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.

 

Life summarized 

This existence seems to be merely an awareness based on fabricated thoughts and individualized perceptions we call “reality” that dictates most of our behaviors.  This overall existence called “life” is mostly preferred over the notion of “death” because we usually don’t want to acknowledge the inevitable end of this perceived existence.

We choose what we believe, many times without realizing it, and continue our existence as if what we believe is an ultimate truth.   We deceive ourselves with fantasies and illusions that nourish our egos and makes us feel secure and important… but it is all an attempt to distract us from our destiny: death.

We tend to want to belong to some kind of group and community , creating societies, in order to feel secured and protected (trying to recreate the experience inside the womb).   But we often fail to realize and accept the fact that we are simply deceiving ourselves.  Unconsciously afraid of facing the reality of our mortality.

And because of this profound fear, we continue our journey of biased perceptions attempting to maintain a state of awareness we call “happiness”, not realizing that it depends solely on circumstances that we choose to cherish.

This existence is slowly decaying and shutting down.  This awareness will eventually cease to be present and we will  not even know it has happened.  All we can be aware of is what is experienced at the present moment.  Right now.

Think about it.

 

 

 

Dissecting reality

dissection_tools1

We create our own worlds in our minds… We create images and ideas in our minds, which creates our realities.   .. When we like someone, it is not the person itself but the idea that we have of the person that we like. When we go through some difficult situation, it is the interpretation or the idea of the situation that we dislike. Everything we experience is through our interpretations, our ideas.  So I have learned to break down my ideas and images. So I have started to dissect what we call “reality.”

I see people driving down the road in high speed, and my first instinct reaction is to get mad at them.   But then I ask, why am I choosing to be mad?  What thoughts and perceptions do I have about people driving fast that are triggering the anger?  Then I find no good reason to feel anything, except to be cautious.

Then I have a disagreement with my spouse, and she withdraws.  I also isolate myself in rebellion.   I automatically feel upset and nervous, but then I question the reason why I feel so anxious.  What am I afraid of?   Argument?  Separation?  Being alone?

The next day I may be at work and trying to meet a deadline.  I feel anxious that I may not do the job on time.  Then I stop myself and rethink.  I take a deep breath.  I dispute the reason why I may be feeling anxious.  What is the worst that could happen?  Is there a need to feel this anxious?

I look back at all the things I have learned to take for granted.  I have taken a second look at all the things I thought were simply “normal” and “acceptable”.  And I start questioning them.

Assumptions.  Beliefs.  Customs.  Expectations.  Discriminations.   Family traditions.  Habits.  Ideologies.  Myths.  Obsessions.  Religions.   Social rituals.  Values.  World views.

They all can be taken apart… dissected.   They all can be questioned and dismissed.  We don’t have to adopt any of them if we don’t really want to.

They are all in our minds.

They all can be dissected.

 

A day at work

imageHere I am. Just coming out of a counseling session with a client who is feeling depressed and physically tired and sick.  He lost both of his legs due to diabetes and he has no hope for the future .. He used to be a great man, he used to educate  other people about history and writing.  But now he does not have any hopes of doing any of that again ..  He is afraid of dying .

Yesterday I saw another client with schizophrenia. His apartment looks like a total disaster , but he is content with his chaotic life.  It is his norm.

The other day  I saw a woman with PTSD with psychotic features.  The voices tell her to cut herself but she tries to ignore them .  She says it is not easy to ignore.  She tries meditation and walking to cope .  But she has been abused and threatened so much in the past that it has become part of her life to be anxious all the time .

I hear all the stories when I go visit the clients that I see. I feel bad at the moment but as soon as I leave,  I go back to my routine. I go back to my own life with my own problems.  Because if I don’t temporarily leave it behind, I may not have a life of my own.

And the next day I do it all over again.

Guys, would you feel embarrassed buying feminine products for your ladies?

The other day, my wife texted and asked me if I would feel embarrassed to buy feminine products for her at the grocery store. I thought about it for a second and then responded  by texting that I would not mind.  I never buy  this kind of stuff for her, but if she needed it, then I would buy it with no problem.   So she texted me back with a smiling face with loving hearts.
In another time, I think I would feel embarrassed, but after being married for so many years, I don’t have that much “insecurity” anymore. I would feel worse if I am in an isle in front of birth control products or in a book store looking at books about intimate relationships or romance.
I wonder, do other guys feel embarrassed if they are asked to buy feminine products? And if they do, what is the source of their embarrassment? What about  holding the ladies’ purse while they use the public restroom?   If we guys are sure of who we are and what we are, why do we sometimes worry about what other people think?

Any thoughts…?

Sick of being Sick

 

I have bimageeen fighting something nasty for the last three days.. First I thought it was allergies.  Then I started getting chills at night.  And now  I’m just feeling like I am in a fog.   I take all kinds of medication.. They don’t seem to help much.

But I shouldn’t complain… A few days ago another one of  my uncles passed away (I have three gone already ).  I was not close to him at all, but my father was.   I just spoke with my father about him.   He said “he was younger than me,  yet he was gone first.”

I cannot help to think of the day that my father passes too.  I have been trying to accept it without getting too emotional.   But the day will come… it is inevitable.  And so will be the day that I am gone and every family member that I know … Because we’re not eternal.

So,  sick or not,  I will simply live this day.   Without complaining.  I may recover tomorrow.  Who knows?

What do you think?

 

Excuse my French

I have been thinking about this lately.

When you are going to curse and you say : “Excuse my French” prior to cursing, that means you can actually STOP yourself from cursing.

But if it slips your mouth and you curse first, then it makes more sense to excuse yourself afterwards.     I suggest you don’t say “excuse my French ” and then curse .   Because if you can pause to excuse yourself, you might as well take the opportunity to change how you choose your words.

Here is an idea: If you are going to excuse yourself first, just don’t curse at all.