New Year, Yoga and Writing

This year I have avoided the usual obsession with new year’s resolutions versus intentions and turning over new leaves, etc. Usually I get excited to start new habits, make all kinds of exciting changes and feel like I’m going to accomplish all these goals, then, like most people, run out of steam and keep very little going or follow through.

A while ago, as a way to look at the new year differently, I started picking words for the year. Last year was “Abundance”. It really turned into a year of abundance, which required patience and trust because abundance doesn’t just pour into your life on day one or month one or two! This year the first word I came up with was “AWESOME”. Then I picked two other words, “Quiet” and “Concentration” as intentions/motivation to continue things I’m already doing, especially my yoga practice.

My yoga practice has been the one thing I’ve kept up regularly for the last 3 and a half years. I already wrote two very long disorganized posts about it and realized I do want to write about it, but I need it to be organized and as usual, much shorter.

So this year, to add to my 6-7 times weekly 25-40 minute home yoga practice, I decided to link yoga with writing, as my intuition was that the two will go together well.

So this post is just a short post about my new year’s intention to link my yoga with writing. Since the new year, I have read a bunch of blog posts about different aspects of yoga, found some books, and started writing about my yoga practice.

Yesterday I wrote a long draft for a post on this blog, journaled a bunch before doing yoga, and then attempted to write in my journal a little while doing yoga and filled a page after my daily yoga in the evening. I decided to try to write immediately after doing yoga at least 3 times a week.

It’s going to be an experiment to see what comes up that I feel like writing about and how I am thinking about my practice, or what comes up specifically in any sequences or poses or other things that come up that may have little to do with yoga or seem to have little to do with it.

The words “Quiet” and “Concentration” can be connected to my writing and yoga. Sometimes doing yoga on my own is for the goal of getting quiet and working on disciplining the mind and body and learning how to be able to really focus and concentrate, which is definitely challenging with an undisciplined disorganized and full ADHD mind. I also associate these concepts with a story that I read a few years ago with my daughter that we’ve read several times and is one of both her and my favorite stories,  “The Wonderful World of Henry Sugar”, by Roal Dahl. It’s written long ago but the basic concepts are very universal and the story is about the use and misuse of yoga/training the mind. It’s a great transformation story in the category of stories like A Christmas Carol and the movie Groundhog Day. A selfish self involved character full of flaws, who goes through a spiritual transformation and becomes an enlightened evolved person who gives of themselves to the world, very uplifting. Everyone loves a sinner to “saint” type of story!

Sometimes getting quiet while doing yoga involves just noticing how not quiet my mind is and how distracted I am or how I am focused on what the next yoga pose will be or getting over with each pose. The challenge of concentration involves a lot of mindfulness/DBT “Radical Acceptance”.

Other topics I’d like to write about that go with yoga/writing are:

-how I got going with my home practice after 7 year hiatus of not doing yoga

-what my home yoga practice actually involves and how I learned to sequence from an intuitive approach in the moment

-the role of my yoga “coach” and teacher Liza in helping me learn about the physical, mental, and spiritual practice and deepen my practice

-yoga in everyday life and ways to use yoga to live life from a more accepting and moment to moment awareness

-yoga and “failure”

-the yoga of speech

-my specific challenges with my writing process

-yoga and ADHD and other issues like anxiety

 

Short Post: “Thanks for Sharing”

I intend to post a whole series about the phenomenon of the “Selfie”, and started writing a long complicated post. However, I will be out of town next week, so I probably won’t post then unless I find something great to “reblog”.

So this post is about the film, “Thanks for Sharing”, starring Mark Ruffalo and a with a great supporting appearance by the singer/performer Pink who turns out to be a really good actress. Gwyneth Paltrow and Tim Robbins and Joely Richardson. ImDB describes the movie as “A romantic comedy that brings together three disparate characters who are learning to face a challenging and often confusing world as they struggle together against a common demon: sex addiction.”

It’s directed and partly written by Stuart Blumberg who is known for writing the movie, “The Kids Are Alright.”

This movie did not get much attention before, during or after its run in the movie theaters, however, I went to it and actually really liked it and I think it is very under appreciated. I have told many patients to see it as I work with a lot of people who attend 12 Step Meetings of various kinds and for whom the 12 Step Program is a healing and integral part of their lives and recovery.

