Wednesday, October 31, 2012

The 17th Mile: Vulnerability, Founder’s Syndrome and My Own Mental Illness


For those of you who know me, you know I am a slow and steady marathon maniac. For the past decade, I run a couple of marathons a year trying to someday run a marathon in all 50 states. For me marathoning is a metaphor for my life: committing to audacious adventures and figuring out how to get there step by step, finding dedicated partners to jog along with me, and riding the adrenaline rush when crossing the finish line. The other metaphor, which has been a focus of my year, is mile 17.

Photo by D. H. Parks Courtesy of Flickr Creative Commons
At mile 17, I lose hope. I am a long way in with a long way to go. My feet feel like someone is setting a torch to them, my stomach is doing back flips, and my brain is shutting down lobe by lobe. I go into a very dark place inside myself, put my head down and shuffle along, talking myself into one more mile. And then another. I hate this part of the race. For me, this year – with all of the accomplishments and celebrating – has had many 17th miles.

It started last February when a series of experiences brought me to my knees. First, I had dental surgery that left me unable to eat anything but mush for over a month. The lack of food made me irritable, and I started losing weight. Then I had to let go of an employee I cared about, and the transition filled me with worry – for her safety and for the organization. My computer crashed slowly over about four weeks, and I lost the ability to communicate effectively and could no longer rely on this key instrument in critical moments like public presentations.  Then my dog suffered a spinal cord stroke that left him completely paralyzed from the rib cage to the hindquarters. We considered putting him down, but decided to rehabilitate him instead – a costly decision with a very uncertain outcome.

As these stressors coupled with some unnerving family issues added their weight to my already weakened state, it felt as if my brain was being hijacked. I have always known that I was vulnerable to mental illness – it runs in my genes – and wondered when it would be my turn. I used to say, “I am on the bipolar spectrum” because I have a chronic case of hypomania but had never been depressed. During these 9 weeks last Spring that changed. First, I couldn't sleep. I would spend night after night tossing and turning. Then the anxiety got worse, and I just couldn't stay in the bed because I was so agitated like ants crawling in my skin.  I knew what was happening but was completely unable to get on top of it, even with all the best coping strategies at my disposal. Soon, I found I couldn't eat at all. I have a vivid memory of sitting alone at a Thai restaurant while I was traveling to a conference in Atlanta. I knew I had to eat to have strength for my presentation, but I just couldn't swallow and sat there trying to choke down a few pieces of tofu in broth filled with sadness. During these weeks, my mind was consumed with catastrophic thoughts about my family and the future of the Carson J Spencer Foundation. I would be driving to work and find myself terrified of getting into an accident, and as a result found I really had to really focus on my breathing to get from one place to another.

Putting the pieces back together
Photo by Leopard Print courtesy of  Flickr Creative commons


Then two things happened. My doctor give me some medication to sleep and control my anxiety, and I went to the American Association of Suicidology annual conference where I was able to get a better sense of perspective on what I brought to the world that had value. I felt love from my colleagues, valued for my expertise, and connected to something bigger than myself. The tide of the depression started to ebb out of my experience, and now, I am humbled to acknowledge that like so many I have worked to help, I too have a mental illness.

Like others with bipolar, I love my hypomania. I love having tons of energy, creative ideas, and unstoppable drive. The more life I live, however, the more I realize that others are not as keen on this state of being. I exhaust and frustrate people on a regular basis for trying to cram too much in too short a period of time, for living in an adrenaline-filled world of pressing deadlines, and for my lack of understanding of the effect I have on others. In the past, confrontations regarding my behavior often led to defensive reactions, but now, I can no longer deny, I must find a better way.

For me and many others, failure is so hard. I have always put a lot of effort into achieving – one of my blessings and curses. This year during my episode of depression and beyond, I found myself teetering up on the high wire, completely consumed with fear of failure. How could I not succeed doing something I feel I was destined to do, something my entire history has prepared me for, something I am doing in honor of my deceased beloved brother. My drive to overcome this fear snowballed into panic and has rippled through my organization like a cancer. Through many discussions, confrontations and reflections, I have come to accept that I have a classic case of Founder’s Syndrome

Here is how one author describes it:

“When someone with passion and commitment creates and builds a strong association, members and society benefit. But these founders can turn into their own worst enemies when they refuse to recognize that their organization has "outgrown" them, needing leadership skills the founder does not have or refuses to develop. The result? A nasty case of "founder's syndrome" or "founderitis." The cure? A tricky mixture of growth opportunities, board involvement, and a firm delivery method.” ~Maryll Kleibrink, The Center for Association Leadership, December 2004 from http://www.asaecenter.org/Resources/euarticle.cfm?itemnumber=11531

Last week, I had the great privilege to hear Dr. Brene Brown speak at the Women’s Success Forum in 
Denver. For those of you who have watched her viral TED video (http://www.ted.com/talks/brene_brown_on_vulnerability.html), you know she is a researcher on the area of vulnerability. At this forum, she talked about how we can't opt out of vulnerability - uncertainty, risk and emotional exposure and how daring greatly is about understanding vulnerability as courage.



