Thursday, October 31, 2013

Martyrdom Just Gets You Shot: Why Sacrifice for Family Isn't Always a Good Thing

In my workshops on psychological well-being, there's one question that keeps popping up: "Should I still support my family? I already feel drained and stressed but I don't want to be a bad son/daughter."  The question typically comes with frustration, resignation, and not a small amount of guilt. Being the sole breadwinner, or at least someone who single-handedly takes on major responsibilities at home, is paradoxically a position of power and weakness.

Now, before I start answering this question, let me say at the onset that I've been always impressed by Filipinos' (and Asians' in general) love of the family. I think one of the reasons Pinoys are resilient is because we know that no matter how hard life gets, there's family to come home to. Those who live in individualist countries tend to suffer more anxiety and mental health problems, presumably because they're cut off from a major support system. So the ability and willingness to sacrifice for family?  Definitely a value worth preserving.

But as with anything in life, excessive is not a good thing. Healthy families take care of the well-being of all individual members, not a select few. Society may pat you on the back for being the responsible and considerate one, but if you're no longer able to live your life, you're actually not being responsible or considerate ---- to yourself. Family care needs to be balanced with self care.

So here are some guide questions to help you muddle through the sticky business of self-sacrifice. It won't apply to every family with a "tagasalo" (catcher) but it can be good starting point when making decisions about how long and to what extent you should help out.

1. What are you giving out of choice and what are you giving out of pressure?

There are people who take on the tagasalo role and yet they're perfectly happy. The reason is, they know the sacrifices they're making are freely chosen, and this gives them peace even if their sacrifice comes at a price.

So ask yourself, did I make a choice to do what I'm doing? If yes, what are my reasons for making that choice? Will I make the same choice again given the chance? True, choices can be difficult to make, and sometimes you're forced by a situation into a choice you don't like, but taking ownership of a decision is the first step towards settling into a particular set-up.

Now, there are tagasalos who only do things because (a) family members will get mad at them if they don't, (b) they're worried other people will call them ungrateful, or (c) it's the only way they know how to get appreciated. If these are your reasons, for sure you'll feel depressed and frustrated all the time. You'll feel taken advantage of and/or manipulated by guilt.

In these cases, you have to know how to identify and defend your boundaries. You may have to engage in a heated discussion with family, true, or you may have to survive gossip and whispers.  You may even have to struggle with feelings of worthlessness. But some issues do need to pass through rough waters before it can get resolved. There's nothing wrong with family members fighting, for as long as they fight fairly! Being afraid to rock the boat is not going to get you anywhere.

2. Are you overfunctioning because someone is underfunctioning?

Your intentions may be to help your family but if what you're actually doing is nursing irresponsibility, or at least complacency, you're doing your family more harm than good.

So look at each member of your family and see what each one contributes to the pool. Your parents may have asked you to shoulder your little sister's tuition and allowance, but if your sister is old enough to take part-time work to earn extra cash, let her. You may actually be doing your sister a favor as you're teaching her self-sufficiency. You have a brother who job hops, resigning from work everytime he encounters something he doesn't like? Stop feeding the monster by not making him face the consequences of his actions.

Now this is the tricky part: even when tagasalos realize they're creating dependency, they would still resist change. They feel bad making loved ones take on extra tasks --- "kawawa naman ang kapatid ko kung pagtratrabahuhin ko din."  They have lost faith that underperforming family members will actually pull through. They don't have the patience to wait for others to find their feet. Or they've gotten used to the "perks" of being the responsible one (e.g. the praises, the power to make decisions) that letting go makes them feel all lost. When this happens, you have a lot of self-processing to do.

I always tell clients that families are systems designed to survive. Hence, if you decide to trim down the bills you're taking on, your family will find a way to find the money --- especially if you stick to your guns and let others hit rock-bottom. In fact, letting go of the tagasalo role is often the catalyst for new ideas on how the family can survive. You might even get pleasantly surprised with the discovery that loved ones are actually stronger and more competent that you realize.

3. Can you prioritize self-care?

But what if all of your family members are actually overfunctioning? Sadly, this situation happens. Sometimes the family's needs are greater than all the members' ability to respond. When a loved one has a chronic illness for example, understandably you may have to work double even triple shifts to pay hospital bills. When the family business fails, adjustment has to be made by all concerned. Death of parents may force the eldest of the family to set aside his own dreams and take charge of the household.