Anyway, what struck me the most about the movie is that the 12 Step Program, in this case S.A. Sex Addicts Anonymous (there is also SLA, Sex and Love Addicts Anonymous) is the main character portrayed on many levels in the flim.

Well, I just learned something: there are 4 different 12 step programs that address this kind of addiction/compulsionnn, not just the above two:

Sexaholics Anonymous (SA)
Sex Addicts Anonymous (SAA)
Sex and Love Addicts Anonymous (SLAA)
Sexual Compulsives Anonymous (SCA)

FOr a good description of the differences between these, here is the link I found:
http://www.billherring.info/atlanta_counseling/how-different-12-step-meetings-for-sexual-recovery-define-sexual-sobriety

THat’s what I love about blogging. I learn as I write! As the main character, SA links all the characters together, not just the main one played by Mark Ruffalo. In the opening shots the camera goes down streets in NYC, and what I found great was that the cinematographer captured the point of view of people with sex addiction in terms of their having a different brain response to stimuli in the environment, especially visual stimuli. As the camera goes down a crowded day time NY street, it captures how just about anything, not just people, but inanimate objects, can be taken in as a sexual stimuli, and gives you an idea of the brain of a sex addict getting “triggered” by anything, even a fire hydrant or street light, as well as any random person walking down the street of any gender.

The movie captures the essence of the 12 Step Recovery System which is not for everybody as it follows an abstinence sobriety model, not a moderation/balance model. It is highly effective for many people with sex addiction issues though. The main human character in the film has about 5 years “sobriety” which means he has had no sexual activity including masturbation in 5 years. The longer recovered addict played by Tim Robbins is his sponser and the Ruffalo character is sponsoring a newly in recovery, forced to go to 12 steps person who is still out of contol. Pink enters the movie later and is also a sex addict with little recovery time. So the movie does a good job portraying the different challenges of 12 Step Receovery for the long recovered married addict, the 5 year person with the challenge of having to stop avoiding dating and relationships to more fully recover, and the struggling beginning addicts who are stumbling along having a lot of trouble staying sober and “slipping” while still going to meetings. What saves the two early recovery people is that they bond and help each other because they are on the same level. Ruffalo refuses to sponsor the new sponsee because he is not actively doing anything in his recovery and not being truthful in the meetings or with his sponsor.

For the long recovered addict played by Tim Robbins, there is a great portrayal of a split that can happen with 12 Step Recovery. His SA sponsor role model self is very dedicated and he has saved his marriage and developped a kind of father son relationship with his sponsee, thus making progress with SA while in his personal life, he is having a lot of trouble with his son who is also an addict. He does not accept or validate his son and his disagreements with his wife are about the son. So his main conflict involves changing as a father and stopping hiding behind the replacement father role of being a better sponsor to his sponsee than father to his son…

The Ruffalo character has the challenge of starting to date someone and figuring out how to “come out” about his sex addiction without scaring away his potential girlfriend, and being challenged by relapse and the messiness of life that he cannot avoid anywya.

THe movie zeroes in on the special fellowship of the people at this SA meeting and the way it can be a supportive community, but the challenge is to go back out in the world and manage on your own with your sobriety. The movie is complex enough that we see several different kinds of challenges faced by the characters in SA, as well as seeing how they fare trying to explain their addiction and recovery to non addicts. Because the movie takes on the challenge of sex addiction, which is not understood by the mainstream culture very deeply and which has a lot of shame associated with it, it does have a lot of gorund to cover and cannot be extensive, so unfortunately it only shows people identified as heterosexual with these struggles, and would have been a deeper movie if there were characters from the LGBTQ community.

Much more can be said, but I will end with a few important 12 Step phrases that were important in the film and quite helpful to anyone. “CLean your own side of the street” said by a non sex addict, the partner of the Tim Robbins character, about how she has managed to stay in her relationship and be growing in it. She is aware that she has her own work to do on herself and that her husband’s sex addiction is his “Side of the street” and his problem, not hers. “THanks for sharing” is of course the title and based on what people say in meetings in response to someone sharing their struggles. This phrase is actually very meaningful, it covers the attitude of gratefulness for recovery and rebirth and second and third chances as well as a grateful attitude towards everyone who comes to a meeting. All can equally share no matter how much sober time they have. It is the “Sharing” and community that really aids in the healing process and can be true for any kind of therapeutic healing or group. The mere act of sharing and being validated is very powerful for anyone struggling with mental illness and/or addiction. The two minor characters with little experience sober are sharing with each other outside the meeting and it actually works, because the writer knew not to drama things up and have them sleep with each other. Instead they are learning to have a non sexual relationship through SA, which is incredibly healing for them to “share” in the kind of friendship neither has yet experienced.

