Beach encounter

Yesterday B and I walk about a mile and a half of beach on Marrowstone Island. We see five other people total. There are long stretches with no one in sight anywhere.

Way down the beach there is a sand cliff. A coyote runs half way across the exposed face and stops. It looks precarious. We watch it. “That’s weird,” says B. “They don’t hang out in plain sight.”

It scrabbles and runs the rest of the way across. It stops and turns and sits. Watching us.

I laugh.

B. frowns. “They don’t DO that.”

“I think it’s listening to us. We’ve been singing and laughing.” We are goofballs on the beach. Wordplay. We’ve both been coming up with advertising songs. Horrors, ear worms.

“They don’t do that.” he says, “Can you take your camera out slowly?”

I have my Panasonic FZ150, 24x zoom. I get some shots. B is acting nonchalant, hunting for agates again. He finds more than me from both practice and I am busy taking pictures and being distracted by other pretty rocks, not just clear agates. He is disciplined. I am a generalist.

I get lovely shots. We zigzag back and forth on the beach, trying to look at ALL the rocks. “If you are hunting like this, other animals think you are foraging. Birds and animals will ignore you. I can get really close to them.”

The coyote is watching us. “He’s listening to us, really!”

“Maybe he wants to know what we are foraging for.”

“Rocks.”

“He’s hungry. Or he’s young.” We don’t really know it’s a he.

I start singing. I zigzag closer and take more pictures. She is flicking her ears at the song.

“She doesn’t seem rabid.”

“There isn’t much rabies out here.”

“Bats.” I say. I’ve researched it twice in the last 8 years.

“Yes, but not mammals.”

I start a video and sing to the coyote. I sing The Fox, though I leave out the verses about Old Mother Flipperflopper and the hunters. Coyote flips her ears and turns her head. She is checking where B is since he is moving further down the beach. I finish the song and turn off the video. “Thank you!” I say.

We walk again.

When we turn around, there is Coyote. She has shadowed us down the beach, and she slips into the brush at the foot of the cliff. She is quickly not visible.

“Humph.” says B.

I laugh.

Later, we look up and a larger animal is coming toward me. We both startle, but it is in a submissive posture. A dog, not a coyote, with a red collar. We both thought it was a coyote for a moment. It comes up to me and is very friendly. Then to B. Then back to it’s owner, who limps into sight.

“Wow, I thought it was another bigger coyote for a minute.”

“Me too. I thought it was coming right after you.”

“It’s owner looks frail and old.”

“Our age.”

“No way!” laugh.

“Yes.”

I don’t think so, but maybe. I was more focused on the dog.

I find two clear agates, but come back with two windbreaker pockets with other rocks. B only finds one that meets his specifications. My two really aren’t up to the quality he wants. Well, one is borderline and one doesn’t qualify.

Cognitive behavioral therapy

Dr. Aaron Beck, father of cognitive behavioral therapy, died this week, November 2021, at age 100.

Oddly enough, the best explanations of cognitive behavioral therapy that I’ve read is on a writing website. It talks about writing down all of the horrible thoughts and then going back and writing counter thoughts. Psychologists have been talking at me at medical conferences for years about cognitive behavioral therapy, but they never explained it. They said we could do it in clinic. I thought cynically that maybe I could if I knew what the hell it was.

And the explanation by the author is oddly similar to what I think of as the angel and devil on my shoulders. It turns out that I do do it in clinic.

When I react to some event, I let the devil out first. It has a fit about whatever is happening, writes poems, is reactive, paranoid and full of anger and grief. It often imagines over the top terrible things happening to the person or people that did whatever it is. Then the angel wakes up and says, wait. What are you saying? What you are imagining and cursing that person with is WAY worse then what they did. The angel writes the poems of forgiveness.

So I have been doing a homemade form of cognitive behavioral therapy.

However, I would say that it can be overused. We need to listen to patients carefully. If they are in an abusive relationship, it should not be papered over with cognitive behavioral therapy. A friend and I have been comparing terrible childhoods. His involved being beaten without reason.

I said recently that what people hit with in my family is words. They make grief and fear into stories, funny stories, that make people laugh. Shame and humiliation and reliving the feelings. I said that I am reactive and pay close attention to words. But I have reason, back to age 2. I said that books are my refuge because the words are not about me, they don’t shame me, they do not humiliate me, and if I read a book twice, it has the same words. Home, love and safe.

In my maternal family, if I said that I was not comfortable with a comment, I was told that I took things too seriously, that I have no sense of humor, that I can’t take a joke. Gaslight and then dismiss any objection. That is how one side of my family loves. I do not like it. Unsurprisingly, they do not love me, or at least I do not feel loved.

And my friend said, your family, your childhood, was worse than mine.

One of my talents in clinic is that I can listen to insane family stories. I can listen because my family is insane. They are cruel. At least, it feels like cruelty and horror to me. I didn’t ever try to find out if a family story is true. I listen and then say, yes. I think it is appropriate for you to feel angry/sad/horrified/appalled/scared/hurt/whatever.

Somehow that listening and validation is huge. I have people come in and say, “I NEED AN ANTIDEPRESSANT.” They want to supress the feelings. So I had time in my clinic: why do you need an antidepressant? Tell me the story. Fill me in. What are you feeling and why?

And more than half the time after the story, after validation, I ask, “Do you need an antidepressant?”

The person thinks. “No. I don’t think so. Let me think about it. I feel better.”

