Falling

I fell today. For the second time in less than a week. Hard. I'll be sore tomorrow (I already am). Last week's tumble was just a fluke. I stepped down weird and my ankle turned. Tonight it was lack of attention. I almost fell off the same landing yesterday when I forgot there was one more step. And I even thought about it today when I was on those stairs again. But somehow it didn't fully register, and all it took was me having my back to the room to forget where (or even that) the landing ended.

Is it the same in my non-physical life? Do I keep falling off the same damn ledge every time? And if so, is it because I keep forgetting that it's there, despite vigilantly reminding myself to be aware? Perhaps. But I think not. I think it isn't forgetting. It isn't inattention. It's stubbornness. It's a desire to be on the ledge, even if it means I might step out into air instead of onto the hoped-for solid ground.

I don't forget how much it hurts each time. That much is certain. But, so far I'm only bruised, in body and in ego. Nothing has broken (except that baby toe that one time falling down the cellar steps. That one stung for sure. And maybe my heart a time or two). Does that portend inexhaustible resilience? Or foolish cockiness? Will I always be able to get back up, massage and ice whatever's damaged, cry a little and keep on climbing up on ledges?

I think my sisters hope I'll start paying closer attention. Not that I'll remain stationary, but that I'll look a little closer before I step, much less leap. Watching where I put my feet. God knows they've helped me across many a literal and figurative stream, steadying me on the rocks and willing me not to slip. And then when I fall they are bemused. They shake their heads. And give me epsom salts and a good stern talking to. I have excellent sisters. We rarely trip over the same hazards.

And I am reminded of a poem (actually it's a song lyric) I wrote several years ago about falling. Evidently I've known this truth about myself for awhile.

There's a letter I once carried from a girl I used to know.
There's a question I once buried, and hoped it wouldn't grow.
There's a truth I have proclaimed and a lie that I have lived.
And the answer that remains, leaking anger like a sieve.

And this is where I stand, and this is how I fell
And if I never land it may be just as well.

And the room was almost empty and the past came to the door
And I lean against it gently, and I end up on the floor.
But if I push too hard the bruises might not heal
So I let down my guard and know exactly how I'll feel.

And this is where I stand, and this is how I fell
And if I never land, I think it's just as well.

And it's best to keep is simple, keep it sweet.
And of course we'll it quiet and discreet
Keep your distance, keep your head
And most of all keep on pretending that you're somewhere else instead

So each of these confessions arrives in masquerade
And each on is a lesson, and each a debt unpaid
Beginning at the end with no much still to lose
Empty paper and a pen and decide which words to use

And this is where I stand, and this is how I fell
And if I never land, you know it's just as well.

What's in a name?

I have a very low threshold for the smell of rotting food in the garbage. There are many unpleasant scents I can adapt to but that one I cannot. And so, just as I was settling in to work on this blog entry, I noticed the unmistakable putrid odor, and I got back up to take the bag outside.

The air is perfection tonight: warm but crisp. I was instantly nostalgic for football Friday nights in the marching band. Just a little cooler and I'd also have been flooded by images of Halloweens of my childhood, setting out in the twilight, clutching empty pillowcases and returning in the dark, hands now weighted down with bounty, slung over our shoulders. Yes, it's almost that kind of air tonight.

There's a crescent moon. Full moons get all the poetry, dramatic and dreamy as they are. But crescent moons are charming. Whimsical. I don't know if the one I just saw is waxing or waning. There's a metaphor there to be explored some day. But not tonight.

This post seems rambling so far, does it not? But it's actually an appropriate prelude to the topic I mean to explore. Today is World Mental Health day. Stinking garbage and la bella luna fit right in.

I am a therapist. I've been a counselor for nearly twenty years. And, in truth, I have always been one. My father used to admonish me, when he'd overhear me talking to my best friend on the telephone about his adolescent angst (wall phone in kitchen = zero privacy), "you know it's illegal to practice psychology without a license." He meant it. Heh. Well, Dad, I've got a license now. But who even knows if I'm any more skilled today than I was at 15. If I am, it's possibly owing more to 27 years of experiencing life than any formal education I've obtained.

