“Vulnerability sounds like truth and feels like courage. Truth and courage aren’t always comfortable, but they’re never weakness.” –Brene Brown

Tags

change, clinical practice, fear, research, social work, vulnerability

I’ve been thinking a lot about vulnerability lately, especially how it relates to research and clinical work. Boundaries and ethics largely shun vulnerability on the part of professionals, and historically this has been in an attempt to protect those receiving services. Similarly, the term “vulnerable” populations is used frequently to refer to communities and individuals who require special attention when being considered as part of studies or certain treatment modalities with the idea that they are higher risk of harm. And while I completely acknowledge the need for rigorous, careful thought surrounding work with people who are suffering or have less opportunity to speak for themselves, I’ve come to believe that tossing around the phrase “vulnerable” population is a cop-out and is preventing progress.

“Vulnerable” populations are in fact the exact opposite. They show incredible resilience and creativity in their coping with adverse circumstances and lack of resources. Low-income communities have family and friend networks that support and encourage one another, figure out ways to use the finances they have to survive, navigate in a world that has been set up to keep them down. Individuals with mental illness cope in a variety of ways that keep them on this planet even when it feels unbearable and they don’t have access to services that teach them skills. We are so quick to look at deficit, to pick out what is missing, or going wrong, and use that as justification for academic and clinical distance.

We need to come up with a new word, or drastically re-frame this one. Because right now it is so often used as a judgment, a predictor of failed outcomes and lost causes, rather than a statement of empathy or support. What started as a label that was meant to prevent manipulation and harm has morphed into something that is harmful in and of itself. We cannot let our concern for ethical care and research be tampered by stigmas and biases that have loomed over certain populations for generations. In over-protecting people that are assumed to be weak and incapable, we loose out on any chance to develop evidence based interventions and practices, as well as any opportunities for the members of those populations to have a voice, and more than that, direct involvement in decisions regarding services, funding, and care.

Applying the term “vulnerable” to certain populations has more to do with the people that work with them than the members of the communities themselves. Clinicians and researchers might be required to put more effort into their work with populations that face a myriad of challenges that are not easily solved, might have to think outside the box and push ourselves in ways we haven’t before. We, the professionals, are the ones that open ourselves up to vulnerabilities, for we might come under scrutiny for trying new things and empowering individuals that haven’t had much historically. We might have to do more work examining our own internal biases and attempt to look at the world in new ways. We might have to give up some of our academic privilege in order to allow the people we are work with equal chances to participate. We might have to be okay with being uncomfortable with truths are realities drastically different than our own.

We can no longer afford to dismiss research and treatment possibilities under the paternalistic gauze of protect those “most vulnerable.” Ethical, fair, social just work can be done with these populations with the understanding that they have inherent strengths and capabilities that come solely from the fact that they have had to figure out how to survive. Because “vulnerable” populations have become such largely due to systemic injustice and fear on the part of those in power, not because of an intrinsic failing or certain characteristics. We need to work together to develop research and clinical practice that support these communities, involves them, and recognizes their strengths and capabilities. “Vulnerable” populations do not need our pity or protection, they need attention and resources, partnerships with people who are willing to work alongside them to innovate and expand. Vulnerability does not have to be equated with weakness or helplessness any longer.

“But who ever said the easiest path is the one you should choose?” – Ellen Hopkins, Rumble

Tags

bravery, change, Intensity, journey, Living, mental illness, social work, vulnerability, words

I can feel it lately, though I don’t know how to describe it other than a deep internal rumbling, almost like hunger but thicker and complicated by a stew of emotions.

It started during my first graduate school class, when my professor told us that silence condones, that our voices as social workers are one of the most powerful tools in our possession, that words are a vehicle towards change.

It continued as my eyes were opened to the unearned privilege I’ve carried my entire life with complete unawareness, unawareness born because of that very privilege.  It strengthened as I learned about our American system and how it is oppressive at it’s very core, how for the first 30 years of my life I have been quietly and passively walking on soil that is stained and stolen.

