Ambiguous Grief
How are you coping this holiday season?
In response to the latest restrictions involving social gatherings and measures that have been taken in general to stay safe with Coronavirus, things will look much different this year. I know for myself, I will be celebrating at home. The physical presence of family/ friends who usually gather at this time of year with me will be missed. Many of us are mourning the loss of holiday traditions as we know them. I describe it as an experience of ambiguous grief. While our loved ones may still be alive and even live nearby, they can feel distant. The physical separation can be such a painful loss. I am grateful for the advances in technology that have allowed us to continue work, school, and social interactions in ways that would otherwise not be possible. This does not; however, replace the experience of meeting someone face-to-face and sharing an embrace. Parents, grandparents, friends, and family are grieving as they mourn ambiguous loss, perhaps searching for answers to bring some comfort.
The loss is ambiguous as we are uncertain how long it will last. The effects of prolonged uncertainty take both a toll on one’s physical and mental well-being. Many people have already lost so much…jobs, financial security, COVID-related deaths. Accomplishments such as graduating high school/ college and celebrations such as birthdays and anniversaries have looked different as do the holidays. The stages of grief can be helpful to recognize and name some of the emotions you may be feeling right now. Denial. Anger. Bargaining. Depression. Acceptance. There is no “right” way to grieve and this will look different for each person. For some, acceptance may come faster than others and we may go back and forth among various stages.
So what now?
One thing that has been helpful when feeling a strong difficult emotion is to think in terms of opposites. Recognizing ambiguous grief, leaning into the emotion to mourn and move through it as we grieve with others can provide space to celebrate what remains. As we enter into a season of Thanksgiving, I am choosing to express gratitude–to notice and appreciate the important people and things that remain in my life. One theme that has definitely come up this year is noticing what really matters when you begin to remove all the distractions from life.
For those of you who watch Charlie Brown around the holidays, I am reminded of the Charlie Brown Christmas tree and Linus’ response to “I never thought it was such a bad little tree. It’s not bad at all, really. Maybe it just needs a little love.” Here are some additional strategies to help cope during times of ambiguous grief around the Thanksgiving holiday.
Notice the Positives:
What is going well? Do you find yourself focusing on the negative or positive aspects of your life/ circumstances? Try writing down three things each day and reflect on these.
Reflect:
Where are my priorities? What really matters? Where do I find my source of happiness? Am I able to experience joy in my life? Who can I lean on for support? What brings me comfort? What am I thankful for?
Express Gratitude:
Take time to slow down and notice who and what you are grateful for, and express this! Try being creative in your expression of gratitude such as dance, writing letters, journaling, volunteering, verbalizing words aloud, meditating, prayer, silence, etc. The possibilities are endless!
Discover Hope:
Are you able to find a source of peace, happiness, and even your within the midst of your circumstances? Reflection on one’s values and cultural identity can be helpful in understanding how you view the world. If you would like a place to reflect and process values, identity, and/ or existential concerns, therapy can be a great place to do so. Try investing in new or different traditions this year. Take time to nurture your body and mind rather than escaping or numbing with self-destructive behaviors.
Seek Support:
Reach out to your friends and family. Don’t be afraid to reach out for community support. If you are currently struggling with anxiety, depression, or grief/ loss, CARE is happy to help.
There are also excellent local and crisis resources available such as the National Suicide Lifeline: 800-273-8255 for 24/7 support.
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Our wellness experts will be happy to take care of you. You can CLICK HERE to schedule an appointment now or call (612)223-8898.
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The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
Suicide Survivor Loss
The holidays tend to be a difficult time for those who have lost a loved one. This is especially true for family and friends who have died by suicide. Within the last year, I have been able to come alongside friends and family who have lost loved ones by suicide. As we celebrate the holiday season, suicide survivors are reminded of the “empty chair” at the table. The Saturday before Thanksgiving has been designated as International Survivors of Suicide Loss Day. It is a day where family and friends of those who have died by suicide can come together for support and healing.
Now, more than ever it is important to support those who are grieving and take care of ourselves as we grieve. In addition to the ambiguous grief with uncertainties and loss, there is also the aspect of traumatic grief in death by suicide. Considering the mental health crisis we are in, many suicide survivors are currently struggling with the own mental health struggles such as major depression as in complicated grief or otherwise known as complex bereavement. The bereavement process also can be more complex due to the traumatic nature of suicide.
