Category: Reflections on Counseling

Taming and Treating “Privilege Syndrome”

 

At some point, with many clients, comes an earnest variant of the same question: Who am I to have pain – or see a therapist – given that so many other people suffer in visible, heartbreaking ways?

I call this the Privilege Syndrome. The reasoning usually sounds like this:

• If I don’t live in a less-developed country where I only have access to one meal of day, I should be happy. (But I’m not.)
• If I have money, I shouldn’t feel depressed. (But I am.)
• If I have a job, I shouldn’t be annoyed with my work. (But I am.)
• If I don’t have to represent my race on a daily basis, or live in fear of violence, then I shouldn’t complain about the challenges I do have. (But I do.)
• If I have a loving family, I shouldn’t be lonely. (But I am.)
• If others respect me, I shouldn’t live in fear of rejection. (But I do.)
• If I haven’t survived one or more traumas, I shouldn’t be suffering. (But I am.)
• If my life looks good on paper, I should be happy. (But I’m not).

How lovely that so many of us know that other people also struggle! How terrible that we deem ourselves not worthy of struggling and suffering because of our privileges!

From a mindfulness perspective, Privilege Syndrome is all about getting caught in a mindstate of comparison, or what I and many other mindfulness practitioners call Comparison Mind. The good news about Comparison Mind is sometimes it makes us feel superior to others! But the bad news… well, you know all about the bad news of comparison. We end up feeling inferior and unworthy – and then judge ourselves for feeling so bad.

The truth is that we increase our suffering when we can’t acknowledge and accept our own pain and heartache. When we dismiss or minimize our own pain because So-and-So has it worse, we are acting from a faulty belief that suffering is reserved only for others.

The only “cure” for Privilege Syndrome is to learn to accept and honor our own suffering – no matter our privilege – while also acknowledging the suffering of others. When we can work toward the end of our suffering and the suffering of others, we stop comparing ourselves. Instead of landing in Comparison Mind, we access compassion. Instead of being better than or worse than others, we’re simply with ourselves and with others. That is connection. That is healing.

 

What Information Should Families Have If Their College-Age Kid is Depressed?

I read with sadness but not surprise this article about suicide on college campuses. A big question the article talks about is when and if parents should be informed if their age 18+ kid  is struggling.

I’ve written before about the rise in anxiety and depression in teens and the general public. The news on the subject continues to be disturbing, with a 33% rise in depression diagnoses between 2013-2016.

I’m so glad that depression is continuing to be identified more quickly, and that more and more people are willing to seek help. But these numbers – and the stories behind these numbers – speak to a pretty terrifying moment for young adults and those who love them.

Anytime I work with a new client, we talk openly and honestly about confidentiality. Lots of us have had the terrible experience of having someone betray our trust and confidence, and I’m committed to keeping therapy a private space. It’s impossible to get the most out of counseling if we’re worried about someone out of the psychotherapy office knowing what we’re talking about.

BUT – I tell everyone – if I start getting worried about a client in an immediate life-or-death kind of way – I will tell that client directly, not going behind their back, and we’ll talk about if my concerns are justified or not. If so – if a client agrees they’re in a scary moment – together we’ll figure out a way to pull in someone from their life who cares about them, and loves them, and desperately wants and needs them alive.

I love being a therapist, and I take the responsibility of it incredibly seriously – both in figuring out when and how to support someone to get more help, if needed, and when to uphold and protect confidentiality if more support isn’t needed.

 

TV Families and What They Have to Do With Us

TV Families and What They Have to Do With Us

I haven’t seen the new reboot of Roseanne but grew up on the original series (along with so many other shows… I was permanently indented into my family’s couch for a few years there.) It’s been interesting to follow different reviews of the new version, including critiques of its social or political messaging and diversity as well as positive reviews (sometimes both from the same source).

But what’s been most interesting to me is what the show has already spurred – lists of other shows that may be worth watching for their depictions of “real” America and real families. I read this list with tons of interest: it includes shows I’ve heard of like Black-ish and Fresh off the Boat, and then others that my pop-culture-oblivious self had no idea about (like The Good Place and Speechless).

So why does this matter so much I’m posting about this? Because there’s often a link between what we watch and how we feel about ourselves and the world. When we consistently don’t see people who look like us on TV (as is the experience of most people of color), we get the message we don’t matter, and that our experience isn’t important. We begin to believe the lie that a “normal” exists and that we’re different in a bad way. Racism on TV shows can make us more racist too

There’s also lots of research, of course, that shows that when we only see stick-thin actors with perfect skin, we compare ourselves negatively to those images. In these and other moments, these TV images can make us feel worse and more isolated instead of what good TV can do: make us feel more connected and empathetic, and even boost our emotional IQ.