It grew louder, more ferocious, when the majority of the academic community which so loudly touted social justice values went mute surrounding mental illness issues. It writhed with loneliness and fear when I was told not to speak of my own struggles, not to share my personal story, not to be who I am.

And it’s there now, this rumbling, as I write these words.  I’ve cried over it, denied it, tried to throw it away.  I don’t want the heaviness of caring so much.

But I do.

So I’m releasing that rumbling, turning it into a thunder clap, a roar.  I don’t want to be a part of a world where so much is broken, so many differences are ostracized and demonized and oppressed.  I don’t know what it’s like to be black, to be homeless, to be Native American, and I hope to continue in my learning about allieship, about ways in which I can be a part of empowering those communities, raising those valuable voices above the din of privilege.

I do know what it’s like to have a mental illness.  And I’m finished walking the tightrope between silent safety and outright openness.  In a year and a half I am going to be a social worker who has attempted suicide, has scars from self-harm, has been in a psychiatric hospital multiple times.  And I’m going to be a damn good one.

And I’m allowing that rumble to guide me, that passion to drive me towards working for change.  I’ve always believed in the power of storytelling, that words matter.  Now my words will have rumbling behind them.

“Something happened here. In your life there are a few places, or maybe only the one place, were something happened, and then there are all the other places.” -Alice Munro, Too Much Happiness

Tags

emotions, faith, Intensity, labels, light, notenoughtoomuch, vulnerability, words

***This post may contain material that might be triggering for some.***

Too much is sometimes not enough, and not enough is sometimes too much.  This sounds like a tongue twister, a spin on words conjured up by dark-suited advertising men with slick hair and thick cigars.  I’ve found it to be mind-bendingly true, though, now that I’m shining the light on it a little.

I didn’t stop eating all at once, or even consciously.  It happened in a series of moments, entirely separate and contained, that somehow compacted like a rock gathering speed down a snowy slope.  When first set in motion, a rock rolls aimlessly, and slow, as an art-lover walks among museum paintings when an entire day lies before them. As it continues, however, the rock’s course becomes smoother, aligned; it is hard to catch the shift in speed until it is careening, with wild and precise abandon, downhill.

So when exactly I stopped eating enough is impossible to pin down; it happened gradually and all at once.  I didn’t notice, or want to notice, at all, and those around me didn’t notice until the rock was going full force, collecting flakes of snow and bits of pine needle to form a growing, evolving mass, impossible to catch.

At this point, enough for me was a fluid word, a feather blown about erratically by gusts of wind.  Some days enough meant breakfast and that was it.  Others enough was a calorie count, or three Diet Cokes, or as much gum as my aching jaws could chew.  It shifted rapidly and almost unconsciously, though the word repeated in my head rhythmically like feet slapping on a treadmill.

Simultaneously, too much became fragile and without shape.  It was ice cream and peanut butter, then any kind of bread, then red numbers on a scale.  And then the two concepts become almost intertwined, vines ensnaring a trellis, until not enough became too much, and the control that had seemed so concrete and logical crumbled like old brick in my hands.

Family and friends and doctors told me the amount I was eating was not enough, that the weight I had lost was too much.  What they couldn’t see was that notenoughtoomuch was the rolling rock, a new word with its own muscle and grit, a force howling along with its own cruel agenda.  And this entity was no longer external, but inside me; I was notenoughtoomuch, and I was the only one that seemed to see it, seemed to understand that the way to conquer it was to embrace it with bony arms.

It’s strange, looking back, how much I deeply understood my eating disorder in some ways, how I befriended it and protected it and cradled it like a small child.  Even before treatment I recognized it for what it was, and that was not the calorie counts in my notebooks or the rigid exercise routines I followed daily.  It wasn’t even an eating disorder, at the core of it; it has manifested itself as cutting, and drinking, and binging, and “risky behaviors” that are hard to put a diagnostic code on, like trying to please others, desperately attempting to fit neatly into Labels placed upon me, at the expense of loosing Myself.  If I were writing the next version of the DSM, I would put notenoughtoomuch as a spectrum “disorder,” because if a doctor really wants to help me on my path to wellness, asking me about notenoughtoomuch would be the best place to start.

