What Really Happens in a Therapy Session

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When you take your car to the car mechanic, you know what’s going to happen: Your car will get repaired.

When you break a bone and visit your doctor, you know what’s going to happen: Your bone will be set in a splint or cast and eventually heal.

But when you make an appointment to see a therapist, do you know what’s going to happen? Many people aren’t quite certain. Will you just talk? Will you have to discuss your childhood? Will you be “hypnotized?” And what’s the “point” of seeing a therapist, anyway? Why not just talk to a friend?

There is a great deal of uncertainty in our society about what actually happens during a therapy session, what types of issues and problems are suitable for therapy, and what benefits a therapy session can provide. I’d like to address a few typical questions—and misconceptions—about what therapy is, what it isn’t, and how it really works.

Q: Do I have to be “sick” or “disturbed” to go see a therapist?
A: No. Thinking that one has to be “seriously disturbed” in order to see a therapist is a myth.

While some therapists do specialize in severe emotional disturbances—including schizophrenia or suicidal thoughts—many focus on simply helping clients work through far more typical, everyday challenges like mapping out a career change, improving parenting skills, strengthening stressmanagement skills, or navigating a divorce. Just as some physicians specialize in curing life-threatening illnesses, while others treat “everyday” illnesses like flus, coughs, and colds, psychotherapists can serve a wide range of clients with a range of needs and goals, too.

In fact, most of my clients are successful, high-achieving people who are quite healthy, overall. Most are challenged by a specific, personal goal—like losing weight, creating more work-life balance, finding ways to parent more effectively, or feeling anxious about dating again after a rough break up.

Q: How can I choose the right therapist for my goal/situation?
A: Choosing a therapist is like choosing any other service provider—it’s a good idea to visit the practitioner’s website, and read client testimonials or reviews (if they have any—many do not, for confidentiality reasons). It’s also good to ask friends and family members, or your physician, for referrals (and of course, check to see who is covered in your health insurance network).

If you are hoping to work on a specific issue—overeating, smoking, making a career change—try to find a therapist with expertise in that area. Many list their specialties or areas of focus on their websites. There are therapists who specialize in relationship issues, parenting issues, anger management, weight issues, or sexuality—pretty much any issue, goal, or situation you can imagine. If you’re not sure about someone’s expertise, just call them and ask. If they can’t be of assistance with your issue, they may be able to refer you to someone who can.

Q: What actually happens during a therapy session?
A: Each session is, essentially, a problem-solving session. You describe your current situation, and your feelings about it, and then the therapist uses their expertise to assist you in trying to resolve that problem so you can move closer to having the life you wish to have.

At the beginning of a session, the therapist typically invites you to share what’s been going on in your life, what’s on your mind, what’s bothering you, or whether there are any goals you’d like to discuss. You’ll be invited to speak openly. The therapist will listen and may take notes as you speak; some, like myself, take notes after a session. You won’t be criticized, interrupted or judged as you speak. Your conversation will be kept in the strictest confidentiality. This is a special, unique type of conversation in which you can say exactly what you feel—total honesty—without worrying that you’re going to hurt someone’s feelings, damage a relationship, or be penalized in any way. Anything you want—or need—to say is OK.

Some therapists (like myself) may give clients some homework to complete after a session. That homework might be to set up an online dating profile and reach out for a first date, or to exercise three times a week. It may be to spend some time each day pounding a pillow to safely release pent-up emotions, make a nightly journal entry, or any number of “steps” and “challenges” relevant to your goals. During your next session, you might share your progress and address any areas where you got frustrated, stuck, or off-track.

Of course, every therapist is different, every client is unique, and every therapist-client relationship is distinct as well—which means that there is nouniversal description of a therapy session. Some therapists employ dream interpretation in their work. Others bring music or art therapy into their work. Others incorporate hypnotherapy, life coaching, meditation, visualization, or role-playing exercises to “rehearse” challenging conversations. The list goes on and on. Ultimately, regardless of their approach, a therapist will listen without judgment and help clients try to find solutions to the challenges they face.

Q: Will I have to talk about my childhood?
A: Not necessarily. Many people think that visiting a therapist means digging up old skeletons from your childhood, or talking about how awful your mother was, etc. That is a myth. What you talk about during a therapy session will largely depend on your unique situation and goals. And depending on your goals, you may not actually talk about your past that much. The focus of your therapy is as likely to be your present-day reality and the future that you wish to create.

That being said, if you REALLY do NOT want to discuss your childhood, the intensity of your desire NOT to talk about it might suggest that you should! When people have strong negative emotions—about their childhood or any other topic—it’s typically worth doing some excavating to figure out why that is. Whatever is causing them to feel such strong emotions about the past is more than likely impacting their present-day life in some way, too.

Q: How long will I have to go to therapy?
A: This varies from person to person. I’ve had clients who booked one session, we worked out their issue(s), and they were all set: They marched out and didn’t need a follow-up session. Sometimes, one brave, honest conversation is really all you need.

Other clients have booked sessions with me over a period of several weeks or months, focusing on one issue, resolving that issue, then perhaps moving on to a different challenge. Then there are other clients who I’ve been working with for some time—they appreciate having a weekly, bi-weekly, or monthly “check-in.” They may share their feelings, sharpen their life skills as needed, or perhaps enjoy a deeply nourishing guided meditation or hypnotherapy experience to de-stress. As one client put it, “Every two weeks when I meet with you, I leave your office feeling like you pressed my reset button.”

