living with a broken heart {2/8/13}

Over the past few years I have learned this: there are different kinds of grief, and each kind of grief has its own rhythm. Grief for my brother came in steady, pounding waves, like a hurricane. Grief for my grandparents pulled like an undertow. And now, grief for my inability to have a successful pregnancy rises and falls like a tide.  

Today the tide is high. At a doctor's appointment this morning the waiting room was full of babies, and the water rose up through my chest until it began to spill over into tears.

A decade ago this would have been the end of my day. I would have gone home, locked myself in, and spent hours obsessing about my feelings. More accurately, I would have spent hours searching for a way to change my feelings. This panic would have layered over the original pain, leaving me paralyzed for days, weeks, even months. Today, instead, I am trying something different. I am trying to live with the pain.

The crappy news is that there is no step-by-step guide, no "top 10 ways" to push through your grief. Some days you can walk the dog, take out the trash, read a book, or make a meal. Some days all you can do is keep breathing. The important thing is to treat yourself gently and honor your pain. That pain is valid. That pain might even have a silver lining. It might encourage you to reach out to someone new, or hug your family and friends a little closer. 

That pain also might do nothing but suck. That's okay too. In this culture of incessant positivity, it's hard sometimes to remember that we don't have to make something good out of everything. Actually, we don't have to make anything out of anything. If we can be mindful of our experience for what it is, without judging or trying to change it, we are succeeding. WILDLY. 

Mindfulness isn't about feeling good. LIFE isn't about feeling good. By trying to convince ourselves that it's possible to feel good all the time, we are setting ourselves up for more suffering.  

Today living with a broken heart looks like this: I fold a little laundry, make baba ganoush, talk to a friend on the phone, cry in the car, go to the gym and walk on the treadmill. I hug my dog. I hug myself. I write a blog post, even though it is scary to admit to the world that I am hurting. But I do it anyway, because maybe someone else who is hurting will read and know that they are not alone, that they don't have to look on the bright side, and that whatever they are doing is enough. 

cleaning house {1/24/13}

I'm having one of those angry revising weeks. You know, the kind where I keep poking at the same chapter, and I know how I'm supposed to change it but for whatever reason my mind goes blank every time I open the word doc. And then I start thinking do I even need this stupid chapter? And then, whose freaking idea was it to write this book anyway? And then, WHY AM I DOING THIS WHEN I COULD BE PURSUING A PERFECTLY REASONABLE CAREER AS A BARISTA??? 

I bet there's some practical advice somewhere for getting through these rough patches. Trying to find it would be a great way to procrastinate. Instead, I decided that today I would clean my house.

Cleaning is one of a writer's healthier distractions. Watching TV, surfing the Internet (or "social networking," as I like to call it), and sleeping are a writer's junk food. Reading and blogging are somewhere in between. Like a Subway sandwich.  

Why would I rank cleaning above reading and blogging? Because it has nothing to do with writing. Sometimes you just need to get the hell out of the way and let your subconscious do a little work. Which is hard to do if you're still working on writing, however tangentially. But cleaning, ahhh cleaning. Anne Lamott calls it "monk-work." It puts you in the present moment and forces you to shift your focus on the external. You have to look at the floor in front of you if you want to do a halfway decent job vacuuming. You can't really zone out while washing or putting away dishes.

There's another benefit to cleaning: ordering your environment tends to help you order your mind. If I'm able to sort, clear out, and throw away all the junk on my kitchen table, I'm setting myself up for sorting the jumble of my thoughts.

So now that I've brought a little order to my home, I'm going to see if I've cleaned out any of the dust bunnies in my brain. And if I haven't, hey, at least the vacuuming is done.

UPDATE: I got some editing done on my chapter today without wanting to throw my laptop out the window. I deem this a raging success. Big fat plus sign in the cleaning column.

letting in the chaos {1/9/13}

I'm in the process of moving right now, and let me tell you, my house is a mess. There are boxes everywhere, things half-packed and stacked. And if you are anything like me, your external environment has a hefty impact on your internal one. This week the inside of my head feels as chaotic as my living room. Once I start packing, I start stressing about how I'm not writing. But when I try to write, I stress because I need to pack. Not ideal working conditions.

On top of that I am not just revising right now--I'm trying to generate a new chapter. From scratch. There is nothing quite so uncontrolled, so messy, so uncomfortable as a first draft.

But this is how things begin. It's necessary to embrace, or at least accept, the tumult. The brightest flowers and most magic of mushrooms sprout up from piles of shit. And here's the rub: you don't have to do anything to make that happen, other than leave the shit alone.

