Tag Archives: mental health

Connection, the Opposite of Depression

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So, I promised I’d write about my out-patient experience at John Muir Behavioral Health (the out-patient program for folks at their wit’s end).

Having only been incarcerated 48 hours, I was released from my seventy-two hour hold in the looney bin at noon on Thanksgiving Day (paroled for good behavior, I guess). Pre-insanity, I had planned a nice afternoon Thanksgiving repast properly Covid distanced with our neighbors on the back deck. Rick had the turkey already roasting. I was grateful for my freedom and the decreased despair provided by the quickly prescribed anti-depressant, which was the whole reason I went willingly. But, I still felt fragile. In the passenger seat of the car, I felt like I’d just gotten off of a backpack trip: cars and people were moving too fast, colors were too bright, noises were too loud. In forty-eight hours I’d lost my desensitization to the jarring pace of the modern world. I’d been floating on a cloud wrapped in eiderdown for forty-eight hours and I came to like it. I came to make it a baseline, a default. I came to call it home. Now, stepping through my front door, I looked around: shelves full of stuff I could live without, a mess of magazines on the coffee table, Abby the Dog jumping on me. In the kitchen, veggies were chopped for stuffing, potatoes peeled for mashed potatoes, and my office – I couldn’t even open the door to that chaos. Dinner was to be at two, so I did what I’d always done – I jumped into gear, but very mindful of the serenity I was leaving behind.

As it turned out, our neighbor was having her own emergency in the ER. Having also been released at noon, she, too, jumped into gear and assembled her part of the dinner. At four o’clock the four of us plopped into our respective chairs on the back deck like ball players siding into home base and took a deep breath and a moment of thanks. “Yep, it’s a 2020 Thanksgiving,” said Brian.

On Friday I waited, expecting a call to set up my entry into the out-patient program. Too late, I noticed I missed the call. They were closed for the weekend and I found myself teary and anxious. I’d have to sign up on Monday when I thought I’d be starting on Monday. I found myself hungering for a program that I didn’t even know anything about. Later, I discovered that it wasn’t necessarily the program I hungered for, but the human connection I’d found at the in-patient program. The isolation of Covid made everything worse.

On Saturday we had our young friends, Banning and Regina, over for a socially distanced lunch on the back deck. At the mention of my 5150, Banning lowered his head and looked over his glasses at me. Unlike Banning’s experience as a fifteen year old, unlawfully locked up for eleven months in the largest insurance fraud case in the United States, my stay was nurturing and helpful. I missed the spare contained environment where all I could see of the outside world were the green crowns of trees through the top windows, the lower windows, frosted, emitting a soft glow. All the surfaces were smooth, no door knobs, nothing to hang yourself by, where all our needs were met and we could just focus on us.

I yearned to arrive at some steady state that I could live with or at least know what to expect. Or maybe I needed to learn to ride the waves, to accept that the waves ARE my new steady state. With nothing to do that weekend and the misery still going on with my feet and eyes, I wrote to God in my journal:

God, Godforce, Great Mystery: What am I to do? I’m lost without my feet and eyes. And I’m tired and teary.

My pen answered: This is a time for that.

Me: OK. I guess I have no choice but to accept it.

MY pen: Yes.

Me: Why? What good is this?

My pen: It just is.

Me: My ego likes reasons and answers and timelines and schedules and certainty.

My pen: This is not that place.

Me: So, I’m in this alternate plane while the rest of the world spins productively?

My Pen: Yes.

Me: I feel a rift between me and my friends that can hike and do and see. I feel separate and more than a little bit less than.

My pen: It’s OK. It’s just your ego. Your ego thinks it’s running the show. It is not.

Me: The world tells me otherwise. The world honors doing and accomplishing.

My pen: Let that go. It’s an illusion.

Me: It feels like a convincing illusion.

My pen: It is just an illusion.

Me: So how do I navigate this realm?

My pen: Write.

Me: OK. You said so. I am left with little choice, anyway. Do you mind if I share this conversation?

My pen: No. I don’t mind. More people need to know this. This is your job.

So, getting orders from The Great Somewhere, here I am.

