Things we accept but, if we really think about it, are actually unethical and wrong

Killing people during war ( and glorifying war ) .
Killing animals for food.

 
Listening to music that condone unsafe sex. 

Telling others what they should wear and eat through advertising . 
Allowing children to watch TV or use other electronics more than engaging in healthy activities.
Killing unborn babies through abortions .

Voting for a candidate simply because they say they represent the political party of your choice .

Killing animals for sports , as in hunting . 

Telling people what they should believe in, such as in religion.

Buying things we don’t need when poor people a few miles away have nothing to eat tonight. 

Spending time on the internet more than we spend (real) time with family members and friends. 

Denying health care because of lack of health insurance. 

Continuing to pollute the air when there is available alternative ways of creating energy. 

Spending money to support big companies (through binge shopping) instead of giving money to charity organizations and the poor. 

Can you add to the list? 

Feeling Bad

I have been feeling bad lately.  Let me explain.

I work as a supervisor in a mental health program.   I manage other clinicians, nurses, and psychiatrist who serve people with severe mental illness.  It is a stressful job by itself and involves a lot of therapy, case management, medical follow up, consultation, traveling, etc.  It is a job that not anybody can withstand or even consider taking, because it is not a typical mental health facility.   The program is based on the PACT model (Programs of Assertive Community Treatment) and it involves intensive psychiatric and rehabilitation services , similar to what clients receive in psychiatric hospitals, but in the community.  So you can imagine the amount or work and tension that we often experience in trying to help individuals with paranoia, delusions, disorganized thinking, and poor social skills remain living in their homes.   Even though I may be describing it as a difficult job, it is very self rewarding.  We are actually helping people stay away from institutions and jails simply because of the severity of their illness.  We are helping them live normal lives like the rest of us.

But I recently started feeling really bad about my job because of the way the company sometimes treats our staff.   They are not usually paid the salary that other facilities and hospitals in the community pay their clinical staff, plus they started hiring more bachelor levels so that the  cost of hiring people would be less.  So the competition has been an uphill battle which results in a high turn over rate.

Since I started working for this PACT program in 2011, we have had two full time doctors, and recently two part times.  The two part time psychiatrists  shared the case load of a total of 101 clients.  The last two psychiatrists were working under a contract  instead of being regular employees.  But unfortunately , one of the two part time doctors decided to move out of the state for a better paying job (its usually  because of the money) and we found ourselves planning to have one part time doctor cover  while starting to recruit for another doctor to take over the other half of the caseload.   The situation became more complicated when the company advertised the position and found a candidate who was willing to work full time instead, as a regular employee.  Having a full time practitioner is what the PACT model is based on primarily and it facilitates the overall function of the program.    So needless to say, the company had to make the difficult decision to “get rid of the part time psychiatrist” so that we can officially hire the new full time practitioner (who happens to be an ARNP who can do the same type of job as a psychiatrist).   Of course, letting the remaining part time psychiatrist know was the hard pill to swallow.  Not to mention informing the clients (once again) that their psychiatrist was resigning and they were going to be seen by a different practitioner.   Our clients who all suffer from a severe and persistent mental illness, are already marked by difficult times in their lives, and change is one of the most difficult experience which can exacerbate their symptoms.

The CEO of the company is the one who negotiates with psychiatrists and makes the final decisions about which psychiatrist to hire.  My supervisor and I interviewed the new candidate and we liked her, but the CEO was the one making the decision about moving  forward with her, meaning that the part time psychiatrist who was still working with us had to go.   Part of me said we were doing the wrong thing… that we should’ve looked for a another part time psychiatrist so that we wouldn’t have to lose the one we already had.  I was informed that the CEO would then speak with the part time psychiatrist about our plans, which I was glad I did not have to do, although I wished we could have done something different so that we can keep the part time psychiatrist.  But that was not my decision to make.

To make matters worse, last week, the part time psychiatrist approached me and asked me about what the company was planning to do with her if they find a full time practitioner.  I was dumbfounded and caught off guard, not knowing what to say at the moment.  I thought that the CEO had spoken with her about his decision already,  but it turned out he had not informed her yet.  So I had to tell her the truth at that moment, I don’t believe in lying or hiding things from people, especially staff people who work with me.   But I also told her that the CEO should be speaking with her about the matter in more details soon.  So, understandably, the part time psychiatrist seemed upset and said she will just resign.

I felt as big as an ant.

Here we are, literally getting rid of a part time person, a human being with a family to feed and a career to keep, so that we can replace her with a full time person who will take her place to “serve our clients.”  The company has a budget to keep, so having one full time psychiatrist was more financially convenient.   I understand the technicality and the business part of the reason why we need to make this decision.  But the human side of the matter sucks.

So I feel bad.  I feel we made a mistake.  I wish I could have done something different and prevent having to get rid of the part time psychiatrist.  I wish the CEO would have contacted the part time psychiatrist early and offer her to stay with maybe less hours, but still stay working with us along with the full time ARNP.

