Nina Gaby

Essays, art, and healthcare


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Trump Has to Go. It’s Scientific.

I have spent six hours this morning in virtual conferencing with experts from The Harvard Psychopharmacology Master Class. I have fourteen hours to go this weekend. Usually the conference is held in the grand ballroom of the Fairmont Copley in Boston but this year I am in striped socks, hoody, a warm hat, lying on my toile fainting couch with no lines for the bathroom and no fancy lunch. I am writing from my own understanding of today’s information, and my decades of experience with these issues, not the interpretation of the presenters. No one mentioned our administration, no politics. Just to be clear on that.

 

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As I followed along on my screen today I correlated much of what I was hearing to the environment of our present world, considering how I can apply this research to examine how we move beyond all this intact. Or can we?

Dr. Charles Nemeroff, researcher, professor and consultant states in his presentation–“Interface of Medical and Psychiatric Disorders”: “Covid 19 is associated with a cytokine storm (cytokine is a category of peptide proteins associated with inflamation). There will be consequences.”As he continues it becomes apparent that he may not just be speaking to the immediate Corona illness, but to the interconnectedness of systems which we can extrapolate far beyond our own bodies. That is why I think of our survival and the Trump administration and its dangerous effect on that survival.

So these are nuggets from the research presented today about mental and physical health. I will simplify so we can make own extrapolations to why these dangerous times are are deeply exaggerated by our present administration, and administration that promotes hate and greed when simple kindness would go far to ameliorate the physiological responses I am about to describe. When action based on fact and not opinion would go far to ameliorate the world’s stress.

I cannot replicate any of the slides without permission so you will just have to take my word for it.

  1. Our mesolimbic reward circuitry is affected by stress. The limbic system is the walnut sized structure right behind our nose. It is considered the seat of emotional memory and houses the little light switch we call the amygdala, a peanut-sized structure which can modulate the experience of traumatic events. The mesolimbic dopamine system is the normal pathway for feeling good, but its circuitry is supremely sensitive to alterations brought on by trauma and stress. Poetic words such as “cascades” and “first and second messengers” and “de-arborization” and “connectomes” explain the transmission of chemicals–among them neurotransmitters and neurohormones– and also explain the new study of epigenetics. Basically “epigenetics” describes when events can actually influence gene expression (not sequencing) that leads to dysfunction of brain cells and their circuitry. This is DNA stuff.
  2. Alterations in circuitry affect neurotransmitters and hormones. Peptides which affect oxytocin and vasopressin (the attachment chemicals) can also be impaired. Receptors for these are present in the amygdala and affect bonding–between parents and children, between adults. Disruption changes this. Mammals lacking these peptides are at risk of
    attachment disorders as the presence in one mammal stimulates the system in another mammal. Think, “milk let down” in new mothers. Think, children in cages.
  3. Both physiological and psychological damage to these systems have long term implications that travel through generations. Through generations.
  4. The research shows inarguable effects on cancer and depression, as well as other psychiatric disorders. This is the schema:
  5. Increased environmental stress and/ or Adverse Childhood Events increase the inflammatory process (increases in cytokines and other stress chemicals) with increased risk of depression/heart disease/cancer.
  6. There is a proven bidirectional relationship between depression and medical illness. Autoimmune illness is also correlated with these events. Social connectedness has been proven to improve outcomes. I might suggest that concerns for one’s medical treatment and how to pay for pre-existing conditions might influence one’s mood state. The research shows an increase in suicide among certain demographics receiving diagnoses of certain illness.
  7. PTSD goes without saying. And this may also have a bi-directional schema. One must have been exposed to the stressor, and we now know there is a scientific basis for both developing or mediating the disorder. Understanding and providing support to the specific populations most deeply affected by violence and trauma would go far in healing the world. Homophobia, misogyny, racism, bullying, antisemitism, xenophobia has no place in the world we need to develop. (I am editorializing a tad here but the statistics don’t lie.)
  8. Most of the conference is about treatment, specifically medications, and other options. A couple items of interest: The odds of developing a psychotic disorder with high dose daily cannabis use is 3-4X greater. Use of cannabis in adolescence and pregnancy-a big NO. CBD has anectdotal therapeutic implications but metananlysis suggests data inadequate to recommend clinical use. I don’t even want to discuss ketamine. And what does this have to do with Trump? I don’t have the research on that, just opinions. But tomorrow’s another day.

 

 

 


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About being your own lyrical essay

https://brevity.wordpress.com/2019/12/16/preamble-ramble/#comment-85364

I already wrote the rambling preamble for this hybrid piece which the Brevity blog so generously published. What I didn’t talk about, for the sake of brevity, is finding small islands of sanity in these times of grave darkness. At least for many of us, the current political climate stains us even as we work hard to keep our own hearts and minds above the murky water line. For me, I can find some peace–at times–cutting paper with tiny scissors, holding a yoga pose or chanting in my Kundalini class, or writing the perfect sentence. Sometimes contentment finds me as I listen to a patient make sense of their own pain or tell me that a medication is working and they feel, at least in a tiny way, that their life is back on track. Sometimes at 4 AM, that crazy witching hour, my little, once feral cat sits on my chest and purrs me back to sleep.

Whatever that is for you, I hope you find it tenfold in this season of darkness to light. Happy holiday, whichever one you choose.How to be Your Own Lyrical Essay_scan.jpg


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Liminal Spaces

 

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“Liminal Space” mixed media, Nina Gaby 2019

I am working with a student one day a week at the clinic. She is already a seasoned medical nurse practitioner who is now studying for her second certification in psychiatry and I mentor her on Thursdays. At first I was anxious, as while I know the psychopharmacology, in my practice I use a lot of intuition and experience. I match symptoms and medications (or maybe no medications) and try to “get” the person before I make recommendations. I’m not one to ponder long on the functionality of a receptor site in the brain or the half life of a molecule. I want to know what the patient wants out of this experience, what has worked in the past, and what their insurance (or the generosity of a pharmaceutical rep) might cover. And then it’s on to the next patient because it is always a busy day. Is this even going to begin to answer all a student’s questions?

So it is a great surprise to find that, at the end of the day, she and I can actually explore the “beingness” of our patients. That instead of rushing through my documentation alone in the now quiet office before jumping in the car to commute home, sometimes a little teary or anxious about all the stories I have heard that day, I can actually sit with a brilliant colleague and ponder the bigger questions. Some of them pretty existential in nature. As my Kundalini yoga teacher said to me yesterday, “You guys sit in the belly of the beast.” And as I like to think–we stand staring into the abyss, holding hands and containing what we can. Feeling honored by the process.

And then I go into the studio or sit down at my laptop and try to transform what I have learned from the process into something meaningful that reaches people through words or images. Art is a beautiful antidote, and here is a link to my latest published essay on Randon Billings Noble’s journal “After the Art”:

https://aftertheart.com/2019/03/19/certain-imperfection-revisiting-zetsu-no-8/

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Detail, “Zetsu #8” by Nishida Jun, Museum of Fine Arts, Boston-permanent collection

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Nina Gaby: “Ways to Tell a Story,” interview by Shirley Dawson; Ceramics Art + Perception, #111

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To read more by Shirley Dawson, go to: rochesterartreview.blogspot.com

To order Ceramics Art + Perception: http://www.mansfieldceramics.com