change

image credit... ronald n. tan

i have been appointed to sit on a planning and advisory council for the newly formed office of behavioral health for colorado. this system shift is due mainly to the anticipated health care reform shift which is intended to create parity for mental health and substance abuse disorders in the larger health care system.

man- there seems such a distance to travel. the current status quo is sectioned into quadrants and the  players  du-jour are conditioned to fight for their selective scraps.  my interest is twofold i think.

firstly i remember struggling to contain my behavior and my use when i was younger. because of lack of understanding mostly, i believed that something was intrinsically wrong with me which caused me to constantly fuck up. it was as if it was expected. had my small town, my family, and my educators understood bi-polar disorder better, perhaps an intervention early could have saved me from suicide attempts, running away from home, and the lifestyle of a gay runaway that came with heavy drug and alcohol use and addiction, ptsd, and hiv. lgbt youth and adults, persons with multiple occurring disorders, children of single parents, lgbtq families (of all colors) rarely sit at these policy shaping tables.

secondly, i wonder if the veil of aloofness that accompanies psychiatrists is truly helpful for the patients. i know it is to protect the providers and i can accept that. but i think that relationship is one of the main driving forces  behind behavior change and the nature of psychiatrist-patient relationships leaves the one getting paid in the relationship with far more than the one behind the payments. and since my new task involves advocating for people with no money there are very few people minding after their interests. peer coaching and recovery oriented relationships may offer the lubricant that could enable some of our citizens to seek more spiritual ground.

i am curious about the direction the next year or so will take me. i breathe in hope that a more holistic people oriented system will replace the policy oriented system we currently have. my experience was that i had to jump through substance treatment hoops to be assessed for any other mental health issues. the catch-22 there is that i had become accustomed to self medicating my mental well being and it took several years for me hurt enough to be willing to change. this is a provider driven policy. jump through hoop 1 and then you earn a chair at the big table- where you will asked a plethora of questions and then given a prescription. but make sure you find someone else to talk with because the prescriber will remain aloof.  this process took me  awhile to swallow and accept as well. there was no one i remember offering me any guidance during this process. not like 12 step- where a sponsor becomes a cultural guide. i wish i had access to a guide like that for my medication journey as well as my ptsd journey and my shame journey (all of these continuing btw)

and i guess this is where prevention fits in. had there been education about mental health and lgbt issues, as well as thoughtful early interventions including healthy discussions about substance abuse and mental health medications, i might have had a different path. i wouldn't choose it now, but i would like to make it a possibility for those that come after me.

what i hope is that this effort will help shine a greater light upon the idea that our people who get hiv, hep-c, many cancers put themselves in the vulnerable positions to contract these illnesses because earlier behavioral health issues went unaddressed. i am becoming an advocate for a behavioral health transformation- prevention, holistic treatment, and recovery. we might save lives, we certainly will save heartache, and undoubtedly save resources.

i dream that we can move towards a more inclusive system- and philosophy. the sheer numbers of people that  are being shut out is increasing before our eyes. and all the while we are barraged with messages of how more and more people don't deserve to be at the big table. and the rest of us writhe passively, numbed out by the sheer audacity of separatism and the cacophony of shrews.

why the pain

Hungry Ghosts:



Characterised by - Greed; Insatiable cravings; Addictions.


"I want this, I need this, 1 have to have this".


This is the realm of intense craving. The Hungry Ghosts are shown with enormous stomachs and tiny necks - they want to cat, but cannot swallow; when they try to drink. the liquid turns to fire, intensifying their thirst. The torture of the hungry ghost is not so much the frustration of not being able to get what he wants. rather it is his clinging to those things he mistakenly thinks will bring satisfaction and relief. The Buddha in this Realm holds a Bowl from which the 'gifts of the gods' are distributed. This is to entice the hungry ghosts to desire for the Truth which is the only way that the deepest longings and hungers can be satisfied.
Consider: 'Gollum' from Lord of the Rings; The obssessive nature of Video Games; Addictions of various sorts; We can be helped in this Realm by our willingness to 'look up', to see beyond our obssessions...... reposted from buddhamind

i went to a dinner hosted by the harm reduction action center in denver last night. the hrac work with injection drug users to reduce health risks and also inject human kindness into their worlds. the evening was also benefiting improbable pictures who have been filming the creation and development of u.s.e.d (underground syringe exchange denver) as needle exchange has been completely illegal in colorado until may of this year. btw, exchange has not been implemented anywhere in colorado to date, the only legalization was that local governments can now decide for themselves about appropriateness.

the keynote speaker was dr. gabor mate, a vancouver physician who has been working with idu (injection drug users) for 12 years and runs a residential program in that city. he recently wrote a book that i have previously written about briefly called "in a realm of hungry ghosts". it refers to a buddhist concept of the 7 realms that we move through in life. the realm of hungry ghosts is depicted by a very thin dark creature who is always eating and never full. his perspective on addiction and causation and treatment. he blends  20 years of addiction science with a sense of common sense and simple human kindness to highlight a whole new direction of treatment which makes the assumption that the reason someone is over medicating is due to pain. and he maintains that instead of asking individuals "why the addiction", we should ask the question "why the pain" and his experience demonstrates a completely different response. he frankly finds that all the female addicts he works with were sexually abused when they were young.

"why the pain" is a question that seems so simple, yet i don't actually think there is an easy answer at all.  i don't mean that the response "my mother abandoned me" or " my uncle molested me" or " my father abused my mother during my childhood" are not simple. the words are simple. not more than 7 or 8 strung together at one time. no, the complications are not in the expression of the concrete aspects of theanswer. the challenges in the answer come forward in the manner in which the individual comes in the treatment door.the bio-psycho-social factors that have brought them this far. they have a lifetime of (not) coping skills that have been built up. a trauma that happens early in life (especially when repeated or endured over time) can cause a person to shut down so as to stop the emotional pain.  it makes complete sense that these individuals would find external chemicals such as opiates or alcohol that help them feel (especially pleasure). what makes even more sound sense is that letting go of these compounds is not an easy task, especially since for most of them, they may connect to the only pleasure these individuals have felt for as long as they can remember. btw, they usually forget a lot of the pain that led them to addiction with good intention- survival.

for me, i look to the explosion of crystal meth use in the gay male population in the industrialized world in the last two decades, with the highest percentage being hiv positive. this reasoning brings clearly into focus an explanation of this madness. is it not common that gay men identify feeling love and intimacy through their sexual contact, and being hiv positive would directly inhibit this process. crystal meth no doubt allows men to circumvent this inhibition and refill their emotional coffers. but when the emotional coffers never feel full, happiness is elusive, and continues to be chased.

it's a simple question... why are they doing meth? to feel better. to connect with ohters sexually, to feel loved.  if sex is how we communicate- how else do they make this happen?  the only way they have known to feel loved has been diminished and neutered?