This week I started something new: Executive Coaching. I am excited about facing these deficits and becoming a better me. I know the weeks ahead will have me taking a long look at difficult things, and I am ready.

Today, I am grateful for all of this. I am thankful for the courage Dr. Brown has given me to stand imperfectly, accept my challenges and ask for forgiveness from those I have affected. I appreciate my doctor, my medication, and my support system. I value all those who have confronted me in a respectful and solution-oriented way. I am looking forward to learning and changing, knowing that it won’t be easy, but the benefits will be magnificent.  Now I feel like I am somewhere at mile 22 – it’s still a tough road but there in the distance is the threshold of hope.

Photo by Dru Broomfield courtesy of Flickr Creative Commons



Sunday, September 9, 2012

WORLD SUICIDE PREVENTION DAY: CHANGING THE CONVERSATION AMONG MEN OF WORKING AGE

Colorado has the 6th highest suicide rate in the nation.  Men between the ages of 25 and 54 account for 44% of the suicide deaths in the state, and in 2010 had the highest suicide rate among all age and gender groups. The high number of suicide deaths in this group, coupled with the limited prevention and intervention efforts, targeting this difficult to reach demographic, confirmed the urgent need to develop suicide prevention strategies to better serve this population. In 2006 the partnership between Cactus, The Office of Suicide Prevention (OSP) and the Carson J Spencer Foundation began and we made a commitment to address this growing public health crisis.  In 2011 the partnership received funding from the Anschutz Foundation to further these efforts and on July 9th 2012 launched the Man Therapy™ campaign with an article in the New York Times.

Dozens of Denver Metro Billboards with Man Therapy messages
 
The purpose of the Man Therapy™ campaign is to provide men with a place to learn more about men’s mental health, examine their own situation and consider a wide array of actions that will put them on the path to treatment and recovery. The universal message is that all men should be aware of their mental health status and treat it like they would any other ailment and strive to get better.

 

video
 
From the outset, Man Therapy was created to be shared with other states and mental health organizations around the U.S. that are working to prevent suicides in their communities.  It has been created so it can very easily be implemented in communities throughout the country.

 
Man Therapy reshapes the conversation, using humor to cut through stigma and tackle issues like depression, divorce and suicidal thoughts head on, the way a man would do it. The campaign features a mental health hero, the good Dr. Rich Mahogany. He’s a man’s man who is dedicated to cutting through the denial with a fresh approach using his rapier wit, odd sense of humor, no BS approach and practical advice for men. Dr. Rich Mahogany is dedicated to helping men take charge of their own mental health.

Posters and Bus Station Displays

 The centerpiece of the campaign is the mantherapy.org website, where men and their loved ones will find they have a virtual appointment with Dr. Mahogany.  Visitors can navigate through Dr. Mahogany’s office where they can find useful information about men’s mental health with Gentlemental Health™. Men can also take an 18-question quiz to evaluate their own mental health status.  Within the site you are able to access resources and explore a wide range of choices from do-it-yourself tips to professional therapist referrals. Additional resources include links to local support groups as well as a national suicide crisis line that is ever present on the site.

 

In addition to the engaging experience viewers can find at mantherapy.org, the integrated communications campaign includes a 30-second TV PSA, three viral videos, social media promotions, outdoor boards and outreach materials including posters, coasters and Dr. Mahogany’s business card. 

video


Results and Evaluation

Impressive results in just the first six weeks. After generating 5,000 hits in the first day, the mantherapy.org Web site has seen an average of 1,000 unique visitors per day and has had 40,000 total visitors averaging 7 minutes on the site.  A total of 8,000 people have taken the quiz and been given advice and recommendations to consider.  A thorough evaluation is being conducted currently to obtain more detailed feedback and analysis of the effectiveness of the campaign and Web site experience. The evaluation includes a one and three-month follow-up component designed to measure whether the website contributed to positive behavior change among men who have visited the site.  A survey on the website also captures users’ immediate impressions.

  • 73% were satisfied with the quality of the Gentlemental Health™, video testimonials, and Man Therapies
  • 86% said the Web site was useful to them
  • 89% would recommend the Web site to a friend
The survey also revealed that the 34% of those who came to the website were looking for resources for themselves, and 14% were looking to help a friend or family member. The model user is a man aged 25-34. Some of the qualitative responses include:

  • I have never regarded myself as a stereotypical macho male, but was struck by (i) how many of the macho-male myths I subscribed to and (ii) how fast they crumble when they are examined.
  • I am a mental health clinician and I love the idea and the concept of using humor to get men the help they need. This is such an important area.
  • Awesome way to reduce "stigma" for men seeking mental health assistance! This is what we need instead of the same old SAMHSA, DCOE, NIMH, etc. sites. This makes men want to use it as it delivers info in an easy to understand format! Love it!
  • Extremely engaging use of humor, not only via the actor and faux therapist, but throughout. As a therapist and a man, I was pleased to see such a resource. Well done! Hopefully this will become the model for preventative campaigns within public health using modern media.
  • Brilliantly uses a classic manly character to say that it's ok to be depressed and offer advice. The small jokes in the information booklets like Gentlemental Health 101, such as Ben Leizman ‎"The effects of substance abuse on your brain are as ugly as an 80-year old fat man in spandex," really make the argument more effective and appealing. A very well done website and an idea that will save hundreds of lives.
  • Dr. Mahogany is hilarious, with just the right level of warmth to keep me feeling engaged. That's not easy!
 
