Category: Uncategorized

Staying Safe Means Staying Sane – Virtual Therapy in COVID Insanity

How do we stay sane during a pandemic? It’s not just a rhetorical question. The CDC’s thinking about it and offering advice. And for good reason. In virtual sessions, my colleague Maggie Akstin and I are helping clients respond to unexpected financial instability, changes in routine, job losses, grief, and uncertainty about the future. These are all things that can understandably make calm people anxious and depressed – and can make people already vulnerable to depression and anxiety pretty fearful about their own sanity. Oh, and that brain fog you feel making it hard to get anything done? It’s real. So is moral fatigue, especially in places like Atlanta where politicians and public health officials are offering contradictory advice for us to sort through.

Here are a few suggestions I’m offering clients:

Seek out things that make you smile and laugh. Puppy cams and silly memes are two possibilities. It may be that you have a dog at home ready to help with this. Good boy, Harold!

Be realistic (and kind to yourself) about all the COVID projects you may be tempted to take on. Sure you *may* have more time on your hands – but what about your energy level? Do you really need to learn a new language right now? If you start something and then realize it’s adding to your sense of overwhelm, instead of helping you feel sane, then please stop or scale back. SMART goals are realistic, and what’s realistic for each of us today may be different than it would have been two months ago.

Pay attention to what level of news consumption is useful – and what level is making your anxiety creep or jump up. Experiment with which ways of getting the news work best for you and your sanity (podcasts vs. TV vs. internet vs. scrolling vs. newspaper). If you get notifications on your phone, consider turning them off.

Go outside. If it’s safe to do so, take a walk and spend some time intentionally looking around – find all the flowers you can find, notice the shapes of leaves on trees, and see if you can sense the movement of air on your hands.

During abnormal times, it’s normal to feel abnormal. Stop beating yourself up about it if you can (and it is easier said than done).

Finally, remember there is support available for you (including therapy). You may have always thought “I’ll never go to therapy” or “I’ll never need therapy” but you also may never have thought “will there be toilet paper at the grocery store?” These are humbling times. Don’t let pride or ego get in the way of what’s best for your sanity. (And by the way – most therapists – including us – offer a sliding scale. Reach out for details.)

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.

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?

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.

 

What I’m Reading: Grief, Loss, And Life After

What I’m Reading: Grief, Loss, And Life After

Grief and loss are the worst. And really it doesn’t matter whether it’s anticipatory grief (waiting for a death that you know is coming sooner rather than later), grief after an unexpected or expected loss, a collective grief (like after a school shooting) or grief involving trauma. What does matter is that grief can change our internal landscape and lived experience in an instance, sending us lurching into an existence we didn’t want and don’t know how to maneuver through. Probably I don’t have to tell you this, though. You know this from personal experience. If we live long enough, we end up carrying the losses of loved ones who’s died. It’s inevitable. And often very, very lonely.

When I heard Megan Devine talking  about her book “Its OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand” it was immediately clear that she gets grief in all it’s pain and complexity. She gets how terrible grief is and doesn’t try to sugarcoat it. And instead of trying to “fix” grief, she suggests tending to our own grief in a new, tender way.

Needless to say, I immediately went out and bought the book (from my favorite bookstore, Charis Books, how’s that for a plug?) Even though it’s been a number of years since my own latest grief, reading this book is like breathing a sigh of relief: finally someone who gets it!

Mindfulness, Kids, and the Fading Cupcake Craze

Tcupcake meditationhe mindfulness craze is still going strong, with articles in today’s New York Times about the positive benefits of mindfulness for kids and techniques for teaching mindfulness to children. Scientists have known for a long time that training the brain to concentrate on the breath and body has potential positive long-term benefits on everything from emotional regulation to executive functioning. (In other words, mindfulness meditation can make us calmer and happier.) But it’s cool to see these ideas continue to gain mainstream traction.

Still, I can’t help but think of mindfulness and the cupcake craze (now come and mostly gone, according to reputable sources) as somewhat similar. Our culture gets excited about an idea, whether it be cupcakes or mindfulness, and then we start to see if everywhere, and then … poof. Something else that’s shinier or newer catches our attention. Cupcakes are just the start. Almost everything that comes into fashion or that enters the mainstream consciousness eventually fades out of view for most of us.

As someone with a daily meditation practice, I suppose I should feel invested in this particular craze for mindfulness sticking around. Wouldn’t we all be more relaxed if we had access to the set of coping skills that mindfulness provides? Absolutely. But I also know that no particular technique or tool can serve as a magic pill. There are lots of ways to grow, heal, and change, and mindfulness is just one avenue. It will be exciting to see what craze comes next.

One Surefire Parenting Tip To Help Avoid Meltdowns and Power Struggles

many_kids_on_swingsI’ve spent a lot of time this summer with my daughter at a particular Atlanta playground, becoming intimately familiar with, among other things, how slides are not made for my adult rear end, how seesaws take significant leg muscles, and how to apply sunscreen to my child’s face before she starts crying.

I’ve also gotten the chance to observe other parents with their own children, and have seen a pattern play out so frequently that I can write it out, word for word, for your very eyes.

Parent: Are you ready to go home?

Kid: No.

Parent, a few minutes later: Would you like to go have dinner?

Kid: No.

Parent, a few minutes later, sounding less patient: You look tired. Would you like to go home?

Kid: No.

The only reason this conversation hasn’t happened to me is because my daughter only knows one word so far and that word is “dog.” But I’m sure some variation of this situation will happen, soon enough, and that’s because it is so easy to fall into the parenting trap in which we ask questions offering our kids choices that we don’t actually want them to have. These false choices lead to fights, irritation on both ends, power struggles, and meltdowns — in other words, our least favorite parts of parenting.

At the playground, when parents ask, “Are you ready to go home?” they usually want their kid to say yes. But by asking that questions, those same parents are usually setting themselves up to hear a resounding “no.”

After all, kids don’t respond to what’s implied — they’re too young and too literal. They respond to what’s asked. And of course they don’t want to go home from the playground! They’re simply giving an honest answer to the question.

So here’s a parenting tip from my therapy office. Don’t ask your kids questions about what they want if what they want isn’t going to be okay with you. If you are absolutely against your kid wearing his favorite dinosaur pajamas to school for the fifth day in a row, instead of asking, “What do you want to wear today?” ask a different question. (“Which of these three outfits do you want to wear today?” is a good start.) Instead of asking your child, “Do you want to brush your teeth now?” you can offer them a more narrow choice. (“Would you like to brush your teeth now or in five minutes?”) Think of these sorts of questions as a form of limit setting that still empowers your child to make age-appropriate choices for him or herself.

It’s a small change that I hope can make life a little bit easier for you and your family.

 

 

A Counseling Space Like No Other

A Counseling Space Like No Other

Whenever new clients are impressed with my office (which is all the time, really), I make sure they know I have absolutely nothing to do with how cool the space is. All credit goes to Atlanta psychiatrist Eric Fier. Here’s a recent article from the Atlanta Jewish Times about the therapy space and his vision for how it can create a new experience for counseling clients of all ages.