Re: question about ACT and psychiatry

[Guest guest]

I can't speak as someone who knows what you've gone through or as an expert in ACT. But your use of the word " shame " hit me like a kidney punch so I felt I had to speak. I had/have acid reflux that has gone unchecked so long that it has eaten away at the enamel of some of my back teeth. (ew!) Its a known predictor in oesphageal cancer, which is extremely prevalent in my race and even in my family. I would also like to have been 'stronger' in controlling the contributing factors: stress, alcohol, coffee, chocolate, spicy food, cigarettes, sweets etc (or it is 'ect'?). Finally, under medical advisement, I took a little pill for a course of 2 months and thereafter only for flare ups. The problem hasn't gone away but its arguably better now but when I use the pills, I feel like they're making it worse so I avoid it if possible. Would you ever think me weak for having to resort to drugs because I am wired this way? Do I judge you for being wired the way you are and turning to the answers that you did? NO. We all make decisions and not all of them are good. Thats life. I feel like you are stigmatising your illness. I'd wager that this goes against the A in ACT. Is it possible that your meds are an enabler? Would you be in a state to even contemplate ACT at all?

Some background info first: I've been on psych. meds for 4 years or so

for depression and OCD. My depression got a lot worse and more

incapacitating this past year or so, resulting in multiple

hospitalizations for suicidality, and ECT this summer, which definitely

helped, though I'm still not out of the woods yet. In addition, I see

a therapist who practices ACT (which I am VERY thankful for) - w/o him,

I don't think meds and ECT would have gotten me anywhere.

Anyway... I feel ashamed for all my psychiatric treatment, b/c I feel

like if I were " stronger " I would have been able to just deal with my

depression, and be mindful of my emotions and be able to just have

them. I'm working on that now - but what is ACTs perspective on meds,

ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and

acceptance? I am not using them to numb myself, though...

Thanks!

-- I'm still from the Blog.

[Guest guest]

Hi--

I've definitely had my share of shame, so what you wrote here

resonates with me. Notice how you are buying into the thought that

you're weak because you've used medication to manage your

depression. Alongside this, your mind might throw similar thoughts

at you.....you're not good enough......you're bad....and so on.

Very understandably, your mind is essentially asking in your email

if it's OK, from an ACT perspective, that you've used medication for

your depression. In other words, your mind appears to be very

cleverly trying to find a way to rationalize away the feeling of

shame that shows up around your medication use. I don't want to

minimize the shame you're feeling or the intensity of the battle

that's going on in your mind and in your life (as I've said, I've

often felt shame and have often tried to desperately talk myself out

of it). I do want you to notice the thoughts--the evaluations--

that you're buying into here. You're feeling ashamed, and you're

having the thought that " if I were 'stronger' I would have been able

to just deal with my depression " . And behind all that is you--the

you who notices those thoughts, those feelings. The You who values

intensely vital and meaningful things, and wants to move toward

them.

The ACT line drawn here is evaluation-free. In your experience,

does taking medication help in dealing with your depression, and

does it in any important way hinder your movement toward what you

value? Your direct experience of what works for you and what

doesn't work for you is the ultimate guide here--not your mind.

Once you're reasonably clear on the answers, you have a continual

series of choices as to whether or not to keep taking medication for

your depression, or to try something different. Any talk about

the " goodness " or " badness " of your choices--from your mind or

anyone elses--is just talk, just words, just letters strung

together, as compelling as they may seem. And there will be a whole

lot of talk to notice.

Best,

JT

>

> Some background info first: I've been on psych. meds for 4 years

or so

> for depression and OCD. My depression got a lot worse and more

> incapacitating this past year or so, resulting in multiple

> hospitalizations for suicidality, and ECT this summer, which

definitely

> helped, though I'm still not out of the woods yet. In addition, I

see

> a therapist who practices ACT (which I am VERY thankful for) - w/o

him,

> I don't think meds and ECT would have gotten me anywhere.

>

> Anyway... I feel ashamed for all my psychiatric treatment, b/c I

feel

> like if I were " stronger " I would have been able to just deal with

my

> depression, and be mindful of my emotions and be able to just have

> them. I'm working on that now - but what is ACTs perspective on

meds,

> ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and

> acceptance? I am not using them to numb myself, though...

>

> Thanks!