That is probably too much to hope for, though, because notenoughtoomuch is so frightening, so hairy and hard to look at, that it scares people who know me well and who don’t know me at all.  Even as I write this, I tremble with the fear of sharing these notenoughtoomuch Words.  And yet, what I can do-must do-is allow notenoughtoomuch to manifest itself in healthier, Shinier actions and Words.  Hold on to the Faith that, while I am notenoughtoomuch for some people, there will be others for whom that is not their Truth, and rather than fearing the vulnerability, I can gather them as part of my tribe.

Notenoughtoomuch is a force, something within me, of me, is Me.  I can’t escape it. And I have glimpses every now and then of not wanting to.  Because I can train my Brain not to fear it, and maybe someday even love it, and allow it to be loved.  My toomuchnotenough Self will always have a wild, speedy course, but now it will be on a path that I blaze for Me.

“It is important for the poet not to be emotional because you cannot see the world clearly with tears in your eyes.” –Billy Collins

Tags

dialectics, emotions, poetry, vulnerability, wants, words

And what if

what the world needs-

and the world is too grand so

i’ll begin-again-with me-

what if

what i need-

and i don’t need

having Water

a Roof

Air in my lungs-

what if

what i want-

for i do want, though i have to practice

the saying of it-

what if, what i want

is a poet who allows us, allows

-me-

to witness the salted rains of stormy emotions

as each teardrop falls onto the keyboard,

releasing their Heart

releasing their Brain

lightening-Lighting-

my own

-because what if, what

I Want

is proof that i can be more Powerful,

See as clearly,

when i face The World

with tears in My eyes?

And so i’m left with

the gift of

what is

instead of what if.

And what is,

is that the only proof i might ever have

is the Words i type

and the tears i allow to fall as my

keyboard clacks and

I Write On…

“It was a lone voice in the middle of the ocean, but it was heard at great depth and great distance.” -Gabriel Garcí­a Márquez

Tags

dialectics, ocean, voice, vulnerability, words

Like tide-salted Ebb and Flow, each Word I write drags me further away and pulls me closer to the Truth I actually hope to Say.

“Good things come, and I’m not just referring to riding the buses.” -Lionel Blue Read

Tags

dark, emotions, faith, human, light, the bus, vulnerability

The day bus and the night bus are different.  In the sunlight, people board brief-cased and fresh.  We have a purpose, or the air of one, a destination in mind as we check our watches with a practiced flick of the head and sigh into our Smart Phones.

In the shadows, riders come and go unseen and silent.  We move with a weight, the stench of exhaustion heavy on our sloped shoulders.  Defeat is a passenger on the night bus, and Poverty, and Loneliness.

The bus itself is an entirely separate creature in the dark.  Like the fluorescent fish that haunt the ocean’s unlit trenches, the bus brings streaks of dazzling glow to the sullied and tired corners of the city.  It lures the drunk and tired with light that bursts forth, effulgent amidst dingy brick buildings and parked cars.  Alleyways that remain mired in gloom even in the noon sun are suddenly exposed by headlamps, and people crawl forth like termites from the woodwork, scuttling towards the blaze and quiet community of fellow riders.

I realized, recently, that even when I’m riding next to Defeat, musty and crumpled, I’m sitting three seats away from Hope, too.  I can catch an eye-glimmer from Glee, who is wearing a sunshine-yellow suit and whose jolly-nosed red shoes seem to be tap dancing under the bench.  It might be me who is Sorrow, walking in the trenches of my well-trained Brain, until I look up and see Joy bouncing down the aisle with an alligator-grabber from the Zoo gift shop and the wide smear of a chocolate grin.