Families are trying to make sense and process their loss. Why would a parent kill themselves, leaving behind their partner and children? How could someone who appeared to be outwardly successful be gone the next day? It is estimated that for each person who dies by suicide, that they leave behind at least six “suicide survivors.
Learning that a close friend or family member died by suicide is a traumatic event that can be incredibly painful to talk about. Witnessing a loved one’s attempt or the aftermaths leaves one in a state of emotions such as fear, helplessness, and horror. These feelings can be frequently triggered depending on the circumstances of death. Survivors may have to recount disturbing details of events. These may be experienced as recurrent, involuntary and distressing images that relive the trauma. Survivors may find themselves replaying details from earlier events, trying to understand and make sense of their loved one’s final moments. They may blame themselves and suffer from distress in response to cues that are reminders of the loss. Survivors may begin to retreat and avoid thoughts, memories, feelings, or talking about the suicide.
The circumstances that were surrounding a loved one’s suicide can also be difficult to address due to stigma around mental health and sense of shame talking about events such as suicide. How does one talk about suicide within their communities? How do you talk to children who have lost a parent? Can you talk about suicide in your religious/ faith communities? How do you respect the privacy of families who may not feel comfortable to talk about suicide loss?
The Suicide Prevention Lifeline offers some great tips
How to Support Others Who Lost a Loved One to Suicide:
- Accept Their Feelings
- Listen and validate feelings, no matter what or how intense they are
- Just be present to listen.
- Use Sensitivity During Holidays and Anniversaries
- These events may be especially triggering. Be there to support friends/ family during this difficult time.
- Choose your words wisely.
- Be attentive to what the suicide survivor and/ or their family needs.
- Offer your physical and/ or emotional support to help out in practical ways where you can.
- Use the Loved One’s Name
- There is great power in using the name of the person who died when talking about them as they are not forgotten.
- Share memories and stories about the loved one.
How to Support Yourself After Loss by Suicide:
- Find a Support Group
http://www.suicide.org/support-groups/minnesota-suicide-support-groups.html
https://afsp.org/find-a-support-group/ - Do What Feels Right to You
- Everyone grieves differently; there is no “right” way to grieve.
- If talking or meeting in person does not feel comfortable at the moment, that is OK–there is no need to rush the process.
- Write. This can be a great outlet when talking is too difficult. Letter-writing is also a safe outlet to express words to the deceased.
- Ask for Help
- Lean on family and friends for support.
- Reach out to your local faith/ religious or other local community support.
- Look for a therapist that is skilled in working with grief/ loss, particularly loss after suicide. CARE Counseling has a great team of clinicians who are skilled in these areas.
Books:
Life After Suicide: Finding Courage, Comfort, & Community After Unthinkable Loss by Jennifer Ashton
No Time to Say Goodbye: Surviving The Suicide of a Loved One by Carla Fine
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Our wellness experts will be happy to take care of you. You can CLICK HERE to schedule an appointment now or call (612)223-8898.
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The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
National Diabetes Awareness Month
November is National Diabetes Awareness Month
Awareness, being informed, taking action, and connecting to the appropriate support makes a huge difference in managing diabetes.
We CARE about awareness. At CARE Counseling, our clinicians can assist with managing symptoms such as depression related to medical health concerns. We welcome care coordination/ referrals from primary health and specialty care providers. We are trained in managing mental health distress and have a clinician on staff with special interest in Type 1 Diabetes.
Check out the following stats on diabetes:
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- More than 34 million Americans have diabetes (about 1 in 10), and approximately 90-95% have type 2 diabetes
- Diabetes is the 7th leading cause of death in the United States
- Nearly 1.6 million Americans have type 1 diabetes- up nearly 30% from 2017
- Type 1 diabetes is growing most sharply in African American and Hispanic youth populations (33.5% were ages 10-14, 27% were 5-9)
- Type 2 diabetes disproportionately affects racial/ ethnic minority women
- 1 in 5 adults with Type 2 diabetes has depression
- 1 in 3 adults with Type 2 diabetes experience diabetes distress (worry, stress, frustration, & burnout from managing diabetes)
- In any 18-month period, 33% to 50% of people with diabetes have diabetes distress
Source: https://www.cdc.gov/diabetes/
Do you know the difference between Type 1 and Type 2 Diabetes?
