Letter to City Voices Editors

Letter to City Voices Editors

Dear City Voices Editors:
Thanks for “Animal Companions Help Us to Heal” (page 14, Winter 2017 edition). My cat Sasha has been, is now, my life-saver! I would have perished long ago from loneliness. My schizophrenia has made it very hard for me to build relationships for friendships, marriage, etc.
Michael Gottlieb, New York, NY

The Aftermath of a Major Psychiatric Episode

The Aftermath of a Major Psychiatric Episode
By Kurt Sass
Coping Strategies for Dealing with Relapse Fears
Back in 1998, I began a two year, long-suffering battle with major depression, which included, among other things, daily suicidal thoughts, self-abuse (cutting myself up to 70 times a day), numerous hospitalizations, 22 ECT or “shock” treatments and a period of 11 months in which I could not leave my bed on my own—not even to take a shower or go to a doctor's appointment. 
Fortunately, I have not had to endure anything even remotely close to that in the 16 years since that two-year ordeal ended in the year 2000. 
One might think that it would be easy to be grateful that the “past” is behind me and that it is easy to go on. However, I think most people who have gone through the trauma of a major psychiatric episode would tell you otherwise. 
While I am extremely appreciative and grateful everyday that I have not returned to that horrible state, the fear of it recurring is always there. My belief is that most people who have endured a major psychiatric episode, especially a long-term episode, suffer from a form of Post-Traumatic Stress Disorder as a result. I still get flashbacks of when I cut myself and when I was hospitalized for attempting suicide. And when those flashbacks occur, the fear of the episode recurring also resurfaces.
This cycle occurs most often when my body is in a weakened state. A few years ago, I was confined to a bed for a number of days when I had a virus with a high fever. With my physical body feeling so weak, my thoughts began to shift. I started thinking that this was the beginning of a new depression and that I would not be able to get out of bed, even after the fever lifts. Another time this occurred was when I started a vigorous exercise routine and ran eight miles a day, without building up to that level. I wore out my body, and was almost too weak to fight my thoughts of oncoming depression.
I noticed that whenever I feel either tired or sad, I immediately start to panic and wonder if this is possibly the beginning of a major psychiatric breakdown.
The good news is that I have discovered many tools to successfully cope. The first is cognitive thinking. Whenever I start to feel any inkling or thought at all that I may be going into a deep depression, I sit back and analyze the situation. I ask myself questions: Are you physically sick at the moment? Are you tired because you didn't get enough sleep? Are you sad because of something that happened at work or with family? The answer to one of these questions is almost always yes, and that usually explains it. Meditation and yoga are two great ways to help get into a nice, relaxed state before asking yourself these questions.
Unfortunately, however, I sometimes go through unexplained periods of complete panic and fear which can last anywhere from a few hours up to seven to eight days. There seems to be no apparent trigger. When this happens, I must be continually cognizant that this is not going to end up being a two-year depression and that eventually it will fade away. It always does. 
Finding the right therapist, one you can trust, is an important piece of the puzzle, as well as finding close friends whom you are able to confide in.
If you have suffered through a major psychiatric breakdown, and you are often afraid that it may recur, you are not alone. If you think you see any signs of a possible recurrence, please take a moment to step back and analyze them first.