But it is too late now.  She decided to suddenly resign , sooner than what the contract mandates.  I can understand her anger and frustration. I also understand the need to have a full time practitioner who also has more flexibility with traveling and visiting our clients.

So I am split in half, feeling glad that we found a full time practitioner soon;  but still feeling bad that we lost a very good psychiatrist and made her upset in the process.

At the end of the day, the ones suffering the most are our clients, who will have to face another change of providers.  And most likely run the risk of  increasing their symptoms of mental illness because of this transition they are forced to face.

It’s hard being a supervisor sometimes.

 

Identifying with the Self: Part Two 

 I had a counseling session with one of my clients.  She is a cutter and was questioning whether or not she would be getting any better in her life.  She was comparing herself with others who also receive therapy and who seem to be getting better faster. My client thought she was not improving like she should and asked about the concept of PTSD and resistance to treatment.

I try to explain to her that PTSD involves living in the past after a traumatic experience… versus learning from the past without necessarily reliving the past.  When we experience PTSD , we tend get stuck in the past and not move forward.  When the pain is avoided then we continue to experience PTSD and continue to relive the past and experience an emotional cycle which is nourished by substance-abuse, self harming behavior, and depression.

On the other hand, when we learn about the past, we develop new skills and we develop new ways to cope with the upsetting memories.  One of the ways is to talk about it, process feelings, write about it, and accept the fact that the pain was done.   When we choose to develop new skills and process feelings by accepting the pain, then we begging to acknowledge that it was a difficult time in our life and be able to move forward with new skills.

And then there was the question of why she is still cutting when she’s in her 50s now, when most of the cutters are either teenagers or young adults.

Then a lightbulb turned on in my head. I asked my client who she would identify as and she could not answer the question.  She first said “I’m already in my 50s why am I asking this question now? ” Then I asked her to not think about her current age but to focus on the question itself : who am I?

The observation that most cutters are teenagers or young adults gave me the idea that, since she has always been dependent on others to tolerate her who she is and what to do with my life, that sounds almost like what teenagers and young adults do in the early lives.

Basically my client is experiencing what most teenagers and young adults experience : finding their identities in life, facing the unknown after depending on the parents.  My client said she always depended on her parents and she was taking care of and nourished as a child even during her adulthood.  This can explain why she has difficulty identifying who she is now in her 50s. I explained that most of us experience the same identity crisis in different times of our lives. Most of us identify with what we have been assigned to be, for example our names, our ethnicity, our gender, and our religion. But we ultimately face a time in life, usually during young adulthood, where we start questioning  our assigned entities and find our own identities. And maybe that’s what my client is experiencing at the present moment.

Like I mentioned in my previous post, we mostly live inside our heads. Inside our thoughts and perceptions. We rarely get out of our thoughts and face reality. We don’t usually live in the present moment.  But we rather stay living inside our heads.  Inside our minds. But we rarely step aside and start perceiving ourselves as we really are.

Have the rest of us done the same thing in our lives?  Have we taken the bold step of “peeling the onion” all the way until we find our true selves?

In my own experience , that “true self” remains a mystery.  It remains a great part of the unknown, which is why I tend to ignore it and replace it with all the entities I have been taught to identify with.

I have learned to identify with being a Hispanic middle age male, an American, a mental health professional, a  Florida resident, a parent, a husband, a son, and many other entities.  All of these I can question and deny if I choose to.  What I have not identified with as much is what can never question or deny.

My true self.

But what is the true self?  Is it simply being human? Being a person? After all, isn’t that what we all have in common? Identifying with being Human beings ? Anything else could be used to separate and segregate us.  But being humans could only keep us united.

Identifying with the self

What makes us who we are? How do we determine our personalities ? Does the self even exist ?

Identifying with the “self” is what determines our feelings and perceptions. If I identify with the concept of being a “husband” , and my wife leaves me, then I would feel distraught..   If I identify with the concept of being a “professional” -and somehow I lose my professional license , I would feel ashamed and sad.  If I identify with the idea of being an “American citizen” and a terrorist attach occurs in my country, I would feel anger and rebellious.  But only if I choose to identify myself with these entities.  But do these entities really exist ?

It’s like living a comic strip where the bubbles above our heads are our thoughts and perceptions which we believe to be true … and which we choose to identify with.  

I read a quote the other day that said:

“As soon as we are born, we are assigned a name , a nationality, a religion, a race , a sports team. We will spend the rest of our lives defending a false identity.”

This is so true.  We are given several identities , simply because we feel that we need to belong to a certain organization or group so that we don’t feel vulnerable .  We need to think that we are part of a whole so that we are not alone. So that we can distract ourselves from the inevitable destiny we call “death.” We decide to continue to live an illusion that keeps us in a dream like state and prevents us from experiencing confusion and chaos.

