Author Archives: Bridget Blasius

What is “Happy”?

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It’s OK not to be happy.

This may seem like a stereotypical thing for a therapist to say.  We seem to always be telling people that all of their feelings are valid and that it’s OK to cry.  There is often an assumption connected with this sentiment, though:  It’s OK to not be happy, for a limited amount of time. It’s OK to cry and “get it out of your system”.  Whether therapists mean to say this or not, clients often hear it that way.  Many people place expectations on themselves that there is some sort of “goal” or “end game”, where they will eventually transcend these painful feelings.

It’s true that therapy can help people feel better.  As clients progress in therapy, they  learn to sit with challenging emotions without being overwhelmed. Eventually, the emotions pass over and through, and something else takes their place.  This is where healing occurs.  Depression and anxiety often arise when we resist or hold onto an emotion. This leaves us “stuck” in that emotion, which just makes us feel worse.

Our definitions of “happy” need to be reexamined.  Recently, I ran across a humorous but poignant comic, which sheds some light on the issue.   I know that The Oatmeal is not a exactly scholarly source of information, but I do believe this comic is worth reading, especially for many people who struggle with  mental illness.

The comic paints a vulnerable portrait of someone who experiences ongoing anger and anxiety, and throws themselves utterly into their work.  They spend 12 hours per day on their comic, and when they stop, they run for miles until every part of their body aches.  This is someone who admits that they do not feel the cheery positivity that most of us think about when we imagine “happy”.  What they do feel is curiosity, ecstasy and a passionate drive to create.

When discussing this comic with friends who have chronic mental health conditions, I heard several people say “yes, that’s me!  I’m so happy someone is writing about this!”  We tend to box happiness into a neurotypical model where we maintain a consistent state of calm and positivity.   This simply isn’t they way emotions work.  Our restrictive definitions of happiness not only disempower people with anxiety, depression or PTSD, they also give all of us an unrealistic set of expectations, and ultimately set us up to fail.

While I don’t advocate that people adopt author’s work habits or exercise routine, there is beauty in this person’s passion, and their vulnerable choice to create something beautiful in a world where anxiety and anger are a day to day reality.  In this world, there is a lot to be anxious and angry about.  There are also a lot of reasons to feel awe, reverence and love.

Sometimes, an intense emotion is an appropriate response to an intense experience, especially in our current global situation.   This does not mean that we will feel that emotion forever, nor does it mean that something terrible will happen because of that emotion.  It may be that we will just have a day or an hour or a minute where we feel…unhappy.  Until we don’t.  And then the sun rises, the tea kettle whistles and the cats rub their heads against our legs, reminding us that our love matters to them.  Then there is joy, and we get to drink that up.  It’s OK to cry over small joys, just as it is Ok to cry over great tragedies.

Be curious.  Busy yourself with what matters most.  Create something.  Let contentment arise naturally and wash over you.  It can’t be forced, but it can be enjoyed when it comes.   It is OK to be happy with our perfectly unhappy states.

The Summertime, Summertime Sadness

Lana Del Rey

Be honest with yourself, do you have it?

You know what I’m talking about.

For some of us, summer is a time of excitement and celebration.  Many people thrive on travel plans, family visits and 9 p.m. sunsets.  They enjoy the heat.  For people without body image issues or gender dysphoria, swimsuit season is no problem.  For the able-bodied, the expectation of increased physical activity means fun, fun times.

For many of us, however, at least some of the above events are causes of stress.  When that stress goes unaddressed, it can lead to depression.  One difficult part of summer can be the perceived expectation of happiness.  If we aren’t “happy”, we might get the sense that other people are wondering what is wrong with us.

It helps some people to know that they are not alone.   There has been a lot written about Seasonal Affective Disorder, and there are lots of effective coping strategies to get through the dark time of the year.  Summer depression is rarer (about 10% of people with SAD get it in the summer), and there isn’t as much information published about it.  It’s real, though, and often doesn’t manifest the same way as winter depression.

Summer has a high-energy quality, and it is sometimes difficult to get grounded.  Anxiety can run high as we find our schedules booked up with vacations.  Vacations are great, but planning them takes a lot of emotional energy.  There can be a lot of pressure on us to make the vacation go well.  If we do not make our summer plans in a mindful, self-loving way, we can end up taking care of everyone while neglecting our own needs.