>

[Guest guest]

Sounds to me you have put together a good combination

of support! ACT doesn't hold a position for or against meds, ECT or the

like. Medications and alternative treatments are sometimes indicated. Of

course this is between you and your medical treatment team to decide. If

you have some concerns about medications or ECT, you may want to discuss

this with your ACT therapist and physician. I understand sometimes folks

sense a stigma ( real or imagined or both) and feel a sense of shame when

they reach out for help. There is no need to fight the shame. You can have

a feeling of shame, you can have some thoughts you should be stronger, you

can have all that and still gently move forward to what works for you--as

indeed it appears you are. :-)

Best,

Joanne

homuncu_lie wrote:

Some background info first: I've been on psych. meds for 4 years or

so

for depression and OCD. My depression got a lot worse and more

incapacitating this past year or so, resulting in multiple

hospitalizations for suicidality, and ECT this summer, which definitely

helped, though I'm still not out of the woods yet. In addition, I see

a therapist who practices ACT (which I am VERY thankful for) - w/o him,

I don't think meds and ECT would have gotten me anywhere.

Anyway... I feel ashamed for all my psychiatric treatment, b/c I feel

like if I were "stronger" I would have been able to just deal with my

depression, and be mindful of my emotions and be able to just have

them. I'm working on that now - but what is ACTs perspective on meds,

ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and

acceptance? I am not using them to numb myself, though...

Thanks!

[Guest guest]

Thanks for this very lovely reply, JT.

"And there will be a whole lot of talk to notice"--you betcha!

Joanne

T. Blackledge, Ph. D. wrote:

Hi--

I've definitely had my share of shame, so what you wrote here

resonates with me. Notice how you are buying into the thought that

you're weak because you've used medication to manage your

depression. Alongside this, your mind might throw similar thoughts

at you.....you're not good enough......you're bad....and so on.

Very understandably, your mind is essentially asking in your email

if it's OK, from an ACT perspective, that you've used medication for

your depression. In other words, your mind appears to be very

cleverly trying to find a way to rationalize away the feeling of

shame that shows up around your medication use. I don't want to

minimize the shame you're feeling or the intensity of the battle

that's going on in your mind and in your life (as I've said, I've

often felt shame and have often tried to desperately talk myself out

of it). I do want you to notice the thoughts--the evaluations--

that you're buying into here. You're feeling ashamed, and you're

having the thought that "if I were 'stronger' I would have been able

to just deal with my depression". And behind all that is you--the

you who notices those thoughts, those feelings. The You who values

intensely vital and meaningful things, and wants to move toward

them.

The ACT line drawn here is evaluation-free. In your experience,

does taking medication help in dealing with your depression, and

does it in any important way hinder your movement toward what you

value? Your direct experience of what works for you and what

doesn't work for you is the ultimate guide here--not your mind.

Once you're reasonably clear on the answers, you have a continual

series of choices as to whether or not to keep taking medication for

your depression, or to try something different. Any talk about

the "goodness" or "badness" of your choices--from your mind or

anyone elses--is just talk, just words, just letters strung

together, as compelling as they may seem. And there will be a whole

lot of talk to notice.

Best,

JT

>

> Some background info first: I've been on psych. meds for 4 years

or so

> for depression and OCD. My depression got a lot worse and more

> incapacitating this past year or so, resulting in multiple

> hospitalizations for suicidality, and ECT this summer, which

definitely

> helped, though I'm still not out of the woods yet. In addition, I

see

> a therapist who practices ACT (which I am VERY thankful for) - w/o

him,

> I don't think meds and ECT would have gotten me anywhere.

>

> Anyway... I feel ashamed for all my psychiatric treatment, b/c I

feel

> like if I were "stronger" I would have been able to just deal with

my

> depression, and be mindful of my emotions and be able to just have

> them. I'm working on that now - but what is ACTs perspective on

meds,

> ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and

> acceptance? I am not using them to numb myself, though...

>

> Thanks!