But we can’t escape it forever. We will eventually realize and accept the fact that our various identities ; our numerous fictitious entities that we desperately try to defend and justify, are meaningless and useless when we are facing our final days.

It bothers us when things end because  we don’t like to admit our mortality.  We feel  sad  when a vacation ends … We feel disappointed  when our favorite sport team loses.  We often experience sadness when a loved one moves away or decides not to be our friend anymore.  We rather want  the pleasurable experience to go on.  It is like going to the theatre and enjoying a movie even if it’s fictitious, and we don’t want the movie to end because that would mean exiting  the theatre and facing reality again.  We rather stay inside and continue to enjoy the fictitious movie. We prefer  to pretend to be immortal and prevent having to face the reality of our existence.

We prefer to stay inside the “womb” which keeps us warm and comfortable.

But the closer we get to our inevitable death, the more meaningless all the fictitious fabricated identities become.  And the more we are forced to accept our true identities.

Going back to the “bubbles” above our heads, which represents our thoughts, can illustrate how we live our lives. We mostly live inside our heads.  Inside our thoughts and perceptions. We rarely get out of our thoughts and face reality.  We don’t usually live in the present moment.

But we need to, if we want to live this life more fully.

And the question remains : what is outside of our heads? What is this so called “reality”? What would we be facing when we live in the present moment ?

Peace.  Serenity.   Freedom.  Acceptance.

I will continue on this topic at a later post .

Something as simple

Something as simple as doing laundry for a poor man 

can make a big impact on his life. 

Something as simple as delivering food to a hungry person

can make them feel rich again. 

Something as simple as accompanying a lady during her grief

 can make her feel whole again. 

Something as simple as helping clean up their apartment 

can make a sick person feel like they are in heaven. 

It’s the simple things we do out of true care and concern that can make a great difference in people’s lives. 

I am thankful for experiencing this almost everyday. 

English only?

So what if people don’t speak English while in the United States?  Would that make them less welcoming and not deserving to live in this country?   I have a big problem with people glorifying aspects of their culture, specifically the dominant language.   If you have seen my recent posts, you probably noticed how disturbed I feel with all the political propaganda that regards the United States as exceptional and unique.  I must say, United States is not exceptional (and the US is not the only “America” either).  I recognize that this statement may offend some readers.  But the simple fact that I am posting this post should indicate that I don’t care if people choose to feel offended. Please click the following links regarding discussions about a candidate speaking a language other than English in the political arena:

http://www.cnn.com/2015/09/06/politics/sarah-palin-diversity-spanish/index.html

http://www.cnn.com/2015/09/02/politics/donald-trump-jeb-bush-spanish/

I assume that those who hold an egotistical and superior image about their “American” culture would probably agree with these discussions.  They probably agree with the statement that English is  “kind of a unifying aspect of the nation …. that is understood by all.” The language that is understood by all is not a specific uttered speech, but the meaning behind it, such as love and compassion.   For example, should Bibles be written only in English for it to be effective in sending a message in the United States?  Is English the only language that would make every family functional?  Yes, it is the dominant language and it is a great asset when looking for a job… but it is not the only language.

What really unifies a nation is a common goal for peace, improved economy, equality, and affordable insurance. Not a language.

Why are some people so afraid of accepting the diversity that makes this country truly great?

We Have Failed

What are we?  Are we humans… ?  Or are we blood thirsty animals who fight each other, while some of us turn our backs and pretend it is not our concern and, therefore, somebody else’s fault?  When I saw the images of migrants trying to escape wars for a better life; images of families with children; and most of them dying in land and sea; my heart broke into pieces.  People fleeing war, poverty, political repression, trudging over deserts and back roads, with only the clothes on their backs; packed into stadiums, boats, detention centers; arriving exhausted, or dead, on Mediterranean shores.

When I saw the picture of the toddler’s lifeless body on the shore, my heart simply shattered.   The following videos illustrate it better than I can:

Crisis in Syria

Toddler dies and his father mourns

And here we are in the United States arguing about whether to let immigrants cross our borders illegally or not.  Not exactly the same scenario, but similar goals for a better life.  Are some of them criminals who come to break the laws?  Yes they are.   But we have to be careful and not let the evil intentions of some people  dictate our overall attitude of the majority who are simply trying to find a better way of life.  It is easy to label and categorize a whole group of people.  It is easy to simply put a label on them to justify our comfortable lives.

We fail terribly to choose to perceive ourselves as human beings.  We have failed to treat each other as we would like to be treated.  Instead, we prefer to have a narrow mind set and focus only on that which is convenient for us.

As a human race, we have failed.  We have yet to learn to look at humanity as a whole, and start to look at each other as fellow human beings.  It feels as if this world has not done enough to make a significant change.  There is a lot more to learn.

Like the father of the dead toddler said “I don’t want anything else from this world.”