Emotional Support and other Assistance Animals: It’s More Complicated Than That
Human-animal relationships are older than human civilization itself. From dogs (about 10,000 years ago) all the way to cattle (latest being around 6,000 years ago). Humans and domesticated animals have been living side by side for so long our neurochemistry has changed. Studies have been done on both dogs and cats that have demonstrated oxytocin (colloquially called the “love hormone”) is released in both the human and the animal when they play, cuddle, look into each other’s eyes, etc.
It is natural then that we love and want to be with our animals as much as possible. It is completely understandable. And it causes very big problems. The misuse of the emotional support animal (ESA) letter is widespread. The internet is rife with scam websites promising ESA letters for hundreds of dollars to individuals who want to bring their pets with them on airplanes, take them to restaurants, or keep them in housing that does not accept animals.
It has gotten so bad that the US Department of Transportation (DOT) has banned all ESA animals from aircraft cabins as of December 2020. The famous incident of the emotional support peacock was the final nail in the coffin for this abuse of the system. The only animals that cannot be barred from the cabin are service dogs.
In this post we will cover the following:
1. The differences between emotional support, therapy, and service animals,
2. Where each kind of animal is allowed to go in public,
3. The legal and social ramifications of falsely representing an animal,
4. What lay people and businesses can and cannot ask about an animal
We will talk later about both the social and legal consequences of misrepresentation a pet as either an ESA or a service animal. First, we will lay out the differences.
The Differences
Emotional Support Animals
An emotional support animal is an animal whose presence offers comfort to it owner. Two common conditions ESAs as used for are anxiety and depression. It is not trained to provide this service nor is training required. Because of this they have significantly fewer access rights than service animals, as discussed below.
What if I still want an ESA?
The title of this post is “It’s more complicated than that.” We mentioned the scams. The growing number of legal consequences are below. If you still think an ESA may be right for you, good form dictates:
1. Regular therapy with a licensed professional for a minimum of six months
o to adequately determine if an ESA is the right choice for you
2. Updates to the letter at a minimum of every six months.
If you are faced with legal actions having a letter dated within the past six months offers you better protection than one dated a year or three ago.
Therapy Animals
Instead of providing comfort to a single owner, therapy animals work in conjunction with a handler to provide comfort to large groups of people.
Therapy animals can include animals that visit hospitals or nursing homes, animals that participate in animal-assisted programs such as Sit, Stay, Read, or animals that assist in a therapeutic process such as horse-assisted therapy.
If you think your pet would make a good therapy animal and you want to help others in your community here are a few resources to help you get started:
Rainbow Animal Assisted Therapy
AKC Recognized Therapy Dog Organizations
Friends for Therapeutic Equine Services
Service Animal
According to the American Disabilities Act (ADA) “a service animal is defined as a dog that has been individually trained to do work or perform tasks for an individual with a disability. The task(s) performed by the dog must be directly related to the person's disability.”
Therein is the key difference between service and emotional support animals. Service animals are highly trained to work for a single, specific individual. Service animals do not double as family pets.
Where Each Animal Can Go Public
Any animal, including service animals, can be removed from any public setting at any time if any of the following occur:
· The animal becomes unruly or distracting to other patrons.
· The animal poses a threat to others through demonstration of aggressive behaviors.
· The animal becomes destructive of property.
· The animal fails for any reason to be under the control or supervision of its handler.
Emotional Support Animals
If you take nothing else away from this post, please remember this – ESAs are not an all-access pass.
ESA are, by law, only allowed in spaces where pets are also allowed. They can be barred from any and all other locations without penalty. The only exception is housing. An ESA letter from a licensed professional prevents a landlord from evicting a tenant from that living space because of the animal. This applies more to individuals in subsidized housing. It does not apply to someone who brings a pet into a “no pets” apartment and then gets caught.
This means any business can legally allow or bar an ESA from their premises at their own discretion, just as the DOT has done. Businesses can also ask for the animal’s ESA letter and the owner must provide it.
Remember, even if your ESA animal is allowed into a business if it becomes in any way disruptive and you are unable to curb this behavior the business can have you leave. This applies to service animals, as well.
Therapy Animals
Therapy Animals require verification from each individual facility they are working at prior to entering. Meaning, a therapy animal may work at multiple hospitals but will require verification from each of them. This is the only place therapy animals are allowed to be. Otherwise, they can only access places that are already pet-friendly.
Service Animals
A service animal cannot be barred from any public setting.
The Ramifications of Misrepresentation
Falsely claiming your pet is a service animal just to bring it with you to a restaurant, the grocery store, or on the bus, etc. is incredibly detrimental to every person who relies on their trained service animal. It is thoughtless and, increasingly, illegal.
Doing this not only inconveniences those around you who have to tolerate your animal, you are also poisoning public attitudes towards genuine service animals. As a result, service animal users have been harassed, accused of “faking it” and barred from places where they are legally allowed to be.
On top of this, if you encounter an actual service animal your untrained pet may jeopardize the safety of the service animal and its handler. Pets masquerading as ESAs have attacked and injured service animals. Now their handler not only has to cope with having an injured animal but their own lives are now hampered and/or put at risk because their animal cannot perform its job.
You may also be breaking the law. Leave your pets at home. Allow service animals to do their jobs unhampered.
What Can/Cannot Be Asked
Do not approach a person asking about their animal unless you are a) representing the business/public space the animal is in or b) the animal is being disruptive.
If you are in a position where you need to ask about an animal’s qualifications here is what you can ask here in Illinois per the state attorney general and the ADA:
1) Is this a service animal?
a. remember, you cannot ask for proof unless the animal is identified as an ESA.
2) What tasks has this animal been trained to perform?
If the answer to question 1 is “Yes” then question 2 can follow. If the answer is “No” then follow your business’s policies. Also, remember, even service animals have to behave themselves. Any animal that does not can be asked to leave the premises
Conclusion
The subject of assistance animals is a complicated and currently evolving state of affairs. In addition to the links provided throughout the post here are a few more that will help you navigate this subject:
ADA FAQs about Service Animals
American Veterinary Medical Association
American Psychological Association – Is that a pet or a therapeutic aid?
Michigan State University Animal Law Info
Here at Obsidian, we love what we do and we always do our best to give you the best we possibly can. If you ever need help or guidance, please do not hesitate to contact us at the following:
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Ilyssa Lasky –
(224) 255-4411
What Do You Mean My Life Coach Isn’t My Therapist?
Clarifying the Differences Between Various Mental Health and Related Professionals
In our February, 2021 post “How to Find the Right Therapist” we talked, among other things, about what all the various licensing abbreviations mean. This time we are going to clarify the differences between various mental health and related professionals including training and certification/licensure.
We will be looking at therapists, psychologists, psychiatrists, and life coaches. We hope this information will help you determine what kind of care you need.
What is a Therapist?
A therapist must hold a master’s level degree from an accredited academic program as well as a license to practice in their state. If a person only holds a master’s degree but not a license, they are not legally able to provide you with therapy although they are able to provide other sorts of mental health services. Therapists are also legally bound to observe HIPAA and other health privacy laws as well as the Code of Ethics of their governing body – the American Counseling Association.
Why Might You Want a Therapist?
Therapists are trained to help you with a vast array of life challenges and mental illnesses. These can include making career changes (such as a licensed therapist with career counseling expertise), overcoming depression, family issues, or severe mental illnesses such as Bipolar I disorder or Schizophrenia.
What is a Psychologist?
A psychologist is a person who has earned either a Ph.D or Psy.D in psychology. Like a therapist, a psychologist must also be licensed before they can practice therapy. Clinical psychologists have an even more advanced and sophisticated level of training than therapists. Psychologists are also legally bound to observe HIPAA and other health privacy laws as well as the Code of Ethics of their governing body – the American Psychological Association.
A non-clinical psychologist also has an advanced level of training but may adhere to the American Counseling Association’s guidelines.
Why Might You Want a Psychologist?
Whether or not you want to choose a psychologist or a therapist depends on what challenges you are facing as well as the training of the specific professional. A therapist with 10 years of experience may or may not provide better care for your issue than a newly minted psychologist with less experience.
What is a Psychiatrist?
Above all, psychiatry is a medical degree. Unlike a psychologist, a psychiatrist has an MD or “Doctor of Medicine.” A psychiatrist’s education is in mental health medication. There are many places you might find a psychiatrist working. For a person who is seeing a therapist or psychologist in an outpatient setting—meaning one or twice a week in a therapist’s office—they may also work in conjunction with a psychiatrist for mental health medication.