Therapy is really about whatever a client needs—a one-time conversation, a temporary source of support during a life transition, or an ongoing experience to optimize health physically, mentally, emotionally and spiritually.


Q: Is meeting with a therapist over the phone—or through video chat—just as effective as meeting in person?
A: That depends on your personality and preferences. In the state of Hawaii, where I live, at least one insurer that I know of covers doing therapy virtually via video chat (like Skype or Facetime). This makes it a convenient option for people. Many of my clients do enjoy having some, or all, of their sessions via video chat because it means they don’t have to take time out of their busy schedules to drive, park, and so on. They can just close their bedroom or office door, pick up the phone or log in, and away we go—very convenient.

Where feasible, I suggest trying out both ways—do a traditional, in-person therapy session and then try a video session—and see which format is the best fit for you.

Q: Why see a therapist? Why not just talk to a friend or someone in my family?
A: If you are blessed with caring, supportive family members and friends, by all means, share your feelings, goals, and dreams with those people. They are a big part of your support network, and their insights and encouragement can be very helpful. However, people who already know you might not always be completely objective when listening to you. For example, you may want to change your career, and you confess this dream to your wife. She may want to support you 100%, and try her very best to do so, but she may also be dealing with emotions of her own—such as anxietyabout how a career shift will change your lives, not to mention your income. These emotions could make it difficult for her to listen and support you objectively.

This is why working with a therapist can be so valuable. It’s a unique opportunity to share everything you’re feeling, and everything you want to create, without anyone interrupting you, imposing his or her own anxieties onto the conversation, or telling you that you’re “wrong” or that you “can’t.”

A therapy session is a space where you don’t have to worry about hurting anyone else’s feelings—you can be totally honest. It also means you have the potential to solve problems faster and with greater success. In the long run, that’s better for you and everyone else involved in your life, too.

To sum it up:
Therapy is a valuable tool that can help you to solve problems, set and achieve goals, improve your communication skills, or teach you new ways to track your emotions and keep your stress levels in check. It can help you to build the life, career, and relationship that you want. Does everybody needit? No. But if you are curious about working with a therapist, that curiosity is worth pursuing. Consider setting up one or two sessions, keep an open mind, and see how things unfold. You have very little to lose and, potentially, a lot of clarity, self-understanding, and long-lasting happiness to gain.

Suzanne Gelb, Ph.D., J.D, is a clinical psychologist and life coach. She believes that it is never too late to become the person you want to be: Strong. Confident. Calm. Creative. Free of all of the burdens that have held you back—no matter what has happened in the past. Her insights on personal growth have been featured on more than 200 radio programs, 200 TV interviews and online at Time, Forbes, Newsweek, The Huffington Post, NBC‘s Today, The Daily Love, Positively Positive, and much more. Step into her virtual office, explore her blog, book a session, or sign up to receive a free meditation and her writings on health, happiness and self-respect.

20 Enjoyable End-of-Year Review Questions

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When life is busy and demanding, it’s easy to overlook small ways you’ve improved yourself and your circumstances. This is particularly the case if you’re self-critical and tend to most easily see and recall what you’re doing wrong.

Read more

The Power To Create Change Comes From Within

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By Katherine Ponte, BA, JD, MBA, NYCPS-P, CPRP | Oct. 24, 2018

 

Stigma is a shield created by society, made up of misunderstanding and fear of mental illness. When we look away from someone behaving erratically or “strangely” on the street, that’s the fear society ingrains in us. Perhaps we’re scared to consider the possibility that the same could happen to us; that we might be shunned by society, too.

The shield of stigma also stops us from seeking help for our own mental health. When faced with a stressful life event or emotional challenges, we might carry the hurt or confusion inside. Perhaps we avoid facing a potential diagnosis, so our illness only grows worse. Stigma facilitates mental illness turning into the “monster” it doesn’t have to be.

Social perceptions need to change. However, stigma is so deeply rooted in societal norms that it can take a long time to eradicate. And people like me, people living with mental illness, can’t wait on society to change. We need to live now. In fact, we need to be pioneers.

Our Experience Combats Stigma

First, we need to overcome our own belief in society’s fears. This requires finding hope, and specifically recognizing the possibility of recovery. Recovery from mental illness is living a full and productive life with mental illness. With this mindset, we can take ownership of our condition and live a fulfilling life. This can be one of the most powerful forces for change.

Stories of living fully with mental illness can help reshape society’s bias. They also provide inspiration and guidance for other people living with mental illness. This is the power of peer support and sharing lived experience. It creates a cycle of more people finding recovery, and then in turn, society seeing more positive examples of people living well with mental illness. Society needs to see what life with mental illness can and should be—a life of possibility, not a life sentence.

Our Experience Inspires Others

When people share their mental health journeys, it also helps set our own expectations. Recovery is hard and there is no smooth path to get there. It’s also not a cure, it requires continuous patience, discipline and determination. There will be stumbles and uncertainties along the way. This is the reality of mental illness. That’s why relatable, real-life examples are so valuable.

Knowing that others are going through similar challenges can help us build resilience. The result is self-empowerment by the example of others. We, the mental health community, rely less on the image society projects upon us, and instead focus on the image reflected to us by our peers. This is the power from within ourselves and our community.

I believe that this type of person-driven recovery has been overlooked as a way to combat social stigma. It’s become so ingrained that not even people with mental illness think recovery is possible. Too many of us allow society’s fears to become our own. Together, we can reverse the vicious cycle of stigma and instead, power the virtuous cycle of hope and recovery.