On Tuesday I got up, showered, and got dressed, all within an hour. This was a first during Covid. I shimmied into a top I hadn’t worn in the nine months of Covid and wrapped a pretty scarf around my neck. It was cold outside so I grabbed my coral colored down jacket, as opposed to the black backpacking puffy. I had somewhere to go – somewhere to BE, at 8:30. It felt great.

At the door of the big box-shaped building next to the green lawns of a golf course, I got a new mask, gelled up, and had my temp scanned. Upstairs there were papers to fill out, cards to show, and signatures to make. Then I was off downstairs to the big meeting room where things were already in motion. The sign on the door read, “Cafeteria.” Opening the door, I quickly scanned the room. It was full of chairs all six feet apart lined up like little soldiers on parade. Later, I would count forty of them. They were all filled except for one chair, front and center. Years ago I would have wilted at the conspicuousness of interrupting a big room full of people and then having to sit in front of everyone. More than wilted. The room would have spun like a Maytag washing machine on spin cycle and, seeing a blur, I would only want to disappear. On this day I welcomed the human energy in the room and was excited to join them, even if at one time they all wanted to off themselves.

Written on a white board in cerulean felt pen was the schedule for the day. Basically, forty-five minutes to one-and-a-quarter-hour sessions with therapists, a chaplain, and an art therapist. In these sessions I learned about Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Cognitive Distortions, Metacognition, Acceptance and Commitment Therapy, neuroscience of addiction, coping vs fixing – a lot of fancy words asking you to look at your life differently. At 11:15 all forty of us would break off into smaller groups in separate rooms and meet with a therapist to talk about what was going on with each of us on a more personal level. There was also time for a fifteen minute one-on-one session with an assigned therapist.

Having had a ton of therapy, I was already aware of a lot of these suggestions and devices to massage my brain in the direction I wanted it to go. But the hands raised and answers given in response to group brainstorming were validating, helpful, and made it feel like we were all soldiers in an army fighting a common battle, even though we could not be more diverse.

And even though we spent five hours a day together, it was hard to really get to know anyone. There was the gambler, the fighter, the anorexic, the wife who, angry at her husband, slashed her own arm, addicts of all sorts, and the eighteen year old with his hair in his face and a sewing machine leg. Due to Covid we were instructed to stay six feet apart. Break-apart sessions in the big room, were loud and noisy with our six-foot distanced shareings. I mentioned to my therapist in a one-on-one session that I had a blog that was pretty honest and raw. She responded that “we don’t want that here. It might trigger someone.” I was astounded. How does one heal without learning new ways to respond to triggers? How can we comfort that scared child within if we’re unaware of their distress? How do we connect without showing our wounds, our vulnerability?

Being depressed, no one was excited to talk. We introduced ourselves daily (new people came, others graduated) with an answer to a question posed by one of the therapists, like “what’s your favorite pizza topping,” and your name. Two weeks into the program the art therapist suggested we make some kind of a sound followed with our name. She modeled it by making a funny squeaking noise to which no one laughed. Then, in unison, everyone was to mimic the sound. Wrong approach. A room full of forty depressed, suicidal people mostly responded with “eh” as their sound. I decided to liven it up and, when my turn came, I held up both my arms, swayed them left to right overhead, and sang over the crowd, “Aaaaaaaa Ooooo,” like Freddie Mercury at a Queen concert. Yep. I had my own stadium following along. The therapist looked at me with wide eyed wonder. I grinned back like Jack Nicholson.

After a week of this, from 8:30 until 1:30, with no lunch but fifteen minute breaks between sessions where the smokers were the only ones who chatted together in the cold, windy parking lot, I sensed that this program was simply providing techniques to keep you out of crisis – to keep you alive. I was not seeing a lot of progress in my fellow inmates. I mentioned to my therapist that there was no deep work being done. She said, “No, this isn’t that. Everyone is supposed to have their own private therapist, as well.” This program was all designed to manage thoughts and behavior, not the why that makes you respond to life the way you do. After a week of listening in our small group to an obviously very smart and accomplished middle-aged woman struggle, overwhelmed, and paralyzed by stacks of ever accumulating papers on her kitchen counter and hearing the therapist suggest for the umpteenth time that she file just five pieces a day, I’d had it. I raised my hand. “I don’t know, but I think this has nothing to do with the papers.” I was afraid I had upset the apple cart, overstepped my bounds, and maybe even violated a HIPPA statute. Sitting six feet to my left, she swiveled her bowed head, looked directly into my eyes, and said, “I think you’re right.” Hallelujah! We were making progress.

