When I speak to conference rooms full of people on the topic of mental health, the most common themes to pass over my lips are: self-compassion, mindfulness, and the importance of cultivating courage, kindness, and an open mind.  The most prominent concept I speak to is change. What journalists seem to be driven to write after hearing me speak is another story, one wracked with sensationalism, voyeurism, and an incredibly narrow view.  I have yet to read an article about me that does not reference in the title the infamous buzz words attached to my name: my diagnoses. 

A number of years back, I was diagnosed with schizophrenia, the worst of all of my psychiatric name-tags I’ve acquired over the course of my 20s.  I work at a university, I hold a Masters degree, I am a therapist, an artist, I have won awards for mental health advocacy, and none of this is really a big deal – except if you remember that I apparently live with schizophrenia. 

I just preface my resume with the words “I have schizophrenia” and I dispel my reader’s hope that anything I say will be of relevance, or just as inaccurately – they may come to believe that I am some kind of hero.  Of course, neither of these extremes are true.  But people who survive a diagnosis of a major mental illness are often placed in the category of victim, or champion.  And in the mean time, all I am trying to do is to be a human being.

What would be more helpful is to accept people with all of their challenges and vulnerabilities, to not force them to put on some sort of mask in order to prove that they are over their bad days.  Bad days, bad months, bad years – so what?  What are we so afraid of?  I once had a relative say to me that I had reached my quota of bad days years ago.  It is precisely this kind of pressure to be perfect or to be “recovered” that leads people away from the self-compassionate, tolerant view that would allow them to be resilient, full human beings. I do have bad days, but they’re really not that as bad as they used to be.  In fact, everyone has bad days, but if you have a mental illness diagnosis, they are seen as somehow different – they are viewed through a pathological lens. And even though I do still have some bad days, I personally do not think too much about my diagnoses anymore on a regular basis.  However, I know that many people who meet me can’t seem to forget it.  I typically get one of two responses:

“Wow, isn’t she amazing; doing all that with schizophrenia!” or

“There’s no way that woman has schizophrenia.  She’s not representative.  What a fraud.”

As I am aware that both views are rooted in stigma, I try to ignore them.  But this same predicament affects my clients, and many of my friends.  It is certainly a reflection of a larger social injustice issue.  So I am speaking up. I try to be patient with people, but I am still waiting for the day when someone might meet me somewhere in between these extremes, somewhere in the middle, where I wouldn’t have to to play either a victim or a superhero.

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From the origins of psychiatry to the present, there have been two distinct paths one could walk toward the understanding and the treatment of mental illness.  These paths are the neuro-biological path, and the environment path, or nature vs. nuture.  Although most scientists of any notoriety would purport that genes, neuro-biologcal structure and environment are all implicated in the development of what we call mental illness, only recently have these paths begun to converge when it comes to treating it.

An important lag in our public perception is found with the understanding of epi-genetics, or the notion that genes are turned on or off by environment (and are even impacted by the environments of our progenitors several generations back).  For some reason, epi-genetics has largely been left out of the public discourse on mental illness.  One possible reason for this is because this wide array of possible influences over our mental states may appear threatening.  Just when we thought we had it figured out, it appears a lot more complicated and at least partially out of our hands.  Thinking we can map the brain and therefore understand and prevent mental illness is perhaps not as direct a goal as we had once hoped.

And in the meantime, when it comes to treatment, we risk getting knocked over by the massive pendulum swinging between the worlds of psychotropic medication, and psychotherapeutic and psychosocial efforts.  At this point, most practitioners only practice delivering care from one end of this spectrum or the other.  Our opportunities to visit a practitioner trained in dispensing and monitoring medication AND administering psychotherapy are few and far between. We are indeed more likely to come across individuals with strong biases in either direction, thereby potentially leading people in need of complex care interventions, toward lopsided and incomplete recovery outcomes.  And as most schools of thought uphold the covert ideal that IT is the preeminent path toward mental wellness, even when we have care teams composed of professionals with varied training, they often fall short of being able to cooperate and collaborate to the best of their abilities.