 

Katherine Ponte is a Mental Health Advocate and Entrepreneur. She is the founder of ForLikeMinds, the first online peer-based support community dedicated to people living with or supporting someone with mental illness and is in recovery from Bipolar I Disorder. She is on the NAMI New York City Board of Directors.

https://www.nami.org/Blogs/NAMI-Blog/October-2018/The-Power-to-Create-Change-Comes-from-Within

Talking To Kids About Mental Illness

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By Kathleen Boros | Nov. 16, 2018

 

In my children’s book about mental health awareness, Binky Bunny Wants to Know about Bipolar, Binky Bunny sees Mama Bunny sleeping a lot and wonders why she won’t wake up and play with him. When he asks his mom what’s wrong, he learns about bipolar disorder.

Binky learns that Mama Bunny loves him very much, but she needs her naps to function from day to day. It’s not that she’s avoiding Binky, or the chores that need to be done around the house; she wants to work and play, but she was born with an invisible illness in her brain that slows her hop.

Binky learns that he needs to work with his father to help Mama Bunny feel better. He doesn’t want bipolar disorder and its symptoms to keep her from experiencing life’s everyday gifts. Now educated and engaged, Binky is determined to help his mom live in an environment where she can heal.

This book is my way of showing how important it is to talk with our children about all aspects of mental health—including mental illness. As a parent with a diagnosis of bipolar disorder, I’ve already started a dialogue with my 8-year-old son to help him get a better grasp of what’s going on with me. I believe I was given my illness for a reason, and I’m not going to keep quiet about it, especially with my son.

I don’t believe in hiding behind stigma and just telling him I’m tired. I’m upfront and honest, because I believe if we want to live in a society free of stigma, we have a moral obligation to educate our children.

Keep Your Kids In The Loop

As soon as children are old enough to understand that mommy or daddy isn’t “like the other mommies or daddies,” it’s time to have a talk. It’s OK if they don’t understand right away. Every day is another opportunity for more education. Have a recurring family meeting or a set, consistent time when you all sit down and have a candid conversation about mental health. This will provide repeated opportunities for discussion and for your children to ask questions.

My family does this pretty informally. When my husband and I are together at the end of each day, we ask my son how his day was. This is a perfect opportunity to let your child know if you’re having a good day or if you need a little extra help. For example, on a day when loud noises might be bothering me, I might ask my son to keep it down for me and explain why.

Also use this time to explain how your mental illness is currently affecting your daily routine. If you’re a parent with a mental health condition who needs to be alone or take naps to recharge (like Mama Bunny and me), kids might be worried there’s something wrong with you, or worse, that you don’t want to spend time with them. Make sure they know nothing could be further from the truth. It might not be every day you have to sleep in or take naps, but if you have a particularly sleepy week, reassure your children it’s not something you’re doing to avoid them. Taking a nap is sometimes like taking a shower—just a part of daily hygiene.

Answer Their Questions

I know I don’t have all the answers, so if my son asks me something I’m unsure about during our talks, I’ll seek resources from my doctor or local library. If I need to explain something about mood, depression, mania or hospitalization, I’ll try to find something age-appropriate I can read to my son. But there really isn’t a lot of reading material about mental illness for children. So, I’ll often write down his questions and bring them to my next appointment so my doctor can give detailed, kid-friendly explanations I can bring home.

A few times, I’ve set up appointments for the two of us or our whole family to visit my doctor. My family finds this very helpful because no matter how much research we might do on our own time, bipolar disorder is different for everyone who experiences it. No two people with the same diagnosis have identical symptoms or express their illness in the same way. So, it’s great when my family can get together to talk to my mental health professional, who helps me with my illness, about how we can all cope together as a family. When we leave, we feel like we’re all on the same page.

Be Honest About Medication

This might not be a popular opinion, but I think children should also be informed of the medications their parents are taking. Medications for depression cause certain side effects, while medications for psychosis cause other side effects and medications for anxiety cause different side effects still. I think it’s important for children to know what to expect.

And it’s OK to tell children that having to take medication for your illness is something not under your control. Just like how they need shots to stay healthy or take antibiotics when they get sick—with mental illness comes medication. We might not like it, but we need it.

Keep The Conversation Going

Teaching kids about mental health should not stop once they leave the house. School is an important place for them to learn more, and school counselors and teachers should have resources about mental illness and suicide. It’s also beneficial for a child to have a non-biased counselor to talk to if they have questions they don’t feel comfortable asking you, or if they’re having mental health concerns about themselves.

A great resource for schools is NAMI Ending the Silence, an in-class presentation in which students learn about mental illness from someone with lived experience. Having conversations and learning about mental health in school will only reinforce the information you share with your child at home. The more education your child receives about mental health, the more important it will seem.

As parents, we’re not mind-readers, and we can’t afford to pretend we are. That’s why it’s so important to communicate with our children about mental illness—even if it’s difficult to talk about or explain. We never know what they might be thinking, and it’s only fair to you and your children to be honest about your mental health.

I wrote my children’s books about bipolar disorder because my son was starting to ask questions, and I’d rather he learn from me about mental illness than the callous things he might learn from those who aren’t educated.

I’ve seen amazing ripple effects since starting our talks: My son now educates others on the topic. He has tools in his toolbox to use if someone says something about mental illness he knows isn’t true.

To help end stigma, we need to start with our own children. So if you’re a parent living with mental illness, fill your house with love and mental health awareness. Don’t procrastinate, educate. And feel free to use Binky Bunny. Together, we can all hop to stop stigma!

