Walking Through the Invisible Fire

What’s going on is pretty darn bad

As you have surely noticed, a lot of things really don’t feel okay right now. And a lot of us do not feel okay about that.

I’ve been hearing from people in health care doing their utmost to save those who may not survive and those who will not survive. I’ve been hearing from people trying to secure adequate storage space for human remains. I’ve been hearing from other therapists. From people who have gotten ill and been hospitalized. From those who are losing loved ones, losing jobs, losing savings, losing health insurance, and from those feeling trapped and scared and angry.

We are all facing an enemy that uses our greatest human strength in its attack against us: our connections with others. An invisible fire is burning through humanity, and we don’t know who is aflame, who will burn, and who will pass through unharmed. The uncertainty is nerve-wracking.

You may hear people saying “Humanity got through previous pandemics, it’s not the end of the world!” Well, yes…humanity survived, but we didn’t all get through those crises. Many died. And for those who died, it was the end of the world. (At least, this world.) And the world was permanently altered for survivors and their descendants. So this event is a true threat. It makes sense to feel distress.

What our experiences are and how we are dealing with them – it’s okay

Whatever we may have already been struggling with has been exacerbated: loneliness, depression, illness and disability, social issues, financial issues, employment, relationships. Meanwhile, many of the life trajectories we were working on in the hope that they would provide us with security, stability, and balance, have been upended. Exposed as transient, fragile, or even inconsequential: careers, money, possessions, self-image, institutions, political and social dynamics. These are great losses that may leave us feeling anchorless, or make the world feel frighteningly unreal.

For many there is also a cognitive dissonance between feeling the background hum of constant threat, while other parts of life continue apace as though nothing is happening and things are normal. “When your world falls apart, some things stay in place” (Billy Bragg). This dissonance can be crazy-making too!

With all that is happening, many people are experiencing an increase in symptoms. Some new, and some familiar. Many are symptoms of depression, anxiety, or past trauma. But please know that you are not alone in this. The most common symptoms I’ve been hearing about in the past few weeks are:

Sleep issues: insomnia, exhaustion, hypersomnia.
It’s hard to sleep when you’re feeling threatened. It’s not surprising many are having trouble falling asleep or staying asleep. If you are sleeping more than usual, it is partly because you have so much more to process, and that is exhausting!

Dreams: increased vivid dreaming (or increased memory of dreaming), not necessarily nightmares, either. We have a lot to process lately and it’s spilling into our nighttime hours.

Impaired executive function: forgetfulness, loss of concentration, unusual time perception (speeding up or slowing down).

Dissociation: losing track, losing time, spacing out, not being present, feeling numb, feeling unreal or that the world is unreal.

Hypervigilance: being easily startled, easily woken, heightened anxiety about possible contagion and contamination.

Grief and anger: we have incurred countless losses, individually and as a society. It is not wrong to grieve losses or to feel anger about them. It’s understandable.

Guilt: This has been a big one for a lot of people! Specifically, guilt about productivity, guilt about parenting, survivor guilt, and free-floating guilt. Please understand that unnecessary guilt is a symptom of both depression and anxiety, but it’s a feeling that makes it especially easy to buy into the content, so we tend to think it’s real.

Regarding the productivity guilt: your value as a human being is not your productivity. The most important thing you are producing is someone who survived the pandemic! If you come out of this alive, and with your children alive, you did it!

This is the earliest reference I can find, but we all know this statement by now. You’re not “working from home,” you’re at home, working under a global crisis.

Furthermore, you are not obligated to somehow optimize yourself. You never have been! But this is a good time to finally understand that at a deep level. It’s an especially ludicrous expectation right now.

Many people are struggling with unhealthy coping mechanisms right now: drinking and substance use, eating behaviors, self-harm. But the first thing is to cope. To get through this day, and this night, and the next. So if you are using unhealthy coping mechanisms, instead of beating yourself up about it, allow yourself first to cope. And then start working on adding in some of your healthier coping mechanisms. All behaviors, even dysfunctional ones, are adaptive in some context. Sometimes an unhealthy coping mechanism is healthier than not coping at all.

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Future directions & hope

Listen, we don’t get to choose what arc of history we occupy, only what role we play in that arc. You are living through a historical event that you did not choose.

A lot of things are not okay right now, many of us aren’t okay with that, and it’s okay to feel that way. It’s reasonable to feel distress. We are all walking through this invisible fire, but what matters most is how well you walk through the fire (Charles Bukowski). You can still choose what role you will play.

Humans have an immense capacity to take something good and positive out of surviving even the most horrific events. Things we always heard could not be done are now being done: work flexibility, distance learning, accessibility, financial and personal support. Meanwhile, things we always heard were implacably crucial, are turning out to be not so important. Deadlines! Attendance! Fees! Work pants!