Why in the midst of this massive mental health crisis are we still fighting over our own piece of the pie?  Well, for many of us, our livelihood depends on it.  We are set up to prove through evidenced-based studies that what we are doing is valuable, and essential.  And those of us whose practice is better suited to qualitative analysis, or who are not represented in the current discourse on recovery-oriented interventions –  well, I’m afraid that for now, we’re mostly out of luck.

Even with several studies on the remarkably small difference between antidepressants and placebo for moderate depression, not to mention the question of long-term impact and the possible contribution to chronicity of depressive states, we still dole out pills faster than we can read the literature on them.  But it’s not only pharmaceutical money that drives the system.  Several reputable meta-analyses reveal that only a small percentage of therapeutic impact of Cognitive Behavioural Therapy(CBT) and other psychotherapies (15% of the total impact) is due to specific technique, while readiness of a client for change, their other supports, empathy from and rapport with the therapist, account for the majority of therapeutic change.  Yet, CBT techniques are seen as the gold standard, and today’s therapists are counseled to uphold firm boundaries, focus principally on technique, and hope for the best, leaving their basic human impulse to connect at the door.

It is clear to me that when massive amounts of funding are involved, when you have professionals with varying expertise pitted against each other for research money, when the popular discourse on mental health is years behind the research, you have a recipe for a less than ideal situation.

What can we do?  Educate ourselves.  Dare to be critical of the care we receive and the rationale behind it.  Stand up to the system that tells us there are only one or two options for any mental health problem.  Treatment plans should be client-centered, involve a choice of interventions, and clients should be trusted to take a principal collaborative role with providers.  When there is a medication with fewer side effects you have researched and would like to try, advocate for yourself.  When you come across a therapist with poor bedside manner and you know that empathy and rapport create the foundations for a healing relationship, ask for someone else.  Trust yourself if you come across an alternative treatment that seems to work for you.  It’s time to remember who is serving whom, and take some of the power out of the hands of clinicians and researchers, and place it in the hands of service users and advocates.  It’s time to realize that although most clinicians have our best interests in mind, their systems of learning are as human and as fallible as the people who create them.  As long as mental health care is fighting for the same small scraps of government funding, we are bound to place jobs, survival, and ideology over individualized care.   In my opinion, although I hope for the best, I think we just might be decades (or a massive federal government shift) away from anything we might dare to call “best practice.”

It all started quite innocently.  My room mate came home from her work at a café and mentioned that well known Hollywood actress, Christina Ricci, had dropped into the shop – for a second time in the past couple of weeks.  This wasn’t so surprising to me, as I know that the actress is in the city shooting a film, and famous people shoot movies in Halifax quite often.  I also know many of my actor friends who auditioned to play supporting roles in the same film, and I would like to think that I am somehow above being star-struck.  After all, I don’t watch Hollywood movies so much anymore, nor do I usually follow Hollywood media culture, but I do know who Christina Ricci is, and she fascinates me.  Why?  A few reasons.  One: she’s my age.  Two: she possesses an intensity and a courage in the roles she plays that I admire, and three: we both struggled with anorexia at the same time – she in the public eye; myself, only in front of the relatively few people who cared that I existed in my insular, small town fishbowl.  I am morbidly fascinated by this poor young woman’s relationship with her weight.  Years ago, I looked to her as a role model – the subtly defiant Wednesday Adams who seemed far too sardonic and oblivious to things as insignificant as her appearance, to fall into the same traps as me. 

