You Are Only as Sick as Your Secrets

Years ago, I unexpectedly found myself responsible for a table of about 8 customers at an Advisory Board dinner. If you aren’t familiar with Ad Boards, they are exactly as they sound – a group of people brought together for the purpose of advising you. Ours usually lasted a day and a half and were typically held in 4 star hotels. Seems like this one was at a W. I’d been invited to the meeting to lead a discussion on some patient education materials my company had developed. Earlier in the day I’d done so and as we headed into the hotel ballroom for dinner, I was relieved my obligations were over. Or so I thought. No one bothered to mention until right before we sat down that oh, by the way, I would be the only one from my company at my table and it would be my great fortune to play the role of host. Yikes! My palms immediately began to sweat.

You see, I don’t have an affinity for small talk. Which is to say I pretty much suck at it. Small talk seems pointless. I mean, life is short. If you’re going to have a conversation, well then, have one. Why waste oxygen talking about the weather? Or the price of gas in Muskeegee? Sure, it’s polite to inquire about one’s job and the ages of one’s kids, but time is ticking, so why not get right down to the good stuff? Like one’s most embarrassing moment. Or the thing one prays one’s significant other never finds out. I’m just saying I’m not afraid to ask. Something to think about before you plop down beside me on an airplane and interrupt my novel.

So I wiped my sweaty hands on my dry clean only suit, heaped my plate at the buffet and made my way over to table 5 to play hostess for the evening. One by one, guests joined me; 2 doctors, 2 pharmacists, and 4 nurses, and after everyone was seated and the wine poured, I looked up from my baked chicken to discover all eyes on me. I put down my fork, wiped my mouth with my napkin and tried to say something introductory. Something small talk-ish. I opened my mouth fully intending to say, “Hi everyone. Glad you could all join us this evening. Shall we go around the table and introduce ourselves?” Truly. That was my plan. And then I’d ask, “What do you think about the meeting so far?” and scarf down my food while everyone else talked.

But that’s not what happened. Instead my brain hijacked my professional intentions and my mouth produced something very close to the following:

“So. None of us really know each other and we will likely never meet again. Feels like the perfect place to get that thing off your chest. You know, that thing you really don’t want anyone to know but you really need to tell.”

Eyes widened. Someone giggled. There was a decade-long pause during which I thought, you’ve really stepped in it this time, sister, and then a lady sitting next to me took a big ole swig of wine and said, “my son is turning himself into a pin cushion. He’s got 10 body piercings so far and he just did a nipple. I love him but I can’t hardly talk to him without laughing. He looks so ridiculous, you know?”

And then the floodgates opened.

It was freaking AWESOME. I don’t even remember what anyone said. Except for the mother of the pin cushion. It was just so great to open up the closet and expose all the skeletons. We laughed and groaned and commiserated. One of the doctors racked his brain for something to share. “I’m just too normal,” he shook his head glumly. “That’s OK. Somebody has too be.” And we all roared with laughter.

All of the other tables kept sneaking glances. They couldn’t get over how much fun we were having. Long after everyone else had gone up to their rooms, we were still sitting there, lingering. We didn’t want to leave. We started out strangers and we left there, well, still strangers but a little lighter, as if having tossed a heavy backpack overboard.

A wise friend recently said, “We are only as sick as our secrets.” I believe this, wholeheartedly. Which is why I don’t have secrets. Also because I’m just not good at keeping them and partly as a reaction to growing up in such a dysfunctional family. Putting up a good front was ingrained in me. What other people thought about our family was paramount. I kept all sorts of family secrets – I had to. It was expected. And you know how it made me feel? Ashamed. Damaged. Broken. Less than.

But after I decided to no longer keep those secrets, know how I felt? Empowered. Unencumbered. Lighter. Free.

As an adult I realize you can’t actually control what others think of you. You can try to hide the dark stuff but you will always live in fear of it surfacing. Of someone finding out. It’s actually easier to eradicate the dark stuff than to hide it. To just stop doing the things you’d be horrified if others knew about. But some of our dark stuff is out of our control – it’s not the things we have done but the things others have done to us that we’re ashamed of. We worry what others would think if they knew we were abused or our spouse cheated on us or we were bullied in school or we grew up in foster care. We feel this inexplicable need to protect the people who harmed us by keeping their secrets. We take on their secrets and make them our own. This is unhealthy for both us AND them.

