Category: Reflections on Counseling

White clients, it’s time to talk about whiteness

I have been thinking lots about what psychologist and writer Natasha Stovall wrote almost a year ago, before the police killing of George Floyd, before the COVID pandemic exposed (yet again) racial disparities in our country. Stovall wrote this:

The couch in my therapy office is occupied mostly by white people. Anxious white people and depressed white people. Obsessive white people and compulsive white people. White people who hurt people and white people who hurt themselves. White people who eat too much, drink too much, work too much, shop too much. White people who are bored, envious, guilty, numb. Racist white people and antiracist white people. White people who look across the room and see a white therapist listening. We talk about everything. Except being white.

Stovall goes on to make the point (and this is a gross simplification; the article is worth reading in full) that white therapists need to support white clients to explore racial identity, including the negative ways white culture impacts all of us—even those of us who also benefit from it due to our whiteness.

I’ve been exploring my own white identity for the last few years, primarily through the workbook Me and White Supremacy, through regular meetings with other white therapists wanting to dismantle our own roles in systemic racism, and through expanding my reading list so it does less to center whiteness. I keep coming back to this checklist about white supremacy culture only to cringe as a recognize myself and many of my attitudes and behaviors on this list.

I am committed to doing my best to support all clients. That means continuing to work to become as anti-racist as possible, and, when clients are ready, helping them unpack the ways their challenges may reflect and result from our problematic culture. This is our work right now. This is my work right now.

Trevor Noah, Depression, and The Ongoing Gaps in Mental Health Care

I just love Trevor Noah. And he’s just given me one more reason. He’s using The Daily Show to raise the issue of why black people and other people of color have a hard time seeking out therapy and finding useful therapists.

Trevor Noah has been public about his own experience of depression in the past, using his leverage as a celebrity to speak bravely and truthfully about what so often goes unsaid and unspoken. Is it a surprise that this extraordinarily funny and smart man also struggles with depression? It shouldn’t be. Noah reminds us that we can never know from looking at someone what their internal experience is. Never.

I’ve written about mental health access for people of color and crappy differences in therapists’ response before here. But it’s still hard to see these disparities continue. “Disparities continue” makes it sound clinical, impersonal—but what that means is that unless you’re white and middle class, it’s still extremely hard to find a therapist who is likely to get you and understand where you’re coming from. That’s the worst. It’s deeply painful to acknowledge you need help and seek it out just to come up empty or invalidated.

It’s time for therapists, and especially white therapists, to do better. As we prepare to enter 2020, us white therapists need to consider our own limited understanding of the varied experiences of People of Color and do our own work to see how race – including whiteness – affects how we care for our clients.

Are the holidays tough? If so, you’re not the only one.

There’s no way around it: the season of Thanksgiving and the holidays that follow suck for so many of us. As I’ve written here before, grief can be extra lonely and difficult when everyone around you is wishing you a merry Christmas or Happy Hanukah or meaningful Kwanzaa. All of us with complicated families struggle as we perhaps spend more time with family members than usual – or notice their conspicuous absences. Sure, spontaneous gratitude and good cheer may arise. But also there’s the potential for surges of sadness, sorrow, disappointment, anxiety, and pain.

Here’s what I want you to know:

The cultural myth that you “should” be happy at this time of year is not based in reality. If difficult things are happening or have happened to you, especially in November or December, it would be weird if you were suddenly all cheery. Same too if you have seasonal depression. Your low mood likely makes sense given the situation. And, when you beat yourself up for feeling bad instead of good, you’re adding to your pain.

Also, I want you to know that you are not the only one struggling right now. I have the privilege of sitting with lovely, kind, intelligent people every day who are grappling with how to navigate the holiday season without feeling crazy or eating all the cookies you didn’t actually like in the first place. I wish there was a secret handshake or cool badge people could wear to say you’re part of the club of people who’d rather just skip to January, so you could all know and enjoy each other, but alas… I don’t know of anything like that yet.

So, take good care. I MEAN IT. The only way to get to January is to get through November and December. And as stupid as it sounds, drink water! Sleep regular-ish hours! Take walks! Pet animals! And know you’re not alone. Really.

If I got a dollar every time…

Say I got a dollar every time I heard the following words:

  • “But other people have it worse.”
  • “Yeah I’m depressed and anxious, but I have privilege so I shouldn’t feel this way.”
  • “I’m not sure I deserve to be in counseling.”
  • “I’m worried I’m taking your time away from people who need help more than me.”