>

[Guest guest]

I noticed an odd thing in High School (pardon the oversimplification that follows): the jocks wished they did better in class, the nerds wished they were cool, the "in" crowd wished they could "express themselves," the drama people wished. . . It seems that there is something about being human that makes us wish were something else. It is a hard thing to accept who you are and what you are, unless you are that rare person who is exactly who you want to be. I was that kid who just wanted to be good at everything.As I write this, I'm up late again, wishing I could be in bed asleep. At some point, I realize that accepting those agitations, thoughts, and feelings is just not going to help me sleep, so I get up and let them be there. Something inside me won't rest until I speak my piece on this, so I am just going to accept it and see what quiets down.I can't speak too eloquently about what ACT has to say about meds that hasn't already been said, but I know how I

feel about meds for depression. My mother was diagnosed bi-polar and goodness knows what else when I was on 5. When she died last year, she was still on a "refill as needed" combination that consisted primarily of lithium and Haldol. I developed a very, very fused opinion of meds that has less to do with flexibility and acceptance than it does with watching the HMO throw drugs at her instead of help her find good therapy. I know she responded well to counseling when she got a good therapist and accepted the help, but she never really got past needing the meds. As a child, that made me fear meds, and I personally recoil at the thought of taking them myself, even though I do see that other people can benefit from them.I believe that drugs are a crutch to a lot of people who don't really want to get better, and they are a tool on the path to a better life to a lot of people who do. Some of those people eventually stop needing medication, and some people have to accept

their need. Just stay on the road and keep moving. I may never get to where I want to be, but getting closer beats giving up and waiting to see if a miracle or inevitable doom shows up for me first!homuncu_lie wrote: Some background info first: I've been on psych. meds for 4 years or so for depression and OCD. My depression got a lot worse and more incapacitating this past year or so, resulting in multiple hospitalizations for suicidality, and ECT this summer, which definitely

helped, though I'm still not out of the woods yet. In addition, I see a therapist who practices ACT (which I am VERY thankful for) - w/o him, I don't think meds and ECT would have gotten me anywhere. Anyway... I feel ashamed for all my psychiatric treatment, b/c I feel like if I were "stronger" I would have been able to just deal with my depression, and be mindful of my emotions and be able to just have them. I'm working on that now - but what is ACTs perspective on meds, ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and acceptance? I am not using them to numb myself, though... Thanks!

Stay in the know. Pulse on the new Yahoo.com. Check it out.

[Guest guest]

To clarify, I don't think OTHER people are weak for taking meds, just

myself - which I know makes no sense.

Thank you - that's a good point - I don't think I'd even be able to

even think about ACT w/o being on meds. They have helped me move

closer to my values, and that's what matters.

> >

> > Some background info first: I've been on psych. meds for 4

years or so

> > for depression and OCD. My depression got a lot worse and more

> > incapacitating this past year or so, resulting in multiple

> > hospitalizations for suicidality, and ECT this summer, which

definitely

> > helped, though I'm still not out of the woods yet. In addition, I

see

> > a therapist who practices ACT (which I am VERY thankful for) -

w/o him,

> > I don't think meds and ECT would have gotten me anywhere.

> >

> > Anyway... I feel ashamed for all my psychiatric treatment, b/c I

feel

> > like if I were " stronger " I would have been able to just deal

with my

> > depression, and be mindful of my emotions and be able to just have

> > them. I'm working on that now - but what is ACTs perspective on

meds,

> > ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and

> > acceptance? I am not using them to numb myself, though...

> >

> > Thanks!

> >

> >

> >

>

>

>

> --

> I'm still from the Blog.

>

[Guest guest]

" In other words, your mind appears to be very

cleverly trying to find a way to rationalize away the feeling of

shame that shows up around your medication use. "

Yes - though I hate to admit it, you are right. I do a lot of

reassurance-seeking to try to convince myself that I'm not a bad

person. I am always trying to rationalize away feelings - I get into

so many arguments with my mind, going back and forth, but in the end,

I just have to ask my experience.

Thank you - this was very helpful!

> >

> > Some background info first: I've been on psych. meds for 4 years

> or so

> > for depression and OCD. My depression got a lot worse and more

> > incapacitating this past year or so, resulting in multiple

> > hospitalizations for suicidality, and ECT this summer, which

> definitely

> > helped, though I'm still not out of the woods yet. In addition,

I

> see

> > a therapist who practices ACT (which I am VERY thankful for) -

w/o

> him,

> > I don't think meds and ECT would have gotten me anywhere.

> >

> > Anyway... I feel ashamed for all my psychiatric treatment, b/c I

> feel

> > like if I were " stronger " I would have been able to just deal

with

> my

> > depression, and be mindful of my emotions and be able to just

have

> > them. I'm working on that now - but what is ACTs perspective on

> meds,

> > ECT, etc. (haha, ect, etc...)? Do they go against mindfulness

and

> > acceptance? I am not using them to numb myself, though...