This is the stuff I’ve lost tolerance for as I get older. You don’t want someone to know you’re an alcoholic? Then get sober, no matter what it takes. Don’t tell your child to cover for you. “Daddy’s a deacon at church and it would look bad if others knew he drank. Let’s just keep it in the family. OK?”

Nope. Not doing it. I wonder how many people in our lives would choose to eradicate their dark stuff if we refused to cover for them? Keeping their secret isn’t doing them a favor. It enables their sickness. It helps keep them sick.

Of course, refusing to keep the secret isn’t a walk in the park either. Whether it’s your personally owned secret or one foisted on you second hand, outing it will jeopardize relationships. Some people will judge you. Some people will likely walk away. But are those the kind of people you actually need in your life? I say, good riddance.


Brain Training, Ruzzle, and CET

20130511-112031.jpgThe Zipper Girls (besties and participants in the annual Girls Adventure Weekend) introduced me to Ruzzle on our last trip. Ruzzle is a word-search app for all your i-technology. I can waste spend literally hours playing against myself, the Zipper Girls, and complete strangers. Whenever Stan hears the Ruzzle ten second count-down (each game is timed), he says, “Again? Really?” But when the term “addiction” gets tossed around, I just put on my smug face and say, “Researchers have shown that elderly adults who engage in mentally stimulating activities are less likely to develop dementia.” Is there even such a thing as RA? (Hello, my name is Trophydaughter, and I’m a Ruzzleaddict.) Yep, classifying my Ruzzle time as mental exercise let’s me engage guilt-free.

Seriously, I worry about dementia. That is, when I’m not worrying about the economy, the puffy circles under my eyes, the devaluation of the dollar, how fat I actually look, whether or not I need to own gold, the overall health of our nation, my job, my husband’s job, how outdated my house is, my sister’s health, the deer eating my yard, our healthcare system, and the ultimate fate of social security. When my grandmother died, she didn’t know who I was. The last time I visited her at the retirement community, she said, “Why are you here? Will you please stop following me?” My dad has also had some inexplicable cognitive episodes. Once he was angry with Mom for a week for stealing $20 from his top dresser drawer. Mom said he’d never even kept money in his dresser drawer.

I’ve also noticed some inexplicable cognitive issues with my sister since re-entry into her life. She can’t keep up with her stuff. She is constantly “losing” things, leaving stuff in my car, misplacing her apartment keys. She struggles with memory (as do I) but she will tell me something one day and when I bring it up again, say, “I don’t know why I told you that. That never really happened.” She will chalk a mistake up to a “life lesson” and then repeat the same mistake in a month or two as if she’s completely forgotten what happened the last time. Recently, she allowed a new friend to spend the night at her apartment and woke up to find the friend gone along with her new Nexxus tablet (which she’d saved for for months). Previously, when she’s allowed friends to stay over, they’ve stolen medication, clothing, and food from her. So why does she keep doing it? She will call me 3 or 4 times a day to tell me something because “If I don’t tell you right this minute, I won’t remember it later.” I do this too at times but I’m juggling a LOT of stuff. Which is not the case for Jerri.

She complains about her ability to concentrate. While I tend to tuck these comments away in the “How can I convince Terri I really do need Adderall?” file, I know Jerri truly believes her ability to focus has diminished significantly. She also took an online Autism test recently and scored in the “moderate” range. I’ve observed her awkwardness in many social situations – she doesn’t always pick up on visual cues and she goes down inappropriate conversation paths at times.

It has been challenging to discern what is illness vs. cognitive impairment from medication vs. this mysterious, unnamed “something else.” Just yesterday Jerri said to me, “I’ll never be the person I was before. There’s been too much brain damage.” I refuse to accept this.

user:Looie496 created file, US National Institutes of Health, National Institute on Aging created original / Foter.com / Public Domain Mark 1.0

The brain is an amazing organ and has the natural ability to repair itself which is called neuroplasticity. Neurons, or nerve cells, are the basic building blocks of the central nervous system which includes the brain. The connections between nerve cells, called synapses, allow information, in the form of nerve impulses, to travel from one neuron to the next. The human brain is made up of trillions of synapses. Its this network that allows us to feel, behave, and think. The more connections in your brain, the greater your cognitive function. When connections are broken, it impacts cognitive ability. Connections that are used regularly become stronger. Connections that aren’t used eventually get eliminated through a natural “pruning” process. “Use it or lose it” is actually a fact when it comes to connections in your brain. Drug use and excessive alcohol consumption can cause connections to deteriorate or break as can exposure to some heavy metals and pesticides, and brain trauma. But because of neuroplasticity, broken connections can sometimes be restored.