How much $$$ would I have at the end of a year if I faithfully put a dollar in a jar each time I heard a variation of these words?

Enough to go out to a great dinner. A really great dinner.

We often wish we could decrease stress and depression and anxiety by reminding ourselves of the hard stuff that other people face. But that’s not how it works.

I’ve written on this blog before about what I call “privilege syndrome” — the belief that if we have privilege in some way, it can be easy to feel guilty or judgmental about the ways in which we struggle. And this is common.

I wish that privilege could buffer us from anxiety. I wish that knowing about climate change or homelessness would mean that people with secure housing and middle class incomes could be immune or invisible from stress or depression or trauma.

But the brain and body don’t work like that. While those of us with stable housing or relationships may be less likely to experience trauma or stress, our nervous systems aren’t designed to tease out nuances of privilege. The body just experiences a flood of stress hormones like cortisol or adrenaline. The body just knows we’re depressed or anxious. The body knows we don’t feel okay, even if we try to use our intellect to convince ourselves we should feel differently.

And the research shows that judging ourselves for our responses and reactions don’t actually do much help.

Instead, I try to help clients cultivate neutrality or even self-compassion for our experience. It’s only by accepting what’s here – the pain, the suffering, the fear, the sadness – that we can begin to move through these difficult feelings. It’s only by acknowledging what’s true for us – whether we like the truth or not – that we can begin to move forward.

Family Therapy Works!

There’s a lot that I’m not intimidated by. While I’m naturally a bit introverted, I’ve worked hard to talk in front of groups fairly comfortably. I’m not scared of Atlanta’s parking garages, elevators, or boats (unlike certain family members). I don’t enjoy shopping, but I can hit up an Ikea and come out alive and well. In my therapy practice, I can comfortably help clients tackle sticky issues like challenging relationships, infertility, abortion, depression, grief, and trauma. But what puts fear in my heart?

The idea of being in counseling with my parents.

And I’m not the only one. Quite often when I’m working with a kid or teen, I mention that a few family counseling sessions might help with improving communication or clarifying expectations or figuring out how to respectfully disagree with one another. And then I watch those teens as their faces go from open and interested and curious (because after all, teens are awesome if you’re not their parents) to shut-down, please-Dana-don’t-make-me-you-must-be-crazy-if-you-think-I’ll-do-that.

And I get it. Family therapy can be intimidating. Kids worry they’re going to get teamed up on or lectured. Often they hate their parents seeing them emotional and would really rather not cry in front of their parents. Teens already recognize there’s a lot they don’t control in their lives, and family counseling can appear—at first—to be another place where they won’t have control or a voice.

And yet. And yet. Family counseling can be powerful: healing, reinforcing and strengthening relationships, shifting communication patterns to be more healthy and constructive, and building trust and mutual respect. Kids and teens find they have a voice and relax as they see their parents listening to them; parents find that their kids can hear them differently through family therapy. Together, we make strides to strengthen the family. Because at the end of the day, none of us lives in a vacuum. We’re all connected. So let’s work on being connected in healthy, happy ways… even if it’s intimidating at first.

Let’s have more moments like these, okay?

A New Location!

I had no intention of moving to a new office. I wasn’t even looking. I liked my own space too much, the great colleagues, the funny signs in the bathroom (“Clients with OCD must not wash their hands”), and even my commute by bike down the Beltline. When friends asked if I wanted to work closer to home, I’d say, “I’m receptive if the right space appears, but I’m not out looking.”

A year or two passed. Then in February my colleague and friend Liz Wilder Young called: “Want to come see a possible office space with me?”

“Sure,” I said. “But you know I’m not really interested.”  

Soon I was in front of a building I had passed many times before: grey stone, two stories, nestled between the church where I vote and my neighborhood’s police station. I had been inside a handful of times when it held a small grocery there, mostly buying ice cream on quiet Friday evenings. It was in the heart of the intown neighborhood of Kirkwood, a 15-minute walk from home.

Upstairs, Liz and I entered an office suite. Meandering through, I came to an office with windows on two sides: one overlooking the public library across the street, the other with a view of the church next door. And as crazy as it sounds, I felt a thrill inside me, my heart cracking open, the rightness of this space thrumming in me. The space just felt right. How could I resist? And a stone building for Stone Cottage Counseling!