Supplemental Needs Trusts and Government Benefits

Supplemental Needs Trusts and Government Benefits 
By Joe Rosenberg, Professor of Law, CUNY School of Law
What You Need to Know
Who Needs a Supplemental Needs Trust?
• Miguel is 50-years-old and receives SSI, Medicaid, and SNAP (Food Stamps). Miguel is about to receive a $50,000 settlement from a discrimination lawsuit against a former employer who fired Miguel after the employer learned he had schizophrenia.
• Sonja is 35-years-old and suffers from depression. She receives SSI, Medicaid, and a Section 8 housing subsidy. Sonja’s mother died recently, and left a will that gives Sonja $100,000.
• Ella is 60 years old and became eligible for Social Security Disability due to mental health problems after many years of employment. Ella receives Medicare, but now needs a level of home care that is available from Medicaid. Ella is not eligible for Medicaid because she has excess monthly income above the Medicaid level.
These are a few examples of when a supplemental needs trust (“SNT”) can be used by a person who receives government benefits:
• If Miguel transfers his settlement money into an SNT, he will remain eligible for SSI and Medicaid. Miguel will also be eligible for SNAP, whether or not he uses an SNT, because in New York, SNAP does not count a person’s assets. 
• If Sonja transfers her inheritance money into an SNT, she will remain eligible for SSI and Medicaid. Sonja will be able to keep her Section 8 benefit, but may have to pay a small monthly increase in rent.
• Ella can transfer her “excess income” each month into a supplemental needs trust to satisfy her “spend down,” become eligible for Medicaid, and have the extra income used for her benefit by the trustee. 
How Does the SNT Work?
The trustee manages the trust, which directs how distributions are made to improve the beneficiary’s quality of life. The trustee usually makes payments directly to providers of goods and services to the beneficiary. The trust is used to pay for basic needs not covered by government benefits and anything else that will improve the beneficiary’s quality of life (for example, “extra” health care, housing, travel, personal care, computers, and education).
The trustee does not make payments directly to the beneficiary. If the beneficiary needs services beyond what Medicaid covers, the trustee pays the provider directly. The SNT is not considered an “available” asset and the beneficiary maintains eligibility for government benefits. 
If the trustee pays money directly to the beneficiary, it would be counted as income, which might affect the beneficiary’s eligibility for government benefits.
What is the Difference Between “Pooled” & “Individual SNTs?
There are two main SNT “structures”: 
• A “pooled” SNT is for people with disabilities of any age. A nonprofit organization establishes and manages the trust. Each beneficiary has an account within the “master” pooled trust. 
• An “individual” SNT is limited to people with disabilities under age 65. An individual trust document must be drafted. Unlike the pooled SNT, a responsible person or bank/trust company must be selected to serve as trustee. 
Who Funds the SNT? “Self-Settled” & “Third Party” SNTs
There are two main types of SNTs:
• A “self-settled” SNT is funded with money or property that is owned or controlled by the beneficiary (for example, a settlement from a lawsuit, or an inheritance). The beneficiary is considered to "own" the money that will fund the trust, so it is necessary to use a self-settled SNT. A transfer of money or property into the SNT does not create a “penalty period” of ineligibility for SSI or Medicaid, unless the beneficiary is over 65 and applies for Medicaid nursing home coverage within 60 months of the transfer.
• A self-settled SNT can be created by the beneficiary (if the person has enough decision-making capacity), or by a parent, grandparent, legal guardian, or a court. 
• A “third party” SNT is funded with money or property from someone other than the beneficiary (for example, a family member or friend). The beneficiary does not own the money used to fund the trust. A parent creates a third party SNT when the parent includes the SNT in a will that takes effect when the parent dies. 
Is There a Medicaid “Pay Back” from the SNT Remainder?
With an individual “self-settled” SNT, there is a required “pay back” to Medicaid from any remaining assets when the beneficiary dies (up to the amount paid by Medicaid for the beneficiary). With a pooled SNT, there is an option to keep any remaining money in the pooled trust when the beneficiary dies, instead of the “pay back” to Medicaid.
A third party SNT, because a parent or other person (not the beneficiary) creates and funds the trust, does not have a required “pay back” to Medicaid. The creator of a third party SNT can choose who gets any remainder after the beneficiary dies. 
Does a Person Need a Lawyer to Create the SNT?
I recommend that a person work with a lawyer, who should be able to explain options and help the client make informed decisions. 
For example, a lawyer can help under the following circumstances:
• A parent or grandparent is doing “estate planning” and wants to provide for a child or grandchild (or other relative or person), but does not want to cause the beneficiary to lose eligibility for government benefits.
• A person receiving SSI and Medicaid inherits money from a relative or friend, or receives a lump sum settlement from a personal injury, discrimination, or other case, and needs to protect the money without losing the government benefits.
The cost of setting up an SNT will vary, depending on the amount of money involved, the type of SNT, and if a person needs to create a new SNT or can establish an account with a pooled SNT. 
Private attorneys who specialize in Elder Law, Disability Law, or Wills, Trusts & Estates, may have the necessary expertise. A private attorney may charge anywhere from $1,500 to $5,000 (or more) for an SNT.
Local legal aid, legal services, and bar associations may have referral services for pro bono or more affordable attorneys.

Bruni in the City: Number 100 is on His Way

Bruni in the City: Number 100 is on His Way

A Column by Christina Bruni

I Fell for a Pinhead

Readers: I broke the cardinal rule of dating.