So I’m putting Black-ish on my list, along with a handful of other shows. Maybe you will too.

Instead of Resolutions, Try Reflections: 12 Questions to Reorient for the Coming Year

Instead of Resolutions, Try Reflections: 12 Questions to Reorient for the Coming Year

I managed to carve out two hours last week to reflect on the year that’s almost past. It can be hard for me to think about goals or even intentions for the future without such reflection. And the truth is we learn best when we can think about what’s happened and what we might do differently next time. When I sat down and thought and wrote about these questions, I was able to clarify to myself how I got in my own way during 2017 (mostly by overcommitting) and imagine what I want more in the future. I’m sharing my reflection questions in case they may be useful prompts for you as well.

-What in my life would I happily get rid of if I could? 

-What in my life would I be happy to have more of?

-What external factors are holding me back?

-What internal factors are holding me back?

-Where do I feel most insecure professionally and personally?

-Where do I feel most confident professionally and personally?

-What were the big areas of learning and growth for me this year in terms of my personal life and work? 

-When I was fatigued, why?

-When I was energized, why?

-What goals were easiest and hardest to meet this past year – and why? 

-If I gave myself permission to dream big, what would I want for this next year or in general?

-What big areas of learning and growth do I want in the coming year, both personally and professionally? 

 

 

 

What the Media Gets Wrong about Depression and Anxiety

What the Media Gets Wrong about Depression and Anxiety

Here are your instructions:

Go stand on the Beltline. Hang out across the street from my therapy office at Ponce City Market. Go anywhere in Atlanta. Go to Decatur or Midtown or wherever. Look around and do this: Spot the person who’s struggling with depression, anxiety or grief. 

Trick question? You betcha. I was grateful to read this story from Slate called Stock Photos are Terrible at Depicting Illness, Mental or Physical. In a nutshell, it’s looking at the feeble attempts made by photographers — and newspapers, and websites, and bloggers (including me), and everyone else — to depict anxiety, depression and other mood disorders. If you want to see for yourself, do a web search for “depression” and see what comes up. Same with “anxiety” and “grief” and “stress.”

The reality is that most people who are struggling are experts at looking like everything is fine. My clients work hard not to show how rough things have been. My clients don’t walk around with their head in their hands all day, double face-palming with tears streaming down their cheeks. They don’t crouch in a corner photogenically. They are working or going to school, being social, acting like everything is normal (even when everything feels terribly abnormal).

In counseling, we work so that acting “normal” comes from a place of feeling “normal.” Just because you can pretend you’re okay doesn’t mean you should have to. After all, you have better things to do with your life than spend copious amounts of energy trying to look like nothing’s wrong.

 

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

The research is out, and loneliness is a public health epidemic. I was struck by this story on NPR earlier this week about not just its connections to depression and anxiety, but also its link to stress and resulting physiological problems. Of particular note: about 40 percent of people experience loneliness. That means there’s a lot of people feeling lonely… meaning we’re simultaneously alone in it, and also not alone with the experience.

The story comes from reporting from — who knew? — the Harvard Business Review about the impact of loneliness on workers.

I see teen and adult clients every day who you wouldn’t expect to be lonely. Lots of people have busy lives that may look fulfilling from the outside. Lots of us have relationships with people that have substance and depth. And yet – it may be that when we’re alone with ourselves, loneliness creeps in. Or we’ll be at a party, or at work, or with our families, and feel separate, like we’re pretending to feel something we don’t actually feel or pretending to be someone we’re not. Sometimes when we feel isolated, we stop going out — and then, as a result, feel even more isolated. Or we get busier and busier to avoid the feeling altogether.

There is a way out of loneliness that doesn’t require becoming busy beyond belief. I work with people every day on loneliness in a few different ways. First, we work so that relationships can become more authentic – so you have to hide less of yourself. This can mean dropping the need to look perfect, to yourself and others, which isn’t an easy task for many of us. We work on figuring out what you want for your life, so that you spend less time on things that feel fake or meaningless to you. We also work on your relationship with yourself. How can you spend time with yourself in a way that’s comfortable, and grow to have a relationship with yourself that’s companionable? Loneliness loses its steam when we grow comfortable with ourselves, and with being ourselves.