I have also found that people in relationships sometimes struggle in the summer.  With partners traveling, our relational insecurities may be heightened.  If we are traveling WITH partners, latent tensions in our relationships can become worse.  I see more breakups in the summer than at any other time of year, which is probably the most common reason that people give me setting up their first summertime session.

Another issue that does not get discussed is how expensive summer actually is.   Many people love to travel, but the financial burden of travel is rarely discussed. One of my offices is in Boulder, where people are struggling to pay the increasingly high rent costs.  For them, travel may be out of the question.  Unfortunately, people in this situation often stay home with feelings of inadequacy or throw themselves into debt to keep up with their more affluent friends.

If you are struggling with the “summertime sadness”, self-care becomes all the more important. There is a great article with some tips on how to take care of your mental health:  http://www.webmd.com/depression/summer-depression.

To these tips, I would add the following with regards to sleep:

  • If sleep is difficult, try soft music, nature sounds or progressive relaxation exercises before bed.  Try a few different things until you find out what works best for you.
  • Turn your phone and computer off at least one hour before sleep.  Your brain will interpret screens as daylight, and think that the sun still hasn’t set.  This will keep you up, especially if you read/watch something stimulating.
  • If you do take in media, avoid violent or suspenseful movies. Even if you love them, keep in mind that they put your nervous system on high alert. Your autonomic nervous system does not know the difference between real violence and movie violence.
  •  If news or politics evokes a strong emotional reaction in you, limit your exposure to such things to one hour per day (And not before bed!).

As far as vacations are concerned, here are a few more tips: 

  • Respect your limitations and boundaries around time, energy and money. If an expensive vacation is too much, try a relaxing “staycation”, spending time with friends and family at home.
  • Make a list of things to do in town that are inexpensive, or even free.  Research museums, nearby parks and wildlife preserves.   There are several lists online for summer fun on a budget,  Here is one to get you started:  http://www.colorado-for-free.com/.
  • Getting some exercise and time outside will be helpful, but only push your body as far is it can go!   Don’t compare yourself to your athletic friends, especially if you struggle with a chronic illness.   Your body knows what it needs to stay as healthy as it can, and you know your body more than anyone else.

And with regards to relationships:

  • Discuss your needs and boundaries with loved ones BEFORE situations become emotionally tense.
  • If you have difficulty getting words out, try journaling about these things before talking about them in person.  Sometimes, just writing these things out for yourself is a huge step in the right direction.
  • If you have a therapist, bring your journal to the session and talk about what you wrote.   Your therapist can help you work on assertiveness skills.

Above all, remember that the feelings which arise for you during summer are valid.  Beating yourself up will only make things worse.  Surround yourself with support and work as many calming activities into your schedule as possible.

 

Fall Workshops coming up

Fall_aspen_leaf_multiple_colors

Are we approaching Fall already?  It’s hard to believe that so much of the year has gone by. Autumn has always been my favorite time of year.  As the busy summer winds down, people seem to settle into themselves.  There is a quietude that comes with the darker evenings, and an invitation for personal reflection.

I’m happy to be offering two trauma-informed workshops this fall, for self-care and personal growth:

Honoring Your Boundaries, Honoring Yourself:  

When we think of setting boundaries, we often have a limited understanding of what that actually means.   Having healthy boundaries does not just mean “being assertive” or saying “no” when necessary (though obviously, these things are important).  Boundaries are a felt sense of our personhood, an understanding of where we end and where others begin.  They are not just a wall that keeps things out, they are a protective shield that holds what we cherish.  We could all stand to learn more about how we can hold and cherish ourselves.

Participants have said that our boundary workshops are be fun, educational, nurturing, vulnerable and sometimes a bit silly.   Come alone or bring a partner if you wish to explore this subject with someone you love.

This workshop will be co-facilitated with the amazing Masako Suzuki, who has facilitated numerous support groups and workshops with me over the past two years.  We are excited to be offering this workshop to the community again.

Date:  Saturday, November 5th

Time:  10:00 a.m. – 3:00 p.m.

Location:  Wash Park Counseling, 1711 S Pearl St
Denver, Colorado 80210

Fee:  $60.00

Space is limited.  Register now:  www.blasiuscounseling.com/workshops.

