Tuesday, August 26, 2014

The Ache

The Ache,
When it intrudes,
Is watermelon-sized,
Like a third lung in the chest,
Pressing everything else out of place;
Heart pushed back,
Tears pushed up,
Soul pushed down.

The Ache,
When it intrudes,
Makes announcements, at strange times,
Like television commercials,
Drowning out meaningful conversation,
Tarantino of dreams
Shyamalan of visions
Steven King of memories.

The Ache,
When it intrudes,
Weighs in at twice bodyweight,
Like instant obesity,
With a sweat-sheen of shame,
Knees buckling,
Lungs laboring,
Back hunching.

Oh unwelcomed intruder,
You are invited,
To leave,
And relocate,
Into the sea,
Into space,
Into Hell where you belong

This space is reserved for the One,
Who lived pre-Ache
And outlives all Aches
And redeems the mess you made
With soothing mercy balm
To the soresoul
To the worrysoul
To the hopesoul

Monday, August 25, 2014

Psalm For Home

We are all tender inside;
Wounds so slow to heal;
Places so easy to wound;
We can get so afraid,
Because it can hurt so bad
Just to be touched

We wonder why flesh covers bone,
And not the other way around;
We fight like warriors,
But we are built to play and dance -
Like children

Don't touch:
Too hot,
Too cold,
Too strong,
Too - This place is just too

Shaken from:
The storm,
The quake,
The war,
The abuse,
The dismissal,
The neglect,
The forgottenness,
The sting after sting after sting after sting - they just keep stinging,

To stop the shock - get stuck one more time.

Were we even meant for this place?
A parody of home,
A caricature of home -
This is bizarro home!
With cracked mirrors that lie,
And full of things that die,
How are ever going to get some rest?

I want to sing a song
And walk through the melody
That opens the door home
Close my eyes
And harmonize
With a song I know from home

I'll just sing til I'm there
Let's just sing our way there
We'll join a song already going
And it will carry us home
The Spiritsong in our voice
And we are home

Sunday, August 17, 2014

Blue Thief Walks

Hung jury -
The Blue Thief free -  
To kill, to steal, and to destroy,
Creative souls, 
Delicate hearts, 
Lives saturated in potential.

"Blame the dead!"
They chant at the intersection of
Ignorance and Pomposity, 
Like billionaires comment on slums,
Like Iowans speak of the ocean,
Like the history of Winter in Maui

Compelled to debate, 
While the Blue Thief walks
Into more lives, 
Like fog rolls in obscuring sight,
Like mildew creeps in souring the soul,
Like allergens debilitate with so much sneezing - 
As life is slowly extracted,
From the body,
Such that the body alone remains, 
Compelled to debate;
Missing the point.

"Who killed the clown?"
Says the Blue Thief, 
"The search for the real killer continues,"
Says the Blue Thief, 
As though his murders are not staged. 

Saturday, August 16, 2014

Community Engagement: Marriage and Family Therapy Has Left The Office

Marriage and Family Therapists are trained as systems thinkers. What this means is that when an individual presents with symptoms of depression or anxiety, the family and social context of the individual is considered to be at least as important as the thoughts, feelings or biological factors at play. In short, MFTs view the individual through the context in which they are situated.

To push the idea of systems even further, the MFT views the social system as the client, not a collection of clients. MFTs treat families in which someone bears the symptom of depression as opposed to an individual with depressive symptom that also happens to have a family. Context is everything for MFTs.

But what would happen if MFTs engaged on a level one step up from the family system? What if MFTs entered the system at the community level? What does MFT work look like at the community level?

Well, the good news is that it is happening already and it is happening more and more frequently. Here is what I mean: Traditionally when a family comes in with a child with school problems, MFTs think of the family taking their position relative to the school system. That is excellent. But now MFTs are engaging at the school level seeking to help develop systemic processes in the school to help families. When a family comes to therapy because their child is not complying with his diabetes regime we consider the medical community - and that is awesome. But now MFTs are developing ways to collaborate with medical professionals to help families to work in the context of other families with the similar challenges to build supportive communities of families. Healing happens better in community.

As mental health professionals trained in systems thinking, MFTs are taking lead in creative ways to engage at the community level for the benefit of individuals, couples, families, and the overall health of the community.