###

About Cactus Marketing

Cactus is a full-service brand communications agency providing business solutions for companies and causes through brand strategy, advertising, design, interactive and media services. Cactus has been nationally recognized for its breakthrough creative executions by The One Show, Communication Arts, The Webby Awards, South by Southwest, Favourite Website Awards, Advertising Age, Creativity and Print’s Regional Design Annual. To learn more about Cactus, visit http://www.sharpideas.com.

About the Carson J Spencer Foundation - Sustaining a Passion for Life

The Carson J Spencer Foundation (www.CarsonJSpencer.org) is a Colorado nonprofit, established in 2005.  We envision a world where leaders and communities are committed to sustaining a passion for life. We sustain a passion for life by:

  • Delivering innovative and effective suicide prevention programs for working-aged people
  • Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention
  • Supporting people bereaved by suicide
About Colorado’s Office of Suicide Prevention

The Office of Suicide Prevention, a legislatively mandated entity of the Colorado Department of Public Health and Environment, serves as the lead entity for statewide suicide prevention and intervention efforts, collaborating with Colorado communities to reduce the number of suicide deaths and attempts in the state. To learn more about the Office, visit www.coosp.org.

 

Wednesday, August 1, 2012

PULLING TOGETHER IN THE AFTERMATH OF THE AURORA SHOOTINGS



Listening to our car radios as we drove into work on the morning of July 20th, the staff of the Carson J Spencer Foundation learned the news that our students and teachers from Rangeview High School and Gateway High School were directly affected by the Aurora shootings. As soon as we got into the office, we went right to Facebook to track down the students with whom we had connections to see if they were okay. For hours we waited for updates and felt optimistic when we heard the instant messaging beeps. Briana, our Junior Achievement Scholarship winner was safe and was also desperately trying to get status updates on her classmates. Kim, our teacher from Rangeview, had been with some of our students that morning receiving an award from 9HealthFair for their FIRE Within project. It was a rollercoaster morning for all of them, and so far she hadn’t yet heard that any of her students had been harmed. Then we talked to Courtney, the teacher from Gateway. Clearly shaken, Courtney let us know that three Gateway had been shot: one in the neck, one in the leg, and one “that didn’t look good.” The last student was A.J. Boik, a recently graduated senior. We learned later, A.J. had died at the theater.


Glued to the newscast all day like the rest of the nation, we grieved for this community. Knowing we had some tools and connections that might be of assistance, we decided we would to see if we could help in some way. Then, serendipitously, a number of pieces came together is just a couple of hours.
I shot off an email to my colleague from Crisis Care Network, “Bob, are you coming to Colorado? We need you.”

Based out of Michigan, Bob VandePol is President of one of the leading crisis service providers in the country. We had recently been selected as Co-Leads of the National Action Alliance for Suicide Prevention’s Workplace Task Force. Bob and I had presented together on a number of occasions on how workplaces can manage the crisis of a suicide, and I knew of his deep passion for and competence to help victims of major crisis incidents. He describes it as a calling.

Bob replied, “You’re not going to believe this, but I already had a trip planned, and I will be arriving on Tuesday. My evening is free.”

Then I reached out to Kim to see what, if anything, might be helpful. I told her that Bob would be in town and that I could help facilitate a candle-lighting ceremony if that fit the needs of the community. Kim reached out and found Reverend Ron Frierson.

“Pastor Ron” had led prayers for the first responders at the large memorial service on Sunday night. I had heard him share his compassionate words as I flew home that night from a speaking engagement in Indianapolis. Watching the small screen on the chair in front of me, tears streamed down my face as I listened to how he honored their service, “You are the first ones on the call and the last ones people think of that went through something. You were chosen to answer the call, and we are grateful you did.”
Pastor Ron was looking to do something for his congregation, and thus, the pieces came together.



Late in the afternoon on Tuesday, August 24th, Bob’s plane touched down and we all made our way over to Pastor Ron’s Heart for the World Church. On my way I stopped at the makeshift memorial just across the street from the Century 16 theaters. There I saw huge mounds of flowers and stuffed animals, thousands of candles, and dozens of signs pleading for peace, love and remembrance. Scores of mourners braved the 100 degree heat and paid their respects to the fallen.