 

Kathleen Boros is originally from Massachusetts and was brought up in Florida. She’s been married for 15 years and has an 8-yearold son. She was diagnosed with bipolar disorder at 19 and is now 41. She received a bachelor’s in behavioral science and a master’s in special education. She enjoys writing to educate children and their families about mental illness. Join her efforts to educate children on mental health with Binky Bunny.

https://www.nami.org/Blogs/NAMI-Blog/November-2018/Talking-to-Kids-About-Mental-Illness

Avoiding Holiday Stressors: Tips For A Stress-Free Season

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By: Jessica Maharaj

The “most wonderful time of the year” can quickly turn into the most stressful time of the year for many. When compounded by a mental illness, common holiday pressures can create a perfect storm of exacerbated stressors, symptoms and setbacks if not proactively addressed.

The reality is that potential hazards exist at every turn during the holidays. These situations can trigger heightened difficulties for people suffering from depression, anxiety, PTSD and other mental illnesses. The holidays can also introduce additional stressors such as complicated relationship dynamics at family gatherings, grief over losing a loved one or simply trying to live up to the unattainable expectations of the “perfect holiday.”

While it’s important that all people consider the impact of the holidays on emotional well-being, it is crucial that those with mental illness consider tactics for avoiding pitfalls. Of all the things on your holiday preparation to-do list, the most critical one is maintaining your mental health and practicing self-care.

Major Depressive Disorder With A Seasonal Pattern

Major Depressive Disorder with a Seasonal Pattern (formerly known as seasonal affective disorder, or SAD), is a form of depression that often accompanies changes in seasons. This disorder results from chemical changes in the brain and body and is best controlled with the help of a mental health professional who understands the nuances of treating this condition. Whether through online, remote care options such as telepsychiatry or in-person treatments, seeking professional support is truly beneficial in proactively managing this condition leading up to, during and following the holiday season.

Symptoms of SAD can become more pronounced as the holidays approach. These tips can help you manage your symptoms during the holidays.

  • Stay hydrated. Drink plenty of water and herbal teas, and don’t forget to hydrate your skin with lotions and lip balms. Hydration nourishes the brain and its physical effects can improve your overall mood.
  • Find time to exercise. The holiday season is a great time to ice skate, ski or hike. If you don’t have access to these outdoor activities, any form of exercise will release endorphins, which can lessen the symptoms of depression.
  • Spend time with loved ones. This offers an opportunity for social interaction, which can help lessen the feelings of loneliness that may come around this time of year.
  • Pamper yourself. Taking a bath, having a warm drink or getting a massage can create a sense of calm and happiness, especially during the stress of the holidays.
  • Indulge without overconsuming. Treating yourself can make you happy, but over-indulging in unhealthy food around the holidays can negatively impact symptoms.

Grief Over The Holidays

One of the greatest holiday stresses is the absence of a loved one who passed away. The empty seat where they would have sat can fill families with a sense of grief, loss and emptiness, as well as worsen symptoms for individuals with mental illness. The following recommendations can help you and your family cope:

  • It’s not all sad. Know that some parts of the holiday will be wonderful, and some parts will be sad. The anticipation of sadness may be stressful, but the holidays provide an opportunity for healing. You can still take joy in the relatives that are present and remember fond memories of holidays past.
  • It is okay to feel the way you feel. It is healthy to acknowledge your feelings and work through them, rather than suppressing them.
  • Take care of yourself. Find healthy ways to cope, such as exercising. Organizing family walks is a great way to get fresh air and enjoy the company of others. Don’t search for solace in unhealthy foods or alcohol. If alcohol is present, drink responsibly.
  • Don’t feel pressured to uphold family traditions. While they might be a comforting way to remember a loved one, sometimes family traditions are too painful to bear. Your family will find new ways to celebrate, and your traditions will adjust with time.

Keep in mind that the loved ones you lost would want you to remember them fondly, to enjoy the holiday season, and to find comfort in having the family come together.

Managing Holiday Expectations

The holiday season only comes once a year, and while it’s understandable to aspire for perfection, it’s important to set realistic, attainable goals. The following are a few key tips for avoiding the stress of perfection.

  • Make a budget. While the average American household spent nearly $1,000 on holiday gifts in 2017, it’s important not to go overboard. Do your best to stick to a budget while still leaving a small amount extra for wiggle room; the holidays tend to bring out the generosity in us.
  • Come up with a plan. Spread out your errands, so you don’t become overwhelmed with too many tasks at once, and don’t forget to schedule some relaxation time!
  • Find the best time to shop. Malls are less crowded on weekdays and weeknights. If you can manage, try to go during the day and park farther away from the stores. Your time in the sunlight walking to or from your car can boost your serotonin levels. Practicing mindful activities while you wait in line can also help you stay calm among the holiday shopping chaos.
  • Be kind to yourself. All you can do is your best and your best is good enough. It’s impossible to please everyone, but we are often our own harshest critics.

Keep in mind that the holidays are about spending time with loved ones, not gifts. Your friends and family will be happy to create memories with you, so don’t worry about finding an expensive gift or if they will like it; they will appreciate your efforts and affection regardless of what you give them.

The holidays bring joy and happiness as well as frustration and stress. This holiday season, you may have many things to take care of, but the most important one is yourself.

