Tag: mental health

F is for Feelings (and Fight, Flight, Freeze)

Published on by Pam1 Comment

Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom. –Victor Frankl

For a species that has been gifted with the ability to name and express our feelings and needs, we humans sure are terrible at it. Instead of allowing ourselves to feel, we do everything in our power to not feel. We eat. We run. We nap. We bully. We hit, yell, scream. Withdraw. We reach for a bottle or a pill or an edible.

If we grew up getting the message that it’s not okay to have feelings and emotions, we might not even know what we are feeling at any given time, other than to know we don’t like it. I can remember being a very emotional 15-year-old (like most 15-year-old humans), and my dad saying to me “We do not have emotions is this house, young lady.” His solution was to take my concerns to Jesus through prayer. That solution never really worked for me, though I tried mightily. Others of you, Dear Reader, may have heard similar messages. Something like “stop crying or I’ll give you something to cry about” or “boys don’t cry” or “big girls don’t pout.” All messages designed to help our caregivers/parents feel more comfortable but none of which did anything to get to the heart of the matter:  what we were feeling and more importantly why and what could be done.

Fortunately, The Center for Nonviolent Communication has published a list of Feelings divided into two categories:

  1. Feelings when my needs are satisfied
  2. Feelings when my needs are not satisfied

They have also published a list of needs to which we can refer when we are having feelings about unsatisfied needs. For example, if I wake up irritable, and I sink into a morning mood of anger and despair for no clear reason that I can determine on my own, I might look at the needs inventory in order to figure out what I need in order to change my feelings. What need is not being met?

I help clients walk through the process of identifying their feelings, encouraging them to sit with their emotions, to (as my own therapist used to tell me) invite the feelings in for tea and get to know them. I help my clients figure out what they need based on their identified feelings. We also work at sitting with the feelings, getting comfortable feeling uncomfortable and recognizing that feelings come and go and don’t actually hurt us. Feelings are based on thoughts and stories we create about those thoughts.

One example I use often and one that most people, especially Gen Z, seem to related to best is not getting a response when we send a text message. The most common assumption about text silence is that whomever we are waiting for a response from must hate us. Think about it . . . what assumptions and stories do you create when you don’t hear back after sending a text message? Some of us, a few, just figure their person is busy and get on with their day. Others struggle. Some people spiral and assume the absolute worst has happened: death, break ups, hatred, that somehow in the matter of a few minutes or an hour that they have lost the love of their nearest and dearest. Tragically and irrevocably.

We engage in this behavior because as human beings, we are wired for danger and anxiety. Anxiety kept us safe on the savannah. Worrying about danger, real or imagined, kept us from being eaten by lions or from being kidnapped by the strangers who live downriver. Our danger alert systems, our fight, flight, (fawn), and freeze responses are overly well-honed for this current world, and so overreact to smaller, non-life-threatening, perceived dangers.

Sometimes we seem to be held captive by these fears and anxieties, immobilized by imagined dangers. How can we overcome them? How can we learn to not make up stories and to not believe the worst-case scenarios that sometimes feel overwhelming?

Mindfulness helps. Meditation helps. Simple strategies such as slowing down enough to breathe when we start to have an uncomfortable feeling, giving ourselves enough time to choose our reaction. We can choose how to respond. If. We. Slow. Down. And when we have choices, we have power. We have control. We no longer feel like victims, buffeted by our emotions. We learn that we can feel uncomfortable feelings and not be undone by them. We can learn to not automatically think (and believe) the worst-case scenario.

But it takes practice.

Just like those I work with, I’m not always adept at being able to identify my own feelings and needs. Like most folks, I am eager to chase away the uncomfortable feelings—I’d rather not sit with anxiety or anger, bewilderment or burn-out. And like everyone else who is human, I get really good at developing strategies for not feeling my feelings.

One helpful strategy that nearly always works, I learned from Buddhist meditation teacher and psychologist/author Tara Brach. The technique is called RAIN and stands for Recognize, Allow, Investigate, and Nurture. In short, we first recognize we are having an uncomfortable feeling and we allow ourselves to feel it, instead of chasing it away, getting more comfortable with being (temporarily) uncomfortable. Eventually we learn that the discomfort will pass. Then we can create some space around the feeling and investigate it—how familiar is it? How big is it? When did we first feel it? How old is that feeling? Where in our bodies do we feel it? Focus on that part of our body and breathe into it. Ask yourself, what do I need in this moment to feel better?

Finally, we nurture ourselves. Hold our hand to our heart and press, releasing dopamine and oxytocin, happy hormones to counteract the adrenaline and cortisol the anxiety and fear produce. We can nurture ourselves.

We can learn that feelings come and feelings go and we don’t have to be held captive by them.

A is for . . . so many things.