Creating Healing Ritual (At the WINGS Conference) 

Do you do rituals for yourself?   You probably do.   Many of us are familiar with ritual as part of an organized religion, but that is only one vehicle through which the power of ritual can be experienced.  We do ritual through small, comforting acts that awaken the senses and connect us to what is truly important.

When we perform these acts intentionally, and place them in the context of symbolism that is meaningful for us, ritual can be a meaningful resource and spiritual practice that can guide us in our recovery from trauma and grief.  We can use it to consciously mark major life transitions as we embrace the birth of a new Self.  This workshop will be part discussion and part experiential work, with a collaborative, peer-led ritual focused on supporting each other and healing our community.

This workshop will be one of many 90 minute presentations offered for survivors of sexual abuse and the service providers who support them.  Please stay tuned for updates as we continue to organize the event.

Date:  October 8th.

Time:  2:45-4:15 p.m.

Location:  7150 E Montview Blvd, Denver, CO 80220

Fee:  Check the WINGS website for details on how to register.  If you are a WINGS group member, scholarships may be available.

 

Trauma Work: What it really looks like

Aloe_polyphylla_spiralTrauma work isn’t glamorous.  When therapists start to learn new techniques, we often get very excited about them.  We see our favorite teachers do impressive demos in front of the class, and can’t wait to do the work ourselves.  What we forget is that our day-to-day work rarely resembles the demos.  Demos are done with students who are excited for the opportunity to experience the work of a faculty member who has already impressed them (after all, they’ve invested a lot of money in paying for the class).  For real clients, trust and rapport are not a given.  They must be earned.  They can be easily lost.  If they are lost, they take time to repair, and sometimes the most healing thing we can offer to clients is humility.

In my personal work, I’ve seen several some highly skilled instructors as therapists, after being impressed by their demos.  I found out that even they don’t work with clients the way they work with demo students.  The vehicle for healing isn’t the technique.  It’s the relationship.  If we try to force our techniques before trust is established, we can do more harm than good.

Targeting the trauma material is only a small part of trauma work.  A big part of the work, in my experience, is helping someone get in touch with their sense of agency.  Sometimes this starts by simply listening, and allowing oneself to become fascinated with a client’s world.  People often find themselves identifying with their trauma, and through that restrictive identification, they disconnect from the full experience of who they are.  They forget the subtle nuances of how they engage with the world…their attractions, their aversions, the subtle pleasures that they dismiss because they know they are fleeting.  Yet, it is these momentary flashes of non-sexual, non-addictive pleasures that wake people up.  They create flashes of brilliance, in which the nervous system says “Oh look!  I’m capable of being aware of the world and experiencing something other than suffering!  Maybe there are moments of safety, and I don’t have to be afraid all the time.”

This is a slow process.  When I talk about people being “afraid all the time”, I’m not exaggerating.  This is how some clients actually experience their world.  A huge part of trauma work is meeting them there, while holding the awareness that they don’t have to be afraid forever.  Everyone has internal resources.  Sometimes, though, forcing someone to be aware of something positive in their experience can seem dismissive, if phrased the wrong way.  There IS something positive in their experience, but focusing on what seems non-threatening means letting their guard down.   If they are recovering from a situation where their guard had to constantly be up, why should they trust a feeling of safety?

This is why we must let ourselves be genuinely interested in our clients’ worlds.  It opens us up to sharing in their joy. It reinforces the idea that their joy, comfort and safety matter to us, not in some abstract and theoretical sense, but on a personal level.  This is personal work.  We cannot create a healing relationship if it isn’t a real, human relationship.

The capacity to experience something pleasurable is like a muscle that can atrophy.  When we are recovering from a physical injury, we may need months of physical therapy before our muscles work the way we want them to.  The same is true of psychotherapy. New neural pathways do not get built over night, but we must hold implicit faith in our clients’ ability to heal themselves.  Eventually, they will start to have the same faith in themselves.  When people learn to attune to pleasurable moments, they start to create more of them in their lives.  They start to set boundaries with others, because they attune to their own signals that people are starting to make them uncomfortable.  Relationships improve, and support systems widen.  Eventually, slowly but surely, the therapist becomes a lot less important…which means that therapy is working.

This is the bulk of the work.  Trauma therapy is often a long rambling paragraph of conversations, punctuated by the sessions where the trauma material is targeted directly.  Nobody wants to read a story where every sentence ends with an exclamation point.  The statements lose their meaning, and people become frustrated with the story.

