December 25, 2008
Merry Christmas!
Mother and I watched a couple Laurel and Hardy videos, laughed our heads off, and then chatted for awhile. It was raining cats and dogs when I drove her back to her apartment. She was laughing and happy, delighted to have been with us. That was a wonderful Christmas present, right there.
When one takes the time to think about life in this world, it doesn't take long to eliminate all the things that don't really matter in the larger scheme: Christmas presents, notoriety, wealth, the latest countertops in the kitchen. These are lovely things, but you can't take any of it with you when it's time to die. But to have a spouse who love me, a Mother who is happy, a warm and inviting home where people love to come be with me--these are wonderful. A peaceful heart, warmth and understanding with Sam, having done all to be at peace with my family members, contentment because of the work I do--these have been wonderful gifts that I paused to thank God for this day.
So on the day that we celebrate the miracle of God With Us, may you also pause to consider all that you have that really matters, and give thanks to God for these things.
December 22, 2008
Traumatized
Work with traumatized individuals can traumatize the therapist, too. Hearing about blood, gore, loss of safety, life threatening experiences, witnessing hideous sights that play and replay in the mind--all of these are the stuff of Posttraumatic Stress Disorder.
I can't talk about my clients or say anything that would give away their identities. But I can tell you about my response to what I see and hear over the weeks and months that I work with my them. In the beginning of my work with a new client who has been traumatized, I typically have secondary traumatization symptoms for a day or two. There are unwanted dreams, preoccupation with what was heard in session, and a lull in my mood. I tend to want to be left alone and not talk to anyone until I can work it through in my mind and separate their story from my personal story which doesn't include the threats to safety that they have had.
So today I heard a story of incredible bravery in the face of danger. Heroic acts were performed that most of us wouldn't even think of. Lives were saved and death averted. But it emotionally disabled the heroes. They are afraid to burden their families with the horror of their story, so they come talk to me about it every week. I know the course of treated PTSD: initial exhiliration that they have survived (several weeks) followed by awareness of fear and vulnerability (few weeks), followed by major symptoms and relational difficulties due to intrusive flashbacks, nightmares, panic, dissociation, etc. If they are faithful in working it through--which is a daunting and frightening experience for many traumatized people--the symptoms will start to fall away after about nine months and they will be functional without crippling fears or memories. My client is just getting to the major symptom manifestation stage and is particularly anxious.
Most of the time in therapy I'm listening for exceptions to the hopelessness, pain, vulnerability, and negative symptoms so I'm focusing on something other than the sensational details they spill out. I think of what I'm hearing as a piece of a larger puzzle, and I'm thinking about what needs to happen so clients can think about their trauma in a less pathologizing way and move on with their lives after they work it through. Maybe I'm listening to the way they are expressing themselves: what isn't said or acknowledged? What is the focal point of their comments? How does this tie in with their interpretation of their value as a person? Where are the entry points to the story where new interpretations can be explored?
But there are times when the rawness of the story takes me by surprise and I carry it away on the inside of my soul. Today was such a day. It was a session that left me feeling as though I needed to come home and soak in a hot tub until I was like a piece of warm taffy. All these little bits of trauma, sadness, and pain that I pick up in therapy have to go somewhere. Since my worldview is that awful things do happen to good people, and that it's not safe here and that good-hearted people are placed in untenable situations, then I'm typically not shocked by hearing too much. But alas, I am human, too. My clients' panic as they explored another facet to their story, the horrifying experience that was endured, and the way they were reduced to survival behaviors--all of this impacted me more than usual. Perhaps I wasn't emotionally prepared for our session today. I noticed that as they spoke, I was struggling to step back and see the forest rather than the leaves on the trees, and I wasn't fully successful. A good night's sleep will rearrange all the facts, impressions, and story fragments in my head so that the stories of my clients will become part of the story of my life without eclipsing the future. I am grateful that I will wake up feeling considerably better and more clear-headed. They will wake up frightened, disoriented, and struggling to recognize that they are living now, December 22, 2008--not back when their trauma occurred.
God bless all these good folks.
December 21, 2008
I received an email from my cousin last week, who lives in Fitchburg Massachusetts. This came after the terrible snow storm that swept through and knocked out all the utilities and shut down almost the entire city. Here are parts of my cousin's letter:December 18, 2008
Bon Voyage, Dad!