At a time when it is scary and uncomfortable for me to Come As I Am, the bus community reminds me that sometimes it is okay.  Evenings right now are especially challenging, as the fatigue of the day wears through my protective coat, and I long to be alone and held all at once.  So as dusk settles in, the bus pulls blazingly, blindingly up to my downtown stop, and my fellow termites and I scurry on board, join this tiny subsection of the Human Community with all its Emotions and Thoughts.  And in a strange way, I am held by this sea of people, even as they are all alone in their own heads.  We are alone, and yet forced to connect for a split second when we stand to allow someone else to sit, united when we hear the giggle of a child.  Whoever I sit next to, whether it’s Shame or Frustration or Happiness, I get to hold a little piece of it for a short time, even if they don’t know it.  And I get to give up a little piece of Who I Am, in the moment, too.  In a strange way I am struggling to articulate, we strangers on the bus share the Weight of being Human until we get off at our stop.

It is imperfectly perfect, this Coming As We Are, this showing up as Human.  I’m going to keep trying it, with Faith that good things come-on the night bus, on the day bus, and beyond.

“It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.” -David Foster Wallace

Tags

emotions, faith, Ghandi, Intensity, panicjoy, suicide, voice, vulnerability, war, words

Alert: this post may contain material that is triggering for some. If you find yourself in crisis, you can call 1-800-273-8255, or visit www.crisischat.org for support.

What I know to be true in this moment is that mental illness is like faith.

Some people say they believe absolutely in whatever they believe in, do it blindly and without doubt even if it is something they can’t experience through their 5 senses.  They call this Faith.  To me, Faith is believing absolutely, except when you are doubting absolutely, or when you are somewhere in between. It is having Faith that the only constant is change.  It is absolutely believing it is okay to doubt, and okay to believe, and okay to be in the middle.  Faith is believing, absolutely, that it is okay to come as you are, that you can show up as your True Self, even if you are punished for it.  Joan of Arc was punished for it.  Ghandi was, too.

Mental illness is scary, and full of suffering and pain and panicjoy.  Pain and suffering, both physical and emotional, are subjective; there are pictoral spectrums for people in hospitals to help their doctors and nurses understand the amount of pain they are experiencing, because Words are of little help in accurately describing an internal experience (though for me they are the closest I can get).

Joy is subjective, too, though we don’t like to think about that, because it is a shiny, sparkly emotion that we like to think we can share.  And we can share it, just as we can share pain-but my Sarah experience of Joy will never be experienced by anyone who doesn’t have my Brain.  And the same is true for my Sarah experience of Pain.

And so I believe that Faith is subjective.  My definition of Faith, as described above, is true only for Me in this moment.  It might be true for others, in the moment that they read it, too.  I can only hope, because that would mean that I’m not quite so alone.  And it would mean that they aren’t quite so alone, too.  Because even though my Sarah experiences will only ever be my own, they might resonate with the experiences of others who are Living, or trying to Live.

People start wars because of Faith.  They always have.  People start wars because of mental illness, too-it just isn’t spoken out loud.  And I don’t mean that the people that start them do so because they are crazy.  I mean that wars begin because of fear and lack of understanding, and the fierce desire to stand in Your Truth, even if it means killing someone else who is trying to stand in Theirs.  Mental illness is biological, chemical, Real things happening in your Brain.  And it is, for me, being surrounded by fear and lack of understanding when I am Living My Truth, and being punished, sometimes, for Living In It.

Mental illness is scary to talk about, because when you are experiencing depression, or mania, or anxiety, or suicidal ideation, It is a uniquely You experience.  There are common threads, there are links, there are helpful and unhelpful things to say that are true for most humans when they are in It.  And what I, Sarah, look like when I am in It, and how I feel when I’m in It, only I will ever know.  That’s terrifying.  And that’s where Faith comes in.

My Faith is that, as I continue to show up as My True Self, in my Sarahness, it might allow others to do the same.  That in giving Words to this subjective experience, it might shine the light on the fact that it is subjective, but not unique.  That because I have personally been trapped, I have personally felt the flames, that I can truly “understand a terror way beyond falling.”  I’m on the sidewalk, now, and I’ve done the jumping.

David Foster Wallace understood the flames, too; he wouldn’t have been able to write those Words otherwise.  I wish that he had known, in the moment before he hung himself, that his Words would help someone else, like me, be a little more brave, a little more willing to use my wild trembling Voice.  Perhaps he would still be alive.  Not because I have any delusions about my power or impact, but because what saves me, daily, is people around me modeling bravery through vulnerability so I that I can imperfectly attempt the same.

