Tag Archive for: CARE Counseling

An Important Conversation With My Mom

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July is Minority Mental Health Awareness Month, and I wanted to take this opportunity to explore a particularly difficult season in my life: the years my mom served time.

As a quick background, my mom has always been as much of a friend as a mother, and before this period we spoke every day. The years she spent incarcerated were intensified by my severe depression and overeating disorder, but we’ve never fully talked about how they impacted one another. I thought now would be the right time to have that conversation:

DeWanda: Let’s start with logistics because my memory is the worst. What were the dates of your incarceration?

Mom: I was sentenced on July 2, 2008 and went straight to first Howard County Detention Center. I was transferred to the MCIW (MD Correctional Institute for Women) on July 20 and was there until April 20, 2010.

D: It felt so much longer in my head. Do you remember your first day? How did you feel?

M: The very first day was when I went to court for the sentencing. I was told that I needed to be prepared that they might not allow me to return home that day. The lawyer was right because I was told I was being given seven years out of a 15-year maximum. At that moment, I was silent, I felt numb, nauseated and like I was going to faint. They took me out of the courtroom in handcuffs after the judge spoke and to a cold room with cement floors, a single steel commode and a sink. There was also a cot. I felt dizzy and like I had just lost a loved one to death so I lied on the cot in the fetal position, pulled a blanket over me and immediately cried myself to sleep.

D: I can’t believe I never asked you that before. I think I must have been somewhere doing the same. I was in-between living situations then, couch-hopping with my friends, but I never felt more alone in my life.What would you say was your main coping mechanism during your time at MCIM? I mentioned mine was food. (Spoiler alert: It did not make me feel better.)

M: My coping mechanism became an obsession with reading lots of books. I would isolate myself during times when I could’ve been out mingling and talking to other people in the recreation area. I instead would hide in my room and read. I read and slept all the time. The other ways to cope was that I volunteered to clean up the entire tier of our living quarters as many nights as I possibly could. I cleaned the hallways, the main area and the shower stalls. I was constantly cleaning my cell (which all my cellmates loved). That went on until one day I finally decided to volunteer to help in the Chaplains office in which I ended up directing the choir, teaching people how to sing properly in a choir and helping to teach the new believers classes.

I basically spent the first month feeling sorry for myself and tried to do nothing but sit there and read. When I got over that phase I substituted it with being constantly busy so I’d be too tired to do anything but sleep when I did lay down. It also made the time go so much faster being busy.

D: So, it seems safe to say that faith played a significant part of how you spent your time. Me too, I was attending Redeemer then, and praying with my Bible study group about everything. I also worked on that play, “In the Continuum” down in North Carolina. My character, Abigail, was a woman of great faith too. It was the first time you had ever missed a performance. What else do you feel like you missed out on during your time?

M: I was worried about you because I didn’t know if you had jobs enough to have sufficient income. I didn’t really feel like I was missing anything because life {outside} had become so hectic and stressful that I just needed to lay down somewhere. It probably helped me to get to the point where I don’t have to go places as much as I used to.

D: You’ve always been the glass-half-full type. Yeah, I was miraculously fine. I remember coming to get you for Great-Grandma’s funeral and making sure they released you. That was a little light in the midst of things. I still feel bad about getting married while you were away, but I guess I thought you wouldn’t want me to stop living.

M: I was in no way offended about you getting married cause look at what a great husband you got. We ain’t want Alano to get away.

D: You’re too funny! This conversation is good. I’m over here crying.

M: Don’t cry! It’s over now and I actually got to help others which also helped me get through it. I saw other people who had to be on depression medication all the time while I was there. I have never been diagnosed as depressed but I supposed OCD is a problem.

D: Statistics regarding incarcerated women and mental health are pretty staggering.

M: Oh, wow!

D: OCD is definitely a thing—under-eating makes people feel like they’re in control, even if the food is gross.

