Your Mental Health

 with
 Dr. Cathy Chovaz McKinnon, C.Psych.

 My name is Cathy Chovaz McKinnon and I like most of you sitting before me carry many labels. I am a woman, a wife, a daughter, a mother, a sister, a friend, a neighbour, a colleague, and a clinical psychologist. As I look back from the moment of my birth, I seem to have accumulated labels on quite a regular basis. In one sense I suppose these labels all represent different areas of my life, yet in another sense are nothing but perhaps a more complicated way of seeing myself and presenting myself to others. The basic truth is this: I was born a child of God, I am living as a child of God and I have utter confidence I will die as a child of God. What I call myself or what others choose to call me based on what I have done or what I have not done throughout my life in no way changes the fundamental essence of who and what I am.

 That said, when I was asked to talk about my faith and my profession, the topic deeply puzzled and I suppose in some ways intrigued me. The simple answer is my profession is my faith and my faith is my profession. I find it interesting to reflect that during baptism or confirmation we are asked to profess our faith - profession and faith. To me, I suppose in many ways the two are in essence one just as all those labels of being a wife, a daughter, a mother, a sister, a friend, and a clinical psychologist are one in the same as being a child of God. Some of the other Lenten speakers have been able to tease out this concept much better than me and have been able to give concrete examples of how they incorporate their faith into their profession. When I finally sat down to write this talk, I was unable to do that for the two seemed so inexplicably interwoven and I am not sure which is clearly my faith, which is my clearly my profession, and which is both. My faith is my profession which happens to be a doctor of psychology and my profession is my faith which is my belief in God.

 What I began to realize was that although my profession is important to me and I consider it an honour to work with Deaf individuals who are struggling with mental health and mental illness, I suspect this intertwining of faith and profession would have occurred in the same way if I was a plumber, if I was a lawyer or if I picked coffee beans on a plantation. For you see, I believe with all my heart I was not born a clinical psychologist or a sister or a wife or a mother or any of those things - I was simply born a child of God.

 The topic of profession and faith also gave me problems, as I never really set out to do the things I am doing. Much of it has happened only because the professional doors I originally chose to enter were quite literally slammed shut in my face when I became ill and subsequently lost my hearing. There is a saying that when one door closes another opens and I suppose in one way that was true although it still feels in many ways that I have had to kick open the professional doors. Furthermore, they often seem to be the type of doors that as soon as I relax my efforts, they will swing tightly shut on me again.

 I was born into a household of love and a household where the church early on became the norm. At the age of 5 years, I was told along with my older brother that my father had quit his job, my parents had sold our house, and we were packing up the car and moving to Beverly actually it ended up being London. And it could not have been farther from Beverly Hills as my parents had a bit of a tough time finding a place for the four of us to live and so we lived the first summer in a screened in porch in a house which is now Hooks tavern out on Wharncliffe Road. I remember seeing horses in the field out the window and I wonder if that was where my passion for both horses and wine began. The following September the four of us moved into one bedroom in the men's residence, which was then called Seager Hall. This was a residence for men attending Huron College and studying to be Anglican priests. I have never before and never since seen so many white undershirts in my entire life. We moved together into a very small house where we lived until my father completed his education to become a priest.

 Life from then on was as normal as it could be as the daughter of a priest. It is interesting for me to look back though as I remember that God and religion was rarely taught formally in our home, but was rather lived as an example in everything and all that we did. My brother and I grew up healthy, happy and after university ready to take on the world. My brother graduated from medical school and went on to become an anesthetist and is now married with four sons and has a thriving practice in Michigan.

 My life was to take a different turn. I attended UWO and got a degree in nursing and worked one year in the Neonatal Intensive Care Unit at St. Joes. There was a purpose to that year for those tiny babies taught me much about the human will to survive. The following year I became ill myself with an encephalitis which is an infection of the lining of my brain and was hospitalized for 4 months. I remember little of that time although my parents say they remember each and every night when they struggled with the questions would I live? Would I die? and if I lived, would I be asked to face life with extensive neurological damage?

 Many people sitting here in these pews likely remember that time, as the next ten years of my life became one of intense pain, frustration, and a certain disbelief that this was happening to me. I recovered from the encephalitis but I began having transient ischemic attacks or small strokes leaving permanent damage. When the doctors and specialists here were unable to diagnose my disease, they felt I should go to the Mayo Clinic. The provincial government paid the cost of transportation and it was the people of this church who pulled together to raise money to assist us with all the expenses. Ultimately it was the neurologists here that diagnosed my disease as an autoimmune disorder which left damage mainly in the form of blindness and deafness. I was left with a severe bilateral sensorineural hearing loss and a blind area in one eye. At the time of my diagnosis the doctors told me I was 1 out of 24 people diagnosed with this disorder in the world. My parents had often told me I was one in a million but I proved that I was actually 1 in many, many more.

 As my illness took over my body, the nature of my faith changed. I grew up with a faith born of absolute trust and conviction only seen in the innocent and that quickly changed as I went through phases of intense anger and rage. My friends were getting married, having babies, leaving for trips - I spent months and months in the hospital, taking chemotherapy drugs and feeling sick. Pain, confusion, and the lack of control made me viciously at times turn on God - how could He do this to me, what was the purpose, how would I live, why???? I vividly remember sitting on the banks of the Thames river around Easter time with my great big white standard poodle Bailey. I had just spent over one month in the hospital with another flare, my face was swollen and my hair thinning from the drugs and my future seemed hopeless. I cried and cried one arm flung around my big dog looking at the river asking again and again why me? why me? For some reason, the words "why not me?" replaced my anguished Whys and in that moment some of my anger subsided and I found some measure of peace. I don't think I found understanding but I somehow found solace in those words which I firmly believe were those of God. From that day on, I thought of my dog as an angel in a giant poodle suit and I framed my illness and misfortune around the words Why not me?