It is now more common than ever for an MFTs to engage with:

  • Hospitals, medical centers, and clinics
  • Public and privates schools, homeschool co-ops, and school districts
  • Non-profits, service organizations, and agencies that serve specific populations or needs
  • International NGOs, mission groups, and relief organizations
  • Religious congregations, parachurch organizations, and faith-based agencies
  • Neighborhoods and community associations
I am so eager to see the creative collaborations that the new MFTs will develop in the next decade. I believe that the MFTs being trained today are going to be the most creative and innovative MFTs since Minuchin and Whitacker. 

I am excited about the MFT students in the Lipscomb University masters program and the community engagement projects they will develop this Fall. It is going to be a joy to see what they invent and an even greater joy to see them get out in the community and deliver. 

Friday, August 15, 2014

Kenya: Safari

One of the cool things we did while we were in Kenya was to go on a safari with the whole group. It was amazing. We saw some of the most beautiful and majestic creatures that roam the earth. Seeing this giraffe so close was a  treat. So tall, it felt like Jurassic Park. 
We saw this cheetah eating a wildebeest. Just missed the kill. It was kind of incredible and kind of nasty. 

This elephant was the first of the creature we saw. It charged a little bit at us and the van driver's hit reverse faster than I have ever seen someone put a vehicle into reverse. 

This zebra and wildebeest represent the, oh, million or so of them during the migration. Wildebeest and zebra as far as the eye can see. 

 We imagined that God was looking down on us - right through the clouds.

This giraffe pair was so beautiful

 There were crocs down by the river. Made me think of Steve Irwin.
 And then there was this guy, a secretary bird - I think
Hippos are so big. There were probably 100 of them down in the river and the shore. And how can you not say, "put a bird on it?"
 And seeing over a dozen lions was pretty cool. Seeing this one walking about and not sleeping was great.

Mork, Mr. Keating, Patch and Me

I was 8 years when Robin Williams first made me laugh. His appearance on Happy Days as Mork from Ork spoke deeply to my third grade sense of humor and gave me a whole lot of joy. Since then, he has delivered the gift of laughter to me and millions of others in consistent and generous portions. What is more is that he punctuated the stream of hilarity with poignant and compelling roles in such films Dead Poets’ Society and Good Will Hunting. Every age I have been since my introduction to Mork, Robin Williams has provided meaningful and life-giving experiences. There is a part of who I am now that would never have been given space to develop without this man. His life’s work was replete with messages that opened up parts of me.  

His final message breaks my heart. The heart of the 8 year old boy in me breaks because that little boy still wants to hear about the zany culture on the planet Ork.
The teenage young man in my still wants the courage to stand up and say, “Oh captain! My captain!” The 20 something man in me, who is sorting out his past, still wants to cry and be held and be told that it’s not my fault. There is a health professional in me that needs Patch Adams to remind me that we treat patients more than we treat diseases and disorders and of how laughter is so healing.

As a mental health professional and educator, I also see the death of Robin Williams through the lens of depression. Williams, like millions of others, did not sit down one day and make a choice that he would like to wrestle with depression, but rather it rolled in like dense fog obscuring his psychological clarity or perhaps slowly crept in like black mold infecting him and his ability to psychologically breathe. Depression is an insidious experience that no one chooses. Sometimes it goes away all on its own like a common cold, but sometimes it is psychological Ebola that requires immediate, intense, and sustained intervention or else it is fatal. The problem is that there is no way to know on the front end whether it will heal on its own or will progress toward death.

Depression is always a serious situation. It always deserves meaningful and professional attention. The death of Robin Williams has further reinforced within me how important it is for people with symptoms of depression to go and get those symptoms checked out with a mental health professional. Getting symptoms of depression checked out by a mental health professional is no different than getting an x-ray on your arm to check for a break after an injury. It is just a smart thing to do. 

“I Am Depressed”

“I am depressed.” I have heard it so many times. You probably have heard it too. It is possible that you have even said it yourself. I know that I have. When someone is feeling down, having a bad day, has experienced a serious loss, or is having significant symptoms of depression, “I am depressed,” is often the way their emotional state is described.

I don’t like it – the language that is. The language that has become the most common way to talk about the problem called depression is also a personal identity statement. This is not good.

Think about it – people fighting cancer do not say, “I am cancer.” People who have the flu do not say, “I am flu.” And yet, the most common way to communicate a struggle with depression is to make an identity statement – “I am depressed.”