Given all this, I was enthralled by an article about CET, Cognitive Enhancement Therapy (Improving Cognition in Schizophrenia) in the Spring edition of the NAMI advocate. Per the article:

Many individuals with schizophrenia and related disorders exhibit signs of impaired cognition: they have problems paying attention, remembering, solving problems, and making decisions. Brain-imaging studies have revealed that individuals with schizophrenia show reduced activity in the prefrontal cortex, precisely the area of the brain involved in attention, working memory, and judgement.

Wow, this sounded like Jerri so my first question, since she doesn’t have a diagnosis of schizophrenia, was what are “related disorders”? Turns out that a study funded by the National Institute of Mental Health (NIMH) was just published on February 28, 2013 (Lancet, Identification of Risk Loci with Shared Effects on Five Major Disorders: A Genome-wide Analysis) that identifies specific gene associations between schizophrenia, bipolar disorder, ADHD, depression, and autism. This so fits what I’ve observed in my own immediate family where besides Jerri’s bipolar disorder, others have been diagnosed with depression, ADHD, and mild forms of autism.

But back to CET. CET involves structured activities that exercise the brain and mind. CET Cleveland is the first CET program to be established outside of academia and is currently only available at 21 sites in 10 states, however, new sites are in development in other states and YAY!!!, North Carolina is one of them. (Still trying to track down the location of the site and when the program will be up and running.) The program requires one 3.5 hr session per week for 48 weeks. Each session involves 3 components: computer-based exercises, group-based interactions, and one-on-one coaching sessions. Complete brochure in PDF format is available here. Participants are able to improve overall cognitive functioning by strengthening and developing new neural connections. Through group-based interactions and coaching, they are able to increase their understanding of how society and the workplace function. Most graduates of the program continue to improve and go on to enroll in school, work, or volunteer. To me, CET is a missing link for my sister in her recovery. This is definitely another opportunity Jerri and I will be keeping our eyes on as CET becomes more widely available. Learn more about it at cetcleveland.org.


Caramore, Part 2

Those of you following the blog may recall Jerri’s interview at Caramore Community back in October –the one cut short when she confessed she’d smoked crack the day before. Yep. Not one of her more stellar moments. If you’re new to the blog, you can catch up here.

I’m sort of crushing on Caramore. I know, I know. It can’t possibly be ALL THAT but what I’ve read and observed is truly impressive. Caramore is a structured, residential support program for adults with mental illness that uses a step-up approach to empower independence and community employment. Not sure why this is such a novel approach–but trust me, it is– no one else seems to be doing it. Caramore puts brain disorders in their place; chronic conditions to be managed as you get on with the business of living your life.

At first, participants establish a daily work regimen, 30 hours a week, as employees on Caramore’s janitorial or landscaping work crews which provide services to the community. The janitorial crew, for example, cleans churches, businesses, and homes. Participants live in Caramore apartments where Residential Advisors supervise and help them establish personal goals like sticking to a budget or improving social skills. There are 4 participants to an apartment. Everyone has his/her own bedroom, shares a bath with one other person, and shares the kitchen and den with all housemates. Chores are assigned and everyone contributes to maintaining the living space.

Participants earn minimum wage which is applied to their housing. Disability income goes into a savings account which after several months is enough for a deposit and first month’s rent on an apartment outside the program.

As you progress in the program, there’s gradual lessening of supervision and Caramore helps you secure employment in the community at sponsoring businesses. A HUGE shout out to Lowes, Target, Whole Foods, and UNC for being Caramore employers.

After 3 or more months of steady employment, participants move into community apartments. Many split the cost with housemates they met at Caramore. Slowly, Caramore’s services are reduced and eventually phased out. Eventually, participants “graduate” but can continue to network and get support from other alumnae.

Did I mention Caramore has a 90% success rate?