I was not able to return to work as a nurse for many reasons the most obvious being my deafness. I returned to school and got my Masters in Counselling Psychology. I did my Masters while I was still quite ill and some of the nurses at My professional life changed dramatically as a result of and since my illness. University Hospital remember pushing me in a wheelchair with an IV pole attached to attend some of my lectures!

 Following my M.A. I worked at the Robarts School for the Deaf here in London. By this time my own deafness had afforded me a glimpse into the world of culturally Deaf people and the Deaf community have been very good to me and continue to support my work. A culturally Deaf person is one who considers American Sign Language to be their first language, belong to a community of people who have similar beliefs and life orientations and often function in the world with the belief that their deafness is a difference and not a deficit.

 After several years working there I realized I wanted more education and I returned to university to do my doctorate in clinical psychology practice.

 I now have a private practice where I serve individuals who consider themselves culturally Deaf. Who would have thought I would end up in this profession? I tend to see very ill people who clearly fall through the cracks of our mental health care system. The barriers facing these people are immense - most do not have family doctors because of the communication, most are chronically underemployed or unemployed and as such have no insurance, most have little family support given that the majority of hearing parents never learn to sign to their deaf child, and a growing number of Deaf individuals have other compromising disabilities such as CP, developmental delay, cognitive limitations or medical problems. They often face oppression, hostility and isolation in a world based on sounds which we cannot hear.

 In terms of mental health care, how can these people access it? The sad reality is most can not. As a clinical psych I am excluded from OHIP and the Deaf people cannot pay for my services. I spent an extraordinary amount of time lobbying for services from the governments, agencies etc and much of it seems to do little good. When a person arrives at my office in acute distress, I cannot turn them away and as such much of my work is done pro bono which my husband and I cannot continue to afford to do.

 So what happens to my patients? They are falling through the cracks in the system and it breaks my heart to see. The profession I so love is also a profession of immense frustration to me given the doors that seem to shut on a daily basis in my face. I cannot use the voice telephone easily and as such cannot communicate with my colleagues including other specialists and family doctors. I face these frustrations on a daily basis and at times wonder why in the world did I end up here?

 But when I am calm and in my mind again back on the riverbank with my dog, I know why I am in my profession. My profession is a testament to the resiliency and determination of people who are marginalized by deafness in hearing world and furthermore often by serious mental illness in a world which still views it in a derogatory and unsympathetic way. It is such an honour to walk with these people that despite the frustrations of not being paid and feeling excluded by the hearing mental health professionals I marvel that I have been given this opportunity.

 Let me give you an example. Recently I was asked to provide a consultation at the Regional Mental Health Centre which was what used to be the London Psychiatric Hospital. A Deaf man was hospitalized and nobody on staff could communicate with him in American Sign Language. The referral question asked of me was for a clarification of the diagnosis and a cognitive or intellectual assessment. I arrived at RMHC and went to the floor where one of the nurses took me to a consulting room and brought me the patient's chart to review. I settled down at the table, opened the chart and began to read. A few minutes later a man walked purposefully into the room over to where I was sitting. I looked up at him as he stretched out his hand and I read his lips as he said quite clearly "Are you the woman from Mission Control2??" Now all my life I have had an inner dialogue going on inside me. Sometimes it is my form of prayer, sometimes it is my way of grounding myself, and sometimes it is my way of making sense of a situation. I looked this man in the eye and saw his psychotic symptoms yet my inner voice was saying "well, to be quite honest, so far today I have packed two children's lunches, got two kids dressed, got myself dressed, found a pair of mittens, filled and turned on the crock pot, made plans with my husband for dinner as were having company, figured out who was picking up who that afternoon at what time and where, discovered that the dog had been sick in the night and caught the fact that I had on one blue shoe and one black shoe before walking out the door and I'm thinking .... I just might be the woman from Mission Control". ` Yet I said to the man No I am not the woman from Mission Control to which he said Oh, well it was your briefcase that threw me as you see I have a job interview today". His psychosis stopped m short as I realized the extent of his delusion and I shook his hand and wished him luck in his job interview. As he turned to leave the room I watched him and I thought as I have so many hundreds of times "there but for the grace of god goes I".

 I have learned mental wellness and mental illness is a fine line. Despite what side of the line we may find ourselves upon, I try never to lose sight that we are all worthy of being treated with dignity and respect. It reminds me that we all have imperfections or cracks in our finish. Some of us have more obvious ones perhaps, but we all have them. That is one of the reasons why I have always loved our chapel where there is a crack in the wall behind the altar. As I receive communion, I often look at the crack and in my deafness I feel reassured. When all is said and done, we are all basically the same - I may give it a label such as delusional disorder or schizophrenia but is that any different really from my label of clinical psychologist. Underneath all the labels, my faith has taught me through illness, through suffering, through raging on the river bank that God is always there at level much deeper than what our human language might allow us to say or our human minds allow us to see.

  I believe that the acts of a profession become the acts of God. Perhaps we need to start believing that ordinary common acts of works can also be sacraments to God. The construction worker builds safe roads, the computer techie helps us to communicate, and the gardener helps our world stay beautiful. I feel that my sacrament of diagnosis and assessment is similar to the sacrament of teaching Grade 3 children or repairing roads or selling groceries. What we do in our work despite what labels we give it is really only an extension of what we do here on a Sunday morning - which is to profess our faith.

 Thank you for listening.