Published on by Pam3 Comments

A is for alopecia and aphasia. Also for assault. Anger. And atonement. What might all of these words have in common? Aside from being in the headlines recently? We all suffer from something and usually our suffering is invisible. For a variety of reasons. We may have a hidden or not so obvious physical disability. We might suffer from an emotional issue or be diagnosed with a mental health condition that we don’t generally discuss with others. And when others don’t know what is going on with us, they make assumptions. I’m not here to be an apologist for anyone, I’m simply here to point out that as human beings, we spend much of our time making decisions based on our assumptions which are often wrong. We are great at filling in the blanks with whatever story makes sense to us, and again, because we are human, we tend toward the negative. We generally believe the worst unless we make an effort to choose otherwise.

Take Bruce Willis’ Razzie for example. The Razzie Awards did not consider that perhaps Mr. Willis was suffering a medical issue when the organization awarded him a Razzie. But, after his family issued their statement about his health condition, the Razzies retracted their award. They atoned for their poor treatment based on their faulty assumption. I won’t get into the altercation that occurred between Will Smith and Chris Rock over Jada Pinkett Smith’s alopecia, except to say again, assumptions—this time about a person’s appearance—led to inaccurate (and unkind) conclusions, including violence. We can make all manner of assumptions about Will Smith’s slapping of Chris Rock, but we do not know what is going on with Will Smith. So we make assumptions.

Because we live in a culture that champions youth and vitality, we may not be comfortable bringing up or exposing those parts of ourselves that don’t fit neatly into the cultural narrative. We may curate our online presence to artfully conceal the imperfections that lie beneath. And what happens when we hide our vulnerabilities? Do we feel better? Do other people feel more comfortable around us when we are not authentically our whole selves? Not really. When we let others see the real us, our unvarnished true selves, we become more attractive, not less. As Brené Brown says in her book The Gifts of Imperfection, “Authenticity is a collection of choices that we have to make every day. It’s about the choice to show up and be real. The choice to be honest. The choice to let our true selves be seen.”

L is for Letting Go (and Hot Lava)

Published on by Pam4 Comments

One day you finally knew
what you had to do, and began

                        –Mary Oliver

Hello, Dear Readers. This week has certainly been one full of lessons on Letting Go. It’s funny—as I make my way through the alphabet, ever so slowly, I have realized that each blog presents itself when it’s time. And not before.

So many things have converged in the past week, from family shit to online dating adventures, to the possibility of moving, to health concerns (not mine). As we emerge from this pandemic, like so many light-deprived moles crawling out of our long dark tunnels, blinking at the bright sun and shrinking from the intense heat (seriously, it was over 100 degrees here last weekend—that is not normal), we can only hope that the future is better, but it has not been a stellar re-entry back into the world.

The first lesson in Letting Go has to be that life is not going “back to normal.” What was before lockdown last March will not be returning. We have to let go of a “return to normal” and adjust to moving forward into something new. A friend invited me to a movie this week, at a theater. Inside. I’m not ready yet. And from the looks of the news headlines—shootings, forest fires, climate change havoc, declining vaccination rates, increased political polarization—it seems we should all just continue staying home. There needs to be a global Letting Go of the status quo. We cannot go on like this. I have no answers. Just a sense that if we don’t let go of what was, we will not be able to move forward, collectively.

On a more personal level, I have decided it is time to Let Go of my house. I put it on the market a couple of weeks ago. I don’t have a set plan yet. I just know that I’ve been in this house for 23 years, it has served me well, and now I no longer need it. When I was a kid, our family moved around a lot—I went to four different high schools—and when I landed in Bellingham 40 years ago to attend college,  I immediately put down deep roots. Maybe I didn’t even decide so much as just instinctually grounded myself here. I needed the continuity. But now, that need has subsided. It’s time for adventure. It’s time for me.

I spend my weeks urging clients to take care of themselves, reminding them that no one benefits if they aren’t getting their own needs met, that we can’t fill up others if our own wells are dry. Occasionally I remember to heed my own advice. But Letting Go of my home has repercussions beyond just me. My adult kids have feelings about me selling. Of course they do. I understand. My parents divorced and sold their home 20 some years ago, evoking all kinds of feelings of loss for me. I’ve had to Let Go of an intense urge to take care of my girls and to “do better” by them. But, Letting Go also means letting go of the past, of old wounds, of old habits, of old feelings that keep me trapped. Keeping my house is not going to heal the wounds I felt 20 years ago.

Letting Go means no longer being a place of refuge for others, and at times, I feel guilty for closing that door, but if not now, when? This house has been a refuge, a sanctuary, and now it feels more like a burden, a weight, an unnecessary commitment. Too much for me. I can’t wait. Some days, I am pursued by the specter of Alzheimer’s—it got my mom by 65 (in retrospect, it seems to have started there). She’s been robbed of her final decades—I cannot wait for it to get me too. I have to Let Go and Get Going into my own future.

