This weeks anti-depressant

"The Full Catastrophe"

"Am I not a man? And is not a man stupid? I’m a man. So I married. Wife, children, house, everything. The full catastrophe."

-Zorba the Greek

Those of you familiar with the movie "Zorba the Greek" might remember this quote. It is also to be found in the book, with the same name, by the Greek literary giant Nikos Kazantzakis, one of my very favourite authors.

The "father" of Mindfulness Based Stress Reduction (MBSR) named one of his best books on the subject after this quote: "Full Catastrophe Living" (Kabat-Zinn, 1990).

MBSR was Developed by Kabat-Zinn et al. in the Nineteen-eighties, it is based on ancient Eastern methods of dealing with the “Full catastrophe” of living Zorba refers too.

MBSR is a structured group intervention that uses the techniques of mindfulness meditation to relieve and/or remove symptoms of various physical and mental disorders.
Its main goal is, to put it simply: being in the moment without judgment.
The method is meant to methodologically create increased awareness with the practitioner that will in turn improve various physical and psychiatric outcomes (Kabat-Zinn, 1990).

There is an increasing body of evidence forming on its efficacy treating various mental and physical disorders.

I teach most of my patients the basic principles of the method, along with a short meditating exercise. Most of them find it extremely useful.

There are MBSR courses held all over the country. They usually take 8 weeks, with a three hour weekly session, one whole day retreat and extensive homework.

I attended one last summer. It proved extremely useful, although I have been a daily meditator for more than eight years.

For those interested in knowing more I suggest this website . To find a class near you go here. The book referenced below is a great introduction and a great read also.


Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York: Dell Publishing.

One problem solved, on to the next...

Serenity Prayer

"God grant me the serenity

to accept the things I cannot change;

courage to change the things I can;

and wisdom to know the difference."

Reinhold Niebuhr

Those who are atheists or agnostics can use "May I have the serenity ........." instead.

Either way this works.

Really nothing more to it.

Now that I have dealt with the complexities of living life I can get back to implementing the APA style on my plan b.

Spirituality and mental health

I had the privilege of being introduced to the work being done in Alcoholics Anonymous (AA)when working at a chemical dependency (CD) unit a few years ago. I heard amazing stories of recovery and hope through these "recovering alcoholics" who came to bring their message to the patients of my unit.

What is unique about AA is that their methods are all based on a spiritual foundation (not religious), and all though there is great controversy still surrounding this subject they have become a respected and trusted resource for those mental health professionals involved in the CD field. A place where many recovering alcoholics can find a philosophy and fellowship to maintain and improve on the work already done in treatment facilities and hospitals the "got clean" in.

I find it fascinating that, at least in this one field, CD, a spiritual approach is often one of the key components to a persons recovery. I can't help to wonder if perhaps we who work in other areas of mental health can learn something from this...

Perhaps the spiritual approach is not just for clergymen to contemplate. Perhaps we should, in some cases, place the spiritual recovery in the front seat, next to the physical health, and the mind will follow. AA has be doing this for more then 70 years, and it seems to work for them.

Of course I realize AA is perhaps not the appropriate place for everybody, but they do seem to offer exactly what some of our patients need. Perhaps a portion of other clients in the mental health field have similar needs. Needs we psych-nurses are in a unique position to help them meet.

I am a psych nurse. Now what?

These are the things that came to mind.

The opportunity to help. The autonomy. Helping people one on one, having more chance of having a positive influence in peoples lives. Developing my own style or approach in therapy, become respected in my field. Having the ability and credentials to have a real impact on things. Really making something happen. Touching peoples live in a deep and meaningful way. Creating a space for me and the client to work in and existing comfortably in that space.

Some more infantile and simplistic aspects do pop up though, that is a part of my humanity too: Doing something that is recognized as complicated and requiring skill (unlike nursing??). The respect. Not having to wear scrubs. Getting respect from environment.

In my experience the more ego driven things do not last though. They will not and do not sustain me through the hard times, the trying times and all the moments of truth that lie ahead and behind.

A sincere desire to do good, and a passion for the field. Those are the bigg'uns, for me... today...

Then it helps to get paid too

On the usefulness of being mindful...

Theres a hole in my sidewalk: by Portia Nelson

chapter 1..
i walk down a street
there's a dep hole in the side walk
i fall in
i am lost...i am helpless
it isnt my fault.
it takes me forever to find my way out.
________________________________________________________
chapter 2..
i walk down the street
there is a deep hole in the sidewalk
i pretend that i don't see it.
i fall in again
i cant believe i am in the same place.
but it isn't my fault
it still takes me a long time to get out.
________________________________________________________
chapter 3..
i walk down the same street.
there is a deep hole in the sidewalk.
i see it is there.
i still fall in...it,s a habit..but, my eyes are open.
i know where i am.
it is my fault.
i get out immediately.
________________________________________________________
chapter 4..
i walk down the same street
there is a deep hole in the sidewalk
i walk around it.
________________________________________________________
chapter 5
i walk down another street.

Burnout

"Burnout is a psychological term for the experience of long-term exhaustion and diminished interest (depersonalization or cynicism), usually in the work context." (Wikipedia.com).

I have had the “privilege” of working with a good many burned out healthcare professional in the eight years I have enjoyed (most often;) working in healthcare. There is a whole body of research and literature on this subject now but the major symptom, in my experience, is loss of joy. Not enjoying the client interaction anymore. Other beginning symptoms I have noticed are loosing ones insight: use of humor becomes increasingly inappropriate and comments are made to and about clients that are inappropriate. But the main symptom to look for is lack of joy, I think.

Because of the danger of this I do watch myself, emotionally, pretty intently, both throughout the day, and I do an inventory at night. I also do a bigger inventory approx. once a year. This hopefully all helps with my catching the early signs.

Also alerting my friends and close family of these symptoms so they can alert me if they see them popping up. Last but not least, it is beneficial, I think, to have a good collegial relationship with someone at the workplace. A person that has “permission” to alert me of potential beginning symptoms of burnout I might be displaying.

I am young and have not been in this business for that long, but still I have felt the stingy odour of burnout twice, emmiting from my sensitive skin. Both times I did not set down proper boundaries regarding my work hours and/or work conditions.

I am responsible for taking care of myself. And if my place of work is hurting me, I must do what is necessary to change the situation, and if that is not possible, leave.

Simple, not easy...