A psychiatrist must also be licensed. A psychiatrist must obtain a certification from the American Board of Psychiatry and Neurology and as well as a medical license, as outlined here by the American Psychiatric Association, in order to prescribe you medication. If you haven’t guessed already, psychiatrists also have their own Code of Ethics that they must abide by.
Why Might You Want a Psychiatrist?
A psychiatrist’s bread and butter is mental health medication. While your general practitioner or primary care doctor is legally allowed to prescribe mental health medication this is not their area of training or expertise. Nobody knows the ins and outs of prescribing and monitoring mental health medication like a psychiatrist does.
What is a Life Coach?
I went to certified coach Sasha Davis, founder of Mercury & Kolb life coaching, to get the answer. As she describes, proper life coaching is not toxic positivity on Instagram. A proper life coach is someone who can help you set and reach your goals, support you so you accomplish more than you would have on your own, and improve your focus so that you can produce the results you want faster.
Sasha explained life coaching is not regulated in the same way the other professionals identified here are. “Anyone can hang their shingle” (Davis), however, there is a gold standard of life coaching that has been set by the International Coaching Federation (ICF). The ICF has its own Code of Ethics, framework, and strict standards for accrediting their member coaches.
There are four levels of recognized ICF coach accreditation and each requires more education and hours practicing life coaching than the one before it. These are:
1. Certified Coach
2. Associated Certified Coach
3. Professional Certified Coach
4. Master Certified Coach
Because of this ICF associated life coaches are the way to go. Additionally, clients can file complaints with the ICF if they believe their coach has done something inappropriate. While this does not include legal actions, a coach can be stripped of the ICF accreditation.
Why Might You Want a Life Coach?
The practical difference between a therapist and a life coach is that a therapist helps you “dig really deep into your backstory” (Davis). As we discussed above, a therapist helps you to process, sort, and resolve all manner of mental health challenges.
A life coach, on the other hand, may be a good choice for next step after therapy as a life coach can help you identify what is getting in the way of achieving your new post-therapy goals. Questions Sasha has seen among her clients post-therapy have included:
“What do I do now?”
“How do I take what I learned and apply it?”
“What steps do I need to take to maintain the progress I’ve made?”
If you want to find a life coach Sasha recommended The Academy of Creative Coaching for their focus on diversity and actively pairing you with a coach they think will be a good match. You can also go to the ICF website to search for credentialed life coaches.
Here at Obsidian, we love what we do and we always do our best to give you the best we possibly can. If you ever need help or guidance, please do not hesitate to contact us at the following:
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Ilyssa Lasky –
(224) 255-4411
Your Rights as a Client
Last month we talked about finding the right therapist. Now that you’ve hopefully done so (and if we’re lucky you chose one of us here at Obsidian!) I think it is time to discuss your rights as a client.
That’s right! You have rights as a client. We always talk about being a knowledgeable and informed consumer, and while the relationship between a client and their therapist is not really a “business-consumer” relationship, it is still helpful to know how to advocate for yourself.
You are NOT Stuck with Your First Therapist
If something is not working in your sessions tell your therapist. We do not invest our egos in this job, or at least we shouldn’t. This is all about your care. Tell your therapist. Then you can work together to determine if an adjustment can be made.
What might not be working? The therapist’s approach might not be the one for you. Maybe you need someone who gives you strict deadlines on tasks. Or perhaps Cognitive Behavioral Therapy (CBT) does not click for you and a different evidence-based approach is a better fit.
You might also just not connect with this therapist. While therapists are professionals, given the very personal nature of our work together it is not a surprise that sometimes two people just don’t mesh. That’s okay!
If after a few sessions you are just not connecting with this therapist go ahead and tell them. Again, we do not invest our egos into this job and no offense will be taken. In fact, if you ask, your therapist may even be able to help you find a better fit.
You Have a Right To…
1) A licensed therapist or supervised intern. The name and abbreviation for licensure differs between states, however, you are absolutely encouraged to ask your therapist what their licensure is and the qualifications to earn it. You absolutely want someone who has earned at least a Master’s degree in psychology.
If you are working with an intern you should be informed of that fact. An intern works under the supervision of a licensed therapist. However, if you are in any way uncomfortable working with an intern you are within your rights to request a fully licensed clinician.
2) You also have a right to ethical treatment practices as outlined in the Code of Ethics of both the American Psychology Association and the American Counseling Association. This means any treatment method or modality used in your therapy has been researched, tested, and validated as safe when applied by a trained clinician. Your therapist should never use a treatment they have not been trained to use.
3) You have a right to confidentiality. This means files are locked and secured, no identifying information is given to anyone without your written permission, and informed consent and the limits of confidentiality are observed.
Informed consent and the limits of confidentiality involve situations wherein your written permission is not required for the therapist to break confidentiality. This includes a reasonable belief that you might hurt yourself or another person, or the safety of children, adolescents, or elders are at risk. In these cases, your therapist is required by law to break confidentiality.
4) You also have the right to a safe environment during your counseling sessions. This means the location is reasonably secure and confidential (typically an office with a closed door).
This also means you are safe from flirtations and sexual advances from your therapist. You are also safe from coercion to provide gifts, favors, skills, access to other people, etc.
5) You have a right to continuity of care. This means your therapist will not abandon you (i.e., suddenly stop seeing you or responding to you) and that there is a backup plan for known absences such as a vacation or leave of absence. This also means that advanced warning of such changes is provided. The last session you have together is not advanced warning.
This also means if your therapist is no longer able to work with you for any reason—the therapist is moving away, changing practices, or is not trained in your newest presenting issue—they will provide you with resources for finding a new therapist.
If you would like some more information on continuity of care these studies provide summaries of their findings:
“Continuity of care as experienced by mental health service users - a qualitative study” by Biringer, Hartveit, Sundfor, et al
“Continuity of care in mental health: understanding and measuring a complex phenomenon” by Burns, Catty, White, et al
“Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study” by Sweeney, Davies, McLaren, et al
How to Report a Therapist for Violations
Reports of violations are taken very seriously, and thus making such a report is a serious matter.
If you think any of the above rights have been violated please talk to your therapist first. Just as you talk to a company or business if you are not satisfied with the services they provided talk to your therapist. Do not report a violation if you are angry at your therapist for something that was said. Talk to your therapist first, just as you would a friend or family member.
It is likely the two of you can reach a satisfying resolution whether that is making your therapist aware the current mode of therapy is not working, that you are angry or hurt by something that was said, or finding someone else who can treat you either permanently or until the therapist is able to return to regular sessions with you.
If you do not reach a resolution together you can also talk to the therapist’s supervisor or practice owner. If none of this brings a resolution, or if you feel sexually exploited in anyway please make your report.
To do so look up the professional State Board they are licensed with. In Illinois this is the Illinois Department of Professional Regulation.
Here at Obsidian we love what we do and we always do our best to give you the best we possibly can. If you ever need help or guidance please do not hesitate to contact us at the following:
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Ilyssa Lasky –
(224) 255-4411
How To Find The Right Therapist
You’ve taken the first and the biggest step: you’ve decided that you can’t do this alone and you need support. You need a therapist. But now how do you find one?
Finding a therapist is easy. Finding the right therapist can feel like a long process. How do you select a person from a list? How do you choose based on an “about me” paragraph? Where do you even look? This post aims to help demystify the process and give you some tools and resources for your search.
Where to Look
There are plenty of internet sites to assist your search. Many therapists list across multiple platforms. Because profiles are self-monitored these sites tend to be more accurate than referrals from an insurance company.
Below are some of the most popular and handy sites meaning more therapists are listed which give you more to choose from.
American Association of Sexuality Educators, Counselors, and Therapists - AASECT – a directory of professionals specifically educated in sex-related concerns and sexuality.
National Coalition for Sexual Freedom - KAP – Kink Aware Professionals. A directory of sex-positive, kink and polyamory accepting clinicians.
Open Path Collective – perfect for those without insurance. All therapists charge a sliding fee scale between $30 and $60.
Psychology Today Therapist Finder – probably the most popular therapist directory out there.
Therapy Den – stands out for the vast number of filters to help narrow your search including language, sliding fee scale, ADA accessible offices, and racial justice
TherapyTribe – a defining feature is having a separate group therapy/support group search function
ZenCare – one of the few places with a video from your therapist so you can get an even better feel for who they are.
Utilize Site Filters
Now that you have started your search on some of these sites be sure to utilize all available search filters. This allows you to narrow your search to your specific challenges and, importantly, your insurance carrier or sliding fee scale needs. It’s frustrating to get to the end of your search and then realize the therapist is not empaneled with your insurance company.
What Are All These Abbreviations?
MA/MS – Master of Arts or Sciences. Every therapist must have a masters degree in psychology in order to practice talk therapy and so not everyone lists this among their credentials.