If this is the case, you have to accept the situation and grieve for your losses. Grieving is good; cry if you must, yell at the universe if you must. But this doesn't mean you have to have a bad life. Take regular time outs for little pleasures --- dirty ice cream with friends, a quiet walk in the park, quality time with your family. There are ways to get work-life balance if you're determined to have one. More importantly, articulate to your loved ones if you're no longer okay, and let them take care of you for a change.

Meanwhile, explore concrete plans on how you can get out of the situation you're in --- maybe take an investment course to get passive income or call on extended family members to help. You can cope better if you know there's an end to your sacrifices in sight.

Monday, October 14, 2013

Mental Illness is a Disability --- When Will the Philippines Catch Up?

I've been looking for an article similar to this for a long time.

See, some 5 years ago, I took on a writing project for a US-based NGO that advocates for Persons With Disabilities (PWDs). While doing research for the series of articles I had to make, I came across US laws that specifically identified mental illness, such as Major Depressive Disorder, as disability. Like learning disabilities, mental illness is classified as a hidden disability.

What does this mean?

Being a disability, persons with mental illness are legally entitled to the same rights as those with other kinds of disabilities. These rights include discounts on basic necessities like medicines and food. It also means being entitled to reasonable accommodation in the workplace. Furthermore, companies are prohibited from asking questions related to mental health history without a concrete job offer. 

Sadly, our definition of mental disability in this country is limited to mental health issues related to loss of reality testing (e.g. schizophrenia) and mental retardation. Thus, rights for persons with mental illness are not accessed by everyone concerned. When will, say, diagnosed mood disorders be included as an acceptable definition of disability? For yes, those with these conditions can spend days, if not months, unable to earn a living. I know there were months, back when my mood disorder was at its peak, when I could not even summon the will to work.

An excerpt from the article worth reflecting upon:

It is also important to note that there is no mental health legislation for those with mental disabilities. The Department of Health does have mental health policies, but the Magna Carta for Disabled Persons is not specifically for mental disabilities. It provides for special rights and privileges for the physically impaired (their mobility is enhanced through sidewalks, railings, ramps and the like); the hearing-impaired are benefited by TV stations that provide a sign-language inset or subtitles, and telephone companies are encouraged to install special devices for them. The Magna Carta provides for the “mentally retarded” under the provisions on education. Mental retardation, however, is only one kind of mental disability. In fact, there are mentally disabled persons with superior intelligence—the complete opposite of mentally retarded persons. 

Why does this matter interests me so much?

One of the things that I've worried about being a person with Bipolar Disorder is surviving full time work in a company. I'm lucky, I have skills that help me become an independent service-provider, which means that I can basically control my schedule. I can, for example, choose to take a break when I feel an attack coming. 

But part of me also feels that if I can find a company understanding enough to provide reasonable accommodation I can thrive in the corporate world. Reasonable accommodation doesn't equate to special treatment --- key result areas are not watered down and only adjustments that don't represent "undue burden" qualifies. For instance, persons with diagnosed mental illness can request to take breaks based on need not on company schedule. If the job is flexible enough that there's room to take stress breaks, no harm is done. (You can learn more about reasonable accommodation here.)

Here's the problem: without a law protecting this right, dare you even raise the matter to management? Requesting reasonable accommodation is a tricky thing in a country where stigma against mental illness is strong. Ensuring that your request is kept confidential is another. Getting your co-workers to understand without feeling that life is unfair is something else.

It makes me wonder how many persons with mental illness out there are potential star employees. Probably a lot. Many persons with mental health conditions are smart, skilled, and hard-working. The question is: can the government protect them enough so that they can pursue a fuller life? Furthermore, can the state punish companies who refuse to do the right thing?

I am passionate about doing something about this. This is why I started Possibilities, I want to give workshops to companies about psychological well-being in the workplace that includes mental health advocacy.

Anyway, kudos to Ms. Corpuz for bringing this matter into public awareness. I pray for improved service to persons with mental illness in this country soon.

Obsessing About Failure

There are people who obsess about missed opportunities or being bested by others. They spend hours, even weeks, replaying what had happened, wondering what went wrong and figuring out why they weren't successful. They do this to the point they get emotionally drained.

Obsessing about failure is different from an honest, realistic assessment of your strengths and weaknesses. When people experience setbacks, it's always helpful to find out what could have been done differently and how to do better next time. Failure is nothing but feedback; just the universe’s way of telling us that something needs tweaking.