In June, we moved into the office suite—what we’ve named the Neighborhood Counseling Center — with fellow therapists Maggie Akstin (who is joining Stone Cottage Counseling—yay!) and Ginny Thompson. We’re all aiming to provide the best possible experiences for clients (through high-quality counseling, classes, and workshops) in this sweet space, and hope to also be a big asset to the neighborhood.

As I ready myself for this change, I’ve been reflecting on the uniqueness of this process for me. I usually work so hard to make things happen, and yet this new office appeared without effort. I have been taught, like we all are, that we can only succeed and be happy if we’re doing, working, striving. And it’s true that often times these skills and related qualities are so valuable.

But not always. Sometimes hard work is no guarantee of success, despite our best efforts or well-connected networks, and I am beginning to know viscerally that there are times when receptivity, or simple openness, can be rewarded. I am practicing staying open to things unfolding on their own timeframe. I am practicing resisting a false sense of urgency that things must happen. I am allowing myself the opportunity to be surprised by what emerges.

So far my experience with this new office is showing me that sometimes things really do unfold in terrific ways without lots of energy or effort. So here is my query for this season: Can we be open to the possibility that sometimes things emerge and change in good ways without our hard work, that things can simply be right without having to strive to make them so?

Talking Drugs with your Teens: Good Luck!

Every time I do a presentation for parents of teens, two questions just about always come up:

  1. Will my kid be a functional, productive adult, even if right now they’re (fill in the blank):
  • not doing enough homework?
  • not doing anything but homework?
  • not taking school seriously enough?
  • taking school too seriously?
  • going out too much?
  • not going out enough?

AND…

2. What is the “right” thing to say to teens about drugs and alcohol?

The first question has an easy-ish answer: Despite (or because of) your kid’s idiosyncrasies, they will most likely make it through adolescence relatively unscathed and learn enough adulting skills to have a pretty reasonable life, even if their life, values, and priorities are different from yours. Most of us get through adolescence. If you’re reading this, I’m guessing you did.

But the second question is trickier. What is the “right” thing to say to teens about drugs and alcohol?

For starters, I’m pretty sure there is no one right thing. Teens (and the rest of us) are getting insane mixed messages about drugs, especially marijuana, right now. Some parents buy marijuana for their kids; some pull out a frying pan and an egg to give a 1980s-esque demonstration showing this is your brain on drugs. Some places it’s legal; some it’s not. Some people swear marijuana helps with anxiety, depression, creativity, and sleep; some people argue it interferes with all of the above as well as with brain development, makes ADHD and motivation worse, decreases efforts to build alternative coping strategies, and lowers the effectiveness of anti-depressants.  It’s especially tricky when we consider how common marijuana use is among white people as well as people of color, and yet marijuana laws are so selectively enforced, with huge disparities in enforcement based on race. A black teen getting caught smoking marijuana may face drastically different legal consequences than a white teen doing the exact same thing. So how do you create rules or express family values when there are so many shifting cultural messages, and no coherent community principles or agreed-upon research to support, reinforce, or guide you? Not so easily.

But I think there’s an even more important question that’s even harder to answer. How do parents build a strong enough relationship with their teens to be able to talk about drugs and have the best chance of a positive impact? That’s the gazillion dollar question. And it has no simple answers… except maybe family counseling (which is of course my bias).

I loved this article and this follow up  for their thoughtful discussions of these topics. Pro tip? Print the article and send it to your kid and ask them what they think about it. Sometimes introducing a topic through an article is a way to open up a conversation without defensiveness.

Hi, I’m Dana – She/Hers/Her (Gender, Gender, Gender!)

I led a workshop yesterday on mental health for parents of high school seniors. Introducing myself, I said, “I’m Dana, and my pronouns are she/her/hers.” Those same pronouns are at the bottom of my email signature. Were the workshop attendees confused by my sharing of pronouns? I couldn’t tell. But for lots of reasons, saying my pronouns is something I’m trying to do more often.

For many cisgender people (cisgender: people who’s gender identity matches what they were assigned at birth) the movement toward saying pronouns has been a bit baffling. Isn’t it obvious when someone’s male or female, man or woman? Not always. I was excited to go to a great workshop recently all about gender with multilingual Atlanta therapist Irene Celcer (her website’s in Spanish), hosted by the Georgia Society for Clinical Social Work. We talked about the difference between sex and gender (“sex is biology; gender is society”; “sexuality is who you go to bed with; gender is who you go to bed as”), gender incongruence (often known as gender dysphoria) and best practices for therapists working with LGBTQIA+ clients.