So I highly recommend this film as a great effort at portraying some aspects of 12 Step Recovery and the humanity of a person who has done the kind of terrible behaviors sex addicts are compelled to do. This is the other side of it, so we can have compassion for all the characters wherever they are in their recovery, and understand the struggles they have due to a probably biological as well as environmentally caused disorder/imbalance.

The “New” Fairy Tale: “Brave” and “Frozen”, Finally “Feminist”!

A quick post on Disney’s newest princesses.

The movie “Brave” is the older movie that came out in 2012, awhile “Frozen” is on a long run currently still in theaters and has become a big hit with both boys and girls. In both these movies, I was excited to notice that the relationships that are revealed as most important and the ones connected to the main “conflict” of the story, are between the main female characters, mother and daughter in “Brave” and sisters in “Frozen”. Both movies focus on relational conflicts between the two female characters, with the male characters in supporting roles or pushed very much to the side of the action…

One unfortunate part is that in each one you have the stereotypes of the archetypal females, such as “the ice queen”, the “cold” type of woman who doesn’t seem to have “needs”, the very rigid and insensitive mother in “Brave” and the distant rejecting older sister in “Frozen”. The young girl in “Brave” is actually a well fleshed out character with contradictions, but the young girl in “Frozen” is a little too flat, portrayed as “naïve”…. Unfortunately, I ultimately prefer the earlier movie “Brave” because the main character is much more appealing and “full”.

When I saw “Brave”, I was very excited to finally see a princess movie about a princess not wanting to get married. The main driving force of the plot is Princess Merida’s wanting to escape her mother’s rigid enforcement of her getting married and getting married when she the queen wants. The movie turns the princess meets prince and lives happily ever after on its head in many ways. Merida is the antithesis of the typical Disney princess; her hair is neither blond nor black; it is red and wild. She loves archery and horse back riding. She is smart, adventurous, independent, unique, and, well, brave! Her mother is not dead and not an evil stepmother, but nonetheless not very open-minded. Her father is not dead either, but like most of the males in the movie, he is portrayed as rather impotent and does not “do” anything to help his daughter, as his wife is the one in charge. He also is missing one of his legs due to his fight with a bear. All of the “suitors” are also portrayed as rather helpless and hapless. Merida is the best archer and they are also portrayed as rather unintelligent and slow. Even Merida’s little brothers are not very developed; they mostly want to eat sweets. Even though, these are castrating portrayals of males, it seems ok that Disney does this, as forever, we have been subjected to portrayals of females as weak, innocent, and needing a man to complete their identity.

The main conflict in “Brave” is between mother and daughter, who want different things. The mother does not listen to her daughter’s plea to be left alone and not forced to marry, so Merida ends up turning her into a bear. By the end of the movie, the daughter and mother have both changed, grown and evolved; they now appreciate each other and have become closer. The mother “lets down her hair” and opens up, and the daughter, having saved her mother and got her back to being human, mends “the bond” between them. Instead of the movie ending with a wedding, it ends with the mother and daughter riding off on horseback together, with their hair getting swept and swirled by the wind, both having learned a valuable lesson and become closer in the process.

Hair is a big thing in fairy tales and movies based on them, which is why I focused on it in describing “Brave”. The color and kind of hair, the hairdo, all of it is meaningful. In “Brave”, the mother tries to “tame” her daughter’s red locks but they return to their natural state of wildness and the mother’s hair goes from being tightly controlled and “perfect” to loosening up. In the movie “Tangled”, the most recent portrayal of Rapunzel, I noticed that the wicked person looks like a Polish woman with very dark curly hair, and I think some grey streaks, which struck a cord as it looked like my own hair is currently. Of course, the whole fairy tale Rapunzel is centered on her long hair and a whole blog post could be written about that. Anyway, in “Frozen”, hair is again metaphorical and symbolic. Anna, the narrator and main character, has a white streak in her red brown hair from when her older sister almost “froze” her as a young child. Later on in the movie, her hair turns completely white when her sister has frozen part of her heart. Her hair turns back to its regular color at the end of the movie when the conflict between the sisters is resolved.