When I found the directions to the Church, I realized that we were just one block away. The church was located in the back of a strip mall, just a few retail spaces gutted out and transformed into a beautiful place of worship. Deep purple flower arrangements and luxurious drapery gave it a sense of elegance. Hand-painted murals in all the children’s rooms, gave it a sense of community. It was clearly a place built out of love.
Pastor Pam (Ron’s wife) met me at the door and walked me back to the office where I met Pastor Ron. Bob had already arrived, and we talked for a few minutes about our children, our work, and our common desire to provide hope and comfort to this traumatized community.



Congregation members started trickling in. Kim came with some students. Neighboring church leaders came to stand in solidarity. Sarah Burgamy, President of the Colorado Psychological Association, arrived and said to me, “Yes, I am here to let people know we are here to provide mental health services if needed, but I am also here for me. I too need a chance to pause, reflect and grieve.”

Pastor Ron welcomed us all. The choir came filed out from the back and sang, clearly moved by the moment, about how God puts his hands on us and about how demons try but do not triumph over us.
I spoke briefly about how “the phoenix hope” helps us revive from ashes and rise and about how when communities pull together they can overcome unimaginable distress.

Bob helped people understand that God has given us gifts to survive this, but we often don’t realize these are gifts. He explained that we are fearfully and wonderfully made to flee, fight or freeze in reaction to life threatening events. Hypervigilance, insomnia, and even digestive problems are all normal responses to abnormal events, and for most, these reactions will pass in time.

Bob also shared with us the story of Holocaust survivor Viktor Frankl, and how he discovered three commonalities among the people who survived that horrible tragedy:
  •  They believed in something bigger than themselves. They had a sense of purpose and a faith that there was something more to come.
  • They had positive coping skills before the tragedy and drew upon those sources of resiliency.
  •  They had healthy and supportive relationships and a community that was a safe place to come together.

Then Rondah Frierson, Pastor Pam and Pastor Ron’s youngest daughter took the podium. Rondah had been a member of our FIRE Within class at Rangeview High School from 2010-2011, and was currently a sophomore in college. A radiant light of optimism and splendor, she moved us all to tears again with her heartfelt ministry.


“Love harder,” she said. “They [the people who died] are looking at us now and telling us that’s what they want us to do. We know these people and we are changed forever; the only way through this is love. With love comes unity, and from unity we have community.”

As the choir’s soul-stirring music began again, we lit our candles – cream-colored tapers with Styrofoam cups to catch the dripping wax – and swayed together. All ages, all races, all faiths, swaying together.
A Pastor from a neighboring church gave the closing prayer, “We stand with you,” he said. “Take back this land.”



We filed out into the reception area and spent time in fellowship together over rice crispy treats and lemonade. We hugged, we shared our experience, and we expressed gratitude for being together.
On the way home, I went to the memorial site again and found Bob there too. With the sun down, the candles glowed more brightly. The wind blew up the dust and threatened to blow them all out, but it could not blow out the spirit of community that is so steadfast here in Aurora. 

Monday, July 23, 2012

Aurora Rising: Phoenix Grievers Emerge from the Ashes of Tragedy


“The phoenix hope, can wing her way through the desert skies, and still defying fortune’s spite, revive from ashes and rise.”  ~ Miguel de Cervantes Saavedra, Spanish writer, author of the masterwork El quijote (1547-1616).



Al Siebert coined the term “phoenix grievers” in his book The Resiliency Advantage, and the term describes so many people I have met who find ways through their unimaginable pain with grace and growth. Siebert opens one chapter by saying, “Survivors of extreme trauma are never the same again. Their lives have two parts: ‘before’ and ‘after.’ How their new life turns out for them depends on their resiliency.” (p. 171)

Photo by thevsky


65 hours after the Aurora shooting I found myself flying home from Indianapolis after a speaking engagement on resilience. Tears streamed down my face the entire flight as I watched the non-stop coverage of the Aurora memorial service on CNN. Images and words from last night will stay with me for a long time as they showed such promise of the resilient spirit of all those affected:

· White roses and candles everywhere.
· Parents hugging their children and holding hands tightly in prayer.
· A large banner with hand-written words: “Angels walk with those who grieve.”
· Scores of service members in uniform. Offering formal salutes at the makeshift memorial. One by one.
· Governor Hickenlooper asking the audience to recite “We will remember” after he listed the deceased one by one.
· Mayor Steve Hogan surrounded by other Colorado leaders emphasizing, “This community is not defined by this tragedy.”
· “We shall wipe away every tear from their eyes,” said President Obama and then told the inspiring story of two teens in the front of the theater. When one was shot in the neck, the other put pressure on the wound with one hand while calling 911 with the other. “They represent what is best in us,” he said. “They represent that out of this darkness a brighter day will come.”
· Countless stories of strangers carrying strangers from the fray; of police officers transporting dozens of the wounded to hospitals.
· Pastor Debbie Stafford in her prayer lifted up this plea, “We honor the lives of these incredible people. May the comforter of your holy spirit wrap your arms around each one who suffers in their body and mind. May they know your love we thank you for your protection over each of them.”
· Reverend Ron Frierson remembering first responders to swells of cheering, “You are first on the call and the last ones people think of that went through something. You were chosen to answer the call, and we are grateful that you did.”
· Twelve balloons tied together soaring to the heavens.
· The melody of “Amazing Grace” lifting above the crowd as families of the victims started to leave in bandages, slings, crutches and wheelchairs.
The names of those who lost their lives were stated several times, but the suspect’s name was not mentioned once.

