Autumn Beauty

Autumn, the year’s last, loveliest smile.” ~William Cullen Bryant.

It didn’t take me long to figure out one of the first few things that I am missing from my previous life of 20+ years in the U.S. The Autumn season. Oh, the changing of colors. You look around and strong, captivating colors are popping out all over. They come slowly, perhaps in your neighbor’s yard first, then around the whole block, in your neighborhood, and in your town. Pretty soon, everywhere you drive, all you see are bright colors. Red, yellow, orange, pink, purple, blue, green, brown; I mean it’s just a colorful world. And the fresh cool breeze that it brings, what a relief sometimes after a hot, humid summer. There’s something that Autumn brings that feels so special to us humans. It’s a reminder of how precious our nature is to us.

To say that I miss Autumn is probably an understatement. My heart is aching for it, to feel the cool breeze, to see pumpkins everywhere I go, to walk through the falling leaves, to see the Halloween decorations that have been up since July in some places, to be awed by the colors, and to see the birds starting to fly in a big pack. Of course, since I used to live in Indiana, there’s also the smell of fall harvest, or in some cases, the smell of fertilizers. Hmm… Then, along with the sensational smells, also came the sneezing and watering of eyes. Yes, I can truly say I miss them all, the whole package.

No doubt that Autumn has its own uniqueness. Whereas Summer is about relaxing, enjoying the afternoon nap, going to the beach, and wearing summer dresses in the sun, and Spring is about cleaning, putting away long-sleeved and heavy-material clothing, Autumn, on the other hand, is about preparing for what’s coming next, Winter. It’s about putting away the light summer clothing and digging into the closet to look for the long-sleeves that you put away a few months back, thinking about making hot soup and other hot food (and feeling sick of the light summer sandwich), and (it’s never too early for) making a list of what to buy for Christmas. Whereas the hustling and bustling of the Spring is about what to do outdoor, the hustling and bustling of the Fall is about what to do indoor for the next half of the year. Exactly, in some parts of the U.S., be prepared to focus your life towards indoor activities for half of the year. If you’re lucky, it will only be for a few months. The hustling and bustling are probably made for a reason. For me at least, it was part of the grieving process. Grieving for all of the outdoor activities, the barbecue, the long outdoor walk in the late afternoon and into the evening, the sun, and the list can go on. Like I said above, grieving for the soon-lost-outdoor activities and focusing on the indoor activities.

There’s something kind of sad about the whole process in Autumn for me. As someone who came from and spent the first half of her life from a one-season-only-place (if you call rainy season as something different than dry season; both are part of summer, mind you), I never got used to the changing of the season and the getting used-to part. I never liked the fact that I started to have favorite and less-favorite seasons, which led me to enjoy parts of the year better than the rest.

We’re now coming to the part on what I don’t like about Autumn, which is the thinking of what’s coming next: my arch nemesis, Winter. Every time in the past when this thinking passed through my mind, a different feeling of aching also came by, which I disliked. I hated it so much that in the past perhaps two or three winters, it affected me mentally more than usual. It’s a common knowledge there that seasonal feeling of melancholic or depression happens to many people, including me, in varying levels. However, I was able to notice that the effect seemed to have increased year by year towards the end.

So Autumn, with its magnificent colors, and as much as I miss it, has its own flaws too for me. Then again, which beauty really that has no flaws? Perfection does not exist in reality, only in our mind as ideas. As much as I would love to feel Autumn again, I honestly don’t think I can live in it again. It’s too painful. But here’s the irony (as we humans love to have ironies in our lives), I also ache for its beauty. So with that thought, I leave you with this poem. I wrote a part of it a month ago at the beginning of Autumn and I have since added a few more to the poem. For those of you who are lucky to live where you can experience Autumn and does not have to feel what I felt, please do enjoy it. It’s a gift from nature to you. Go out there and feel it before it goes by.

what a wonderful name you have
what a gentle nature
what a peaceful feeling you bring
lucky are those
who have been swept away by your wind
because they’re forever changed,
doomed are those
who have been touched by your color
because they’ll forever ache for your beauty,
you’re always beautiful to me
and i will always adore you
even with your flaws
you are a wonder on this Earth
an awe to us
and we are humble to have you