At first glance, it might appear Jerri doesn’t need this kind of program. After all, she’s already able to live fairly independently. She takes her medicine on her own, does her own shopping, pays bills, and has her own apartment. Still Caramore has a lot to offer. Jerri’s not great with money and spends it all within days of getting payed. Probably as a technique to remain clean (if she doesn’t have any money, she can’t buy drugs) and perhaps as a post-traumatic stress response (if she doesn’t have any money, no one can steal from her.) Caramore could help her work through money issues. Jerri is also ready to get a job but fears losing disability and the possibly of getting sick again. Caramore has experts in disability law and can help navigate this. On her own, she lacks the discipline to get up every morning and go to work. Plus she has a felony on her record and that makes it difficult to even find employment. Lastly, her social skills aren’t great. These are all challenges, Caramore can help address.

After the botched interview back in October, Jacob, the Admissions Director, said typically new admissions have to be clean and sober for 6 months prior, however, he would cut that to 3 months for Jerri and scheduled another interview for January 8th. Jacob has since had a promotion and on the 8th, Jerri met with Blake, the new director. The interview went well – no drama this time – and Blake scheduled a trial visit for Jerri to test drive the program.

That was this past week. Trial visits are supposed to be 5 days but with Martin Luther King day on Monday and the ice storm on Friday, Jerri’s visit lasted only 3. She worked on the janitorial crew mostly vacuuming and complained of backaches daily. She described the other participants as “heavily medicated” and likened the experience to “being in a mental hospital” because Caramore dispenses all medications and you have to take them while they watch. When I pressed for one positive thing about the experience, she said “everyone is really nice to me.” She also felt better about the visit after talking to her Residential Advisor for the week.

Yesterday morning, we sat down with Blake and discussed the visit. He said the 3 days really hadn’t been enough time for Caramore or for Jerri to fully assess whether the program was a good fit. Jerri is concerned she might not be physically able to vacuum for 6 hours a day, 5 days a week. (Ha! Who among us is?) So Blake asked her to do another trial visit, for a full week, starting Monday.

For my part, I’m trying my best to remain objective. To me, Caramore seems like a life-saver. On the other hand, what could possibly be worse than ending the relationship with Telecare (her current mental health provider), letting her apartment go (for which there was a waiting list to get in), and moving all her stuff to Caramore only to receive a call 2 weeks later saying it’s not going to work out? Jerri has said as much. “I want to be sure I can physically do the work before I commit.” She was seriously doubting herself when I picked her up yesterday.

“What will you do, Jerri, if you decide you can’t manage the Caramore program? Just go back to watching TV all day?”

“No. Catherina will take me to Vocational Rehabilitation and I’ll try to get back into work that way.”

She’s got good intentions – I’m just concerned about follow-through. And likelihood of success without more structured support than what Telecare can provide. I know, it’s out of my hands. God, grant me the serenity . . .


Christmas Ghost Busters

I am not a Scrooge. I may say a lot of Scrooge-like things around this time of year but that’s only because I, too, am haunted by the Ghost-of-Christmas-Present and the Ghost-of-Christmas-Past. So much so that some years I host my own personal little Occupy Christmas movement to protest the bastardization of a season meant to be a celebration of the coming of the Christ. I don’t put up a tree or send cards or string lights. I don’t play carols or give gifts or make sausage balls or gingerbread or hot spiced tea. This doesn’t actually solve anything but as the song says, “whatever gets you through the night” or the unbearably long over-commercialized holiday season that appears to begin some time immediately preceding Halloween.

This, apparently, is not one of my Occupy Christmas years as I’ve already hung lights on the decks of the beach house, attended a Mannheim Steamroller concert, and stocked the Frig with eggnog. Still, the Ghosts are hovering and the days are filled with reminders of why I find this season to be so noxious.

This week the Ghost-of-Christmas-Present introduced me to the lady seated to my right at Shrek the Musical. As I was squeezing my way past and back to my seat after intermission, she leaned in and said, “You’re tapping your heels to the music, I’m sure you don’t even realize, but could you possibly stop? It’s bothering me.”

Seriously? One has to wonder what she was even doing at a show like Shrek. Does she sound like the kind of person who would be entertained by public farting to you? (Afterwards, I impersonated her using the voice of Gingy the Gingerbread Man and felt ever so much better.) Being a notorious people pleaser, I did cease the tapping and the earth miraculously resumed its rotation around her.

