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?

OVERTHINKING: CHANGING A RIGHT ANSWER TO A WRONG ANSWER?

I wonder if most of us have had the experience of changing an answer on a test and finding out that we changed a right answer to a wrong anwer.  It is actually hard for some people to stop doing this as they feel that they have the correct answer after thinking about the question for a period of time.  So, why would anyone reject their first answer [first impression?] and instead change it?

Maybe this is influenced by our brain's being organized so that it will provide us with a response to something when we need it. It appears that information is stored in a way that what we need to know is there but not how we got to that place. There is no paper trail of the process of our learning something. Presumably this is because it is efficient to store just the answers and not all the steps it took to get there. Also, when we need an answer [or information] our brain will give it to us if we actually need it.  So, if we are quizing our brain [ourselves obviously] to recall something to reassure ourselves that we actually know it, our brain will not provide it [because we actually don't need it?].

So what does all this have to do with changing right answers to wrong answers? Well, what so many of my patients have made clear is that if they are feeling stressed, their brains will automatically focus on trying to figure out what is causing our stress and if we cope with stress by over thinking then that will take over and we will doubt that our initial answer is correct. When we have had traumatic experiences in the past, second guessing ourseslves and overthinking are very common ways that we learn to cope as these help us to believe that by doing this we are being careful, not making sudden decisions, and we are considering other's opinions. All of this reasurres us that we are keeping things from getting out of control, and thus we believe that we are changing wrong to right answers. Since overthinking and second guessing are ways that we cope with past stresses, it really is not actually about changing wrong to right answers, but it is about continuing to use coping mechansms that we no longer need as they are left over from past stresses. What do you think?