Type 1 Diabetes
In type-1 diabetes, the body does not produce insulin. The body breaks down the carbohydrates you eat into blood sugar that it uses for energy—and insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body.
Type 2 Diabetes
In type-2 diabetes the body doesn’t use insulin properly. Some people can control their blood sugar levels with healthy eating and exercise, but others may need medication or insulin to help manage it. Type 2 Diabetes often develops in people over age 45 but can also develop in children through young adults.
What about Gestational Diabetes?
Gestational diabetes is a form of high blood sugar that impacts pregnancy in mothers. In gestational diabetes, the diabetes develops for the first time during the mother’s pregnancy They may develop insulin resistance which makes it difficult for the body to use insulin. The pregnant body may also not be able to make and use all the insulin it needs for pregnancy. The ADA explains that “without enough insulin, glucose can’t leave the body and be changed into energy. When glucose builds up in the blood, it is called hyperglycemia”.
Nearly 10% of pregnancies in the U.S. are affected by gestational-diabetes each year, according to the American Diabetes Association. Most of the time it will go after having the baby; however, the mother is at risk for later developing Type 2 Diabetes and the child is at risk for obesity and Type 2 diabetes.
Here are several ways to help manage diabetes:
BE INFORMED
Educate yourself about diabetes, depression, and diabetes distress
Access information on eating healthy and develop healthy eating plans
Have information on exercising and develop exercise plans
Be aware of medical and mental-health related resources
Understand how to take prescribed insulin, other injectable or oral medications
Know how to properly care for your diabetes supplies
SCREEN
Do regular diabetes screenings
Watch blood pressure levels
Watch cholesterol levels
Regularly check blood sugar and record results
Include alerts to help monitor results and potential warning signs
Do mental health screening for depression
Discuss mental health concerns with your care team
REFER
Connect with a health care team for diabetes self-management education
Coordinate care for medication management
Seek referral to specialty providers such as an endocrinologist for diabetes care
Refer to support services to help develop healthy lifestyle goals
Connect with a mental health provider to reduce symptoms of depression and/ or diabetes distress
Join a diabetes support group
Sources: Center for Disease Control and Prevention and the American Diabetes Association
Written by Charlotte Johnson MA, LPCC
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Communicating with L.O.V.E.
As a follow up to the blog on CARE-ing for a Friend/ Family Member who is Misusing Drugs or Alcohol, I’d like to share some practical tools customized for parents and partners, the first tool being a 20minuteguide. It includes motivational techniques for behavioral change, worksheets, and examples of how to apply and practice CRAFT, or Community Reinforcement and Family Training strategies with your loved one. This approach was developed by Dr. Robert Meyers at the University of New Mexico and is known as the leading evidence-supported way to help partners and families support loved ones who are using substances.
Here is a list of several of the skills CRAFT teaches:
- Understanding a loved one’s triggers to use substances
- Positive communication strategies
- Positive reinforcement strategies – rewarding non-using behavior
- Problem-solving
- Self-care
- Domestic violence precautions
- Getting a loved one to accept help
The CRAFT approach utilizes a behavioral perspective as a way to think about problems. Family members who are trained in CRAFT are found to have greater success in their loved one seeking help and decreasing or stopping the misuse of substances. It takes time to rebuild trust when there are ruptures in the relationship due to substance use. These strategies offer techniques based on research that will help you focus on your own mental health well-being while learning practical ways to communicate and help implement positive behavioral change.
Since expressing concerns was #1 on CARE-ing for a Friend/ Family Member who is Misusing Drugs or Alcohol, I’d like to offer a “sneak peak” at some of the great CRAFT skills by sharing an acronym for a communication skill that will help express with LOVE: Listening. Offering. Validating. Empathizing. The first two letters (L,O) are specifically related to communication whereas the last two letters (V,E) are more about setting up a respectful environment to have effective communication.
L=Listening
Listening is such an important component of communication. Incorporating motivational interviewing techniques of open-ended questioning, affirming, reflective/ active listening, and summarizing is a very effective approach to listening.