So, what’s the big deal? Who cares how a person articulates their experience? Isn’t this just a nit-picky thing for academics to argue about as they try to sound important enough to justify their position?
Well, as it turns out,  it matters quite a bit. Here is why:

Objectification. When a person says, “I am depressed,” they are making a self-objectifying statement. Objectification is treating a person like a thing, and it is corrosive to the soul. No person is the problem that they are dealing with, and yet that is what “I am depressed” is communicating and reinforcing. Furthermore, When the rest of us allow depression and identity to be synonymous, we participate in the objectification. People deal with problems, but people are not problems.

Dangerous. When people say, “I am depressed,” they are making no distinction between the problem they are dealing with and who they are. When there is no distinction between a person and the problem the only way to get rid of the problem is to get rid of the person. WHOA! This just got real. When the problem is as insidious as depression and people identify themselves as the problem, it can seem logically impossible to get rid of the problem without harming the self. With depression increasing the risk of suicide, this is no small matter.

Externalizing is healing. When we are able use language that makes a distinction between depression and the person, the problem can be externalized. When depression can be understood as something other than the self and instead something that happens to us, that ambushes us, that pays us unwelcomed visits, the problem can be resisted without damaging oneself. Many people experience some relief with the simple distinction that they are not the problem.

Just changing the way we communicate about depression, and mental health issues of all kinds, can help bring some relief. Changing how we communicate about mental health is a way that all of us can be part of a supportive social system for people struggling with depression. It is certainly not the cure, but it can contribute to a cure, it can be a first step to a cure. 

Wednesday, August 13, 2014

Suicide Narratives That Fail To Help

The tragic death of Robin Williams has caused quite a bit of conversation about depression and suicide. The topic is difficult enough to discuss all on its own, but in the midst of shock and grief over someone so loved as Robin Williams, the conversation becomes even more challenging – and even more salient.

There are social narratives of depression and suicide that inform, challenge or reinforce existing beliefs and ideas people have concerning these topics. Some of the narratives are accurate and useful while other narratives are riddled with flaws and are not the least bit constructive. Here are four narrative about depression and/or suicide that do not help.

The Freedom Narrative.  One of the suicide narratives that is difficult to handle is the freedom narrative. The Academy decided the go this route. We all love the genie metaphor and the iconic voice work Robin Williams did in Aladdin. The image below is awesome and memorable. The play on words is clever. However, the assumptions supporting the message are troubling.

The Freedom Narrative is meant to be generous and liberating, but what appears to be a message meant for the one who died is really an attempt for those of us remaining to be soothed – and in some way let off the hook for the tragedy. Of course is it not my fault Rabin Williams is dead, but at the same time I feel terrible about it and wish it did not happen. The Freedom Narrative is an attempt to gloss over the tragedy without responsibility.

But if the embedded selfishness in the Freedom Narrative of suicide were not enough of a problem, the message it gives to those who are on the brink is worse. People contemplating taking their own life are in such a dark and pained place that they are looking for a meaningful end to the pain and suffering. None of these people desires to take their own life, but when every other option appears to be a dead end, then taking the dead end option makes sense. The Freedom Narrative allows for the literal dead end option to appear far more reasonable than it is.

The Choice Narrative. Another suicide narrative that is seriously flawed in its failure of depth is the Choice Narrative. Matt Walsh has espoused this narrative and aggressively defended it on his blog. The Choice Narrative functions in many ways (ironically) as the opposite of the Freedom Narrative. The Choice Narrative assigns complete and total responsibility for the death of the individual on the individual and only the individual – without exception.

This is a flawed and risky blame-the-victim narrative that serves to absolve everyone from any responsibility, as though people just end their lives out of context. Only through the myopic lens of hyper-individualism does such a narrative begin to make any sense.

Walsh seems too understand that the effects of suicide are contextual in that people who knew and cared about the person who died are hurt, but fails completely too understand how context can contribute to the suicide itself.

He makes the same mistake many people do when trying to make sense of something so tragic – going to the single story. Suicide is NEVER a single story of a person who takes their own life. There is ALWAYS a complex interplays of biological, psychological, social, and spiritual factors with each suicide. Suicide is not the problem in and of itself, it is the horrific symptom of a complex systemic function and dysfunction on all levels.

To say that it suicide “is a choice – end of discussion” fails to address the issue. It is a gloss over just as much as the Freedom narrative. The Choice Narrative:
  • Is not a thoughtful or accurate understanding of suicide
  • Leaves people unnecessarily absolved or hurting even more
  • Does not prevent future suicides
  • Hurts others in its self-righteous disposition
  • Fails completely to demonstrate empathy for the hurting people who live with the aftermath
  • Increases the risk of suicide because people on the verge are only discouraged by the necessary social distance that the embedded blame causes
The Spiritual Narrative. The Spiritual Narrative is probably the most disturbing to me since I am Christian who holds his faith as more important than anything. I should start by saying that this is not about theology, but about BAD THEOLOGY.