Letting Go of my home also opens up a new range of possibilities—a life on the road, of Airbnbs in cities that call to me, of the possibilities of meeting people beyond the confines of this state, of opening myself, my life, my world up to more, bigger, different. Letting Go of what I thought work and the future held and embracing uncertainty.

When I work with clients who want to move forward but can’t seem to let go of what feels secure, I use a metaphor of the monkey bars. Remember hanging there, suspended over the “hot lava” your best friend breathing down your neck behind you, urging you to let go of the back rung in order to swing forward? The fear of falling, the knowledge if you didn’t let go, you’d eventually succumb to gravity and fall to the ground and be consumed by the metaphorical lava or crocodiles?

So, you took a deep breath, summoned your courage, and Let Go. Into the unknown, flying unsupported for one terrifying moment, the specter of death, of failure, of pain fleeting, until your hand met the cold, smooth metal and you were again safe. Ready to do it again, and again until you reached the end. Triumphant.

you strode deeper and deeper
into the world,
determined to do
the only thing you could do –
determined to save
the only life you could save.

-Mary Oliver, from Dream Work

K is for Keeping On (and Kayaking, of course)

Published on by Pam5 Comments

The sun is shining and the days are getting warmer. We may be about to emerge from our cocoons, and I’m reminded of last spring at this time when the world seemed like such a scary place. I stopped going to my office. I stopped going running because the trail suddenly filled with scads of people who were no longer going to work. Two of my best friends were trapped in Vermont, one was in the hospital. I met with clients all day on Zoom and then in the evenings, bewildered and disoriented, joined friends for virtual happy hours. Gone were side conversations and incidental run-ins with acquaintances.

I renewed my relationships with my neighbors, slowly, over the weeks as we dared to leave our homes, stunned, frantic, scared.

At Baker Lake last summer

Eventually, I felt safe enough to go mountain biking, joined similarly isolated friends in outdoor meals, taking advantage of the improving weather and longer days. We gathered, carefully distanced, on decks, in yards, at the parks, still stunned, still disoriented. I spent hours plucking dandelions from my front yard and grooming my aging and cantankerous cat, Mittens, ducking back indoors to see clients on Zoom, urging them to not panic, assuring them they wouldn’t be trapped back home with mom and dad for too much longer. What did I know then? What did any of us know?

Baker Lake, Summer 2017

We knew we had to keep on. I kept on by throwing my hat in the online dating pool. I kept on by doing jigsaw puzzles and by hauling out the old Wii Fit. I went kayaking. I’ve already written here about how kayaking seemed a reasonable and safe first date in a plague. I watched ducklings from my kayak, monitored the lily pads’ blooming, spied on the great blue heron, and the parade of goslings. Kayaked at midnight to see the bioluminescence and did it again the next night and again a week later. Sat on the water in our kayaks and talked for hours with new friends and old.

I want to return to that feeling—the satisfaction of meeting someone new, of making a connection, of being in my boat, on the water, in my own skin, keeping on. In the face of a pandemic. In the face of a return to whatever normal will look like, in the face of a future that only unrolls a moment at a time.

So, I keep on. Working from home. Dating. Kayaking. Looking for The One. Making the most of the lessons I learn along the way.

What keeps you keeping on, Dear Reader?

A Return to the Interwebs. Happy New Year!

Published on by genassecretsanta6 Comments

Consider this my Christmas Letter for 2017

Relaunched the website tonight. I’d taken it offline while I looked for a job. I go back and forth on this issue–should I let prospective employers see what I’ve written here or should I not? Will my writings help my career or harm it? I have no idea. But, now I have a job, so there.

I have a job! As a counselor. Good thing, since I woke up on Christmas to an email from the Federal Student Loan Servicing Company, reminding me that I was half way to the end of my Student Loan Repayment Grace Period.  Yay! I won’t get thrown in debtors’ prison. Yet.

And I’ll be in private practice soon, since my job affords me time to see clients on my own as well. I will be working three, twelve hour shifts each week, so I will have a few other days in which to start building my own practice.  I am very excited about both of these opportunities and couldn’t have imagined or hoped for a better outcome and transition into the mental health counseling field.

On the homefront, my 27 yo kid has moved in with me for awhile and I am completely digging having her around. It’s a chance at redemption for me. How often do we get an opportunity to have a real life “Do-Over?” I am one lucky mother.

Speaking of Mother, she has moved to a memory care facility. We reached a bit of a crisis point after Thanksgiving with a pulled tooth, a root canal, and a bottle of pain meds. Suffice it to say that her level of needed care exceeded my level of competency. She has a roommate who has a PhD in Sociology, so Mother is both duly impressed and thrilled to have someone to talk to who is at about the same stage of Alzheimer’s. They arrived within a week of one another, and both seem content (generally) with each other.

Charlie (or Chuck, as I like to call him), Mom’s shitzu, moved too, and seems quite happy to be there along with a handful of other dogs, a couple of hedgehogs, a Siamese cat, a tankful of fish, a cage of birds, and a chinchilla.