M: I never really knew what that was; I just know I have to do something when I’m stressed.

D: Any lasting thoughts you’d like to leave with the NAMI community?

M: Yes. Get up every day and write a list of all the good things and blessings that you have. It helps to create a more positive mood for the rest of the day. The more we focus on the good things and also remember that someone else may have a harder time than we are experiencing, it keeps it all in perspective. Also, don’t be afraid to tell others how you are really feeling the next time someone asks, “How are you?” It makes all the difference in the world if you have someone who you know genuinely cares. Try to be that person for someone else and see what a difference it will make in your life.

 

DeWanda Wise is an actress whose work includes roles on Fox event series, Shots Fired, and the critically acclaimed series, Underground. She resides in California with her husband and the best cat in the world, Rascal.

https://www.nami.org/Blogs/NAMI-Blog/July-2017/An-Important-Conversation-with-My-Mom

College Students Of Color: Overcoming Mental Health Challenges

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July is Minority Mental Health Month which provides an ideal opportunity to talk about the mental health of young people of color. Our country is becoming more and more diverse—the proportion of children of color are projected to become the majority by 2020 and people of color are expected to make up the majority of the U.S. population by 2045. It’s crucial that we pay attention to the mental health of young people of color as they become the future of our nation.

Mental illness affects young people of color at similar rates as white young adults. However, they are less likely to be diagnosed or seek mental health services. This is largely due to stigma and a cultural mistrust of mental health professionals who lack cultural competence.

Not seeking needed mental health care is problematic for this (and any) population—but especially for college-aged people of color. Because 75% of all lifetime cases of mental illness begin by age 24, college is a time during which many mental illnesses first appear. Coping with an untreated mental illness can affect a student’s social experience and academic performance. And for students of color, there’s often more under the surface working against them.

How Discrimination Affects Mental Health

The social determinants of mental health include factors such as where people are born, live and work as well as their age. They also include things such as discrimination and exclusion, socioeconomic status and access to health care.

Some colleges and universities have recently become settings of discrimination, racial profiling and xenophobia. Universities that create these feelings of marginalization and isolation can be harmful to mental health, and for students of color who have a pre-existing mental illness, such acts of alienation can actually worsen their condition.

Many of us grew up hearing the adage: “Sticks and stones may break my bones, but words can never harm me.” Dr. Altha Stewart, who, in May 2018, became the first African-American President of the American Psychiatric Association, stated recently that “this old saying is incorrect and the truth is that  negative words, can be damaging to mental health, especially for young people.”

Racially hateful expressions broadcasted on social media or communicated face-to-face are harmful to the mental health and well-being of college students of color. This is especially true when cyber-based comments are anonymous. Not knowing if comments are coming from a classmate or someone living next door in the dorm can be frightening and anxiety-provoking.

Colleges and universities should create environments in which young people of color are valued. This can be done by recruiting and retaining a diverse staff and faculty; establishing zero-tolerance policies to racist actions; and developing and maintaining cultural supports, such as culturally-themed clubs, dorms and diverse student identity groups.

Positive actions like these are delineated in the Equity in Mental Health Framework developed by the Steve Fund in collaboration with the Jed Foundation. These resources can help young people of color thrive socially, academically and emotionally.

 

Annelle B. Primm, M.D., MPH is currently senior medical adviser to the Steve Fund, and senior psychiatrist adviser to Hope Health Systems and several other organizations. During her career, Dr. Primm has been Deputy Medical Director of the American Psychiatric Association; Director of the Johns Hopkins Hospital Community Psychiatry Program; an editor of the books, Disparities in Psychiatric Careand Women in Psychiatry: Personal Perspectives; and a lecturer and video producer on the mental health of diverse and underserved populations.

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

What I’ve Learned about Relationships and Mental Illness

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Relationships and mental illness — can it work out? People who struggle with mental health issues might find themselves wondering if they can handle a relationship as well. I know I did. After all, it’s hard to think about being with another person when some days just managing life feels hard.