A Counselor’s Thoughts on Anti-Depressants and Other Meds

Happy? Antidepressants?New therapy clients often wonder where I stand about anti-depressants. Will I be pushing them? Completely against them? Chances are, your own thoughts about anti-depressants put you in one of three categories:

a. You see anti-depressants as similar to other meds that you might take for medical conditions like high blood pressure, migraines, or a bad cold. If this is you: You may have friends and family who have been open about struggling with depression, panic attacks, and anxiety. You may know people who’ve benefited from meds.

b. You want to avoid anti-depressants at all costs. If this is you: You believe you should be able to handle how you’re feeling without drugs; you may think it will mean something negative about you if you decide to try meds for awhile. You may also have known someone who’s had a negative experience on an anti-depressant (or perhaps you have had a negative experience in the past). You may worry that you’d be on a med for life, and you definitely don’t want that.

c. You’re wary, but open to anti-depressants if needed. “If needed” may mean that things would need to get unbearable for you to consider meds. If this is you: You may know people who’ve gotten some use out of meds, but others who may not have. You may have had some bad experiences of your own. You may have lots of mixed feelings and see the possible benefits but may have significant concern about possible side effects.

So where do I stand when it comes to anti-depressants and their psychopharmacology siblings? I’m pretty cautious about meds, but I don’t think they’re evil. I see medications as a tool that should be used thoughtfully and under close supervision. Here are some facts for you to know:

  1. Every person is different. Most people can benefit from counseling, and, sometimes, medications can help people get more out of counseling and make progress more quickly (especially in the case of severe depression).
  2. I always, always want to rule out a medical condition that may be causing anxiety or depression. Funkiness with the thyroid can often lead to depression and anxiety symptoms. I often ask that new clients go have a physical to rule out medical conditions as a cause for low or anxious moods. 
  3. If you’re struggling with basic daily tasks like going to work or school — and counseling hasn’t helped you with these tasks after a chunk of time, then a medication consult may be appropriate. 
  4. There are lots of alternatives to medications. Exercise, meditation, social time, meaningful activities, consistently getting good sleep, the much-derided self care, and some supplements can often be as helpful as medication.
  5. Most people who take medications for anxiety and depression don’t stay on them forever. You always, always get to decide whether to stay on a med or not. (That said, going off cold-turkey is never a good idea!)
  6. I always want any client trying a new medication to have a good psychiatrist or physician and to be in close contact during the first weeks of taking it. Most people do quite well on meds but we never want to take that for granted.

I’m always happy to talk with you about therapy and medication. Feel free to call or email  if you want help figuring out what’s going to be most supportive for you at this time.

Warmly,

Dana

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

I got to talk on the radio recently about depression, suicide, and teenagers. I’m glad to continue to spread the message about adolescent mental health concerns, even though it’s always sobering to consider how mental and physical health issues can be created or exacerbated by so many preventable factors.

I’m a big fan of the Adverse Childhood Experiences (ACE) Scale as a quick way to look at what sorts of factors may have been present – or absent – in my clients’ lives that may impact them to this day. None of us exist in a bubble. There’s good research on how trauma, neglect, race, class, immigration status, gender and gender identity, and so much else plays into how others treat us, brain function, and how we end up feeling about ourselves. (Here’s a recent reminder of racial bias affecting views toward young black girls.)

In my work as a therapist, I continue to be committed to seeing my clients as individuals whose own stories and experiences are a part of a larger social and cultural framework.

Some helpful stats about the importance of ACEs.

 

Microagressions, Race, and Beloved Community

I do a fair amount of eye rolling at the Atlanta Journal-Constitution for the unsubstantial click-bait on its homepage. (Currently “Hawks to Hold Cheerleader Auditionsmicro-agression” is front-and-center.) But I’ve been interested lately to read their Race in Atlanta series, and appreciative of the different perspectives they’ve highlighted. (For a few examples of stories, click here or here.)

The latest story is on microaggressions, with AJC journalist Willoughby Mariano providing some useful examples of daily indignities that People of Color endure and that people with my skin tone are often oblivious to.  It’s worth a read and conversation.

A Quick Note on Birthdays

happy-birthday-to-me-memeMy birthday has come and gone once again, and unlike my daughter – who would like to have her birthday happen every day – I’m a little relieved it’s over. As a kid, birthdays are hopefully magical. Presents! The world centering on you!

But as an adult, birthdays can so often be bittersweet or downright disappointing. We may note who has or has not called. We find ourselves in comparison mode with other people based on our age. We may find ourselves comparing aspects of our lives — relationship, work, home, interests — with where we’d hoped we would be. (To state the obvious: These are not usually comparisons that make us feel better about ourselves.) Perhaps we touch into our mortality in a way that’s uncomfortable. Perhaps we are all too aware of who is no longer alive or in our life to celebrate us. Sometimes things get better with age … but sometimes we end up feeling jaded and confused about our own meaning and purpose.

As a mindfulness-informed therapist, here is the long-winded question I have at moments like this: How can we turn toward the difficult feelings that events like birthdays conjure up, getting curious about our experience so that we can find clarity and create intentions and actions that enable change? 

I offer this question to you in hopes that it will be useful.

All my best,
Dana