Spirituality, religion, and faith can serve as protective factors against depression and suicide, but there is no evidence that a deep faith, regardless of the religion or spiritual bent, is an impenetrable psychological dome of mental health perfection. People of faith fight depression. In fact, Jeremiah the Old Testament prophet would most likely have been diagnosed with Major Depressive Disorder. Did God judge him for having no faith? Nope. Did God just heal Jeremiah’s depression because he was a believer? Nope. He did find Jeremiah a good follower just as he was. Depression did not disqualify him from service. In fact, there were times when it drove him toward a deep and meaningful outpouring of pain that people can identify with.

Another sliver of the Spiritual Narrative is that suicide is a one way ticket to Hell. This perspective is completely unsupportable and is rooted in a theology that is void of the grace and generosity of the God of the Bible and the Jesus found in the new testament. No, of course God does not desire suicide, but what kind of God sends someone to Hell forever just after that person has already been through Hell on Earth?
It is a contempt of scripture to use it for the blaming or damning of people who suffer from depression and end up taking their own life.

The Disease Narrative. This is one of the perspectives I hear from people in my field – mental health practitioners. I have a problem with the word disease in this context. The reason I have a problem with the word is that due to its connotation, it does a few unintended things that are not helpful at all.

For many people, the word “disease” is reserved for infections that are bacterial, viral, or fungal in nature or a process that is in their minds tangible, like heart disease. When the word “disease” is used to describe something that looks like a “behavior,” the word become unhelpful. For example, addiction as disease makes no sense because there is an observable behavior that appears to be synonymous with the diagnosis. Thus, when the word “disease” is used and there is not an infection or condition that can be identified AND there is an identifiable behavior that is present, the whole conversation about the problem gets dismissed and people get polarized talking about the definition of the problem, but not the problem.

For others the term disease is debilitating. If something is a disease it means that it is beyond their capacity to resolve it. For some people there is a debilitating permanence connected to the term and thus makes treatment seem like a meaningless waste of time and energy.

Finally, it seems like the term “disease” is used as push back against people who deny that there is a problem. It is as if the problem is elevated to the level of “disease",” then people will take you seriously. In my opinion, the disease language is more about being taken seriously in a world that objectifies, stigmatizes, and dismisses what it does not understand or would prefer not to deal with than it is about a meaningful and useful terminology. The Disease Narrative is playing defense in an offensive world.

Depression and suicide are not easy topics to discuss ever, but are even more difficult or more charged when we are still aching from a loss from suicide. My suggestion is to be generous and thoughtful when discussing these topics without giving in to simply dismissing it altogether. There are many narratives about depression and suicide and many of them do not help in conversations because they are infused with assumptions that are filled with blame, abdication, or dismissal. And yet, many of these narratives are so easy to latch on to because they are plenty, come from what seem to be trusted sources, or allow for simply closure and a moving on to the next topic.

Monday, August 11, 2014

Kenya: Kenya Life

There is no way to tell the whole story of any story. Words capture as much as an image at a moment in time. All the smells, sights, sounds, sensations, tastes and moods cannot be gathered into writing.

Such is true with gathering words to write about Kenya life. What was it like day and day out at MITS? Being submerged into a culture different than my own made for everything being worth noting. I even understood the people I knew from the states differently in Kenya.   Context can change the meaning of something that itself does not change. Weird, but true.

There are four things I want to share that were a constant experience in Kenya: weather, mobility, access, and time.

Weather: The weather is important no matter where a person lives, but I would argue that it is more important in Kenya than in the states. The reason has not so much to do with the weather, but rather than so much of Kenyan life is outdoors.

We were within about 100 miles from being on the equator. Prior to going to Kenya, my assumption was that being so close to the equator would mean being super hot. I geared up for it.  I had been to Ghana twice, about 300 miles north of the equator, and it was always hot there. However, where we were in Kenya was about a mile high in elevation. Mornings were cool, in the 50’s and days were warm, but not hot, in the high 70’s and maybe low 80’s.  Days run about 12 hours near the equator. Since we were south of the equator, it was technically winter in Kenya. Felt pretty good to me.

