Patient Recovery Quotes

We are all damaged. We have all been hurt. We have all had to learn painful lessons. We are all recovering from some mistake, loss, betrayal, abuse, injustice or misfortune. All of life is a process of recovery that never ends. We each must find ways to accept and move through the pain and to pick ourselves back up. For each pang of grief, depression, doubt or despair there is an inverse toward renewal coming to you in time. Each tragedy is an announcement that some good will indeed come in time. Be patient with yourself.

BEFRIENDING THE BODY Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past. In my practice I begin the process by helping my patients to first notice and then describe the feelings in their bodies—not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on. I also work on identifying the sensations associated with relaxation or pleasure. I help them become aware of their breath, their gestures and movements. All too often, however, drugs such as Abilify, Zyprexa, and Seroquel, are prescribed instead of teaching people the skills to deal with such distressing physical reactions. Of course, medications only blunt sensations and do nothing to resolve them or transform them from toxic agents into allies. The mind needs to be reeducated to feel physical sensations, and the body needs to be helped to tolerate and enjoy the comforts of touch. Individuals who lack emotional awareness are able, with practice, to connect their physical sensations to psychological events. Then they can slowly reconnect with themselves.

Patients who were rarely praised as children, often distrust the positive things people say about them as adults. A child's concept of self is formed in childhood and it takes a long time with many affirmative examples to turn that self-concept around.

I urge you to find a way to immerse yourself fully in the life that you’ve been given. To stop running from whatever you’re trying to escape, and instead to stop, and turn, and face whatever it is. Then I dare you to walk toward it. In this way, the world may reveal itself to you as something magical and awe-inspiring that does not require escape. Instead, the world may become something worth paying attention to. The rewards of finding and maintaining balance are neither immediate nor permanent. They require patience and maintenance. We must be willing to move forward despite being uncertain of what lies ahead. We must have faith that actions today that seem to have no impact in the present moment are in fact accumulating in a positive direction, which will be revealed to us only at some unknown time in the future. Healthy practices happen day by day. My patient Maria said to me, “Recovery is like that scene in Harry Potter when Dumbledore walks down a darkened alley lighting lampposts along the way. Only when he gets to the end of the alley and stops to look back does he see the whole alley illuminated, the light of his progress.

In these days before antiseptics, doctors themselves also suffered high mortality rates. Florence Nightingale, a nurse during the Crimean War (1853-1856), watched one particularly inept surgeon cut both himself and, somehow, a bystander while blundering about during an amputation. Both men contracted an infection and died, as did the patient. Nightingale commented that it was the only surgery she'd ever seen with 300 percent mortality.

no recovery from trauma is possible without attending to issues of safety, care for the self, reparative connections to other human beings, and a renewed faith in the universe. The therapist's job is not just to be a witness to this process but to teach the patient how.

The mental health system is filled with survivors of prolonged, repeated childhood trauma. This is true even though most people who have been abused in childhood never come to psychiatric attention. To the extent that these people recover, they do so on their own.[21] While only a small minority of survivors, usually those with the most severe abuse histories, eventually become psychiatric patients, many or even most psychiatric patients are survivors of childhood abuse.[22] The data on this point are beyond contention. On careful questioning, 50-60 percent of psychiatric inpatients and 40-60 percent of outpatients report childhood histories of physical or sexual abuse or both.[23] In one study of psychiatric emergency room patients, 70 percent had abuse histories.[24] Thus abuse in childhood appears to be one of the main factors that lead a person to seek psychiatric treatment as an adult.[25]

...some patients resist the diagnosis of a post-traumatic disorder. They may feel stigmatized by any psychiatric diagnosis or wish to deny their condition out of a sense of pride. Some people feel that acknowledging psychological harm grants a moral victory to the perpetrator, in a way that acknowledging physical harm does not.

And one cried wee, wee, wee, all the way—" Jessica breaking down in a giggle as he reaches for the spot along her sweatered flank he knows she can't bear to be tickled in. She hunches, squirming, out of the way as he rolls past, bouncing off the back of the sofa but making a nice recovery, and by now she's ticklish all over, he can grab an ankle, elbow— But a rocket has suddenly struck. A terrific blast quite close beyond the village: the entire fabric of the air, the time, is changed—the casement window blown inward, rebounding with a wood squeak to slam again as all the house still shudders. Their hearts pound. Eardrums brushed taut by the overpressure ring in pain. The invisible train rushes away close over the rooftop.... They sit still as the painted dogs now, silent, oddly unable to touch. Death has come in the pantry door: stands watching them, iron and patient, with a look that says try to tickle me.

For instance, it is not the function of medicine to restore a patient to health, but only to promote this end as far as possible; for even those whose recovery is impossible may be properly treated.

True insights happen only when the therapist gets out of the way so that the patient is able to gain his or her own psychological knowledge.

There comes a time. The pain of existence transcends the fear of change. There comes a time.

Spring is for planting the seed because the morning dew is perfect! It has the right amount of sun and the breeze is blowing gently to mold the seed in its rightful order. Summer is for growth because the sun rises at the right time and sets later in the evening to feed the developing seeds as we wait patiently. Fall is for the harvest, as we gather and collect it. During the harvest we have to make a decision to either keep unwelcome visitors in our life or move forward with producing peace in our life. Our harvest season is to enable us to produce action. Winter is for recovery as we rest and take it easy to see what our hard work will produce in our up and coming seasons. In order to reap from the planting of the seeds, it takes time and patience. We have sowed and produce our harvest. It is hard and time consuming, but we cannot give up.

And now of a sudden my illusion vanished. What was my body to me? A kind of flunkey in my service. Let my anger wax hot, my love grow exalted, my hatred collect in me, and the boasted solidarity between me and my body was gone. Your son is in a burning house. Nobody can hold you back. You may burn up, but what do you think of that? You are ready to bequeath the rags of your body to any man who will take them. You discover that what you set so much store by is trash. You would sell your hand, if need be, to give a hand to a friend. It is in your act that you exist, not in your body. Your act is yourself, and there is no other you. Your body belongs to you: it is not you. Are you about to strike an enemy? No threat of bodily harm can hold you back. You? It is the death of your enemy that is you. You? It is the rescue of your child that is you. In that moment you exchange yourself against something else; and you have no feeling tat you lost by the exchange. Your members? Tools. A tool snaps in your hand: how important is that tool? You exchange yourself against the death of your enemy, the rescue of your child, the recovery of your patient, the perfection of your theorem...Your true significance becomes dazzlingly evident. Your true name is duty, hatred, love, child, theorem. There is no other you than this.

I hate the way people react when they learn Charlie spent a few weeks as an in-patient. As if it’s the most horrific thing they’ve ever heard. It’s because it automatically makes them think mental asylum and crazy people, instead of treatment and recovery and learning to manage an eating disorder.

Analytic experience has taught us that the better is always the enemy of the good and that in every phase of the patient's recovery we have to fight against his inertia, which is ready to be content with an incomplete solution.

Individuality is deeply imbued in us from the very start, at the neuronal level. Even at a motor level, researchers have shown, an infant does not follow a set pattern of learning to walk or how to reach for something. Each baby experiments with different ways of reaching for objects and over the course of several months discovers or selects his own motor solutions. When we try to envisage the neural basis of such individual learning, we might imagine a "population" of movements (and their neural correlates) being strengthened or pruned away by experience. Similar considerations arise with regard to recover and rehabilitation after strokes and other injuries. There are no rules; there is no prescribed path of recovery; every patient must discover or create his own motor and perceptual patterns, his own solutions to the challenges that face him; and it is the function of a sensitive therapist to help him in this. And in its broadest sense, neural Darwinism implies that we are destined, whether we wish it or not, to a life of particularity and self-development, to make our own individual paths through life.