Jessica Maharaj, a Certified Nursing Assistant, is currently pursuing a master’s degree in Clinical Mental Health Counseling at George Washington University while also working at InSight Telepsychiatry. She earned a Bachelor of Science degree in Psychology with a second major in Biology and a concentration in Human Services from the University of Maryland, Baltimore County (UMBC). Jessica was the President of UMBC’s campus chapter of NAMI during her undergraduate career. 
https://www.nami.org/Blogs/NAMI-Blog/December-2018/Avoiding-Holiday-Stressors-Tips-for-a-Stress-Free-Season

Traveling With A Mood Disorder

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I was diagnosed with bipolar II disorder when I was 14. It has taken me decades to come to grips with what that means, and to be in a place where I’m comfortable talking openly about it. Nowadays, I’m really open, because I work as a travel blogger, connecting with people and places for a living. I actually started my career at a nonprofit office job, thinking that was what I wanted. But the traditional professional life was something I couldn’t live up to, and I frequently used travel to re-center. I’m very lucky to have turned it into a career, because I’ve learned that travel can be one of the most incredible experiences for those of us struggling with our mental health.

For many of us, myself included, it can be hard to get out of bed some days. Depression comes crashing down, and just the thought of moving becomes overwhelming. Needless to say, the idea of journeying to the other side of the world can seem downright impossible.

But I’ve found that waking up in a new place can be very effective in breaking a downward spiral into an extended depression. My brain becomes too preoccupied with learning about a new place to focus on my mood. That said, traveling with a mood disorder also has its perils. So here are some tips and lessons (some of which I learned the hard way). May they help you, too!

Before You Go

Make Sure You Have Enough Medication. Most of us go month-to-month on our meds. That can be a challenge for an extended trip that overlaps with your refill period. I usually work with my doctor to get a two-month’s supply when I know I have a trip coming up to help with that issue. My pharmacy is also aware that I travel often and works with me to push up refill dates if needed.

Brief Travel Companions on Your Needs. Solo travel is easier for me in many ways because I don’t have to justify my emotional needs to anyone. However, when I travel with others, I try to discuss with them what I need (downtime, alone time, etc.) before we go. That way, we can work out systems that allow me to get what I need within the framework of our trip.

For example, I love taking road trips with my father, and it’s something we’ve been doing since I was a little kid. One of the systems we have in place is that when I feel like I need some alone time, we stay at a hotel with one-bedroom suites. He sleeps in the bedroom, and I sleep on the couch in the living room. Just that one wall and a few feet gives me the precious personal space I need.

Plan. For many of us with mood disorders, our anxiety worsens with the unknown—so having a plan can help with that. This doesn’t mean I have every day planned out, but I go into a trip with at least a rough itinerary. I also try to alternate busy days with lighter days to build in some downtime for myself.

While Traveling

Prioritize Self-Care. I refuse to neglect my self-care when traveling. For me, emotional balance begins with a good night’s sleep (at least eight hours, preferably more). I’ve accepted that this means I will rarely enjoy the nightlife in a new place, and I’m okay with that.If your self-care involves exercise, meditation or something else, structure that into your trip. Try to find hotels with fitness centers, room in your suitcase for your meditation materials, or anything else you may need.

Know Your Triggers. Our illnesses (unfortunately) don’t disappear because we’re on vacation. Our triggers are there as well, so we need to continuously pay attention to situations that can activate them. Knowing what our triggers are ahead of time can help us avoid things that might set them off, but sometimes it still happens. What do we do then?

When I was in Japan, I visited the Fushimi Inari Shrine in Kyoto. It was extremely crowded, and at one point, people were all around me, and I felt like I was trapped. I had a panic attack, and I decided that rather than push

through the rest of my day, I would take care of my needs and leave. I told my travel companion that I would meet him back at our hotel, and I left.

Practice Self-Compassion. This one is still hard for me. After a situation like the one in Kyoto, my natural inclination is to be upset with myself. What I (and my illness) needed that day prevented me from seeing a place I wanted to see. While shame, guilt or disappointment might be our natural first reaction, it’s important to then be compassionate with ourselves. Doing what is necessary to maintain balance is hard, and doing it at the expense of something we were looking forward to is even harder. We make tough choices like that every day, but prioritizing our emotional needs is never the wrong choice.

Keep Your Support Structure Engaged. For some people, this means doctors or therapists. For others, like me, it means certain friends and family members. My friend Ana is one of my first calls when I have panic attacks or depression spirals at home. So even when I was in Kyoto, she was my first call when I got back to the hotel. Hearing her voice, even while on the other side of the world, made me feel like I wasn’t helpless or isolated just because I was gone.I do my best to make sure my support structure is aware of what’s going on with me while I’m gone, and I have emergency procedures in place with my therapist and psychiatrist just in case.

After You Return

Update Your Doctor and Therapist. I find it helpful to do a “debrief” with both my psychiatrist and therapist when I return from a trip. What situations did I handle well? What do I wish I would’ve handled differently? How did my meds work in a completely different environment? I believe that we learn by doing, and keeping the professionals we trust informed of our discoveries along the way is important.

Congratulate Yourself. Regardless of whether or not you handled every situation in a way you consider “perfect,” you were able to travel with a mood disorder. That is an accomplishment that needs to be celebrated! Look through your photos, tell stories to your friends, and know that if you did this, you can do anything.

 

Jonathan Berg is a volunteer facilitator for the Depression and Bipolar Support Alliance and the founder and editor of the travel blog The Royal Tour (www.theroyaltourblog.com). He struggles to keep his bipolar disorder in check and shares his adventures and struggles with his readers.

https://www.nami.org/Blogs/NAMI-Blog/August-2018/Traveling-with-a-Mood-Disorder

Spreading Hope Through Peer Support

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What does it mean to be a peer support specialist?