Years ago, a woman gave me a psychic reading in her apartment on the waterfront in Sheepshead Bay. She told me: “Don’t throw yourself at a guy. Remember: you’re a diamond, not a rhinestone.”

Diamond, my ass. My brilliance hasn’t attracted a guy to me.

So, my curiosity got the better of me. I threw down a challenge to T.—the guy I have pined for since 2016—and sent him a short e-mail in these exact words: “I realize you don’t like me and that’s okay.” The cardinal sin. Then:

“You keep talking about your numerous ex-girlfriends. I’m a woman with a photogenic face and skinny body and I can’t get one guy to go on one date with me. What’s your secret?”

Since he was “date bait” himself with striking good looks and a kind heart, couldn’t he spare a few alluring ideas about how I could reel a guy in? Couldn’t he tell me this as one great friend to another? I clicked send on the e-mail and shut down my computer for the night. 

T. responded: “Most romances are played badly just on the surface level. Even the ones where people are happier are adolescent. Are you at the library this week? We can talk then.”

I responded to T: “Yes, I do attract guys—what a psychic called ‘turkeys.’ Like the guy with the screen name sexywomanneeded—adolescent indeed. How is a guy going to get a woman if he frames it in terms of what she can give him not what he can give her?”

Then I told T.: “I’m not going to wear a cleavage-bearing mini dress, yet apparently, that’s some guy’s sole criteria for a love match.”

Our conversation quickly sidestepped that he was the first guy I was madly and physically attracted to. He had conveniently deflected any reference to my comment that he didn’t like me.

That Sunday was the first time in my life that I ever felt like something was wrong with me. Having a diagnosis of schizophrenia doesn’t upset me and hasn’t upset me for decades. It only crushed me to know that a kind, sensitive and intelligent guy like T. didn’t like a kind and compassionate and elegant lady like me. 

“Pinhead!” I wanted to tell him. “By all means go out and get another chick that will treat you like shit all over again. Get going—Number 100 is on his way to me.”

It’s over—partly because T. has moved to Austin, TX where he found a job.

T. and I were a photogenic item out in public. I was confident people thought we were a romantic item. Thus, when we appeared together I wanted to wear a tee-shirt that proclaimed: He’s Not My Boyfriend. Try Your Luck.

The ending with T. reminded me of the Donna Summer song, lyrics about the cake left out in the rain. It took so long to bake the budding romance with him and I won’t ever have this recipe again either. The cake’s been soaked. That’s all there is to it.

On some days, I still pine for a guy. On other days, I’m happy to be alone. I miss the cake frosting.

