To New Beginnings!

Hey Readers,

I know it’s been a minute, but I swear I have a good reason–as of this month, I am now in private practice! Unsurprisingly, I’m specializing in grief and trauma. My goal is to have at least a certificate in Thanatology by the end of the year.

I want to also say that I have loved my 3+ years at various mental health organizations. It provided me with incredible opportunities for professional growth (not to mention, allowing me to put my existential navel-gazing to good use). I realized when I was wrapping up at my previous job just how many different clients I’ve had the pleasure of working with over the years. Each one had a different diagnosis and with each discharge, the breadth of my experience sank in a little bit more.

I’m currently pouring a lot of time into my new self-care project, afternoonified.art, where I draw people who both do and do not exist. I’m really getting into portraits that tell a story without using the face as well.

My internal weather is certainly changing in a positive way, and I hope it’s not too forward to share this leg of my journey with you. After all, we’ve only been together for eight years now. (We have to stop meeting like this; people will talk.)

Until next time, stay sane and safe! Know your worth; then add tax.

I aced the quiz! Part One: Know thy enemy.

Disclaimer: The information contained in this post is not intended to diagnose or treat any condition. I am a licensed therapist, but I am not your therapist. 

I ACEd the quiz! Tongue firmly in cheek, of course. There is no quiz, but today I would like to touch on trauma and its physical effects–hence the reference to ACES, or the Adverse Childhood Experiences Scale.

As any even casual reader of the blog knows, trauma is kind of My Jam. I love working with clients who are struggling with the same core issues I struggled with the first 20+ years of my life. I knew that was going to be bailiwick from the time I started therapy myself, at 18, but I didn’t really do much with it until I entered grad school and suddenly had to write a thousand different papers (that were not centered around arguing whether the box of money in Faulkner’s The Sound and the Fury is actually a box of shit. Look it up. It’ll change your life).

When I got my very first assignment, my brain went “PING!” and told me trauma was the area to hit. It’s a touchy area, for sure. Go too fast, and you risk re-traumatizing your client and damaging rapport. Go too slowly, and your client will stagnate. It’s like a dance.

The ACES study began in an obesity clinic in 1985, believe it or not. Physicians were interested in figuring out why people kept dropping out of their weight loss program; long story short, they developed the Adverse Childhood Experiences Scale and administered it to their patients. The results were unprecedented: they uncovered a link between childhood trauma and struggles with controlling their weight later in life. 

I’d love to wax poetic about the biology of chronic stress and implications for adulthood, but that needs its own post.

On to the significance of ACEs. The instrument itself is simple–ten self-report items, scored either “0” or “1.” I’ve re-typed it here for the sake of your eyes, but you can see the original and lots of great info on acestoohigh.com.

To avoid inadvertently triggering readers, I’m going to put the actual scale underneath this spoiler tag, as the questions do involve all forms of child abuse.

On Vulnerability

There are so many words in the English language relating to innocence and vulnerability, and most of them can bring me way down if I’m not careful. They provoke some ancient anxiety that I’ve come to realize, with the help of my excellent therapist, are linked to what she calls my “wounded younger self.” (I was incredibly skeptical of inner child work at first, but it is incredibly effective and incredibly healing.)

“Little” is an adjective that, when paired with certain words that also remind me of innocence, usually messes me up emotionally. That’s the word that got under my skin tonight.

I’ve been feeling kind of “off” the last few days. I recently blocked my mother completely on my phone–including the second number I thought she’d deleted until she used it to contact me after I blocked the first number–and was treated to some really unsettling dreams on Monday and Tuesday night.

Monday’s main feature involved me skipping my grandmother’s birthday party because my mother was going to be there and I knew she’d be drunk. Tuesday’s late-night horror show involved a healthy helping of guilt because I was hiding from her (in a Target, of all places) while she wailed and lamented that she “couldn’t believe [I] didn’t want to talk to her.”

Naturally, this put me in a pretty weird headspace today. Wednesdays are my big clinical days and I do group as well as individual client work. As such, I generally store my feelings away to deal with later and do a pretty good job of not thinking about them at all during the day because I’m 100% focused on my clients. (Side note: I adore them, and I’m bummed that I’m leaving my practicum site in a few weeks!)