To me, it means providing a voice for people when they struggle in finding their own. It means advocating for people, encouraging their recoveries and even sometimes standing in courtrooms as a show of support. And it often means educating community members and outside providers about First Episode Psychosis (FEP) programs like the Early Assessment and Support Alliance (EASA)—a program where I transformed from a participant to a peer support specialist.

For many, psychosis is a scary experience, and it can be easy to lose hope. When I received my diagnosis, I felt like all hope was lost. I thought my life was over. I thought I was doomed to serve a life sentence, confined to the four walls that enclosed my bedroom in my mother’s basement. That’s a tough pill to swallow at 20 years old. Due to my fear and paranoia, I often found it difficult to leave not only my house, but even my room. I felt completely alone, hurtling in a downward spiral of despair.

This is typical for a person whose experiencing psychosis—to withdraw from those around them. For that reason, psychosis breeds isolation and loneliness. But what made a huge impact for me during this period of isolation was being able to talk with others who understood what I was experiencing. What I needed at that time is exactly what I work to provide for people now: messages of hope. At its core, I view peer support as the strategic use of telling one’s own lived experience as a tool to work with others through their experience.

What Does A Peer Support Specialist Do?

As a peer support specialist, I can meet people where they are comfortable. If they decide they don’t want to meet in the office, I can travel to them. I’ve met people all throughout my community. Often, we even interact via text message to coordinate meetings or just be in contact. Everyone engages in their own way, and I work hard to build rapport and trust with participants and their families.

As a peer support specialist, I work with program participants to help reduce their social isolation. We may look at a participant’s hobbies and interests and use those passions to help reconnect them to their community. The social support that can be gained through hobbies is an important coping strategy for those experiencing psychosis. I work with participants to create organic social supports, so when they move on from our program they have a natural support system in place.

As a peer support specialist, I act as a model for recovery. In the past year, I met a psychiatrist who didn’t even know recovery from psychosis was possible. After sharing my journey with him and combating the idea that a diagnosis is the end-all for patients, it’s my hope that he has changed his message to the patients he works with, potentially creating a dramatic difference in their recovery process.

As a peer support specialist, I work to help people to see diagnoses for what they are: words. A diagnosis is not a definition. See, a word by itself doesn’t have power—it’s merely a series of letters mashed together. The negative connotations associated with the words “psychosis” and “schizophrenia” are learned, taught to us through sources such as the media. And it’s all too easy to take what the media tells us about these diagnoses and use that information to form beliefs about yourself—but a diagnosis says nothing more about you than the color of your hair. What defines each person is theirs to create and own.

As a peer support specialist, I work with people who need me to hold onto their hope for them until they’re ready to hold it for themselves, just as I once needed.

Everyone Deserves Adequate Mental Health Care

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As a caretaker and advocate for my mom, it’s been daunting navigating both the cultural barriers in my Latino community and trying to access mental health services. Thus far, these challenges have proven too difficult to surmount in getting my mother adequate treatment for schizoaffective disorder.

Years before my mother got an official diagnosis, we viewed her “locura” (craziness) as just part of her personality. In hindsight, it was clear there were times when my mom was harboring extreme delusions and experiencing bouts of mania. At the time, though, it was our pride that probably led us to downplay my mom’s problems.

Pride is a common problem among Latino families—we don’t like people seeing our weaknesses. We don’t want to admit we even have any. Many of us also come from working class or impoverished backgrounds, which instills in us a deep-seated perseverance—an attitude encapsulated by the slogan “¡si se puede!”

Latino families are also very private, as problems are settled within the immediate family. This extends even to family gatherings. During these events, I would try to help my mom socially navigate, in the hopes of concealing any irrational behavior. But attending extended family functions began to occur less frequently as my mom’s mental health deteriorated.

She started to accuse the family of working for the FBI to spy on her and my dad of trying to kill her by putting poison in her food and drink. She’d wake up in the middle of the night and insist she heard people trying to get inside the house to kill her. Suggesting she see a psychiatrist made my mom angry and hostile, and everyone else miserable.

About three or four years into my mom showing symptoms, I began to take a more direct role in trying to get help and treatment for her. By then, my parents were divorced, but still living together. My mom was unemployed and uninsured, and her psychosis was constant. She had nowhere else to go and my dad was reluctant to kick his high school sweetheart out of the house.

Lack of health insurance was a significant barrier for us when I first tried to get her help. This is a problem experienced by too many Latinos. Additionally, my mom didn’t have an official diagnosis (which is proof of a disability) that we could use to apply for Medicaid.

I decided to move my mom in with me in San Francisco. The city was in its early years of offering health care services to impoverished, uninsured residents. I enrolled my mom, and we began accessing community medical and mental health services.

Fast forward nine years later. Despite my best efforts, my mom still remains untreated. In that time, my mom has been released from hospitals against my wishes and has developed various serious medical issues. Trying to access outpatient services, whether community centers or county services, has proven to be entirely useless. In one case, it was hard to even get in the door when we tried to access a county mental health program. My mom was denied services (“found not eligible”) because she didn’t admit to having a mental illness during her initial interview/evaluation. It took pressure and advocacy on my part to finally get her enrolled.

There are gross inadequacies and structural problems in the mental health system. More and better family education and outreach are essential in order to mitigate the cultural barriers that play a part in impeding Latino families from realizing and accepting they need help. Training and employing more culturally responsive and competent mental health staff and psychiatrists, and expanding community mental health centers/clinics are also important.