A Thought on Friendship for Pink Saturday


This is my first time joining Pink Saturday, and it happens to be their third anniversary conducting this Saturday routine. I’m happy to join the party. My birthday wish goes out to Pink Saturday for their 3rd birthday. Please go to How Sweet the Sound blog to see more participants and blog entries for this celebration. Some of them actually give away gifts 😉

The challenge for me is that I don’t have a lot of pink stuff. I don’t normally like pink that much and I rarely got myself pink items. I do have this one t-shirt I bought last year that I wore so many times during my trip to my home country, Indonesia, in January this year. It’s probably the only pink t-shirt I got. Ever since I got back from the trip, I haven’t worn the shirt because I’m still WAITING! for the right weather to wear it. So far, we haven’t had the same nice, warm weather here in northwest Indiana, as in Indonesia. Therefore, I haven’t been able to wear it. One of these days, I will wear it again. It’s one of my favorite t-shirts actually.

So, here’s to the wonderful, warm memories I’ve collected with that t-shirt and many more to come. I miss my home town, I miss the close friends and family there, I miss everything there, but I know the time will come. Patience is a virtue. In the mean time, I want to share a picture of me wearing the shirt and a friend below and remember the moment. I apologize for not being able to share more than this, but this was taken during a meaningful time and trip that I thought would be appropriate to be remembered on Pink Saturday’s birthday. I also share a 5-line poem, a tribute to all of my friends, where ever they are in this world.

On Friendship

no changing of season

nor distance and time

can wither it, if

we hold on, to

those moments

Last Name

I went to the Indonesian Consulate over a month ago to renew my Indonesian passport, but was told that I had to get a new passport book, complete with a new passport number. Okay, whatever you say, dude. Can I just get a passport please, on time before my flight leaves in a few weeks?

I got my first headache dealing with last name with the “rude dude” working at the Consulate on that day. Actually, it’s not really my first time dealing with this headache. Any married woman living in the U.S. has gone through this headache one way or another. See, the custom in the U.S. is for married women to change their last name, take the husband’s last name, and the wife’s name become a middle name. More often than not, the wife’s middle name ends up becoming just an initial, which bothers me. The thought of losing my family of origin’s name doesn’t settle well with me. My family’s last name, my parents’ last name, is just too important for me to become an initial, or worse, completely gone.

The struggle in deciding what my last name would be after marriage took a while. I contemplated, thought about different options, change or not change, what should I do? If I don’t change, I hear that I may need to always show people the marriage certificate for important situations when our civil relationship status will be questioned, such as buying a car/house, getting a loan, you name it. I remember a story a friend told me one time. Her car was towed by the city. She went to the towing company to get it out. The company refused to let her take the car because the car’s license and ownership is under her husband’s name. Surprise, surprise, she is one of the very few women who decided to keep her name intact and not add her husband’s last name. She was given two choices, either get the husband to release the car or bring back their marriage certificate as a proof.

The most recent solution for this headache of choosing last name for women is a hyphenated last name. I chose it. Makes sense, why not both. I still don’t have to carry the damn certificate all over the place (it’s not a small piece of paper, you know). And boy, am I glad to pick that decision, and here’s why.

The rude dude at the Consulate looked at me blankly when I explained my last name situation. He said one thing when he saw the marriage certificate in my hand. Well, actually, he was kind enough (*sarcastic tone*) to take it and bring it closer to his eyes to read. Then threw the paper back onto the table, saying “Nggak laku.”  It’s roughly translated to “This doesn’t mean anything.”  I gritted my teeth quietly. Ouch, hurt.

The name on my passport ended up to be exactly the name I was given by my parents on my birth day.  I was worried there for a while, wondering whether I may come across difficulties at the airport immigration in both countries during my trip.  But one thing I was very glad at that time is on the fact that my Indonesian name shows up on both my passport and marriage certificate, if anyone ever doubts my identity. I ended up dragging the damn marriage certificate on my trip, along with other documents that I deemed important. Just in case. I was damn paranoid and worried at that time. I get nervous anytime I have to deal with the Immigration people in any country. Luckily I didn’t encounter any problem during the trip.