I didn’t date that much in my twenties. I was diagnosed with depression and anxiety at the age of 19, and I honestly thought that being in a relationship would be too much stress. I had all these worries — what if I wasn’t fun to be with? What if my partner got fed up with my issues and left? What if I wasn’t ready to deal with being in a relationship alongside dealing with my mental health?

And worst of all — what if I told someone about my mental health issues and they ran in the opposite direction? There’s such a stigma about mental health that I worried a lot about how my prospective partner might react.

I’m nearly 40 now and have been happily married for 15 years. Along the way, I’ve learned a few things about balancing a relationship together with mental health issues. Here’s what I’ve learned about relationships and mental illness.

  1. They Are Totally Compatible

Having a relationship is as possible for you as it is for anyone else! Whether we have mental health issues or not, each person comes with their own “stuff.” A mental health condition doesn’t have to be a barrier to a healthy relationship. Yes, it does take a bit of work, but it’s totally doable.

  1. But You Have to Find the Right Person

The key to having a good relationship is to find the right person. You’ll need someone who is open minded about mental health and empathic enough to be willing to learn and understand. Someone who shows patience when you are having a rough day.

  1. Disclosure Is a Must

Keeping your mental health a secret puts immense pressure on you, and that stress will only add to your problems and make your symptoms even worse. To have a successful relationship you need to know you can be open about your issues, even on your worst days.

  1. But Pick Your Time

Knowing when to disclose is a tough call. On one hand, you probably don’t want to mention it on the first date. It’s nothing to be ashamed of, but it is very personal. On the other hand, you don’t want to get really invested in the relationship only to find out they can’t handle it. I waited until it was obvious this was more than just a handful of dates, before we made any commitments

  1. Know Your Limits

Your mental health condition most likely put some limits on what you can do in a day. For me, I know if I get too stressed, my anxiety gets worse. So I have to take things more slowly than some people. Stress might affect you in a completely different way, but be aware when it does.

  1. But Don’t Make Your Partner Responsible

Ultimately, only you are responsible for your behavior and for managing your mental health. It’s a good idea to make your partner aware of how your condition affects you and it’s absolutely ok to ask them for support — but don’t make them responsible for you. For example, sometimes my depression makes it hard for me to get motivated for a night out, but I don’t stop my husband from going out. My depression is not his problem to solve.

A healthy relationship can actually boost your mental health by bringing joy, laughter, and support into your life. If you’ve been worrying about having a relationship because of your mental health, I’d say, why not give it a try? Just be aware of your needs and limits — make sure the relationship is nourishing, not draining, you!

By 

Getting Involved With Minority Mental Health

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Mental health conditions do not discriminate based on race, color, gender or identity. Anyone can experience the challenges of mental illness regardless of their background. However, culture, race, ethnicity and sexual orientation can make access to mental health treatment much more difficult.

America’s entire mental health system needs improvement, including when it comes to serving marginalized communities. When trying to access treatment, these communities have to contend with:

  • Language barriers
  • A culturally insensitive system
  • Racism, bias and discrimination in treatment settings
  • Lower quality care
  • Lower chance of health care coverage
  • Stigma from several angles (for being a minority and for having mental illness)

These are all in addition to the usual road blocks. Many cultures also view mental health treatment as a luxury, considering symptoms a “phase” that will eventually pass. These harmful perceptions of mental illness can further isolate individuals who desperately need help.

We can all help ignite change against these disparities and fight stigma this Minority Mental Health Awareness Month. It simply starts with learning more about mental health and informing your community.

Consider Giving A Presentation

Starting conversations about mental health in your community may feel intimidating—especially if your community views mental illness as a personal fault or weakness. But the more we talk about mental illness, the more normalized it will become. And NAMI is here to help!