LPC – Licensed Professional Counselor. This person has their MA/MS and has passed a licensure exam.
In Illinois this is generally (but not always) a clinician in the first few years of their practice. By law they must work under the supervision of an independently licensed therapist. In practical terms that means a more experienced therapist that the state recognizes as able to work on their own without legally required supervision.
LCPC – Licensed Clinical Professional Counselor. This therapist has accumulated thousands of hours of therapy work and taken a second, harder licensure exam. This is an independent license.
MFT – Marriage and Family Therapist. Similar in application to the LPC with a focus on marriage and family therapy.
LMFT – Licensed Marriage and Family Therapy. This is also similar in application to the LCPC with a focus on marriage and family therapy. It is also an independent license.
LCSW – Licensed Clinical Social Worker. This is an independent license. Therapists with this license attended a clinical social work master’s program rather than a counseling or clinical psychology program. Such programs incorporate social work skills and principles in addition to psychology.
CADC – Certified Alcohol and Drug Counselor. These counselors do not require a master’s degree. However, they are still extensively trained through thousands of hours of education and therapy work. It is not unusual to see a therapist who holds a CADC as well as a master’s level license such as those listed above.
Psy.D – Doctor of Psychology. This person earned a doctoral degree with a focus on treatment of clinical psychology issues.
Ph.D – Doctor of Philosophy in Psychology. In practical terms a Ph.D psychology program includes conducting research as well as additional learning in treating mental health concerns.
Read Those Profiles
This is your best way to learn about each therapist. A good profile will include the therapist’s treatment philosophy and their outlook on the process of therapy. Find the ones that speak to you. This is also where you will find the therapist’s treatment modalities (always look for evidenced-based modalities) and what issues they are knowledgeable enough in to treat. For example, if you’re looking for counseling for your teenager, you want to make sure the therapist frequently works with teens. Don’t be concerned if you see several specialties listed. It is common for therapists to gain knowledge in more and more mental health conditions as our careers go on.
Contact Your Choices
Use the contact information listed to reach out to the therapist. Please be aware that we do not always have openings in our schedule or times that work for you. While I personally believe every phone call and email should be returned regardless this does not always happen. If you do not hear back within a week move on.
Getting the Most Out of Your First Session
If you have never been to therapy before you might not know what to expect in your first session. The first session is called “intake” but it is as much a “getting to know you” session as it is information gathering.
The therapist will ask you various questions that may not seem related to what brought you in. This may include information about your family growing up, where you work, or even your hobbies. This is how your therapist gets to know you so they can get down to the work of helping you.
This is also when you start interviewing your therapist and identifying if this is the person you want to work this. Things to consider include:
· Do I genuinely feel this person can help me?
· Do I feel like I “click” with them?
· Do I think they adequately listened to the things I said?
As with any relationship you may or may not know right off the bat whether you will get along. But, if after the first three sessions you are not sure how you feel about this individual then it may be time to move on and look for someone new. Mental health therapy is a deeply personal process. The best results come when you are able to form a solid, mutual working relationship with your therapist.
Do not be afraid to tell your therapist this. Do not worry about disappointing us or hurting our feelings. This is our job, and our job is to help you. If we are not accomplishing that then there is no reason to waste your time and money. Find someone you click with.
Come back next month for our post about your rights and advocacy as a client.
Ilyssa and I welcome any questions anyone may have about this process. Even if we are not the right fit for you we want to make sure you find the right person. If you would like to speak to me or Ilyssa, or anyone else on the Obsidian Counseling team, about finding the right therapist please do not hesitate to reach out to us. You can contact us at the following:
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Ilyssa Lasky –
(224) 255-4411
Self-Harm: A Symptom Not A Disorder
Self-harm, also called self-injury, is not an uncommon or new phenomenon. An estimated 2 million Americans engage in some form of self-injury. An analysis across 40 countries identified 17% of all people will self-harm during their lifetimes. The average age of first incident is 13 but individuals as young has 5 have been reported, and although young white women are the typical face of self-injury as many as 35% are men.
It can be very upsetting to learn a friend or family member has engaged in self-harm and difficult to understand. The purpose of this month’s blog post is to educate on what self-harm is and is not, separate the fact from the myths, and to provide some guiding resources on how to help a loved one who is self-harming.
What is Self-Harm?
By definition, self-harm is the deliberate act of harming one’s own body without suicidal intent. That is an important take away from this post: self-harm is not a failed suicide attempt. Self-harm, in many ways, is the anti-suicide. That being said, accidental suicide can happen particularly when an individual is under the influence of a substance. A common cause is cutting deeper than intended.
It is also important to understand that self-injury is not a mental disorder. It is a symptom of deeper distress and is a coping mechanism, which will be elaborated on below.
What are Common Myths about Self Harm?
I am starting off with the myths. I will explain some of these in further detail however, suffice to say, if it is on this list it is not true. For fuller explanations of each of these myths please visit The Recovery Village and this handout from Samaritans.org.
Specific self harm myths –
1) Self-harm is rare.
2) Young people self-harm to fit in.
3) It’s a way to manipulate others.
4) Only “emos” self-harm.
5) It’s just a phase that will soon be grown out of.
6) It’s just a bid for attention.
7) People who self-harm want to die.
8) Self-harm is a failed suicide attempt.
9) Only those who have been sexually abused self-harm.
10) All people who self-harm have been abused.
11) People who self-harm do not feel pain.
12) Self-harm is not treatable.
Why Do People Self-Harm?
In short, a person’s primary reason for self-harm generally fits into two rather broad categories:
1) Feeling too much emotion
2) Not feeling enough emotion
How either of these states comes into being requires a rather long answer. The summary is either a person does not know how to self-regulate their emotions (see point 1) and self-harm helps them with this, or, a person feels so numb inside that the pain from self-harm shows them “At least I’m still alive,” (see point 2) as one of my clients described it.
What Exactly is Self-Harm?
The general definition of self harm is any action deliberately harming oneself physically as a way of dealing with difficult or overwhelming emotions.
How do People Self-Harm?
There are a number of ways in which people can self harm. Cutting is the most common. However, other methods include burning, scratching, hair pulling, biting, picking at skin and wounds, and hitting one’s self and/or head.
Self-Harm as a Coping Tool
I tell all my clients the brain’s number one concern is our immediate survival. This is where I marvel at our brains. Our brains work so hard to protect us that they will come up with anything, do anything, as long as it works to protect us right here, right now. Because if we do not survive right now we are not going to be alive later to decide whether or not we regret what we just did.
The mind—which I conceptualize as our logical part with our critical thinking and problem-solving parts—decides whether or not something is a good idea. The problem is, even if the mind knows self-harm is a bad idea, as most who engage in self-harm know this, it needs to come up with a better alternative in order for the brain not to choose self-harm. Simply knowing “This is a bad idea” is not enough.
How many times have we heard dialogue like this in a movie?
“This is crazy!”
“Do you have a better idea?”
A similar conversation goes on between the brain and the mind.
Why is Self-Harm a Coping Tool?
First, why it works. Harm to the body increases adrenaline and endorphin production. This induces both a greater sense of control and a relaxation effect. These, in turn, help to tolerate one’s emotions and regulate the nervous system.
There are many reasons why a person may not have learned how to regulate their emotions and nervous system:
· It can be due to trauma throughout childhood.
· It could be due to parents who likewise do not know how to regulate their emotions and thus never modeled it for their child.
· It could also be a child getting lost in the shuffle of family life. Think “middle child syndrome.”
· It could also be a person who, for one reason or another, finds intense emotion distressing.
For those who feel numb and dead inside severe depression and trauma are frequently the root causes.
How Do I Help Someone Who Self Harms?
There is a lot of information out there on how you can help your loved ones if you suspect they are self-harming. Below is a few suggestions. For more information on each them please visit Banner Health and Mental Health First Aid.org. There are also more resources as the bottom of this post.
1) Avoid judgement
2) Reassure and be supportive
3) Express your concern comes from caring
4) Provided educational information/resources
5) Seek understanding
6) Do not dismiss
7) Do not ask for promises
8) Try to be accepting and normalize
9) Encourage professional help
Counseling & Help For Self Harm in the Chicago Area
As a therapist, I have worked with many, many clients who do or have self-harmed. If you like to speak to me or Ilyssa, or any other therapist on the Obsidian Counseling team, about helping you or a loved one with symptoms like this please do not hesitate to reach out to us. We offer online therapy to individuals in the Chicago area and throughout Illinois.
