Tuesday, December 31, 2019

Greatest Hits

I repost a lot here from my blog on PsychCentral, "Getting Older With Bipolar."  I plan on doing less of that in 2020, and putting up more original content here.  In the meantime, here's a link to my most popular posts in 2019.  Happy New Year!


Monday, December 23, 2019

A Season for Giving

I love Christmas, so I’m not about to ruin it by making you feel guilty for worrying about yourself because some people have more challenges than you.  Don’t ever diminish your own suffering by comparing yourself to others who may be worse off.

But don’t stop serving them, either.

Thursday, December 19, 2019

About Those Kids with Bipolar Disorder

Can children have bipolar disorder? 

After years of being told that the typical age of onset of bipolar disorder is late adolescence or early adulthood, we are now overwhelmed with elementary school-aged children with mood disorders.

Wednesday, December 11, 2019

Healing From Trauma

“In a recent government survey, 60% of US adults said that as children they had experienced significant abuse and/or neglect.”

That’s how James S Gordon kicks off his new book, The Transformation: Discovering and Healing After Trauma.  So, of course I was skeptical.

Gordon then goes on to include in his definition of trauma serious illness, discrimination and loss of a loved one, things well beyond physical abuse and/or neglect.  Suddenly, the 60% figure seemed low.  I expected another book for the “worried well.”

I was pleasantly surprised to find a lot of useful information in each chapter.

Wednesday, December 4, 2019

Revolution, Madness & the Visionary Doctor Who Became a Founding Father

I often get the bus at Third and Walnut in Philadelphia.  There’s a beautiful garden there with a plaque on the wall that identifies the site as the location of Benjamin Rush’s residence.

Rush signed the Declaration of Independence and brokered the peace between Thomas Jefferson and John Adams, but his most lasting legacy was as a physician and the role he played in the treatment of those with mental illness.

Wednesday, November 20, 2019

New Drugs: Less Regulations, Maybe Less Effective

What happens when competition replaces science as the most important reason to develop new medicines?

Wednesday, November 13, 2019

We Must Work

Productive activity, be it  a paying job or a serious hobby, is necessary for mental health.

Wednesday, November 6, 2019

Wait Two Weeks Before You Buy That

I have spent an awful lot of money while manic. Almost all of it on things I later regretted buying.

Thursday, October 31, 2019

Open Enrollment for the ACA

The majority of people with bipolar disorder will be hospitalized during their lifetime, and as much as 62% of all direct healthcare costs for bipolar disorder are due to hospital expenses.

Health insurance is crucial.

Wednesday, October 23, 2019

Behind the Numbers - Longevity and Bipolar Disorder (part two)

The research is pretty conclusive: people with bipolar disorder die earlier than their peer group’s average. But the data leaves out a lot. It’s worth taking a peak behind the numbers.

Wednesday, October 16, 2019

Longevity and Bipolar Disorder

What’s the average lifespan of someone with bipolar disorder? Now that I’m in my 50s, and now that I’ve lived with the diagnosis for nearly three decades, I wonder if I’ll live as long as others without the disorder. According to research, probably not.

Wednesday, October 2, 2019

Play Sports, Get Better

The camaraderie and competition of sport can make a person feel vital, included and productive - and improve a person's mental health.

Wednesday, September 25, 2019

Can Exercise Cause Mania?

I'd like to spend a few weeks writing about movement.  Exercise is crucial to good health, and it can help regulate moods, too.  I spend a lot of time with this blog on meditation, but not enough on this other, possibly more effective, form of stress relief.

Wednesday, September 11, 2019

The Problem With Secular Mindfulness

I write about and teach meditation with a very specific aim:  to help people manage mental illness.  It works. Still I make no other vast claims about the practice.  I avoid calling what I do mindfulness because mindfulness speaks to a whole slew of now contradictory goals attributed to the same simple practice I recommend.  My practice is born of that undertaken by the desert fathers and ancient Zen masters, and still practiced today by spiritual seekers across the world.  It’s also practiced by people like me, who use it for a very specific purpose instead of mystical experience or enlightenment.  It’s also practiced by the purveyors of secular mindfulness, who I think overpromise results for too little effort.

Wednesday, September 4, 2019

Meditation and Mental Illness

Here's another excerpt from the book I'm working on:

It happened to me sometimes when I went to Center City Philadelphia at night, fixed on the red beacon flashing atop every skyscraper, and definitely when I visited Manhattan.  For a while the lights and the sounds and the pace just took me, and before I knew it my mood would be ablaze, my decisions poor, my sleep a short annoyance and my future barely considered.  With each pulsing minute my impulse control deteriorated and my ability to make good choices took a thumping.  The vibrant city would have been a great laboratory to study what it is that takes me as I turn manic, but I couldn’t handle it and was lucky when someone with me would whisk me away.