The story is simply about two people, coming together and believing that life is worth living.  We are here to help clients live the life they want to live, no more and no less.  Once we let go of the idea that therapy is “trauma work”, we start to become better as trauma-informed therapists.

 

The Wisdom of Dissociation

I’m a somatic psychotherapist, so the following post may seem surprising.  I don’t believe that people should be “in their body” all the time.

This is not to say that bodily awareness is not important for healing.  Indeed, it is one of the most powerful vehicles for healing that I have ever witnessed.  At the same time, I do not believe it is possible, or even healthy, to constantly force ourselves into the body.

Therapists in the last 20 years have become much more educated about dissociation, a natural process that allows us to disconnect from sensation and awareness of the surrounding world. It can take many forms.  Someone experiencing dissociation may feel that they are in a fog.  They might feel that they are watching life like a movie, rather than actively participating.  In some cases, they can feel a loss of identity, as though they are not a real person.  “Multiple personalities” may develop, and a person may switch between personality states to deal with triggering situations.

Dissociation helps us survive an actual or perceived threat to life. It takes us out of the direct experience, and offers a release from pain.  I’ll offer an example below.  It’s a popular nature video often shown during beginning-level SE trainings.  If any SEPs are reading this, they will probably recognize it as something they have seen many times:

For a wild prey animal, dissociation is nothing short of a blessing.  If the predator perceives an animal as dead, they may leave it alone, allowing the animal to escape.  Even if the animal does not escape, at least their death is painless.  For humans, dissociation has the same effect.

People who have experienced trauma often pathologize the freeze response.  “I should have done something, but I just froze”.  They discount the wisdom of their nervous system, which allowed them to survive the experience and may have also protected them from disruptive trauma memories that would have seemed overwhelming later on.

I also want to name that dissociation isn’t just a trauma thing.  People without PTSD use dissociation all the time.  Have you ever been lost in a book, so absorbed in the story that you disconnect from the external world?  Have you ever been in a deep state of meditative trance which allowed you to connect with spiritual allies?  Throughout history, daydreams and fantasies have inspired us.  For trauma survivors, a character from myth, religion or even science fiction may become a healing archetype that serves as a resource for recovery.  In many ways, one might say that dissociative states are sacred, in that they help us access the healing wisdom of our own psyche.

Now, I am not saying that we should walk around in fantasy land all the time.  If somebody loses their ability to come out of dissociation, then this needs to be addressed.  What I am essentially saying is this:  The goal of therapy is not to eradicate or pathologize specific states of consciousness.  The goal is to support resiliency, so that somebody can have access to the state that is appropriate in the moment.

If you notice yourself dissociating today, be curious about it.  Rather than berating yourself for the dissociation, ask yourself this:  Was it adaptive for the given situation?  If not, you may want to explore ways to bring yourself back to the present moment.  Here are some things to try:

  • Look around the room and name five yellow things (or green, or purple.  Pick a favorite color).  This will instantly focus your attention on the external environment and help you become present.
  • Take a walk.  Be mindful of your feet on the ground.  Notice where your attention is drawn in the natural world.  If you feel drawn to a specific object, like a rock or a pine cone, pick it up and notice the texture in your hands.
  • Carry favorite sensory objects in your pocket or purse.  These might be smooth rocks, stress balls or soft fabric.  Some eclectic shoppes carry rocks printed with positive messages.  If you find one you like, consider getting it for yourself.
  • Eat small amounts of a favorite food or beverage.  One cup of tea or a square of dark chocolate can awaken the senses instantly.  Notice how your body reacts to that small act of self-care.  You may notice some feeling of relaxation or relief.
  • Make sure you are comfortable.  You are less likely to be in your body if your clothes don’t fit, or you are experiencing dehydration.  Try having a glass of water or putting on sweat pants.  You will be surprised how quickly you feel better.

Now, if you decide that your dissociation is adaptive, then don’t be afraid to let yourself enjoy it.  Notice how you feel as you emerge from that restful state, and thank yourself.

Life Finds a Way

It’s gardening time again.

