Stained? Mental Health Services, Spaces and Shame

June 6, 2017 / Lavender L.  / 
spill, stain

Dear Outpatient Clinic,

I won’t be coming to my next appointment; please transfer my medical records to the address below. Judith Lewis Herman, who first characterized complex PTSD, calls it a “shame disorder” [1]. The inability to act when the self is at stake causes a person to doubt, even to loathe, herself. Trauma is shame; complex trauma is shame that lasts long enough that there is very little ‘self’ left by the end. Trauma is one type of loss of self. Depression, anxiety, and many others – often in tandem – also chip away at the self-worth of your clients.

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Here Comes the Sun…How it feels when you find the right therapist

May 16, 2017 / Amy Krolak  / 
therapist, sunshine

“Little darling, I feel that ice is slowly melting
Little darling, it seems like years since it’s been clear
Here comes the sun
Here comes the sun, and I say
It’s all right…”

Here comes the sun

I don’t know about the rest of you but song lyrics (like this one from the Beatles) often intersect with my thoughts. When I was thinking about what it feels like to find the “right” one, sunshine definitely comes to mind. I have turned to various practitioners to help me with physical and mental health issues over the years.

As a teen, my mother thought a family counselor, available through the University where she was a student, could help our broken family. My memory is we had one session and it wasn’t successful. As a college student, I availed myself of several sessions of free counseling. Ok… but not life changing. My doctor recommended a couple of sessions with a psychologist during a stressful pregnancy and anticipation of two children very close in age. This was really helpful and I will always be thankful for this time. I did end up going back to see her after the early death of my mother due to cancer. Through the therapist, I ended up seeing a Psychiatrist and began taking medicines, for ADD, Depression, and Anxiety and would need to continue seeing him for medical Management.

I heard once that 1 in 5 people are affected by some type of mental illness but many do not ever seek treatment. The Huffington Post notes that. “Psychologists attribute this low rate of treatment to the stigma and many myths attached to seeing a therapist. Among them, the concern that only ‘crazy’ people need therapy or that accepting help is a sign of weakness or that the treatment options will be time-consuming and expensive. These are not true, says psychologist Mary Alvord, Ph.D.” 

Success isn’t easy

Not everyone has success with their practitioners. Is it due to a poor connection, incompetence on the part of the provider, dishonesty and unwillingness on the part of the patient? It could be all or none of these things. But how does one go about choosing these people to help them?

Before you hire someone, think about the following questions (from therapyreferral.org):

  • What do I want to accomplish in therapy? Do I know what my goals are?
  • What kind of approaches am I most drawn to? Am I interested in dealing with a current concern? Do I want to work on underlying emotions or patterns? Am I in need of immediate assistance?
  • How important is it that the therapist has similar values, race, spiritual beliefs, sexual or gender orientation, or life experience to mine?
  • What’s my financial situation? Do I need to use insurance to offset the cost of therapy?
  • When am I available and what locations work best for me?
  • Am I unsure of what I want or even if I want therapy? (It’s okay to not know what you want or have mixed feelings about approaching therapy!) 

When I was experiencing symptoms of increasing depression and panic as I entered into the empty nest syndrome, I sought out a new therapist. A friend was working with a wonderful woman, who she recommended to me; it was an immediate match. I had prior experience with people who I didn’t mesh with. Over the last nine years, I continue to grow in all the ways that we have been setting goals about. I would certainly recommend her, however, it’s not a one size fits all situation.

So how do I find my match?

The following information will be helpful to those who are seeking help from professionals. According to the Good Therapy website, “The help of the right therapist can promote self-actualization, empower self-growth, improve relationships, and reduce emotional suffering.

“Therapy is about the fine art of asking directive questions. So what should you expect from your first appointment with a counselor, social worker or psychologist?”