Especially given Atlanta’s big-big-big population of gender-nonconforming queer people, and the continuing discrimination and abuse they face – and often resulting trauma – it’s important to me that I and other cisgender therapists and counselors do our best to be respectful and helpful to these clients.

For lots of us who are no longer young adults, it’s a bit jarring to re-think our old ideas of gender, ideas we took for granted as reality. But one of the things I love about being a therapist is that I get to rethink old ideas and learn new ways of seeing and being. I am so grateful for this work.

I love the creativity of all the different affirming bathroom signs popping up around Atlanta.

Revisiting Habits, asking “How’s This Working For Me?”

A month ago I went cold turkey.

No online, paper, or radio news.

No social media.

No falling down the internet rabbit hole.

It wasn’t a particularly well-thought-out, planned-for decision. (Which defies everything we think we know about habit change – right? Conventional wisdom is that habits are easiest to change if we have a plan, have prepared, told significant others, have figured out alternatives, etc.)

But I had no plan. It was an impulsive decision, and I had prepared no one, including myself. I just knew that I felt attached at the hip to the news cycle, and wasn’t sure if it was serving me even though it’s easy to believe that we “should” be paying moment-to-moment attention. Life felt loud, like a bunch of clanging bells always ringing, shaking me out of my own thoughts and efforts. I felt attached at the hip to social media because of FOMO, but didn’t find myself happier or more connected as a result. (The research supports that anxiety and depression and isolation can actually increase because of internet usage!) I’m not morally opposed to the internet, and am grateful for the amazing things that happen on it and because of it. I hold no judgments of other people’s internet habits, but was finding that my own habits weren’t feeling particularly skillful. In other words: was it really worth the time and attention I was giving it?

Now, it’s been almost a month and I find that the impulse to open news and social media websites has mostly faded. Sometimes I find myself staring at my email, wanting there to be something entertaining and new there that somehow I missed, but then I realize – oh, I’m tired – or, oh, I’m not doing anything – and close the computer. Somehow, taking a sabbatical from most of my online world has reduced my stress and quieted the clanging.

I don’t miss the news. I hear from friends or family about what’s happening politically, and am concerned but also don’t miss the roller coaster ride. I’m finding other ways to be involved and engaged – reading more books (like The New Jim Crow and Mindful of Race), getting together more with colleagues, and listening to a series of Tara Brach’s lectures on Mindfulness and Psychotherapy. Somehow it seems like I’m experiencing more spaciousness as well – perhaps because I’m bombarding myself less with stimuli. I certainly don’t feel worse. If anything, I feel a bit healthier – a bit more here, in the present moment, with therapy clients and when I’m with family or alone.

My experience has reminded me that taking a step back to assess a part of our life – even a minute, mostly inconsequential part – can sometimes be useful. In the words of America’s favorite non-therapist therapist, Dr. Phil, “How’s that working for you?” He’s cheesy as hell, but it’s a great question.

 

Put Off The Laundry! Instead: An Important, Overlooked Tool for Habit Changing in the New Year

I should be doing laundry, or scrubbing the toilet, or any number of household tasks. But I’m here to tell you to put those things off. If you have a few moments (and I’m going to guess so, if you’re reading this blog post) it’s likely the most useful way you can spend this time is in the simple act of focused self-reflection.

Studies and anecdotal evidence show that when we take time to reflect on a regular basis, we are often able to grow and make changes in ways that otherwise have been impossible. Last year I posted some year-end reflection questions here, and I just spent an hour looking over my own answers from a year ago and answering the same questions again, from where I am today.

Having time and space to reflect is both a luxury and a necessity (kinda like all those other good things: physical movement, time with people who care about us, nourishing food, etc.). Sure, it would have been helpful to have spent the last hour doing laundry or another hundred household tasks, but when we prioritize the immediate, it makes it harder for us to make medium and long-term changes. I believe strongly that most of the time household tasks can wait – what’s a little extra laundry tomorrow? – in favor of reflection that could have way more long-term payoff. 

So here are a few questions to kickstart some reflection time. Turn off your phone notifications, find a quiet space, and give yourself 10 minutes to reflect.

  1. To the extent I have control and influence over my life, how would I like to start the new year?
  2. What would I like to let go of (self-defeating thoughts, behaviors, relationships, etc.) as 2019 starts? Who and what can support me to do this? What barriers can I anticipate and prevent?
  3. What would I like more of in 2019? Who are what can support me to do this? What barriers can I anticipate and prevent?
  4. What are the values and priorities I want to keep front-and-center in 2019?