Monday, July 30, 2018

Mental Health/Politics in Iowa: 2018

Senator Grassley was quoted in the Quad City Times article on Thursday, July 25th, “I always stick to policy when I’m campaigning, and I would advise other people to stick to policy.” I agree with Senator Grassley and I want to address mental health issues in this state.

If Governor Kim Reynolds and the Republican legislature think they have corrected the mental health issues in this state they have their heads in the sand.

I have been over my head in family mental health issues this past year and as a professional hospital chaplain the experience gave me a frontline window.

First, there are dedicated people on the frontlines. They can’t always do what needs to be done. They live with constraints like everyone else. I have heard them first hand.

The mental health terrain is more like a countryside with a number of silos that don’t speak to each other. More collaboration between these institutional entities would be a start. The issue is not new, Dr. Vera French knew about this first hand. Years ago she brought Dr. Brotman to lead a workshop on this very subject. I was there. Instead of silos he called the separate entities grids. They have different training, certification, financing, language, policies, TURF, etc., that doesn’t make for the best cooperation and understanding. 

Second, Governor Reynolds and the Republican legislature may have gone forward with some items but they went backwards with others. You can’t reduce the budgets of the judicial system and the Department of Correction two years in a row and say you have done something for mental health when 40% of the inmates in the Scott County Jail have mental health problems. The Mental Health Court relies on people from the Department of Correction to keep in touch with clients. No state money has been allocated for the Mental Health Court which demonstrates they can save money: less jail time, less recidivism. 

Another place they went backward was to remove the court from the hearing decision after a 72 hour committal. I experienced this when I was told there would be a hearing the next day, three days after the new rule went into effect. The hearing never happened, no judge was present, and I wasn’t even present when the decision for discharge was made. The result: We had to go through the committal process all over again, leg work, paper work, discussion with various locations, while the bizarre behavior continued with the discharged patient. I am told the medical lobby won the day by removing a judge from the hearing. Strange to remove them when judges are present to approve the committal. You can draw your own conclusions as to who had the most money for that decision.

Third, Iowa is short long term beds for the mentally ill. The legislation is lacking. 

According to the NAMI of Iowa (National Association of Mental Illness) “A 2017 report from the Treatment Advocacy Center gave Iowa a D- grade for its mental health bed shortage. … The report said in 2016, Iowa ranked last of all states in terms of psychiatric bed availability, with only 1.2 beds per 100,000 adults: this is a far cry from the national average of about 12 beds per 100,000 adults.”

These articles, important as they are, don’t come close to the emotional impact you experience from all the complex realities at grand zero. We are most fortunate to have a supportive Church community for worship and conversation. They are also doing their part to support the Mental Health Court.

Three cheers for Mr. Hubbel who is hoping to elected Governor, a Democrat. He came to listen to the Mental Health Court Board and some of the clients. I saw him in action at a home gathering. He is a listener. In my management training and from my oldest son working for Hewlet Parkard when the two men were still present, I know about Management by Walking Around, MBWA. The book is called the HP Way. Mr. Hubbel has that style of leadership. He has listened to the mental health needs and he has a plan. He sent a person to hear my story. I will vote for him.

The Rev. Canon Marlin Whitmer, retired hospital chaplain
Now serving at Trinity Episcopal Cathedral as a community facilitator.

Saturday, July 28, 2018

The Grazing Principle

The Grazing Principle

I grew up on a farm in Iowa, Cedar County, Sugar Creek Township, nine miles north of Wilton. It was 160 acres, a quarter section, with the north side of the farm bordering the Bennet Sunbury road. The Sugar Creek Presbyterian Church is on the north west corner of the farm. My great grandparents gave the land for the church.
 don’t know the longitude or latitude to locate more precisely.

The farm, the animals, the vegetation, and climate and environment all become my teachers. There are yearly patterns to be studied in this changing scene. No two years are ever alike.

Today I want to say something about horses and the grazing principle.

I became aware of this early since the horse pasture was on the other side of the lane off our front porch. I had watched the horses many times as their long necks bent over to eat the grass with their front legs apart as if to take the next step. It wasn’t until a number of years later in New York City of all places, in an Adlerian therapy session, that my New Hampshire therapist named the action more precisely: The Grazing Principle. That was it.

The horse starts at one end of the field, one clump of grass at a time, one step at a time, gradually making their way to the other end of the pasture. There is no rush to get to the other end of the field. To start with you have no idea the horse knows that is where they are going. Each clump is chewed before the next is found for the same process. It must come as a surprise to the horse to realize they are at the other end of the pasture. It is at that point that I lose track. I don’t know if they turned around and did the same thing coming back.

The point the therapist made was to concentrate on the present and do the task at hand. Thinking you have to devour all the clumps of grass In a day only generates an overwhelming anxiety you don’t need. You contaminate and jeopardies what you are doing in the present.

This truth about horses is true for farm work horses and saddle horses alike. My early observation was with farm work horses since we farmed with horses. This was before tractors became the power source.  And believe it or not, there are more horses in American today than when we farmed with horses, the saddle horses are more plentiful. You see horse trailers parked in many a farm lot ready to transport them to a trail some place. But when they are out to pasture they will be following the grazing principle. The outcome: the grazing principles is being followed more than ever before, at least by horses.

I suggest we apply some beneficial horse sense to our daily routine.

Marlin Whitmer
You can take the boy off the farm but you can’t get the farm out of the boy.