But after curiously looking at recent pictures of her online, what I found threw me for a loop.  As I found myself scanning these recent pictures of her modest frame, I stumbled upon a tweet from a teenaged girl: “I want to look like Christina Ricci, 95 pounds of pure muscle.”  In the same breath, I found an article extoling the discipline Ricci possesses in her exercise and diet routine, and a quote from the actress stating that no matter what she does, she will never look like the average person in a bikini.  Now, think about that.  Of course she won’t.  Everyone’s bodies are on a vast continuum, and she will probably not often in her life, fall into the average category.  But what did she really mean by this comment (if it is indeed her comment)?  Well, I have a hunch that my recovered anorexic brain knows exactly what she meant.  She meant that no matter how hard she tries, she will never look as good as everyone else in Hollywood, that she will never be “enough.”  It broke my heart to read these comments, and more importantly, it broke my confidence.  This is the sequence of events that followed:

I nervously went to the bathroom to weigh myself, sighed, and went to the mirror.  Sighed again.  I have gained weight in grad school – normally not such a big deal to me – but today, the gulf between me today and the slightly more fit me that started 3 years ago seemed enormous.  And 15 or so lbs is not an f-ing big deal.  But I suddenly wanted to look at pictures of when I was 95 lbs, or 85lbs, or 78lbs, my lowest as a teenager- to remind myself of how unhealthy I looked.  And I remembered that I don’t have them.  There is a reason for this.  The reason is not because I looked sick, or because the images contain some sort of anorexia-relapse trigger.  The reason is because they freak me out: I simply was not even present in these photos.  My eyes were vacant.  I had checked out.  In these photos, I was not really looking at the person behind the camera, but at the future reflection of how “not enough” the picture would prove me to be.  And many women can spot this look – the shot where you’re trying to capture the best angle, your good side, where you’re terrified of what the picture will reveal, and are using sexuality and coy bravado to mask the feeling that you are NOTHING without them. 

My first instinct was to look into the future to where I could lose some of this excess, grad school weight.  And then I paused.  I am now in a role of peer mental health coordinator – a position where I will be working closely with many young people whose very culture dictates that they give a shit about how much they weigh.  They are already in the thick of it.  If I lose weight in front of their eyes, particularly if I dip below what I have come to see as my own average, what message am I sending?  I am not meant to be 95 lbs.  Not at all.  And I do not have the excuse of having Hollywood producers breathing down my neck.  All of us are role models.  All of us are examples for each other.  Social learning allows for a spread of both revolutionary ideas, and of subtle, silent oppression.  Every woman who ever lost weight told me they did it the healthy way, that they did it for their health, and for themselves.  Bullshit.  We do it because “health” has become synonymous with an impossible standard of physical fitness, with the Victorian belief that self-control makes us somehow stronger and higher status human beings.  There are sooo many problems with this notion.  One: it is often centered around doing what is socially desirable, and with the homogenous, tall, thin, large-breasted, big-eyed, toned bodies looking back at us from the check-out counter, alongside the high calorie, high fat, guilt-inducing snack foods.  In this social system, we are set up for failure.  Well, I have literally just decided that I would rather fail.  I would much rather fail at being a thin person who naturally isn’t so much, than be one of those who convinces themselves that their countless hours at the gym makes them a better person, that it gives them more control.  Well, what are you controlling, I ask?  Or rather, who’s standard of beauty is controlling you?  Don’t get me wrong, as described above, I have by no means overcome the societal systems I live inside.  I am not trying to say that I am somehow stronger for being able to sometimes not give a shit.  Some days, I do care.  Some days, I feel like my hairy legs and my fleshy body make me an avid feminist, and sometimes, I wonder if people might like me more, if I might have more social and work success if I looked more like the ideal.  This is a question I want to raise to everyone out there: Roughly what is the percentage of self-care that you practice that actually involves self-compassion, and what is the percentage that seems more like a punishment in disguise.  I’m not knocking being healthy.  I’m not saying that in order to be role models, we all have to be perfect according to some other standard of being unaffected by culture or personal mental health issues. I’m just trying to lead myself and others to question the sneaky ulterior motive of the notion of watching your weight in the service of “your health”.

As I reflect on a day well spent, facilitating connections between people, trying to disseminate information that will be helpful in the human struggle towards mental wellness, I am struck by the gnawing feeling of shame, hovering right at the front of my diaphragm.  This hot feeling of shame is as visceral and ancient as my first memories, and is equally as powerful.