The transition to the facility was as awful and wrenching as I imagined it would be. Mom was none too happy with me that night, but I had to move her for her own safety. Who wants to have to make that sort of decision for someone? I certainly never imagined I would have to. And, I am thrilled to have my life back, my time and my home back. You can’t know what it’s like until you live it.

I spent the holidays working. Mom spent Christmas and Christmas Eve with my kids and their other mom. I am grateful for everyone’s love and caring these past few weeks, these past sixteen months. I couldn’t have done this on my own.

Happy New Year!

Pam

B is for Behind (Already!) or Boundaries

Published on by Pam2 Comments

I decided a few days ago that B was going to be for Boundaries—a relevant topic now that I am a counselor and caregiver (see A is for Alzheimer’s). But then life intervened in unexpected ways and while I should be cranking out my C is for . . . blog, I’ve still not gotten around to B. Also, there’s the little matter of a poem to go along with. Every time I sit down to write a poem, I get interrupted. Poetry is challenging enough without constant interference. I wrote one the other night, but I’m not sure it is suitable for public consumption—in fact, I know it isn’t. So, back to the drawing board.

A few words about Boundaries. Boundaries are those imaginary lines that we draw in the sand between us and the rest of the world. The word “no” is a boundary, as in “No, I cannot help you move this weekend (or ever).” Boundaries are personal bubbles, as in “if there are 90 empty seats in the movie theater, don’t sit right next to me if you don’t know me.” I am continually amazed at how often this boundary gets violated (especially in Bellingham). Boundaries can be fences, hedges, the edge of the lawn, a strategically placed flowerbed, or (if you are Cheeto Satan) a $65 billion wall between countries. What all of these borders, imaginary or actual, have in common, is they separate me from the rest of you in some way, or us from them, or my yard from your yard, or my body from your body, or my time from your time. Stepping across the line means I am choosing to merge some part of myself with you.

As a counselor, having boundaries means that I must keep our relationship confined to the counseling setting. It’s a bit odd, this particular boundary because while you (the counselee) may chose to tell me (the counselor) many intimate details about your life, I will not reciprocate with intimate details of my own. Normal relationships (friendships, intimate partners) rely on the mutual sharing of such information across boundaries to create a sense of closeness. You tell me an intimate detail, a secret, something you’ve not shared before, and I reward you with a secret/intimate detail of my own, our friendship grows, intimacy flourishes, the exchange is reciprocal.

Not so in counseling or therapy, which works differently. You tell me (the counselor) a secret, and I reflect it back to you, usually with a question. Something like “what meaning might you assign to the anger you have for your father?” or “what would it mean to you if she asked you out on a date?” or “how has being abused as a child affected your parenting of your own children?” Or maybe even (if I’m feeling stuck) “how do you feel about that?”

As a counselor, I have to have Boundaries because how helpful would it be if you disclosed your traumatic childhood to me, expecting insight and healing, and I said to you “Wow! My childhood was traumatic too”? Or, even if I did determine that some level of self-disclosure might be warranted (a quick rule of thumb re: self-disclosure: it can be ok if it helps the client, but not if it’s only for my own sake, i.e. to make me feel better), how helpful would it be if I confused you by having loose boundaries in the therapy room but then ignored you when I ran into you at the supermarket? If I took your money (or insurance payment) under the auspices of helping you but came to rely on your feedback and your insights? If you leave a counseling session knowing more about your therapist or counselor than he/she knows about you, somebody’s Boundaries are too loose.

Therapy is a very specific sort of exchange, one that depends on firm Boundaries. Less than firm Boundaries create all sorts of havoc and may result in the counselor or therapist losing their license. Lapses in ethics often result from lapses in Boundaries and can be a very slippery slope. Loose Boundaries can lead to inappropriate friendships and perhaps even sexual liaisons between therapists and clients. Sleeping with a client is never a good way to help them heal. It might make the client feel special initially, but will eventually destroy them (and probably the counselor as well).

Even something as seemingly benign as a friendship can become problematic between a therapist and client. As your friend, I have a vested interest in telling you things you want to hear, things that will keep you as a friend. As your therapist, I have a duty to tell you things that you might not want to hear but need to, things that will help you heal and move forward, things that a friend wouldn’t tell you. Boundaries make it possible for me to be your counselor.

Confused yet? It’s tricky, I know. But trust me, this is one lesson you’re better off NOT learning directly.

Related Haiku (this is an old one, but relevant)

Please do not invite
me in and then abandon
me at the threshold

The Pinocchio Paradox, or How to be a Real Counselor

Published on by Pam11 Comments

“The doctor is effective only when he himself is affected. Only the wounded physician heals.”                                                                                                                                         —Carl Jung

methow morning
My writing table in the Methow Valley

A year ago I sat at this very table faced with the onerous task of writing a final class paper. Again, I have the same chore in front of me, albeit for a different class. Back then, I had to write a proposal for a group therapy group. Now I must reflect upon my time as a practicum student, as a fledgling counselor seeing clients for the very first time. What are my strengths? What are my weaknesses? (No, it doesn’t say weaknesses, the assignment says “areas of growth” but we all know what that really means). What did I learn about my clients? How did I experience myself in supervision, and how do I want to grow in this area?