“I refuse to say his name,” said Governor Hickenlooper. “In my house, we will just call him ‘suspect A.”

When people suffer the loss of a loved one, they often feel guilty about leading full lives. The thought process goes, “If my loved one didn’t get to live out her days with joy and fulfillment, who am I to do so?” In addition, there may be a desire to do penance: “I do not deserve happiness, because my loved one has died.” Dr. Viktor Frankl, a famous Holocaust survivor who helped many others find their way through the grief of losing a loved one,  raised these questions to those impacted by a tragic loss: “If you were the one who died and your loved one was still alive, what would you wish they would be doing? What kind of life would you hope your loved one would lead if you were the one who had died?” 

Phoenix grievers like those in Aurora dive into these questions, and rise from the ashes transformed.

Friday, July 6, 2012

Guest Blog: Unemployed, Depressed and Searching for Hope Part II

Moving On After Professional Disaster Hits
Editor’s note:  This is the first of a two part series.

By Dr. Christina McCale, author, “Waiting for Change

In the subsequent months after the publication of my book, “Waiting for Change” I have had innumerable people contact me: some thanking me for the book. Others commenting how they could relate to my situation. Others describing their own stories of job loss and the terror that ensues after that catastrophe has been set upon them.
But invariably, as I talk with, thank and continue to share with these incredible human beings, the question comes up: So how do you move on?
I wish I had a good answer. But in this posting, I’ll provide a bit of “framework” for thinking about the grieving process after your loved one has lost their professional identity.
Most times, when I’m asked this question, I compare the experience of the last two years to the grieving process Kubler-Ross describes: you’re going to go through different phases. There really isn’t a logical “pattern” for getting from point A (the day you lose your job) to point B (the day you realize you’ve gotten past the pain).  Not everyone is going to go through all the same phases in the same way or in the same order – because grief is a personal thing.
As I was told by a kind soul, so long ago, upon the death of my own family members:  “I promise you there will come a day – a whole 24 hour time period – when you will forget that they’re gone; that the pain has slipped away. But it may take a whole year of birthdays and holidays and missed vacations to get through all the ‘what might have beens’ before you can move on.”
While I know intellectually that there has been some comment and criticism of the Kubler-Ross model (denial, anger, bargaining, depression and acceptance), and I am hardly an expert therapist or knowledgeable about psychology, to me, it does at least seem to provide somewhat of a framework to begin to make some sense of what has just occurred – and perhaps a perspective that can help the loved ones who will now be called on to buoy the unemployed person through the next phase of their life.
A Complicating Factor
What might complicate matters, though, is that as a society we don’t see job loss as a “death” per se – although many have described work as an innate part of our identities and in many cases a cornerstone of one’s social life.  The notion of unemployment – or rather the inability to move on and find a new job – carries a stigma with it that dates back to our colonial America.
The Puritan work ethic, a belief that our dedication to doing a job well is a way of honoring God, is a part of our very social fabric. Our very language is peppered with the language that reinforces the importance of getting the job done and doing it well:
“Make hay while the sun shines.”
“Go the extra mile.”
“Your work should speak for itself.”
“Actions speak louder than words.”
“Don’t waste time.”
“Idleness is the devil’s handmaiden.”
“Don’t put off to tomorrow what you can do today.”
“Don’t just stand there … DO something.”
Some of our most fundamental attitudes come from that colonial society which emphasized the importance of work: where the community had to prioritize and safeguard its resources. Therefore, the poor then fell into two categories: the deserving poor and the non-deserving poor – those who through some character flaw or lacking in their effort to contribute their work. Later these attitudes morphed – that the poor were acculturated to be poor – that they didn’t know how to behave any differently and that their own actions perpetuated their lot in life.
So not only are we as a society taught to believe that work is an important part of our lives, to the degree that we identify ourselves through our work, but we are also then lead to the fallacy that if we are not working there must be something wrong with us.
Or if we were fired, laid off, etc., then we must have done something wrong…  been inadequate in some way.
We failed.
And let’s face it – failure is not something our society talks about willingly, let alone accept and forgive readily.
So understanding that there is a whole host of acculturation, societal expectations and psychological identity elements – not to mention the greater issues of macro-economics, social justice, and equity that I won’t even begin to touch here – how do you get through those stages of grief and attempt to get your life back in some fashion?
Not easily.
When my own identity had been ripped from me, destroying a decade’s worth of effort and dedication to complete my doctorate – something that had cost me dearly in so many other ways –to say that I had been laid low would be too cliché, too much of an understatement for the reality that would ensue. I could barely get off the couch for weeks.  I didn’t sleep more than a few hours a night. I could barely eat. The most mundane tasks of getting kids to school and dinner on the table (which turned into a lot of nights with Domino’s) became insurmountable peaks to climb.
Much like what some may feel when they lose the one they love – a spouse, a parent, a child.  You are now experiencing the unthinkable. The unimaginable is now real. After all,  our profession is a part of our identity. So it follows that we grieve at the loss of a job because we are not only losing a part of ourselves, but experiencing a social death as well.
Editor’s note: Next week Dr. McCale will discuss suggestions for navigating the emotional landscape after layoff, termination or downsizing.