And so,  as Intensely Intense as I am, today, I am so very grateful that I am Alive, and so very saddened that he, and many others, are not.  And all I can do in this moment, despite the very real risks, is continue to stand in my Truth, to say the Scary things, and to hold on tightly to My imperfectly perfect Faith as I press the “Update” button on my blog.

“WHY you lost your paperclips?!?” -John John

Tags

change, children, emotions, human, Intensity, labels, Living, paperclips, skillz, thesamedifferent, vulnerability

I was a fabulous teacher. If you’re thinking it sounds self-centered for me to state that, don’t worry-I’m thinking that too, and saying it anyways. I was a fabulous teacher.  I was a fabulous teacher because I would have done the job for no money at all (and it’s a sad truth that many teachers would say the same and many make so little that it is virtually true). I was fabulous because many of the traits that make me Me are traits found in Fabulous Teachers I’ve worked with or had.  Fabulous Teaching traits, and traits that I have when I am in my Sarahness. They are are these: I listen, and I allow people to come as they are.  What makes it Truly Fabulous, though, is that those are two traits children naturally possess, in a way that is so beautifully raw because they aren’t aware that they possess them.

You might be thinking I’m crazy (and I don’t use that word lightly!); anyone who has taught preschool, or had a child, or known a 3 year-old, would have good evidence to say kids can’t listen to save their lives (and I don’t use that phrase lightly, either!).  You need only watch 1 minute of a typical circle time to have concrete behavioral examples of how challenging it can be for young children to listen to each other.  But what I know to be true is that it isn’t challenging at all, it just has to be worth it.

Humans, little and big, young and old, make change only when they are personally invested.  The layers of that investment might be thick; someone’s reason to change might be that changing will ease the suffering of those they care about, thus easing their own suffering.  “I’m not going to binge today because I know that when I binge, people I love worry more, and it helps me when I help others not worry.” Or the layers might be thinner, more obvious: “I feel less physical discomfort when I eat one cookie instead of three, so I’m only going to eat one right now.”

We call children under a certain age “ego-centric” because they are; they can’t imagine that the way they experience the world isn’t the way everyone else does.  It’s something we try to teach out of them.  But, ultimately, all humans are ego-centric, regardless of age.  We all act only when it is worth it, on some level, to do so.  We all struggle to see outside our own lens of experience.  The problem is, we “adults” add layers of shame and guilt and fear onto this-we tell ourselves we should be able to step into someone else’s shoes, that acting for selfish reasons is selfish, and that selfish is bad.  But ultimately, we are all always acting for selfish reasons, no matter what.  Children just aren’t afraid to be blatantly selfish, until we show them that they should be.  We do this out of love and a desire to protect them, but what we really do is protect them from being their True Selves, give them the message that showing up as you are is not always okay, especially if “as you are” is Intensely Intense.

I stumbled upon this clip from an old Sesame Street show the other day, and I think it is brilliant.  It is brilliant because I remember watching it as a kid and seeing it as entertainment, and wanting to find some paperclips after the end of the episode.  And it is brilliant because when I watch it now, I see something totally different.  I see a little boy who is listening intently, and picking up cues, and becoming more and more confused because the experience he is having doesn’t match other experiences he’s had.  People don’t usually express Sadness, Anger, and Happiness all within a 1 minute, 25 second span (when they do, we label it disordered).  He, at the age of three, knows this, because he is unable to do what the puppet is asking him to do-show on his face what it looks like to be genuinely Sad or Angry or Happy.  Because he’s not any of those things, he’s totally, legitimately, confused.

 

John John does, in this brief clip, what I know kids to be innately capable of, when given the chance and motivated by their own desires: He listens, and he allows space for this puppet to come exactly as he is-Sad, Angry, Happy.  He does this naturally, despite his own confusion.  He teaches me more about emotion regulation and non-judgment than the adult human behind the puppet.