Let me just say this at the outset: seeing clients for the first time, the first two, three, four, five times is flat out terrifying. I’ve had two years of classes and coursework preparing me for sitting in a room with someone who wants help. I’ve participated in numerous role-plays and fish bowls and practice sessions with my student colleagues. I’ve had more personal therapy than the average bear over the last twenty-five years, and still. What can I possibly do for the anxious or the depressed, the overtaxed, the under functioning, the overcompensating, the abandoned, the unloved, the overachieving, the lonely, and the traumatized who sit in the chair across from me?

How can I possibly help?

For years I wanted nothing more than to be a therapist. The women I most admired were the ones who had listened from that chair as I unburdened myself of my anxieties, depressions, anguish, loneliness, and traumas. I thought about how amazing it would be if I could bring the same sort of listening ear, the same sort of compassion, the same sort of hope to others that these women had given to me. But I didn’t think I was healthy enough to be a counselor. I didn’t believe that I had the capacity to help myself, let alone anyone else.

But then in the spring of 2013 I had a chance encounter with the author Claire Messud who wrote The Woman Upstairs and The Emperor’s Children. We chatted about her character Nora and what happens to us as we age and begin to realize that perhaps our previously unlimited horizons are shrinking. At some point, Ms. Messud said to me, you wake up and realize that you simply don’t have enough time left on this earth to fulfill all of your dreams. Where once so much was possible, you begin to grasp the reality that you’ve reached a point where that is no longer the case.

That is when I understood that regardless of what I thought about my own mental health or lack thereof, if I didn’t do something about pursuing my dream my horizon would shrink even further. If I didn’t enroll in school soon, my dream might slip away. I signed up for the necessary prerequisites and enrolled at Antioch a few months later.

And what I’ve learned in the time since then, and particularly this quarter as I’ve worked directly with clients, is that my experience on the other side of the couch, my years as a client, what I previously saw as my greatest weakness, is actually my greatest strength and most valuable asset.

What I have learned in practicum and in supervision is that I am enough. Who I am is precisely what I need to be to be effective with clients. I haven’t learned this from my clients. I’ve learned this from my peers primarily, and from my instructors, and from my own therapists. And slowly I’m beginning to see it for myself, from within myself. And that’s the thing—we usually can’t see in ourselves our own strengths. As I move forward into my second quarter of practicum and then into a full year of internship, my greatest opportunities for growth will be in recognizing my own strengths and trusting my own wisdom, sourcing my confidence from within rather than looking to others to reflect my strengths back to me.

I’ve learned from my clients that they too have all they need within them and simply need to be heard, to be given a chance to lay their vulnerabilities and fears out there in order to sort through them, evaluate and ponder, decide what’s working and what’s not, learn how to hang on to the useful and discard the useless. While self love and self compassion are the ultimate goals, sometimes we need external validation from someone we trust, someone whose values align with our own, someone who can see what we’re seeing and tell us we aren’t crazy or imagining things. Sometimes we just need to be seen and heard in a world that seems to be ignoring us.

I learned basically the same thing in supervision that I learned from my clients—I learned to trust myself, that I didn’t need to put on a persona or be an all knowing font of wisdom or channel the great mystics of the ages. I learned to be real, to be myself,

The actual Pinocchio
The actual Pinocchio

to trust my instincts, and to be present. I learned that I am enough and to bring my self to the sessions. I think my greatest learning this quarter came when I was seeing my own counselor and parsing through my anxieties about practicum and seeing clients. She stood up and walked over to a cabinet near me, opened the glass door and took out a porcelain Pinocchio statue. She set Pinocchio on the small table between us and asked me what Pinocchio wanted more than anything.

“To be real,” I answered. “He wanted to be a real boy.”

“Exactly,” she said. “Don’t be afraid to be real, Pam. When you are real, you are enough.”

 

 

 

 

C is for Counseling, or How I Got into this New Gig

Published on by Pam12 Comments

 

CTurns out that April is Counseling Awareness Month. Isn’t this just a serendipitous turn of events? I’m writing a blog a day, A to Z about my adventures as a graduate student in Mental Health Counseling and the American Counseling Association is making it a special month. Pretty sure I can’t take credit, but still . . . (maybe tomorrow I’ll tackle Delusional and Diagnosis).

I have a long history with counseling. I started seeing a psychologist in 1992 and have been in therapy of some sort consistently since then. For a long time, I thought of myself as having a serious character defect. I was young. I didn’t really understand how counseling worked, or could work. I had only a vague notion of Freud and his couch and Woody Allen’s neuroses.