And pain is relative; My particulars may be "better" of "worse" than the patient next to me, but individually our biological framework limits our ability to tolerate suffering; that is what brings us to out knees, flips the switch of our depression, and forces us to retreat from the rest of the world. That is what we have in common.

or to what we hope they are. The more we work through our family of origin issues, the less we will find ourselves needing to work through them with the people we’re attracted to. Finishing our business from the past helps us form new and healthier relationships. The more we overcome our need to be excessive caretakers, the less we will find ourselves attracted to people who need to be constantly taken care of. The more we learn to love and respect ourselves, the more we will become attracted to people who will love and respect us and who we can safely love and respect. This is a slow process. We need to be patient with ourselves. The type of people we find ourselves attracted to does not change overnight. Being attracted to dysfunctional people can linger long and well into recovery. That does not mean we need to allow it to control us. The fact is, we will initiate and maintain relationships with people we need to be with until we learn what it is we need to learn—no matter how long we’ve been recovering. No matter who we find ourselves relating to, and what we discover happening in the relationship, the issue is still about us, and not about the other person. That is the heart, the hope, and the power of recovery.

Never congratulate a doctor for the fast recovery of a patient.

I peered around the corner into the main recovery ward. All I could see were surgeons. Surgeons filling out those incessant forms. Surgeons bringing cups of tea and little sandwich triangles to patients. Surgeons laying in a lethargic stupor, recovering from eye surgery.

Like so many survivors of childhood abuse, Marilyn exemplified the power of the life force, the will to live and to own one's life, the energy that counteracts the annihilation of trauma. I gradually came to realize that the only thing that makes it possible to do the work of healing trauma is awe at the dedication to survival that enabled my patients to endure their abuse and then to endure the dark nights of the soul that inevitably occur on the road to recovery.

Rangarajan, your other patients are waiting. Thank you very much for your help.” “But it is no trouble—” “Thank you, bye-bye,” said Coomy. For a moment, Mr. Rangarajan looked offended. But he recovered his poise, wished the professor a speedy recovery, and left. They pushed Nariman’s

Mental illness is no different than a heart condition. In the same way a faulty valve can cause harm to the body and require medication and care, so does a malfunctioning brain. Insanity is a crude, culturally loaded term setting the sufferer apart in a way which will not aid the patient’s recovery. The way we regard those whose brains hinder them with fault or injury is a prejudice, not a diagnosis.” Dr. North

In therapy, when pathological defenses start to crumble, the patient lets in more material from their background that they've been defending against. Suddenly, memories emerge that were unavailable at the beginning of the therapy. When Laura had been intent on defending her father, she'd blocked many of her negative memories of him; but now, after two years of therapy, those painful memories began to flow like hot lava.

Surely now was the time to begin faking that recovery? To utter a few words here and there, then a few more; to slowly communicate some kind of remorse? But no. Week followed week, month followed month, then the years passed—and still Alicia didn’t speak.

This apparent calm before the storm may reflect different things: The suicidal patients may be experiencing a genuine calm in the midst of recovery but then switch precipitously into a severe depression or a mixed state. They may, on the other hand, be calmer because, having decided to kill themselves, they are relieved of the anxiety and pain entailed in having to continue to live. They may also be deliberately deceiving their doctors and families in order to secure the circumstances that will allow them to commit suicide.

Rage that has nowhere to go is redirected against the self, in the form of depression, self-hatred, and self-destructive actions. One of my patients told me, ‘It is like hating your home, your kitchen and pots and pans, your bed, your chairs, your table, your rugs.’ Nothing feels safe – least of all your own body.

How to be there for someone with depression or anxiety 1. Know that you are needed, and appreciated, even if it seems you are not. 2. Listen. 3. Never say ‘pull yourself together’ or ‘cheer up’ unless you’re also going to provide detailed, foolproof instructions. (Tough love doesn’t work. Turns out that just good old ‘love’ is enough.) 4. Appreciate that it is an illness. Things will be said that aren’t meant. 5. Educate yourself. Understand, above all, that what might seem easy to you –going to a shop, for instance –might be an impossible challenge for a depressive. 6. Don’t take anything personally, any more than you would take someone suffering with the flu or chronic fatigue syndrome or arthritis personally. None of this is your fault. 7. Be patient. Understand it isn’t going to be easy. Depression ebbs and flows and moves up and down. It doesn’t stay still. Do not take one happy/ bad moment as proof of recovery/ relapse. Play the long game. 8. Meet them where they are. Ask what you can do. The main thing you can do is just be there. 9. Relieve any work/ life pressure if that is doable. 10. Where possible, don’t make the depressive feel weirder than they already feel. Three days on the sofa? Haven’t opened the curtains? Crying over difficult decisions like which pair of socks to wear? So what. No biggie. There is no standard normal. Normal is subjective. There are seven billion versions of normal on this planet.

key to recovery, then, is to get the patient to understand that her perceptions aren’t necessarily reality, that the world might not be as dark as it seems.

It was the bad luck of eating patient zero.

We aren’t trained to see our patients. We are trained to see pathology.

We subconsciously construct a narrative in which the doctor-patient relationship is somehow antagonistic.

Recovery is indeed a manifestation of the law of nature, efforts of patient and guidance from physical therapist or rehabilitation specialist.

For the last time I have my sh*t together ; I just forgot where I put it!

The patient’s body saves itself on its own. The doctor only helps, directing the body’s strengths to take the proper course, sometimes removing something extra, unnecessary, and obsolete. The doctor and patient travel the road to recovery hand in hand, but the primary part – which is always the deciding factor – is played by the patient, with his will for life and the strengths of his body.

The only one of the early investigators who carried the exploration of hysteria to its logical conclusion was Breuer's patient Anna O. After Breuer abandoned her, she apparently remained ill for several years. And then she recovered. The mute hysteric who had invented the "talking cure" found her voice and her sanity, in the women's liberation movement. Under a pseudonym, Paul Berthold, she translated into German the classic treatise by Mary Wollstonecraft, A Vindication of the Rights of Women, and authored a play, Women's Rights. Under her own name, Bertha Papenheim became a prominent feminist social worker, intellectual, and organizer. In the course of a long and fruitful career she directed an orphanage for girls, founded a feminist organization for Jewish women and traveled throughout Europe and the Middle East to campaign against the sexual exploitation of women and children. Her dedication, energy and commitment were legendary. In the words of a colleague, 'A volcano lived in this woman... Her fight against the abuse of women and children was almost a physically felt pain for her.' At her death, the philosopher Martin Buber commemorated her: 'I not only admired her but loved her, and will love her until the day I die. There are people of spirit and there are people of passion, both less common than one might think. Rarer still are the people of spirit and passion. But rarest of all is a passionate spirit. Bertha Pappenheim was a woman with just such a spirit.

LOVE is the most powerful human force!! Let's practice it to improve the fate of humanity! First self love,then love to others and our environment. LOVE is humble,patient,humble patient,charming,it's wonderful feeling!

[hypnosis] does not permit us. . .to recognize the resistance with which the patient clings to his disease and thus even fights against his own recovery; yet it is this phenomenon of resistance which alone makes it possible to comprehend his behavior in daily life.

The healer's job has always been to release something not understood,to remove obstructions (demons, germs, despair) between the sick pa-tient and the force of life driving obscurely toward wholeness. Themeans may be direct—the psychic methods mentioned above—or indi-rect: Herbs can be used to stimulate recovery; this tradition extendsfrom prehistoric wisewomen through the Greek herbal of Dioscoridesand those of Renaissance Europe, to the prevailing drug therapies of thepresent. Fasting, controlled nutrition, and regulation of living habits toavoid stress can be used to coax the latent healing force from the sick body; we can trace this approach back from today's naturopaths to Galenand Hippocrates. Attendants at the healing temples of ancient Greeceand Egypt worked to foster a dream in the patient that would eitherstart the curative process in sleep or tell what must be done on awaken-ing. This method has gone out of style, but it must have worked fairlywell, for the temples were filled with plaques inscribed by grateful pa-trons who'd recovered.