So yes, I can live in the same place for the rest of my life, shuffling around the same words from the same draft of the same manuscript. Or I can choose to move forward, into the unknown, with the boxes, blank pages, and shit that entails. It isn't easy, but today I am determined to let shit be shit, and trust that there will be some psychedelic beauty as a result. And hey, even if mushrooms and flowers don't appear, I will at least have a two-car garage and a backyard.

the next big thing {1/8/13}

Just before the holidays I was tagged by Barbara McDowell to participate in something called The Next Big Thing Blog Hop. Just what is a blog hop, you ask? Well, this is a blog chain that originates from She Writes. Each person tagged answers a series of interview questions and posts them on his/her blog or website while also linking to five other writers. Those writers then answer the questions, post and include links to five other writers and so on and so on. Unless you are like me, and fall pitifully short of five writers.  

Here we go!

What is the working title of your book? A Different Kind of Same. 

Where did the idea come from for the book? The book is a memoir about my brother's struggle with bipolar, his suicide, and my own experiences with mental illness. I knew as soon as he died that I wanted to write about him, but it wasn't until a few years later, when I sat down and wrote a draft about cleaning out his apartment, that the book began to take shape.

What genre does your book fall under?  See above, re: memoir.

Which actors would you choose to play your characters in a movie rendition?  Macaulay Culkin circa 10 years ago would be perfect to play my brother. I'd probably cast Ellen Page as me (people say we look alike, and she's the right age for the time period). Frances Conroy (also 10 years ago) would be great as my mother, and Paul Giamatti would be great as my dad. James Franco would crush it as my husband.

What is the one-sentence synopsis of your book?  See above re: idea for book.

Will your book be self-published or represented by an agency?  I would LOVE to find an agent, but it hasn't happened yet. I am not averse to self-publishing. We'll see what happens.

How long did it take you to write the first draft of your manuscript?  Three, maybe four years?

What other books would you compare this story to within your genre?  Yikes, no clue. I have yet to find a memoir about losing a loved one to suicide written by someone who has also attempted suicide. I am inspired by the writing styles of Anne Lamott and Lauren Slater, so maybe that gives you some idea?

Who or what inspired you to write this book? After my brother died, I searched like crazy for books that dealt with the suicide of a sibling. The pickins were slim. After reading the few I could find, I realized what I was really looking for was a manual for my own grief--which, obviously, no one (other than I) could write.

What else about your book might pique the reader’s interest?   Life changing moments in psychiatric wards and Taco Bell bathrooms. Believe it or not, this book might actually make you laugh. I hope.

Now that you’ve had a peek into my writing, please stop by and visit the only other blogger I know: Gillian Marchenko! 

alternative fuels {1/3/13}

There are some writers out there who don't believe in writer's block. "Freewrite!" they say, with a smile. "Write about something else! Write from the point of view of one of your other characters!" These people always seem to be fiction writers. They use the word "craft" a lot. They are the ones who tell you that, in addition to writing your way through blocks, you need to write everyday--"if you are serious."

I don't mean to slam these guys. This is really good advice: for beginning writers. I followed this dogma frantically for the first four years or so of my career, so much so I damn near gave myself an ulcer. But around year five I experienced a level of language fatigue so severe I nearly quit altogether. I was out of words. I hated words. I didn't even have enough left to think a complete sentence. I'd been told that the well of creativity was bottomless, but there I was, curled in the fetal position on its floor, choking on dust.

This is how I learned to tap other sources. When I got burned out on words, I started making pictures: photographs and visual art. I listened to more music. I cooked. In short, I used my senses. Writing is so cerebral, frequently so one dimensional, that its easy to get trapped in your head. Like Anne Lamott says: "My mind is like a bad neighborhood--I try not to go there alone." The friends you can take with you are sight, smell, taste, sound. If you find yourself getting stagnant, if you find yourself hating words, stop. Breathe. Put on some music, get out a camera or some crayons, make some cookies. And do yourself a favor: stay away from Microsoft Word for a few days. It won't derail your entire writing career. I promise.

succinct {12/30/12}

Saw this Adrienne Rich quote in the NYTimes magazine today. This is what I was trying to say in my last blog post, only tighter, more poetic, and written 30 years ago:

What would it mean to live
in a city whose people were changing
each other's despair into hope?

You yourself must change it.

what would it feel like to know 
your country was changing?

You yourself must change it.

Though your life felt arduous
new and unmapped and strange
what would it mean to stand on the first
page of the end of despair?

stemming despair {12/23/12}

This article, by Andrew Solomon, appeared in today's Sunday Review section of the New York Times. By the second paragraph, I was on board:

Adam Lanza committed an act of hatred, but it seems that the person he hated the most was himself. If we want to stem violence, we need to begin by stemming despair.