So, in my cyclical, long-threaded way, I’m back to this: I was a fabulous teacher. Because I didn’t teach at all.  Because I recognized, early on, that kids are the true teachers.  I got the privilege of observing them closely, of watching and listening and describing their journey as they made messes, literally and figuratively, and figured out entirely on their own how to clean them up.  And because I got to do that, I also got to listen to them, when they needed it, and to always make sure to tell them that it is okay to come as you are.  In telling them that, I was telling myself.  My human selfishness was that, in telling an intensely sad child that it is okay to cry and be intensely sad, I was telling myself that, too.  In writing these words I’m telling myself that right now.  And isn’t that what fabulous teaching is all about?

“I am thesamedifferent” -me

Tags

dialectics, Living, panicjoy, skillz, thesamedifferent, voice, vulnerability, words

I’ve written about thesamedifferent all my life, dancing around the concept by using Words like Change and Stagnation and Light and Dark.  A superhero and cherished friend of mine calls it “showing up differently” and “rising up” and using one’s authentic Voice.  Another superherofriend calls it using skills and Living Your Truth, based on an amazing book we both read.  Yet another superhero I’ve been lucky enough to know calls it “living my Sarahness.”

Today, in this moment, thesamedifferent means I am living in my Sarahness.  I’m also starting to recognize the smallest of ways I’ve been the true Sarah all along, shine the light a little through that darkness.  That’s where the different comes in.  I’m the same as I’ve always been, and entirely different all at once-thesamedifferent.

It’s thesamedifferent that I’m using my own Word to explain my current internal experience, not the words of anyone else.  It’s thesamedifferent that I’m using my own wild, trembling Voice to share this Word.  It’s thesamedifferent that last night, the night before my final Dialectical Behavioral Therapy skills group, I chose not to use skills, and instead used old behaviors to cope with overwhelm and panicjoy.  It’s thesamedifferent because, instead of wallowing in the shame of my choice, I’m holding my choice up to the light, and telling myself it makes sense, that it’s okay, and that I can make the choice to never do it again.  And it’s thesamedifferent that now I’m able to speak those dialectics to myself.

Yet another superherofriend of mine was fabulous at shining the light on my natural ability to understand dialectics at a time when I wasn’t able to.  He gave me many gifts, in the form of True Words, as have all the superherofriends I’ve mentioned.  What unites those superherofriends, in my mind, in this moment, is that they live thesamedifferently in their various ways every. single. day.  They use the very skills they teach, though not all of them would call them skills or DBT, and they show up as their authentic selves even when it fills them with panicjoy.  It’s thesamedifferent that I can thank them, and the various providers and group members I’ve been lucky enough to share a little of this journey with, without giving up any of my Sarahness.  Because, in this moment, I am thesamedifferent.

“Heaven knows we need never be ashamed of our tears, for they are rain upon the blinding dust of earth, overlying our hard hearts…I was better after I had cried, than before.” -Charles Dickens

Tags

emotions, Ghandi, human, Intensity, labels, skillz, vulnerability

I go to therapy in an uprise downtown, an oddly angled, metallic expanse that always seems to be on the verge of blasting off.  It has multiple stories, an eccentric amalgam of all kinds of business offices and insurance companies.  I enter on the ground floor through round-robin glass doors, the kind that simultaneously delighted and terrified me as a child (what if you get stuck going around and around forever?), and am greeted by few plush armchairs and a couch seated beside an electric fireplace, a kind of corporate-cozy gathering space with a Starbucks in the corner and a hushed feeling in the walls.

I love this entryway, because besides the possibility of caffeine, it offers a mixing-pot of people.  There are young men with spiked hair, square tortoise-shell glasses, and rolled-up pant legs, who rode their bikes in to work at tech start-ups.  There are secretaries, almost always in a gaggle, and woman in power-suits and heels who move just a tad too fast because they are perpetually busy and important, and they have to walk that much faster than the men just to prove it.