There are still remnants of last week’s blizzard.   I remember how quiet everything was.  I’ll admit, I did very few sessions.  Existing clients cancelled to stay safely indoors, and nobody new booked an appointment.   I don’t know if it’s the same for other therapists, but I have  noticed that I get few (if any) calls during a storm.  I wonder if people go into hibernation mode, and then emerge as the weather warms, reaching out for support when their system feels ready to receive it.

It’s a natural cycle, like the freeze and thaw of the snow.  Everything happens in its own time.  At no point are we separate from it.

Right now, I’m noticing how green the yard is.  The grass is always the greenest at this time of year.  The spring snow always revitalizes and renews what has been dormant.  As predicted, the phone is ringing again.

We need not fear our internal cycles that mirror the cycles of nature.  At times, we must honor our impulse to cocoon ourselves in our own comfortable world.  We must also honor the times in our lives when we feel more open.  This means trusting our intuition when we know, on some deep level, that openness is safe…that the sun is warming, and that the snow will soon be gone.

We know when it is time to get a new job, and when it’s time to stay with our old one.  We know when it’s time to seek out a new partner, and when it’s time to focus more on ourselves.  All of our wisdom is within, and observation of the natural world can teach us so much about ourselves. We can also look to myths and archetypes to understand the perennial truth of human resiliency.   Some of us celebrate Easter, and some of us do not.  Regardless of our spiritual orientation, there is something deeply awe-inspiring about these stories of resurrection, which we have told ourselves over and over again throughout the ages.

I hope you are taking time, today, to be kind to yourself, knowing that you have weathered many storms.  You are fully deserving of the new life you create for yourself.

If you have time, this week, you may wish to take a walk and observe how nature is transforming.  In my garden today, I noticed many living worms underneath the dead leaves, preparing the soil for new growth.  I interfered with them as little as possible.  In the same way, we need not interfere with our own natural inclinations.  Healing happens on its own time. Sometimes, we need only slow down and observe our natural patterns to understand that there is actually nothing wrong with any of us.

Whether you’ve called a therapist or not, you are already healing. Your impulse to reach out is a natural process of growth, like a plant slowly rising above the snow.

Hold yourself in gentle awareness, and know that you are doing fine.

 

 

The Body Vocabulary

“How do you feel in your body?”

How many times have you heard that question, from a Somatic therapist?  It can be a useful question, but not always an easy one to answer, especially if you are not used to attending to bodily sensations.

Most of us aren’t.  Body awareness is not something we are trained to tune into, in our modern society.   If we live our days working in a cubicle and staring at a screen, rarely moving our bodies, then awareness of how we might feel in our bodies doesn’t serve much practical use for our job.  It can atrophy, like a muscle that is not used, leaving us feeling disconnected from the world around us an unable to fully engage with ourselves.

Add potential traumas into the mix, and body awareness can become even more difficult.  Disconnection from the body can be a helpful coping mechanism, so that we do not feel what we are experiencing during a traumatic event.  When sensory experience has been shut in order to survive, turning it back on can be extremely difficult.  It doesn’t happen over night.

Body awareness, however, is with us all the time.  Our body tells us when we are hungry, when we are tired, and when we want to get up and move.  It tells us when we are enjoying an experience.  We may know that we love walking in the woods, but how do we know that?  So many things may be happening at once, as we take our first hike of the spring season.  Our chest may expand, as we take a deep breath of mountain air.  We might feel our shoulders drop as tension releases.  Or, our pulse may quicken with excitement as we think about the adventure ahead.  All of these sensations are how we experience love for the mountains, and most of us only experience them on a pre-conscious level.

ribcageWhen we attune to sensations consciously, we learn to deepen pleasure.  We also learn to attune to signals that tell us when something is unsafe, or undesirable.  Let’s just say that we found a new hiking trail, but suddenly felt a cold, prickly sensation on the back of our neck.  We may have an impulse to avoid that hiking trail.   Why?  Is the trail unstable?  Are there mountain lions nearby?  Our ability to sense these things is instinctive, and uncanny.  The more we learn to trust our bodies, the more we empower ourselves to do what we need to do, in order to feel safe.

There are many of reasons why I’m a Somatic therapist.  Helping people learn to trust their instincts is one of the biggest ones.  It’s the key to setting better boundaries, having healthier relationships and doing better self-care, overall.

