Tuesday, January 14, 2014

You Only Fear What You Don't Know

I presented a paper this week on research that was done in a region in South Africa and the way care-givers have managed to cope after community members with chronic mental illness were deinstitutionalized after apartheid ended in 1996.  The paper focused a lot on the stigma that exists in South Africa surrounding mental illness.  As I read the data and the research in preparation for my presentation, I was struck by the prevalence of stigma there, but even more so, how many similarities there are right here in Canada in 2014.  Stigma doesn't only align itself with mental illness in the developing world.  It makes its home right here.

As our class was discussing the work and the research, one of my classmates honestly shared about how ill-prepared she felt in working with those with serious mental illness.   She wasn't alone.  So many people have never interacted with someone with a serious mental illness.  Or maybe they just don't know that they have.

I don't feel like that.

For most of my childhood, my mom worked as a nurses aid at the mental health centre in the small town I grew up in.  She worked a variety of shifts, which meant that sometimes I was home in the evening or on weekends without her and didn't have a whole lot to do.  Sometimes I'd ride my bike over to the Centre (aren't small towns beautiful?), hop off, and ring the big door bell at the front of the building.  The security was tight.  There were several doors to get through in the locked facility and getting in or out didn't come easily.  After a few minutes my mom or another staff member would come to the front door to see who had arrived, and I would enter through the big glass doors.

I don't ever remember being afraid.

I was little,   maybe six or seven, when I'd start coming over on my own.  The centre was an inpatient facility which provided care and community for the most chronic and severe mentally ill in the region.  I would walk down the big hallways, stopping occasionally to be introduced and stop to talk to some of the patients.    Some patients were on significant amounts of medication and were slumped in chairs and drooling.  I wasn't afraid.  Some were talking to themselves, engaged in delusions and their own reality.  I didn't feel threatened.  Others sat and cried when I'd come around.  I remember taking their hands sometimes - especially the older patients who looked so weary, so small, and so defeated.  These were women and men from all walks of life; all ages, all socio-economic levels, all levels of education, and all with their own hopes and dreams... none of which included sitting in vinyl chair in a mental hospital.

I made friends there, because my mom had.  She loved that job, and she was good at it.  She saw the value in all of them and cared enough to learn their stories.  I learned to do the same.  Over the years, some of the patients never left.  Sometimes I didn't see them when I came for a walk and a visit because they were locked up in  the secure wing because it wasn't safe for them or anyone else not to be.  I heard those stories, and I connected them with the people I knew.

And I wasn't afraid.

Quite a few years later I was a young University student living in Winnipeg for the first time.  I was invited over to share supper at my friend Jackie's apartment that she shared with her friend.  I first met Jackie when she was an inpatient at the mental health centre.  She was one who was heavily medicated, sedated, and unable to find her way out.  But now she had, and she was living on her own for the first time, making a life for herself.  She told me some of her story of what being a mental health consumer was like.  How hard she had to advocate for herself and fight for support, understanding, and adequate care.  I told her about being in school for the first time; boys I liked, friends I'd made, and courses I was taking.  Sometimes she heard voices.  Sometimes they got too loud.

But I was never afraid.

I was sitting with the girls at a restaurant last Sunday afternoon for a quick lunch.  In walked a couple who were obviously struggling with mental health issues.  I couldn't take my eyes off of them.    I got that same familiar feeling I've had all my life - this overwhelmed sense of the pain that they carried.  I kept looking at them - not because I was afraid or uncomfortable, but because I couldn't stop wondering what their story was, what their diagnosis had been, which meds they were on, how they were coping...

Stigma exists and then grows where there are assumptions, misunderstanding and fear.  I wish we could all walk into a building full of people with mental illness as six-year-olds and learn to navigate it all over again.

Then we wouldn't be afraid.

Wednesday, January 8, 2014

Shop Talk

I returned to school with an abrupt beginning last week Thursday.  Abrupt because I didn't realize until a few days before class, that classes began a full week earlier than I thought they did.  Heading back to school before my kids returned to school?  It just didn't seem right.  And it didn't seem right last Thursday night.  Our program was the only one at the U of W to begin a full week earlier than the rest of the University.  It was minus one hundred, dark and blustery last Thursday night as I parked and trudged across campus.  It was like a deserted ghost town.  Part of my reason for trudging rather than skipping was the class I was taking.  It's a required course called "Research Methods in Family Therapy" and it illicits fear and trembling from all non-Math type people like myself.  Visions of math and statistics and equations danced in my head as I prepared to enter the classroom.  This was the one course in the entire program that I was not excited to take.

Thankfully, my fears were put to rest quickly.  Math will not be a focus, I heard, and most students in the program find it quite painless... The focus of the course is making us critical consumers of Family Therapy research, and that I can handle.  The big project is writing and submitting a research proposal at the end of the term.   I already have an idea.  It's one that I've actually considered pursuing in the past, so purpose and passion already exist which for me, is half the battle.