Wednesday, August 14, 2019

Confronting Suicide

Sometimes something happens that makes you face up to something you did in your past.  Something you may never resolve.

Wednesday, August 7, 2019

How We Can Help

What can people with mental illness do to join the conversation about mass shootings?

Wednesday, July 31, 2019

Can Meditation Really Slow Aging?

Big claims are made for mindfulness, and one of the biggest is that it can slow down the aging process.

Wednesday, July 24, 2019

Counting Breaths During Meditation

People who teach mindfulness meditation often recommend counting breaths to keep the attention focused on the breath.  Methods vary little, all some variation of counting to ten.  Some recommend counting inhales and exhales, others count only exhales.  Most count each breath from one to ten and then start over again at one.  Another method has the meditator count exhales to ten, and then count exhales down from nine to zero.  Repeat.  But you get the point.  Focus on the breath by counting each breath.  If you lose your count, or realize you’ve counted past ten because your mind has wandered, just return to one and start over.

But sometimes the counting becomes so automatic, so routine, that I can count from one to ten and repeat, barely noticing the count, my mind wandering all the while.  Little work with focused attention is being done.  To counter this I learned a very effective counting method from James Austin at a workshop on Zen and the Brain.

Thursday, July 18, 2019

A Contemplation on Contemplation

I've been posting some stuff from a book I'm working on.  Here's more:

Years ago I sat as a student in an eight-week MBSR class.  There was a woman sitting next to me who was disturbed about the class.  During the second class she spoke up.  She said she was an executive at a high stress firm, and she liked the pace.  Type A-plus, she wanted to move fast and was afraid meditation would make her lose a step. She didn’t want to be all calm and laid back and warm feeling.  She wanted to clear her head and be creative.  She wondered if she shouldn’t be in the class.  The teacher missed a tremendous teaching moment.  Meditation could help her realize who she was, not change her into a person she didn’t want to be.  The beauty of the practice is that it offers almost exactly what anyone wants to get out of it.  For crying out loud, this same MBSR program trained military snipers.  But the teacher told her she was wrong.  She should be all calm and laid back and hippie-like.  She would be so much happier.  The woman left at break and never came back.

I swore then that if I ever taught it would be for people like her.

Wednesday, July 3, 2019

Twenty Breaths to Less Stress

Here's a simple meditation technique that anyone can fit into their schedule.  It’s called the Twenty Breaths Practice.  It only takes a few minutes, can be performed almost anywhere, and can yield great stress relief.

Thursday, June 13, 2019

Wednesday, June 5, 2019

Can Meditation be a Bad Experience?

There can be some bumps on the road to the positive effects of mindfulness.  People with repetitive negative thinking should be cautious when considering formal, seated meditation practices.  But a healthy experience is still possible, and there are many varieties of mindfulness practices from which to choose.

Please read my article on this on my blog "Getting Older With Bipolar."  You can find it here.

Wednesday, May 29, 2019

Stay Open

Here's the last of the posts from the introduction to the book I'm working on:

The fifth and final ground rule was the hardest for me to adopt:  Stay open to new ideas; don’t think you know it all.

I’ve always been very curious, so the new ideas part wasn’t too difficult.  In fact, sometimes my experience with mental illness made me very vulnerable to influences I may not have chosen on a better day.  While ramping up into a manic episode I’d adopt some new persona or fall into an interest or belief and go way overboard as I expressed my new lifestyle.  This has happened with things as varied as objectivism, liberation theology, and fly-fishing.  I’d go full into something to the exclusion of all else, only to drop it entirely as I settled down and recovered.

Wednesday, May 22, 2019

Be Responsible

Here's ground rule #4 from the book I'm working on.  No matter how sick you were when you acted out, you have to own what you do:

In asking you to not define yourself as mentally ill (ground rule #1), I stated that while you’re exempt from responsibility for being ill, you need to take responsibility for getting better.  Ground rule #4 expands on that thought and insists:  You must take responsibility for all your actions.

I remember when I was dating my wife.  The night I told her I have bipolar disorder she touched me deeply when she asked if I had a difficult period what could she do to help.  I returned that kindness by vowing to never use my illness as an excuse for bad behavior.

Wednesday, May 15, 2019

Control Yourself

I've been posting the opening of a book I'm working on.  Here's the next section:

Much of what I recommend as a path toward wellness involves great self-discipline and some self-sacrifice. But I realized early in my practice that if the discipline and sacrifice were too severe, my efforts would border on ascetic austerity.  That’s not necessary. 

Ground rule number three is: Exercise self-discipline but keep it gentle.

Wednesday, May 8, 2019

Don't Stop Your Meds; Keep Seeing Your Therapist

Here's the second ground rule from the book I'm working on:

Ground rule number two: Keep taking your meds and keep seeing your doctor and/or therapist.