Take the steps below to begin therapy:
OTHER SERVICES AT OBSIDIAN COUNSELING AND WELLNESS
When you work with a therapist at our counseling practice in the Chicago, IL area, you will be met with compassion and authenticity. We won’t judge you, and we assume there are reasons for all of your actions…even self harm. We’re here to help you find healing and make meaningful change in your life. Our therapists are honored to help guide folks, including teenagers, along their healing process. Specifically, we help people in addressing anxiety, trauma, and work stress. One of our more unique services is yoga therapy, which can also be done using online sessions. Additionally, we specialize in supporting LGBTQIA+ folks for a variety of issues. We hope that you take the leap to begin counseling with us. You deserve it.
About the Author/Therapist
Kari Holman is an LCPC in Illinois who believes you are the expert on your own mental health. She is able to help clients with a wide range of mental health concerns and specializes in providing counseling and psychotherapy services to the Latinx and LGBTQIA communities. If you’re interested in working directly with Kari, or have any questions about this blog post, please call (847) 450-0460 or email her at kariholmancounseling@gmail.com.
Other Resources Related to Self Harm
For more resources on how to help someone who self-harms, including what to say or not say, please see the follow:
Self.com – 5 Helpful Things to Say to a Friend Who Self-Harms (and 3 to Avoid)
Fandom Spaces as Sacred Spaces
This month we are going to talk about an unusual kind of sacred space: fandom spaces.
Encyclopedia.com defines a sacred space as “a defined place, a space distinguished from other spaces. The rituals that a people either practice at a place or direct toward it mark its sacredness and differentiate it from other defined spaces.” While typically religious in meaning, a sacred space can be any space that holds this meaning and these practices for an individual or group.
Fandom is not a new concept, per se, as it applies to sports fan and particularly those who are dedicated to a certain team. The current use of the word, however, typically denotes a specific subculture that contains communities built around a shared consumption not of sports but of movies, TV shows, fiction, trading card games etc. Typically of a “nerd” or “geek” variety. Examples include Harry Potter (books), Supernatural (TV show), Star Wars (Movies, etc.), and Magic: The Gathering (trading card game).
Drs. Plante, Reysen, Roberts, and Gerbasi delineate in their research a difference between “fanship” and “fandom.” Fanship is defined as a “psychological connection with a fan interest” whereas fandom is a “psychological connection with others sharing the same interest.” They also observed that different fan groups have differing levels of fanship and fandom within them which they stated suggests “that fan groups may differ not just in content, but …. the motivation underlying fan participation.”
Fan participation and the connection with others this engenders is where the sacred space lies. Fan participation in fandom includes a vast array of creative output. This can include fan-made fiction, art, hand painted playing pieces for board games, or hours and hours customizing the perfect card deck or making the best costume (called cosplay) to show off both one’s skill and love for a specific property or character.
The internet has allowed fans to stay connected year-round. All of this communal involvement creates an extended sense of belonging to a community that is larger than oneself. Some fandoms are international in their scope.
In the sense of a sacred space being a prescribed location wherein people come together, such as a religious building, modern “nerd” fandom has a unique place for its members to engage with each other and their fandom content: conventions.
Despite the largest fandom conventions—called cons in fandom parlance—garnering mainstream media attention these events are still widely unknown to the public. They resemble trade and industry conventions insofar as including topical panels and containing a product floor (called the Dealer’s Room in most cases) where attendees can buy merchandise the similarities widely end there.
To understand cons as a sacred space it is best to look at fandom through a sociological lens (i.e., as a subculture). The Oxford dictionary defines subculture as “a cultural group within a larger culture, often having beliefs or interests at variance with those of the larger culture.” Subcultures are also defined as having developed their own norms and values regarding cultural, political, and sexual matters.
Recall the difference between fanship and fandom. Fanship is an interest. Fandom is frequently incorporated as a way of life with the fan’s yearly calendar planned around cons and other fandom events.
This is the importance and the sanctity of cons. Fandom has its own rules, norms, and social mores that are not always in line with mainstream culture. Cons are the place where fans can exercise and experience their norms, social mores, etc. without the pressure or stigma of the mainstream or their everyday life.
Many feel a need to hide this aspect of themselves and/or the depth of their involvement to avoid ridicule or harassment from peers, coworkers, or family. Attending every game for a favorite sports team is viewed as acceptable whereas attending multiple card game tournaments is mocked. Others, such as furry, are seen as a psychological disorder by the uninformed.
Thus, cons are a “home” and place of that all-important psychological need of belonging. Many have “con friends” that they can only see at conventions much like cousins one is only able to see at family reunions. I contacted some of my colleagues who also identify with various fan subcultures and asked what con space means to them:
“It’s a space where I don’t have to mask my weirdness, the things I spend so much energy hiding. Furry was the first place I ever really felt accepted, and that’s still really powerful for me, nearly 21 years later” – Dave L.
“There is a feeling of being amongst my people that is all too rare despite living in what is largely described as an open minded and accepting area. Within a con space it is safe to express myself however I choose to. As a gay man, that is worth preserving and venerating.” – Chris B.
“Funnily enough, the image comes to mind of stepping through the hotel doors like one might step into a church. A large, well-lit space where you’re in the presence of a grander uniting idea. People partake in sacrament (giant pizzas and booze) and cultural music and dance.” – Chris B.
“I think they’re sacred spaces because it’s like a homecoming…Cons provide that connection to the family of my choosing. There’s the sense of being a part of something bigger. I think that’s such a core spiritual ‘thing.’ Being able to help create that space as con staff is really meaningful and allows me to give back.” – Damon @.
It is not unusual in the sacred fandom space to hear talk of chosen family nor it is unusual for romantic relationships to form. In essence, the sacredness of a con can be described as a place that fulfills an essential emotional need: the need to belong. The majority of humans need to be able to affiliate with and be accepted by a larger group. Many bridge the gap from fanship to fandom because of the belonging and because of the breadth and depth of acceptance that is far more common in these spaces than in the mainstream. That is the sanctity of having a place to belong.
If you would like more information about fandom please follow any of these resources:
Fandom and Participatory Culture by Jenkins, Jensen, and Hills
Fandoms: Subcultures on the Rise! by Alessio, LaMinta, and Vinci
Fandom and the Search for Meaning: Examining Communal Involvement With Popular Media Beyond Pleasure by Tsay-Vogel and Sanders
Finding Meaning within a Fandom: Not all Fans are Alike by Rojas, Edwards, Griffin, et. al.
Routes to Fandom Discovery and Expression of Fan Identity in Furry, Anime, and Fantasy Sport Fans by Reysen, Plante, Roberts, et. al.
Defeating the Covid Winter Blues
Well, this is certainly not were any of us wanted to be this winter. The desire to be with our families through the many winter holidays is going to be strong even though we know it will not be safe to do so.
The longer nights and colder temperatures in much of the US can be difficult to bear for many people, estimates are around 1 in 4 people experience negative changes during the winter, and this year we in mental health field expect it to be even more difficult as so many of our winter coping activities will not be available to us. So, in recognition of day light saving time messing with all of our internal clocks this month we are going to suggest some ways to beat the Covid winter blues.
First, we are going to talk about Seasonal Affective Disorder or SAD. SAD is a depression disorder that is related to seasonal changes. Most typically the symptoms begin in the fall and persist throughout the winter. Symptoms will look familiar to anyone who has experienced depression:
· Depression
· Anxiety
· Irritability
· Loss of energy
· Changes in sleep or appetite
· Weight gain or loss
· Feelings of hopelessness
· Trouble concentrating
The severity can vary between individuals, between years, and even across a person’s life time. The tips we are going to share here will be helpful to those with and without SAD.
Keep Active
How? YouTube has thousands of movement and exercise related videos. Whether it’s an actual exercise routine or an activity with the kids, movement of some sort is a good way to beat the winter blues. Timeout.com has a list of 101 things to do when you’re stuck at home.
Did you know you can take online classes for everything from cooking to geology? Both Coursera and The Great Courses (also available on Amazon Prime) have hundreds of options YouTube has also had an explosion of documentaries of various lengths and topics ranging from football to ancient history.
Stimulate Your Senses
Hand in hand with staying active is stimulating your senses. Maybe it’s time for a colorful accent wall. Or colorful nails. Or new smells in the home. Smell is actually our most powerful and evocative sense. None of the others can active a memory or sensation as powerfully as our sense of smell. This does not necessarily mean cover your house in plug-in oil diffusers, though of course you can! Find a smell you like and spritz it on your wrist, your pillow, or your favorite throw blanket. An orange kept in the freezer can give you a blast of citrus when you need it. Good old scented candles are also good, though be mindful of small children and pets.