> >

> > Thanks!

> >

>

[Guest guest]

" You can have a feeling of shame, you can have some thoughts you

should be stronger, you can have all that and still gently move

forward to what works for you "

Thank you for this reminder!! I need to print that out and paste it

on my computer

>

> > Some background info first: I've been on psych. meds for 4 years

or so

> > for depression and OCD. My depression got a lot worse and more

> > incapacitating this past year or so, resulting in multiple

> > hospitalizations for suicidality, and ECT this summer, which

definitely

> > helped, though I'm still not out of the woods yet. In addition, I

see

> > a therapist who practices ACT (which I am VERY thankful for) -

w/o him,

> > I don't think meds and ECT would have gotten me anywhere.

> >

> > Anyway... I feel ashamed for all my psychiatric treatment, b/c I

feel

> > like if I were " stronger " I would have been able to just deal

with my

> > depression, and be mindful of my emotions and be able to just have

> > them. I'm working on that now - but what is ACTs perspective on

meds,

> > ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and

> > acceptance? I am not using them to numb myself, though...

> >

> > Thanks!

> >

> >

>

[Guest guest]

I am really sorry about your mother - I don't know what to say. I am

very lucky to have a therapist, and a psychiatrist who actually

speaks to me for a full hour instead of just throwing pills at me.

" Something inside me won't rest until I speak my piece "

I know exactly what you mean. I frequently bottle things up inside

me, but as long as they stay trapped inside, there is this constant

nagging feeling in me.

Some background info first:

I've been on psych. meds for 4 years or so

> for depression and OCD. My depression got a lot worse and more

> incapacitating this past year or so, resulting in multiple

> hospitalizations for suicidality, and ECT this summer, which

definitely

> helped, though I'm still not out of the woods yet. In addition, I

see

> a therapist who practices ACT (which I am VERY thankful for) - w/o

him,

> I don't think meds and ECT would have gotten me anywhere.

>

> Anyway... I feel ashamed for all my psychiatric treatment, b/c I

feel

> like if I were " stronger " I would have been able to just deal with

my

> depression, and be mindful of my emotions and be able to just have

> them. I'm working on that now - but what is ACTs perspective on

meds,

> ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and

> acceptance? I am not using them to numb myself, though...

>

> Thanks!

>

>

>

>

>

>

> ---------------------------------

> Stay in the know. Pulse on the new Yahoo.com. Check it out.

>

[Guest guest]

> Thank you - that's a good point - I don't think I'd even be able to

> even think about ACT w/o being on meds. They have helped me move

> closer to my values, and that's what matters.

This is how I feel about meds, as well. I am pretty sure that without

meds, I would not be alive, let alone able to be a good parent,

spouse,

citizen, worker, etc.

We often hear that people take meds as an " easy out. " I think that's

something of a myth.

For one, I don't think psych meds, properly used, work that way

(speaking from having been on more than 10 meds in as many years, and

also working in the mental health field).

I also personally believe that far more people avoid (because of

stigma

and shame) taking medications that might benefit them and help them

live a richer life than take meds as an " easy out. " That is a

terrible

loss for them, IMO. Not that meds are a panacea, and not that they

shouldn't be accompanied by other therapeutic techniques, but I

believe

that for some, including myself, they are an essential component of

wellness, and to not take them is akin to a diabetic not taking

insulin, etc., etc.

In my case, there is something wrong with my brain, and it causes me

enormous psychic pain from time to time. Some of my docs have called

this bipolar disorder, some have called it depression, some have

called

in generalized anxiety. I call it " the thing that happens to me

sometimes. " I expect that some day, long after I have passed,

scientists will pinpoint what, physically, in the brain is aberrant

in

syndromes like mine, but we don't yet have that knowledge. So we use

the tools and remedies that seem to work for us. ACT is just one tool.

ACT addresses how people can work with their own thinking, but it

never

says there aren't other approaches that can also be used to address

psychic pain. If it claimed it was the only way, it would be

demagoguery, not therapy, as I see it.

I hope that you continue to use the tools that bring you closer to

health and closer to your values. Be kind to yourself. I wish you

well.

K.D.