I maintain, and insist, that meditation, movement and meaningful work are adjunct therapies.  I believe they are absolutely necessary to manage mental illness, so in this sense one may think of them as primary therapies.  I just don’t want to imply that they will replace medication and psychotherapy.

Wednesday, May 1, 2019

Don't Say, "I Am Mentally Ill"

I'm working on a book about using meditation, movement and meaningful work to manage mental illness.  It begins with five ground rules necessary to establish a positive, helpful practice and overcome a mental illness.  Here's number one:

Before practicing therapies to get over a mental illness, some ground rules must be set. The first involves your relationship with your disease.  How do you relate to your mental illness, and how do you describe yourself?

Language can have a powerful influence over self-definition, revelation, and healing.  The way we describe ourselves and our condition speaks volumes about our outlook and our outcomes.  I was diagnosed decades ago with bipolar disorder, I still adhere to treatment, and I still suffer occasional mood changes.  Yet I strongly maintain that I am not bipolar.

Wednesday, April 24, 2019

Rejecting or Embracing the Sacred in Meditation

A version of this post appears on my blog for PsychCentral, "Getting Older with Bipolar."

I spent the weekend at my parents’ house in the mountains, very quiet, and found the entire secularization of sacred traditions troubling.  I thought about the way I’ve been teaching meditation.

I recently taught a class in creative contemplation that was based on Lectio Divina, or divine reading.  It is a practice undertaken by contemplative Christians and monks in which one completely surrenders to the voice of God as inspired by a line of scripture.  

I have no real allegiance to Christianity, other than my upbringing, and I presented the practice as a completely secular way to meditate.  Many modern meditative and contemplative forms are presented this way.

Wednesday, April 10, 2019

What to Do With All of These Thoughts

It’s easy to say that when meditating one should focus on the breath and release thoughts as they arise, but it’s incredibly difficult to do.  I’ve been a bit hypomanic lately, and ideas are flying through my head.  Concentration and attention are very difficult.  Acknowledging thoughts and letting them go is hard enough on a good day.  What do I do now?

During mindfulness meditation you keep your attention on your breath, but you want to be fully aware in this moment.  So you still take note of sounds and smells, aches and pains, all that makes up the present.  When thoughts arise the instructions are to notice them, let them go, and return to the breath.  But to just blot out thoughts without paying attention to them would not be very mindful at all.  Don’t ignore your thoughts, work with them.

Wednesday, April 3, 2019

Why Work?

I’m grateful we have a social safety net.  It’s important to help people pull themselves up, and to provide care for those who cannot support themselves because of serious disability.  The net may not be cast broad enough, as too many people who need help are denied services.  That said, the most important thing that led to my recovery from serious mental illness was being denied Social Security Disability Income. 

Wednesday, March 27, 2019

Acceptance, Part Three

Limitations.  We all have them, but sometimes illness adds new ones that we never before had to deal with.  Accepting this fact was a challenge.

When I was hit by one episode that left me psychotic, suicidal, and hospitalized I was 31 and had just been promoted to VP of Sales at the company for which I worked.  An incorrect diagnosis and my poor response to the medications prescribed, as well as my refusal to accept mental illness and my subsequent noncompliance with my doctors’ orders, left me reeling for years.  I fell into a string of small jobs, just to keep health insurance, and checked into and out of psychiatric hospitals several times.  The hole in my resume became so large, and my ability to deal with stress so frail, that it became clear that I was not going back to the executive suite, probably never.  The effect that stress had on my moods, and the moods themselves, severely limited the amount of responsibility I could handle in any job. 

Wednesday, March 20, 2019

Acceptance, Part Two

I wrote in part one how my father and I were both sick, each with a poor prognosis.  It was our refusals to accept likely outcomes that laid the groundwork for our healing.  Or was it?

While it is true that I chose not to accept the likelihood of a dismal future, it was the acceptance of things that I had no choice about that began my healing.  In mindfulness, to accept is to acknowledge the truth of an immediate experience.  So yes, I was sick, unable to work, broke, and broken.  Those things were simple facts that needed to be accepted.  Only then could I begin to move forward and change my situation.

Wednesday, March 13, 2019

Acceptance, Part One

I’m starting to sound like an evangelist.  “Meditate and you’ll manage your mental illness.”  “Be mindful and you’ll stay present, even as your mind pulls at you, trying to take you toward the abyss.”  Well, for years this has worked, most of the time.  But it’s not always so simple.

Wednesday, March 6, 2019

Spend Less, Breathe More

This article is published on my blog on PsychCentral, "Getting Older With Bipolar."  See the blog here.

Mindfulness is either on the cusp of something great, or risks becoming the latest self-help fad to perish from oversimplification.  It has, without a doubt, improved my functioning with bipolar disorder.  In working with others, I have seen similar results.  And while research specific to meditation and bipolar disorder is scarce, the effect of mindfulness on other mental illnesses is well documented, and positive.