Sun Lamps/Light Boxes
One of the causes of winter blues, and SAD in particular, is a reduction in Vitamin D. Sunlight triggers natural Vitamin D production. Those who love walks, no matter the temperature, can go outside for 10-30 minutes to get that Vitamin D production. For the rest of us, a sunlamp or light box (which run around $40) may be a good alternative.
Sun lamps do not cause vitamin D production. This is because quality sun lamps filter out UV light. In fact, do not buy a sun lamp that does not specify this. What sun lamps do do is regulate your body’s production of the hormones melatonin and serotonin. Melatonin helps regulate your sleep-wake cycle and serotonin helps regulate your moods.
There are some risks to be aware of, however.
1. Those with light colored eyes are more prone to eye strain
2. Those with a bipolar diagnosis should not use a sun lamp without careful consultation with a psychiatrist. Sun lamps can trigger manic episodes.
3. Some medications can make a person more sensitive to light
Additionally, the Cleveland Clinic recommends avoiding sun lamps if you have:
· Macular degeneration
· Connective tissue damage
· Existing skin cancers
· Diabetes
· Lupus
Be sure to read the instructions on your sunlamp for distance away from your eyes and amount of time. It is better to start low and work your way up. Also do not look directly at the sun lamp. Sun lamps are meant to be set at an angle to your face.
Check out The Cleveland Clinic, The Mayo Clinic and Healthline for more information.
Focus on the Positive
Yes, I know, this one sounds cliché but there is science behind it. Our brains are malleable and physically change shape in response to many, many factors. If you have ever heard the adage “Negativity breeds negativity” or vice versa for positivity that is because your brain has changed shape to be more attuned to the one or the other.
I regularly recommend clients take note of at least three good things that happened in their day. It does not have to be big. It can be as small as seeing a dog on the side work, or making it through the intersection before the light turned yellow. These will help your brain stay in “positive shape.”
Talk About It
One of the best ways to feel better is opening up and talking about how you are doing. I have had clients tell me they do not want to bring their family and friends down by whining or moping, especially because they are in the same boat right now. Some may not want to be reminded things are hard right now but many others benefit from sharing their feelings with a person who has been or is in the same boat. If nothing else, you can trade tips.
However, if your lethargy or sadness is continuing over days or weeks and making it difficult to function, reach out to a therapist or other professional for help.
Aim for a Healthy Diet
Of course this is going to be in here. We have all heard it. We all know eating healthy helps with mood and overall body health. But, we’re still going to include this in here. If you feel like reading a little more about current research check out this Forbes article.
Even though wintertime is a real draw for comfort foods try to focus on those fruits and veggies (particularly dark, leafy greens) as your budget allows. Complex carbohydrates, like whole grains, can also boost energy.
Nurture Your Spirit
Whatever this means to you. If you need some ideas try these from US News or these 50 ways to nurture your spirt.
As always, if you would like to speak to any of us here at Obsidian Counseling about helping you with symptoms like this please do not hesitate to reach out to us. You can contact us at the following:
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Ilyssa Lasky –
(224) 255-4411
Additional Resources:
Stress Dreams as a Response to Covid-19
As quarantine measures continue to drag on our clients have reported an increase in stress dreams. This is no surprise given stress dreams are a sign of chronic stress. When I was first applying to graduate school I had a different stress dream every night for the five days leading up to putting my applications in the mail! Suffice to say, I was not handling that stress too well.
What is a stress dream?
A stress or anxiety dream is an unpleasant dream that can sometimes be more disturbing to the dreamer upon waking than a nightmare. Stress dreams include feelings of uneasiness, distress, or apprehension upon waking and sometimes within the dream as well. Common themes include:
· incomplete tasks,
· embarrassment,
· falling,
· getting in legal or financial trouble
· failed pursuits, and
· being pursued by another.
As a result, sufferers may experience daytime sleepiness from poor sleep, waking in the middle of the night, mood problems (because stress dreams are emotionally draining), or resisting sleep because your brain does not want to experience those stress dreams again!
Each of us responds to stress a little differently but the way it manifests in our dreams appears to be fairly consistent. Following are nine common stress dreams. Because interpretation of dreams is vast, varied, and individual we won’t try to tell you what your dream means for you, specifically, other than it is a sign of continued stress:
Teeth – Specifically dreams about teeth crumbling, falling out, rotting, or becoming crooked. This was on every list and article we reviewed!
Falling – The full body jerk with waking just before hitting the ground is not unusual.
Being late to something important – Such as a business meeting, a flight, or a family function.
Incomplete tasks – Such as not being prepared for a presentation, not being packed for a trip, or failing to finish a big class assignment.
Naked – Who hasn’t dreamed about being naked in their middle school?
Being chased – Particularly being unable to unable run away or outrun the pursuer.
Out of control driving – This could be the car not responding to you or even you’re in the vehicle but no one is driving it.
Bugs – Such as infestations, being bitten, or coming out of our bodies. These dreams appear to be on the rise since the beginning of the pandemic. Maybe it’s because our loves ones are bugging us more through living in close quarters!
Tidal wave or giant wave - Interestingly, I hear this one from my younger clients more often than my older clients. If any of you are familiar with J.R.R. Tolkien’s The Lord of the Rings novels then you will know this was a recurring dream for Tolkien himself that he then attributed to his character Faramir (Or Eowyn in the movies).
What Can I Do About My Stress Dreams?
If you want to reduce the number of stress dreams you have there are a few things you can do before bed. These include:
1. Winding down before bed.
a. Start an hour before bed time
b. Turn off the TV and your phone
c. Engage in activities you find relaxing such as reading, listening to music, or taking a shower or bath before bed
2. Scheduling “worry time.”
a. If it’s difficult for you to control your worry before bed schedule a specific time each day when you’re allowed to worry.
b. Write down your worries
c. Mull them over for no more than 30 minutes
d. Then continue to another activity such as a favorite TV show, dinner, or family activity
3. Make your bedroom a place for sleep, sex, and pleasant activities only.
a. Do not bring work to bed. No laptop. No phone calls.
b. Limit the time you spend feeling anxious or worried while in bed.
i. If you find yourself in this state while in bed leave the bedroom and spend time in another room until you feel sleepy
4. ASMR (autonomous sensory meridian response) videos
a. These have become a popular way to relax before bed time.
b. Be aware of the negative effects of looking at a TV or phone screen right before bed.
c. Otherwise, find an ASMR that works for you and have a listen.
5. Make relaxation part of your bedtime routine.
a. Guided imagery or guided meditations are great for just before bed.
b. There are an endless array of apps and YouTube videos for you to choose from that range from a few minutes to over an hour.
What Can I Do If I Wake From a Stress Dream?
1. Give the dream a better ending
a. If you remember the dream retell it to yourself with a better ending. Instead of falling you sprout wings or a gust of air allows you to land gently on your feet. Or maybe Indiana Jones arrives and takes out the thing that was chasing you. These are dreams so your new ending can be as crazy as you want it. If you notice the dream fighting you give it a little room and see if it will show you a better ending on its own.
2. Also stop watching the clock
a. This will only heighten your distress. Turn your alarm clock around and don’t look at your phone.
3. Try to relax your body
a. Any of the pre-bed relaxation techniques you use can be applied here
b. Try progressive muscle relaxation
4. Get out of bed
a. If you can’t fall back asleep get out of bed and either relocate to another place in the home or take a walk around it. This helps you to not associate your bed with frustration and anxiety.
5. A warm drink
a. But no caffeine
b. That warm glass of milk can actually help relax your body.
If you would like to speak to a therapist here at Obsidian Counseling about helping you with symptoms like this please do not hesitate to reach out to us. You can contact us at the following:
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Ilyssa Lasky –
(224) 255-4411
Resources:
Healthline – Anxiety Dream Prevention
Executive Dysfunction: Why the Easiest Tasks are So Hard
Are you a person who has struggled their whole life with staying organized, focused, or on time? Are you a person who has lately noticed that you just can’t make yourself do even the most simple of tasks? Maybe the laundry has been in the dryer for four days and you just haven’t folded it. Or the dishwasher needs to be unloaded, and it will take less than five minutes, but it just doesn’t get done. Or you stand in the middle of the room either wondering what you were about to do or questioning what you should do next.
If you are, you may be experiencing Executive Dysfunction.
Our executive functions are a broad group of mental skills that allow us to complete a wide range of tasks and engage with others. This includes:
· Focus and concentration
· Managing time
· Organization and planning
· Processing and analyzing information
· Problem solving
· Remembering details
These functions are higher order skills and take time to develop which is why children can struggle with organizing their lives, staying focused, etc. but improve as they get older. An impairment in these skills, that is to say executive dysfunction, is not a standalone condition but can be a feature of multiple mental health diagnoses including ADHD, Bipolar disorders, Alzheimer’s, and depression. Brain injuries, particularly to the frontal lode, can also cause problems with executive functioning.