The only one problem I have with having a hyphenated last name is when I’m being asked by people to give my last name. The confused, blank “huh” look I get from people can be pretty entertaining sometimes. At other times, it can be annoying too. Worse is when they ask me to spell it. I said, “No, better yet, why don’t I just let you copy it yourself” and hand the person my driver license.  😀

Uncle Ted, You Will Be Remembered

The Immigration Reform movement has just lost a major ally. But it’s more than just this group who has lost an ally. On August 25, 2009, this country lost a major icon and a fierce fighter for the unfortunate, the poor, and those with very little voice and power to fight. The world has lost another human rights supporter and promoter. All of these should be the highlights of his life. Many articles and blogs have been and will be written about his accomplishment, but I’d like to focus on him as a human being whose response and coping style to the multiple losses in his life was typical, ordinary, yet inspiring throughout.

If you look at the history of his life as a Kennedy, you can see that he had many ups and down, some downs were very extreme. I don’t need to list them all in this essay. Turn the television on for the next few weeks or go on the internet and you can find them. I can only imagine that being a Kennedy then and now is not easy. All of these Kennedy adults and children have lived their lives under the eyes of the whole nation. Particularly with Senator Kennedy, the eyes of the nation and the rest of the world were on him in the years following his brothers’ assassinations, watching his every move. The pressure and the stress must have been tremendous.

As a human being, he responded the way many average people would do, by coping. He was not without a flaw. As a matter of fact, he had plenty of them; some had even stood as obstacles to his political pursuit to the White House. His chosen coping mechanisms were to drown himself in work, alcohol, and unstable relationships. If we take the Kennedy name out of his last name, give him another last name, and take politics out of his family history to make it sound like a typical U.S. family, his coping style would have been seen as predictable. Those who work in the field of mental health have been trained to detect coping mechanisms, particularly after so many losses.

What is amazing about Senator Kennedy’s life is how he bounced back from all those dark, challenging years. In 1991, he made a speech to the public and apologized for his wrongdoings in the past. A year later, he remarried and made a major turn around in his life. But some of us remain to wonder how he did it, especially with the background history of having been to a series of funerals, many as a result of tragic death, and given many private, heart-wrenching eulogies. My guess is that in order to turn his life around, he must have gone back and faced those dark years that pushed him to rely on those less effective coping mechanisms. Before he could move forward, he first had to deal with his past. He then started a new chapter when he made the turn around in early 90s. This time, the new chapter has been jam-packed with what he was meant to do. We are all familiar with the content of that chapter, which just ended on the evening of August 25, 2009. That day also marks the exact one year from the day he gave his memorable speech in the 2008 Democratic National Convention for President Obama, where again he reminded people of hope and change, as he did for himself almost two decades ago.

His life story is a story of resiliency, possibility, hope, and redemption. I think his losses, pain, and suffering had better prepared him to do his job as a senator and made him a strong, humane, fierce fighter that we all know. I believe we haven’t seen the ending of his legacy yet; a new chapter has just begun. Young people and leaders in this country will take over the torch and continue to run, filling up the new chapter one page at a time. It’s just part of the Kennedy’s legacy and curse that no Kennedy can leave the public view that easily.

So, Uncle Ted, you will be remembered. Rest in peace now and watch your legacy continue your work.

Healthcare Crises and Democracy

Health care systems

Image via Wikipedia

Healthcare has been a hot topic in the U.S. lately. The country has been having health care crises for so long now, and the length of these crises varies depending on who you talk to. I think the problem has been happening for over a decade, since teh 90s, probably even before the 90s. I came to the U.S. iin 1990, and so I can talk based on my experience and what I have observed in almost two decades. The sad thing is that there are people in this country who defiantly believe that there is no crisis. Then there are those who admit that crisis does exist, but believe that no intervention needs to happen because eventually the problem will take care of itself. These are the same group of people who also believe that no intervention is needed regarding the economy crisis because that is just how the economy works; it has its ups and downs and that the government should not interfere with it. Nonsense.