But it’s not so easy.

Thursday, February 28, 2019

Working Within Limits

Limitations.  We all have them, but sometimes illness adds new ones that we never before had to deal with.  Accepting this fact was a challenge.

When I was hit by one episode that left me psychotic, suicidal, and hospitalized I was 31 and had just been promoted to VP of Sales at the company for which I worked.  An incorrect diagnosis and my poor response to the medications prescribed, as well as my refusal to accept mental illness and my subsequent noncompliance with my doctors’ orders, left me reeling for years.  I fell into a string of small jobs, just to keep health insurance, and checked into and out of psychiatric hospitals several times.  The hole in my resume became so large, and my ability to deal with stress so frail, that it became clear that I was not going back to the executive suite.  The effect that stress had on my moods, and the moods themselves, severely limited the amount of responsibility I could handle on the job.  I continued to work, but limitations were holding me back.

Wednesday, February 20, 2019

Mindfulness and Anxiety

Anxiety disorder is much more than being very nervous or edgy.  In anxiety, a person will report an unreasonable exaggeration of threats, repetitive negative thinking, hyperarousal, and a strong identification with fear.  The fight or flight response is kicked into overdrive and physical symptoms such as rapid heartbeat, high blood pressure, and digestive problems often join with the cognitive challenges that anxiety disorder presents.  In General Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD) the symptoms become so severe that normal daily functioning becomes impossible.

Wednesday, February 13, 2019

Inertia, Failure, and Work

I have a lot of ideas.  Some of them good ones.  I’ll get started down the path to developing one, maybe even turning it into a thriving business, and somewhere get derailed and left in a gully beside the path sure that some competing idea is better, or the original idea had some philosophical flaw making it of little positive benefit to the people I wished to serve.  I’m experiencing that right now.

Wednesday, February 6, 2019

The Dark Night

I've received many benefits from my meditation practice.  Yet, as I've written in some of my most often read posts, I'm skeptical about the vast positive claims the proponents of mindfulness meditation make.  It truly can't be this good for everyone who undertakes it.

Today many teachers with little depth of understanding of the challenges meditators can face are leading students into practices that, while often very positive and relaxing, can lead a troubled mind to very dangerous places.

Wednesday, January 30, 2019

Our Fear of Silence

The cultivation of mindfulness requires periods of focused attention.  Many proponents of mindfulness maintain that this is best developed through seated, silent meditation.  So, in exploring how to focus the attention, we must first consider our relationship with silence.

Whether in the center of a city or deep in a forest, the cacophony of sounds around us makes it apparent that true silence is impossible.  Composer John Cage wrote music that included long periods of silence.  When the musicians stopped playing, concertgoers were quickly confronted with the shuffling, shifting, and coughing sounds in the concert hall.  So what is silence?  I like to think of it as the absence of intentional sound.  Intentional sounds are the things we turn on such as TVs and phones, the words spoken or heard in a conversation we are engaged in, music we make such as humming or tapping, and the noise of tools, keyboards, or other objects we are interacting with.  Sounds that remain are unavoidable.  So silence is when we are purposefully quiet.  For many of us, this can be unsettling.

Wednesday, January 23, 2019

Getting Older with Bipolar

I'm writing a new blog for PsychCentral called Getting Older with Bipolar.  It deals with issues of aging and mental illness.  I'll cover everything from the long-term use of medication to living successfully with bipolar disorder; from relationship issues to financial planning and more.  Please have a look:

Getting Older with Bipolar

I'll still be posting here on this site each week as well on meditation, movement, and meaningful work.

Wednesday, January 16, 2019

How Guided Meditation Can Become A Distraction

I come from a long line of seekers, my mother’s side of the family known for trying on various spiritual traditions in a search for truth.  My mother herself has been experimenting with meditation recently, and has tried several forms of guided meditation.  The one that has worked best for her is Oprah Winfrey's and Deepak Chopra’s 21-day meditation challenge on the computer.

Last week she wanted to share with me a meditation she finds beneficial.  It was a busy day at her house, with much of the family in and out, so we escaped to her office to follow the guided instructions.  While I am glad so many people are following this program and finding relaxation in meditation, I found it too distracting to be truly mindful.

Wednesday, January 9, 2019

State Your Intention

Mindfulness Meditation, or working with the breath and releasing thoughts as they arise, has been very helpful to me for many years.  The health, cognitive, and emotional benefits of this practice are well documented.  But sometimes, to the horror of my teachers, I pull out a notepad and start paying closer attention to the thoughts skipping through my mind during meditation periods, turning each meditation into a period of contemplation on goals and intentions.  Meditation has demonstrated that it makes us more open to more ideas, and more noticing of novel thoughts.  So why not put this to use every once in a while?