Therapy isn’t all about “How do you feel in the body?”  However, a list of sensory words can help people who are new to Somatic therapy…or who have found it difficult in the past.  So, for your reference, here is a list of words that some people have used to describe their experience:

Achy Frozen Raw
Airy Full Rolling
Alive Fuzzy Shaky
Bloated Goose Bumpy Sharp
Blocked Gurgling Shimmering
Breathless Hard Shivery
Brittle Heavy Shudder
Bubbly Hot Silky
Burning Icy Smooth
Buzzing Intense Soft
Chilled Itchy Spacious
Clammy Jagged Spacious Breathing
Closed Jittery Spasming
Cold Jumbly Sticky
Congested Jumpy Still
Constricted Knotted Stretchy
Constricted Breathing Light Stringy
Contracted Limp Strong
Cool Loose Suffocating
Cozy Nauseous Sweaty
Cramped Numb Tender
Dense Open Tense
Dizzy Paralyzed Thick
Dull Pounding Throbbing
Elastic Pressure Tickly
Electric Prickly Tight
Empty Puffy Tightness of skin
Energized Pulled Tingling
Expanding Pulsing Trembling
Faint Quaking Twitchy
Fluid Quiet Vibration
Flushed Quivering Warm
Fluttery Radiating Weak
Frantic Ragged Wobbly

You can bring these words to therapy.  You may find that you wish to delete the ones that don’t work for you, and add some new words of your own.  As you continue to explore the world of body sensations, you may end up creating a list that is uniquely yours.

The “Spoon Theory” of Mental Health

spoonsBy now, most people with chronic illness have heard of “spoon theory“.  The idea of having enough “spoons” has worked its way into the vocabulary of loved ones and even people who do not suffer from chronic illness, but who understand that we all have a limited amount of “spoons”.

The original article was written Christine Miserandino, several years ago.  The idea is that spoons represent our daily allotment of energy.  We wake up with a handful of spoons each morning, and each activity represents and expenditure of spoons.  Once we run out of spoons, we are done for the day. Some of us are fortunate to have an abundance of spoons.  Others may only have a few, and must budget their spoons carefully.

The spoon theory has become more broad, over the years, becoming part of the discussion around mental health as well.  Despite this, it hasn’t really made it into clinical circles, and I think it’s valid to discuss it from a clinical perspective.  This may be especially useful for loved ones, who are supporting someone’s recovery.

When people are recovering from depression, anxiety or trauma, there can be a lot of effort applied to re-gaining a sense of control.  In the initial phases of therapy, there can be a lot of psychoeducation involved.  What I usually do is brainstorm with the client to come up with a list of coping skills.  I usually start by asking when the client felt most relaxed or most like themselves throughout the course of the week.

Some people say they feel most relaxed when they took a walk, spend time with a pet or read a fantasy novel.  This usually leads to people coming up with a list of relaxing activities that they can do in times of stress.  I prefer to work with things that the client is already doing for themselves, so their coping skill “toolbox” is uniquely theirs. Sometimes, however, people just need suggestions to get started…so I offer a few they can try, to see what works best for them.

As a general rule, people tend to start feeling better after a few weeks of consciously taking care of themselves.  That said, it is important to remember that applying coping skills takes effort, at least at first.   It takes courage and determination to tell ourselves, over and over, that we deserve self care.  As cliche as it is, we often have to fake it ’till we make it.  When we are not used to valuing ourselves, coping skills are not our habitual inclination.  Changing deeply-ingrained habits takes energy, until they become habitual.

In time, the “list” of coping skills stops being a list and starts to be a habit that we do not have to consciously think about…but it takes time, and sometimes we just have to forgive ourselves for setbacks.

I’ll offer an example.  Please understand that it is just an example, not meant to apply to everyone:  Someone who experiences panic attacks may need to learn to ground, grab some soothing tea or take a momentary break from a social situation.  For someone who has never had a panic attack, they may not understand that their friend needs these things.  Applying those coping skills may involve an expenditure of a spoon (though less expenditure than continuing to have a panic attack).  This means that the friend may need more “down time” to rest and recuperate.

This is not something to take personally.  It just means that your friend has a lower allotment of spoons.  One can use money as an analogy.  A friend whose job does not pay as well as yours may not be able to afford an expensive vacation.  It is important to understand that if they decline an invitation to travel, this is not personal.  It may be supportive to help your friend get a better paying job (assuming they dislike the job they have), but pressuring them to take the vacation without understanding their situation would not be helpful.  Only they know how much money is in their bank account.