Psychologists Michael Scheier and Charles Carver found a correlation between optimism and recovery from coronary artery bypass surgery.15 Others have studied how attitudes affect recovery and found that this improvement is not a function of a patient’s tendency to deny that he was ill.

Depression frequently is internalised anger or anger turned inward. A clinically depressed person is most often someone who is sitting on a great deal of rage - to the point when a patient self-diagnoses with depression, the first reasonable clinical question to ask is: What pissed you off?

Will either passengers, or patients, find fault and complain, either the one if they be well carried, or the others if well cured? Do they take care for any more than this; the one, that their shipmaster may bring them safe to land, and the other, that their physician may effect their recovery?

approach to health care and recovery. She firmly believed that it was just as important to talk to patients and offer them compassion whether they were awake or dormant. Although she was only thirty-seven, she had received the hospital alliance’s “Nurse of the Year” award six times in the past fifteen-years.

I never lie down at night but I know that in the course of that day he has alleviated pain and soothed some fellow-creature in the time of need. I know that from the beds of those who were past recovery, thanks have often, often gone up, in the last hour, for his patient ministration. Is not this to be rich?

As each day passed the community became more and more indoctrinated into the world of psychobabble. It was used to keep patients in subservient positions. "Poor impulse control," "defiance," or "you want what you want when you want it" were all catch phrases. Pronouncing judgement, Brian said, "These recovery institutions are all alike. Former addicts own and operate them. They're founded on the cliches these individuals accuse us of, grandiosity, arrogance, and selfishness. They take away human dignity and wrap themselves in the AA free spiritual principals, while charging so much money you'd think you were staying at the Ritz in Paris.

The aged Summerlea nurse pushed past Valik and Laci and stalked over to his sickbed. “You are supposed to be sleeping.” Her face scrunched up in an expression of severe disapproval. She didn’t care that he was king. She chided him like she might any misbehaving schoolboy. He almost smiled. It was clear Tildavera Greenleaf was accustomed to being in charge, and equally accustomed to speaking her mind and having her orders obeyed. But this was one order he had no intention of heeding. “I’ve slept long enough. Khamsin told me you were the best healer in all of Mystral, and it’s clear she wasn’t exaggerating. You did a fine job bringing me back from the brink of death. I’m sure you can keep me clinging to life a while longer.” The old woman’s lips pursed. “My patients do not ‘cling to life,’ ” she snapped. “I pride myself on their making a full and miraculous recovery. But carting them all about the countryside with their insides hanging out is not at all conducive to that outcome!

Molar pregnancies like Janet’s are indeed rare, but they do happen. Over the last decade, frustrated and worried women have emailed me, asking why their doctors won’t pay attention to their symptoms, telling them to just “wait it out.” I think this happens because obstetricians see so many situations, and most of the time, it works out the way they expect—the recovery may be short, medium, or long, but will not require intervention. But statistics like one in five hundred are meaningless if you are the one. I always tell women who can’t get through to their doctors to start looking for one whose office responsiveness matches her needs. Not every doctor and every patient are going to be a good fit.

Under the heading of "defense mechanisms,” psychoanalysis describes a number of ways in which a person becomes alienated from himself. For example, repression, denial, splitting, projection, introjection. These "mechanisms" are often described in psychoanalytic terms as themselves "unconscious,” that is, the person himself appears to be unaware that he is doing this to himself. Even when a person develops sufficient insight to see that "splitting", for example, is going on, he usually experiences this splitting as indeed a mechanism, an impersonal process, so to speak, which has taken over and which he can observe but cannot control or stop. There is thus some phenomenological validity in referring to such "defenses" by the term "mechanism.” But we must not stop there. They have this mechanical quality because the person as he experiences himself is dissociated from them. He appears to himself and to others to suffer from them. They seem to be processes he undergoes, and as such he experiences himself as a patient, with a particular psychopathology. But this is so only from the perspective of his own alienated experience. As he becomes de-alienated he is able first of all to become aware of them, if he has not already done so, and then to take the second, even more crucial, step of progressively realizing that these are things he does or has done to himself. Process becomes converted back to praxis, the patient becomes an agent.

What [my patients] care about is my presence or absence as a human being. They gauge with unerring eye whether I am grounded enough on any given day to co-exist with them, to listen to them as persons with feelings, hopes and aspirations as valid as mine. They can tell instantly whether I’m genuinely committed to their well-being or just trying to get them out of my way.

However, the nurturing person must be able to nurture and the person in need must be able to let go, to surrender, in order to be nurtured. In my observations of patients, their families, and of other people, this reciprocity is unusual in human interaction. It is not the child’s job to nurture their parent, and when this happens repeatedly, it is a subtle form of child abuse or neglect.

A patient complains of feeling nervous or fearful. These feelings and behaviors suggest that the patient has an anxiety disorder, and the doctor prescribes whatever drug will most probably work for an anxiety disorder. However, there's no conclusive way to tell that this patient definitely has an anxiety disorder. Even if the doctor did get the diagnosis correct, there's a great deal of variation regarding which drug class (for example, anti-anxiety drugs versus antidepressants) a particular individual will respond to and which drug within a class (for example, Prozac versus Zoloft) will work best. If the drug doesn't work, the doctor will try the next one on the list and so on, thus delaying treatment success and complicating the process with the mix-and-match type of treatment.

As the feminist psychiatrist Judith Herman puts it in her book Trauma and Recovery: “His correspondence makes clear that he was increasingly troubled by the radical social implications of his hypothesis. . . . Faced with this dilemma, Freud stopped listening to his female patients.” If they were telling the truth, he would have to challenge the whole edifice of patriarchal authority to support them.

Conventional treatments miss the real cause of most back trouble—they simply don’t address the stress and muscle pain problem. Most treatments also emphasize “taking it easy,” “trying not to hurt yourself,” or waiting for the pain to go away before resuming activity. Yet all the research and our experience with patients show that a quick return to unrestricted physical movement is the fastest and surest way to recovery.

Then again, on another day, one might open the newspaper to read that the largest study of prayer ever undertaken had discovered yet again that there was no correlation of any kind between “intercessory” prayer and the recovery of patients. (Well, perhaps some correlation: patients who knew that prayers were being said for them had more postoperative complications than those who did not, though I would not argue that this proved anything.)

The process of curing is passive; that is, the patient is inclined to give his or her authority over to the physician and prescribed treatment instead of actively challenging the illness and reclaiming health. Healing, on the other hand, is an active and internal process that includes investigating one’s attitudes, memories, and beliefs with the desire to release all negative patterns that prevent one’s full emotional and spiritual recovery.

