IS GIVING ADVICE OVERRATED?

A better question might be if giving advice is ever helpful. Now that might sound radical and yet in my experience with a few thousand people I have never noted that advice was helpful to anyone nor actually accepted by anyone. If it seems to be that people seek advice and then reject it. What is that about? Also, if the above is true then what about my attempts to help people? Am I not at least fairly frequently giving advice and then are my patients also frequently rejecting my advice?  

I have seen repeatedly in my treatment of people that it is critical that they decide what to do and then take responsibility for themselves and their actions. Can advice help that? Since advice is so frequently rejected it seems that advice does not help. There seems to be a wish for advice and for answers to problems and for solutions to problems with others and yet this does not seem to be helpful. When we give advice what message is that sending? It seems to be received as a lack of faith in the person's ability to problem solve for themselves and manage their lives. This may not be an intended message and yet giving advice does not seem to reinforce their being able to problem solve for themselves and to take reponsibility for themselves. Of course, the intention of the advice giver might be to have their advice help the person to start being more responsible for themselves and to take responsibility for their lives. Yet, I have never seen advice giving be helpful for either party as it risks separating the advice giver and receiver. This separation may be related to the stress for the advice giver who feels responsible for the advice receiver [which is the reason that advice was given] and need that the receiver has to be responsible for themselves. This appears to be a basic need and the receiver will likely feel that the advice giver does not have faith in the receiver's ability to manage for themselves. 

So what is the alternative? It is to encourage and support the person you are tempted to give advice to. What is encouragement and support? It requires listening without our own reactions and thus allowing ourselves to see the strength in the other and then share this with them. Listening by itself is supportive as we are with others and therefore are supporting them when we are listening. The support is emotional support and often does not require any words. This encouragement and support is what I try to do with my patients as I listen and have an opportunity to reflect back what I have heard and to encourage them to trust themselves and see what happens.

Does any of this make any sense?

ST. AUGUSTINE: LOVE AND DO WHAT YOU WILL

Well, what does that mean? Does it mean that if you love then you can do anything that you choose to do? Is love really that powerful? Don't we humans need more checks and balances to keep us in line? Don't we need protection from ourselves vs having the license to do anything that we want? St. Augustine in a sermon about God's love for us said "love and do what you will." The meaning seems to be connected to St. Augustine's belief that God's love would transform those who opened their heart's to it and then they would follow God's will and do good things. So then they could do what they wanted as they would want good things for themselves and others. This might be an answer for the critique of "do unto others as you would have them do unto you" pointing out that if you do bad things to yourself then you could justify doing bad things to others...if that were actually what you wanted to do to yourself or others. 

So. what does this have to do with us? Over the last 30 plus years helping people with a variety of problems but virtually all were feeling stressed and were self-critical and hard on themselves. I tried to help them to be kinder to themselves and to be more self-aware. I have found that when we are more self-aware, we are more likely to see the good parts of ourselves and are then more able to let go of some of the self-criticism. So maybe part of the "love" in "love and do what you will" is our choosing to be kinder and more loving towards ourselves and then we would be kinder and more loving towards others. If we do this, we will then feel less stressed. What do you think?

LITHIUM FOR PTSD: A LITTLE BIT GOES A LONG WAY

For a couple of years I have been prescribing low doses of lithium carbonate to help people with PTSD [post traumatic stress disorder] not react as much to past traumatic experiences when they are recalled.  Those who respond report feeling less anxious and less reactive when they think about past stressful events. It is like they are not as on guard and overall more able to experience events throughout the day without having to react with anxious feelings and a need to be vigilant.  

Unfortunately it has been hard to determine a range of optimal dosing as many of my patients do not respond to the lowest lithium carbonate dose of 150 mg [in a capsule]. Therefore, I have started prescribing a liquid form of lithium to see if a dose range from 6 mg to 120 mg would be helpful. I am also prescribing compounded doses of lithium. Once my patients respond to a specific dose range, I ask them if they are willing to change their doses to see if a small change leads to improvement and then seeing if their most positive response is replicable with repeated trials. This can lead to important information about the range of optimal dosing for lithium in treating PTSD.

SUICIDE AND THE IMPACT ON THOSE LEFT BEHIND

Suicide continues to increase in the United States. I have no doubt that this is directly related to increased stress in the lives of those who have died by suicide. I also believe that a major factor in their decision to harm themselves was feeling alone and isolated. So, they felt disconnected from others and yet afterwards a lot of people are left distraught as they grieve for the who is tragically gone. So, how come they didn't feel this? 

Well, sadly, people often withhold their caring and affection for a variety of reasons: it is too painful to care for someone who is talking about hurting themselves; not wanting to enable or unwittingly encourage negative behaviors [make the person more suicidal]; cope with their sadness about the person's hopelessness by giving advice over and over which only serves to make the person feel more isolated and lonely.

What can we do to help those who we love and who are suicidal or at risk to become suicidal so they are more likely to feel our caring about them? 

• We can listen! Listening is an effective way to demonstrate caring for someone...especially if we are able to listen without having our own reactions. When we listen without reacting we are being present with that person and they can feel that. Their own feelings and thoughts will be clearer and if we need to say anything to them our brains will provide this for us [really!].
• We can tell them that we are worried about their safety and remove any lethal means of suicide that are available to the person.
• We can encourage them to talk with someone about how they are feeling and even suggest specific people that the person can call, as this is one way to help a person who is feeling depressed and it is estimated that 90% of people who attempt suicide are depressed.
• We can call 911 if we feel that the person is still at risk to attempt suicide and tell the 911 dispatcher that we have a mental health emergency and give details of what is happening. 
• We could also offer to take them to the emergency department of a hospital so that they can be evaluated and have a chance to talk about how they are feeling. 

Taking the steps outlined above can help us to maintain a feeling of connection to the person who we are worried about. This can help us to feel that we are with them, as we are encouraging and supporting them. This way of supporting others can help the person we are worried about to feel connected to us and cared for even if we have to call 911.  

If the person that we are worried about [and likely love] dies by suicide, we are less likely to feel as overwhelmed and less likely to have a prolonged recovery period. I did not call this a prolonged period of grief because I believe that grief gets blamed for stressful emotional states that are not part of grief. These emotional states can actually delay the opportunity to grieve for the lost loved one and for us to realize that we they are part of us and we can then give ourselves permission to participate in our own lives again. 

THE BUTTERFLY EFFECT AND YOU

With reference to chaos theory, the butterfly effect refers to the phenomenon whereby a minute localized change in a complex system can have large effects elsewhere [Dictionary: In chaos theory, the butterfly effect is the sensitive dependence on initial conditions in which a small change in one state of a deterministic nonlinear system can result in large differences in a later state [Wikipedia].

So, since humans are complex deterministic nonlinear systems and we interact with other complex deterministic nonlinear systems, can an action by one of us have profound influences somewhere else? If that is so, does this mean that what each of us does have an impact elsewhere and therefore we are responsible for [the impact] of our actions? I bracketed "the impact" of our actions as even though we are responsible for the impact of our actions we can not know what these impacts will be...we can not [and do not need to] predict the future. However, we are still responsible for our actions and can exert control over these actions in order to improve our lives and the lives of those around us. Now, with some level of awareness that the definition of "those around us" can be expanded significantly to include even a multitude. 

What do you think?