Soulful Connections

Soulful Connections
A Column by Relda Hill
Cultivating the Inner Voice
I have been hearing a lot recently about people who hear voices and how disruptive these voices can be. I want to say that I have empathy for these individuals and I validate their daily struggle to deal with this mental health condition. However, there is another voice that exists in each of us that does not get much attention. To be clear, this voice is called the inner voice. This voice is not a pathology; it represents the inner child at the core of our being. I have found in my spiritual practice that this inner voice can lead me through any distress that I may be feeling. In this article I will discuss my struggle to hear my inner voice and how I achieved peace and wholeness by listening to it. 
Throughout the last 25 years, I have done a lot of research on spiritual practices. I was raised as a Christian, but when I reached adolescence Christianity no longer worked for me. I do not relate well to a God that deals with black and white rules and who does not have a sense of humor. In addition, since I had poor boundaries in the past I did not know where I began or ended. I was like an open book and anyone could write on the pages of my soul and mind. Moreover, since I was sensitive, I found that people really did not have to say anything to me. I was able to pick up their negative energies and I made the erroneous assumption that the feelings and energies of others were my feelings and energies. Sadly, my authentic self got lost in the struggle to gain my identity as Relda. 
As the years passed, I developed a lot of “chatter” in my head. I define “chatter” as white noise. This white noise made it difficult for me to connect to the inner child in me and to my inner voice. For instance, when I was in the throes of a deep depression, my inner voice was my worst critic. I entertained thoughts like “You don’t deserve to live,” which caused me great distress. I felt that I did not deserve to live and I was very judgmental with my Self. This judgmental part of me caused me to act out in self-defeating ways. I nearly lost my life to this harsh inner critic. 
One might ask “Why should I seek out the inner voice when it can be my own worst critic?” I believe that it is important to seek out the inner voice even if what I discover is harsh, negative criticism. I know that when I listen to the negativity that is contained within me that I can very slowly begin to change it. When I become aware of what is rotting within me, I am given the opportunity to liberate my soul. In simpler terms, I have a choice. I can either succumb to the negative talk or I can learn to transform it. Transformation occurs for me when I “starve” this negative energy by engaging in some positive activity like exercise, doing artwork, singing, cleaning my apartment or any other kind of positive activity. In my experience, I have found it worth my while to dig up toxic, old tapes so that I can face them and symbolically discard them. Whenever I engage in transformative activities, I am building positive, self-esteem. My salvation is not in medication but in meditation! Let’s be clear, I am not advocating that peers come off their medication, I am stating that meditation can be an instrument that leads to wholeness and healing.
Luckily, I have a persevering spirit and I began to read spiritual books and magazines. In addition, I went on retreats, entered therapy and spoke to many people who had similar struggles. Fortunately, I was able to find the strength to meditate even if it was only for short periods. I learned about techniques that helped me to understand cognitive distortions and how they distorted my world. I also learned that many of my reactions were based on traumas that I had endured during my life. 
As my meditation practice grew stronger, I was able to hear my inner voice. This small voice inside of me became calm and periods of upheaval lessened. I discovered through meditation that I am able to get to the bottom of any problem. I was able to reach the “still” part of me. From this serene space, I began to heal. The “internal offender” or the “harsh inner critic” are still a part of my psyche, but they do not run my life. My ability to hear my truth from my inner voice strengthened me. I am not suggesting that I do not need other people in my life; I still choose to work with a therapist. However, I am not as dependent on others as I used to be. Simply put, I have learned to bear my own burdens.
For those brave souls who want to find their inner voice, I can offer a few tips. You can begin this journey by creating a sacred space for yourself in your home. You can decorate the space with pictures of a spiritual leader or decorate your space with meaningful, universal symbols. Some people like to have a jar of water to represent spirit and others use incense to purify the air. Also, you can use flowers or green leaves to represent life and eternity. After this sacred space has been created, you can sit on a chair or sit on the ground. Do only what works for you. There is an abundance of books that will give you more ideas on how to create sacred space. Observe your breath and make sure that it is calm and steady. 
As you begin to do the practice diligently you will begin to move past the chatter of the “monkey mind” and find your inner voice. You will begin to get in touch with the part of you that has never been violated. Your inner voice will make itself heard and you will eventually feel calmness and a deep peace. Deep in your soul you will know that you have achieved something special that will be your guide through the rest of your life.

The Healing Art of The Memoir

The Healing Art of The Memoir
By Ayesha 
Writing My Personal Story Has Been a Cleansing Experience
I want to write about how cleansing it was for me to write a 3,000-3,500-word personal narrative. This memoir is the beginning of what I hope will become a book-length personal narrative. I like to think of the benefits that I get from writing personal narrative as “narrative therapy.”
When I write about my experiences as an African American woman living with schizophrenia, I am writing my story which began twenty years ago. I have made progress simply by sharing my story with others. As I read the first two pages of my narrative with students and alumni at Memoirfest—a memoir-reading party that Dr. Giunta, the memoir class professor, holds every May and December at her house in Teaneck, New Jersey—I was being bolder than I have ever been before.
I have written personal essays and narratives that I have shared in safe spaces, but never as part of a college-level workshop or at a gathering of students as I did at Memoirfest. I felt so good after sharing the first two pages of my memoir with everyone and getting their positive feedback. One student told me she really enjoyed my piece, which I shared with her just before she left at the end of the night. She was doing her honors thesis and, although I cannot remember her name, her comment meant a lot to me. 
The first class that I shared my life experience as an African American woman with schizophrenia was English Composition II while doing research in the Guarni library for our final research paper; Dr. Alina Gharabegian was my instructor.
I had been encouraged by Dr. Hamburger to take ECI and ECII at the university level. I took the Advanced Creative Writing Workshop with him and did not do well, barely passing the course. Dr. Hamburger encouraged me to repeat ECI and ECII, which I did to improve my writing skills. 
Dr. Gharabegian had assigned the class a five- to seven-page research paper on the broad topic of love. We could approach the assignment in any way we liked. In her comments on my proposal, Dr. Gharabegian suggested that I write about schizophrenia and love. I felt like someone was opening a door for me. I was surprised by her suggestion, but also thrilled. I had not yet written a paper about my personal experiences with schizophrenia during my time at New Jersey City University. 
I was happy to be taking Memoir Workshop with Dr. Giunta, who taught me to avoid writing my story as a chronology or autobiography. When I nailed voice, it was like church bells were ringing at that moment, and I felt so accomplished, mature and independent. I am so glad I took Memoir Workshop and then Advanced Memoir Workshop during the spring of 2015. I graduated from NJCU in August 2015 with a BA in Creative Writing. 
I am fond of NJCU because of my experience in Dr. Giunta’s class. She was an amazing, supportive, caring and sweet person as well as a great teacher. I feel such an overwhelming debt of gratitude to her. I never thought I would have such an experience with a professor or as part of a class. It had such an amazing impact on me and on my life.
Now I am back at NJCU majoring in Early Childhood Education. I feel more a part of the university's community now than when I began in the fall of 2007. 