Consider giving NAMI presentations to your community, like Sharing Hope for the African American community and Compartiendo Esperanza for the Hispanic and Latino communities. These presentations go over the signs and symptoms of mental health conditions as well as how and where to find help. If neither of these presentations fit your background, feel free to use them as models to create your own presentation tailored to your community’s needs.

Emphasize Treatment

Make sure to stress the importance of a culturally competent provider. These mental health professionals integrate your beliefs and values into treatment. To find a provider that does this, you may have to do a significant amount of research. In addition to searching online, you can also ask trusted friends and family for recommendations or ask for referrals from cultural organizations in your community (like your local AKA Chapter).

In your first session, make sure to ask any questions you may have about the professional’s cultural competence. For example:

  • Do you have any experience treating someone from my background?
  • Have you had any cultural competence training?
  • How would you include aspects of my identity into my care?

Be confident when disclosing relevant information about your beliefs, culture, sexual orientation and/or gender identity that could potentially affect your care. Your provider will play a vital role in your treatment, so make sure you feel comfortable and can communicate well with them before committing to them. Remember: If you feel like your provider doesn’t understand you, it’s okay to leave. Cultural competency is very beneficial to effective treatment. It might take a bit of effort to find the right fit, but recovery is worth it.

Share Your Story

When a person experiences symptoms of mental illness, one of the most helpful and comforting feelings is knowing that they’re not alone. It can be incredibly reassuring to know in this moment right now, someone else is going through similar struggles as you are—regardless of where they are, who they are, or how they identify.

If you’re ever feeling isolated or that your community doesn’t understand mental illness, explore story-sharing platforms like Ok2Talkand You Are Not Alone. On these platforms, everyday people write about their deepest struggles with mental illness and their hopes for recovery. If you feel comfortable, post your thoughts and feelings about or experiences with mental illness—it’s rewarding to know you are helping others feel less isolated.

Minority Mental Health Awareness Month is an opportunity to raise awareness and stop stigma in diverse communities. It’s time to improve the harsh realities minority communities face when it comes to mental illness treatment. In fact, it’s long overdue.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/July-2018/Getting-Involved-with-Minority-Mental-Health

How Fireworks Can Trigger PTSD

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You may see the signs popping up around your neighborhood this July 4—red, white and blue notices that indicate the home of a vet with the request to “Please be courteous with fireworks.”

The signs are the work of a Facebook-launched nonprofit, Military With PTSD, begun by Shawn Gourley, whose husband, Justin, served in the Navy for four years and returned with post traumatic stress disorder (PTSD). Sudden and loud noises can trigger episodes of PTSD, bringing veterans back to traumatic experiences they have lived through during their service. According to the U.S. Department of Veteran Affairs, up to 20% of military personnel who served in Iraq or Afghanistan experience PTSD each year.

The signs are posted on the lawns of veterans’ homes to alert people to be more considerate when setting off fireworks in the area. According to Gourley, who spoke to CNN, the group has mailed 2,500 signs, some of which were paid for by donations and others by the vets themselves, while 3,000 people remain on a waiting list.

The signs are not meant to quash any Fourth of July celebrations, but to raise awareness that the explosive sounds, flashes of light and smell of powder may trigger unwelcome memories for some. “If you are a veteran, on the one hand July 4th should be one of the most patriotic holidays that you feel a part of,” says Dr. John Markowitz, professor of psychiatry at Columbia University. “On the other hand, the rockets’ red glare and the bombs bursting in air are likely to evoke traumatic memories, and you might want to hide. It’s a tricky one.”

Having advanced knowledge of a fireworks display can help some people with PTSD to better prepare and cope with any symptoms they may experience. “A big component of the startle response and PTSD is the unexpected,” says Rachel Tester, program director of the Law Enforcement, Active Duty, Emergency Responder (LEADER) Program at Harvard Medical School’s McLean Hospital. “When people are able to anticipate, they are able to put into place mechanisms they have to cope ahead of time.”