Open-ended questions are asked by inviting dialogue, as the response goes beyond a simple one word answer. For example, asking “Did your interview go well?” is likely to generate a much shorter response than “What was your experience like in the interview?” The second example creates space to learn more about the individual’s thoughts and feelings rather than a yes/ no response. It also demonstrates interest, inviting a back and forth dialogue rather than just seeking a response to a question.
Affirmations is a way to support by being attentive to listen for the positives and acknowledging this. Giving a specific affirmation is helpful with reinforcing and praising another in a positive direction. It feels good to have positive things acknowledged such as one’s effort. “I notice that you really worked hard on your homework”. It also feels good to be appreciated and feel supported. “I appreciate your sense of humor”. “You made my day”. Noticing positives and giving affirmations is so powerful.
Reflections is also known as active listening. In this approach, you are paraphrasing what you hear the other person communicating. For example, “I hear you say that you were really hurt by the situation”. Reflections are helpful to make sure that you understand what is communicated and the other person knows that you understand.
Summaries help tie in all the above and shows that you were actively listening.
O=Offering
The “information sandwich” is a three step technique (think bread, filling, bread) that includes elements of asking permission to offer, layering information in the middle, and checking back or clarifying.
Asking permission – By asking permission you are allowing yourself to be “let in,” which can feel more respectful than not asking permission and just “letting yourself in”. It sets the tone for a more comfortable conversation, no matter how uncomfortable the topic may be. For example, “May I share a thought I had about…?” “Can I ask you a question?”. By allowing yourself to be let in, it creates a sense of safety to where the other can feel some sense of control. It also gives you a sense if the other person is in a position to truly listen.
Providing information – Once permission is given, then provide information or feedback. It helps to be given options and allow space for disagreement. Each person has the right to their own thoughts and feelings. It is also important to remember offering your thoughts rather than imposing this one someone.
Checking back or clarifying – This is considered the final layer of the “sandwich” in which you check or clarify that the information communicated was received. You want to ensure that the information was understood and also check in about how it was received. For example, “I wanted to check back about…”.
V=Validating
Validating is all about acknowledging one’s experience in efforts of promoting a feeling of being understood and accepted as well as that their thoughts and feelings are valid.
E=Empathizing
Empathizing is a way to convey understanding of your partner’s experience without the need for many words e.g. “That sounds awful” “I would have felt ___ too”. This strategy can help one open up on more vulnerable topics by reducing feelings of shame. Paying special attention to tone and attitude is important. Responding when emotions are heightened is not going to be as effective than words expressed through a lens of compassion.
I encourage you to set aside 20 minutes each day to practice CRAFT skills with a loved one who is misusing drugs or alcohol and see how this can help rebuild trust within the relationship. These skills take time to develop. Practicing within the context of a structured supportive environment such as therapy can be helpful. Imagine the possibilities of a relationship where each individual feels heard and understood through communicating with L. O. V. E.
Start developing and practicing your L.O.V.E. approach with a CARE Counseling clinician today.
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The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
Discussing the Queen’s Gambit
Spoiler Alert: Queen’s Gambit
The Queen’s Gambit is a fascinating mini series from a mental health perspective. The storyline is based off of Walter Tevis’ 1983 novel, which follows the life of Beth Harmon from orphan to chess prodigy. The setting takes place in Kentucky through the mid 1950’s and 60’s and takes us around the US, ending in Russia. If Beth were to seek counseling, there are many areas that may be helpful to further explore, especially from a narrative perspective.
Beth is portrayed as a complex character as are several others characters who are an important part of her narrative. I would have loved to learn more about early significant relationships including her mother, friend at the orphanage, Jolene, and janitor Mr. Shaibel. Beth had multiple aversive childhood experiences- from parental mental illness, death of a parent, and growing up in an orphanage. She was inspiring in so many ways in which she “beat the odds”, not only with her early trauma but also with the strict gender roles and societal expectations of her time. I would be interested to learn more about how she “made sense” of her experiences and assess for trauma-related symptoms. I would also build upon Beth’s resilience and internal coping mechanisms.