I know well enough that analyzing my feelings about how I said the wrong thing at the wrong moment to the wrong person will not help me to do anything except justify the nattering storyline that is simply a reflex – the story that says that I am not worthy, that I am a fraud.  Maybe even evil.  And I don’t even believe in evil!  But somehow I worry so much about hurting others – and about leading them to think I’m an asshole and to subsequently reject me – that my defensive response to this possibility reaches cataclysmic proportions.  Shame is by definition, a fear of disconnection, and the associated belief that we must be unworthy of connection, and must cover up our unworthiness with layers of pungent defenses.  This raw and prehistoric gut feeling is sometimes so centrally located within my identity that I think that shame might as well be my middle name.

Shame, for me, leads me straight to the dress up closet.  I will put on any number of different masks to try to cope with this raw feeling in my chest, but none of them have breathing holes, and like clockwork, by the time I’ve finished even one interaction while wearing one, the feeling of nausea and suffocation is palpable.

I’ve come to try to have compassion for my mask-wearing compulsion, but I think that a natural revulsion toward inauthenticity is as natural as bringing up breakfast after not realizing how hung over you still were from last night’s drunken debauchery.  I think it’s similar, because like breakfast, there is nothing inherently wrong with the masks.  It’s just the attempt to act like eating breakfast is a sane response to a bad hangover that resembles the use of the mask to cope with the after effects of shame.  It’s the shame that makes us sick.  Self-deception is dangerous.  Because it impedes authentic connection, it creates widespread isolation.  It erodes our basic sanity; we do it because we are too afraid to face ourselves.

Today, because I felt the momentary panic of not feeling helpful in my helping role, and I was too tired to question this simple busybodying sort of unconscious reflex, I let the feelings of worry about being not enough drop today’s particular mask like a lead curtain.  I felt instantly that something had shifted.  I was irritable.  I lost empathy.  I felt worry and shame about being irritable and about disconnecting from empathy.  But, as I have learned, empathy and shame are not common bedfellows.  Even if, on the surface, I was managing the outer workings of the group with a certain perfunctory, mechanical ease, the most important elements were missing.  Shame had seeped into the transparent, fluffy clouds around the sun in my heart, and before I knew it, not only was a storm brewing, but my heart was no where to be seen.

I KNOW this is how the human heart works.  I know it.  But goddamn, is it hard to stop getting all meta about this, and to stop feeling shame ABOUT shame and it’s results, to stop feeling such annoyance at what is, only essentially, weather.  Maybe the clouds in my heart are storm clouds, maybe my thunder and lightning have freaked a few people out.  Probably, people sometimes feel not quite right around me because I show up in a sun hat and a bathing suit in the middle of the hurricane, trying to act as if it’s a goddamned heat wave.  Sigh. But I try.

I wish I had the shame-resilience tactics to work with this annoying old voice that keeps telling me that I can’t possibly meet the day without hiding behind so many layers that I’m no longer visible.

I am habitually accustomed to these accoutrements.  I once had a friend tell me that my theatre performances were flawless on one level, but that I was somehow inaccessible, unreachable, that my experience was somehow executed from under a glass case.  I knew instantly what she had meant.  To be fair to myself, I have had moments on occasional nights on stage where I would slip out from beneath it.  I was desperate for real contact, but too afraid that I would muck it up.  So I usually kept my heart under glass.  You could see it.  But just try to touch it, and you would be sadly disappointed.  Those shame storm clouds were forecast to start closing in as soon as the cover was lifted.  Yes, my weather is predictable.  But it is overall, becoming less so in time.

The seasons change, and for a while, my heart may peak through the clouds.  I just happen to be in the middle of one snowy, freezing rainy, shit storm of a mess this week.  But like weather in Nova Scotia, I forget that instead of complaining or reacting, I’d better wait five minutes. Freezing rain might turn into a rainbow for all I know.