I resolved to come right to the point. "Hello," I said as coldly as possible, "we've got to talk." "Yes, Bob," he said quietly, "what's on your mind?" I shut my eyes for a moment, letting the raging frustration well up inside, then stared angrily at the psychiatrist. "Look, I've been religious about this recovery business. I go to AA meetings daily and to your sessions twice a week. I know it's good that I've stopped drinking. But every other aspect of my life feels the same as it did before. No, it's worse. I hate my life. I hate myself." Suddenly I felt a slight warmth in my face, blinked my eyes a bit, and then stared at him. "Bob, I'm afraid our time's up," Smith said in a matter-of-fact style. "Time's up?" I exclaimed. "I just got here." "No." He shook his head, glancing at his clock. "It's been fifty minutes. You don't remember anything?" "I remember everything. I was just telling you that these sessions don't seem to be working for me." Smith paused to choose his words very carefully. "Do you know a very angry boy named 'Tommy'?" "No," I said in bewilderment, "except for my cousin Tommy whom I haven't seen in twenty years..." "No." He stopped me short. "This Tommy's not your cousin. I spent this last fifty minutes talking with another Tommy. He's full of anger. And he's inside of you." "You're kidding?" "No, I'm not. Look. I want to take a little time to think over what happened today. And don't worry about this. I'll set up an emergency session with you tomorrow. We'll deal with it then." Robert This is Robert speaking. Today I'm the only personality who is strongly visible inside and outside. My own term for such an MPD role is dominant personality. Fifteen years ago, I rarely appeared on the outside, though I had considerable influence on the inside; back then, I was what one might call a "recessive personality." My passage from "recessive" to "dominant" is a key part of our story; be patient, you'll learn lots more about me later on. Indeed, since you will meet all eleven personalities who once roamed about, it gets a bit complex in the first half of this book; but don't worry, you don't have to remember them all, and it gets sorted out in the last half of the book. You may be wondering -- if not "Robert," who, then, was the dominant MPD personality back in the 1980s and earlier? His name was "Bob," and his dominance amounted to a long reign, from the early 1960s to the early 1990s. Since "Robert B. Oxnam" was born in 1942, you can see that "Bob" was in command from early to middle adulthood. Although he was the dominant MPD personality for thirty years, Bob did not have a clue that he was afflicted by multiple personality disorder until 1990, the very last year of his dominance. That was the fateful moment when Bob first heard that he had an "angry boy named Tommy" inside of him. How, you might ask, can someone have MPD for half a lifetime without knowing it? And even if he didn't know it, didn't others around him spot it? To outsiders, this is one of the most perplexing aspects of MPD. Multiple personality is an extreme disorder, and yet it can go undetected for decades, by the patient, by family and close friends, even by trained therapists. Part of the explanation is the very nature of the disorder itself: MPD thrives on secrecy because the dissociative individual is repressing a terrible inner secret. The MPD individual becomes so skilled in hiding from himself that he becomes a specialist, often unknowingly, in hiding from others. Part of the explanation is rooted in outside observers: MPD often manifests itself in other behaviors, frequently addiction and emotional outbursts, which are wrongly seen as the "real problem." The fact of the matter is that Bob did not see himself as the dominant personality inside Robert B. Oxnam. Instead, he saw himself as a whole person. In his mind, Bob was merely a nickname for Bob Oxnam, Robert Oxnam, Dr. Robert B. Oxnam, PhD.

To explain the metamorphosis that takes place in the process of recovery from addiction, we have to wait for that physiological change to occur -you can’t rush it, it will happen in its own time. Imagine trying to teach a caterpillar how to fly. The poor thing might listen, take flight lessons, watch butterflies darting around. But no matter how hard it tries, it won’t fly. Maybe we get frustrated because we know this whole day has it in him to become a butterfly. So we give him books to read, try to counsel him, scold him, punish him, threaten him, maybe even toss him up in the air and watch his flap his little legs before crashing back to earth. The miracle takes time, we must be patient. But just as it is natural and normal for caterpillars to become butterflies, So can we expect addicted individuals, given the appropriate care and compassion, to be transformed in the recovery process. The metamorphosis is nothing short of miraculous, as people who are desperately sick are restored to health and a “normal” state of being. So don’t sit around feeling sorry for yourself, be grateful that you have a disease from which you can make a full recovery.

Environmental cues associated with drug use—paraphernalia, people, places, and situations—are all powerful triggers for repeated use and for relapse, because they themselves trigger dopamine release. People trying to quit smoking, for example, are advised to avoid poker if they are used to having a cigarette while playing cards. Unless they move to a different area of town or to a recovery home, my Downtown Eastside patients find it virtually impossible to stop drug use, even when they form a strong intention to do so. Not only are drugs readily available, but everything and everyone in the environment reminds them of their habit.

shake my head. “These aren’t supposed to happen,” I say. “I’m on medication. I’m happy. It’s meant to go away now.” “Steffi,” Jane says, still gentle, still calm. “You know that’s not how it works.” “Why not?” “Because anxiety doesn’t care if you’re happy or not,” she says patiently. “Just like cancer doesn’t care if you’re happy. Or a broken leg. Or diabetes.” “That’s not the same.” “Blaming yourself for your illness will hinder your recovery process,” Jane says. “It won’t help. If you tell yourself you’re not allowed to have panic attacks because you’re ‘meant to be happy,’ it will make you feel worse. It will feed the negative emotions.

Therapeutic fasting accelerates the healing process and allows the body to recover from serious disease in a dramatically short period of time. In my practice I have seen fasting eliminate lupus and arthritis, remove chronic skin conditions such as psoriasis and eczema, heal the digestive tract in patients with ulcerative colitis and Crohn’s disease, and quickly eliminate cardiovascular diseases such as high blood pressure and angina. In these cases the recoveries were permanent: fasting enabled longtime disease sufferers to unchain themselves from their multiple toxic drugs and even eliminate the need for surgery, which was recommended to some of them as their only solution.

When you are depressed, you may have a tendency to confuse feeling with facts. Your feelings of hopelessness and total despair are just symptoms of depressive illness, not facts. If you think you are hopeless, you will naturally feel this way. Your feelings only trace the illogical pattern of your thinking. Only an expert, who has treated hundreds of depressed individuals, would be in a position to give a meaningful prognosis for recovery. Your suicidal urge merely indicates the need for treatment. Thus, your conviction that you are "hopeless" nearly always proves you are not. Therapy, not suicide, is indicated. Although generalizations can be misleading, I let the following rule of thumb guide me: Patients who feel hopeless never actually are hopeless. The conviction of hopelessness is one of the most curious aspects of depressive illness. In fact, the degree of hopelessness experienced by seriously depressed patients who have an excellent prognosis is usually greater than in terminal malignancy patients with a poor prognosis. It is of great importance to expose the illogic that lurks behind your hopelessness as soon as possible in order to prevent an actual suicide attempt. You may feel convinced that you have an insoluble problem in your life. You may feel that you are caught in a trap from which there is no exit. This may lead to extreme frustration and even to the urge to kill yourself as the only escape.

When I first stopped trying to fix other people, I turned my attention to 'curing' myself. I was in a hurry to get this healing process over. I wanted immediate recovery from the effects of growing up in a family riddled with alcoholism and from being married to an alcoholic. I looked forward to the day I would graduate from Al-Anon and get on with my life. As year two and year three passed, I was still in the program. I began to despair as the character defects I had worked so long to overcome came back to haunt me, particularly during times of stress and during periods when I didn't attend meetings. I have severe arthritis in my joints. To cope with my condition, I have to assess my body each day and patiently respond to its needs. Some days I need a warm bath to get going in the morning. On other days I apply a medicated rub to the painful areas. Yet other days some light stretching and exercise help to loosen me up. I'ave accepted that my arthritis will never go away. It's a condition I manage daily with consistent, on-going care. One day I made a connection between my medical condition and my struggle with recovery. I began to look at myself as having 'arthritis of the personality,' requiring patient, continuous care to keep me from 'stiffening' into old habits and attitudes. This care includes attending meetings, reading Al-Anon literature, calling my sponsor, and engaging in service. Now, as long as I practice patience, recovery is a manageable and adventurous process instead of an arduously sought end point.