December 17, 2008
Memories and Change
Found hereI decided to look for comfortable shoes and was telling Brother that ugly shoes are an occupational hazard for professors. He stared blankly at me. Since we're on our feet so much, we wear "sensible shoes." It seems that the more education a woman has, the uglier her shoes. Most of my professors at the University of Minnesota wore beautiful suits. Then when they walk away you notice that they are wearing hideous leather loafer type shoes that one would never wear with a suit in any other venue. In fact, we had some internationally known researchers give a presentation at our university and both of these women wore wretchedly ugly shoes with beautiful suits, scarves, and blouses. I warn my female students about this and they laugh, looking down at my shoes--which for the most part, are dressy and pretty. But my feet have been hurting me and ugly shoes have become more appealing somehow.
So pur political views, sense of style, beliefs about people--so many things--have been influenced by our lives after childhood in these diverse geographical areas. We are influenced by the fact that his wife is a combination of Lebanese and Southern belle, and my husband is a Puerto Rican, Angelino (L.A.), father of three. Brother is extremely conservative politically, and I am quite liberal. He hates leaving home and I've traveled abroad numerous times. Religiously, he is quite liberal and I am more conservative.

December 15, 2008
Freedom
Found here
One of the greatest gifts that God gave humanity was the freedom of choice. He could have created us so that it was imperative that we performed only certain acts and experienced a proscribed range of feelings. We could have been forced into only one way of being. Everyone has the freedom to choose how they will live and what they want to do with their life. Even though it hurts oneself or those whom they claim to love.
It is the ethical obligation of all mental health workers to encourage self determination of those who have the mental competency to make their own decisions. A common question that arises is how one knows whether or not the mental health consumer is of sound mind and capable of making such decisions that affect their future. For example, take a young man with schizophrenia. While he is taking his medication he can make fairly decent decisions and he may choose to go off his meds. But say that once he does, he becomes completely confused, hearing voices and becoming antagonistic to others. At that point, do you force him to take his meds again, since he went off them knowing what would happen to him? (This is possible particularly for those people with severe mental illness who have had a prolonged course and who realize what happens by experience). Or do you allow them to live on the streets and become a menace?
Many mental health practitioners make the decision to allow mental health consumers to make their own future. Problem is, they often aren't accountable for their subsequent actions and everyone else has to pay for their actions, emotionally and financially. So where is the line between accountability and freedom? This was the question that the existentialists asked: how does one balance freedom and responsibility?
I ask this question of myself these days because Mother informed me today that she went off her antidepressant/anti-anxiety medication and has no intention of going back on it for any reason. Even though I've shared with her how pleased I've been that she went on it and that she was more fun and enjoyable while she was on it than any other time I've ever known her. Now she has become antagonistic, irritable, and roiling in her grief and sense of geographic dislocation. I realized today for perhaps the first time, that no matter what I do for her, it cannot make up for the other three children who choose not to be in contact with her. And even if I give up my job and my relationships and decide to stay with her 24/7, she would continue to be unhappy because she has depression. It is not because I'm not good enough as a daughter, not because I've done something wrong, or because I don't spend enough time with her or do enough things in the community for her to feel proud about.
Her mood is not about me.
And yet I will have to pay for her decision in the long run. It is not appropriate for me as a daughter to neglect her and avoid her. It is very hard to be in her company though as she is because it is very sad to see her in such pain, and it is painful for me to be the recipient of her irritability. She has made the decision herself and I am struggling with the balance of responsibility and freedom. I keep telling myself that I also have freedom and responsibility. My responsibility is to be a good daughter. I only wish I knew how to do that in this situation. She may have also gone off some of her anti-hypertensives, too. She acts as if she has. Mother claims that her medications have given her some sort of rash and she becomes hostile and beligerant if I ask her about which medications she is taking. "I'm not taking any more of those %@#$ medications. They only have given me problems." No they haven't. And if they have given her a rash, she hasn't used the medicated cream that I took her to the doctor to get. Why? I'm not sure except that she feels that she has a better way to treat it (I don't know what that is).