There are two current crises in healthcare now. First, there are just way too many people with no health insurance. Because of the lack of access to healthcare coverage, these people usually have no opportunity to have regular check-ups and early intervention for any sign of health problem. They tend to wait then until the symptoms become worse and create a much worse of health issue. If given a choice of seeing a doctor and having regular visitation to their doctor, I’m positive that they’ll be able to maintain better physical and mental health condition. Many of these people would visit a doctor when their health condition is too dire for early intervention. Often, hospitalization is required by then. By the time they see a doctor, it is also likely to occur through a visit to an emergency room (ER). The U.S. has a law that prohibits hospitals to turn away patients who enter ER. The problem with this situation is that the cost of hospitalization and late intervention is likely to be much higher than the cost of early intervention and regular check-ups. Therefore, I don’t think it takes a genius necessarily to realize that there is definitely more benefit in making sure that everyone should have health insurance, access to healthcare services, including access to regular phsycal checkups and primary intervention. The key is to avoid a last-minute trip to ER. ER should really be used only as a last resort because each visit costs a lot of money to the hospital. The high cost of ER treatment is then billed to the insured patient, hoping that the patient should be able to pay it, which is just a wishful thinking. If patients cannot pay for the bills, guess who will cover the rest of it, the hospitals and the taxpayers.

This is obviously a hole (a big hole!) in the system and it needs to be fixed before it gets even worse than it is now. I don’t recommend that the law regarding the role of ER should be eliminated. That law should stay. Ethically and morally, I believe ER should always be available for everyone. What needs to be changed is to do whatever we can to ensure that everyone has access to healthcare.

Another major crisis in healthcare is the amount of power health insurance companies have in this country. Currently, they can refuse coverage based on whatever terminology and rules they created. To sue an insurance company is like suing God; I wish you luck. Unless you have a very strong case, which means that the insurance company has blatantly broken a law, I would say forget about it. Even so, it will still cost a lot of money, time, and emotional ups and downs.

The Obama administration is trying to change all of these above and some other problems that I haven’t even mentioned, and I’ve been amazed at the amount of ugliness the effort has brought out in the public by people who are against it. If you haven’t seen anything about this, check out recent footages (from the past one month) from the Rachel Maddow show or the Countdown with Keith Olbermann show. People in this country have what they called town hall meeting, which is usually done during the month of August when congressmen and congresswomen are usually back in their home state. Townhall meetings can be done actually at any time too, not just in August, but August has been famously known for these activities. Town hall meetings are used as a way to gather constituents and discuss about a new bill or policy. Throughout the month of August so far, meetings have been held in almost all states about the healthcare policy that Obama has proposed. In many of these meetings, protesters of the bill have shown up in large groups with angry shouts, signs and effigies conveying hatred and racist messages. Some people have even shown up carrying pistol or machine gun. Why? Some of the most disturbing signs I’ve seen are those with Obama’s picture with a hitler mustache, or an effigy of a doll hanging on a rope and with the name of a senator or Obama attached to it. They are disturbing because they send hatred and violent messages to the public. Obama has been called racist, fascist, Hitler, socialist, the ‘n’ word, and so on. Who’s the racist now? If children see these signs, what messages would they take in?

There has been an argument regarding democracy as well. Town hall meeting is really a reflection, a symbol, and a sign for democracy. It is meant for people to raise their voice and send messages directly to their representatives and it is meant for their voice to be heard loudly by their representatives and fellow citizens. It is a form of democracy. What has been happening during these town hall meetings about healthcare policy is that these groups of protesters were screaming and protesting so loudly that they prevented other people to talk. Sometimes they even stopped people from entering the building because of the loudness and the violent messages. I mean, if you see people carrying guns, will you also go in? Maybe, but it made some people to think twice. The gun-carrying, by the way, doesn’t happen in all states. The law regarding the right to carry a gun in the public differs from one state to another.

Democracy has been violated at some of these town hall meetings, and it is a shame! I really don’t think many of these people even understand democracy and what it means to have democracy. To have democracy is to uphold democracy. You don’t just demand it, you also keep it up yourself. It’s not going to be given to you as a present; you take it and keep it by continuing to work hard at upkeeping it. It makes me so angry when I saw those footages on TV about this violation of democracy. My blood just started to boil. I feel like shouting to them to wake them up, but then if I shouted at them, then I just become them.