Many more people who are in a tough spot now suddenly understand that we all need support and we are all mortal. We are all vulnerable. This kind of insight can be a turning point for great change. This is a liminal space in which we can effect that change.

It’s easier to see the real rock-bottom truth from here. Human connection is still our most important strength, even without physical proximity. We take care of each other: family, friends, neighbors, community, churches, local government and organizations. Our strength comes from sharing via those systems. Power comes from the people. You are the people! So let this radicalize you, rather than leading you into despair (Mariame Kaba).

Let this radicalize how you treat others: What can you do to help reshape an inequitable system? Is there some way you can help support those who are already marginalized, on whom the bulk of the crisis falls? The illness and death, the job loss, the financial hardship, the limited access to resources. If there is to be a new normal, what social improvements do you want to help solidify?

Let this radicalize how you treat yourself: Learn that your value does not lie in your ability to produce. Learn to treat yourself as well as you would treat an honored guest, a close friend, or even a beloved pet. If there is to be a new normal, what habits do you want to bring back from this experience? What deserves to be left behind in the ashes?

Walk this invisible fire with compassion, flexibility, and acceptance. Acceptance for others, but also for yourself.  ❤

Intersectional Life Counseling and Psychology offers remote video sessions for PA residents, as well as sliding-scale rates from $70. Please EMAIL if you would like to schedule or have any questions!

Psychosocial Resources for Surviving a Quarantine

Staying home as much as possible helps keep ourselves and our community safer as the coronavirus pandemic grows, but it can be a challenge to mental health. Even those who are not usually prone to depression or anxiety may be experiencing the effects. And for those who already had mental illness of any kind, this may be a trying time indeed.

While living and connecting primarily through the internet may not be ideal under normal circumstances, for this kind of crisis it is an enormous aid. To help you find essential supports for maintaining your stability, we have compiled a number of great internet-based resources below.

Remember to start with the basics: sleep, nutrition, exercise, and social support, to give yourself the best foundation for managing your moods and emotions. And consider remote therapy if you need support.

Resources for mental health / recovery:

Help with medical issues

What to do if your child is sick:

Lancaster information:

Lancaster Local News

Help with sleep:

Help with food / eating

Exercise support:

Activities for adults:

Activities for families:
(Children)

(Teens)

Free Software (short-term):

Ways to help others

 

Remember, Intersectional Life Counseling and Psychology offers remote video sessions (in-office sessions suspended temporarily) for Pennsylvania residents, as well as sliding-scale rates from $70.

Please email us if you would like to schedule or have any questions!

(*Please note: clients MUST be in PA during sessions due to licensure and legal issues.)

 

 

Flattening The Curve – Sessions Go Online This Week!

Dear clients, friends, and community members,

In light of recent recommendations from the medical community and state government to reduce social contact and public exposure in order to help reduce overall spread of the novel coronavirus, therapy sessions will be moving online as of the upcoming week (Monday 3/16/20). Let’s work together to #flattenthecurve and keep our community healthy!

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thera-link-mug

 

 

 

 

 

Thera-Link is a secure, HIPAA-compliant, appropriately encrypted platform that a number of clients have already been using since early 2019. Clients have joined therapy sessions using their computers and/or phones, and have so far usually reported it to be very easy to use.

Current clients will be contacted individually with the necessary information to join their therapy sessions this week. New clients* are also still welcome to schedule sessions!

Intersectional Life Counseling and Psychology offers remote video sessions (in-office sessions suspended temporarily) for PA residents, as well as sliding-scale rates from $70.

Please email us if you would like to schedule or have any questions!

(*Please note: clients MUST be in PA during sessions due to licensure and legal issues.)

StayHomeGame

Stay Home Simulator by Brendon Chung @BlendoGames

Flattening The Curve – Sessions Go Online This Week!

Dear clients, friends, and community members,

In light of recent recommendations from the medical community and state government to reduce social contact and public exposure in order to help reduce overall spread of the novel coronavirus, therapy sessions will be moving online as of the upcoming week (Monday 3/16/20). Let’s work together to #flattenthecurve and keep our community healthy!

waitingroom2

thera-link-mug

 

 

 

 

 

Thera-Link is a secure, HIPAA-compliant, appropriately encrypted platform that a number of clients have already been using since early 2019. Clients have joined therapy sessions using their computers and/or phones, and have so far usually reported it to be very easy to use.

Current clients will be contacted individually with the necessary information to join their therapy sessions this week. New clients* are also still welcome to schedule sessions!

Intersectional Life Counseling and Psychology offers remote video sessions (in-office sessions suspended temporarily) for PA residents, as well as sliding-scale rates from $70.

Please email us if you would like to schedule or have any questions!

(*Please note: clients MUST be in PA during sessions due to licensure and legal issues.)