Knowing all this is helpful, even the revulsion toward inauthenticity is helpful.  As long as I can let it go.  Like a blog written from exhaustion in a hotel bed when I know it’s time to turn off the lights.

Speaking of shame-resilience, I think I’ve just been practicing it just now.  I’m reaching out, I’m narrating my own experience of the shame.  All I need is a little self-compassion.  There’s self-compassion in humor right?  For tonight, I think I’ll cut myself some slack.  Sending my thoughts, imperfectly out into the world and allowing myself some sleep, are both kind acts.  Sleep well, friends and strangers.  I hope it’s sun shines brightly tomorrow, but if not, try surrendering to the rain.  You never know what might happen.

I sit, hands wringing, heart pounding, cross legged in front of my computer in my 2nd floor apartment living room.  I hear the refrigerator buzzing loudly, and I feel more than a little bit detached from my body.  Such is the result of my decision to finally reduce the dosage of my antipsychotic medication.  If it goes well, I may come off of it completely, but who knows?  It all depends on how I fare over the course of this next year or two.  Year, or TWO?  Yes, I am sensitive and aware enough about my own body (and about neuroscience) to know that a typical 3 week weaning process would have me back on the psych ward faster than it would take for any doctor to say “I told you so.”  No, I’m too smart for that.  And too cautious.  If even with this snail’s paced titration, I stop functioning at the level I’d like to professionally and personally maintain, I can always run crying back into the arms of Big Pharma, and hopefully resume my life as the only kind of mental health advocate I can professionally be on a public scale: one who swallows pills and gets others to do the same.

This will be a complicated transition, to be sure.  Even with a recent reduction of less than 10% of the D2 dopamine blocker I have swallowed willingly for more than 2 years (following the adherence to a different one for 5), I am experiencing transient hot flashes, depersonalization, a hypersensitivity to light and sound, poor concentration and some intermittent difficulty coming up with words.  BUT, instead of the hasty conclusion I always came to when I tried to reduce my meds in the past (that I’m sinking into psychosis again, that I can’t live without pills) I contemplate the idea that maybe my brain is just reacting to a massive neurochemical adjustment, and so I have decided to endeavor to explore this further.

I am by no means a neuroscientist, or a psycho-pharmacologist, but I am lucky enough to include a few of them among my peers.  And, I have been studying this stuff myself since 2004 when I began to transition into my first and only psychosis and needed to know what to do.  And as everybody knows, hypochondriacs have great memories and abilities to synthesize medical information.  Just kidding.  Actually, in one sense, the more frightened you are, the more easily you will jump to the most catastrophic conclusions possible, without giving much credence to the notion that your experience might not be so severe or chronic.  I did this.  I jumped to the most dire conclusions and the worst case scenarios I could find.  Yes, the same terror that fed my psychotic processes were also luring me into the belief that my life was over and I would never recover.  One can understand why I thought like this, right?  I was young, and increasingly less in touch with consensus reality .  But sadly, it is the very establishment that is meant to help people like me, that fed this obsession with my own imminent annihilation.  It didn’t take more than a one word google search to come across headlines like “youth’s greatest disabler” and “chronic, degenerative brain disease.”  It was so-called reputable articles like these that sent me straight to a psychiatrist, pleading to obtain the magic pills that would somehow at least minimize this horrible disintegration process.

7 years later, I have begun to think differently.  There are a few things I know now that I was too fearful to absorb back in 2005.

One: evidence does not show psychosis to be biologically degenerative.  The same studies that tried to prove that anti-psychotics prevented brain shrinkage have actually contributed to the data that they in fact can cause it.  Not to be a fear-mongerer or anything.  Brains adapt.  It’s probably minimal in any case. Nonetheless, it is of note.

Two: Several American RCTs of patients being given antipsychotics or no meds at all showed that the antipsychotic group got better faster.  No surprise there.  But here’s the kicker: patients given no meds recovered more slowly, but they had less incidence of relapse and far better long-term outcomes than those given meds.