About Waiting for Change:
Part memoir and part social commentary, the book Waiting for Change profiles the very personal realities of job loss during the Great Recession and the domino effect to one’s housing, sustenance, employment, children, and social support systems.  The book takes the reader on a guided tour “behind the story” of all the statistics on the evening news to explore the new and evolving landscape of poverty in the richest country on Earth.  Waiting for Change provides a mental “travelogue” that illuminates not just the immediate impacts of poverty, but the downstream repercussions, all in very personal, relatable and easy to read ways.


About the Author:
Prior to getting her doctorate in Marketing, Christina McCale worked for 17+ years in some of corporate America's biggest companies. For the last 10 years she has taught marketing and management instructional duties at the university level for the last 10 years, she has also been one of the key and has conducted research on how to best prepare our undergraduates for career entry. Today, she lives in Olympia, Washington with her son, daughter, and their two beloved greyhounds.

Tuesday, April 3, 2012

Guest Blog: Unemployed, Depressed and Searching for Hope

By Dr. Christina McCale

           “I can’t live like this,” I said to the person at the other end of the phone. I’d seen several flyers for free and sliding scale health services, to include mental health while making my very first visit to the Food Bank, and had picked one up. “I just know I can’t go on living this way.”

            It wasn’t the first time I’d come to this conclusion or had this conversation with a medical professional. But it was the first time I was having such a conversation with so few options due to the lack of insurance. I’d lost my health insurance when I had lost my full time job teaching at the university level: a career choice I had loved with every fiber of my being.

            Being a classic over-achiever who had worked three jobs while completing my doctorate; the stress of that coupled with two young children and a deteriorating marriage; and a family history full of stories of women who were plagued with “melancholy” or “the blues” had probably made me a prime candidate for depression, which, perhaps today, might have been diagnosed even earlier.

            So then throughout the remaining years of my doctoral program (and then, later, dissertation), the doctor continued monitoring me, adjusting my medication as need be. And things were relatively fine. Sure, there were bad days, even stressful, horrible days. After all, I passed my comprehensive exams, wrote my dissertation and ended my marriage all during these subsequent years.

            But all of that was manageable by comparison to what was to come.

            When my professional career as an academic, and the entire identity I had built for myself was suddenly yanked out from under me, I was left gasping for air and struggling to find any sense of self outside of what I had loved to do for the previous 10 years. Medication became the only way I could manage through the waves of sadness, the raging anger, and the sense of complete and utter ambiguity.

            I hadn’t even taken time off for maternity leave after the births of both of my children – in part because I had no such time to take as maternity leave did not apply to me as an adjunct faculty – but also because I couldn’t imagine not being in the classroom with my other “kids.” My students were children who were on loan to me from their real parents: kiddos I had an obligation to give my best self to each and every day.

            As I used to explain to my classes of undergraduates: “I’d better be doing what I love because each and every day I choose to leave the three people I love most in the world, and come to be with you.”

            Some people describe the day they were laid off as being the worst day of their lives. That day – and the days to follow – became the worst “life” of my life.

            Some don’t really understand the debilitating blow job loss, and the subsequent emotional turmoil that follows. Maybe that’s because some have been lucky, and have been spared that particular experience during the Great Recession. For others, the notions of unemployment come from deep seated feelings that date all the way back to Puritan America: if you are unemployed, and not infirmed, it must be because there is something deficient about you: you’re not trying hard enough, you deserved to be laid off, or you’re just too lazy to go out there and get another one.

            While I suppose there are exceptions to every situation, I tend to believe that everyone , at some level, wants to feel productive: like they are contributing. Work, as Freud once noted, is a part of who we are.  And to deny that work is a part of our identities is to deny a part of our cultural ethos: Do what you love. That your talents are a part of who you are. That we choose to make our 40-80 working hours a week not just a way to earn a living but to make it a personal expression of self.

            But work is a part of our identity.

            Work is where we find meaning.

            It’s often how we define ourselves.

            So when what we’ve been doing is abruptly taken away, it’s no wonder there can be significant repercussions. So the job loss, at least for me, became a spiral of depression and grieving. It’s nothing so simple as being linear – a straight or even sloped line from bad to worse. No, depression becomes a progression of stages when you’re trying to job hunt. Because each new step forward, puts yourself at risk. The perpetual changes take you through a perpetual cycle:

            You have jobs to apply to, so you’re up.

            When the job doesn’t come through, and you were so sure you did so well on the interview, you become morose.