My Mental Health Journey: Mirroring Success Through the Eyes of a Relationship

My Mental Health Journey: Mirroring Success Through the Eyes of a Relationship
A Column by J. Alfreda
Success is Obtained by Letting Go of the Toxic Pieces
Our relationship has been strained at best, a really rocky road. It’s a love/hate relationship that borders on psychosis. But, in the final analysis, I am the one who knows her best. She is the closest person to me. She is me.
There was a pouring of rain on our already strained relationship. You see, I have schizophrenia, bipolar type, which onset at age 20. Many voices and much pain have infiltrated my mind over the past 35 years. I have just arrived at a place of readiness to accept this illness as mine.
You might possibly think it’s strange that it took me so long, but I have always thought of my illness as another entity, an alter-ego, an arch nemesis. I refused to see myself as a whole person. My war had an enemy though I couldn’t see that the enemy was unintentionally me. Success would start with forging my “selves” and attaining as much peace as possible. 
Schizophrenia is a different realm of reality. You realize what you go through intermittently. But, when you are there, it is real. It is marked by delusions, extreme paranoia, suicidal thoughts, steep highs and lulls of depression in my case.
In the beginning, it was like having my life, mind and soul hollowed out and strewn across the four corners of the Earth in scraps, feeling like I had to travel to each site and retrieve them piece by piece in a zombie state. The disease alienates you from yourself.
Schizophrenia is a useless, evil being who can’t stand in a church for fear of bursting into flames. It is a pimp that bids actions contrary to your will, turning you inside-out. That is, until you fix it.
I walked around in this nightmarish, delusional state for 24 years before a medication was created that I would respond to and not put me in the conveyor-belt-shuffle-mode.
When I was 20, I was sure that by now I would have an engineering firm, a great home, kids, and the whole nine yards, but that hasn’t been in the plan for me. I have barely been able to take care of myself. I did manage to finish college, though on the revolving door plan; one quarter in school, the next in the hospital and so on. I changed my major from chemical engineering to journalism because after the first break, with the tranquilizers I was taking (that was all they had for schizophrenia back then), I found I could not comprehend my coursework anymore. I was in my junior year before the break.
You can imagine why I would rebel against this entity. It has undermined my every opportunity and effort to gain success, but it is a part of me and I have resolved to make myself whole.
After some soul-searching prompts, my first stop was in the gratitude market. You can’t ask the Universe for more without thanking It for what you already have. It just wouldn’t be polite. I bought a gratitude journal in which I write daily those things I am grateful for: past, present and future.
The little things that I appreciate and make me happy fascinate me the most. In my first entry I always thank God for “waking me up this morning clothed in my right mind,” a phrase my grandfather used to say in his prayers, which has taken on a new meaning for me. You can guess why.
I’ve also created a gratitude board somewhat akin to a vision board, visually celebrating all of the things that make me happy, appreciative and that I am thankful for. It has things as frivolous as vintage clothing and jewelry, as marvelous as a multi-hued sunset or a cobalt night sky, and as welcoming as family and all that it entails. It helps me to embrace the positives of my life.
Some would say I lost everything in the deal. It may seem that way from one perspective if viewing my past, but it is far from the truth. In picking up the pieces for the umpteenth time, I discovered me, the whole of myself. I am coming from a natural place, a place of gratitude and love─not someone else’s definition of who I am, or even who I think I am; it is a place of true character.
My true character has been revealed by letting go of the toxic pieces and embracing the positive aspects of my true self. This is how I define success.