I learned that in addition to the help I found by being in the presence of others, their contributions, and the daily classes, I gained meaning, purpose, and a lightness of being by bringing my true wild and natural self to the party. I disregarded the therapists warning to not trigger anyone. I spoke of my past, my childhood, how I had conquered old destructive thoughts and behaviors. The therapist in our small group leaned forward and implored, “How did you get this way?”

“I took a leap. I prepared myself to die, because that‘s how doing the new behaviors felt, and I found that I didn’t. In fact, I felt better.” People started coming up to me during the breaks saying how everything I said helped them. Women would talk about their over-bearing mothers, their verbally abusive husbands. Men would talk about child abuse from their abusive drug addicted or alcoholic parents. I had the same unsolicited response; “Drop kick them.” Pretty soon all I had to do was kick my foot out and they knew my answer. One gal crumpled up a letter she’d written to her narcissistic ex and literally drop kicked it across the room.

On my last day, after ignoring, “You’ll have time to do that in your small group,” I addressed the whole class with a heartfelt thank you for being part of my journey and a good bye. I read a letter to my small group:

The situation that brought me here was in response to a medical condition magnified in my mind by the powerlessness, hopelessness, and despair I felt as a child.

While each of our journeys is unique and special, I think they all require immense courage. You’ve shown your courage just by being here. This work requires feeling feelings you think you might die from. I encourage each of you to gather more courage, either from an armful of stars gathered from a clear night sky or form it from the mud of the riverbank. However you do it, open that door to that dark room. Bring the light of your heart. Shine it on the remnant memories of your past. Clean it out, even if you need a pick and a shovel, or even a blow torch. Shine your light into the dark corners and find in each corner, a child of a different age who’s been cowering behind the trauma. Kneel down. Open your arms and gather each of them to your heart and promise that you will be their advocate… always. They will inspire your strength. They won’t believe you at first until you show them with your actions. Gradually, with their building trust, the cloak of depression you’ve felt safe in will lift and they will show you the lightness of joy and ways to find connection and fulfillment. With your heart for a compass and your soul for a pair of wings, hold their hands and follow their dancing footsteps down a new sparkling path paved with diamonds. It’s time. You were born for this.

The biggest lesson learned: We need each other. We need to be open to hearing each other’s stories and courageous enough to tell our own. More people need to know this.

© Karen Najarian 4-16-2021

PS. Yesterday’s PET Scan showed “no clear evidence of cancer.” It may still be lurking and it may very well return but for now, this is good news. I don’t know what this means as far as drug regimens which are still kicking my ass but right now I’m happy to share the good news.

The Looney Bin

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By Karen Najarian, March 6, 2021

In the 1800’s, from the floor of Yosemite Valley on a windy day, John Muir witnessed a rare natural phenomenon happening to 2,435-foot Yosemite Falls:

 “while I watched the Upper Fall from the shelter of a big pine tree, it was suddenly arrested in its descent at a point about half-way down, and was neither blown upward nor driven aside, but simply held stationary in mid-air… while I counted one hundred and ninety. All this time the ordinary amount of water was coming over the cliff and accumulating in the air…, the whole standing still, resting on the invisible arm of the North Wind.” – John Muir.

A dark-haired woman in light blue scrubs led me by the arm into the mental hospital. I’d just heard the clank of the metal gate locking shut. We passed through a courtyard garden. Resigned and sad, I looked down at the part in her hair. We came to a room where I passed the Covid check-in questions, got my temperature scanned, and received a new mask. I was used to being strong. Just being in this place confirmed my fragility – like a delicate vase, possibly broken beyond repair.