            A friend doesn’t understand your disappointment, and you feel like it must be something “you’re doing” – so you’re pushed three steps back.

            You find a new job listing you’d be perfect for – so you’re optimistic.

            Weeks go by and you don’t get a call back, so you worry.

            A friend lets you know about a possibility he might be able to get you in to, and you are elated.

             People ask about the job hunt, so you get more down because you have nothing new, and no good news to share.

            You get an email from a potential employer that says you weren’t qualified enough, and so you’re back in the gutter of despair until the cycle starts all over again. The part of your bleeding soul that had started to scab up is now pulled off with the new wound of loss.

            I have a new found respect for actors and other performers who live through this cycle by choice, in pursuit of their craft. I have no idea how they do it and remain sane. Is there an inner sense of balance they draw on? Accepting themselves and knowing their value with or without the gig?

            The lesson so many long term unemployed have had to learn is that it’s not that we all haven’t dealt with sadness. And it’s not like we all haven’t wrestled with disappointment. We all have. We’re human beings. We live in the world. We know there are disappointments, set-backs, and frustrations in career management.

            But this is a new kind of “emotion management” because a person who’s been laid off may not be managing a 3, 6 or 9 month time span… but potentially years where you have to find the strength and the resources to navigate the self-doubt and rejection you experience when one is laid off.  A set of skills to navigate the ambiguity and the rollercoaster of emotions for more than just a few months … but potentially for 12-24 months?

            So what is helpful? That may depend on the person involved, just as the grieving process can look different from person to person. But undoubtedly one of the most important things is to find the resources you need to survive during this time: find the people who are supportive. Find the organizations who can help you.

            Additionally, for the people surrounding the one who has been laid off, this next period of time might seem a bit like being a caregiver. Learning as much as you can about depression and long term unemployment may certainly be helpful.  But just as caregivers of those with Alzheimer’s or Cancer need to take care of themselves and find their own support networks, so do those who are providing care and support to the long term unemployed.

            Because we certainly couldn’t get through those hard times without you.


About the Author:
Dr. Christina McCale, author of Waiting for Change 
www.waitingforchange.us

Prior to getting her doctorate in Marketing, Christina McCale worked for 17+ years in some of corporate America's biggest companies. For the last 10 years she has taught marketing and management instructional duties at the university level for the last 10 years, she has also been one of the key and has conducted research on how to best prepare our undergraduates for career entry. Today, she lives in Olympia, Washington with her son, daughter, and their two beloved greyhounds.

About Waiting for Change:
Part memoir and part social commentary, the book Waiting for Change profiles the very personal realities of job loss during the Great Recession and the domino effect to one’s housing, sustenance, employment, children, and social support systems.  The book takes the reader on a guided tour “behind the story” of all the statistics on the evening news to explore the new and evolving landscape of poverty in the richest country on Earth.  Waiting for Change provides a mental “travelogue” that illuminates not just the immediate impacts of poverty, but the downstream repercussions, all in very personal, relatable and easy to read ways.

Tuesday, March 6, 2012

Tensions in Postvention: An International Dialogue, Part II

By Sally Spencer-ThomasAAS Survivor Division Director

In the last issue of Newslink, I shared the first part of a historical discussion that took place at the International Association of Suicide Prevention’s World Congress in Beijing, China on September 15th, 2011. In this issue I continue to share a summary of that dialogue among some of the world’s leading postvention experts:

·     Karl Andriessen, M.Suicidology, (BELGIUM), Coordinator of the Suicide Prevention Program of the Flemish Mental Health Centres, and Co-Chair of the IASP Taskforce on Suicide Bereavement and Postvention is a tireless advocate for the needs of people bereaved by suicide.

·     Prof. Onja Grad, PhD, (SLOVENIA), clinical psychologist who has worked with survivors on a daily basis for the past 22 years — with individuals, families, groups. She is also a teacher at the University of Ljubljana School of Medicine.

·     Tony Gee

·     Jill Fisher M.Suicidology, M. Health Studies (Loss and Grief) (AUSTRALIA), National Coordinator for the StandBy Response Service and was the recipient of the 2011 International Association for Suicide Prevention Norman Farberow Award.

·      Myfanwy Maple, PhD, BSW (Honours Degree), (AUSTRALIA). Senior Lecturer, Social Work Course Coordinator, School of Health, is a social work academic and researcher in suicide bereavement over the past decade, particularly examining the loss experiences of individual family members.

·     Sandra Palmer, Ph.D. (NEW ZEALAND), a registered psychologist and Clinical Manager Community Postvention Response Service, provides support to communities experiencing suicide clusters or contagion. She continually faces the challenge of balancing the need for communities and families to honor the loss of loved ones with safe postvention practices to manage contagion to prevent further losses in the community.

·      John Peters, M.Suicidology (UNITED KINGDOM), lost his son to suicide 19 years ago and has for many years been a volunteer with Survivors of Bereavement by Suicide including staffing their Helpline each week and running peer-led support groups and an annual support day.