The Ghost-of-Christmas-Present is after my sister too. In mortal dread of the holiday, she asked Bryce, her psychiatrist, to add Lamictal to her bipolar cocktail. I had to break the news to Jerri over Thanksgiving that she couldn’t spend Christmas at the beach with us because Stan’s brother and family are scheduled to visit. I feel incredibly guilty when she has to spend Christmas alone. She’s had to do that most years over the past two decades because she’s purposely excluded from family gatherings. So am I, but to be honest, for me its mostly a relief.

The Ghost-of-Christmas-Past has started whispering in my ear, reminding me that the event that shredded our family fabric occurred the Christmas Stan and I tried to treat everyone to a week at the Outer Banks. She reminds me of all the sadness and confusion at Christmas I endured as a child due to mom’s depression and overcompensation for parenting sins throughout the rest of the year. She reminds me that it was Christmas when I first realized my parents were never going to love me, no matter how hard I tried, that they really didn’t even understand the word, let alone, the emotion. The-Ghost-of-Christmas-Present chimes in and says, “They’ve totally replaced you and Jerri with her children. They have a new family now. They don’t even miss you.”

Shut up, shut up, SHUT UP!

This year I refuse to listen. I also refuse to kill myself trying to have the BEST Christmas EVER. I refuse to feel guilty because I can’t make Jerri happy. I give myself permission to do the things that I can manage, to spend as much time alone as I need, to celebrate with people who may not be my blood relatives but are family all the same.

20121203-011905.jpgTonight is the first night of Advent. And even through I’m not Catholic, or Lutheran, or any Protestant faith that traditionally celebrates Advent, tonight I will light a purple candle and read Isaiah 9 about the Light of the World who has penetrated the darkness. I will remember again how Israel longed for the birth of its Messiah and I will savor the longing in my own heart for His return.

O come, O come, Emmanuel,
And ransom captive Israel,
That mourns in lonely exile here
Until the Son of God appear.

Rejoice! Rejoice!
Emmanuel shall come to thee, O Israel.


Total Whine

Jackie, my Zumba instructor, is taking a break. On Thursday, she announced she would continue the class until Thanksgiving and then take off the month of December. We all kind of nodded at this because it is the holidays after all and really busy. Then she said, “In January, I’ll decide if I’m going to continue the class or not.”

20121024-111016.jpgAwww! Really? But I love Zumba! All those Latin moves where I completely lose control of my hips. I mean, there are plenty of other Zumba classes but I like Jackie’s. Awwww.

When we pressed, she confided she’d lost some of her passion for Zumba. “I feel like I’m not giving you my best anymore. And that’s not fair to you.”

Awwww! That’s okay. Be unfair to us. We don’t mind, really!

But Jackie held firm. “We’ll see how I feel after the break.”

Crap. I’m not surprised really. Just two days ago, I said to myself, “Wonder how long this Zumba thing will last. Probably not too much longer because you like it so much.” It’s been that kind of a year.

I know, I know, all things come to an end. The things we despise, never fast enough and the things we love, all too soon. But Jackie’s Zumba class? It makes me sad. For me, yes, because I’ll have to get my Zumba on elsewhere, but more sad for Jackie who’s lost passion for something she’s totally loved.

Jackie is great. She’s near my age unlike every other Zumba instructor I’ve had who’s like ten. She’s short and cute with freckles and a thick chestnut mane that refuses to stay constrained by elastic band. She tries not to laugh when I completely mess up or lose balance but I see that twinkle in her eye as she quickly looks away. She was a cheerleader in high school and there’s a precision to her moves that I wish, wish, wish I had. Our taste in music is similar and she always tries to hunt down the “clean version”. And she doesn’t work us like we’re twenty-something’s, making us jump and squat until our knees freeze up and we hobble out to our cars all crab-legged. Still the routines are challenging and glucosamine has wheedled its way into my daily regimen. I miss her already.

20121024-124532.jpg (This is EXACTLY how I look with Zumba;-) ——————->>

Not to mention the location of her class is about 4 miles from my house, so really convenient. Waaaaaahhhh!

I know a few details of her life and like all of us, Jackie’s got stuff. A college-aged son living at home with no idea what to do with his life. A house that needs updating and repair and no money to do it. A job as a school teacher that’s not making her rich. An ex who still makes her eyes roll on the rare occasion she mentions him. Difficulty sleeping. A knee injury. Extra pounds that she can’t seem to lose.