So, World Mental Health Day. If "every day is Earth Day to a farmer," then certainly every day is Mental Health Day to a therapist. But I didn't celebrate it. I didn't even know about it until I heard it randomly mentioned on the radio. Evidently, we think the earth is in greater need of our collective attention than is our mental health. We couldn't be more wrong.

But that also is not the theme I wish to explore, at least not directly. What I thought about immediately when I heard it's Mental Health Day is how much I do not care for the term "mental health." I am sometimes accused by my sisters and the occasional observant friend that I can get bogged down a bit in semantics. And perhaps this is one of those cases. But hear me out first, before you tell me to quit splitting hairs already.

In truth I'm a little surprised it's still called Mental Health Day. It seems the current preference is "behavioral health." I work in behavioral health care now. Because we all know that mental problems are just behaviors gone all sideways, right? Depression makes it hard to get out of bed. So does arthritis. But arthritis is just an illness. Not a mental or behavioral one.

Admittedly, we've come a long way. We used to have insane asylums. Loony bins. Madhouses. People weren't mentally ill, they were crazy. Lunatics (ah, see, la bella luna!). Nut jobs. To a lot of people, they still are. And, often enough, we call them mental. "She's a mental case." "He went all mental on me." The word itself is pejorative.

So, what's my problem with it? I do believe that cognitive dysfunction is central to many of the problems that bring people into therapy. Learning to think in a different way is a key to recovery.  I do subscribe to Cognitive-Behavioral Theory. And there are the two terms, side by side. Mental and behavioral. But don't let's forget about emotions. If you forget about feelings, your quest to understand or change your behaviors and thinking will be an exercise in futility.

Of course, some psychiatrists and neuro-scientists would have us believe it's all about finding the proper combination of medications to balance out a brain chemistry gone haywire. And they are right. It is about re-calibrating our chemical circuitry. But not through medication alone. Aerobic exercise re-calibrates brain chemistry. So does a welcomed hug. So can sex. So can a sunny day. So can sharing honestly. So will a massage. Or stroking a pet. Or a hot bath. Or a belly laugh. Or praying. You know what else all those things, along with the proper medication, will help improve? Diabetes. Heart Disease. Hypertension.

It's all connected. Diabetes and depression co-occur at an astonishingly high rate. And we're not sure which direction is causal- diabetes leads to depression or vise versa. So why is it less stigmatizing to admit to being diabetic, than to being depressed? Mood disorders are exacerbated by poor emotion management, poor diet, and lack of exercise along with underlying biological predisposition. So is hypertension. But it's easier to get insurance to pay to treat hypertension than depression.

Every mental health disorder I have ever treated is a bio-psycho-social phenomenon. Most "physical" disorders are too. Thinking, emotional and behavioral change is necessary for someone with social phobia to walk into a party without coming undone. And maybe a daily dose of something to keep those neuro-transmitters firing properly. Thinking, emotional and behavioral change is also necessary for a diabetic to embrace a low carb diet without coming undone. And perhaps a daily dose of something to keep that insulin firing properly.

In New York, where I started my career, at least one county calls their social service department the Mental Hygiene Department. Hygiene? No negative connotation there, no sir. No listing, however, for the Physical Hygiene Department.

Okay, so while others give me occasional feedback on my semantic fixation, my personal concern is that I may tend towards belaboring points through redundant example. And without a face or even voice to gauge whether I've reached that level here and you are now zoning out, I can only guess.

But it is late and I am tired anyway, so my own mental health is pleading with me, for love of all things good and holy, to go to sleep before midnight tonight. And so, I shall employ my cognitive, emotional and behavioral awareness to comply.

And maybe, in a half hour, that eye-catching crescent moon and I will be setting together.

The more things change, indeed.