When it is part of a diagnosable disorder like those mentioned above executive dysfunction can be a life-long struggle. But it can also be a symptom of, hopefully, temporary struggles. Non-disorder causes can included:
· Exhaustion
· Severe pain
· Stress
· Distracting environments
· Drug or alcohol use
· Severe boredom
In these cases, once the cause is eliminated the executive dysfunction dissapte. At the time of this writing, the US is coping with a pandemic and related quarantine measures. The stress thereof, and even the boredom of staying home without one’s regular schedule and activities, can contribute to executive dysfunction.
Individuals with even a mild level of executive dysfunction may recognize in themselves some of the following symptoms:
· Trouble planning, organizing, starting, or completing tasks
· Trouble listening or paying attention
· Short term memory issues
o such as remembering something that was just said
· Issues with “multitasking” or balancing tasks
o such as starting and stopping multiple chores without finishing any of them.
· Difficulty in learning or processing new information
Moderate to severe dysfunction, such as seen in some individuals with ADHD, Autism and Alzheimer’s can appear as:
· Trouble controlling emotions and impulses
· Socially inappropriate behavior
· Inability to learn from past consequences
Any of these symptoms of executive dysfunction can lead to poor work or school performance, problems with forming and maintaining relationships, low motivation, loss of interest in activities, avoidance of difficult tasks, and low mood.
So What Can Be Done?
There is no medication to make executive dysfunction go away, although there is evidence that stimulant medications can help with some aspects of executive dysfunction for those with a long-term diagnosis. In addition to this, and/or if you believe your symptoms are because of a temporary cause, a professional therapist can help you learn how to improve your time management, your work habits, focus, and managing your work and living space.
Some find benefit from Cognitive Behavioral Therapy (CBT) as it can teach a person how to self-monitor thoughts and behaviors as well as social skills training to help one learn culturally appropriate responses in social situations.
If you would like to speak to any of us here at Obsidian Counseling about helping you with symptoms like this please do not hesitate to reach out to us. You can contact us at the following:
Ilyssa Lasky –
(224) 255-4411
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Resources:
ADDitude – Children’s Executive Functions
ADDitude – Treatments and Strategies
Headway Brain Injury Association
Quarantine Fatigue: the Effect of Prolonged Stress and Uncertainty
As Covid-19 containments efforts continue across the US and we enter our fifth month of quarantine more and more individuals are experiencing what has been dubbed Quarantine Fatigue.
Any prolonged period of stress can cause fatigue, and not the kind that is fixed by a weekend catching up on sleep. The kind of fatigue we are talking about is the kind that can lead to burnout. This kind of fatigue is a state of physical, emotional, and mental weariness that is regularly caused by prolonged or excessive stress.
Our April entry about symptoms of quarantine stress and trauma points to factors that are causing many individuals and families to feel quarantine fatigue. If you are feeling any of the following you may be feeling the effects of quarantine fatigue:
· Irritability
· Overwhelmed
· Emotionally drained or exhausted
· Eating more or less
· Difficulty falling or staying asleep
· Racing thoughts
· Feeling unmotivated or unproductive
· Difficulty in making decisions
· Problems with concentration and/or memory
This all comes from the stress of the situation we are in. It’s overwhelming, it’s already been a long time, and it’s all uncertain, unpredictable, and filled with unknowns. That puts both the mind and the body in a constant state of arousal because that is what stress is. The autonomic nervous system, in particular, gets out of whack (watch this video from the award winning Crash Course series if you want to learn a little more about the ANS).
The end result is that we struggle to get through our day, struggle with our jobs, or our job searches, struggle in our interactions with our family members, and even those few friends we are able to see. So what can we do to work through quarantine fatigue? Here is our list and while some of these many sounds cliché or hokey, we promise there is science behind them.
1) Practice mindfulness
If mindfulness is new to you try starting with these four mini relaxation exercises from Massachusetts General Hospital. YouTube also has some mindfulness for kids videos as well as mindfulness for fatigue and some promising mindfulness for quarantine videos. Or, check out this blog post we wrote about mindfulness walks you can take in the Chicago area.
2) Proper eating
Massachusetts General Hospital has another useful article on eating for physical and mental health during Covid-19.
Given the lack of energy characterized by quarantine fatigue it is okay go with making simple meals. Googling “easy X recipe” is a sure-fire way to get lots of simple ideas with the added bonus of these being new foods for the family. Each family member can be given one or two items to prep in order to spread out the pre-cooking load. Our therapist, Kari, personally loves her fullstar vegetable chopper as a time-saving device.
3) Proper sleeping
Sleep is not one of our specialty areas although we know just how important it is. So try giving these tips from the sleepfoundtation.org a try. Dr. Michelle Drerup from the Cleveland Clinic also has this helpful video specifically about sleep during quarantine.
4) Exercise
We aren’t suggesting you pick up a three-times-a-week pumping iron routine. But we are suggesting you get out of the house. A single walk around the block is effective. Or an early evening walk, even the weather is cooler, on a local trail. Bring your masks to put on if you pass other walkers and/or maintain six feet of distance.
If you live in or near an area that has a walkable downtown or pedestrian area stroll around there even if the stores are closed. “Quarantine Scavenger Hunt” turned up a number of surprising results on Google. Or make one for each other. Grab your phones to take photos, go to that walkable area, and meet back in 45 minutes.
5) Connect with your friends and loved ones
We get it. This summer just isn’t the same for anyone. No beach. No barbeque. No trips. As of this writing Kari should be packing for her annual Pennsylvania camping trip with all of her best friends. So what is she doing instead?
Try the now ubiquitous Zoom call but with a few twists. The Wrap has a handy list of board games that can be done online. There are also group playable games that can be purchased on various platforms such as one’s iPhone or iPad, or gaming systems such as the Nintendo Switch which now has the “Jack in the Box” collection of party games.
Group movies can also still happen whether through a dedicated platform such as Kast or via phone call or Facetime with some well-timed fingers. Pick a movie, have everyone meet on the phone, Facetime, Zoom, etc. Get everyone to the same point in the movie, pause, count down, and then hit play. Everyone may not be exactly synced up but it will be close enough. If you have a Netflix account, there are ways to “watch a movie” with a friend in two different houses so you don’t have to bother with the syncing up. Cool, right?
6) Acknowledge your feelings and reframe your thinking
It may seem silly or even heartless and selfish to talk about your feelings of boredom, frustration, or disappointment about seemingly minor things when others have lost family members. Of course, saying “Stupid virus. I miss baseball” to someone who has lost a family member is ill-considered and ill-timed, nonetheless you are still missing out and that is still valid.
Even if you just voice it to yourself, identify the emotion, identify the “why” that may be attached to it (for example, “I’m angry and disappointed because I had to postpone my vacation”), validate this emotion. Then reframe your thinking.
By “reframe” we mean change up the language to focus on what you are accomplishing through your self-deprivation. From the example above it could be “I’m angry and disappointed because I had to postpone my vacation. But it is better than getting sick, or getting someone else sick. I can replan for next year.”
7) Remember everything is temporary
As difficult as everything is right now it is important to remember nothing lasts forever. All things comes to an end sooner or later. We may not have a specific end date but know there is an end. We will get past this crisis.
If you would like to speak to a therapist here at Obsidian Counseling about helping you with symptoms like this please do not hesitate to reach out to us. You can contact us at the following:
Ilyssa Lasky –
(224) 255-4411
Kari Holman –
(847) 450-0460
kariholmancounseling@gmail.com
Secondary Pandemic Post-Covid: the Mental Health Fallout
We will start this June blog post by stating what we hope you will receive from it: knowledge and awareness. The purpose of this post is not to scare you. It is to draw your attention to a potential crisis that you, friends, or loved ones may be experiencing. Also know that this can be overcome.
Even though many states in the US are reopening public spaces to one degree or another, there is a potential new pandemic on the horizon: a mental health crisis.
Since the beginning of quarantining actions psychology experts have been concerned about a nation-wide collective state of trauma. Unlike normal stress symptoms which typically vanish once the stressor is removed, traumatic stress can persist well after the original stressor is gone.
The Pandemic Has Been Traumatic
As outlined in our April post “Common but Often Unknown Symptoms of Quarantine Stress and Trauma” many, many people are experiencing traumatic stress symptoms in response to the pandemic due to a variety of reasons such as:
1) Job loss
2) Financial burdens
3) Greater isolation
4) Anxiety for themselves and loves ones
These are factors that have been previously linked to poor mental health outcomes and that are becoming more prevalent during the Covid-19 pandemic. Polling data from the Kaiser Family Foundation shows that more than 50% of those who have lost income or their employment reported experiencing an increase in negative mental health impacts due to stress and worry about Covid-19.