The concept of “brain plasticity” refers to the ongoing capacity of the brain and the nervous system to change itself. Everything that we do, think, feel, and experience changes our brain. A stroke or a traumatic brain injury can affect brain plasticity, and plasticity may also be associated with such developmental disorders as autism. Increased brain plasticity may also potentially endow a person with unanticipated new abilities, as John appears to have experienced in this book. TMS, or transcranial magnetic stimulation, the intervention that John undergoes, provides a unique opportunity for us to learn about the mechanisms of plasticity, and to identify alterations in the brain’s networks that may be responsible for a patient’s problematic symptoms, and also for recovery.

In 1978, an activist named Judi Chamberlin published one of the movement's most revered manifestos called 'On Our Own: Patient-Controlled Alternatives to the Mental Health System.' Chamberlin had been diagnosed with a mental illness and found traditional psychiatric intervention unhelpful and even traumatic. She did recover, however, and she credited that recovery to an alternative mental health care facility she stayed at in Canada. Chamberlin and many other madness pride activists believe that people with 'lived experience' should not only have a proverbial seat at the table when it comes to the creation of mental health care systems, but that such people are uniquely equipped to understand what constitutes the best treatment. A slogan Chamberlin sought to make famous was 'Nothing about us without us.

I came to see that survival here was all about hope, the most important fuel to our brain-damaged engines. Without it, getting—or being taken—out of bed for another identical day of confusion and failure might have been futile, for both the patients and their relatives. If you woke up with the hope that today was the day you were going to pour yourself a cup of tea, or make a conscious decision to get to the breakfast room and eat cereal with your new friends, then you were on the road to some form of recovery, even if you were never going to be able to make yourself tea again or get yourself down to breakfast. But hope was also the heaviest burden and one that many patients couldn’t carry for themselves. My doctor told me that she often made a contract with her patients to carry it for them, to keep it alive.

Josh’s father felt Josh should bond with his fellow injured patients in the ward. This was something I really dissuaded Josh from doing. I didn’t want him to hear the hardships, battles, and frustrations that others were going through. I also didn’t want Josh to take on their fears and frustrations. We were always pleasant and polite to everyone else in the ward, but my only concern was Josh, and it was enough for us to focus just on his issues. I found the whole Acute Spinal Ward experience extremely negative and distressingly sad with no great healing or recovery objective. The message from the medical team was always, without fail, acceptance of the prognosis. This was totally the opposite message of what we presented and instilled into Josh. We slowly gained evidence that our non-traditional approach was working.

Are you about to strike an enemy? No threat of bodily harm can hold you back. You? It is the death of your enemy that is you. You? It is the rescue of your child that is you. In that moment you exchange yourself against something else; and you have no feeling that you lost by the exchange. Your members? Tools. A tool snaps in your hand: how important is that tool? You exchange yourself against the death of your enemy, the rescue of your child, the recovery of your patient, the perfection of your theorem. Here is a pilot of my Group wounded and dying. A true citation in general orders would read: “Called out to his observer, ‘They’ve got me! Beat it! And for God’s sake don’t lose those notes!’” What matters is the notes, the child, the patient, the theorem. Your true significance becomes dazzlingly evident. Your true name is duty, hatred, love, child, theorem. There is no other you than this.

It took Mr. N. four months to make the plunge. The marriageable widow he chose was more than willing, and she subsequently became Mrs. N. Before this happy time came, Mr. N. had to go through a few more difficulties. He developed a case of prematurity; he had never experienced this in homosexual affairs. This is the "trouble" that confronts many ( not all ) ex-homosexuals in their affairs with women in the end phases of treatment. The majority of the candidates for recovery overcome it. A small minority do not; these patients remain bogged down at that point. Fortunately for N., he was able to overcome this hurdle, too. He was cured, and frankly the analyst was no less surprised at the outcome than the patient. "Miracles do happen," was the patient's conclusion. "Never predict the unfavorable" was the analyst's more conservative resolve, remembering his own unfavorable impressions of N. at the beginning of treatment.

One's prescription can seem extensive--even overwhelming, depending on an individual's circumstance--and I can imagine the prospects exciting few people of any stripe. Lots of eaters are going to balk at abstaining, but to learn that recovery is going to require rigorous honesty, or more attention to spirit, could be far more off-putting. Then again, who gets excited about any serious treatment prescription? Certainly not the cancer patient told she'll have to undergo radiation, or the back patient ordered to a month's uninterrupted bed rest, or the lung patient told he'll need a double transplant. To some, the flaw of those comparisons will be their being equated with food addiction, and that is the rub, entirely. The medical profession and the public at large don't see that they are equivalent. The consequences of obesity (the chief consequence of food addiction) constitute the fastest-growing, and soon the gravest, threat to public health. Obesity is suicide on lay-away: It has plenty of time to degrade quality of life before finally ending life prematurely.

Dr. Fauci, Bill Gates, and WHO financed a cadre of research mercenaries to concoct a series of nearly twenty studies—all employing fraudulent protocols deliberately designed to discredit HCQ as unsafe. Instead of using the standard treatment dose of 400 mg/day, the 17 WHO studies administered a borderline lethal daily dose starting with 2,400 mg.61 on Day 1, and using 800 mg/day thereafter. In a cynical, sinister, and literally homicidal crusade against HCQ, a team of BMGF operatives played a key role in devising and pushing through the exceptionally high dosing. They made sure that UK government “Recovery” trials on 1,000 elderly patients in over a dozen British, Welsh, Irish and Scottish hospitals, and the U.N. “Solidarity” study of 3,500 patients in 400 hospitals in 35 countries, as well as additional sites in 13 countries (the “REMAP-COVID” trial), all used those unprecedented and dangerous doses.62 This was a brassy enterprise to “prove” chloroquine dangerous, and sure enough, it proved that elderly patients can die from deadly overdoses. “The purpose seemed, very clearly, to poison the patients and blame the deaths on HCQ,” says Dr. Meryl Nass, a physician, medical historian, and biowarfare expert.

For amid that unique suffering invoked by severe brain damage, the suffering often felt more by families than patients, it is not merely the physicians who do not see the full significance. The families who gather around their beloved--their beloved whose sheared heads contain battered brains--do not usually recognize the full significance, either. They see the past, the accumulation of memories, the freshly felt love, all represented by the body before them. I see the possible futures, the breathing machines connected through a surgical opening in the neck, the pasty liquid dripping in through a hole in the belly, the possible long, painful, and only partial recovery--or, sometimes more likely, no return at all of the person they remember. In these moments, I acted not, as I most often did, as death's enemy, but as its ambassador. I had to help those families understand that the person they knew--the full, vital independent human--now lived only in the past and that I needed their input to understand what sort of future he or she would want: an easy death or to be strung between bags of fluids going in, others coming out, to persist despite being unable to struggle. Had I been more religious in my youth, I might have become a pastor, for it was the pastoral role I'd sought.

Acceptance is not submission; it is acknowledgment of the facts of a situation. Then deciding what you’re going to do about it. — Kathleen Casey Theisen Recovery offers us courage to make choices about the events of our lives. Passive compliance with whatever is occurring need no longer dominate our pattern of behavior. Powerlessly watching our lives go by was common for many of us, and our feelings of powerlessness escalated the more idle we were. Today, action is called for, thoughtful action in response to the situations begging for our attention. Recovery’s greatest gift is the courage to take action, to make decisions that will benefit us as well as the people who are close to us. Courage is the by-product of our spiritual progress, courage to accept what we cannot change, believing that all will be well, courage to change in ourselves what we do have control over. An exhilaration about life accompanies the taking of action. The spell that idleness casts over us is broken, and subsequent actions are even easier to take. Clearly, making a choice and acting on it is healthful. The program has given us the tools to do both. Decisions will be called for today. I will be patient with myself, and thoughtful. I will listen closely to the guidance that comes from those around me.