·     Diana Sands, PhD, (AUSTRALIA),Director, Bereaved by Suicide Service has worked with families bereaved by suicide for over twenty years, produced a film and written a book for children bereaved by suicide will speak to the complex and sensitive issues in how to talk with children bereaved by suicide.

In the first article I reviewed the group’s responses to the first two questions:

1)      How can we balance the need to prevent contagion with the need to honor loss?

2)      How do we balance getting a familiar sense of normalcy with the acknowledgement of significance to a community that has been deeply affected by a suicide loss?

In this article I summarize the themes of the second set of questions:

3)      Do we tell children about suicide or not? When do we tell them? How much information?

4)      What services do we provide – lay led, professionally facilitated or some combination? Knowing that the research indicates the benefits of peer led efforts, how do we manage quality control and sustainability?

5)      How do we safely involve survivors of suicide loss and attempts in research? What are the best protocols for this?

Part II of the Dailogue on Tenstions in Postvention

Do we tell children about suicide or not? When do we tell them? How much information?

Another engaged conversation ensued around this anxiety provoking topic. As the mother of three young children and knowing that survivors of suicide loss are at higher risk for suicide, I noted, “We don’t have the evidence-based long-term answer on how to do this right [explain suicide to children], and the stakes are high.”

Nevertheless, several excellent suggestions came forward from the group. Some offered that we inoculate children before crisis occurs by letting kids know that when things go wrong there are resources to help them.

When a suicide tragedy strikes, we need to be honest in a way they understand. Parents often think the kids don’t know but they do. Sometimes we have to help the parents work through this more than the kids.

Diane Sands, author of a book about supporting children bereaved by suicide said, “It is important to support our children even in the awfulness. A lot of parents want to protect children from this tragic knowledge. We need to let parents know there are people who can help them navigate these decisions. Parents worry that they will have to explain everything; rather it is a process of coming to terms with this knowledge. Children are extraordinary in picking up on nonverbal.”

When children are lied to, the resulting complications can make things much worse. Children know when there is fabrication even if they don’t know what is made up. It can cause great anxiety in children when what they are told doesn’t match what they intuit. Lying closes down the conversation of the loss, and opportunities for supportive relationships and constructive processing don’t happen. When there are lies, there are trust issues. When children find out the truth, they often become angry that they have been lied to and find they have to grieve the loss all over again.

Several participants noted that children are resilient and can handle age-appropriate information. Just tell the children information related to the exact question they’ve asked and try understand the reasoning behind the question, so you can appreciate the need behind it.

Diane explained, when the person who has died by suicide isn’t talked about, problems emerge because at the center of the process is a secret. When the family doesn’t know how to talk about a person, the story of their life starts to disappear and mystery of their death causes problems as people are not sure what they can and cannot say. Diane explained that the multiple conversations caring adults have with children helps them process this experience over time and assimilate the experience into their lives in a healthy way.

What services do we provide – lay led, professionally facilitated, or some combination? Knowing that the research indicates the benefits of peer led efforts, how do we manage quality control and sustainability?

Myf Maple, a leader on suicide bereavement research commented that much of the research on support services for people bereaved by suicide are often done with people who have accessed peer led support services, so some of the outcomes might be biased because of this sampling.
John Peters responded by saying there are three types of survivors: those who want help and find it, those who want help and can’t find it, and those who don’t want help. It is reasonable to ask those who found help if it achieved a positive outcome.
Tony Gee, a mental health professional who is bereaved by suicide noted that peer support is sometimes undervalued by professionals, but can be very cost effective and accessible.
Jill Fisher observed that peer led groups sometimes are affected by challenges in succession planning. Bereaved people who start support groups and find they are ready to move on struggle with how they can leave the group without feeling like they are dishonoring the reason for their involvement or the people they have supported.
Many agreed that we need more research on a variety of support options for the bereaved as well as guidelines on how to sustain the work of the helpers so they don’t burn out or get compassion fatigue.
How do we safely involve survivors or suicide loss and attempts in research? What are the best protocols for this?

Finally, our time together was running out, but we briefly explored the topic of research with survivors and several commented that we need more research on long-term effects of support services and survivor-researcher partnerships.
Some of the frustrated researchers in the room shared their experiences of ethical review boards that made faulty assumptions about the implications of asking people about suicidal behavior. A research project might have all the safety protocols in place and still get rejected because the review committee did not understand that asking about suicide doesn’t put the idea in someone’s head.

John Peters closed our time together by sharing a quote from AAS President Michelle Linn-Gust, “Fear continues to guide research – this fear is no different than the stigma that surrounds suicide and keeps us from getting the answers we need.”

 Sally Spencer-Thomas, Ph.D., is CEO and co-founder of the Carson J Spencer Foundation, founded after the suicide of her brother. The foundation is known for preventing suicide in the workplace, coaching youth social entrepreneurs to be the next generation of suicide prevention advocates, and supporting the bereaved.

Reposted here with permission from The American Association for Suicidology