“Frozen” is also fascinatingly different from typical princess material in so many ways. It makes fun of the main stereotype of most fairy tales, the idea of “true love” being between a prince and princess and that they fall in love at “first sight”, without knowing anything about each other, that they “complete each other’s sentences and complete each other”. The real “true love” in the movie is that between Anna and her older sister Elsa. Elsa does not know how to control her power to “freeze” things, and at first sees it only as dangerous when she gets scared by what she does to her sister. Her keeping alone and distant from her younger sister is done out of love and fear that she might destroy her with her power. The movie is seen from the point of view of the younger vibrant silly, exciting extrovert Anna who does not understand why her sister has always pushed her away, kept her out, left her alone, rejected and been “cold” to her. Elsa by nature stays alone and avoids people, supposedly due to her powers keeping her literally at arms length from everyone. One thing I noticed in reflecting on this relationship was that the whole event of Anna meeting her “suitor” on her sister’s coronation day and believing she had “fallen in love with him” and deciding to marry him really had nothing to do with her actually falling in love with this man or believing she was infatuated with him. The whole impetus to trust this man came from her I think finally going outside the castle and still feeling rejected by her sister. Her act of coming to her sister with this “fait accompli” and introducing him was more about her relationship with Elsa than any desire to marry anybody. She was essentially saying, “You won’t pay attention to me or let me in or be close to me, so I will go find the first man that is nice to me, spend the evening with him and then tell you that I’m going to marry him because if you really care about me at all you will actually tell me you don’t want me to marry him and ALSO be close to me again in the way that I want you to be.” The fake closeness she has with this stranger is more warmth she has experienced since her sister “dumped” her long ago, so of course she is very open to being with anyone who acts loving toward her. Even her interaction with the other guy, the one she meets when looking for her sister seems related to her sister. He is similar to the cold aloof Elsa in that he is a loner, content to do his work with his deer and not interested in interactions with other humans. He is not very friendly either. Perhaps she is drawn to him not only because he knows how to get around in the cold but because he reminds her of Elsa!

Another funny aspect of this movie is the way it portrays the older sister and younger sister relationship; the older sister stops playing with the younger sister and rejects her. She knows things the younger one does not know or understand. She wants to be left alone, while the younger sister craves her attention, is puzzled by the rejection and saddened by the change from playing together to being left to play by herself. How many sisters have experienced this? Of course there are other kinds of relationships between sisters, but the movie portrays one of the main kinds of older versus younger sister dynamics, where the older sister later comes to see that the younger sister is not as naive and ignorant as she once was; the younger sister has “grown up” and the dynamic shifts in adulthood to a different kind of appreciation of each other’s qualities.

Anyway, there is more to be said about these movies and their attempts to turn the stereotypical princess story on its head, but I must say, I am very pleased to see these mainstream Disney princess movies take on more complex and interesting themes, conflicts and plots, shifting from the unrealistic “true love” marriage tale to some more complicated focus on the family dynamic between two females, mother and daughter and sisters, older and younger and reveal two courageous characters who are fighters in every sense of the word… I wish I could have seen these movies when I was around 5 or 6 and thought marriage and having kids was awful!

Probably Last Post Before Vacation! Should Be About Vacation!

What to say about vacation this year that I did not already cover about a year ago?

I am following my new rule about taking at least 14 days off. I will be away from the afternoon of Friday, July 12 through the afternoon of Monday, July 29, which turns out to be actually 17 days if you count the two half days at beginning and end as one day, so I am pleasantly surprised as I thought this year I could only miss two weeks of work. Essentially I will miss the two weeks and maybe a few more hours total.

Why care about missing days? For one, Money! Money, as I have blogged about it before, is quite important, especially when planning a vacation. First of all, I don’t get paid vacation days or sick days, so every day off is a day I am not making any money. In addition, vacations always cost money. This year, like last year, there are no expensive plane flights, just car rental and gas costs. Staying in a friend’s cabin upstate means no extra hotel costs, so it is a pretty low budget great vacation. Those of you that enjoy camping and being outdoors in the middle of nowhere would appreciate my choice of going again to the Froggy Pond Cabin in upstate NY near Cuba, NY which is close to the bigger town of Olean, NY. Another reason to care about days I will be on vacation is really just that I discovered the hard way that one week is not enough for me. It takes me a while to get used to being away from the noisy energetic city and adjust to the relative peaceful, calm and silent aspects of the woods. Then coming back involves transitioning back to civilization, so usually there is a visit at the end to old friends in Ithaca, which is a small town but not in the woods in the middle of nowhere!