[Guest guest]

I learned at a very young age to keep things bottled up, and I got very good at it. Then I tried letting it all out, and I found that doesn't really help much either. Eventually, when the time was right, I found that there is a third option. You stay in the present. You can have the thoughts and opinions, and you can let them pass without shouting them at whomever "really needs to hear what I have to say!" I still find that my biggest challenge in ACT is trying to do the "train under the bridge" excercise that is in the book. I can see myself, the bridge, and the train. . . but the cars are always empty. I can fill one car, but then it is the only car that I can see. Given my normal penchant for not thinking about only one thing at a time, I find this very curious. homuncu_lie wrote: I am really sorry about your mother - I don't know what to say. I am very lucky to have a therapist, and a psychiatrist who actually speaks to me for a full hour instead of just throwing pills at me. "Something inside me won't rest until I speak my piece" I know exactly what you mean. I frequently bottle things up inside me, but as long as they stay trapped inside, there is this constant nagging feeling in me. Some background info first: I've been on psych. meds for 4 years or so > for depression and OCD. My depression got a lot worse and more > incapacitating this past year or so, resulting in multiple > hospitalizations for suicidality, and ECT this summer, which definitely > helped, though I'm still not out of the woods yet. In addition, I see > a therapist who practices ACT (which I am VERY thankful for) - w/o him, > I

don't think meds and ECT would have gotten me anywhere. > > Anyway... I feel ashamed for all my psychiatric treatment, b/c I feel > like if I were "stronger" I would have been able to just deal with my > depression, and be mindful of my emotions and be able to just have > them. I'm working on that now - but what is ACTs perspective on meds, > ECT, etc. (haha, ect, etc...)? Do they go against mindfulness and > acceptance? I am not using them to numb myself, though... > > Thanks! > > > > > > > --------------------------------- > Stay in the know. Pulse on the new Yahoo.com. Check it out. >

Stay in the know. Pulse on the new Yahoo.com. Check it out.

[Guest guest]

It is

a hard thing to accept who you are and what you are, unless you are that

rare person who is exactly who you want to be.

Hi ,

I know what you mean--acceptance may seem to be hard, but really the alternatives

(denial, distortion, avoidance) are far worse in my view. Acceptance is

not as difficult as we may imagine it to be. For me it is rather an act

of self-grace. Acceptance is not a place to go to. Acceptance is not the same as being 'exactly who I want to be'. I think it a bit of myth that

anyone ever gets to a place of being exactly anything, truthfully.

Acceptance is quite simple, really--surrender to what is so and what is not

so right here, right now. And here's the great irony: To the extent I accept

who I am--right here, right now--I am able to move forward toward my valued

directions, to the person I want to be.

Just some thoughts on this Thursday as I think about the word acceptance.

Hope this doesn't sound too preachy.

Best,

Joanne

Williston wrote:

I noticed an odd thing in High School (pardon the oversimplification that follows): the jocks wished they did better in class, the nerds wished they were cool, the "in" crowd wished they could "express themselves," the drama people wished. . . It seems that there is something about being human that makes us wish were something else. It is a hard thing to accept who you

are and what you are, unless you are that rare person who is exactly who

you want to be. I was that kid who just wanted to be good at everything.

As I write this, I'm up late again, wishing I could be in bed asleep. At some point, I realize that accepting those agitations, thoughts, and feelings is just not going to help me sleep, so I get up and let them be there. Something inside me won't rest until I speak my piece on this, so I am just going to accept it and see what quiets down.

I can't speak too eloquently about what ACT has to say about meds that hasn't already been said, but I know how I feel about meds for depression. My mother was diagnosed bi-polar and goodness knows what else when I was on 5. When she died last year, she was still on a "refill as needed" combination that consisted primarily of lithium and Haldol. I developed a very, very fused opinion of meds that has less to do with flexibility and acceptance than it

does with watching the HMO throw drugs at her instead of help her find good

therapy. I know she responded well to counseling when she got a good therapist

and accepted the help, but she never really got past needing the meds. As

a child, that made me fear meds, and I personally recoil at the thought of

taking them myself, even though I do see that other people can benefit from

them.

I believe that drugs are a crutch to a lot of people who don't really want to get better, and they are a tool on the path to a better life to a lot of

people who do. Some of those people eventually stop needing medication, and

some people have to accept their need. Just stay on the road and keep moving.

I may never get to where I want to be, but getting closer beats giving up

and waiting to see if a miracle or inevitable doom shows up for me first!

.