Monday night I began my second class this term, and it was one I was greatly looking forward to.  I guess you'd have to be a little quirky to think a class called "Working with Families with Serious Mental Illness" sounds like a good time.  The instructor,  Psychiatrist Dr. Stewart Wakeman, is a gifted lecturer and turns all stereotypes for psychiatrists on their heads.  He's warm, engaging, personable, funny, and damn smart.  Well, I guess you'd expect a Psychiatrist to be smart.  But not necessarily all of the other things.

One of the things Dr. Wakeman spent some time talking about at length is the trend towards collaborative health care that we seem to be on the cusp of here in Winnipeg.  Many health authorities are moving away from "fee for service" models of reimbursement for their physicians and are moving towards salaried positions.  This enables health authorities to establish and set-up collaborative care clinics and centres which provide consumers with a more well-rounded approach to health care.  There are a few of these in existence in Winnipeg already, with more on the horizon.

What would this look like and how would it change things?  Imagine you are heading in to see your family physician and you're feeling like you can't cope with the depression and anxiety you've been experiencing.  You're not even sure that's what it is.  You just know you don't feel right.  After chatting with your physician and determining that you do, indeed, have clinical depression, you are offered a prescription for an anti-depressant/anti-anxiety drug to curb the feelings.  Now imagine that there is a Marriage and Family Therapist's office just down the hallway who is on-call.  Your doctor sends you to chat with the therapist immediately, as they are only a few steps away.  You can sit down and have a short conversation about your mental health and receive some preliminary psychotherapy without having to make another appointment, drive across the city, or researching who is covered by your private insurance.  A follow-up appointment is made and to see the therapist again, and care is handled jointly by your family doctor and the therapist.  If the need arises, there is a Psychiatrist on staff who consults with your team to ensure that you are getting the best care possible.  This is what collaborative health care could look like.

This model makes me deliriously excited for many reasons.  First, if I had been offered this kind of care at different stages in my journey with mental illness, it would have made a significant difference for me.  Five minute conversations with a general practitioner are not enough to determine a diagnosis, treatment, or what supports could be of help.    Eliminating the need for the consumer to do the work to look around, call around, and drive around reduces stress significantly and makes it easier access help.  Having someone provide psychotherapy in a medical clinic reduces stigma and normalizes mental health issues as something that shouldn't be hidden or ashamed of.

I'm also happy because this trend means that there will be lots of jobs for people in my field in the coming years.  Dr. Wakeman was confident that there will be therapists recognized and sought after for these types of models of care.   I like the sound of this.   I also like thinking that some of the amazing men and women I'm fortunate to study and learn with are the ones who will be filling the offices and providing care to people seeking help in a few years.  My friends are going to make amazing therapists.

The third class I'm taking this term is full days over three weekends.  It's called "Family Reconstruction" and it's a component of renown therapist Virginia Satir's model of therapy.  It just so happens that Virginia Satir's protege, Maria Gomori, lives and works in Winnipeg, and she teaches the course.  Now the amazing thing is that Maria Gomori is known to be one of the best teachers and lecturers in the program, and guess how old she is.  She's in her 90's!  I am really looking forward to an intensive opportunity to learn from someone with that much wealth and wisdom.

I was struck on Monday night how interesting the Marriage and Family Therapy program is.  When new classes assemble, it's like a mini-reunion of old friends and colleagues from different courses and practicums.  There are hugs and laughter and a buzz of conversation before the class even begins.  There is warmth and openness and room for expression.  I love being in a room with people who think that talking about families and serious mental illness is interesting, captivating, and motivating.  I'm in the right place with the right people.  That feels good.

Sunday, December 29, 2013

Like An Old Pair Of Shoes

It's a Christmas holiday tradition.... Dutch Blitz battle with the Loewen's.

We've got our long-standing teams figured out.
Team Terry (aka Team Delusional).   (Terry and Zach)
Team Good Looking.  (Mike and Ellie)
Team Shazel.  (Caleb and Hannah)
Team Barla.  (Brynne and Carla)
Team Peener. (aka Team Awesome).  (Me and Sasha)

Some things are always the same.  The trash talking, the laughing at the same jokes and ridiculous antics, the "shushing" when things get crazy because the twins are trying to sleep, the battle between Team Terry and Team Peener...

Sometimes we add something new, like this year.  To make up for Team Terry's arm-length deficiency we incorporated a clockwise rotation in the seating plan every round.  Sad to say, it worked in their favor.

Some things are meant to be the same.