The winning attitude is to keep moving forward--- creating version 2.0 from version 1.0. And if you fail again, the next day is simply an opportunity to come up with version 3.0. The goal is to keep improving. People who tend to obsess about failure have probably internalized the “failure message." Psychologist Martin Seligman coined the term “learned helplessness” to describe the phenomenon of people believing they have no control over things that happen to them that, at the end of the day, any effort to change situations for are futile.

 Learned helplessness develops from the attitude that failure is:

(a) permanent ("I will never get that break again!"),

(b) pervasive ("Since I'm a failure at this job, I will fail at that one too!"), and

(c) personal ("I alone am to blame forthis failure!").

As the term implies, learned helplessness is, well, learned. It's not originally part of your personality. You can probably trace it's origins to an experience. Perhaps you received the “you're not good enough” message during childhood. Or maybe there was a project you worked hard on, a project that went badly.

The good news is, while obsessing about failure is learned, it can be unlearned.Underneath it all is a fear, a fear to make a risk. It's more comfortable to toss and turn what happened in the past than to try again and risk failing once more. But see, if you get stuck in the fear zone, you’ll fulfill your prophecy. The attitude of overly-scrutinizing mistakes means you'll lose sight of new opportunities. And stuckness, well, it's never good.

Sunday, October 13, 2013

An Amazing Movie About Bipolar Disorder

I was looking for a good film to illustrate mental illness, particularly Bipolar Disorder, when I came across a powerful film produced by Arpi-Revo Productions. It's entitled "Up/Down  Bipolar Disorder Documentary" and features real people sharing heartfelt accounts of what's it's like to live with the condition.

The producers generously uploaded the film on youtube but it's definitely worth  getting a personal copy  as  it's one of those films that make you experience something new with every watch. In fact, simply watching it is therapy; you'll feel validated by the fact that you're not alone, you understand more about the illness, and you get to process your own experience by answering the interviewer's questions yourself.

Below is a copy of the film. As soon as I have the time I will post feelings and insights from when I watched it. I saw it during an extreme low and it was such a comfort.

Expect uncontrollable weeping --- the good kind.

Sunday, September 29, 2013

Coping Strategies for Bipolar Disorder

I feel bad about not updating this blog for almost half a year. Not that I've been busy, or lacking in inspiration. The truth is: I have nothing to write there as I no longer identify with being a person with Bipolar Disorder. My illness has been in full remission for more than a year.  I've been able to pursue the many goals I've set for myself. And while life is not perfect, I am certainly happy.

I feel FREE.

It would be presumptuous to preach about what others with the condition should do in order to achieve recovery. After all, you're never really cured from Bipolar Disorder, you're only able to successfully manage the condition. I may come back here talking once more about my extreme highs and lows, highlighting the irony that as a practicing psychologist, I should know better. Remission is not something I take for granted, but the respite has convinced me that things do get better.

So let me just tell you what works for me. Most of them are common sense, even standard content of self-help literature. But when practiced, they can be powerful. You might want to give some of them a try.

a. Consistent medication. 

Finance managers would tell you to pay yourself first, so that you'll have healthy savings at the end of the day. If you're a person with Bipolar Disorder, you should buy your meds first. Yes, even before you buy food or pay utilities.

Yes, I've had moments when I'm absolutely convinced that I can live a full life without medication. That's a common delusion among persons with Bipolar Disorder once life gets stable. But I've been accomplishing a mood diary/mood chart consistently the past year, enough to know that missing meds eventually leads to mood swings. Take the need for lifetime Bipolar medication as Gospel truth, boys and girls, and you should be just fine.

b. Gratitude. 

I remember well the times when months would go by and I've barely accomplish a thing. So now when I get something done, even if it's as simple as a 5-minute chat with an old friend, I log it down. I savor the fact that I have a life, and I can live it.

More importantly, I appreciate what I have. I've met enough people to know that, for all the bad times, I live a life that's the envy of others. I have setbacks, true, but I also have blessings. Gratitude gives you perspective.

c. Boundaries.

I used to be a people-pleaser. Worse, I take on the world's cares when enough guilt trip is thrown my way. I am incapable of expressing anger. Now though I feel comfortable telling people to "f@#k off."

We lost our home two months ago. But I refuse to feel guilty about not being able to recover it; it's not my fault the house was mortgaged in the first place, and not my fault the family has no clear re-payment plan. The family survived. We're now renting a smaller house, living a simpler life. More importantly, I am letting those responsible for all our troubles take on the consequences of their actions. I do my part, which is pay the rent every month and provide my mother an allowance. After that everything is my business. I refuse to surrender my extra cash to cover up other people's under-performance.