Sigh. It wears you down sometimes. Life does.

Still to hear Jackie say she’s lost her passion is really sad and a little scary. Because I identify. The same thing is happening to me.

Earlier today I was whining (I know, hard to believe, right?) about my own depleted passion. My coworker said, “it’s just that time of year.” Probably a lot of truth there. The first three quarters wore me plum out. And now it’s dark by 6:30, the leaves are falling, it’s getting down in the 40’s at night. Soon the holidays will be upon us and —don’t hate me—I can barely stand them.

So many things I used to love, I just don’t anymore. And I don’t know why. A twinge of depression? Seasonal Affective Disorder?

The house, which Stan and I built, once brought me great joy. I spent hours pouring over House Beautiful and Southern Living, shopping for furniture and wall decor, selecting paint and fabric. Now it feels like a tremendous burden. I can’t keep up with the maintenance and I can’t stand watching it fall into disrepair. I spend hours googling “downtown loft apartments” and fantasizing about men in brown coveralls who have to fix whatever is broken because they are contractually bound by law.

Antique shopping and rummaging through other people’s junk used to be so much fun. I’d spend entire Saturdays going from store to store, searching for buried treasure. I’ve spent many an hour refinishing pieces on my screened porch. Ugh, the thought now gives me hives. Gardening, sigh, another lost passion. At one time, my backyard might have graced the cover of Better Homes and Gardens. Now it’s just a battlefield where I duke it out with the maples and crape myrtles which are totally taking over, replicating at an alarming rate — think Space Invaders who multiply when you shoot them.

If I psychoanalyze this dispassionate state, I can’t ignore the fact that antiquing and gardening are two of Mom’s favorite pastimes. So what part does our estrangement play? Have I lost interest because these activities remind me of her? Is this a form of disassociation? Or did I only once love these activities because she did and I wanted to please her?

That’s the problem with growing up as I did. Mom had a picture in her head of who she wanted her girls to be. She worked to fit us to that mold, punishing resistance and rewarding compliance. In the process, I lost myself. It’s hard to explain really. I want to be me—because everyone else is taken—but I’m not sure at times exactly who me is. Sometimes I look to Jerri to provide a clue. But when I see similarities between us, I still question whether its embedded in our DNA or its the way we were molded. Interestingly, Jerri has her own version of antiquing and gardening. Good Will and other thrift shops are her treasure trove and she is forever taking cuttings of plants, often without permission, and rooting them in pots in her apartment.

My biggest fear (ok, maybe not my biggest but it’s definitely in the top ten) is that I’ll wake up one morning to find I’ve lost interest in writing which on planet TrophyDaughter is equivalent to Jackie’s Zumba. It’s one of the few things that feels authentic, like its mine and mine alone, because no one else in my family does it or is even mildly interested.

So what are your thoughts on lost passion? Is it normal? Is it just that time of year? Have you experienced it? Have you figured out why


Down and Possibly Out of Durham

Having Jerri in my life has opened my eyes to a whole world of evil that I’d previously been able to pretend didn’t exist. Two weeks ago today, Stan and I took Jerri to buy a scooter. She’d found one for $750. We told her if she saved up half, we’d match it. For two months, she ate at the nearby shelter to save the $200 she normally spends on food for the scooter. She was so proud of herself for saving that money. “I’ve never saved up for anything in my whole life,” she told me. I was proud of her too. I was worried about the ultimate fate of the scooter, worried that she would tire of bringing it into her apartment after riding or that she’d get lazy and forget to put the lock on the tires when she left it in a parking lot and someone would steal it. But we talked about those things and she agreed she had to be vigilant. Ultimately, there are lessons in life that all of us have to experience for ourselves.

What I’d never even considered is that while she was stopped at an intersection waiting for cars to pass, someone would come up behind her, knock her off the scooter, and take it out from under her. That’s exactly what happened on Tuesday afternoon.

I drove over after the robbery to check on Jerri and talk with the police. One of her neighbors had given her a Klononpin to calm her down but Jerri has weird reactions to benzodiazepines and she came off as totally wasted. Its really frustrating to me that Jerri’s first reaction to anything difficult in life is to self-medicate.