Into the elevator we went up to the second floor to an office-like room where she asked me all kinds of questions like part nurse, part therapist. When asked how I thought of killing myself, I easily repeated the car-off-a-cliff scenario that I’d told my oncologist. For extra measure, I added, “Maybe I’d just go sleep in the snow and die.” I’d snow camped before with proper gear and know that without proper gear, snow camping can be incompatible with life. “My eyes are blurry and sting. I can hardly even see.” Removing my shoes to show my feet, “My feet are red and burn. I’m a photographer and hiker and I can hardly see and I can hardly walk.” While I sat there in the small office relating my life story, between sobbing and finishing one of the Big Macs my husband had dropped off along with clean underwear, another woman in scrubs came in and gently pulled my long scarf off my neck. “I’m not going to hang myself with my scarf,” I growled between bites. “Shoe laces, too, please.” Kripes, I thought. I’ve entered the cuckoo’s nest.

            My net bag full of my backpacking essentials was taken. I was told that I couldn’t keep my cancer pills, that they’d dispense them from their pharmacy.  “NO!!! You can’t get them just anywhere. They’re only available at four specialty pharmacies in the country and they’re keeping me alive!” After checking them out, they agreed to dispense them as directed.

            Escorted passed the nurse’s station and down the short hallway to my room, I noticed the large beautiful canvas photographs of redwood trees against the pale blue walls. I would learn that they were canvas to prevent broken glass from smashed pictures. And there were no door knobs, just indentations in the door to open them. “She doesn’t want to be with Chantal. She’s pretty talkative right now,” I overheard one of the staff say. “That would drive me crazy,” I replied. On retrospect, that was an interesting comment from someone committed to the looney bin. I already am, I thought. Later I learned that Chantal, a large, sweet, early twenties, black girl, was there to have her bipolar medication adjusted under supervision.

            My room was spare, clean, and calm: thin beige cotton blankets on a simple bed, a nightstand, a chair, high windows, and the same bare, pale blue walls. I put my paper bag of clean underwear and foot cream on the chair. Finally, a bag lady, I thought. I was ushered into the day room, another clean, spare, light blue space with windows I could only peer out of on my tip toes. It had the feel of a cafeteria – linoleum, small tables and chairs, and a big screen TV in one corner with about six others gathered around engrossed in a cooking show. They were masked and wearing sweats or night clothes. It was only 6:30 pm. They talked and laughed amongst themselves. No one said hi. I was last to get dinner from the portable steam table – meatloaf, mashed potatoes, some soft overcooked veggies. I took my tray to a table and attempted to pull out a chair. I had to set my tray down on the table in order to move it with all my might. Hmm, I thought. They can’t be thrown.

Having eaten the Big Mac and fries, I wasn’t really hungry. It was clear from their talk and laughter that the other inmates had been there awhile and were familiar with each other. Sitting in the middle of the room, I felt invisible. I’d been told there was a group meeting at seven in the day room. I was looking forward to meeting my new tribe and seeing what this program had to offer.

As a small child I would suddenly drop to the floor and sob in the days following my brother’s beatings by my father. My mother’s response to the beatings was to shut the windows “so the neighbors don’t hear.” My mother’s only response to my upset was a threat, “If you don’t straighten up we’re going to have to take you to a head shrinker.” I was about three years old. A head shrinker! I thought. They’re going to shrink my head?!. I stopped crying. I realized then and there that my reaction was a problem. There would be no change in the family dynamics, no comfort. This was my normal and I’d have to deal with it. Now, in the looney bin, I welcomed whatever help they had to give.

            At seven a male therapist entered the room and also got engrossed in the cooking show. “We can stop it,” someone said. “No. It looks like you’re really into it. I’ll just check in with everyone individually.” Because of the blaring TV, I couldn’t overhear the personal conversations with the therapist. I didn’t know how they could even hear each other. He came to me last, introduced himself and my trapped three-year-old said I was fine. I could see the meeting agenda on the paper flip board on an easel and waited in the blaring room for it to begin. After a while, I asked the man if we were going to have a program. He said he was just checking in with everyone. Irritated, I left and returned to lay on my bed in my room and continue sobbing.