One thing that stood out was Beth’s body language–the way she moved her hands, quick, yet skillful. Her quirky sense of confidence was observed in a highly-competitive field and this was conveyed among her male counterparts. I love her determination and dedication. For those that are familiar with the subtle ways in which autism spectrum disorder presents in women, it could be argued that Beth was not neurotypical. She presents with distinct social communication differences in the ways that she responds (or doesn’t respond) to social cues and in the ways she interacts with sharing thoughts and feelings with others. I noticed how Beth had an acute sense of how she might respond to certain situations such as dating/ sex yet appearing to not be totally prepared, consciously trying to figure out the socially appropriate response. Beth also demonstrated specialized ability in an area of high focus, showing obsessive qualities, with her dedication to the game of chess. Beth may be interested in delving into these areas, especially as she continues to navigate the social world.
I love Beth’s curiosity and commitment to learn the game of chess, after being introduced to the game by Mr. Shaibel. The power of their relationship was not expressed so much in words but within nonverbals; they had a life-long impact which was especially apparent by the end of the series. I am reminded of the power of mentorship and having at least one loving parental figure. While Beth’s step-mom was not perfect as she was battling her own issues with alcohol misuse, it appeared that she was trying to do the best that she could. Beth was impacted by grief/ loss as well as ambiguous loss. She may be interested in processing this. I noticed that she was looking for her step-mom’s presence at her chess matches but we are not certain how Beth was internalizing this after her death.
The themes of misuse of alcohol and pills was also portrayed with Beth, with her developing dependence on sedatives, given the fictional name Xanzolam although also referred to as Librium during her time at the orphanage. Many are curious about the drug and this raises concerns about addiction to benzos as Librium is considered a benzodiazepine. This medication has been used to treat anxiety and calm fears (e.g. before going into surgery). It was interesting how Beth made a connection to dependence on the green pills to perform, yet her greatest feat was achieved without them. Throughout the mini-series, Beth was battling her own inner demons, including insecurity and self-loathing which led to self-destructive behaviors. Beth may be interested in working on these areas. A maintenance plan to identify triggers, warning signs, self-care, and coping strategies for alcohol and drug misuse may also be helpful.
Beth’s journey was a tale of self-discovery. While Beth certainly had many “highs and lows” throughout her story, I was inspired not only by Beth’s resiliency but also those who invested into her life to create “family”. Within the therapy room, I have the privilege of being a part of individuals’ unique stories. Although Beth Harmon’s story was fictional, I felt part of her inner-world by watching her story unfold with the rich visuals portrayed through drama in film/ television.
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The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
CARE-ing for a Friend/ Family Member who is Misusing Drugs or Alcohol
Caring for a loved one struggling with the mental and physical reliance on substances can be a very painful experience, especially for those who experience the effects first-hand. Substance use impacts the entire family system; therefore it is important to have support at all steps along the way–from the time of emerging concerns to treatment and recovery. Knowing what to do is not always easy, especially when watching a loved one engage in self-defeating behavior.
Parents with children who are misusing drugs or alcohol often struggle with how to keep their child safe while also trying to create boundaries around rules, consequences, and expectations of behavior. From the couples perspective, being in a relationship with someone with substance use concerns often can create feelings of fear and resentment. Arguments, separation, and divorce are common. Infidelity or domestic violence may be present. If children are involved, there may be additional fear or worries. Consider the costs–financial, legal, and the long-term implications on relationships. Living with a partner who struggles with alcohol or drug use is often surrounded by feelings of shame They may blame themself for their loved one’s addiction, take their behavior personally, or attempt to keep it hidden. There may be a sense of feeling out of control, especially when the loved one is in denial there is a problem or is unwilling to seek treatment.
Friends or family members may find themselves in the role of reinforcing and contributing to co-dependency within the relationship. Friends or co-workers may be struggling with drug or alcohol use but present as “functional”. Since addiction can be viewed as a disease, early intervention is best to begin a path of healing.
Here are Five Ways to Show you CARE
1. Express Concerns
Communicate concerns in love, especially when these are emerging. Being direct and compassionate with examples of specific behavior is helpful. Responding when emotions are heightened or speaking out of anger is not going to be effective. Trying to have a conversation when someone is under the influence of drugs or alcohol is also not going to be effective. Conserve your emotional energy for a time when they are able to be engaged, willing to listen, and respond constructively.
2. Understand Addiction
Be familiar with how substance abuse impacts the body and brain, and the models of treatment that can support. Understand the brain’s role in addiction and how this works with tolerance, dependency, and withdrawal.