Three: a Finnish psychosis clinic has now achieved the best recovery rates from psychosis in the western world.  It’s clinicians use caring, supportive, nurturing psychotherapy and work with the content and experience of their patients’ psychotic “symptoms”, almost always without meds.  Their success rate is 85%, and the incidence of chronic psychotic disorders has decreased by 90% in the region they serve.

Four: According to a number of studies at McGill and elsewhere, dopamine hypersensitivity and an increased density in dopamine receptors is shown to develop in people who stay on anti-psychotic medication over time, hence increasing the susceptibility to relapse of psychotic symptoms once stopped.  Hence the evidence accrued in point number two.

Five: In countries where anti-psychotic medications are far less available, recovery rates from psychosis are notably higher.  See points two and five.

Do I really have to continue?

Well, I suppose I am still somewhat torn.  Psychosis is scary.  And now that I’m probably hypersensitive to dopamine, my chances of relapse may be high (hence the decision to drop my dose incredibly slowly, in the hopes that my brain will adapt and prune away some of those extra dopamine receptors).  Also, I had experienced a lot of cognitive decline 7 years ago.  And a lot of negative symptoms.  I was so flat emotionally, that I could barely function.  And, this drug has served me well.  But just because these last few years have been good to me, doesn’t mean that I owe it all to Big Pharma.  I worked hard.  I certainly don’t want to experience such terror again, but then again, I think it’s time to stop letting my fear of fear itself turn me into a complacent (but certainly compliant) doormat.  I can risk a little.  I can figure this out, one milligram at a time.

I should add that by no means do I recommend everyone to avoid psych meds in all situations.  If someone’s beliefs put them at risk of harming themselves or others, or if they are suffering immensely and want quick relief, they should be allowed it.  And certainly, there is a massive shortage of safe, nurturing places people can go to ride out and ultimately resolve a psychosis.  So, with regard to our current system, how could we not use them?  We simply do not have the resources allocated to the right places to actually provide ideal care.  So, of course, the conundrum of how to effectively treat psychosis in the long term remains.  But I have begun to wonder about the road less travelled – the path toward learning and psychological growth and discernment and agency.  I don’t want my old self back; that’s just silly.  But I do want to dive head first into what life has to teach me, to challenge and transform my tendency toward paranoia and dissociation and confusion.  I want to ride the waves that once knocked me over because I was too afraid to move.  I want to stop hiding. I want to give this a try.  Thoughts?

Silence.  Even as I hear the slushy snow-turned-freezing-rain pattering at my window, even as I can still make out the CBC news jingle in the next room, all I can think of is silence – the silence that is killing us, the things unsaid: important things; life-changing, perhaps even life-saving, things.

Almost one year ago I got a call from a friend to help someone we both know and care about to receive mental health care.  I attempted to get involved, but a family member stepped in and prevented this from happening – all with the best of intentions.  My dear friend’s mother knew how much my friend disliked being in hospital, or being on medication of any kind, and because of her love for her daughter, and because she wanted to respect her wishes, she let sleeping dogs lie.  But no dog sleeps forever.  And psychosis rarely rectifies itself when someone is left to live in their own delusional world without specific attempts at helping the person to move through it.  Whether it be medication, or alternative therapies or through various spiritual paradigms – I have come to feel strongly that people need to overcome the notion that mental health problems go away on their own.  My friend, one year later, is still struggling.

I have lost several people I care about to mental health crises, because of either a lack of treatment or inappropriate or poorly monitored treatment.  They have been lost because no one knows exactly what the best thing is to do, and sometimes we err on the side of social, not medical, caution.   Instead of risking a friendship by undermining a friend’s right to make their own decisions, we allow them to risk their own lives.  I, among many, am guilty of this.