In the days after Newtown I too had thought about Adam Lanza as both the perpetrator and a victim of the tragedy. I thought about his family, the people who cared for him that were still living, and wondered how they would possibly deal with the way he'd ended his life. I thought about his brother. I wondered how I would feel if my brother had chosen to take the lives of others before taking his own. And, though I knew it would be an unpopular, maybe even unfathomable reaction, I felt compassion for Adam Lanza. I kept it a secret, because everyone around me was showing anger. Even the Buddhist service I attended to honor the victims did not list Lanza (or, for some reason, his mother) among the dead. The pictures of Lanza in the media made his actions even more bizarre. This young man looked more terrified than terrifying. What had happened to him, I wondered, to cause such violence? 

Solomon goes on to define the spectrum of perpetrators, the range of difficulty in predicting behavior, and, of course, the hindsight that prompts an outcry. The mad scramble to assign blame. Who failed? Was it the parents? The educators? The mental health professionals? Finding a fixable root for the cause allays the terrifying reality:

[P]eople are unknowable...We have to acknowledge that the human brain is capable of producing horror, and that knowing everything about the perpetrator, his family, his social experience and the world he inhabits does not answer the question “why” in any way that will resolve the problem. At best, these events help generate good policy.

So what is the answer, then? How do we stem despair? Solomon doesn't venture a suggestion. He falls back on the old, tired "better mental health screening for children." I'm not saying that we shouldn't be paying more, closer attention to our children. We should. But screening children won't solve anything. Treating children might. As might treating ourselves. 

As someone who entered the mental health system as a teen, I can tell you this: it was frightening, cold, impersonal, and filled me with shame. I only knew that there was something "wrong" with me. I believed I was broken. Psychiatrists did not educate me in medications or options. Therapists were a world apart from the psychiatrists, and they didn't offer any practical advice on how to deal with problems or feelings. I was treated as though I was a problem that needed to be solved. I felt like it was my job to get "well," and the longer it took, and the more I relapsed, the worse I felt about myself.

These days strides are being made with Dialectical Behavioral Therapy and Acceptance and Commitment Therapy, but I'm not sure how widely used they are, especially in regards to children. Here's the thing, though: they apply to everyone. Life is hard. We all need positive, productive tools to cope. What if they taught mindfulness in schools? What if they taught acceptance and impermanence? What if children, teens, and adults with depression or anxiety or bipolar or any other form of mental illness weren't singled out, pulled aside, and made to feel like they were missing something that other people had? We are all trying to learn to be kind, to be loving, to be gentle with ourselves and each other. Maybe some of us just need extra tutoring.

And maybe that's not a sufficient answer either. The truth is, I don't know how to stem despair in anyone but myself, and it took me 33 years to figure that out. But I do know that mental health is not an exact science. I know that children are in a constant state of change and development, and I worry that chasing after them with clipboards and diagnoses will do them more harm than good. Perhaps the best thing we can do for our children is to become a society of mentally healthy adults. Perhaps if they see us reacting to the world with more understanding, more curiosity, more compassion and less rage, their own fears and insecurities will feel less overwhelming.

We can change policy. We can change procedure. But first and foremost, we have to change ourselves.

an empty place at the table {12/17/12}

I've already posted something about handling the holidays, but since they don't make Thundershirts for humans I thought I would share these practical tips by the American Foundation for Suicide Prevention: 

• Keep in mind that sometimes the anticipation of an event can be more difficult than the event itself.
• Remember that family members may feel differently about continuing to do things the way they've been done in the past. Try to talk openly with each other about your expectations.
• Above all, bear in mind that there is no "right" way to handle the holidays. You and your family may decide to try several approaches before finding one that feels best for you.

While these tips come from the AFSP, I think they apply to anyone grieving over the holidays. I would also add that there is no right or wrong way to feel during the holidays. The first few Christmases and Thanksgivings after my brother died I was miserable--and I think I would have been no matter what I'd done. The truth of the matter is that he was missing from the table. I felt the empty space less when my family changed up our routine, but I still felt it. And I hated feeling it. And I hated that I hated feeling it. And that was okay too.

I want to add one more tip: Be gentle with yourself. Sometimes it gets harder first, but eventually it gets easier. It really, really does.

compassion {12/11/12}

The front yard of the house where I grew up was shaded by two large trees. In spring they were home to dozens of twittering birds, and of course, the nests of their young. Inevitably some of the newly hatched fell (or were pushed) out of the nests. Every year my brother and I would find their small pink bodies on the driveway, the sidewalk, or in the grass. Once in a while we would discover a baby bird that had survived the fall, wriggling blindly, chirping in fear. We would scoop it up and run to the house, begging our mother to help us save it. On the advice of a local veterinarian, she would procure an eyedropper and some dog food. My brother and I would fashion a makeshift nest from a shoebox, which we'd place under a lamp for warmth.  