So What Might This Look Like?
Our brains are naturally clever, and they do everything they can to protect us and get us through. Unfortunately, they are not naturally well-educated on effective coping strategies. As a result our brains will come up with solutions that “work,” more or less, but are not always necessarily the best idea. This is particularly true when we experience a new stressor that we have not encountered before. The CDC has an increase in the following response types due to Covid-19. We briefly highlight the “why” of each:
1) Uncontrollable or persistent worry about your own health, health of loves ones, financial situation, loss of support services
Why?
Your brain focuses on challenges that need to be resolved. When it cannot identify a resolution it may review the challenge over, and over, and over again hoping to finally hit on something. Sort of like opening the refrigerator, looking for a snack, closing it, and then opening it again as if hoping a chocolate pudding will have somehow appeared.
2) Insomnia/Hypersomnia or Undereating/Overeating
Why?
Your brain is spinning its wheels trying to help you cope. Insomnia and undereating are primarily hormonal in response. Anxiety chemicals are racing around your system which communicates the need to be ready and alert. Sleeping is not ready nor alert.
Digestion also takes away energy. In a danger situation your body actually stops digesting until the danger has past. Because anxiety is the anticipation of danger, your brain suppresses appetite so it does not have to divert power later.
Oversleeping and overeating are also a chemical response but they are, in effect, a comfort rather than danger-response. Because we do not stress when we are asleep—stress dreams aside—sleeping is a convenient way to avoid stress. As far as our brains are concerned, of course. In actuality it causes its own set of problems.
Similarly with overeating. Food activates the pleasure centers of our brains (fun fact: cheese triggers the same part of our brains as many drugs) and so activating those centers provides a temporary “good” feeling.
3) Difficulty concentrating
Why?
This is a very common response to stressors of all kinds. Simply put, your brain has decided it has bigger things to think about than what to make for dinner, or focusing on this TV show/book, or this work assignment. The inability to identify a solution folds into that persistent worry identified above.
4) Worsening of chronic health problems
Why?
Short term stress is for the most part harmless. Sometimes it can even increase performance such as on an exam. Long term stress, however, does a number on even a healthy body. Chronic health problems can be exacerbated simply by stress but also by the negative effects of the prolonged isolation, unhealthy coping mechanisms (such as under sleeping or over eating), and also lack of access to the needed care.
5) Worsening of chronic mental health issues
Why?
Even those who have been successfully managing their mental health conditions for years are having a difficult time right now. Anxiety, depression and even trauma abounds. This is because this situation is new. Your brain does not know what to do here because it never has before, and pandemics are certainly not on the standard list of situations your therapist teaches you how to handle.
Even if you have been managing your mental health without support for years if you feel like you are struggling at all reach out to a mental health professional. This situation may be new to us, too, but trust that we have the skills to help you through.
6) Increased substance use
Why?
Even for casual users, increases in tobacco, alcohol, and other substances can be expected during isolation. They activate the same centers of our brain as cheese (see what we did there?). Meaning they bring comfort. You may be an occasional or social user of alcohol, tobacco, marijuana, etc. You may also notice you are using these substances more.
Because this pandemic is a new situation to all of us your brain, in its quest to take care of you, is saying “That glass of wine was always nice. That worked. Let’s do that.” Even for a casual or unproblematic user one can see how this can quickly become a problem.
If you would like to speak to any of us here at Obsidian Counseling about helping you with symptoms like this please call us at (224) 255-4411 or email us at obsidiancounseling@gmail.com.
Other Resources About Mental Health in the Pandemic:
Staying Sane When the View Never Changes: Handling Family Life During Quarantine
Quarantine Mask
One of the unexpected side effects of living in prolonged quarantine is the upending of family norms, family schedule, and even family tolerance of each other. Families are currently stuck in a perpetual present absent of future planning and absent of private space. Even in homes without enough rooms for each member to claim their own, the truth is there is little day-to-day variety including seeing other people outside of family members. Or at the very least, being away from family members long enough to miss them such as after a day of work or school.
As a result tensions rise, patience gets thin, and even the way someone sneezes can become unaccountably annoying. So what can families do to help each other keep peace and stay sane while we continue to isolate for everyone’s safety?
Parents
The good news is, children and teens are versatile and adaptable and really can thrive in a variety of settings as long as good parenting and good family life is maintained. Ways to help your teens and children are outlined below. But for the parents, however, the uncertainty and fear on top of that bring to do right by your kids while maintaining safety, and structure and…is overwhelming.
1) This is a different type of situation that may call for a different kind of parent.
That’s okay.
2) This is a different type of situation that may turn you into a different kind of parent.
That’s okay, too.
3) Maintain aspects of your normal routine.
While they may argue to the contrary, children feel safer when they have a routine. Routines are predictable and thus not as scary. Keeping things predictable can lessen fear for children and remind parents there are things they can control. Not everything about your normal routine can be maintained during this time, of course, but maintaining the same bed times, meal times, and chore times gives everyone a firm base to stand on. Keep it simple.
4) Take care of yourself/selves
This means try to eat healthy, try to exercise (a walk around the block is great), and try to get enough sleep. Find ways to decompress and take breaks. If you have another adult in the family or older children, take turns watching the little ones so everyone can have some off time.
5) Make time for yourself/selves
Private adult time is more important now than ever. Take time to talk with each other. Date night can even still happen. I am a personal fan of The Art of Manliness’s “18 At-Home Date Ideas.”
6) Breathe! And assess
While it sounds clichéd taking deep breathes is physiologically and psychologically beneficial. If you are feeling overwhelmed or especially stressed out or just hit the “freak out” nerve, take a few deep breathes (having a private cry is also acceptable) and ask yourself a) Are we in immediate danger? B) How am I going to feel about this problem tomorrow? C) Is this situation permanent?
And if by “this situation” you mean the quarantine and the pandemic – no. It is not permanent. It is not the “new normal.” It will end.
Families with Children
Children rely on their parents for a sense of safety both emotionally and physically. It can be hard to know what to say when you yourself are also feeling scared and uncertain. As the quarantine continues you may be noticing your children are having new emotional outbursts and behavioral problems that were not there before. Remember, children do not have the brain development to fully perceive what they are feeling, the words to fully express it, nor the insight to identify cause and effect between their environment and their emotions.
1) First of all, be patient.
A lot to ask, I know.
2) Address your children’s fears
Answer your children’s questions about the pandemic simply and honestly. It is okay to say people are getting sick. Just follow it up with how rules like handwashing, mask wearing, and staying home help to keep the family and their friends safe.
3) Acknowledge and validate your child’s feelings
Children always want to feel heard, and now more than ever. You can absolutely say to your child “I can see that you are angry because you can’t have a friend over. It really stinks, doesn’t it?” Or if you do not know what has caused the behavior you can also say “Yeah, things are hard, aren’t they? Let’s figure out together what’s making you so sad right now,” and then whatever it is validate it.
Remember, validation should not be followed with “yes, but.” For example, “I know you’re sad because you wanted to play the game, but we have to share.” Instead, saying something like “I know you’re sad because you wanted to play the game. Can you help me find an answer that will help everyone?” This is validating and it also empowers your child to be part of the solution.
4) Tell your child before you leave the house
In a calm and reassuring tone tell you child where you are going, how long you will be gone, when you except to return, and what safety steps you are taking.
School-age children have a solid understanding of death and its permanence but they may not have a full understanding of diseases and microscopic organisms. For some children, Covid-19 may seem a ghostly and unseen threat that can whisk their loved ones away to the hospital. Therefore, let your children know rather than “disappearing.” Even a teen can benefit from a text message or a note on the kitchen table.
5) Just give them hugs.
Maybe your child is just too inconsolable to help you find a solution. Maybe your child is going along just fine. Either way, times are scary and extra hugs and “I love yous” can go a long way.
Families with Teens
Social isolation is particularly difficult for teenagers. Developmentally they are hardwired to be supremely focused on their peers. While this can be aggravating (questions about bridges and jumping come to mind) it is actually healthy behavior. What then can be done for these young people who are naturally peer-focused but denied meaningful access to them?
1) Share information about the pandemic and quarantine honestly
Be calm and factual in order to help ease your teen’s concerns. Discuss facts as they become available and be sure to correct and misinformation that you may hear. Reiterate the importance of safety protocols such as hand washing and wearing masks in public.
It is also not a bad idea to limit your teen’s consumption of news media if they are consuming hours of content. As an anxiety response they may be searching for an expert or authority that will say the magic words that will calm them. Or they may be trying to control their situation by consuming all of the information so they are extra prepared.