Prozac and SSRIs hit the market about the time I began therapy* and not long after my psychologist diagnosed me with depression, she and my general practitioner agreed I would do well to try the new wonder-drug, Prozac. And, honestly, I looked forward to some relief. At 29, in 1992, I was a fairly new mom of an adopted bi-racial daughter, in a relationship with a woman 13 years my senior. I had just sold the bookstore I started, owned, and operated for three years, and I had moved back home full-time after living 90 miles away for most of each week. To complicate things, my fundamentalist Christian parents were only just beginning to adjust to my, er, lifestyle (as we called it then) and its unconventionality.

There’s more, but that’s enough. You get the idea. I was a stress monster. The crinkling of a tissue set my teeth on edge. The noise of someone actually blowing their nose sent me over the edge. The first time I swallowed one of those little green and white pills, I felt like I was taking communion. I crossed myself and sent up a prayer.rumi

After four weeks of taking that precious little capsule every morning, I no longer cared who sneezed or how loud. Irritation rolled off my back. The grey veil that separated me from the rest of the world lifted, and I started seeing in color again. Cliché, I know, but accurate. Everything sparkled. I got a good job as the bookstore manager at the local technical college with a great boss as well as health and retirement benefits. Did the little pill have anything to do with my new job? I believe happier, less-stressed, less-depressed people tend to have more self-confidence and do better in job interviews, so yes. But I digress.

I felt good, and I loved talking to my therapist. I loved paying someone to listen to me. I loved the 50 minutes of uninterrupted attention. I could do this for a living, I thought. I’d love to listen to people’s stories, to help them make sense of their feelings, to help them gain the confidence to reach for their high dreams. I had no idea that someone who went to counseling could actually ever become a counselor. I thought my diagnosis and being on meds precluded me ever being in the field.

I had never heard of Jung’s Wounded Healer. I was an English major who, stupidly and stubbornly, avoided all social science classes. The books cost too much. The classes met on Fridays. What can I say?

I wanted to get off the meds, though, yet every time I quit taking them, things in my life would head south, and the psychologist would exhort me to stay on the meds. I got stuck in a loop and never really got to the issues that were causing me to become depressed. I’d just start popping the pills again, and things would improve. Etc.

franklquoteI spent about twenty years with the psychologist before I found a new therapist, and the woman I chose to see was an LMHC (Licensed Mental Health Counselor). I didn’t know what the difference was when I made the switch, I was just seeking someone a little more flexible and spiritual, a little less dogmatic and not so pharmacologically oriented. Turns out the switch worked very well for me then. I made several changes in my life at the same time: I got a new job, I relocated, I started taking writing classes and running, and found new community with both activities.

The psychologist got me up and out of the depression and quite literally saved my life on many occasions. And the LMHC has helped me move forward from there, developing self-confidence, practicing mindfulness, introducing me to non-Western philosophies. I have learned so much about myself, about why I am the way I am, and how I can move forward.

I’ll never be done working on myself, but it turns out, I can become a counselor anyway, not in spite of my past, but because of it. Jung believed that disease of the soul could be the best possible form of training for a healer. And as Victor Frankl wrote, “What is to give light must endure burning.” By these measures, I am perfect for this job.

*for a more in-depth—but still inadequate—explanation of the differences among therapy, counseling, psychotherapy, and psychology see this previous blog

A is for Ack! It’s April Already and I am Anxious

Published on by Pam9 Comments

AI can’t believe I haven’t finished my first blog for the A to Z challenge yet. I’ve been thinking about it for weeks, planning, scheming, writing it in my head, but clearly I’ve not put any words down yet. Until now. These few, uninspired, last minute words that seem so unequal to the task, so small and worthless and hurried.

A is for Apology, apparently. Abject. Abysmal. But I’m at AWP this week, a conference all about writing, and so, apology or not, abysmal or not, tired or not, write I must.

I am going to write about Anxiety. My plan for this year’s A-to-Z Challenge is thus: I want to spend this month writing about my experiences as a student in the Clinical Mental Health Counselor Program at Antioch University. I want to weave together a narrative, exploring the concepts (from A to Z) that I study as a student of mental health counseling and how my studies intersect with my life. How my coursework shows up in my day-to-day world.

I haven’t studied Anxiety, per se. I have taken many relevant classes, delved into the DSM 5 and learned how I might diagnose a client who presented with symptoms that fit the criteria for, say,  Generalized Anxiety Disorder (GAD). I learned to write a treatment plan and theorized about which therapeutic modality I might employ to best help my client regain his or her equilibrium.

Most of what I’ve learned about Anxiety comes from first hand experience. I am not one who has been plagued with Anxiety for much of my life. No, my familiarity with this particular demon has only been recent and is one of the reasons I started running regularly a little over two years ago.

