school. She tells me he's been on a bender and she was worried about him. I filled her in on his long past with alcoholism and urged her to not get involved but she kept saying she loved him and she wanted to help as long as he didn't drink. 

Last week my brother wanted to go up in the mountains and have a fire and hang out with her, well they had a roadblock and were checking ID's. And my brother was driving her car, she didn't know he needed an interlock system to drive. So they towed her car and she had to pay $700 to get her car back. Then after a couple of days of sobriety and her her helping him detox, she heads back into work on Monday, she's a substance abuse counselor believe it or not, he takes off and is at the bar the whole day. When she gets back she kicks him out. 

I've come to think now, that I should have listened to my oldest sister when she said my brother is a sociopath. I didn't even take time to research until today. It sure feels hopeless for sure. 

I know the LDS church use to help with counseling to those that couldn't afford it. I might need to check it out for my brother. 

[hagoth7]

3 hours ago, Tacenda said:

In answer to your question in the OP Hagoth7, yes, my brother...believe it or not, he takes off and is at the bar the whole day.  

Most people self-medicate (drugs, alcohol, promiscuity, ponography, other damaging things, etc.) trying to keep psychic pain beneath the surface, sometimes seeking an endorphin rush, to balance out the pain, sometimes helping in the short term, but in the process, digging themselves and making things worse in the long term.

Have you ever had friends, family, priesthood leader, or therapist ask him what really drives him? What source o heartache, or regret, if anything, has happened, unresolved, in the past, that he's repeatedly trying to keep down?

Actions are somewhat predictable. As to his bender, and what may have led to it, I'd venture to guess that his addiction counselor, who genuinely cared about him, told him something along the lines of "whatever you do, don't drink while I'm gone." (I'm willing to be wrong there.) 

But sometimes we tell people the opposite of what we really should ask/say. As Dennis Waitley says (started listening to recordings of him the last few days), when you tell someone "don't think about elephants" ...you know what they'll be thinking about. Elephants. (And curelom.) Because you planted the idea there. As Waitley said of a pitching coach, who walked up to the pitcher at a clutch moment in a series, and said "Whatever you do, don't throw high and outside." And guess what that led the pitcher to unconsciously do....throw high and outside. Something I personally need to take to heart. I need to focus/speak/write more on the outcome I truly wish to see, the do's...

Edited July 13, 2017 by hagoth7

[hagoth7]

3 hours ago, Tacenda said:

...He's the brother that was homeless

Been there.

It sure feels hopeless for sure. 

Cue: Danny Gokey

I might need to check it out for my brother. 

please do.

[hagoth7]

On 7/11/2017 at 1:27 PM, rpn said:

The two so far research proven effective interventions for PTSD are cognitive behavior therapy (CBT) and EMDR....

Hmm. Never heard of EMDR. Will have to look into it.

You can get CBT online (though many therapists claim they do it and few actually do it with fidelity).   One resource is https://ecouch.anu.edu.au/welcome which started as an experiment to see whether online CBT could be as effective as in person.   

Hmm. I would be *very* surprised if solo online training in DBT, all by itself, was effective. we're talking about creating entirely new thinking/feeling habits. 

I see more the need for an appropriate blend of training.

• Online resources. (Reading the chapters. Audio content. Specific music ministry.)
• In-person discussions and role-playing. (Doing the actual work, forming the new habits/neural paths, and getting immediate feedback.)
• And regular progress testing. (Online or in person.)

...."Dialectical behavior therapy (DBT) is ...to help...address specific...deficits in CBT."

The specific deficits are this: the types of people that need DBT are actually harmed by CBT.

CBT makes them worse, more miserable.