At some point in the next hour or so, I will officially reach the five year anniversary of my arrival in Columbus. October 1, 2008, was perhaps the longest day of my life. It started out with Bruno climbing into the cupboard above the refrigerator to avoid capture, necessitating some very rough handling by Ron. And then off I drove in the pouring rain. And before I reached Tupper Lake thirty minutes later, Sara's paws were a bloody mess from tearing her claws off against the rigid plastic carrying case. Sedated though she was, her struggles were ferocious. And desperate. And futile. And she wouldn't stop. Four hours to Syracuse and she wouldn't stop for more than a few minutes at a time. She was a wreck. I was on the verge of a nervous breakdown. And the rain poured down. And my tears poured down. Thirteen hours after I left, delayed by a visit to the emergency vet in Syracuse to bandage Sara's mangled feet, we made it to my townhouse. The rain had stopped around Buffalo, and the night was much like this one- warm and slightly humid. Delicious. Even exhausted as I was, I noted, and felt inordinately overjoyed about, the summer-like evening air.

I am the sister who bears witness to the passage of time. Eliza, interestingly enough, is the sister who for many years created a calendar as a family Christmas gift, replete with nostalgic photographs and stories. Meanwhile, remembering her own birth year often eludes her, and she doesn't even seem to care. Rita is the sister who first set up a Google calendar, and then convinced Eliza and me to join and give each other open access to our schedules. But I am the keeper of dates. I am always late. I resist making definitive plans much beyond a 24 hour cycle. But every anniversary, happy or tragic or even mundane, gives me some kind of pause. I cannot drift through such days obliviously. The past whispers to me, and I find myself awash in memories of where and what and who and, sometimes, why. 

I titled this blog "The More Things Change..." after trying to name it many other things and finding each of those titles already taken. So, I am hesitant to assign much deep import or profundity to it. After all, how significant can a tenth choice be? And yet another part of me is inclined to believe all those other titles were unavailable for a reason. I like to consider things like that. Ascribe meaning to the randomness. It makes for a better story, does it not?

Five years post apocalyptic moving day, the blog title seems imminently relevant. The implied second half of that sentence fragment is "the more things stay the same." Change and sameness. Co-existing. Perhaps inextricably bound. Change is the only constant. And yet in stepping away from one moment and into the next the differences are mostly imperceptible. Until in a single heartbeat everything changes and it is impossible to imagine that the entire world did not also come to a standstill and undergo a rearrangement of its very essence the way you just did. The world just went on? Impossible. My world will never be the same. 

My world will never be the same. I am not who I was five years ago. Except, of course I am. No one who knew me before would find me unrecognizable now. Nor do I. I am me. I am just 42-year-old me instead of 37-year-old me.  I'd like to believe the best parts of me I've retained and what is different is all for the better. But the truth is more complicated than that. Always.

I have learned that I can love and want someone other than the person I thought I'd love and want forever. But I don't know if I believe in forever love at all anymore. And recently I've had some unsettling realizations about who and how I choose to love.

I have observed and experienced, again and again and again, how little the world is interested in fairness or justice. I knew that before I moved here of course. But I've tried to stand up to it more than I ever did. Demand that the world explain itself rather than choosing just to slam doors and fume.

I have learned that communicating and being with the people who mean the most to you is both blissfully easier and radically more difficult when you live mere minutes rather than 12 hours or 3500 miles from them. Oh, how my sisters have taught me about me in ways uplifting, terrifying and maddening. 

I have walked a crooked path towards re-embracing a faith in God. I almost said re-discovering, but that is not true. I have not "discovered" God or faith. I have chosen to believe. I have decided that choosing to believe is every bit as valid as believing without question. The determination to choose to believe is no less a blessing than having no need for such determination.

Five years. A third as long as I lived in the Adirondacks. Tempus fugit. The first five years of my life in New York defy belief in many ways. Catherine at 27 was unrecognizable from Catherine at 22. To me as much as anyone. I changed so much. But I honestly don't know that I grew. Transformation and growth are not the same process. These past five years I have grown. I am more grounded. More secure. More ... me. 

The more things change, indeed.