2) Stress staying home saves lives
The longer the quarantine goes on the antsier teens are going to get. Review the importance of social distancing as a way to slow the spread of the virus and protect everyone. Be sure to emphasize there is “no cheating” on the safety rules and that is it not okay to hang out with friends or engage in outdoor sports or gatherings.
3) Be on the lookout for increased depression and suicide risk
Talk with your teen about how they are feeling through all this. Yes, that can be like pulling teeth in the best of times. Watch for signs that your teen is struggling and may need extra support whether that is from you, another family member, or a mental health professional. Most therapists, including Obsidian Counseling, are conducting virtual video sessions.
Increases in depression can be expected in anyone during this time, and this is particularly true for adolescents who are not able to enact their peer-focused developmental mission. If your teen has a history of depression and/or suicide risk be particularly vigilant.
4) Risky times call for risky behaviors
This is always a risk with teens. The same factors that may cause an increase in depression in your teen may also cause an increase in desire for risky behaviors. Talk with your teen about how this is an especially important time to avoid vaping or smoking, for example. Medical experts have warned that these habits can harm lung health and immune function, which means a potentially increased risk for COVID-19 infection.
5) Make dinner a coming together time.
It can be a conversational time “My favorite part of today was…,” “Today I am grateful for…,” or a time to share a quiet moment. Dinner is a classic transitional time for the ending of the day and the beginning of the evening and winding down time. Even if you have a sulky teen sharing company with others, even silently, is beneficial.
6) Be generous with “private time.”
It is completely normal for teens to want more privacy away from their families. Even if they are not up to mischief. Given your teen(s) space for quiet time, music time, YouTube time, friend time, etc.
Teens are particularly keyed in to virtual spaces. Encourage virtual hangouts with their friends whether it is FaceTime, Zoom, gaming platforms, or hobby based websites like Discord, which is a chat service for gamers.
If you have a gamer teen or a social media teen now may not be a bad time to ease any time limits or restrictions as they can connect and interact with their friends through online games or social media such as SnapChat. Assuming, of course, this has not been a point of difficulty in the past.
7) Empower your teen through responsibilities at home.
I imagine if your teen reads that sentence they will come for my head. Allow me to elaborate: routines have changed and everyone is stressed. You may need some extra help in caring for younger siblings or keeping the house clean. While your teen may want to stay in their room all day and night, talk with them about how they can help out the other adults in the house.
Maybe they pick out a few dinners for the week, or even help plan and/or cook it. Or they can teach their siblings a dance, or a fun game, or just chase them around the backyard while you take a long, hot shower.
Being asked to step forward to help the other adults (none of this “pull your weight” or “act your age” nonsense) can be empowering for teens. Instead of “pull your weight” or “act your age” try “I could really use another pair of competent hands” or “I know you’d rather being doing X, but can I grab 20 minutes of your time?”
Everything about this quarantine is difficult. If you have questions, concerns, or think you or a family member would benefit from talking to a mental health professional please do not hesitate to reach out to us here at Obsidian Counseling & Wellness. We are offering video/ “telehealth” sessions to keep everyone safe during this time.
Common But Often UNKNOWN Symptoms of Quarantine Stress and Trauma
Being quarantined in our homes for an unknown length of time has been a unique and particular struggle for everyone. It has required reordering and rethinking our day and taking on additional responsibilities we had never intended. This is the top worry - the safety of all of our loved ones.
As a result many, many people are experiencing symptoms of acute stress and trauma and do not know it. Social media is full of people questioning and bemoaning their lack of progress on projects and even daily chores. This is because, for many, this is the first time they are experiencing a major traumatic situation. As a result they do not recognize their behaviors and thoughts for what they are: mental health symptoms.
Common Symptoms of Stress & Trauma Experienced During Quarantine
Below are some of the most commonly experienced but least recognized symptoms that I have seen people experiencing during this quarantine.
If you recognize any of these in yourself or a loved one, please remember this: there is nothing wrong with you! Your brain is doing its absolute best to take care of you.
1) Memory loss and memory issues
Short term memory can be particularly affected. Memory issues can also include a distorted sense of time wherein time can either crawl or rush past you.
2) Executive Dysfunction
The best description I’ve heard for executive dysfunction is “brain buffering.” You may find yourself thinking of absolutely nothing while at the same time trying to remember what you were just doing. It can also look like saying to yourself, “I need to get up and do that dishes” and then just sitting there and sitting there while thinking, “Just get up and do the dishes!” There’s no identifiable reason why you are not getting up. You just aren’t.
3) Inability to Make Even Small Decisions
This relates to executive dysfunction and is regularly accomplished by distress or frustration when a person tries to force themselves to make the decision.
4) “Forgetting” Activities of Daily Living
Activities of Daily Living (ADLs) are things like eating, showering, putting on clean clothes, using the toilet, etc. What is actually going on is you’re likely not perceiving the cues from your body asking for these things. As a result you are “forgetting” to take care of yourself because you are not picking up on the reminders that you’re hungry, or need the bathroom, or really should shower.
5) Confusion or Brain Fog
This can also be accompanied by slight dizziness or balance issues.
6) Sleep issues
This one is incredibly common. A person may be sleeping too much or too little, or struggle to fall asleep or stay asleep. Unspecific bad dreams and nightmares can also happen during times of trauma or acute stress.
7) Stomach and food-related issues
Like sleeping issues a person may begin eating too much or too little. A person may feel nauseous all the time. A person can also have no interest in food even when they know they are hungry.
8) Dissociation
Dissociation is feeling like there is a glass, a film, or a barrier between you and everything else. Or, between you and your own body. This disconnection happens to stop the trauma memories/thoughts and to lower your fear, anxiety, and shame.
9) Intrusive Thoughts
These are loops of, usually, bad thoughts. If you have found yourself thinking the same negative thoughts over and over again, even when you try to think about other things then you are trapped into what is a negative feedback loop.
Intrusive thoughts can also take the form of negative spiraling thoughts; wherein the first thought might not be too bad but before you know it you have come to the absolute worst case scenario you can possibly imagine.
10) Shortness of breath and heart palpitations
These symptoms are frequently mistaken for a heart attack but are actually common indicators of anxiety or a panic attack. If you have any doubts, however, call 911.
11) Auditory Processing Issues
This is experienced as watching someone speak (or listening to music/watching TV) but being unable to understand what they said even if you hear them clearly.
This may be watching someone speak but being unable to understand what they said even if you hear them perfectly. You may also struggle to separate the conversation you are having from the background noise of a TV or other conversation.
12) Sounds and Sensations are More Irritating than Normal
This encompasses all of your senses. It could be forks scraping or birds chirping, or being touched, or feeling a scratchy fabric, or even the sound of silence. Your brain struggles to fully function until the sound stops. This can also be recognized by an instant reaction of distress, discomfort, or even anger that is out of proportion to the sensation.
If you are now wondering what you can do about these symptoms below are are links from the Department of Veteran Affairs that provide tips on how to help yourself and loved ones during this time:
Managing Stress Associated with the COVID-19 Virus Outbreak
Helpful Thinking During the Coronavirus (COVID-19) Outbreak
Tips for Providing Support to Others During the Coronavirus (COVID-19) Outbreak
Of course, you can also reach out to a mental health professional. Many of us are offering video or “telehealth” online counseling sessions during the quarantine. The thearpists here at Obsidian Counseling & Wellness are ready and eager to help you.
Impermanence
Everything is impermanent and everything has its time. When we are happy, we never want that moment to end. In contrast, when we are suffering, we wish it would end as soon as possible!
Give yourself permission to take a minute and consider/recognize that all moments are temporary. This thought can immediately allow freedom from dis-ease you are feeling and the attachment to it. In both situations (I.e., happy or suffering), we can become attached and start to use labels, judge ourselves, and compare ourselves to others. The attachments make us feel very connected to that sentiment. For instance, you may think, I am never going to be the same person, or have the same independence, as I did before my baby. This may be true but, every moment ends. Some can find solace knowing that if you are suffering now, you know with certainty that it will end. Some time after that, you will be happy, too. This is the ebb and flow of life.
Obsidian Stones
Did you know obsidian stones have been used for centuries for psychic healing?
It's mirror like quality is said to reflect your true self. I believe in your truest form you are calm, content, and at peace. However, things get in the way and we can't feel our truest self; that is when we need the most support.
This can be especially true for those going through transitions. Sometimes, our normal gets turned upside down and we are left trying to pull the pieces together, and find they no longer fit as well as they used to!
Give yourself time to reflect and heal to find your truest self.