My only consolation when seeing something like that is to remind myself that people sometimes act based on fear and without thinking much. I feel sorry for them in the end because I don’t think they have the ability to do critical thinking. They take what is fed to them by the extreme right-wing leaders that they watch on TV, listen to on the radio, or read from the internet. Then they go out to the public carrying hateful signs proudly thinking that they are demonstrating their right to have democracy and freedom of speech. No, it doesn’t work that way. Freedom of speech is based on responsibility, not just as a permission or ability to say anything at anytime to anyone. It is very dangerous when a right that is so powerful such as this to be taken lightly and irresponsibly. With more power comes more responsibility. How do you explain that to these people?

A Review on Of Two Minds

Before I start, let me just give a little bit of background information about the book, Of Two Minds. The book was written by T. M. Luhrman, and at the time when the book was published in 2001, she was a professor in the Committee on Social Thought at the University of Chicago. She may or may not still be at the University of Chicago now. Let me make it clear too that Luhrman is an anthropologist by education, not a psychiatrist, and never enrolled in medical school. In addition to having a background in anthropology, she chooses to concentrate on American psychological anthropology, with a specific interest in the field of psychology. Luhrman did go through training in psychoanalysis, which is based on Freudian theory. The technique of psychoanalysis itself can still be found in the U.S., but it has received less attention and interest as time progresses. The basic theory behind psychoanalysis, however, is still taught in psychology programs and used by many psychologists, but mostly as a way to conceptualize a case, not necessarily as a technique to be used in therapy session.

Other than growing with a father who was a psychiatrist, Luhrman had no other direct exposure to psychiatry. She didn’t enroll in a medical school for this ethnographic study that produced Of Two Minds, but she did atttend several lectures with other medical students as part of her preparation for this project. She also did a round in several hospitals, following medical students and psychiatrists during rounds and being part of the psychiatric team in those hospitals. Of Two Minds is the result of her in-field project working as a medical student conducting rounds in psychiatric units. Not only that Luhrman reported what she saw in her book, but she also included other pertinent information, such as the history of psychology and psychiatry in the U.S. The book is a result of massive amount of work in the field and of research. I recommend the book to be part of reading requirements in all psychology programs. It’s a collection of real-world situations, and what could be more important than this kind of book for green and naive graduate students like myself. Some of those psychology textbooks are so boring, heavy and ’empty’ that they might be best used as paperweight.

Similar to my previous book review on Faces in the Revolution (see previous blog), the following writing was written when I took the same class in the the summer 2008. Enjoy the reading.

I must say that Of Two Minds has definitely been a pleasure to read. Based on what I have seen so far while working at a psychiatric hospital, Luhrman’s research, insights and interpretation are candid, no-nonsense, and perhaps even very direct when revealing the world of psychiatric treatment in the U.S. She tells her findings as how she saw things happened in hospitals or during medical lectures. The use fo ethnographic method gave her the opportunity to be in the middle of psychiatric work, which consequently provided her with the ability to see things based on two perspectives, as an outsider and an insider. She even includes her own reflections regarding her feelings and the mistakes she made.

In Of Two Minds, Luhrman concentrates on two main responsibilities of psychiatrists, psychopharmacology and psychotherapy (mostly in the form of psychoanalysis). There are other things that I am sure psychiatrists have done, such as administrative work and policy work, but she chooses to concentrate on these two main aspects because these are what psychiatrists learn in medical school. She explains taht psychopharmacology derives from the biomedical model that believes in the disease model. Psychotherapy, on the other hand, believes in the illness model or the interpretation of the patient when trying ot make meaning of the problem. Many psychiatrists no longer do psychotherapy and stay with prescribing psychotropic medications only, especially psychiatrist who work in the hospital setting. The biomedical/disease model relies on strict rules and guidelines when investigating a problem, which is done by focusing on symptoms and using those symptoms to finally reach a conclusion (diagnosis). For every problem (symptom), there needs to be a conclusion (diagnosis) in order for a treatment (most likely in the form of medication) to be done. The illness model, on the other hand, believes in how patients understand and explain their pain and suffering, both physical and psychological.