For example, the Latino mental health center we used in San Francisco was a blessing in helping us finally get an official diagnosis for my mom. With his cultural competence and skill, the psychiatrist my mom saw was able to build trust and a rapport with my mom relatively quickly, despite her deep reluctance in seeing him.

I will advocate for treatment centers like these for the rest of my life. My mom, my family and my community deserve quality care.

 

Mike was born in Fresno, CA, the grandchild of Mexican immigrants. He has been teaching at a community college in the Bay Area for ten years and is a caregiver for his mom who is diagnosed with Schizoaffective Disorder. Read his blog here.

https://www.nami.org/Blogs/NAMI-Blog/July-2018/Everyone-Deserves-Adequate-Mental-Health-Care

A Therapist’s Journey: Learning The Art Of Self-Soothing

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One day, I was standing on the back of my pickup truck and throwing away trash at the town dump when I had an experience that’s hard to describe. My head was swimming, my body felt electrified and I felt detached from the world and myself. A memory then trickled in: I was nine years old, being hit repeatedly by my father one evening because he thought I had lost a 25-cent screwdriver. I remember being scared that he was going to kill me. I remember going numb.

Thirty years later, there I stood, scared and numb again—wondering how or what to do to get out of this state, wondering if I would ever “come back.” I was by myself that day, and not only was nobody home, but I had no one to call. None of my friends had the kind of inclination toward giving me the help I needed, and I also wasn’t in therapy at the time. I was stuck—in more ways than one.

It would take me quite a while before I learned how to soothe myself when I wasn’t doing so well. And I’m still not always the best at it. The old phrase of “physician, heal thyself” rings true for me. Being a therapist, I sometimes think, “Jeez, if my clients knew how difficult it is for me to calm myself down sometimes, I’m not sure they’d keep coming to me.”

Working Through Challenging Symptoms

Therapist or not, learning to self-soothe is hard, but it’s something we all should learn how to do—especially if we have mental health conditions or traumatic pasts. Over the years, I’ve mostly grown past, but I’ve never forgotten, the harshness of my father. That doesn’t mean all my insecurities have gone away, and I don’t expect they ever will; it just means that I’ve concentrated on working toward being independent enough from my experiences. That way, I don’t get so wrapped up in my symptoms of depression and anxiety, and in the fears I still carry around.

Instead of being ruled by these symptoms like I have in the past, I have “worked” psychologically, spiritually and practically to learn and practice the art of self-soothing. I remember when I first started practicing, I latched on to one technique, thinking it would be the answer: breath. I would sit quietly, usually in the morning, and I would breathe in and out, paying attention to the noise of my breath passing through my nostrils. When I became aware of my mind wandering, I would try to refocus. I found this exercise helpful—for a little while.

The sense of peace and calm I once got during the exercise vanished one day, so, I started looking for other ways to self-soothe. This became my pattern. I try a self-soothing exercise, and it either helps me or it doesn’t, then after a stretch of time, I move on to something else.

Over the years, I’ve tried numerous self-soothing techniques. For about a year-and-a-half, I did daily meditations from A Course in Miracles, and once it became too spiritual for me, I stopped. I rode my bicycle for a couple of years. I took up “intentional walking” (a kind of meditation in movement). I tried yoga. I attended spiritual retreats. Jogging was more work than soothing. Walking did not work when I was in my 40s, but was effective in my 50s. Sitting quietly with my legs crossed in meditation was more painful than anything. Qi Gong was not helpful. Tai Chi did not work.

Now, in addition to swimming at the YMCA a few times a week, I meditate while stretching for about 30 minutes in the morning. I also read, at times, from spiritual, poetry or philosophy books, and when I get an “ah-ha” moment, I stop and repeat that saying or sentence or concept throughout the day. I also like to go to the movies and “lose myself” in what’s happening on the screen.

Getting Started

I think one of the most important aspects of self-soothing I’ve discovered is that not every technique works for everyone and it’s unlikely that one technique will be the only technique you ever use. I know that I will likely continue using different techniques, probably for the rest of my life. My initial belief that I would find “one answer” to my anxiety, obsessions and fears was a myth.

I see that a lot in my practice, as well. People want one solution to feel better: one medication, one single action to solve all their problems. The fact is, that’s not how life works. We have to try all kinds of solutions; some will work, some won’t, and some might for a period of time and then stop. Some might not work now, but might later.

That’s a difficult concept to get across to clients and even to myself. I want to feel better right now and forever. But that’s unrealistic. That’s why part of therapy is helping people be realistic in their expectations and to realize that growth, becoming more peaceful and calm as well as happier, is a process that evolves over time. Self-soothing is one of those things as well: It evolves over time. If you’re going to take on learning the art of self-soothing, I have a few pieces of advice.

Realize The Value

Too many of my clients hesitate to take time away from our sessions to practice self-soothing. They have convinced themselves there is little value in learning how to calm themselves when actually, self-soothing can help the recovery process immensely. When you are upset or stressed, it is important to know positive ways to cope on your own—that’s a skill important for our individual growth no matter who we are. Finding ways to self-soothe can help you feel at ease when you are dealing with frustration, excitement or having intense emotions. It can also reduce the amount of worry and fear we carry around with us.

Use Simple, Everyday Experiences

You don’t need to be a guru on the mountaintop raking sand to self-soothe “the right way.” A friend once told me she meditates when she irons. Try to think of something simple you do that you can focus on to relax and find some peace of mind, even if just for a short time.