  1. What brings you here?
  2. Have you ever seen a counselor before?
  3. What is the problem from your viewpoint?
  4. How does this problem typically make you fee
  5.  What makes the problem better?
  6.  If you could wave a magic wand, what positive changes would you make happen in your life?
  7.  Overall, how would you describe your mood?
  8.  What do you expect from the counseling process?
  9.  What would it take to make you feel more content, happier and more satisfied?
  10.  Do you consider yourself to have a low, average or high interpersonal IQ?

Source: https://psychcentral.com/blog/archives/2014/10/24/10-introductory-questions-therapists-commonly-ask/

Therapy models

There are many models and types of therapy to choose from. We believe there are a handful of common denominators present in all forms of healthy, ethical therapy. These elements are described here:

  1. Nonpathologizing: Viewing a person as greater than his or her problems is the hallmark of non-pathologizing therapy. It does not mean problems do not exist; rather, it means one does not view the problems as the whole person. Working nonpathologically requires a shift in both the understanding and the approach to pathology.
  2. Empowering: Therapists who empower the people they work with in therapy maintain the belief that people have the capacity for change and are equipped with the inner resources to change, even if they never do. Therapy is based on the belief that people can heal if they want to and if they are able to contribute to their own growth what is sufficient and necessary.
  3. Collaborative: The spirit of collaborative therapy is summarized in the words of Albert Schweitzer who wrote, “Each patient carries his own doctor inside him… We are at our best when we give the doctor who resides within each patient a chance to go to work.”
  4. Focus: Therapists generally love working with people and tend to be empathic and big-hearted. There is no doubt that providing psychotherapy is gratifying and rewarding for most therapists. Although therapists witness the damage caused by the worst life has to offer–such as emotional abuse, trauma, or violence–they can be rewarded by being present with people during some of their greatest aha-moments, unburdenings, and transformations.
  5. Self: Self is a state of being that a therapist can embody when working with people in therapy. Richard Schwartz defines Self as a state of calm, curiosity, compassion, creativity, confidence, courage, connectedness, and clarity. Self is considered a requisite of good therapy because it is this state that allows a therapist to work collaboratively without pushing, without pathologizing, and without retraumatizing.
  6. Relationship: Beyond technique and theory is the realm of the relationship: the ongoing human-to-human connection that provides the foundation for change.
  7. Depth: Therapy often times needs to “go deep.” There seems to be a split in the mental health field between types of therapy that emphasize cognitive solutions and those that emphasize emotional or body-oriented healing. Addressing the source of pain is not always easy.

Good Therapy Is Imperfect

The phrase “good therapy” encourages a misconception: the idea that there is such a thing as pure good therapy, a process exempt of any problems or issues. In the same way that a good marriage or relationship is not one without problems, but rather one that works through problems, good therapy will not always be free of difficulties.
Sometimes We Can’t Help: As therapists, we are limited. We greet the people we work with great hope. We have spent countless hours studying our trade, doing our own inner work, mastering our technique, and learning to “be” with the people who seek our services.

Source: http://www.goodtherapy.org/what-is-good-therapy.html

Other sources used:

https://www.nami.org/Learn-More/Treatment/Mental-Health-Care-Professionals
https://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml

The Liberating Unknown

January 8, 2017 / Alex Hanna  / 
open road, liberating, unknown, freedom

As many of you read, I wasn’t doing too well a few weeks ago. A visit from my family soothed the burning wounds for a short period of time, but still they were raw. This slight reprieve encouraged me to head back to Pittsburgh with my mom and spend a few days at home with her, my dad, and my sister. Something which I hoped to be liberating.

The only thing that troubled my mind was that my dad and I bought the wrong sized dowels at Home Depot and we had to make a return trip. Other than that, the change in scenery was exactly what I needed.

A much needed getaway

After a pleasant and refreshing weekend, I flew home. It was a cool fall day, and while waiting at the airport, I had a chance to sit and reflect. I reflected upon how lucky I was (and am) to have such a loving and supportive family, spouse, and friends. I reflected upon the fact that this illness is more serious than I want to admit. I reflected upon the truth that this illness is bigger than me – and that I cannot beat it alone.

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