So my mother may have a stroke or be so overcome by depression that she opts to die of her own accord. What a horrible prospect. But I have almost expected that she would take her own life for years now. It has been especially likely in the aftermath of my father's death. I can't stop her. I can't make her pain better. I can't give her what she needs to undo her awful childhood that left her looking for love and approval from everyone--even her children. This is one situation that I cannot control. She does not listen to my reasoning and I'm not willing to have her go on another rant when I try to explain the need for her meds. I wonder why I ever came here (to California) in the first place. I really don't care about anything. I'm sick unto death with... and it goes on and on. Then after awhile she brightens, but I'm left with all the negativity, despair, and anger that doesn't belong to me.
It is impossible to be a therapist to myself or my mother. Any therapist I know would encourage me to set limits with her regarding objectionable behaviors of which I am the target, and to create conditions for spending any length of time with her. This is quite difficult. Even though while she has been on her meds, she had wonderful things to say about me, without them I am either not sensitive enough to her pain or she seems to grovel because I am a busy person and must not have time for her, etc. In any event, I have to pay for her behavior.
My siblings do not know. Two do not care and one would not do anything to help although he does profess to care about her. I'm trying to do what is right for my mother in spite of having no support from my siblings. It is an extremely lonely circumstance and I do the best I can to be connected to everyone in this situation: parent and siblings. Because in a few years I may only have my siblings. But then, after the way I have had to shoulder these responsibilities alone, their disinterest and silence on the issues surrounding Mother's life and care, creates a rift that I'm not sure can be fully bridged. I will try, but this situation is taking a toll on more than just my mother.
I've said before that God wants us to be holy in a very deep place. I still believe this. And that my job is to honor and respect my parents in every way I can. But jeopardizing my own mental health and the happiness of my marriage, is not part of that. It is a time to pray, to be thoughtful, and to balance kindness with firmness. Determination with tenderness. There are not a lot of clear examples of this for me, so I'm making it up as I go along, grateful for the knowledge that I'm doing the best I can and that God will somehow sustain me. My concern is that this will get very bad before it's over. And if it is, I pray that I will remain a loving, hopeful, faithful, warm-hearted and giving person who can set limits and not allow the poor choices of others to limit my usefulness or determining my own emotional wellbeing. That is my freedom to own it, and my responsibility to make it happen.
December 14, 2008
First Snow
This morning, as I rolled over in bed and noticed that it was getting light outside, I noticed with surprise how cold it was in our bedroom. We like sleeping with the windows open and since we have an elderly parent staying with us and he is usually cold, we had closed our bedroom door to keep in the cold and keep out the heat. Sam mumbled something about how cold it was and we rearranged ourselves for maximum warmth under the down comforter. A bit later, I was awakened by Otis who was yowling out in the hall. He was thirsty and very cold. How snuggly he gets when he is cold...
In fact, we had our first snow in the mountains. It was 29 degrees Farenheit this morning. It is a gorgeous day in Southern California: bracing crisp air, clear views (which in itself is a minor miracle), and just enough sun to keep us from freezing during daylight.
It makes me realize that I have tons of work to do out in the yard and that I'd better get to it. There is a rosebush to plant out front by the sidewalk, the vegetable garden to mulch and rake, the golden honeysuckle shrub to put in the ground and calla lillies and tulip bulbs to put in the ground before it is frozen. It's a beautiful, beautiful day.
I'm grateful that we are not living in New England this morning. My cousin's phone service is out so I can't check in on her, but she lives very close to Worcester, Massachusetts and I'm certain that she is without electricity and is very cold. The whole Northeast is in trouble from ice storms. I'm looking out my bedroom up into rolling green hills in one direction, and snow covered mountains (about 30 miles away) in the other direction. Lovely, just lovely.
The laundry is almost done, the banana bread is baked and given to Sam's brothers, and fresh chocolate chip cookies are waiting for Stepdaughter #1 (who is now living with us). Sam has had the car serviced this morning and is now busy with the family bookkeeping.
Time to go outside and get busy.
December 12, 2008
Memory Quilt
So my quilt stayed rolled up and carefully wrapped, stored in the antique travel trunk of my great grandfather Bettinger. I also had a little yellow dress with smocking and flowers embroidered across the top that Mother made after I challenged her attitude about my prospects. If your comments about wanting me to marry and have children are substantial it seems that you will make something--anything at all--to go in my hope chest. So she made me a darling little yellow and white dress for a tiny little girl.