Adopt A Calming Word Or Phrase

Finding words or phrases that help shift you to a calmer state is like having the right tools for a job. You can find these words, phrases or concepts by reading books or articles or daily meditations, by listening to podcasts or videos, or by making them up yourself. When you find something that makes you feel at ease, stop reading or listening and repeat it a few times to commit it to memory. Repeat the word or phrase periodically throughout the day during stressful and non-stressful times; it will likely bring you a sense of calm.

Practice Makes Perfect

Self-soothing is like any other exercise. The more we do it, the better we get at it. You don’t practice running for a marathon by only running the marathon. You practice by jogging shorter distances and building up stamina. When we practice self-soothing techniques even when we don’t “need” them, we are building a skill and more of an automatic response for when we do need them.

Therapy Can Help

I have used therapists in the past as coaches, supports and idea-generators. My therapists have given me great insight into the kinds of situations that trigger me, and helped me learn how to manage those triggers. Learning to manage my triggers reduces the need to self-soothe in the first place.

As you begin this adventure, remember to be patient. Self-soothing is a skill that develops over time. I’m still learning. But through my learning, self-soothing has helped me be calmer in my day-to-day interactions with people, and I’ve found that I’m more prepared for experiences like the one I had in the back of that pick-up truck.

Learn how to soothe yourself. It could make a difference in your life. I know it did for me.

 

Larry Shushansky has helped thousands of individuals, couples and families over 35 years as a counselor and public speaker. He has developed the concept of Independent Enough and shares this when giving talks to businesses, nonprofit organizations and educational institutions. Learn more about him at www.independentenough.com.

https://www.nami.org/Blogs/NAMI-Blog/June-2018/A-Therapist-s-Journey-Learning-the-Art-of-Self-So

Writing Tips That Can Reduce Symptoms

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In 1985, psychologist James W. Pennebaker theorized that the effort it takes to hold back our thoughts and feelings serves as a stressor on our bodies. By confronting these thoughts and acknowledging our emotions, we can reduce the stress and negative impact on our bodies. The result? We feel better.

One of the best ways to confront our feelings is through writing. Decades of research have suggested that expressive writing can help improve mood, increase psychological well-being, reduce depressive symptoms, decrease PTSD avoidance symptoms, reduce days spent in a hospital and improve immune system functioning (to name a few).

Writing a letter or journaling is not a new concept; in fact, for many, it’s a fading art form. With all the recent technological advancements, individuals are no longer opting for the standard pen-and-paper means to express feelings, ideas and thoughts. Instead, it’s become much more common to use social media to express “tip-of-the-iceberg” feelings.

For someone with mental illness, taking time beyond a social media post to write expressively can be very helpful to your well-being. Below are a few ways you can use expressive writing practices to reduce mental health symptoms and improve overall well-being.

Focus On A Specific Subject

A study conducted by the University of Los Angeles found that participants who wrote in detail about a particular stressor showed the most improvement versus writing about general facts of a stressful event. Participants who did not just recount events but rather wrote about how they felt about the event had marked improvement in their health.

This means: You should write about a specific experience and all its features—how it made you feel, and any thoughts or ideas you had as result. Don’t just rehash what happened.

Give Yourself Time

By dedicating a set amount of time to write, you can dive deeper into your feelings and experiences rather than just brush the surface. Studies have reported that short writing sessions have less impact on improved feelings/emotions in the long run. Giving yourself a focused time, day and schedule to write improves the ability for your mind to dive deeper into processing your feelings.

This means: Try to set aside at least 15–20 minutes a day to write, and try to do it consistently for two to three days in a row. Allow time after writing to collect yourself before moving on to other tasks.

Don’t Worry About Grammar Or Spelling

When writing a research paper or dissertation, spelling and grammar are crucial. However, this isn’t the case for expressive writing exercises. Worrying about grammar and spelling tends to pull an individual’s mind out of the free, conscious “space” they are trying to experience.

This means: Ignore the rules and write without stopping to re-read or edit what you have so far.

Use Positive Words

Using words like “because,” “realize” and “understand” helps increase the positive effects of the exercise. Studies found that writing that included “positive-emotion” words had higher rates of improved health. Words such as hope, love, anticipation and awe are also good words to consider using.

This means: The words you use matter. After writing, identify the number of positive words in your writing. You can also visit www.liwc.wpengine.com and paste your text into their system and see how your writing is translated in a positive or negative sense.

Seek Support

While extensive studies have been conducted, there is still much to learn about the implications of writing about emotional topics such as PTSD, anxiety or depression. Therefore, if possible, seek support from a mental health professional to help you through any challenges that may arise during these exercises. It’s important to have resources available while you uncover feelings and emotions through the writing process.

The art of expressive writing has been researched and studied for decades, and the findings demonstrate that it has a positive impact on symptom reduction and overall well-being for participants who use the process as it was intended. Consider the above five tips when beginning your “writing to wellness” journey.

 

Steven Swink has his Master’s degree in counseling psychology and has been working in the field of mental health since 2009. He has provided direct counseling services and provides supervisory-level work in the mental health field overseeing various programs and service delivery to consumers. In addition to his mental health experience, Steven is co-founder and CEO of www.Letyr.com, a platform for people to anonymously share their ideas, beliefs and feelings in a safe and confidential way.

https://www.nami.org/Blogs/NAMI-Blog/February-2018/Writing-Tips-that-Can-Reduce-Symptoms