One year later the society claimed victory in another case which again did not fit within the parameters of the syndrome, nor did the court find on the issue. Fiona Reay, a 33 year old care assistant, accused her father of systematic sexual abuse during her childhood. The facts of her childhood were not in dispute: she had run away from home on a number of occasions and there was evidence that she had never been enrolled in secondary school. Her father said it was because she was ‘young and stupid’. He had physically assaulted Fiona on a number of occasions, one of which occurred when she was sixteen. The police had been called to the house by her boyfriend; after he had dropped her home, he heard her screaming as her father beat her with a dog chain. As before there was no evidence of repression of memory in this case. Fiona Reay had been telling the same story to different health professionals for years. Her medical records document her consistent reference to family problems from the age of 14. She finally made a clear statement in 1982 when she asked a gynaecologist if her need for a hysterectomy could be related to the fact that she had been sexually abused by her father. Five years later she was admitted to psychiatric hospital stating that one of the precipitant factors causing her breakdown had been an unexpected visit from her father. She found him stroking her daughter. There had been no therapy, no regression and no hypnosis prior to the allegations being made public. The jury took 27 minutes to find Fiona Reay’s father not guilty of rape and indecent assault. As before, the court did not hear evidence from expert witnesses stating that Fiona was suffering from false memory syndrome. The only suggestion of this was by the defence counsel, Toby Hed­worth. In his closing remarks he referred to the ‘worrying phenomenon of people coming to believe in phantom memories’. The next case which was claimed as a triumph for false memory was heard in March 1995. A father was aquitted of raping his daughter. The claims of the BFMS followed the familiar pattern of not fitting within the parameters of false memory at all. The daughter made the allegations to staff members whom she had befriended during her stay in psychiatric hospital. As before there was no evidence of memory repression or recovery during therapy and again the case failed due to lack of corrobo­rating evidence. Yet the society picked up on the defence solicitor’s statements that the daughter was a prone to ‘fantasise’ about sexual matters and had been sexually promiscuous with other patients in the hospital. ~ Trouble and Strife, Issues 37-43

Further investigation of the subject shows that the analyst has to combat no less than five kinds of resistance, emanating from three directions—the ego, the id and the super-ego. The ego is the source of three of these, each differing in its dynamic nature. The first of these three ego-resistances is the repression resistance, which we have already discussed above and about which there is least new to be added. Next there is the transference resistance, which is of the same nature but which has different and much clearer effects in analysis, since it succeeds in establishing a relation to the analytic situation or the analyst himself and thus re-animating a repression which should only have been recollected. The third resistance, though also an ego-resistance, is of quite a different nature. It proceeds from the gain from illness and is based upon an assimilation of the symptom into the ego. It represents an unwillingness to renounce any satisfaction or relief that has been obtained. The fourth variety, arising from the id, is the resistance which, as we have just seen, necessitates ‘working-through’. The fifth, coming from the super-ego and the last to be discovered, is also the most obscure though not always the least powerful one. It seems to originate from the sense of guilt or the need for punishment; and it opposes every move towards success, including, therefore, the patient's own recovery through analysis.

Hey,” he called after her, his hands on his hips, “are therapists supposed to give patients heart attacks?

What you are going to find has always been within you. It has given you considerable anguish but only because it was denied, avoided, and feared. Once you can face it, it will help you, it will guide you. You will recognize your fear as what it really is. Perhaps it is simply the fear of the child who is afraid of punishment if he acknowledges and speaks the truth. But you will not be punished now. Now, as an adult, you can insist on your right to feel your reality. You no longer need to cling to the empty word spirituality, a word that soon becomes meaningless because it is used for everything and says nothing that can't be said without using it. Your real, felt feelings will never kill you; they will help you find direction. Only the unfelt yet powerful emotions and needs, the feared and banished ones, can kill us. Researchers are now beginning to grasp the truth that cancer can often be the last available, the ultimate, language of these repressed feelings. Therapists were surprised to see that once patients could feel, could express themselves, could take their unwanted emotions seriously and develop them into a direct and healthy language, full recovery is possible.

Surgery is easy; it's recovery that's hard.

Give your knee replacement a name so you can swear at it. Trust me, you'll swear at it like a sailor many, many times. And when friends ask about it by its name, you can whine to your heart's content. It's not you who's whining; it's your named knee replacement.

The “love” of formerly abused children for their parents is not love. It is an attachment fraught with expectations, illusions, and denials, and it exacts a high price from all those involved in it. The price of this attachment is paid primarily by the next generation of children, who grow up in a spirit of mendacity because their parents automatically inflict on them the things they believe “did them good.” Young parents themselves also frequently pay for their denial with serious damage to their health because their “gratitude” stands in contradiction to the knowledge stored in their bodies. The frequent failure of therapy can be explained by the fact that most therapists are themselves caught up in the snare of traditional morality and attempt to drag their clients into the same kind of captivity because it is all they know. As soon as clients start to feel and become capable of roundly condemning the deeds, say, of an incestuous father, therapists will probably be assailed by fear of punishment at the hands of their own parents if they should dare to look their own truth in the face and express it for what it is. How else can we explain the fact that forgiveness is declared to be an instrument of healing? Therapists frequently propose this to reassure themselves, just as the parents did. But because it sounds very similar to the messages communicated to them in childhood by their parents, albeit expressed in a more friendly way, some patients may need some time to see through the pedagogic angle of it. And even once they finally have recognized it, they can hardly leave their therapist, especially if a new toxic attachment has already formed, if for them, the therapist has become like a mother who has helped them to a new birth (because in this new relationship they have started to feel). So they may continue to expect salvation from the therapist instead of listening to their body and accepting the aid its signals represent. Once clients, accompanied by an enlightened witness, have lived through and understood their fear of their parents (or parental figures), they can gradually start to break off destructive attachments. The positive reaction of the body will not be long in coming: its communications will become more and more comprehensible; it will cease to express itself in mysterious symptoms. Then clients will realize that their therapists have deceived them (frequently involuntarily) because forgiveness actually prevents the formation of scar tissue over the old wounds, not to speak of complete recovery. And it can never dispel the compulsion to repeat the same pattern over and over again. This is something we can all find out from our own experience.

12. So then, he that is left without chastisement is so left by the Divine judgment, and God is long-suffering towards some sinners, not without reason, but because it will be good for them, having regard to the immortality of the soul and eternal life, that they be not too soon assisted in the attainment of salvation, but be slowly brought thereto after they have had experience of much evil. For as physicians, though they might quickly cure a man, will adopt the opposite of remedial measures whenever they suspect lurking mischief, because by so doing they mean to make the cure more permanent, and think it better to keep the patient for a long time in feverishness and sickness, so that he may make a sounder recovery, than that he should soon seem to pick up strength, but suffer a relapse, and the too hasty cure prove to be only temporary: so God also, knowing the secrets of the heart and having foreknowledge of the future, in His long-suffering perhaps lets things take their course, and by means of outward circumstances draws forth the secret evil, in order to cleanse him, who through neglect, has harboured the seeds of sin; so that a man having vomited them when they have come to the surface, even if he be far gone in wickedness, may afterwards find strength when he has been cleansed from his wickness and been renewed. For God governs the souls of men, not, if I may so speak, according to the scale of an earthly life of fifty years, but by the measure of eternity; for He has made the intellectual nature incorruptible and akin to Himself; and the rational soul is not debarred of healing, as if this present life were all.