That might include things such as relaxation techniques or being able to see the fireworks show and therefore know that they’re coming, as well as having headphones, music or other distractions at the ready.

Such strategies may not work for every PTSD patient, but being more aware that the explosive celebrations of the holiday might affect those with PTSD is an important step toward ensuring that everyone can enjoy the holiday without fear, anxiety or pain.

By ALICE PARK

http://time.com/3945001/fireworks-ptsd/

Opioids And Substance Abuse: What Can We Do?

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Opioids and other substances that alter how we feel, think and act have overtaken our culture, and have been declared a public health epidemic. We are losing our loved ones, friends, co-workers and neighbors to these substances. But we have yet to implement the solutions that will beat back this epidemic, as we have so many others, like HIV/AIDS, polio, smallpox and tobacco.

Substance use and abuse—of opioids, heroin, cannabis, stimulants, alcohol, etc.—is universal and the casualties of drug addiction affect all classes, races and regions of the U.S. These substances are too frequently used as an answer to pain, mental and physical, and have become a cure-all for people who’ve fallen on hard times. That’s why so many people use them and that’s why so many people become addicted.

Substance use disorders commonly co-occur with mental health conditions, especially serious mental illness like schizophrenia, bipolar disorder, depression, eating disorders, PTSD and other forms of trauma. People with mental illnesses often turn to drugs and alcohol to quiet their symptoms, and drugs and alcohol can adversely affect our nervous system and increase risk for mental illness.

The Solution

We are failing with this epidemic because of this country’s dogged attachment to policies and programs that have never worked for addiction. Vast sums of money continue to be wasted on campaigns of drug control and on public messages, especially for youth, that rely on scare tactics. We can and must do better. We can beat this epidemic with three public health approaches.

  1. Prevention. This includes school-based programs that provide youth with decision-making skills and methods of controlling their moods and impulses. One proven program is called the Life Skills Training. Prevention also extends to the family, such as “positive parenting,” or actively modeling and teaching children about positive behaviors. Big Brother/Big Sister programs—where an older youth of the same background takes on a younger, high-risk child—is also highly protective. These prevention programs work, and we have hardly started to apply them.
  1. Screening. Early identification of a problem means early intervention, before the substance use disorder becomes more firmly rooted. We have good screening instruments, (such as the Alcohol, Smoking and Substance Involvement Screening Test), and need to make them standard practice in schools, pediatric and family medicine offices.
  1. Treatment. Families and people affected by addiction should advocate for the strong, comprehensive treatment approach they need. Effective treatment means first detecting the presence of a co-occurring mental (or physical) condition and assuring it’s also treated. Treatment for a substance use disorder should then combine:
  • Cognitive therapy that focuses on reducing the triggers of relapse
  • 12-Step programs like Alcoholics Anonymous and Narcotics Anonymous
  • Family education and support
  • Medications

This public health epidemic that is seizing our country can be beaten. And by following these steps, we save lives, help families and restore communities.

 

Dr. Sederer is a psychiatrist, public health doctor and medical journalist. His new book is The Addiction Solution: Treating Our Dependence on Opioids and Other Drugs(Scribner, 2018). www.askdrlloyd.com.

https://www.nami.org/Blogs/NAMI-Blog/June-2018/Opioids-and-Substance-Abuse-What-Can-We-Do

You Can Be Prepared For Crises

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Each year, there are about 5 million visits to emergency departments due to mental illness. Five million people whose symptoms escalate to the point of crisis. Five million people who don’t understand what’s going on or what to do and rush to the ER.

However, this number doesn’t include the people who experience mental health crises without going to the ER—people who are scared and unsure if their situation is a “true emergency.” This number also doesn’t account for the caregivers and loved ones of those experiencing a mental health crisis, standing beside someone they care for, watching them struggle, unsure of how to help.

Mental illness is unpredictable by nature and crises can, do and will happen. Although these crises can’t always be prevented, it is possible to be prepared.