3. Offer Support
Offer to assist with scheduling an appointment, going to therapy, and/ or attending support meetings. It is going to take a support team to treat alcohol and drug concerns. Recovery is an on-going process. Showing support by not joining in on drinking or drug use is also helpful. SAMHSA’s National Helpline, 1-800-662-HELP (4357), 1-800-487-4889 is a confidential, free, 24/7 service for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.
4. Don’t Take Full Responsibility
There is a balance between caring for a loved one with addiction and enabling them. It is understandable to want to protect from the consequences of addiction; however, removing or lessening the negative consequences leads to reinforcing substance use. For example, if my roommate is out all night partying and I find myself waking them up to get to work, I am enabling. If my partner is struggling with drinking too much and I am bringing them alcoholic beverages or making excuses for their behavior, I am enabling. Joining together with them in compassion and empathy is different than reinforcing substance use.
5. Seek out Your Own Therapy
This is a difficult journey to go through alone, so self-care is important when someone you love is misusing drugs or alcohol. You may feel a roller-coaster of emotions being in a relationship with someone struggling with addiction. You may also be feeling torn about decisions within the relationship. Having a space to process thoughts and feelings while learning ways to cope can be incredibly helpful. Your therapist can help areas that are difficult such as strategies to help create healthy boundaries, rebuild trust, learn self-compassion, and work through painful experiences. Anger, fear, regret, shame, frustration, sadness–these are all common emotions.
You are not alone. Though it may feel isolating, many have or are walking a similar path, supporting a loved one with substance abuse. Connecting with support systems and community is a key aspect of caring for oneself in the journey of caring for one another.
We’re Here to help
Our wellness experts will be happy to take care of you. You can CLICK HERE to schedule an appointment now or call (612)223-8898.
Meet Clinicians
We’re united by our commitment to providing effective, relevant, and innovative mental health support at all stages of your journey. Click Here to find out more about who we are, where we come from, and how we live out CARE’s mission every day.
The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
CARE-ing for a Friend/ Family Member with Suicidal Thoughts
When a friend or family member is struggling with suicidal thoughts, it is important to know how to respond as it can literally save a life.
The National Suicide Prevention Website lists a number of warning signs that can be helpful in recognizing if one is at risk for suicide. Knowing the warning signs, especially if behaviors are new or have increased as well as signs that seem related to a painful event, loss, or change are tell-tale signs.
- Talking about wanting to die or kill themselves
- Looking for a way to kill themselves
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious or agitated; behaving reckless
- Sleeping too little or too much
- Withdrawing or isolating themselves
- Showing rage or talking about seeking revenge
- Extreme mood swings
If you are recognizing any of these signs, the National Suicide Prevention Lifeline is available to provide support and information. In addition to knowing the warning signs, remember these 5 ACTION STEPS #BeThe1To
1. ASK
Ask questions in a direct, non-judgmental way. Examples include–Are you thinking about harming yourself? How can I help? What do you need right now? Do you have a plan to keep yourself safe? Have you ever attempted suicide? Do you currently have a plan to kill yourself? Do you have access to means to carry out this plan?
2. BE THERE
Listen and be present. If a person has attempted suicide or is injured, call 911 immediately and stay with them. Especially during times of isolation/ loneliness, it is so important to feel connected. Be there to reach out to loved ones who are expressing distress on social media. Additional resources are available that specifically address how to help with safety-and-support-on-social-media.If you are unable to be physically present, seek out other supports who may be able to assist:
3. KEEP THEM SAFE
Take steps to respond to the information that you have gathered from asking questions that provide responses regarding your loved one’s immediate risk of harm and severity of the risk. For example, someone with suicidal thoughts, with a history of previous attempts and access to means has more risk factors in place than someone who is thinking about suicide but has no plan or intent to harm themselves. It is important that if you think that someone is at imminent risk of harm, call 911. Taking additional action steps to keep loved ones safe such as driving the nearest emergency room or calling local authorities is extremely important when someone is planning to attempt suicide and has access to means. If you are not sure, the LifeLine or your local crisis number can assist with resources on what to do. Reducing access to means (e.g. firearms, pills, etc) and taking the appropriate safety measures to keep one’s environment safe by removing means are additional steps.