By April 23, 2014, thirty-four cases and six deaths from Ebola in Liberia were recorded. By mid-June, 16 more people died. At the time it was thought to be malaria but when seven more people died the following month tests showed that was the Ebola virus. The primary reason for the spreading of the Ebola virus was the direct contact from one person to the next and the ingesting of bush meat. Soon doctors and nurses also became infected. On July 2, 2014, the head surgeon of Redemption Hospital was treated at the JFK Medical Center in Monrovia, where he died from the disease. His death was followed by four nurses at Phebe Hospital in Bong County. At about the same time two U.S. health care workers, Dr. Kent Brantly and a nurse were also infected with the disease. However, they were medically evacuated from Liberia to the United States for treatment where they made a full recovery. Another doctor from Uganda was not so lucky and died from the disease. Arik Air suspended all flights between Nigeria and Liberia and checkpoints were set up at all the ports and border crossings. In August of 2014, the impoverished slum area of West Point was cordoned off. Riots ensued as protesters turned violent. The looting of a clinic of its supplies, including blood-stained bed sheets and mattresses caused the military to shoot into the crowds. Still more patients became infected, causing a shortage of staff and logistics. By September there had been a total of 3,458 cases of which there were 1,830 deaths according to the World Health Organization. Hospitals and clinics could no longer handle this crisis and patients who were treated outside died before they could get help. There were cases where the bodies were just dumped into the Mesurado River. The Ivory Coast out of compassion, opened carefully restricted humanitarian routes and resumed the previously suspended flights to Liberia. Ellen Johnson Sirleaf the president of Libera sent a letter to President Barack Obama concerning the outbreak of Ebola that was on the verge of overrunning her country. The message was desperate, “I am being honest with you when I say that at this rate, we will never break the transmission chain and the virus will overwhelm us.” Having been a former finance minister and World Bank official, Johnson Sirleaf was not one for histrionics however she recognized the pandemic as extremely dangerous. The United States responded to her request and American troops came in and opened a new 60-bed clinic in the Sierra Leone town of Kenema, but by then the outbreak was described as being out of control. Still not understanding the dangerous contagious aspects of this epidemic at least eight Liberian soldiers died after contracting the disease from a single female camp follower. In spite of being a relatively poor country, Cuba is one of the most committed in deploying doctors to crisis zones. It sent more than 460 Cuban doctors and nurses to West Africa. In October Germany sent medical supplies and later that month a hundred additional U.S. troops arrived in Liberia, bringing the total to 565 to assist in the fight against the deadly disease. To understand the severity of the disease, a supply order was placed on October 15th for a 6 month supply of 80,000 body bags and 1 million protective suits. At that time it was reported that 223 health care workers had been infected with Ebola, and 103 of them had died in Liberia. Fear of the disease also slowed down the functioning of the Liberian government. President Sirleaf, had in an emergency announcement informed absent government ministers and civil service leaders to return to their duties. She fired 10 government officials, including deputy ministers in the central government who failed to return to work.

Feelings of suspicion—sometimes rising to the level of paranoia—can be a symptom of many types of mental illness, including Alzheimer’s disease. Alzheimer’s patients may accuse their romantic partners of cheating on them or their caretakers of stealing property or trying to harm or even kill them. While neuroscientists don’t really understand the networks or parts of the brain related to paranoia, in some cases this condition is attributed to temporal lobe damage.

To test this they gave mice a first stroke in motor cortex and then waited a week before beginning retraining. As expected, the mice recovered only minimally because too much time had been allowed to pass before training was initiated. They then gave these same mice a second stroke in an area near to the original stroke, and, not surprisingly, the animals developed an even worse impairment. The surprising result was that with retraining the mice returned to normal levels of performance. In essence a previous stroke was treated with a new stroke. It should be made clear that this experiment was done to prove definitively that there is a sensitive period after stroke that allows training to promote full recovery at the level of impairment. It is clearly not a viable therapeutic option to induce a second stroke in patients after a first stroke. Other means will need to be found to have the same desired effect without causing more damage to the brain. One promising option is to combine drugs, such as the serotonin reuptake inhibitor Fluoxetine (Prozac), with training early after stroke.25 Another is to drastically increase the intensity and dosage of behavioral training that patients receive early after stroke. At the current time in the first weeks after stroke patients spend about 60 percent of their time alone and 85 percent of the time immobile.26 We know from basic science that hundreds, if not thousands, of movement repetitions are needed to induce detectable changes in motor cortex in animal models.27 Current therapy offers only about thirty!28

The sessions had been going on since the eleventh, and I was having a hard time coping with some of my childhood and adult memories. Some I would have rather left tucked inside of some hole that I never again revisited; but my psychotherapist, Doctor Herrenstein, told his patients that the longer they denied themselves remembering their memories, the longer they would deny themselves recovery. That remembering the past was painful, but necessary to the process of growth. Wasn't everything that was worth it also painful in the process of getting there?

With mindful awareness we might still experience judgment arising, but we would accept that as our own problem. When feeling frustrated and angry in response to an uncooperative patient, we would recognize these emotions as our own and understand that we ourselves are fully responsible for how we deal with them.

what counts most towards patients’ recovery is precisely not the theoretical inclinations of the practitioners, but their personality, i.e. how far patients feel able to talk to them and to trust them – how likeable they find them.

It is important to understand when a woman is grieving her husband's sexual betrayal she is in the healing process. Men need to be patient, understanding, calm and stay present during these grieving periods. The guys who learn to do this well are the ones who see their wives recover faster and their marriages restored.

Gravitz and Bowden (1985) describe recovery in their ACoA patients as occurring in six stages: (1) Survival; (2) Emergent Awareness; (3) Core Issues; (4) Transformations; (5) Integration; and (6) Genesis (or spirituality). These stages parallel the four stages of life growth and transformation described by Ferguson (1980) and the three stages of the classical mythological hero or heroine’s journey as described by Campbell (1946) and by myself and others. We can clarify and summarize the similarities of each approach as follows.

In constraint-induced movement therapy, stroke patients wear a sling on their good arm for approximately 90 percent of waking hours for fourteen straight days. On ten of those days, they receive six hours of therapy, using their seemingly useless arm: they eat lunch, throw a ball, play dominoes or cards or Chinese checkers, write, push a broom, and use standard rehab equipment called dexterity boards. “It is fairly contrary to what is typically done with stroke patients,” says Taub, “which is to do some rehabilitation with the affected arm and then, after three or four months, train the unaffected arm to do the work of both arms.” Instead, for an intense six hours daily, the patient works closely with therapists to master basic but crucial movements with the affected arm. Sitting across a pegboard from the rehab specialist, for instance, the patient grasps a peg and labors to put it into a hole. It is excruciating to watch, the patient struggling with an arm that seems deaf to the brain’s commands to extend far enough to pick up the peg; to hold it tightly enough to keep it from falling back; to retract toward the target hole; and to aim precisely enough to get the peg in. The therapist offers encouragement at every step, tailoring the task to make it more attainable if a patient is failing, then more challenging once the patient makes progress. The reward for inserting a peg is, of course, doing it again—and again and again. If the patient cannot perform a movement at first, the therapist literally takes him by the hand, guiding the arm to the peg, to the hole—and always offering verbal kudos and encouragement for the slightest achievement. Taub explicitly told the patients, all of whose strokes were a year or more in the past, that they had the capacity for much greater use of their arm than they thought. He moved it for them and told them over and over that they would soon do the same. In just two weeks of constraint-induced movement therapy with training of the affected arm, Taub reported in 1993, patients regained significant use of a limb they thought would forever hang uselessly at their side. The patients outperformed control patients on such motor tasks as donning a sweater, unscrewing a jar cap, and picking up a bean on a spoon and lifting it to the mouth. The number of daily-living activities they could carry out one month after the start of therapy soared 97 percent. That was encouraging enough. Even more tantalizing was that these were patients who had long passed the period when the conventional rehab wisdom held that maximal recovery takes place. That, in fact, was why Taub chose to work with chronic stroke patients in the first place. According to the textbooks, whatever function a patient has regained one year after stroke is all he ever will: his range of motion will not improve for the rest of his life.