If we go back to the hypothetical friend with the panic attacks, only they know how many spoons are in the spoon account.  The best thing you can do is encourage them to be mindful of that, and take care of themselves when the spoons are running low.

Spending time with a caring, non-judgmental person may be a source of spoon-regeneration for your friend.  You may wish to see how many spoon-boosting activities you can work into your time together.  You might find yourself with an increased level of spoons, just from allowing yourself to slow down and practice and act of kindness.

Why “Tolerance” isn’t enough

We’ve got to do better, folks.

Seriously.

in the 21st century, we’re still hearing the following phrase from some of our clients:  “I’ve been looking for an LGBTQIA friendly therapist, and I’ve had a really hard time finding one.”

There are many layers to what this phrase means.   It does not mean a lack of “specialists”. First off, I don’t even like the term “specialist”.  It implies that we are experts.  While we should always strive for professional excellence, the minute we see ourselves as “experts”, we risk losing our humility.  We risk losing our curiosity, and our openness to take in new information.  This prevents us from actually seeing the client in front of us, with all their struggles and their strengths.

It’s easy to check the “LGBT” box on your psychotherapist profile.  Many therapists check it because they are open to working with people who identify as be being a part of that population.  They have no moral objection, so they consider themselves competent.

There is nothing special about a lack of moral objection.  While openness and non-judgement may make someone a decent human being, it doesn’t make someone a competent therapist for this population.

What does?  Well, there’s the ongoing commitment to professional education.  I’m actually not talking about education about the “how tos” of doing therapy with LGBTQIA folks.  There’s no established methodology for “queer therapy”.  Methodologies, after all, are designed to heal symptoms.  Queer is not a symptom.  It is simply part of who the client is…and there is nothing about that person that needs to be fixed.  So, when I am talking about “professional education”, I am talking about awareness of the types of healthcare that are available, and the types of resources that the community has to offer.  I am also talking about awareness of the current political situation, and how it affects our clients.

Understand that oppression is real.

This is where Cognitive Behavioral Therapy is limited.  I am not saying that it isn’t useful.  It absolutely is, and it is important to have an awareness of how and when to apply it.  I’ll tell you when NOT to apply it:  If a client from an oppressed population is coming to you with a fear that they will be rejected, harassed or subject to violence, it is NOT a cognitive distortion.

There is an old Gestalt saying that I have found very useful:  catastrophic expectations are memories.  I have found this to be true on more occasions than I can count.  Your client may be remembering something that actually has happened to them, or somebody they love.  And yes, there is a legitimate danger that it will  happen again.

Assuming that fear is a cognitive distortion helps the therapist feel safe, but it does not serve the client.   Now, therapists do not protect themselves because they are bad people, or even bad therapists.  None of us want to think that a client, who we legitimately care about, could have something horrible happen to them.  Who among us is ready for that?   Nobody, I hope.  We cannot afford to be complacent.  If the possibility of something terrible happening to our clients does not break our hearts, or make us angry, then we probably should not be working with them.

This, for me, is part of being trauma-informed:  facing the existential reality that trauma happens.  Nothing we say can erase it.  While we can help people heal themselves, we cannot form a healing relationship without acknowledging how bad it actually was.

When we can meet our clients where they are at, and acknowledge the enormity of what they face, we are able to actually see them.  When we do that, we can truly appreciate their strengths.  This turns strength-based therapy from empty platitudes into a true alliance, and that is that most important vehicle for healing.

Most clients who report being unable to find LGBTQIA-friendly therapist are not saying they can’t find someone who checked “the box”.  Often, they have seen several people who checked the box.  All of them have acted dismissive in some way, or worse, terrified.  I fully acknowledge that these therapists do not do this on purpose, but that does not make it any less harmful.  Therapists can, and must, do better.

Therapists talk a lot about being trauma-informed.  I don’t see “trauma-informed” as a methodology.  I see it as an awareness.  It’s about understanding how trauma affects someone’s life, and their ability to engage with the world around them.  This has to include an understanding of societal oppression, which can be the cause of trauma. At the very least, it can exacerbate trauma or be disruptive to healing.  So, educate yourself, be kind, and don’t be afraid to admit when you don’t know everything.