Thursday, July 19, 2018

Starting with the letter A

What the alphabet has to teach us starting with the letter A

This is a follow up to the introductory article "What the Alphabet has to teach us." These are some of the words from various workshops. The workshops were given in various groups: grief; illness groups like heart, pain, cancer; church and community settings addressing any life transition.

The lists here under the letter A does not include all the words. Many times I would not start with a list but blank newsprint and take words from the group and asking how many identify with this word. I would write the word count down. These are words. often heard and written down. Based on some research have each person write the down may provide a deeper form of expression. See the research by Dr. Pennybaker.

The full exercise is a journey in naming the pan and identifying in a word the story that lies behind the word.

Although I have the word anger as number five in this list it often comes up sooner and almost always within the first five. Especially in a group where grief is being addresses the word can appear first.

Most of these words are orientation words, verbs, adverbs, and adjectives. Nouns are named. There were not as many under A. Bunker came up under B  Tunnel.

For a more thorough understanding of and orientation metaphors I encourage all to read Metaphors we live by George Lakoff and Mark Johnson. The PDF is the book. The chapter on orientation will give her some background.

Search Results

Web results
by I i Word - ‎Related articles
ix xi. 1. Concepts We Live By. 2. The Systematicity of Metaphorical Concepts. 3. MetaphoricalSystematicity: Highlighting and. Hiding. 4. Orientational Metaphors.

I suggest to folks you can use this individually when encountering more difficult situations. By putting words in all columns we maintain a more balanced approach to where we are and where we are going.

I haven't figured out how to get feed back on this blog. There is a place for comments but I sometimes wonder if Google is in charge of that. Still learning.

There is some potential to make this interactive with comments but not much has happened. Maybe Face book is another way to go???

Marlin Whitmer
Founder of the Befrienders in 1966, story listeners using the Art of Story Metaphor listening.

Hurts Associated with the Transition 
Contradictions/In Between
Symbols of Hope & Healing
AdviceAsking (Why)Aware




Monday, July 16, 2018

The Alphabet as teacher

The importance of naming.

While journeying with a grief recovery group we became successful. That seems like a contradiction. If size is any indicator of success we were successful. Besides increased attendance people came earlier in their grief --- within the first four weeks instead or after the first four months. They were not ready to be in a group to share their story. They were too emotionally raw and vulnerable. 
What to do? Word association, an intuition, provided a way. I asked the new people in a group by themselves, “What words do you use to describe your pain under the letter a, then b, c, and d. In two weeks I went on to e, f, g, h, and in six sessions we were through the alphabet. We had quite a list of root and orientation metaphors. But by the second session I added another column since they had no problem thinking of words to describe their pain. In fact their vocabulary was on tilt. To establish a balance I asked, “What would you use to describe hope and healing? Give me words from the past or words you want to use in the future even though you may not be there now.” 
These single words worked wonders for many. For a time I had all participants answer the Kiersy Bates questionnaire to indicate how they process information. The majority, 65%, were a Kiersey Bates SJ, meaning make it concrete and down to earth and get me over this as soon as possible. They are 33 % of the general population. Six sessions every other week slowed them down. They had me as their facilitator an INFP, almost an opposite, who is process oriented to the core. Plus when I asked how many others experience anger, bitterness, confusion, a bond and community began to form on a one word identity. The stories were different behind the one word identities but the bonding went on and they knew others were making a similar journey. They were not as isolated and alone. Saying “no one understands” was not the total picture like before. 
I began to try the procedure in a pain support group, a cardiac group, an arthritic group, and with industrial groups where people were learning to be supportive to each other in the work place. I conclude there is a common language for the transitions in life and certain word categories name what people experience more than others. The root metaphors can be unique but the orientation metaphors are more alike than different. 
Angry words were found for every letter except x, yuk and zinger came in for y and z. 
I tried to get the hospital to sponsor a support group for people from different health care specialties. I was discovering at least 50 percent of the words used in a transition were similar. A planning group met for five sessions and another cardiac group was formed instead. Now years later and still today, decision makers for health care in our area are not ready for the non-specificity of language and stories. And neither are the patients who gain their identify and are blessed by the temple priests of health care with the specificity from a particular illness. I have a heart problem, I have cancer, I have ... I say I have something in common with all of humanity --- non specificity. The scientific medical model is very strong and entrenched. The reductionist tendency does good work. They are good people. They still would give Hans Selye a bad time, the researcher on the Stress Response Syndrome, which is a full fledged non specificity response. Different stressors set off the same reponse.
In spite of the resistance he discoveries of non- specificity like the stress response syndrome are gradually making an impact. Our bodies apparently respond in a similar way to different stimuli as story, prayer, meditation, liturgy, the language of transition, humor, music, poetry, etc. 
The non-professionals are not any more ready than the professionals to change, although narrative medicine and narrative therapies are a start. All are in need of an intellectual conversion. Employee Assistance People, EAP, scream confidentiality and liability to protect their turf. And hospital administrators say they could not make any money that way. Too late, a growing community of professionals and lay people are already making new discoveries. 
As time went on “the language of transition” became three columns. The first for words reflecting hurt and cleansing, the third for hope and healing and connecting, and a middle column appeared becoming the place where we live most of the time. The column for contradictions, Aha’s!, paradox, ambiguity, ambivalence, and opposites. The words were yo yo, roller coaster, up and down, having it together and falling apart, “Darkness and light to you are both alike.” (Psalm 139:11) 

Addendum: I will now add mystical experience to non specificity. I think Williams James was on to this is his Gifford Lectures, the Variety of Religious Experience. It has been a very long time since I read the book. If you want to read it many of the Gifford Lectures are available over the internet.