Some of the great things about taking this same vacation for the third (I think it’s three, might be more) year in a row is that I get the same benefits at a low cost: being in nature, away from the city, for the most part away from the internet though I check emails from time to time, but it’s really a vacation from the annoying distractions of TV and internet, then the frogs again. Going there in end of July is a perfect time to hear the frogs wonderful chorus, especially at night! Plenty of time for art making out doors and making art on vacation is different from making art in NYC. This year wanting to pack light, I will not bring a ton of materials but will have the fun of shopping at JoAnne’s, which is really fun, as usually I get things from there online. There is a Joannes in Staten Island but I have no idea how to get there. Plus shopping on vacation is more fun anyway. There are cool dollar stores with odd kinds of things and surprises, plus JoAnnes which has a lot of crafts materials, and once in a while some random shopping mall has cool outlets to check out. There is also some planting to do, so going and buying soil and flowers and stuff like that is fun and different.

Each year we try to think of new things to do. Last year we went to a drive in movie, which I think was the first one I’ve ever been to! So we will do that again. Maybe some berry picking and hiking. For me always there is reading as I love reading but seldom have time to really read a whole book. This year I am being strict with myself, no books related to my work, so I will bring some kind of book of poetry, one or two graphic novels and maybe a memoir…

Ok. I’m off to a movie, so I will actually post again before vacation! as I haven’t finished with my thoughts on vacation…

This week’s post: Celebrities Help With Society’s Progress in Understanding Mental Illness

I am still interested in raising more questions about society’s views, perceptions, misconceptions, stereotypes and prejudices regarding mental illness, as well as asking, “How far have we come in a positive way?” because it is true that we are improving.

Let me make this post more reflective of some positive progress in our society in understanding mental illness. Recent disclosures of celebrities regarding their struggles have been invaluable. Like it or not, celebrities can have a huge influence on citizens’ thoughts and perceptions, regarding everything from attractiveness to mental illness. (Of course, Angelina Jolie’s recent public revelation about her double mastectomy has been instrumental in helping women cope with the possibilities of developping breast cancer, and I even know people who, after hearing about this, decided it’s about time I go get that mammogram I’ve been avoiding. How amazing and wonderful!)

Catherine Zeta Jones comes to mind as the most recent “celebrity confession” regarding serious chronic mental illness. She suffers from Bipolar 2 Disorder, which is less severe than bipolar 1, but her mere talking about her struggles and explaining them even went further to educate people, because the vast majority of people do not even know what Bipolar 2 is or about its existence, so one could argue that though she has a less severe form of Bipolar Disorder, she has been couragesous and invaluable in helping people understand how complicated Bipolar Disorder is and also even more importantly, that many people who have any form of Bipolar Disorder are able to function and contribute greatly to society. The mere fact that many individuals with Bipolar Disorder are “in the closet” about it at work and in other arenas, reveals how easily those people who are taking their medication and other treatments are able to “pass” as not having any type of mental illness.

Wow! How timely. I just googled her and bipolar and she has just the other day, emerged from going to a treatment facility for Bipolar 2. Here is the article in the LA Times:
http://www.latimes.com/entertainment/gossip/la-et-mg-catherine-zeta-jones-bipolar-treament-completed-20130523,0,2772184.story

Actually she first revealed her struggles with bipolar a while ago. In fact, she was “outed” in the fall of 2012 and discussed her struggles in her cover issue interview in InStyle magazine, so actually it should not have come as a shock that she sought out treatment very recently, as most people knew back in fall 2012, as InStyle magazine is pretty mainstream:
http://www.usatoday.com/story/life/people/2012/11/13/catherine-zeta-jones-instyle-cover-helps-defuse-bipolar-stigma/1703053/