My heart is not a baby bird, but sometimes it feels like one. And, nowadays, I try to care for it like one. 

Self-compassion is a relatively new concept for me. For years I excoriated myself for having depression and anxiety. Why do you have to be so weak? I asked myself. Why can't you be like everyone else? I told myself that I was a burden on the ones I loved. I told myself that I was worthless, a failure as a human being. And the harder I was on myself the more depressed and anxious I became, and the more depressed and anxious I became the harder I was on myself.  

It seems sort of obvious, now, that my response to my illness started a vicious cycle. But it took over a decade for me to realize what I was doing, and half a decade to stop doing it. In fact, I'm not even sure I can say that I've stopped--but I'm trying. There are days and weeks when my heart feels naked, vulnerable, and bruised. During those times I try to nurse it like a baby bird.

I'm not calling this a cure and I am definitely not saying this is easy. For some reason (I tend to blame the Puritans), many of us feel that we are unworthy of compassion, though we tend to give it to others. "Treat yourself the way you would treat your best friend," is the first mantra that got to me, and it's one I return to again and again. "Treat yourself the way you would treat an abandoned baby bird" works just as well.

I am not naive. There will always be suffering in the world. The baby birds of my youth, despite our best efforts and my mother's round-the-clock care, never survived. But we never stopped trying to save them. I can't stop myself from experiencing difficult feelings, but I don't have to add anger and self-hatred on top of them. I can hold myself gently.  And I've found that when I do, I recover more quickly than ever before, with less scars.

Besides, my heart is not a baby bird. It beats, it bounces back, it lives.

grief versus depression {12/4/12}

As you may or may not know, the DSM-5 (the American Psychiatric Association's latest diagnostic manual) has been finalized and will be released this spring. It's been about twenty years since the last DSM was released, and obviously there have been a lot of changes in the psychiatric community. Antidepressants have become as abundant as vitamins. Autism diagnoses have skyrocketed. Treatment of children for a variety of psychiatric disorders has become commonplace (though controversial). As someone who has experienced a significant range of psychiatric treatment--both as a teen and adult, both as a patient and a family member/friend--I am naturally interested in all the changes in the latest DSM. But as a survivor of suicide, I am especially concerned about one: the Bereavement Exclusion.  

The Bereavement Exclusion is a sort of clause in the Major Depressive Disorder entry of the current DSM. It basically exists because grief can have symptoms similar to those of MDD, and should not be treated as though it were depression. While drawing a distinction between grief and depression, the current DSM does recognize that grief can trigger a major depressive episode, and that grief that does not improve over time or that exhibits extremes (such as suicidal ideation) may need treatment. 

The Bereavement Exclusion has been removed from the DSM-5. Why? "The “rationale” section on the DSM-5 website’s major depressive episode page explains that the reason for eliminating the BE is that “evidence does not support separation of loss of loved one from other stressors”. The website cites only one reference as the basis for this proposal, a review paper by Zisook and Kendler that claims that bereavement-related depressions are generally similar to standard depression."

What does this mean? One could say it suggests that if you are still feeling sad two and a half weeks after the death of your mother, or spouse, or child, a psychiatrist could chuck some pills at you and send you on your way.

Am I suggesting that?

Yeah, I guess I am.

I have some conflicting opinions when it comes to the differences between grief and depression. Some days I'm not sure there are any. As life is a constant exercise in loss, in a broad sense, grief could be seen as the root of all depressive disorders. My first major depression occurred after my family moved from Detroit to Alabama, and was a result of grieving the home, friends, and family we left behind. 

Here's the tricky part: there are different kinds of grief and different kinds of loss. Grieving my brother's suicide was nothing like grieving my grandparents. Grieving my brother took somewhere between four and six years, and it completely changed my life. Those changes hurt while they were happening--they tore my heart wide open. But now, I am thankful for them. What if they hadn't been allowed to occur? What if they had been chemically suppressed? What if I'd gone on with my life thinking I was supposed to feel "better," "normal," "happy," and "ok"?

Something else, perhaps an even more compelling argument for keeping the Bereavement Exclusion: I was on antidepressants at the time of my brother's death. I continued taking them for two years, and I continued fighting against my grief. I tried to do all the things the DSM would have considered "healthy" and "normal": hold down a job, spend time with friends, get on with my life. I struggled and I failed. It wasn't until after I stopped taking medication that I was able to feel the full force of my grief and move through it. Dampening my feelings only prolonged the process.

I'm not an expert. I haven't conducted any research studies. Maybe I'm the .001% weirdo that doesn't fit the mold. But I tend to doubt it. I certainly think that suicidal ideation in ANY context needs to be treated. But lumping grief in with depression, treating loss with pills...I'm not convinced it doesn't do more harm than good.

Guess we'll see in twenty years?