Learn As Much As You Can

The first step in being prepared is gathering any information, resources and support that is available. Start by fully understanding your loved one’s condition: What are the primary symptoms? How can you tell if symptoms are getting more severe? What can you do to support them? And the list goes on. It can be helpful to go with your loved one to see their mental health professional, so you can ask these questions and any others you may have.

Next, learn more about what a mental health crisis is and what to expect when one occurs. NAMI’s new guide: “Navigating a Mental Health Crisis: A NAMI Resource Guide for Those Experiencing a Mental Health Emergency” is a great resource. This free, downloadable guide offers practical strategies on how to deescalate a crisis, information about available resources, tips for advocating for a person in crisis and a sample crisis plan. Details like these are often critical in supporting your loved one during a crisis.

Make A Crisis Plan

Creating a crisis plan should be a collaboration between your loved one and you. The best time to develop this plan is when things are going well. Take the time to ask them questions that will help build a crisis plan, like: What would be most helpful for you? What would you like to do? Who would you like to call? Waiting to ask these important questions can make it difficult to make decisions during a crisis episode.

A crisis plan should include:

  • Your loved one’s general information (date of birth, social security number, insurance information, etc.)
  • Current medications and dosages
  • Current diagnoses
  • History of suicide attempts, drug use or psychosis
  • Addresses and contact information for nearby crisis centers or emergency rooms
  • Contact information for health care professionals
  • A determined behavior/symptom that would prompt going to the hospital or calling 911

Once you create a plane, share it with family members, mental health professionals or anyone else you think should have it. Make sure to update it whenever there is a change in diagnosis, medication, treatment or provider. A crisis plan can be a life-saving resource, so keep it up-to-date and in a safe place.

Notice Behavior Changes

A person with mental illness will typically experience changes in their behavior before a crisis occurs, such as sleeplessness, mood swings or paranoia. These changes are warning signs and shouldn’t be ignored. “Psychiatric illnesses, for the most part, evolve slowly, so there’s going to be a lot of warning,” says Dr. Daniel Lieberman to U.S. News and World Report.

If you notice warning signs, talk to your loved one and encourage them to visit their treating mental health care professional or doctor. “If somebody has a relationship with an outpatient psychiatrist, that’s the first place to go,” Lieberman says.In many cases, there might be enough time to get in contact with a provider before escalating symptoms become a crisis.

Mental health crises can be frightening for everyone involved. However, being prepared can take away some of the fear and uncertainty around what to do and how to help your loved one. Your preparation and support alone can help deescalate a crisis situation—just knowing you’re there, as a stable force, can be an enormous comfort.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/June-2018/You-Can-Be-Prepared-for-Crises

Why Do We Have The Feeling That We Are Not Enough?

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Mike believed he had a good life and felt lucky for all the things he had. He was married to a loving wife, had a good job, owned a nice house and had three healthy kids.

Despite all his good fortune, Mike could not shake the nagging feeling that he wasn’t enough: “I should be more successful. I should make more money. I should be where my boss is. I should have a graduate degree. I should have a bigger house. I should have more friends.” These were some of the “shoulds” that plagued him daily.

“Could I get you curious about this part of you that feels inadequate?” I asked Mike during our first meeting. “Let yourself travel back in time. How old were you when you first felt ‘not enough?’”

He paused to reflect. “It’s definitely been with me a long time,” he said. “Maybe six or eight years old?”

Mike’s father had become extremely successful when Mike was six years old. Because of his father’s new job, his family moved to an exotic country where no one spoke English. Mike was scared and felt like a stranger. Even though he attended an international school, he had no friends for a long time.

His parents pushed him; they meant well and were trying to encourage him. But feeling scared and overwhelmed by the many changes in his life, he misinterpreted their words as disappointment that he wasn’t enough—it was the familiar feeling he still had today.