I now have come to the conclusion that help – even unwanted – is a better option during major mental health crises than worrying about hurting someone’s feelings, or going against their preferences for how it should be done.  I have had friends come out of psychotic episodes and thank the people in their lives later for making sure they got help, even if they protested it at the time.  I know that everyone should have the right to the best treatment possible, and theoretically to refuse it – but when you know that in many cases, the earlier the treatment is administered (and progress carefully monitored), the earlier you bring your loved one out of harm’s way – it becomes a much more complicated picture.  I am not a die-hard supporter of hospitalizations for major mental health crises – our psych wards in this country are largely un-therapeutic environments in which to heal – but if someone will not agree to any type of treatment outside of a hospital environment, and they are at risk of deterioration or at risk of harm to themselves, the situation becomes a lot more dicey.  Although a part of me feels it is a human right to refuse treatment, a part of me also supports the camp of psychiatry that advocates for early intervention, even when it may be contrary to a person’s wishes, given what we know about how disruptive some severe forms of mental illness can be when left unaddressed.  I’m not saying that this treatment need always be medication, but in our culture it is largely what we’ve decided to pay for.  We haven’t exactly provided many options.  Though psychotropic drugs can be incredibly useful, they are not fool-proof, and should be administered with caution and regular follow-ups, especially early in the treatment process.  I have known people whose lives have been saved by psychiatric medications, and those for whom they have been very dangerous.

But if we could talk about these sorts of things more openly, if we could make sure to be the village of support that it takes to help some of us through difficult times, and to think of long term visioning for our friends in trouble – not just how comfortable they will be with the decisions we make on their behalf in the short term – we might see a very different picture.  Talking about mental illness isn’t enough.  When our loved ones are deteriorating, we need to go further.  We need to risk discomfort, and momentary resentment sent in our direction by the person we care about.  We need to muster our courage, keep our own supports online, and to get our hands dirty.  We need to be respectful, but to surpass the inertia of politeness.  Silence is killing us.  We need to care, loudly and with the determination that our loved one will get the best help our communities have to offer.  Caring is not an adjective; it’s a verb.   Thoughts?

I have been contemplating how to introduce my play that I will be performing at the Douglas Hospital on Friday.  I am noticeably nervous.  This distantly familiar feeling led me to re-read (and this time finish) “Smile at Fear” by Chogyam Trungpa Rinpoche – an outrageous, yet highly practical well spring of wisdom.

It really brought me closer to the fear that underlies my laziness and avoidance, my facades, my false selves, my masks which tell the world I’ve got it all under control, I could care less.  I realized today that underneath it all, I am deeply, profoundly sensitive, and though one of the masks I wear is “healer”, I am still viscerally and palpably wounded.

Of course, the whole basis of my research for my MA has been on the concept of the wounded healer, but in my months of exploration, I have found that what makes one worthy of the title of wounded healer is: knowing the tricks the mind plays, yet also knowing intimately what sanity and wisdom feels like, so that when one is thrown from the horse, one knows how to at least try to climb back on. It is worth it to persevere. And I now know health as well as I have known chaos and despair.  But this subtle and unexpected disconnect I experience still sneaks up on me when I least expect it.  I often slip the veil over my own eyes without even realizing it, so that I don’t know I have even fallen from the horse.   Somehow when I wasn’t looking, I have put on a padded suit so that I wouldn’t notice when I hit the ground, when I fell from the experience of grace that so far I have only so briefly touched.  But that grace has always been there.  Always.  When I laid awake at night, choking on my tears throughout adolescent turmoil, while I filled my diaries with shame and self-loathing, that grace was always there.  I guess I had just learned to talk – loudly – over the simple, profundity of my own heartbeat.  I had come to defend against vulnerability.

It is true that the negative symptoms of emotional numbing I experienced during my psychosis have contributed to some of the changes that have occurred internally within my mind during the last 7 years.  I usually don’t feel as intensely, to be sure.  But then there is also a sense of having habitually covered up the sound of that little persistent pulse of mine that is still trying to break through the layers of meaningless words filling the space around me.  That heartbeat IS the grace I just mentioned.  It is a constant that as long as I am alive, will politely keep thumping and waiting for the moments when I slow down enough that it can be heard.  This heartbeat is my humanity.  It is my vulnerability.  It is beauty, and fragility, and tenderness, and wonderment.  And for some bizarre reasoning based on a lifetime of habitual patterns, I am ashamed of it.