On the drive home from class this evening, though, those neglected feelings reared their ugly collective heads and roared.

The anxiety and guilt were so powerful that I considered just going to bed early and sleeping it off.

Instead, I took a shower.

I focused hard on those thoughts and attempted to get a good, cathartic cry in. Nothing happened.

I turned the focus to that wounded younger self I mentioned and took the opportunity to literally hug myself while I waited for the conditioner to work its magic on my decidedly unruly hair. I decided to speak aloud because I’m home alone most days during the week and hey, I knew the cat wouldn’t judge me. (Audibly, anyway.)

I told my younger self that it’s okay. I told her I love her and that I’m sorry she felt like no one could keep her safe. I told her that I’m going to do it. This changed into me speaking to whatever hypothetical future child I’ll end up having. I promised that child to take the best care of it I can and to make sure it never feels afraid or lonely.

And I cried. Instead of stifling it or trying to be tough, I gave myself over to it completely–ugly, wracking sobs. After a while, those sobs turned into relieved laughter that I’m sure sounded like I’d finally gone completely ’round the bend.

I think there’s something to be said for having a good cry.

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On Monday, I spoke to my clients in group about the concept of “ghosts”–they had all shared some intense and profound stories about their deepest wounds, their secret shames, their most painful memories. I told them that while they can haunt you, they can’t physically hurt you. You can start to let go of them.

I led them in one of my new favorite exercises, which is “HA!” breathing. Basically, you take a deep breath and push that breath out while making a “HA!” sound. I opened the group with the exercise and invited them to imagine themselves yelling at someone or letting frustration out. I demonstrated (because I am not afraid to look silly anymore), and they loved it. After the big, intense sharing session, I led them in the exercise again, this time instructing them to imagine the “HA!” on the exhale as them blowing out part of their ghosts.

I’m glad it was a hit, and I encourage you all to try it, readers. Howling into the void or, as I called it, “therapeutic yelling,” is incredibly cathartic.

 

News Day Tuesday: Digital mental health care

This week, I’d like to touch briefly on digital mental health care, which has become increasingly popular. I recently applied to work as a volunteer with Crisis Text Line, which is an awesome resource that allows people in crisis to communicate with trained volunteers via text message.

I’m still waiting for one more letter of recommendation, but if I’m approved, I’ll get to counsel others via text–how cool is that? It’s a four-hour-a-week commitment that lasts for one year, and I’d definitely encourage anyone with an interest or background in mental health to consider applying.

From Crisis Text Line’s website:

1. We fight for the texter. Our first priority is helping people move from a hot moment to a cool calm, guiding you to create a plan to stay safe and healthy. YOU = our priority.
2. We believe data science and technology make us faster and more accurate. See our Founder’s TED talk for more scoop on how we’re using this stuff. While we love data science and technology, we don’t think robots make great Crisis Counselors. Instead, we use this stuff to make us faster and more accurate–but every text is viewed by a human.
3. We believe in open collaboration. We share our learnings in newsletters, at conferences and on social media. And, we’ve opened our data to help fuel other people’s work.

This article from Scientific American examines digital mental health care and its pros and cons. I’m a huge fan of anything that allows people to get the help they need, and many people simply don’t have the means to physically attend therapy due to income, transportation, disability/illness, or other factors.

The article also raises very valid concerns about “impression management,” or the tendency clients have to only share information that is likely to make the therapist think positively of them. On the one hand, many people find it easier to express themselves through writing; because there are barriers between the writer and the reader, people may share more freely than they would in person.

On the other, it’s hard to overstate the importance of face-to-face interaction, particularly in a therapeutic environment. Being able to see the client allows the therapist to assess the client’s nonverbal cues, such as body language and facial expressions. This, in turn, can help the therapist direct the session in ways that make the experience as comfortable and productive as possible.

What do you think, readers? Would you be more likely to “talk” to a counselor via text, or do you prefer old school face-to-face therapy? Personally, I’m all for attacking issues from every possible angle, though I haven’t tried digital counseling myself (yet). If anyone has personal experience with digital mental health care and would like to share their story, please do! I’d love to hear from you.

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