Showing Self-Compassion

We are not born feeling inadequate. Life experiences and emotions create that sense within us in a variety of ways. For example, when we were little, and we felt afraid or anxious, our mind told us something was wrong with us, not our environment. A child’s mind, not yet rational, concludes, “There must be something wrong with me if I feel so bad.” That’s why children who were abused or neglected grow up to be adults who carry so much shame. They likely spent years telling themselves: “I must be bad if I’m being treated badly.”

As adults, armed with education on emotions and how childhood adversity affects the brain, we can understand that feeling “not enough” is a byproduct of an environment that was insufficient. We are in fact enough! Yet to feel more solid, we must work to transform that “not enough” feeling.

One way to transform old beliefs is to work with them as separate parts of ourselves. With some mental energy, we can externalize ailing parts of us and then relate to them in ways that heal old wounds.

For example, I asked Mike, “Can you imagine that the 6-year-old boy inside you, who feels ‘not enough,’ is sitting on my sofa over there so we can be with him and try to help him?”

With practice, Mike learned to connect, listen and communicate with that part of himself. Offering compassion to the child inside himself helped him feel much better, even though he had struggled with the concept initially.

Since emotions are physical sensations, another way to work with wounded parts is through the body. Mike learned to recognize how “not enough” physically felt. “It’s like an emptiness—like a hole inside. I know I’ve been successful at times, and I believe my family loves me. Emotionally, it doesn’t feel that way at all. Good stuff comes in, but it goes right through me like a bucket with a hole. I’m never filled.”

To help patch the hole in his bucket, I helped Mike develop his capacity to hold onto good feelings by noticing them. “If you recognize and validate your accomplishments, what does that feel like inside?”

“I feel taller,” said Mike.

“Can you stay with the feeling of being taller for just ten seconds?”

Like a form of training, he built his capacity to experience positive feelings. Going slowly, we practiced noticing sensations associated with pride, love, gratitude and joy—getting used to them a little at a time.

What Else Can We Do To Help The Parts Of Us That Feel “Not Enough?”

  • We can remind ourselves again and again that our feelings of “not enough” were learned. It’s not objective fact, even when it feels so instinctually true.
  • We can connect to the part of us that feels bad and offer it compassion, like we would for our child, partner, colleague, friend or pet.
  • We can practice deeply belly breathing, five or six times in a row, to calm our nervous system.
  • We can exercise to get adrenaline flowing and create a sense of empowerment.
  • We can remember this very helpful phrase: “Compare and Despair!” When you catch yourself making comparisons to others, STOP! It only hurts, by fueling feelings and thoughts of “not enough.”

In the long run, we heal the parts of us that feel inadequate by first becoming aware of them. Once aware, we can listen to them and try to fully understand the story of how they came to believe they were “not enough.” Over time, by naming, validating and processing the associated emotions both from the past and present, “not enough” can become enough.

(Patient details are always changed to protect privacy)

https://www.nami.org/Blogs/NAMI-Blog/June-2018/Why-Do-We-Have-the-Feeling-that-We-Are-Not-Enough

Hilary Jacobs Hendel, LCSW, is the author of  It’s Not Always Depression (Random House & Penguin UK), a book which teaches both the general public and psychotherapists about emotions and how to work with them to feel better. She received her BA in biochemistry from Wesleyan University and an MSW from Fordham University. She is a certified psychoanalyst and AEDP psychotherapist and supervisor. She has published articles in The New York Times and professional journals. Hendel was also the Mental Health Consultant on AMC’s Mad Men. She lives in New York City. For more information and free resources for mental health visit: https://www.hilaryjacobshendel.com/

Why Suicide Reporting Guidelines Matter

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Many people have a difficult time understanding why the words we use are so important, especially on a topic like suicide. How can certain images or words influence a person’s willingness to take their own life? How can one suicide lead to another? How can conversations, articles, personal stories and media coverage about suicide carry so much influence?