While we waited for the police, Jerri said (slurry but no less sincere), “This is a terrible place to live. How can I ever better myself here? I can’t get a job without transportation. I can’t have transportation if anyone can just knock me off a scooter and take it. What am I supposed to do now, Terri? It was really hard saving up that money. I went without food for it. I don’t know if I can do it again. And he was so mean, Terri. He was so mean the way he took it from me and the things he said. How can people be so mean?”

It’s a honest question. I feel a little shell-shocked over the whole incident myself, like an incendiary device has just exploded in my face. I can not understand the pure evil that invades a person’s soul and justifies yanking a scooter out from under a tiny, skinny, white woman with mental illness who is obviously quite poor herself. It fills me with such rage that people can be so mean, so self-centered, so evil, that WE can be so unloving to each other. In my head, I’ve downplayed how dangerous a neighborhood Jerri lives in. I’ve driven around there in my Lexis, by myself, at twilight. I’ve told myself that these people are poor, that doesn’t mean they are evil. But there is a certain desperation that breeds in extreme poverty. One that discounts even the life of other human beings. One that says, I’m going to get mine by whatever means and the end will justify it. I’m reminded how far we have fallen from the world God originally intended.

Later in the week, I had the privilege of sitting next to a distinguished, older gentlemen on a flight back from Albany. He is 68, divorced, and an architect for a prestigious firm that is rebuilding downtown Durham. I was surprised by his age. He is dark-skinned and if I’d had to guess, I would have estimated 55. When I commented on this, he confided that he was quite frankly surprised to still be alive. Both of his parents died young; his father was in his thirties and his mother in her fifties. He saw everyday as a gift. His firm designed the Durham Bulls Park. He lives in a condominium downtown and loves what is happening in Durham. He has lived here since 1971. As we talked about the revitalization of downtown, I mentioned that there are still some areas that are quite dangerous like Liberty Street where my sister lives. His eyes widened and he said, “I have two grown children and I’ve always told them there are some places you never need to go. You just don’t. And Liberty Street is one of them.”

I called Catherina, Jerri’s case worker, and told her what happened. “We need to find Jerri a place to live in a safer neighborhood. She’s too vulnerable here. She’s too easy a target.”

“Well you know she’s on the waiting list for Stuart Heights. That’s actually the best place for her. The other places where she qualifies have had a lot of shootings. I don’t think we want to move her to a place where there are shootings.”

Duh. You think?

“I’ll check with one of my coworkers about other options. She really specializes in housing. Maybe there are some new options I don’t know about.”

In talking to Jerri about it, she raised Caramore as a possibility. The Caramore Community was an option I’d identified not long after Jerri moved to Durham. Its a structured program for people with mental illness which prepares them and transitions them back into the community. As part of the program, you work 30 hours a week, first for Caramore and then eventually you transition to a job in the community with an employer like Lowes, Target, or Whole Foods. When I first investigated Caramore, Jerri was not sold on the option. She was not sure she was physically able to work 30 hours a week. And she wasn’t that stable on her medications. But now the timing seems right. She is mentally and physically healthier than I’ve seen her in years. She has an interest in working. She’s concerned about losing her disability but Caramore has financial advisors that work with members to ensure that doesn’t happen.

Caramore is located in Carrboro about a half hour from Durham. Joining the program would get Jerri out her neighborhood as she would be living on the Caramore campus. Telecare has been an absolute lifesaver from the perspective of getting Jerri stable and keeping her from homelessness. But they seem to be not so great at transitioning their clients to independence. Caramore excels at that and is a logical next step in Jerri’s recovery. Caramore would become her mental health provider from a Medicaid perspective and since Medicaid won’t cover both, we’d have to leave Telecare behind.

So this week, instead of succumbing to depression and wrapping herself up into a tight cocoon of despair like she did when her laptop was stolen, Jerri called and asked me for the phone number for Caramore. She spoke with the Admissions Director and then called me back.

“Would you like a birthday present, Terri?”

“Sure, whatcha got for me?”

“An appointment at Caramore on your birthday at 10 am. Can you take me?”

Absolutely.


The Narrowing of Normal

Years ago I was on a work team with a colleague who, as it became increasingly apparent, was bipolar. During a manic phase, she promised a non-profit organization close to half a million dollars for a project which had yet to go through the corporate approval process. When the team business manager caught wind of it, she called our colleague on the carpet. “You can’t promise money for something that’s not approved. There are policies! There are SOPs! We don’t even know if half a million is fair market value!” The conversation escalated. There was a call with our manager. Our colleague refused to back down. She’d promised the money. She was going to deliver. We would find a way to make it happen or she would quit. In the end, that’s exactly what she did.