Ed Taub had shown that the more stroke patients concentrated on their tasks—the more they paid attention—the greater their functional reorganization and recovery. In stroke patients who sustain damage to the prefrontal cortex, and whose attention systems are therefore impaired, recovery is much less likely. Two months after the stroke, a simple measure of attention, such as the patient’s ability to count tones presented through headphones, predicts almost uncannily how well the patient will recover motor function. The power of attention, that is, determines whether a stroke patient will remain incapacitated or not. Ian Robertson’s research group at Trinity College found much the same thing: “How well people can pay attention just after a right-brain stroke predicts how well they can use their left hands two years later.” If the attention circuits in the frontal lobes are damaged by the stroke, the patient recovers less well from injury to other regions of the brain than if the frontal lobes are spared.

For every five of our dialysis patients, one will die within the year. Yet we often don’t bother spending the time it takes to have conversations about what patients would want their care to be like at the end of their lives. Since dialysis can be a life-saving treatment in many circumstances, we develop a false sense that sudden bouts of illness serious enough to land our dialysis patients in the hospital are temporary when, truth is, dialysis cannot change the reality that the path of kidney failure is a continuous one toward death. A path that is littered with sudden illnesses and setbacks, and recovery is never back to the level of function that the person enjoyed before.

obsessions: they’re essentially defence mechanisms that protect patients from looking at what really terrifies them.

The longer he stayed home, the more he felt like a social misfit—and he soon was seeing no one. Eventually he got help toward recovery by visiting a youth club called an ibasho—a safe place where broken people start reintroducing themselves to society. What if we thought of the church as an ibasho? Without a doubt, we are a community of broken people. When Paul wrote to the church in Corinth, he described their former way of life as antisocial, harmful, and dangerous to themselves and others (1 Corinthians 6:9–10). But in Jesus they were being transformed. And Paul encouraged these rescued people to love one another, to be patient and kind, not to be jealous or proud or rude (13:4–7). The church is to be an ibasho where we can find God’s love. May the hurting world experience Christ’s compassion from all who follow Him. Poh Fang

No one chooses to be a patient, but everyone can choose to keep sight of the person in the hospital gown. Samuel Shem’s novel The House of God, about

No one chooses to be a patient, but everyone can choose to keep sight of the person in the hospital gown.

First, I am thrilled that paramedics are finally getting the respect they deserve for being the professionals they can be. The scope of practice is expanding, and patient care modalities are improving, seemingly by the minute. Patient outcomes are also improving as a result, and EMS is passing through puberty and forging into adulthood. On the other hand, autonomy in the hands of the “lesser-motivated,” can be a very dangerous thing. You know as well as I do that there are still plenty of providers who operate from a subjective, complacent, and downright lazy place. Combined with the ever-expanding autonomy, that provider just became more dangerous than he or she ever has been – to the patients and to you. Autonomy in patient care places more pressure for excellence on the provider charged with delivering it, and also on the partner and crew members on scene. Since the base hospital is not involved like it once was, they are likewise less responsible for the errors and omissions of the medics on the scene. Now more than ever, crew members are being held to answer for the mistakes and follies of their coworkers; now more than ever, EMS providers are working without a net. What’s next? I predict (and hope) emergency medical Darwinism is going to force some painful and necessary changes. First, increasing autonomy is going to result in the better and best providing superior patient care. More personal ownership of the results is going to manifest in outcomes such as increased cardiac arrest survival rates, faster and more complete stroke recovery, and significantly better outcomes for STEMI patients, all leading to the brass ring: EMS as a profession, not just a job. On the flip side of that coin, you will see consequences for the not-so-good and completely awful providers. There will be higher instances of licensure action, internal discipline, and wash-out. Unfortunately, all those things will stem from generally preventable negative patient outcomes. The danger for the better provider will be in the penumbra; the murky, gray area of time when providers are self-categorizing. Specifically, the better provider who is aware of the dangerously poor provider but does nothing to fix or flush him or her, is almost certain to be caught up in a bad situation caused by sloppy, complacent, or ultimately negligent patient care that should have been corrected or stopped. The answer is as simple as it is difficult. If you are reading this, it is more likely because you are one of the better, more committed, more professional providers. This transition is up to you. You must dig deep and find the strength necessary to face the issue and force the change; you have to demand more from yourself and from those around you. You must have the willingness to help those providers who want it – and respond to those who need it, but don’t want it – with tough love by showing them the door. In the end, EMS will only ever be as good as you make it. If you lay silent through its evolution, you forfeit the right to complain when it crumbles around you.

Years ago, I received a call from a paramedic I had known for a long, long time. He was a true believer; a provider in it to do good more than to do well. By the tone of his voice, I could tell he was in some serious trouble. His voice did not lie. He was. It seemed that some years earlier he had suffered an injury off the job. The injury resulted in several surgeries and months of painful recovery, physical rehabilitation, and pain medicine. It started as an as-needed remedy for intense pain but before long became a physical necessity. When the actual pain no longer necessitated the monthly refills, the feigned pain took over. When that excuse had run its course, new injuries and favors from friends took over. The cycle had begun. Back at work, he became adept at leading his double life; on the job he was clean, sober, and clear-headed, but off-duty the pills took over. The decline was slow, but steady. It would not be long before he would lose all control. One day, on a call with the entire crew, he found himself in the home of a patient whose medicine cupboard was a veritable treasure trove of pain killing goodies. Jackpot! While logging all of the medicines, it was easy to drop a full bottle of a certain pain killer into his pocket, and he did…completely undetected. The patient was transported, and the scene was cleared, and his addiction would be fed for a little while longer. Nobody would ever know. However, as he exited the scene with his supervisor, he was struck with a blunt and harsh realization: This is not who I am and it’s not who I want to be! While still at the curbside, in front of the patient’s home, he pulled the bottle from his pocket, handed it to his supervisor, and admitted sincerely: “I have a problem. I need help.” His supervisor considered the heartfelt and painfully honest plea for help, but the paramedic was summarily fired from a job where he had an impeccable record of exemplary service for nearly two decades. He was stripped of his Paramedic license and reported to local authorities and was charged with multiple felonies by the District Attorney. That was the response from his supervisor and the rest of the morally superior lemmings up the chain of command. He asked for help, and they fucked him…because they were afraid of what actually helping him might look like to the outside world. Not once was he offered treatment or an ounce of compassion. He asked for help; now he was looking at serious prison time. This brings us to the frightened and helpless tone in his voice when he called me. Thankfully, his story ends with the proper treatment: A new career and the entire criminal case being dismissed (he had a great lawyer). Unfortunately, similar stories continue to play out in agencies, both public and private, all across America and they do not, or will not, end so well.

Through intentional steps, those who follow paths of recovery discover their neediness and weakness and release their shame and their failed efforts to a path made straight (Proverbs 3:6). They are more self-aware, more reflective, and more able to dig into their personal stories, memories, thoughts, and emotions. They pursue ongoing change through the power of the Holy Spirit. They are sinners who get up when they fall (Proverbs 24:16) and cling to the hope and knowledge of Christ’s sanctifying work in their lives. They are dangerous to the status quo. Having awakened, they pursue others. They give away the hope and life they received. Knowing what prison feels like, they are patient and kind, but also skilled in helping others find the keys to unlock shackles.

More than seventy studies on intercessory prayer have shown the same nonlocal energetic connection effects as detected in the cheek cell experiment. One example of such a study was conducted by Dr. Randolph Byrd in San Francisco. It showed that patients undergoing heart surgery who were prayed for by groups scattered around the world did significantly better in their recovery than those who were not prayed for by these groups.9