A small trim woman in street clothes came in, introduced herself as one of the therapists, and sat on the floor, her back against the wall, her legs outstretched, and asked how I was doing. “I can’t stop crying.” I didn’t know how being warehoused in this isolated pale blue bubble was going to help me. They’d promised me a visit with a psychiatrist the following day to get my coveted antidepressant. That was all I really cared about.

            Again, I told my story. I started to hear from myself how remarkable my life had been. I was a college graduate in bacteriology. I’d worked for years as a licensed Clinical Laboratory Scientist. I was a published author. I created, ran, and guided for my backpacking company, Sierra Spirit, that REI had contracted with to run their Yosemite Program. I’d hiked the John Muir Trail, the Sierra High Route, a lot of the High Sierra from the Emigrant Wilderness in the north to the Golden Trout Wilderness in the south, Paria Canyon in the southwest, 200 miles of Spain’s Camino de Santiago, the Wind River Range in Wyoming, plus a bit in Norway. I’d overcome an eating disorder and other destructive coping mechanisms developed from growing up in a dysfunctional family. I was still married to my college sweetheart, had good relationships with my two adult children, and had a treasure trove of friends. I was beginning to sound like a rock star. The therapist was fascinated. But, here I was in The Looney Bin. I complained that I was looking forward to the group meeting that never happened. She said, “Yeah. I saw that. That wasn’t right. I’ll talk to him.” She asked if I wanted a sedative to sleep. I usually sleep well but, this being a different place and all, I thought, what the heck.

            I woke when it was still dark as seen through the high windows in my room. The shower in my room wouldn’t warm up so I gave up. I was uncertain how to operate it. No knobs to hang yourself from.. None of the other patients were up. Breakfast wasn’t until eight. Tears were again gathering in my eyes. They were changing shift at the nurses’ stationI asked for a piece of paper to write on. Might as well journal and document this experience, I thought. There was a plastic jar of pens on the counter.  They were like clear Bic pens only they were flexible. Nope, couldn’t stab anyone with one of these. I asked for a cup of tea (you had to ask for everything) and sat at a small white built-in shelf of a desk and drew a picture and sobbed.

            Breakfast at eight was from the portable steam table again – scrambled eggs, bacon, French Toast with syrup, fruit, etc. Our group meeting was at nine. I was called in and out of the group numerous times to meet with a social worker, nurse, therapist, psychiatrist practitioner, bunch of people. I told my story to anyone who would listen. I found it helped. AND I got my antidepressant.

            We had art therapy in the afternoon. People had started to talk to me by now and share their stories. While coloring with Crayons, I asked Mike, a thin, boyish thirty-one year old construction worker, “Why did you drink three, fifths of vodka a day?” His answer, “Work. I worked three jobs and then came home and drank.” I left it at that. No, I thought, that’s not why. People work long hours and don’t do that. Hell, I had at that age. I didn’t pursue it further and no one else did either. He also recounted how they had to give him a blood replacement of a couple units to dilute out the alcohol in his blood stream in order to save his life. Later I learned of his horrific childhood and I understood why.

            There were other stories, as well. It was another gal’s second time drying out after a painful divorce. She wore a long flannel night gown all day and held her hair up in a wrap. She spoke of times when she attended gala events in full make-up with her wealthy husband. One older gentleman, probably my age, showed up in the afternoon. I sat across from him during art. I asked his story. He replied that his beautiful thirty-five year old son had died in a surfing accident and he couldn’t stop drinking even when his wife gave him an ultimatum. I reached across the table and took his hand.  I asked another gal what brought her here. She just replied, “Life,” and got up and walked away.

            I told how I ended up there. Incredulous, they all queried, “So you didn’t plan to come here? And the police weren’t involved?” “No!” I explained, “I went to a doctor’s appointment and she wouldn’t let me go home.”