When Sam and I were packing to move to our new home this summer, I opened up Grampa Bettinger's trunk and pulled out the baby quilt. One side of it had my embroidered squares. The other was a butterfly pattern superimposed on squares of material that Mother had saved from all the clothing she sewed for us. There's a leftover piece of material from my 8th grade graduation dress; something from the (hideous) bridesmaid dress I wore for my sister's wedding; a couple blouses I had made for myself; and a shirt of Mother's. The black and white gingham was the little scrap left over from the matching dresses Mother had made for herself, my sister and I. As if we didn't stand out enough in matching dresses, she then made my father and two brothers shirts out of it. We all laughed at how we looked: "It looks like we got a run on a bolt!" (of cloth). We made it a point not to wear them all at the same time after that first time because we all looked and felt ridiculous. The quilt was fun to look at because my mind went back to the sewing room at the back of our country house, and I remembered sewing back there for hours, looking out across corn fields, past the freshly laundered clothes hanging outside to dry.
The Sacred Harp
Shape note singing has been around in this country since its colonization. It was a way of teaching young children how to read music and to sing. Each note corresponded with a note on the sol-fegge scale (fa-so-la, etc.) and had a different shape: rectangular, triangular, circular, square. So any child, if she could see the shape, could sing the corresponding tone. It is a very clever method of singing. It was particularly suited to congregational or group singing. Everyone is invited to sing in these groups, not just those with voices that are considered particularly worth listening to. Shape note singing groups usually have bases that bellow and altos whose voices are so strident that they can strip wallpaper. People wail away at a great volume, tremendous enthusiasm, and sing with their whole souls. In another post I said that there needs to be more singing by people in this country--not the polished, perfect music, but the singing that arises from a soul on fire. Shape note singing is such a practice. Old and young sing side by side without distinction. (go here and here to see an example).Typically, the seats are arranged in a square and the leader--who can be anyone: man, woman, or child, with or without any kind of singing voice--stands in the center. They make an up and down motion with their hand to keep time. The tenor gives the starting note and off they go. The first time, the song is sung through on the fa-so-la syllables. Then the fun begins with the words. Some of the songs are dirge-like and others sound surprisingly similar to Scottish bagpipe tunes. The level of community engagement is unlike almost anything else I've ever seen.
Singings, as they are called, are usually an all day event, with dinner on the ground (a potluck lunch) in the middle of the day. The best singing occurs right before and right after lunch. The singing begins with a heartfelt prayer for God to be present, and ends with an equally fervent prayer of thanks at the end. It is a time of fellowship and anyone of any age, faith, or ability is welcome.
There are a few hymnals that are written in shape note, but the most famous by far is called "The Sacred Harp," the harp being the human voice. Most of the songs were composed around the time of the Civil War and the Great Awakening period in U.S. History. Thus, many songs are about Christ's return, the Christian life, and an earnest desire to live apart from a sinful world. Songs in this book are indexed by their tune name, not the first line of the song: Warrenton, Hyferdol, Alabama, etc. Here are the lyrics of one of my favorite hymns in the book:
When I can read my title clear
Should earth against my soul engage,
Let cares, like a wild deluge come,
There shall I bathe my weary soul
The trailer for a very interesting movie documentary on shape note singing is found here. You will hear very strident, open chords, wierd harmonies. But for some of us, it is a tie back to the early days of this country, and an opportunity to keep this form of community music alive. I think that if more communities came together and sang like this, the country would be very different and so would the health of people and society in general.
December 7, 2008
Found hereBATTER my heart, three person'd God; for, you
As yet but knocke, breathe, shine, and seeke to mend;
That I may rise, and stand, o'erthrow mee,'and bend
Your force, to breake, blowe, burn and make me new.
I, like an usurpt towne, to'another due,
Labour to'admit you, but Oh, to no end,
Reason your viceroy in mee, mee should defend,
But is captiv'd, and proves weake or untrue.
Yet dearely'I love you,'and would be loved faine,
But am betroth'd unto your enemie:
Divorce mee, 'untie, or breake that knot againe;
Take mee to you, imprison mee, for I
Except you'enthrall mee, never shall be free,
Nor ever chast, except you ravish mee.