We've been friends since before any kids entered our lives.  That seems like a lifetime ago.  Way back then, we were both newly married and forged our friendship on nights of playing cribbage in our pajamas.  I don't think any of us would have guessed that in 17 years there would be 8 kids between the 4 of us.

It got loud tonight.
But things often do when you fall into step and find reasons to laugh because it just fits so well.

Comfortable and worn-in.  
Like an old pair of shoes.

Tuesday, December 24, 2013

Remember Syria

Six years ago I was haunted by the horrific situation happening in Darfur, Sudan.    I was overwhelmed with feeling like there was little I could do to make a difference.  The problem felt huge, and any effort on my part felt like the tiniest drop in the most enormous bucket.  When Christmas came, I really felt compelled to do something tangible, so our family learned as much as we could about the refugee crisis in Darfur, and what had erupted politically to create the situation in the first place.  Sasha was wee then.  Hannah was only 7, and Ellie 4.  One thing I've learned over the years, is that you can tell the story of a place and a people so that even the youngest ones can understand the basics.    We learned what we could, and we made "reminders" for our tree to honor those in refugee camps in Darfur who it seemed the rest of the world had forgotten about.

The following year we focused on Darfur again.  Not much had changed.  (Isn't that the way it is all too often?)  The following year we concentrated on refugees in other countries around the world.  The next year it was the housing crisis in Attawapiskat that called out for our attention.  Then last year it was the plight of girls in countries around the world whose lives are less than simply because of their gender.  

This year we focused on Syria.  

We have a small tree upstairs that serves as the place to hang the words, facts, and stories of the place or cause we're focusing on.  It's amazing what you can find to help you communicate the story of a place or a crisis to kids.  Syria's situation is not simple.  But there are simple concepts about dictatorships, democracy, freedom, power, and the fall-out that kids sometimes understand more than we do.























Last week I read the paper and listened to the radio as the current situation in South Sudan was discussed.  Things aren't better than they were six years ago when we started to learn more.  In fact, in lots of ways, they're worse.  That realization hit me.  There are parts of this that feel hopeless.  Will anything change in Syria?  Will there still be a need for refugee camps for Syrians at this time next year?   Sadly, there will probably be a need for more.

Hanging these reminders on a tree isn't going to change anything in Syria.  But knowledge is power, and taking hold of that power means we won't forget.  We won't forget Darfur... or Syria.  Christmas Eve seems as fitting a night as any to hope that you won't forget it either.
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To learn more about Syria's refugee crisis:
Click Here for a video that explains the basics to kids.
Click Here for answers to questions about how the conflict in Syria began.
Click Here for information on the refugee crisis specifically.

To help:
Click here for the UN site for giving.

Sunday, December 22, 2013

Early Christmas Gift

It was the end of the day.
The last day of school before Christmas break.

It had been a full day of singing and snacking and parties and presents.  A loud day.

He has only been their teacher for a month - taken on the grade five class of ruffians when their teacher left to have a beautiful baby.  He is their first male classroom teacher, so they are all learning together.

I came up to the classroom to find Ellie and to say goodbye - to wish him a Merry Christmas.

He was standing at the door, wishing his charges well as they left for their two week vacation.  This is when I got my window into beauty.  As we were chatting, one of the taller boys in the class came up to him, wrapped his arms tight around his waist and hugged him.  The gift was returned as his arms wrapped around his student.  It was a momentary embrace, but his student lingered awhile, with his head sideways on his chest, savouring the feeling of the tight strong arms around him.  It was solid and soft at the same time, full of kindness and nurture.

I don't know the student who came for his goodbye.  Maybe he doesn't get hugs from a dad at home, or maybe he gets them all of the time.  Maybe there is a dad living in his four walls, or maybe he only seems him sometimes.

What I do know is that when an eleven year old boy comes for a hug, and his male teacher hugs him back good and proper - in that moment - something breaks open.

It did for me.

Wednesday, December 18, 2013

Christmas Mix

Years ago I took the process of decorating our house for Christmas very seriously.  I had separate bins for different areas of the house and each contained things reserved just for that spot.    It wasn't work to me - I loved it.  It wasn't just the finished product I liked, either.  I loved the whole process... the transformation.  These last few years I take the bins out of the storage room and I open them and look at what they contain and feel exhausted.  I remember the places the garland and the berries and the bows hung and I have good memories of it all, but I just can't conjure up the energy it would take to maneuver what's in the bins to its place in the house.  I am learning to be ok with that.  To look around at the little, subtle bits of Christmas and not feel guilty about how sparse it is, or how simple it has become.  Finding peace in bins that remain closed and contained is important.
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Our big Christmas tree is a mish-mash of lots of different kinds of ornaments from places and times in our life as a family.  It tells our story, in a way.  Lots of people have perfectly matching ornaments and a perfect color scheme on their trees, but we're not that family.  Lately, when our girls have been coming home from their friend's houses they marvel at the fact that their friends have trees that look "perfect".  Hannah, especially, laughs about our tree, and wonders what those friends would think if they saw it.  She feigns embarrassment at our family tree, but if I'm right, I think she's endeared to it and  loves the stories it holds.  