What I like about Luhrman’s writing is how she fairly presents the pros and cons for each model. Although it may look as if her standpoint is against biomedical model, she doesn’t argue for eliminating the model. Instead, she points out that there is an organic characteristic to some mental illnesses. Psychiatric help, however, should not stop at the biological step. In her own words, she describes it perfectly: “…to say that mental illness is nothing but disease, is like saying that an opera is nothing but musical notes” (p. 68). Therefore, in addition to the biological factor, the patient’s illness cannot and should not be taken apart from the sociocultural context where he or she lives. Unfortunately, many psychiatrists have reduced the problem of their patients into a diagnosis of some kind of biological disease.

I like the comparison Luhrman makes between a surgeon’s cutting open a patient’s body and a symbolic action of a psychiatrist writing a prescription as if it is the psychiatrist’s way of surgically open a patient’s body. Both actions have a similarity in that they convey a sense of power. Psychopharmacology and its action of prescribing medications gives a clear, fast and sometimes visible result in reducing symptoms; in which case, these are all actions that may provide an immediate sense of accomplishment to the psychiatrist. Psychotherapeutic approaches to mental illness, on the other hand, may take a longer time and harder work to reduce symptoms. Worse, in some cases, due to complicate circumstances, many symptoms fail to reduce, if not increase. Again, in Luhrman’s own words, “…it is easier to be a competent pharmacologist than it is to be a competent psychotherapist” (p. 81).

I have seen almost everything that she mentions in her book about psychiatric work in inpatient hospitals. The power that psychiatrists have in inpatient hospitals is unbelievably high, even compared to the other medical personnel. Nothing can be done in many units without the order and signature of psychiatrist in charge. For example, patients cannot have a patio pass without a written order from their psychiatrist, or have their own shoes while in the unit without the approval of their psychiatrist, due to safety concerns. Psychological testing cannot be done without a referral from the psychiatrist.

When one reads the history of psychiatry in the U.S., psychiatrists have gained this tremendous amount of power from continuing to believe in the use of biomedical model. If the psychiatric profession suddenly disregards biomedical model, it is questionable whether they will be able to maintain the same amount of power. This is the struggle that the profession of psychologist is going through right now, the struggle to find their own voice and recognition in the field of mental health. Psychologists in most states cannot prescribe psychotropic medications, and therefore, tend to have less freedom to do their work more effectively, which further challenge their opportunity for collaboration with other healthcare professionals in the arena.

The struggle to gain more power, recognition and freedom to make decision has, to a certain degree, influenced the decision for many psychologists to lobby for prescription privilege, which would allow them to prescribe psychotropic medications. This effort is currently happening in Illinois and in some other states. The proponent of prescription privilege argues taht with the ability to prescribe, comes the ability to discontinue medications as well. This argument sounds very appealing at this point due to the problem of an increasing number of overly-medicated population in the U.S., particularly with the young children and youth age group.

My concern with prescription privilege for psychologists is taht I can’t help to wonder whether the profession of psychology will eventually end up where psychiatry is now. In other words, if given the privilege to prescribe medications, will psychologists eventually fall in the trap of enjoying psychopharmacology more than psychotherapy? Based on Luhrman’s book, it is easier to reduce illness into disease and prescribe a quick solution. One source of pressure to come up with a quick solution is the patients themselves. They want a quick answer to their problem. Medication ca provide a quick satisfaction for both the patient and the doctor. Therefore, I can see the temptation for psychologists to take this route in the future. The temptation will make some psychologists to focus more on symptoms in order to arrive to a diagnosis and less on other psychological, social, structural and cultural contexts that define the patient and the illness.

A proponent of prescription privilege also argue that training for prescription privilege for psychologists will be presented as a matter of choice to psychologists, not a must. It means that the profession of psychologist will then have two groups based on the privilege to prescribe. However, given time and pressure from outside forces (i.e., health insurance, patients’ expectations), psychologists may eventually give in to the pressure. This will bring more problems in the future (for one, liability insurance will increase) and then what will happen to psychotherapy?