“Ok. Do you want to schedule a follow up?”

Half do. Half say: “No, let me wait and see. I will if I need it.”

Mostly they don’t need it. They have emptied out the awful feelings in the exam room and they aren’t so awful after all. I say that it sounds like a pretty normal response and I would feel that way too. Because I would. Once the feelings, the monstrous feelings, are in the light of day, they relax and evaporate, dissipate like mist, fly home to the Beloved. Goodbye, dark feelings. You are appropriate and you are loved.

Blessings, Dr. Beck, and thank you.

Falling II

poem: Falling II

I can’t fall
until I let go

my cousin says that people learn
to stay away from angry people

I am hurt and then let that go
and think, yes, she is right
my cousins say over and over
that I am too angry when I’m not angry
until it makes me angry

my cousin gives good advice
I let go and stay away
it’s not my anger

I thought allopathic medicine
was where we listened to the patient
I let go of that too, disillusioned

a family member wants to be free
I let go

I let go of you slowly
I let go of coffee
I let go of sitting next to you
I let go of seeing you daily
I let go of asking
I let go of driving by

I let go of hope

I have not let go of longing

I think that I can fall
without letting go of longing

it is only a thread
like a spider’s web
thrown into the universe

I don’t think it will stop me
from falling

Covid-19: Emotional weather

I do not think of emotions as bad or good. None of them are bad or good. They are information, controlled by electrical impulses and hormones, evolved over millions of years (or endowed by our creator, for those who swing that way).

I don’t dismiss emotions. I listen to them.

I think of myself as an ocean. There is all sorts of stuff happening in the depths that I don’t understand. Probiotics, for example. I don’t take them. If not for penicillin, I’d be dead many times over, from strep A pneumonia twice and other infections. I don’t think we understand probiotics yet. We don’t understand the brain, either.

The emotions are the weather in my life. I don’t really control them but they don’t control my ocean, either. Some days are sunny and gorgeous and then a storm may blow up. I am afraid of hurricanes, one destroyed my grandparents’ house in North Carolina, on the outer banks. I think all the cousins still mourn that house. And I miss my grandparents too, all of them. And my parents and my one sister.

See? The weather got “bad” there for a moment, but it isn’t bad. Storms have their own beauty though we hope to batten the hatches and that not too much damage is done. Maybe there is rain, scattered showers, sun breaks, a lenticular cloud. In the Pacific Northwest on the coast, the weather can change very quickly and we have microclimates. My father lived 17 miles away, but inland from me and in a valley. It was warmer in the summer and colder in the winter.

My goal with my weather emotions is to pay attention to them, let the storms blow in and out, and try not to harm anyone else because of my weather. When my sister was in hospice, we had a sign up in my small clinic. It said that my sister was in hospice with cancer and that clinic would be cancelled at some point with little warning. Patients were kind and gentle with me. And then it was cancelled, when she died. I got cards from people. They were so kind, thank you, thank you, and I could barely take it in. My maternal family then dealt with grief by having lawsuits. I don’t think that is a good way to deal with grief, but we just see things differently. Maybe it’s the right way for them. I don’t know.

Whenever I was having internal emotional weather that stirred me up, I would tell my nurse or office manager. Because they will sense my weather and need to know what is up. I had enormous support from them during a divorce, while my partners treated me horribly. My nurses and office manager knew me and my partners didn’t. My partners distanced me as if a divorce were catching. Whatever. Their loss.

Sometimes patients sensed that I was upset. I could tell by their faces. If they didn’t ask, I would. Bring the emotions out. Reassure them that I AM grumpy but not at them. Stuff in my own life. No worries.

Sometimes clinic is about a patient’s weather. They ask if they can tell me something. Often it is prefaced by “Maybe I need an antidepressant.” or “I feel really bad.” When they tell the story, usually I would say, “I think it is perfectly reasonable and normal that you feel angry/hurt/shocked/horrified/grieved/upset.” And then I would ask about an antidepressant or a counselor and most of the time, the person would say, “Well, I don’t think I need it right now.” What they needed was to know that their weather was NORMAL and REASONABLE.

I am seeing things on Facebutt and on media saying that mental health problems and behavioral health problems are on the rise. Maybe we should reframe that. Maybe we could say, “The weather is really bad right now for everyone and it’s very frightening and it is NORMAL and REASONABLE to feel frightened/appalled/angry/in denial/horrified/confused/agitated/anxious or WHATEVER you feel.” This weather is unprecedented in my lifetime, but as a physician who had very bad influenza pneumonia in 2003 and then read about the 1918-19 influenza, I have been expecting this. Expecting a pandemic. Expecting bad weather. This will pass eventually, we will learn to cope, be gentle with yourself and be gentle with others. Everyone is frightened, grieving, angry, in denial or in acceptance. The stages of grief are normal.

Hugs and prayers for all of us to endure this rough weather and help each other and ourselves..

I took the photograph in color. My program made a black and white version. It looks like the back of a stegosaurus to me, a dinosaur now living as a mountain.

For the Ragtag Daily Prompt: rainbow. Because sometimes the rain and sun combine to make a rainbow.

taking turns

For the Ragtag Daily Prompt: diametric.

I am trying to think how I’ve seen diametric used other than “diametrically opposed”.

Here are diametric robins. Maybe they are discussing politics. At any rate they are facing opposite ways. Look at how polite they are, taking turns singing and listening to each other speak with such attention. Diametric to our current politics, I think.