4. HELP THEM CONNECT
Connecting someone with suicidal thoughts to national and national suicide prevention and 24/7 crisis resources is a great first step 1-800-273-TALK (8255) . Help is available to those who are seeking additional support on how to help their friends or family members. This is also the number that those who are struggling emotionally, whether or not they are contemplating suicide can reach out to for additional support.
Exploring any past connections to mental health-related supports and encouraging these connections is the next step. Do you currently have established care providers? Is there a past provider that you may want to re-establish care with? Offer to assist with connecting to these supports.
5. FOLLOW UP
Take the time to check in with your friend or family member on how they are coping. Let them know that they love/ care about them. Reaching out fosters the sense of connectedness. Consider showing your support in meaningful ways such as a heartfelt note of encouragement or invitation to connect.
Resources:
National Suicide Prevention Life: 1-800-273-8255
Mental Health Crisis Services. Text MN to 741741
Metro Area Mental Health Crisis Response
Ramsey: adults: 651-266-7900, children: 651-774-7000
Hennepin: adults: 612-596-1223, children: 612-348-2233
We’re Here to help
Our wellness experts will be happy to take care of you. You can CLICK HERE to schedule an appointment now or call (612)223-8898.
Meet Clinicians
We’re united by our commitment to providing effective, relevant, and innovative mental health support at all stages of your journey. Click Here to find out more about who we are, where we come from, and how we live out CARE’s mission every day.
The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
Post-Treatment… What life looks like now
You officially completed treatment…congratulations!
Now what? Like other areas of life where one completes a task, there are steps necessary to maintain positive results.
In substance use recovery, this is often referred to as aftercare planning.
In outpatient therapy, we also call this maintenance.
Think “stages of change” model. For many people, the first step to seeking help is the most difficult. Individuals may be pre-contemplating change as there is increasing awareness of a concern and then move along to contemplation, working through ambivalence. Then there is the commitment to change–taking action steps to achieve the end goal. This process can take a while and relapse is common. The Journal of the American Medical Association reports “among individuals with substance abuse disorders who get treatment, 40% to 60% will relapse within 1 year”.
It is important to keep in mind that relapse does not not equal failure. Understanding the relationship between alcohol or drug addiction on the brain can help put things into perspective. Understanding the diagnostic features and developmental course of various mental health conditions is also beneficial. Each one has different risk and protective factors. Consider family history; also consider environmental factors.
Depending on your unique situation, different levels of care may be recommended to address the presenting concerns. Additional supports such as specialized treatment modalities, psychiatry, or a support group, may be recommended. It is common to step down from a higher level of support such as residential treatment or intensive outpatient to a weekly outpatient level clinic such as CARE Counseling. It is also common to step down from weekly outpatient treatment to every other week or less as progress is achieved and progress maintained. Having a maintenance plan in place can help.
Here are Five Questions to Ask Yourself
1. What are my Triggers?
Are there any particular places, people, or activities that are triggers for relapse? Are there any thoughts I may be experiencing that are triggers?
2. What are my Warning Signs?
What thoughts, feelings, or behaviors may indicate risk for relapse?
3. What is my Self-Care?
What are you doing to take care of yourself that is beneficial for your mental health and/ or sobriety?
4. What are my Coping Strategies?
What coping skills am I using to help maintain the gains I’ve made in managing my mental health and/or sobriety?
5. What is my Sign to Return to Therapy/ Treatment?
Difficulties being consistent with self-care, falling out of routine, increased/ new stressors, experiencing a crisis, and difficulties using coping strategies are all signs that it may be time to reach out for help.
Our therapists at CARE Counseling will work with you to help understand your triggers and warning signs. They can assist with safety planning, if needed, as well as strategies for self-care and coping. We understand that life is stressful and maintaining gains takes intentional effort and ongoing support. We encourage clients to return to CARE Counseling in the future, or to call to get referrals to other providers even after services end.
We’re Here to help
Our wellness experts will be happy to take care of you. You can CLICK HERE to schedule an appointment now or call (612)223-8898.
Meet Clinicians
We’re united by our commitment to providing effective, relevant, and innovative mental health support at all stages of your journey. Click Here to find out more about who we are, where we come from, and how we live out CARE’s mission every day.
The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
Laughter
When was the last time you had a good dose of laughter?