There is one ornament, in particular, that makes us all laugh.  It's a plastic spoon with a gold bow tied around it, a face drawn on it, and a halo added on top.  I suppose you could call it  a "primitive angel".   The name "Sasha" is scrawled on the back, and there is no ornament on that tree I love more.

Hannah has laughed and said, "Who hangs a plastic SPOON on their Christmas tree?"  
We do.
And I know she wouldn't have it any other way.

___________

I've been stuffing and addressing envelopes this week.  Just like the ornaments on our tree, the names on the Christmas card envelopes tell stories about where we've been and who we are.  My "master list" holds the key to different doors of our lives.  Friends from elementary school and childhood.   Friends from University years who I still hold dear.  Lots of friends from our two years in BC.  Those envelopes are the hardest to address.  I can usually go about most days and weeks without missing our life in Vancouver too much.  Of course, when the temperature plummets and everything is coated in snow and ice, it's hard not to let your mind drift back to how lush and green and fresh everything remains on the coast.  But when I write out the names and the familiar addresses, the sadness for the beautiful relationships we left behind becomes real and painful again.  I wonder how many more years I will address envelopes for those friends.  Will I be able to keep up and stay connected?  Will we be forgotten?  Will we forget?

But for now we know we haven't forgotten.  And with every swoop of the pen to write another name of a family we love and miss, I take a moment to feel the sadness and the gratitude and remember.

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Hannah went to a Christmas party last weekend.  It was a party comprised of six girls from her grade who have become really close friends.  The mom of the girl who hosted the party showed me a picture on her phone this week that she took of six thirteen year old girls in bathing suits and toques, dancing and singing and about to go jump into the outdoor hot-tub.   I loved the juxtaposition that the picture showed - bathing suits and toques - two  things that rarely go together.   I loved the gigantic smiles I saw and the freedom that was evident in order to  prance around in your bathing suit and dance your face off.

At an age that can entail so much body shaming, and body loathing, the picture of these girls with their heads thrown back with smiles from ear to ear painted a different picture. Adolescence doesn't have to be that way.  

And I was grateful.

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Last Saturday night we had my classmate and friend Mary, and her partner Jennifer here for supper.  After we were finished eating, Jennifer, (who is an incredibly gifted pianist) began to play Christmas songs, and Mike grabbed his violin and played along.  They played old standards and some sacred melodies, and we sat on the couch and sang along, while Ellie danced and we all laughed.  It sounded amazing, and we joked that they could take their show on the road.  It was a beautiful moment, and I couldn't help but think how amazing the world is when your husband is playing violin with an American pianist from Egypt, while her Egyptian partner sits beside you and sings her heart out while your kids laugh.  Who dreams up these combinations?  How did these beautiful souls end up in my corner of the world?  The mystery of connection and relationships astounds me.  Definitely one of the best memories of this Christmas.

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One of the songs Jennifer and Mike played together was "O Holy Night".  There is a line in that carol that gets me every time.  I sing it, and then I can't stop thinking about it:

"Truly He taught us to love one another.
 His law is love,
 And his gospel is peace."

His law is LOVE?  Amazing.
When the word law makes us think of rules and punishment and enforcement and rigidity, God turns it upside down and says His law is love.

That is the kind of God I can get behind.


Sunday, December 15, 2013

Party Like You're 13 (Instead of 39)

I got to go to a party tonight.  Just me.

Everyone else was busy and they weren't really invited anyway.  

Here's the funny part: 
The birthday boy is in grade 8 and is a friend of Hannah's.  
I'm a mom and I'm old.  
AND I got invited!

I sometimes wonder if people who don't know me (and some who do) think it's creepy that I enjoy good relationships with kids Hannah's age.  Maybe it does look strange.  I like fist-bumping and high fiving in the hallway at school.   Sometimes I even have a little entourage of boys come looking for me at the end of the day to have a little chat and share a laugh.  That makes me happy.

It makes me happy because I want to share positive relationship with my kid's friends.  I want them to know they have lots of cheerleaders and safe places in the adults around them.  I want them to believe that they are worth talking to, even if they're "only kids".   I want them to tell me funny stories, and I'm tickled that they might want to listen to some of mine.   I want to know them because I want to know more of Hannah, and they share more of her life with her than I do.   I want them to know they are valuable and significant and LIKEABLE - (even by old moms like me).

I got to celebrate a great kid's birthday tonight.  
He makes people laugh and his eyes sparkle as he draws them in.
My eyes sparkled when I got invited.
I'm glad we're friends.