I started waking up in the mornings with a pit of dread churning in my stomach and found that if I went for a run, somewhere around mile two or three, the pit of dread loosened and eventually abated. I guess the endorphins kicked in, the oxytocin released, and the runner’s euphoria lifted the anxiety. Cured, if only temporarily, I could get on with my day. The next morning, the anxiety would return, and I’d start over. Run. Rinse. Repeat.

A nice side benefit to running off all my anxiety was that I started to lose weight. I felt healthier. My blood pressure dropped, as did my cholesterol, and my pants size. But, I digress. I still woke up most mornings feeling like something horrible was about to happen. I kept waiting for the other shoe to drop, for the axe to fall, for the bottom to drop out, for . . . well, you get the picture.

Anxiety chased me into my running clothes and out of the house each morning. But the thing about being a graduate student in a counseling program is that these sort of disruptions don’t slip by unanalyzed. While one part of me succumbed to the anxiety, another part of my tapped my forefinger thoughtfully against my chin  and asked, “How do you feel about this, Pam Sue?”

Some people have angels and demons sitting on their shoulders. I now have Sigmund Freud and Carl Jung, or their modern day equivalents, Jack Cornfield and Tara Brach. I can have a panic attack and simultaneously know for certain that while what I am experiencing might feel real, it isn’t true.

It’s weird, living with this meta awareness. I had all sorts of anxiety about traveling to AWP this week–logistical stuff that I know I’m capable of handling but for whatever reason just kept spinning on: how am I going to get to Sea-Tac from Bellingham? To the airbnb from LAX? I can’t check in until 4 p.m., but I arrive at 9 in the morning. What would I do? These questions dogged me for weeks. I envisioned myself in dire circumstances, dragging my carryon around LA for hours, sad and alone and dazed.  Yet, I simultaneously knew my fears were unfounded and not based in reality. I could make a shuttle reservation, find a friend to stay with in Seattle, even one who might take me to the airport. I just couldn’t see the logical steps in the midst of my anxiety.

Something similar happened when I realized how expensive it was going to be to eat and drink here in Los Angeles. The first day I spent way too much money on so-so food and paid $8 for a mediocre beer. So, I took myself to the grocery store, but instead of going shopping at the end of the day, when the conference was over, I went in the morning on my way to the conference and so had to schlep my groceries around the conference hall, from one panel discussion to another.

I was so anxious about not having drinking water back at the airbnb that night, I bought a six pack of bottled water and stuck it in my already heavy backpack. All the while I’m hearing Jack and Tara on my shoulders, telling me not to believe the anxiety, reassuring me that all will be well, that I will be fine, that there will be water at the conference. That the universe will provide.  But, do I listen? No. I buy the water. And I vow to do better tomorrow.

 

 

 

Getting My Counseling Feet Under Me (or I’m Two Years into This Program, are We Done Yet?)

Published on by Pam4 Comments

Writers and therapists live twice—first when they experience events and a second time when they use them in their work. Mary Pipher, Letters to a Young Therapist

A few months ago, I met up with a former therapist, a woman I hadn’t been to see in about 20 years and who had since retired. I wanted to talk to her about adoption and addiction since she had been known as something of an adoption guru while she was still practicing. As I explained my course of study and my intentions for becoming a counselor, she exhorted me to pick a theory, a modality to call my own. “You need to decide which theoretical model you’ll work from,” she said. “You need to pick one to ground yourself in and work from there.” She then ticked off a list: Bowen, Adler, Rogers, Jung. I looked across the table at her and shrugged. “I think they all have something to offer,” I said. “I guess if I had to describe my orientation, it would be diverse.”

“That won’t do,” she exclaimed. “You need to be grounded in something. Anything. Just pick one. Bowen is good.”

parents cartoonI shook my head slowly at the thought of Murray Bowen taking up permanent residence in my head. Sure, I can see the value in looking at a person’s issues through the lens of intergenerational patterns and family systems, but as my only, primary orientation? No. So many others had much more to offer, from Jung’s wounded healer to the post modernists and narrative therapy, feminist theory, attachment theory. I couldn’t imagine latching onto just one way of being a counselor when so many modalities offered so many ways to work with people with a variety of needs.

And now this quarter we added Carl Rogers’ Person Centered Therapy and his Unconditional Positive Regard, along with Fritz Perls and Gestalt, John Cabot-Zinn’s mindfulness as well as Pema Chodron to the mix. I am even more convinced that limiting myself to one theoretical lens would be a mistake. Shortsighted.

The metaphor is overdone, but apt—the more tools I have in my tool belt, the more useful I can be to more people. Every client is going to be different. I need to be able to adapt. There aren’t many similarities between working in technology and working as a counselor, except this one: sometimes there are a variety of ways to approach a problem and finding a good solution is often a matter of “testing and tweaking” to see what works best.