Zeta-Jones is not the first to discuss her struggles with mental illness and really help dispel a lot of stigma about it. I don’t usually like to quote from Wikipedia as it is so easy to just go there for info, and I like to cite a variety of websites, but they do have one of the most extensive lists of celebrities who have suffered from some form of schizophrenia:
http://en.wikipedia.org/wiki/List_of_people_with_schizophrenia

There are many celebrities who have talked about their battles with depression, whether as a teenager or adult. Kirsten Dunst was all over the news in August-November 2011 talking about her most recent bout with depression. I learned about it from watching of all things, the E channnel’s coverage of Celebrities with mental illnesses. This supposedly “superficial” channel about celebrities actually did a great show quite a while ago and extensively covered the range of disorders from eating disorders to depression to anxiety, bipolar and also drug/alcohol abuse. I just looked it up and it came out in 2008; I remember watching the show and I really thought it was a great way to help people understand mental illness and related disorders and see that wealth and fame have nothing to do with mental health. This is the summary of that show:

“Celebrity Crises: 10 Most Shocking Mental Disorders is an American television entertainment special produced by E! Networks which documents the mental trials and tribulations of some of Hollywood’s biggest stars.

The special originally aired in the USA on E! Entertainment on 22 August, 2008. It is 50 minutes long.
Synopsis

When Hollywood stars are diagnosed with a mental health ailment it’s big news. From rumours about Britney’s bipolar disorder to Heath Ledger’s bout with depression, phobias and mental illness are getting more attention.

But of course, mental illness can affect anyone. Close to 58-million Americans — about one in four adults — suffer from a mental disorder.

From eating disorders (Mary Kate Olsen) to depression (Heather Locklear, Kirsten Dunst, Mia Tyler, Jim Carrey, Heath Ledger), to cases where stars have harmed themselves (Christina Ricci – cutting) this one hour special will explore ten troubling mental disorders, with interviews from doctors, psychologists and the stars themselves.”

The show may not have been extensive and totally informative about all these disorders. Who could do that in 50 minutes? However, it was great in scope and just introducing these different issues to the public.

There are also people in politics who have a lot of power to help the public understand mental illness and decrease the stigma and shame. There are also pioneers in the mental health field, such as Kay Jamison, who is not only an expert on mood disorders but wrote a great memoir of her own struggles with Bipolar 1 Disorder, titled “An Unquiet Mind”. The fact that she is well known for her own “coming out” about her personal struggles, indicates we still have miles to go in decreasing stigma, as we see that in the field of mental health itself, the majority of psychologists, psychiatrists, psychotherapists that suffer from any mental illness do not actually feel safe disclosing about their personal struggles. Another author and therapist who has written some great personal accounts of her own struggles is Lauren Slater. Her work is more on the edge and less well known to the general public, but she has written many interesting books about a variety of struggles.

So, in closing, I do believe that some of the best ways to educate the public about mental illness is through the mainstream media, whether it be a celebrity disclosing their struggles and talking openly about their treatment, or even films that attempt to focus on the topic, whether documentary TV shows like the one mentioned above, or the many biopics and fictions films about mental illness, such as the film “A Beautiful Mind” and the TV shows “Homeland”, “Six Feet Under” and “The Sopranos”, as well as numerous others. Even when such films or tv shows don’t give a totally accurate depiction of a specific mental illness (see my reviews of “Silver Linings Playbook,” they are still contributing to the more healthy dialogue that we need to have about this topic. A little misinformation is worth it if the subject at hand becomes more familiar to the general public and helps people view this topic with more compassion and less judgments…

Violence and Mental Illness: The Stigma and the Truth

This is a huge topic, so I will only touch on one “mental illness”, as there is a trial all about BPD in the press and the jury is deliberating whether to send the woman to be executed or not. So I am not going to write about BPD, as it is extremely complicated and I’d rather wait and see what happens with the jury’s decision and then post on BPD and violence. Just one thing to say, without any statistics, it is my experience that people suffering from BPD do a lot of self harming rather than violence towards others. Everything from extreme binging and purging, self-mutilation, repeated suicide attempts, drug and alcohol abuse, etc. plagues people who suffer from BPD.

As I was posting about the movie “Silver Linings Playbook” and felt that it gave a bad impression that people who are going through mania and manic psychosis are violent, I wanted to write about that and shed some light on it. A colleague shared with me that unlike my experiences, she had seem many males who became violent while manic and in the midst of a manic psychosis, so I wondered, is this movie off the mark or not?