And I have no qualms getting rid of those who hurt me or those who drain me dry. I will cry for a bit when I experience betrayal, but I readily move on. I know now that what you lose --- whether friends, property, or opportunity --- is often replaceable, and sometimes even recoverable. A bad day or a bad person is not equivalent to a bad life.

d. Balance. 

So I am not earning as much as most people. So I am not as polished as others. I do have what most don't: a a balance life.

I earn enough to fulfill my responsibilities, I do what I love, I have time to bond with family, I have close, supportive friends, I can indulge in movies or workshops or clothes, I have ministries and outreaches, and I have a love life --- of sorts. And each area of my life is moving forward; I am satisfied with everything.

I am even open to the possibility that I may have to re-write my life, surrender some of my loves, to make room for new experiences that will complete the picture. I am not stuck; I can take on challenges.

e. Self-compassion.

And lastly, I can be gentle with myself.

You can choose to let people hurt you, or choose to understand that bad things sometimes happen. You can choose to accept that it's alright to make mistakes. And I can choose to move on, even choose to open up to the prospect that closed doors make you notice the open ones you don't visit. The future is unwritten, but it's ripe with possibilities.

Saturday, April 6, 2013

Dealing with Bipolar Disorder: Why You Shouldn't Let Anyone Tell You "You're Not Trying Hard Enough!"

If you have Bipolar Disorder, then you've probably heard someone say before: "You know what your problem is? You're not trying hard enough to control your emotions!" And yes, it's a painful statement to hear. Basically, what your friend, parent, or just the armchair expert next door is saying, is that you don't have mental illness. As far as they're concerned, what you suffer from is good old-fashioned laziness and bad attitude.

But if you've done your research, you know that managing the extreme high and low moods that come with Bipolar Disorder is not as easy as "snapping out of it." The intense emotions don't just vaporize with pilates, a feel good movie, and some hard-core videoke-ing (though they can help!). Being biochemical in nature, bipolar mood swings can be stronger than one's resources to cope. Certainly, they can take longer to control.

I've decided to browse through more academic writings on Bipolar Disorder, and I found something that I think others with the illness would find comforting. According to this research, contrary to popular belief (or at least the authors' initial hypothesis which equates to popular belief in the scientific community), people with BD actually do report great use of adaptive coping strategies. In fact, people with BD actually try harder than people without the condition to cope with their happy and sad feelings. The only problem is: persons with BD experience less success in regulating emotions despite intense effort.

What could this mean?

It means: that instead of feeling bad because you can't seem to manage your emotions as well as other people, you should be at peace with the certainty that you are actually trying harder than most! True, this knowledge wouldn't make the extreme moods any more tolerable, but it can stop you from bouts of hating yourself for not being "normal" or at least as good as the next guy or gal. And when you consider that you have a steeper mountain to climb everyday (you have more intense emotions than other people), then you should be more proud of yourself for every milestone you achieve.

But less I be accused of hijacking a scientific study to flatter persons with BD, myself included, it's important to note that the study also stated that compared to other people, those with BD also employ way more maladaptive coping strategies than people without BD. These poor coping strategies include expressive suppression--- that is, keeping one's emotions to one's self. Expressive suppression can actually account for the feeling of increase effort in managing one's emotions, intense effort that creates little or no result. Suppression after all is very tiring. It is important then that persons with BD train themselves in using the right kind of coping methodology for the right kind of intended result. More so, it's important for persons with BD to beef up their armory of effective and positive coping styles. For example, cognitive reappraisal, or changing the way we think about a situation, is a good strategy for managing low moods and depression.

There is also a need to sustain every effort to manage emotion, even if they are not showing immediate results.When you are in an emotional high or an emotional low, it's easy to overestimate the amount of effort you've invested in managing your emotions --- five minutes of stopping yourself from crying hysterically in a corner or going out on an impulsive shopping spree can feel like five hours. Hang tough. Persistence, while a difficult muscle to train, can get you through the worst of times.

Thursday, March 7, 2013

Is there balance?

Measure your personal development by how balanced your world is. When you spend too much time in one area of your life, at the expense of others, it is well worth asking: what am I running away from? And yes, you can be martyring yourself for a good cause and still be, at the end of the day, simply refusing to face your demons.