            During the classes/meetings therapists gave presentations on not drinking, managing stress, controlling what you can. There was no deep therapy. No healing of the primal wound of abandonment and abuse, pain and loss. Upon my intake, I told of my blog and how it is real and raw. “Well, you won’t want to bring that up here. We don’t want to trigger anyone.” No wonder people relapse, I thought. No cleaning out the carbuncle of catastrophe so that one can make positive life choices. Addressing our triggers is how we grow, I thought. If we live without challenges, we stagnate in our dysfunction. I spoke of ACA, Adult Children of Alcoholics. The therapist knew nothing of it. I later learned that this was merely a drying out place, a detox station, where folks would later move on to thirty-day in-patient treatment programs. Hopefully, they would deal with their deep issues there.

            Sometime before lunch I stopped crying. Interacting with my fellow inmates and the staff, even though all masked, was the best medicine in this near-year of Covid isolation.

            Wednesday evening I was at the pharmacy window (just like in the movies) getting my evening dose of Xeloda, the cancer drug. I felt renewed, talkative, like life was worth living again. I shared my blog site with the pharmacy tech and then the nurse’s station staff wanted to see, too. They were all pulling up my blog site on their screens. “If anything, read, I am Made From,” I instructed.

I am Made From

I am from swimming, competitive swimming
Alone but on a team. Chlorine in my veins.
From swimming because my mother couldn’t.
Breaking ice on the deck in winter for an hour before school
And for two hours after, after homework,
Because I was also an A student
Because my parents weren’t.

I am from the salt of the ocean
Where I swam free
With waves up my nose
And crunchy salty hair when it dried
And sand everywhere else.

I am from a single white sunbeam
That pierced the hard cold glass of the big front picture window in the living room
Where I lay enveloped in warm radiant love
Lying on the waxed hard wood floor
Behind the big old overstuffed chair.

I am from Leave it to Beaver, Father Knows Best,
Mousketeers, Moose and Squirrel, the Twilight Zone.
The Flintstones, John Wayne, the Addams Family, All in the Family.
Laugh-In.
The Ed Sullivan Show, the Beatles, the Stones, Bob Dylan,
A Land Called Hanalei,
The smell of napalm in the morning, and “One giant leap for mankind.”

I am from sudden loud voices.
Freezing like a rabbit.
From sudden movements and belts not used for pants and
“I’m ashamed of you.”

I am from the mud of the riverbank
Where I created myself anew from what was left
And grew tall and strong like the Sierra Nevada still growing,
Held in the bony arms of my adopted parents,
Mother Maclure and Father Lyell, mountains in the Yosemite High Country
And became acquainted with my relatives up and down the 400 mile range.

I am from the tiny flame that first ignites the tinder,
The roar of the wind as it penetrates the forest only to caress me
And surprise me with its gentleness as I sway in my hammock.
I am from lightening and hail and the wildflowers they oversee.

I need to remind myself that
I am from the blood red on the sides of Golden Trout
As they swim up the crisp clear stream and
Flounder in the sharp gravel beside gentle grassy banks
Laying their eggs
And moving on through the land
As if they knew how to live their life so perfectly.

            See my pictures. See me! I’ve made a remarkable life. I felt like a child at show and tell.  Nothing was handed to me. I apprehended my life out of the aether and formed it from the mud of the riverbank, slapping it and shaping it around Spirit. It’s glowed gently and steadily in the darkness, even lighting the way for others. But lately, I’ve made a pass over the waterfall and darkness is all around. My inner glow is not enough. Now I need to be held up by others as I endure this journey, like the North Wind held Yosemite Falls in mid-air for over three minutes. I need to call friends. I need to visit. I need Covid OVER.

The next morning was Thanksgiving. I was ready to go home. Being on a seventy-two hour hold, there was some question as to whether they’d release me. Tears welled as I started feeling trapped again. I was to host a casual Thanksgiving dinner with our neighbors on the back deck that afternoon. Having called Rick on one of the unit’s phones, I knew that the turkey was already roasting.

            I was released at noon but not before one of the nurses asked me if I’d like to volunteer at an eating disorder clinic. “I would love to,” I replied. “It would bring meaning to my life.”

            The experience was a reset. My falling waters had been supported and held by all the caregivers in this place, like the North Wind held Yosemite Falls, and were gently placed back in the manageable river below.

            Next, I would attend three weeks of outpatient classes and group therapy. Next blog.

Copyright Karen Najarian, 3-6-2021