It rained once while we were there, which of course prompted a chorus of Toto’s 1980’s song, Africa, more than once. The rain was not a deluge as it was not rainy season, however, the rain mixing with the dirt there made for some of stickiest clay-mud I have ever experienced. Since all walking paths and roads at MITS (and everywhere) are dirt, there is no escaping the clay-mud when it rains. Yes, read NO SIDEWALKS.

The way that the mud-clay accumulated on the bottoms of shoes was extraordinary. It was not the sloppy mud that is so messy, but sloshes off after some accumulation. It was not clay that sticks, but might knock off. It felt as though with every step the mud-clay accumulated a little more with the end result being an every  increasing heel of some accidental Kenyan platform shoe.

When it dried, it wanted to solidify so hard as to  simply become part of your shoe. 

Getting around. There is more walking in Kenya than in the states. A lot more walking. I had a 30 minute walk to get from where I stayed to where I taught. Had I a car, I would have driven it. But no one does that. Long slow walks are part of the life in Kenya.  It was good as it provided opportunity for conversation and getting to know people.

In the states, 30 minute commutes are singular activities with radio too offset the solitude. I liked the rhythm of daily walks.

Driving was necessary in order to get into the city or run to the store for something that was not at any of the local vendors. And driving is terrifying. With random, massive, and unexpected speed bumps and humps, with driving on what I consider the wrong side of the road, with the aggressive passing, with all the honking and flickering of the headlights, with all the “overspeeding” (as they call it), and herky-jerky here and there, side to side, speed up fast and brake driving action, it is enough to make one never want to be  in a vehicle ever again.

Locks. Everything is behind a pad lock, gate and wall. Security is an issue. Poverty is just life. Taking what is not yours is not acceptable, but it is understood to be a common occurrence. The challenge with everything being behind a padlock is that most of the locked were key locks with a single set of keys – that were in someone else’s hands when you wanted them.

Not having access to the place you are staying can make for a great deal of insecurity, especially bathroom insecurity.

Time (now). Now is the time. Clocks, schedules, appointments, deadlines, and so many of the situations that time-obsessed Americans tether to the clock are not so much in Africa. Although the more westernized style of educated Kenyans does lean toward time-centered flow of the day, there is still a sense that there is Africa time – which is when it happens. Time is now. We are here now and that is what matters.

There are ups sides and down sides to this. Being present in the moment is easier as a Kenyan. There is less worry about the future as today is all that there is to deal with. Americans may view this as an unproductive way to go about living, and in some measures of American productivity, it is. However, what Americans lose in their ever time-conscious worldview is the moment in which they are living. This can come at a high cost with excesses resulting in regret.

Kenyan life and American life differ, sometimes greatly. I hope to capture being in the moment more now than I did before.

Sunday, August 10, 2014

Kenya: MITS Staff

An organization is only as good as the people who run it. That being said, MITS is an amazing organization.

The staff at Made in the Streets is an incredible collection of people who are dedicated to the mission of rescuing, nurturing, and equipping children who have been on the streets of Eastleigh and preparing them for productive and meaningful lives in Nairobi.

The MITS staff is comprised of nearly 40 amazing people. What is incredible is that about a dozen off the staff are MITS graduates, which means they were on the streets at one time, went through the MITS program successfully, and then were invited to return to be on the MITS staff.

Here are a few of them:

Moses. Moses walks base camps in Eastleigh engaging street children, praying with them, inviting them to programs at the center that provide hope. Once on the street himself, Moses knows that challenges, questions, and experiences of children living on the street. He also knows that there is a pathway off the street.

Mary. Mary is so full of life and energy. She inspires skills students in fashion and design. Mary has overcome much adversity in her life. When she prays, it is a force of nature. When she leads worship, there is no stopping her. She desires to be fully engaged in what God is going in her life, in the lives of the MITS children, and in the world around her. She recently got some press in a prominent Kenyan fashion magazine that featured her work. When I was there, she was interviewed for an hour on one of the most listened to radio programs in Nairobi.

Mbuvi. Francis Mbuvi is the leader of the team in Kamulu. He leads with a quiet and gentle spirit. He is as rock solid as they come.

Irene. Irene is as intelligent as she is passionate about serving the children of MITS. Trained in psychology, she understands the experiences of the children, their trauma, and how to build resilience. She has big dreams too. She has hopes to create a counseling center at the MITS facility. I also have some big dreams that dovetail with hers. I would love to send students to MITS for an internship to do therapy with the children.