“Laughter is the best medicine”, especially now. Scrolling through social media, humor was interspersed leading up the election results. You may think of entertainment when it comes to laughter–your favorite sitcom, comedian, or personality that evokes and good belly laugh. However, laughter has many purposes besides entertainment. It is a great means of coping during difficult times by offering relief from stress.
Check out these awesome short and long-term benefits of laughter for stress-relief identified by the Mayo Clinic
Stimulates the organs (e.g. heart, lungs, muscles)
Increases the release of endorphins in your brain
Activates and provides relief to stress
Soothes tension
Improves your immune system
Relieves pain
Increases personal satisfaction
Improves your mood
Have you ever noticed during an overwhelmingly positive moment, laughing so hard that you cried? Or the opposite during times of pain, laughing when you want to cry? Laughing and crying both help release emotional energy. Medical news today reports show that laughing and crying releases oxytocin and endorphins. Oxytocin has been described as “the love hormone” and also known as “the empathy hormone” due to its role in bonding. It is interesting that we are naturally seeking out these moments with each other to socially bond–to feel some sort of connectedness even if it is through the computer screen or television.
Now more than ever we all need a good laugh. Here are my top 20 ideas to inject a little laughter. How many more can you come up with?
1. Watch something funny on TV
2. Listen to a humorous podcast
3. Reminisce about your favorite memories
4. Laugh with friends-laughter is infectious!
5. Have a fun impromptu activity
6. Watch a dog or cat
7. Keep a journal of gratitude/ fun moments
8. Look at funny auto-correct text messages
9. Listen to little children explain things from their perspective
10. Watch funny memes
11. Listen to a comedian
12. Be your own comedian
13. Create something funny to share with others
14. Laugh out loud
15. Share funny moments with others
16. Incorporate play at work
17. Embrace your inner child and do something silly
18. Watch people
19. Incorporate playful tease into your relationship
20. Share an inside joke
We’re Here to help
Our wellness experts will be happy to take care of you. You can CLICK HERE to schedule an appointment now or call (612)223-8898.
Meet Clinicians
We’re united by our commitment to providing effective, relevant, and innovative mental health support at all stages of your journey. Click Here to find out more about who we are, where we come from, and how we live out CARE’s mission every day.
The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
International Stress Awareness
I find it ironic that National Stress Awareness Day falls on the first Wednesday in November, or the day after Election Day. While the United States is known as a stressed out nation, it was ranked number seven according to the 2018 Gallup survey which found that “more Americans were stressed, angry and worried last year than they have been at most points during the past decade.” The most stressed out country was Greece, followed by the Philippines and Tanzania. Stress Awareness has developed international momentum, with International Stress Awareness Week (November 2nd – November 6th) devoted to raising awareness on stress management.Here are examples of positive stress (eustress):
- Beginning a new job or formal schooling
- Getting a promotion or other outstanding achievement
- Getting married
- Addition of a new baby or family members to the home
- Buying a house
- Taking a vacation
Here are examples of negative stress (distress):
- Death of spouse, close friend, or family member
- Divorce or separation
- Incarceration
- Major illness or injury
- Loss of job or change impacting decrease in finances
- Significant relational conflicts
150 points or less | a relatively low amount of life change and a low susceptibility to stress-induced health breakdown
150 to 300 points | 50% chance of health breakdown in the next 2 years
300 points or more | 80% chance of health breakdown in the next 2 years, according to the Holmes-Rahe statistical prediction model
According to The International Stress Management Association [ISMAUK], topics for this year include the following–
- Experiences people have with mental health challenges and what can be done to help them
- How employers are responding to mental health issues and what can be learnt
- Campaigning against the stigma associated with stress and mental health issues
- The role of stress management professionals in alleviating stress, with practical and proven techniques for building resilience
- What further actions need to be taken in the light of the pandemic and possible changes in future working practices
- Ensuring that those suffering from stress know where to go to seek advice
We’re Here to help
Our wellness experts will be happy to take care of you. You can CLICK HERE to schedule an appointment now or call (612)223-8898.
Meet Clinicians
We’re united by our commitment to providing effective, relevant, and innovative mental health support at all stages of your journey. Click Here to find out more about who we are, where we come from, and how we live out CARE’s mission every day.
The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