Ok.
I looked around the internet and found a study done in England around Sept. 20101. You can read the whole summary here:

http://www.ncbi.nlm.nih.gov/pubmed/20819987

Here’s the important finding, which is that the comorbidity of substance abuse and bipolar disorder is what increases the incidence of violence in people diagnosed with Bipolar Disorder. In regular English, this means that the subgroup of people who have BIpolar Disorder and are abusing drugs and alcohol on a regular basis, usually knows as “MICA” (Mentally Ill and Chemically Addicted), and requiring treatment of both problems, that those people are more likely to be violent than the general population. However, it seems the risk of violence in individuals suffering from BIpolar Disorder alone is minimally different from the rest of the population. This makes sense as there is probably a lot of evidence that especially polysubstance abuse but also alcoholism and any drug addiction that becomes severe and episodic can result in violent behavior. Which is not to say that every alcoholic or person suffering from drug addiction is dangerous, however, I am sure there are some statistics out there supporting a higher evidence of violence occuring among this population…

“During follow-up, 314 individuals with bipolar disorder (8.4%) committed violent crime compared with 1312 general population controls (3.5%) (adjusted odds ratio, 2.3; 95% confidence interval, 2.0-2.6). The risk was mostly confined to patients with substance abuse comorbidity (adjusted odds ratio, 6.4; 95% confidence interval, 5.1-8.1). The risk increase was minimal in patients without substance abuse comorbidity (adjusted odds ratio, 1.3; 95% confidence interval, 1.0-1.5), which was further attenuated when unaffected full siblings of individuals with bipolar disorder were used as controls (1.1; 0.7-1.6). We found no differences in rates of violent crime by clinical subgroups (manic vs depressive or psychotic vs nonpsychotic). The systematic review identified 8 previous studies (n = 6383), with high heterogeneity between studies. Odds ratio for violence risk ranged from 2 to 9.

CONCLUSION:

Although current guidelines for the management of individuals with bipolar disorder do not recommend routine risk assessment for violence, this assertion may need review in patients with comorbid substance abuse.”

So, to get back to the movie, they did not show the protagonist drinking or doing drugs at all in the movie as far as I remember. Even at the football game, I don’t think he was drunk, but I could be remembering wrong. It seemed like the only hints of drinking under stress were evidenced by the character Tiffany who did not suffer from bipolar disorder, and she was not portrayed as abusing alcohol. So I think this movie could mislead the public into associating manic and other forms of Bipolar Disorder with episodes of violence, when the evidence does not support it…

Here’s another article about the topic, talking about men vs. women but also focusing on the co-occurence of substance abuse and bipolar episodes. The memoir by Marya Hornbacher: Madness: A Bipolar LIfe, is a real roller coaster ride, and great portrayal of someone with a huge drinking problem and bipolar disorder and the self destruction and pain she undergoes after recovering from a very severe eating disorder.

Here are her words about her drinking:

I started drinking when I was ten. There’s a scene in the book where I talk about discovering the booze in the cupboard underneath the stove… It, too, functioned very briefly as a mood stabilizer… It elevated my mood, and just made me feel like I was flying. Instead of feeling like I was going up and down and up and down, there were no more crashes. For a few hours at a time, I wasn’t terrified, I wasn’t anxious — I was just high as a kite. Of course, like any other alcoholic, the reasons you do it at first become irrelevant, because then, you’re just drinking because you’re an alcoholic. When you try to stop drinking, as I did many, many times many years later, you realize it’s not about anything. It’s a function of a kind of desperation and addiction.

So, of course, this topic is extremely complicated, but it is interesting how adding addiction to any other issues magnifies the risks of impulsive behavior, self-harming and suicidal behavior, and sometimes violent behavior towards others… But it makes sense that I have worked with and known of so many cases of people suffering from various forms of Bipolar Disorder who never had any episodes of any violent behavior towards others…

Silver Linings Playbook; From A- to B-/C+ in Less than a Week!

ok. I had a terrible day today, so it feels like the perfect time to have fun writing this post because I saw Silver Linings Playbook for the second time the other day and I was blown away — by how much worse it was on a second viewing! I almost felt scammed or literally “played” that I had such a “manic” experience loving it after a first viewing.