As a writer, reader, and storyteller, I’ve always found narrative therapy to be the modality that draws me in. I am attracted to counseling for the same reasons I am a writer—I want my misery, and indeed everyone’s—to be meaningful. As Mary Pipher writes in her Letters to a Young Therapist, as counselors and writers, we get to use our experiences twice and encourage others to do the same. Additionally, I am attracted to narrative therapy’s post-modernist bent, the idea that it is not the individual who is sick, but the culture in which the individual lives. That depression, anxiety, PTSD for example, are legitimate responses to living in a culture that too often demands we abandon our authentic selves. Not to mention that we live in a world that insists on dividing us by race, socioeconomic status, ability, sexual orientation, gender, ethnicity, religion, and more.chickencouch

I began this graduate program with the vague notion that I would emerge in two years, somehow qualified to sit and listen to people for a living. As I progress through each quarter, I become evermore convinced that two years is not nearly enough time in which to prepare me to not just listen to people’s stories, but to help them make sense of their stories, make meaning in their lives, forge on into the future with hope and a sense of purpose, with a deeper understanding of what serves them, what doesn’t, how to make good choices, how to hold onto their dreams, how to have a voice, leave an abuser, nurture their children, their relationships, find meaningful work.

How do I become that mirror, sounding board, holder of stories, cheerleader, confidant, advocate?

From the client side of the couch, I have found Gestalt and mindfulness to be the most effective therapeutic methods. Most breakthroughs in my personal therapy have come when I’ve been talking to the chair, role playing, or acting something out with my therapist. Mindfulness and meditation have worked for me outside of the therapist’s office as a way to self-regulate and deepen personal awareness. So, it’s not really surprising that over the course of this quarter I have gravitated to both, though I see Gestalt methods as being more relevant to therapy and mindfulness as a useful (and indeed maybe even necessary) adjunct for clients to use between sessions.

Gestalt therapy with its focus on the body/mind connection, lends itself well to supporting other interventions and modalities. Rogerian Person-Centered Therapy (PCT) with its mandate for unconditional positive regard seems like it should underlie every therapeutic encounter, particularly the initial few sessions.

chairGestalt works well, too, with mindfulness, attachment, and sensorimotor therapies, which focus not only on how the body holds trauma and past experiences, but also on awareness and connection between the client and therapist. By encouraging clients to stay in the here and now, Gestalt leaves room for the therapist to introduce the client to mindfulness techniques which support being present and staying in the moment when things get emotional or difficult in session.

In my initial session with my practice client, employing PCT worked well to establish rapport and an initial baseline of trust. Once we got to the primary issue, however, Gestalt would have been a great way in to exploring how she was feeling in the “here and now.” I might have employed the empty chair technique had the session gone longer—I could have had my client talk to any number of representatives from her past: her parents, her younger self.

I also might have had her explore her stress about her issue and how it was sitting in her body—what does the stress feel like? Look like? How big is the stress? What color is it? Where does she feel it the most? My therapist often tells me to invite my distressing emotion in rather than trying to banish it. “Invite the stress in,” she says. “Ask it what it wants. Have tea with it.” This technique, of anthropomorphizing the disturbing emotion or feeling and dwelling on it, illustrates one way of working with an issue. When we avoid something, it gets bigger and more intense. By inviting our distressing emotion in and asking it to stay, by getting to know it, we rob it of its power.

In our second practice session, I employed both Gestalt and mindfulness (as well as Roger’s unconditional positive regard), encouraging the client to make her physical agitation bigger (I had her stand up and shake out her anxious feelings) and to incorporate some breathing techniques. This session took the client deeper emotionally than the first session, even though both sessions lasted about 20 minutes and demonstrated my improved ability to sit with a client in their discomfort. I was able to witness her experiencing emotion and hold the experience rather than try to rush her through it in order to alleviate my own discomfort.

As always, I need to be mindful of my clients’ particular culture. Every client, regardless of how they present at first glance, brings with them an individual set of circumstances that sets them apart from every other client. To be an effective therapist, I must refrain from making assumptions, and instead listen, learn, ask clarifying questions, and give the client the space and safety they need in order to fully reveal themselves, their wants, their needs, their problems.lucy

Probably one of the most challenging aspects of counseling this quarter has been keeping tabs on my biases, assumptions, and privileges. While I am nearly always aware of my sexual orientation, my age, and do think a lot about race and how these parts of my identity might influence my interactions with a client, I’m not always thinking about ethnicity, socioeconomic status, or disability. We are, often and on the surface, a homogenous population at Antioch. I have not counseled a person of color or a person with a visible disability. I’m sure I’ve worked with clients who come from a different socioeconomic background, and though I am currently as broke as the next graduate student, I do have to remind myself that I come from a relatively privileged background and have robust support systems should I need them.

As this quarter wraps up, I feel as if I am finally getting my counselor feet under me, that I can work effectively and comfortably within a specific therapeutic framework. This quarter is the first time I have experienced authentic connection with a client, where I seem to have actually helped another person via a counseling session. I am excited to hear my clients’ stories, to listen to them as together we find meaning in and a way out of their suffering.