The fact is: how we talk about, write about and report on suicide matters. For someone already considering suicide, it’s possible to change their thoughts into action by exposing them to detailed suicide-related content, including graphic depictions or explanations of the death or revealing the method used. The recent tragedies are an unfortunate example of this. Two days after the media irresponsibly reported on Kate Spade’s death by suicide, Anthony Bourdain used the same method to end his life.

Tragic events like this are why leading experts in suicide prevention, international suicide prevention and public health organizations, schools of journalism, media organizations, key journalists and Internet safety experts all came together to create research-based recommendations on how to safely report on suicide. The suicide prevention guidelines exist for a reason—to save lives.

Suicide Contagion Is Real

According to the Recommendations for Reporting on Suicide: “More than 50 research studies worldwide have found that certain types of news coverage can increase the likelihood of suicide in vulnerable individuals.” This phenomenon is referred to as suicide contagion and “the magnitude of the increase is related to the amount, duration and prominence of coverage.”

A key phrase here is “vulnerable individuals.” The people affected by suicide contagion are likely already thinking about suicide. They may be experiencing a mental illness or substance use disorder and be switching medications and be in a fight with their spouse or parent and be struggling to make ends’ meet and then they’re prompted to end their life because of what they saw on social media while scrolling through their news feed. In other words, suicide is usually the result of a multitude of factors—and the media’s irresponsible reporting can be one of them.

“The outpouring of collective grief, the tendency to present or discuss the person in almost beatific ways and physical memorials or ceremonies celebrating their lives are common practice,” says psychologist Paul Surgenor, suicide prevention expert. “And unfortunately, for someone who can only see pain, isolation and rejection, this level of adoration may seem preferable to their current state.”

Seeing sensationalized headlines and reporting about a celebrity who ended their life can make a person who’s already struggling believe that they can do it, too. That “it’s okay.” That “it’s easy.” And not only that but learning the method of how a person died by suicide shows how to do it—what “works.”

When Robin Williams’ died by suicide in 2014, suicides using the same method increased by 32% in the months following his death. That’s not a coincidence. It’s also not a coincidence that suicide contagion is also known as “copycat suicide.”

How To Talk About Suicide

The main message of any article, video or TV show about suicide should be to encourage people to get help when they need it and where to look for that help by including local and national hotline numbers or other crisis resources. Here are some other important recommendations to follow.

Inform, Don’t Sensationalize

  • Don’t include suicide in the headline. For example, “Kate Spade Dead at 55.”
  • Don’t use images of the location or method of death, grieving loved ones, memorials or funerals; instead use school, work or family photos.
  • If there was a note from the deceased, do not detail what the note contained or refer to it as a “suicide note.”

Choose Your Words Carefully

  • When describing research or studies on suicide, use words like “increase” or “rise” rather than “epidemic” or “skyrocketing.”
  • Do not refer to suicide as “successful,” “unsuccessful” or a “failed attempt.” Do not use the term “committed suicide.” Instead use “died by suicide,” “completed suicide,” “killed him/herself,” or “ended his/her life.”
  • Do not describe a suicide as “inexplicable” or “without warning.”

Report on Suicide as a Public Health Issue

  • Include the warning signs of suicide and a “what to do” sidebar, if possible.
  • Do not report on suicide the same way you would report a crime.
  • Seek advice from suicide prevention experts rather than quoting/interviewing police or first responders.

Suicide is not a subject that should be avoided, but rather, handled carefully and thoughtfully—the way the suicide guidelines have clearly outlined. For those who believe the recommendations were created to prevent offensive language or spare people’s feelings, please keep in mind that their purpose is so much more than that. This is not a matter of being “politically correct.” It’s a matter of saving lives.

 

If you are thinking about suicide, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255).

 

Laura Greenstein is communications manager at NAMI.

https://www.nami.org/Blogs/NAMI-Blog/June-2018/Why-Suicide-Reporting-Guidelines-Matter