Basically for me, the big test of a movie is, does it stand up to being seen a second and then a third and then maybe even a fourth or fifth time? Doesn’t matter how soon you see it again. As I said in my last post, that is why I love films like “Bringing Up Baby” and more modern ones like “Spotless Mind”; every time I see them, I find something else to love about them and get great enjoyment out of seeing scenes I could practically play over in my head between viewings, such as the dog and dinosaur bone garden digging scene in “Bringing Up Baby.” In fact when I realized how much lower Silver Linings sank on the second viewing I remembered that I talked a lot about Bringing Up Baby in my glowing post; and I realized it was because the elements I liked about Silver Linings reminded me of that classic and maybe reminded me too much of how great that movie was! A really good movie like the “Spotless Mind” one doesn’t remind you so quickly of other movies because there are really great cool things in it to enjoy that seem totally unique to the movie even if it is a familiar “genre”.

So what took the silver linings out of “Silver Linings”? Just about everything except the characters of Tiffany and the father played by DeNiro. The fact that on second viewing the main character Pat did not seem like a real person and those other “supporting” characters were more interesting did not help it. Other complaints that can be quickly listed off: too many montages (I challenge you to watch it again and count how many long montages there are and how much time they take up in between real scenes)– unless you’re watching a cool music video, you do not want to be aware of having a montage much less five or more of them in a movie. OK. I guess my other criticisms do not fit into a short list. Let’s take the most important one, the portrayal of bipolar disorder:
On a second viewing I was shocked I did not notice this important thing the first time: Pat’s big episode was “triggered” by a violent situation which is terrible for many reasons. One, I have worked with many people with serious bipolar disorder and others with family members and close friends with bipolar and never in all the years of hearing all the stories of these people has any of them been described as involving violence, much less two episodes with violence in them (the scene where he almost kills the history teacher and the scene in which he hits his mom and his dad gets violent). This gives the general public a very strange idea about mania and bipolar psychosis and from viewing the film if you did not know about it, you would associate violence with manic episodes. In addition, as I confirmed by talking to a married straight guy about the film, most men in Pat’s situation might have done the same thing upon coming home to their wedding song playing and their wife in the shower having sex with the history teacher, without having any mental illness issue whatsoever, so it confuses the issue to have this event be the major event that results in Pat’s hospitalization. Plus if you watch the movie carefully, you hear that the lawyer obviously used mental illness to get him into the hospital for 8 months instead of put in jail, which puts the reality of him having it in question as it is referred to as “undiagnosed bipolar”. The icing on the cake is the scene where he ends up getting violent with his mom and then realizing he needs to take his medication. None of this fits any of the accounts I have heard of others’ manic episodes. The most common thread is the transition from mania to psychosis involving religious delusions and all kinds of intense meaningful LSD like spiritual experiences as well as grandiose delusions (ie. “I was convinced I had to fly to LA to the big premier of my brilliant movie, or, “I really thought I was god” “I thought I had found the cure to cancer and was about to receive the Nobel Peace Prize,” etc.) Sometimes if a relationship has just ended or some kind of intense love feelings are involved but not receprocated in reality the person while manic is convinced someone or several people are in love with him or her who in reality are not.

Anyway, that is a big problem with the movie on second viewing that makes me change my opinion of the TV show “Homeland”. I was a bit hard on it in my last review of this movie. I still think the ECT was strange and not well explained and that I would like to see the character have a session with a psychiatrist or therapist and also know what meds she takes, however at least her episodes are more realistically portrayed. We see that she is not in reality but we see how subtle it is that her reality is becoming out of wack, which is really well done on that show in that her job is already an inherently stressful and crazy paranoid making job and her obsession with the other character makes sense.

So “Silver LInings” still gets my approval for an ok portrayal of therapy and for the character taking the right medications. Probably the best scene in the movie that reflects the stigma of all kinds of mental illness is when he points out to his family and the others in the scene that maybe he and the other two “crazy” characters in the movie see things and understand things in a way that the others do not; I think that is true. If there is a silver lining to having a serious mental illness, it is that you experience life in a way that others do not and have a unique sensitivity towards others. The way seeing impaired people report that they their sense of hearing is very good…

So, lesson learned: watch out for getting too seduced by a movie that already has a lot of hype. Watch it at least two times before writing a big “I love it” blog post!!! We therapists sometimes get it wrong, that is for sure!