I am afraid that I will not be able to handle really being seen, that I will crack open and fall apart, and like humpty dumpty, I will be screwed.  And since I have now established the wiring behind the switch, it is as easy as the flip of a finger to turn off my sensitivity, to block out my genuineness, to numb out.  It is automatic, it is all encompassing, and I am tired of it.  I am sooo soooo ready to stop letting fear run the show.  Yet ironically, I am terrified of leaning into this, of making the changes in my life-style that will allow for me to stop hiding.  Butt in so doing, I know that I will feel more, of everything.

My play I have worked on as part of my research is a story about fear and fearlessness, although in a wimpy, gradual, stubborn, “I have to start living or die” sort of way.  We do have to move through the flames in order to cauterize our wounds.  There is no other way.  And they could once again reopen.  But there is no other way.  Guides are helpful on this journey, but I have found it best not to reach for a savior in either religion, or in doctors, or in science, for it cannot be found there.  We must ultimately go it alone.  We must face ourselves, our habitual patterns of shame and self-denigration, our tendencies to seek external validation, and learn to answer for ourselves some of the most meaningful questions life can present to a human being – spiritual questions that can only be answered by painstaking honesty and a search that goes down, not up, as Pema Chodron would say, to the center of our hearts.

Where am I on this search?  Well, alarmingly, curiously, I am not afraid to say I HAVE HAD a mental illness, or that I HAVE BEEN vulnerable.  But I AM afraid to reveal my vulnerability in the present tense, to open my tender, fluttering heart to the world.  In fact, I don’t relate particularly well with fear, to be brutally honest.  (Since honesty is, above all else, my point).  I often do hide, curled up under covers, wearing a mask so that even if I accidentally stumble in front of a mirror, I cannot see my own reflection.  And when I have temporarily squashed my tender awakening, I cover up the wound with layers of colorful clothing and pretend, with an Oscar-worthy performance, that the wound is not indeed still there.  I am healed,  “Hallelujah!”  I might as well proclaim.  But this is a repugnant lie.  Why should I care?  Why is this navel-gazing so important? Well, the point is not to be hard on myself, but to get to the root, so that I can learn to work with this, to help others learn to work with this.  When I cover up my vulnerability with apparent flawlessness, I am then separating myself from others.  And no one likes a phony.  More importantly, no one was ever helped or inspired by a phony.  A true healer must lift this veil of alleged flawlessness if they are to speak to those who are suffering and actually be heard.  Words are just words, and no amount of technique can substitute putting one’s own heart on the line, and opening the window and demonstrating that we can survive the cold air, that it is even refreshing, if you learn how to really let it in.  We don’t need another generation of healers trying to keep everyone safe.  Safe, in my experience, is dull, ultimately stifling and suffocating, painful, and boxed in.  And even though safety holds the advantage of never letting in unwanted guests, it also blocks out potential friends, insights, life lessons.  It keeps out life.  It keeps out love. First and foremost, it keeps you from loving yourself, so you clutter up your little boxed in life in order to pretend that it is everything you ever wanted.  But in my case, as in many, I suspect, I have decided to work toward finding the combination out of this safe place.  I think that in order to begin, all you need is to recognize it: I WANT OUT!

And then practice authenticity.  Practice remembering, viscerally, intellectually, in every way: remember what open-hearted vulnerability feels like.  Remember that brief moment you felt grounded, when you realized your truth beneath the bullshit.  You can’t pay for experiences like that.  They are unquantifiable.  They are beyond powerful.  This type of experience is the untold story of the meaning of life, and the process of coming home to it, forgetting it, and remembering it, over… and over, again.

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