We can do better 

We humans constantly deceive ourselves with false ideas.  We trap ourselves with fabricated concepts about who we are and what we are supposed to be.  This existence we call “Life” is a great mystery that few of us consider exploring further than what our five senses allow us to .  

We complain of feeling depressed.  That’s simply our habit of focusing too much on the past that we regret. It is also our selfish way of thinking only about our perceived mysery which is masked by hopelessness.  We are basically trapped in our own living hell, refusing to look beyond ourselves. 

We miss the big picture . 

We complain of feeling anxious and nervous. That’s simply our habit of focusing  too much on an unfavorable  future which will never happen.  It is also our selfish way of thinking about our own perceived  vulnerability and limitations which is masked by helplessness and fear. It paralyzes us, so we make ourselves stagnated in our own ruminating thoughts.  We are basically trapped in our own living hell , refusing to look beyond ourselves. 

We miss the big picture. 

So we tend to create our own addictions to temporarily and superficially cope with the mysery. We become slaves of technology, slaves of substances , slaves of unhealthy relationships .  We fill our minds with more junk that come from the media, religion, and politics.  We dig a hole in the ground and stick our heads pretending we are okay when in reality we are drowning in our own created hell. 

We miss the big picture . 

But we have a choice. 

We can look beyond ourselves and start looking at the bigger picture.  We can start by accepting our mortality and be ok with it.  We can consider the fact that we are not alone in this existence and start helping each other instead . We can escape from our own selfish mysery. 

Donate . Volunteer .  Visit.  Assist.  Serve. 

Reach out to others in need and we will automatically be helping ourselves.  Like living cells that help each other to maintain the organism alive.  Our planet is the organism. 

When death comes, let’s mourn together. When hunger and disaster strike us, let’s assist each other . When blessings come, let’s celebrate together.  Let us embrace our humanness, including our  limitations along with our strengths. 

Not in our own selfish, individual mysery.  But collectively and selflessly in cooperation.  

Let us embrace our fellow human beings. 

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Category 5: a reminder of our fragile lives and the audacity of the federal government . 

The island of Puerto Rico where I was born and raised has suffered a severe storm catastrophe.. it has been almost destroyed. One hundred percent of its power was wiped out. There was no communication for days. We could not reach our loved ones in the island so we did not know if they were dead or alive. It has been one of the worst natural disasters for puertoricans in a century.

It just makes me think about how fragile human life is.  In a few hours everybody’s lives were dramatically changed. . A few people died and others were just left homeless .

Now people are struggling to survive in an island with no power , no water, and few resources .. Food is scarce and gas is limited.  And now the federal government is finally arriving and helping out… but it’s not enough .  The mayor of Puerto Rico’s capital, Mrs. Cruz, made it very clear that there are people who are dying and there is  not enough help from the federal government.

No way to go to hospitals or gas stations because there is not enough gas… can’t get gas because the gas stations are empty or have long lines.. can’t go to the grocery stores to get water and food because there is no gas in cars… can’t call anyone because there is no signal or internet… so on and so forth. 

And now the president of this “great nation” is saying that the mayor of San Juan has poor leadership skills, and that the people of Puerto Rico want ” everything to be done for them.”

Screw him! 

Now he is planning to travel to Puerto Rico this Tuesday.   To do what? Make a show and pretend he cares about the victims ? It’s all politics, and he should be politically incorrect ..  the government will spend too much money sending this clown and protecting him during this trip . This money should be spent helping the people of Puerto Rico.  

The mayor or San Juan said she is mad as hell… we should all be mad  as hell. 

Obsolete thinking

We are living in times when there is still communities and organizations that adopt a way of thinking that should be obsolete by now. Thinking and believing that one particular race is superior to others is simply ignorant and immature. 

These are individuals who cannot accept the fact that their way of thinking is already obsolete. Cannot accept the fact that we are finally realizing that we are one community under the description of simply “being human.”

We have been growing and becoming one community.  Those who resist and practice hatred continue to choose to live in their own premature and underdeveloped frame of mind.  They identify with the old way of thinking that is based on segregation , division, and discrimination.  It is simply a lazy way of describing our society.  It is trying to feel better about themselves by putting others down . Practicing hatred and discriminating is another way of bullying. 

Choosing to perceive one’s race , ethnicity , culture, and belief system as superior to others says a lot about our own insecurities.  It says that we are afraid. It says that there is something we don’t like about ourselves without admitting it .  It says that I cannot look at my own faults and shortcomings , so I’m going to focus on others instead who seem different than me and then attack them.  It is basically based on fear. 

But we can do better. We can live our lives, not based on fear, but based on acceptance and love.  We can live our lives accepting each other as mere human beings and learning to live as one community.  We can still do this and celebrate diversity.  A rainbow would not be a rainbow without its different colors .  A forest would not be a forest without its various kinds of plants, animals, and trees. Our bodies would not be a complete body without its different parts performing their own functions and still work harmoniously together . 

Let us unapologetically expose  the hatred , and then replace  it with acceptance and love . 

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.