And then there’s the patients.  It’s often easy to spot them, for they fold into their sterotype just as easily as the people I described above.  They are the ones without a badge, with a slight hesitance in their step, who have the uncomfortable look in their eyes that comes when you feel slightly out of context.  They are often the ones who stop and sit in the fake sitting room, take a breath to ground themselves, to remember who they are amidst a sea of rushing workers.

There’s the woman with her stone-washed jeans pulled up above her belly-button, who sits next to her rolling suitcase and talks just a little too loud and a little too much to anyone who will take the time to listen (she is the kindest person I’ve encountered yet). There are kids being dragged along by harried parents, reluctantly attending family therapy sessions or getting ADD medicine refilled.  There are students, and salesmen, and teachers, all unified by the noun patient, and a destination: floor E.

I’m brazenly labeling all of these people because, as I said before, I am one of them.  I’m a patient on G, and have been a patient for years, and I’m fairly certain that I betray this every time I walk into that building with my wide-eyed determination to look like I belong.  It’s only recently, however, that I’ve also begun to work on floor J, at a company that is part of the very same system that provides my behavioral health services.

When I take the elevator up, it is a smaller sub-set of that larger melting-pot.  And when I get off on E, it feels less intense, less chaotic.  It’s even more obvious who is who here: patients are in the waiting room, or checking in at the front desk, providers have IDs  and calm, reassuring voices.  I know my role here.  I am A Patient.  I’ve actually been told many times, verbatim, that I am a “good” one.

Because I know my role, I also know what I could get away with.  That sounds terrible, but it’s true.  If I were to scream and throw things, sob in the hallway, allow myself to break down in the bathroom, it would be okay.  People would notice, people would react-some with fear, some with annoyance, some with amazement or embarrassment.  I would certainly be approached by a provider, who would use some kind of step-by-step protocol to calm me down (I say this with compassion and the beginnings of a new understanding after working on J; I have never been a mental health provider and have no doubt it is incredibly hard, and that no one goes into that profession some kind of care and drive to help people), but it would not be outside the realm of normal.  On the floor E, acting crazy is normal.

That’s extreme, the throwing things; it’s not likely I would ever do that, despite my Intense Intensity.  But I did find myself in tears last week, and the only place I knew to go was the bathroom on E.  Because crying on J, were I work, would be unacceptable.  I’m already out of place there; I come to the office on time, I dress according to the company code, I can sit in meetings and listen and understand much of what is said.  My badge grants me access to all that, opens that door to that world of research and education and people who have power.  It doesn’t fool anyone, though, especially me.  I can wear my badge on J, in the elevator, even in the lobby or on the bus.  And people look at me differently; sometimes I even feel more capable, more in control.  But wearing it or not, it’s hard to shake the label of patient.  It’s what I’ve known for so long, feel like it’s in my blood, my bones, my brain chemistry.  I think I’m learning that broken is one of the hardest things to let go.  Who am I when I’m on floor E? And who am I on floor J? It’s the same person, at least I’m trying to be.  And still, I go to E to cry…

And so this week I look to the quote above my writing desk from Ghandi: “In a gentle way, you can shake the world.” If crying on the floor where I work because of stigma and insensitivity in a meeting results in people continuing to see me as only a patient, listen to my ideas as only a consumer, that isn’t the kind of world I want to live in. I want to shake the norm that allowing space for emotions is crazy, weak, patient-like.  Because it’s human.  Yesterday I cried on floor E and floor J, tried to push aside the shame that has held my feelings back, tried to show up in the truth of my Intense Intensity, my Sarahness.

It’s a decision (is crying a decision?) that has me shaking, literally, with fear each day I buzz myself into the office, every time the elevator doors open and I don’t know if a co-worker will enter, or a fellow member of my DBT group, or the psychiatrist who read me my diagnoses one after the other until I felt like a lab-rat.  I hope that, some day, all of those people might feel it is okay to cry, or dance, or admit to feeling afraid, whether it’s on in a workplace, a clinic, an elevator, a lobby.  Because it isn’t us or them, it’s we.  I live the we every day.  And the more we all practice showing up as human, the more understanding we might have of each other, the more normal crazy might become, the more our tears and our joys will overlay our hard hearts.