In the aftermath, there were a lot of closed door conversations between teammates about what the heck just happened. Dr. C. who’d once done a psychiatric residency, commented rather smugly, “She was clearly bipolar. But she’s not the only one on our team who’s not normal. I’ve got a diagnosis for every one of you.”

Hmm. Not exactly what I was hoping to get from my Secret Santa.

I’ve always thought I might be a little defective. How could I not be, given the murkiness of my gene pool? When Jeff, a therapist I saw after Jerri’s tumultuous arrival in Durham, asked me, “how did you manage to turn out so normal?”, I suspected sarcasm. Either that or he just wasn’t very good at his job.

Then today, while surfing, I stumbled upon this great news. It’s not just me. We may soon be living in a culture where very few people are free from psychological defect. According to this article at Psychology Today, the fate of normalcy hangs very much in the balance. With the increasing ability of technology to see us as we’ve never been seen before comes expanded diagnosis. Mental disorders are encroaching on more and more territory. The National Institute of Mental Health estimates that half of us will have a mental disorder in our lifetime.

I’m not too concerned about the fate of normal. I once told Bruce, a friend and colleague, that I was’t even sure there was such a thing. “Who gets to decide what’s normal anyway? Normal means common, typical, usual, standard. Who’s to say what is and isn’t? Maybe normal is just a myth. Maybe it doesn’t even exist.”

20120830-113811.jpg“Sure it does, Terri. Normal exists. It’s a town in Illinois. And guess who was born there?” He rocked both thumbs back toward his chest. “Yep, you got it. Poster boy for Normal here. Where. I. was. born.”

Okay. Maybe so, but I want to see the birth certificate.

The article goes on to say we’ve already narrowed the bounds of normal to the point that doctors are now “treating” personality traits which are normal but considered undesirable by the patient:

As Lane writes, “We’ve narrowed healthy behavior so dramatically that our quirks and eccentricities—the normal emotional range of adolescence and adulthood—have become problems we fear and expect drugs to fix.” Psychiatry’s critics also complain that doctors medicate patients who meet no diagnosis, who practice what I have dubbed “cosmetic psychopharmacology,” to move a person from one normal, but disfavored personality state, like humility and diffidence, to another normal, but rewarded state, like self-assertion.

This is a conversation I’ve had with my sister. “I neeeeeeed that medication,” she says. “Without it I can’t focus. My mind is constantly racing. Always thinking, thinking, thinking. And I can’t shut it off. When I don’t have THAT medicine, I have no interest in gaming. It’s not even fun. But when I take it, my mind quiets down and I can play games all day long.”

“My mind is always thinking too, Jerri. That’s normal. It’s what minds do.”

“Really?” She seems confused. “You think ALL the time? Your mind never shuts off?”

“Yep. And – news flash – I don’t enjoy gaming. I’ve never thought it was fun. It’s just not my thing. Maybe it’s not yours either.”

“Or maybe, you have a milder form of what I do. Maybe you’re bipolar too.”

And according to the article, she may be right.

Recently, I broached the whole self-medicating-to-change-who-you-really-are thing with my nail technician and she confessed to “trying” her son’s ADHD medication so she could “understand what he experiences when he takes it.” Uh huh. She said everything became so much sharper for her. She was able to understand things that had previously eluded her. She wondered if she, too, has ADHD. Her son said when he takes the medication, he can understand mathematical concepts that he can’t without it. He doesn’t take the medication all the time but he will ask for it when his class is studying a particularly difficult subject. She concluded by saying, “I’m glad he’s willing to do what he needs to in order to succeed.” This seems completely whacked-or is it just me?

The article goes on to say that because computers have the ability to identify varying degrees of severity for hundreds of factors associated with different diagnoses, we are likely approaching a future where we find we are all defective to one degree or another. So yay! We can all breath a collective sigh of relief. Pretty soon there will be nowhere to hide. We can all just stop pretending. We will soon be free to walk about the cabin as our crazy, wacky selves. Normal, as we know it, may soon cease to exist. If it ever did. Except in Illinois.