StayHomeGame

Stay Home Simulator by Brendon Chung @BlendoGames

Keeping Your Balance in the Apocalypse

If you have been feeling worried about illness recently, you are definitely not alone. Even people who don’t normally experience health anxieties are affected by news regarding the novel coronavirus, COVID-19. Ships quarantined, cities locked down, schools closing, hospitals overwhelmed. Much of what we hear is the absolute worst of the news, and for now at least the rest is largely unknown.

An endless wave of bad news can certainly increase depression, while facing an unknown can increase anxiety,  so the situation is a recipe for increased stress on everyone’s mental health. In addition, we are carrying the weight of experiencing others’ stress and worries as well. It’s not only a nationwide mental health stressor, but a worldwide one.

It’s common for PTSD symptoms and anxiety symptoms generally to spike during times of crisis, especially for those who are in vulnerable marginalized groups. This is true whether or not you have a trauma history that is specifically related to the crisis itself. So you may be experiencing more symptoms such as insomnia, panic attacks, melancholy or dread, fibromyalgia, hives, flashbacks, migraines, dissociation, suicidality, agorophobia, or obsessions and compulsions, to name a few of the common ones.

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What to do first:

As in any times of crisis, there are four basic elements of self-stabilizing, beginning with the body.

First of all, you need sleep! If you are experiencing insomnia, address this first. Sleeplessness makes everything else hard to manage, both physically and mentally. You may use self-help methods or you may seek professional support from a therapist if your insomnia is entrenched.

Another aspect of stabilization is to make sure you are eating: get enough healthy fuel. If stress has activated disordered eating such as restricting or bingeing, don’t ignore it. Address it directly.

Exercise: If you already have a reasonable exercise program, do your best to maintain it. If you have begun to isolate, try just taking a 10-minute walk daily. Even mild exercise will help both your body and mind feel better and more able to handle whatever stresses are arising. Also, being outdoors and seeing other people can remind you that human life is continuing and you are still part of a mutually supportive, helpful society.

Which leads to another important aspect, that of social support. It’s important to connect with supportive others, in whatever format you can. Even if you must work from home, you can text or email or talk on the phone with someone. Make sure to do this daily!

Maintain Your Routine and Stay Connected

In the broader sense, counteract a sense of helpless disaster by focusing your perception on the many thousands of highly capable and caring people in every possible area of life–health care workers, emergency workers, researchers, spiritual leaders, parents, neighbors, friends–who are planning and preparing to support, save, and take care of all of us as best they can. Maybe you are one of those people!

Remember that your fellow humans feel a sense of care and responsibility towards you, just as you feel towards them. We protect and help one another to get through. And as Mr. Rogers famously described, “looking for the helpers” is a good way to reassure yourself in a crisis. Becoming one of the helpers yourself–even in a small, neighborly way–can help you to feel less powerless.

When you have stabilized your primary needs as best you can

The next step is to do your emotional self-care. First of all, accept your emotions. It is reasonable to feel scared or angry or any other emotion in a crisis. So have acceptance for whatever those feelings may be, and find ways to comfort yourself.

The trick, however, is to not buy into the cognitions that anxiety or depression may generate. Recognize that if your thoughts are becoming dreadful, it’s likely you are experiencing catastrophization or similar cognitive distortions. One way to reframe this for yourself is to recognize what you have control over (sensible interventions and planning) and what you do not have control over (worldwide events).

If it is something that you do have control over (sensible hygiene, having medications and basic supplies available, planning alternate child care / work locations, rescheduling travel), then implement those things. But worrying will not help you with the implementation.

If it is something you do not have control over, then again–worrying will not help. You may feel afraid and it is worth talking through the fear with someone. But you may need to let go of a sense that you must control the situation in order to survive it. Much of this is out of your control and anyone else’s! Seek solidly data-driven, practical sources of information rather than sensationalized or over-minimized sources. This will help you know what to actually prepare for.

The worry protocol includes not only contagion, but another common anxiety: financial fears. For some, this is regarding recent stock market drops, and for others, simply the ability to pay rent each month when society is disrupted or they could become ill. Again, the worry protocol holds: sensibly plan and implement the parts that you can. The parts that are out of your control may happen or they may not. If they do happen, you and others will do your best to recover and repair as soon as you are able. You may or you may not incur losses, but you will deal with those if they occur.

So…in order to keep yourself emotionally stable:

Take good care of yourself, accept your emotions, manage your cognitions, make practical plans that are based on reality, relinquish control of the uncontrollable, maintain your routines as best you can, and find some way to become a helper. If you are struggling with these issues, consider seeing a therapist to help you sort through them!

Intersectional Life Counseling and Psychology offers remote video sessions for PA residents, as well as sliding-scale rates from $70. Please EMAIL if you would like to schedule or have any questions!

 

Your Loved One Has Dissociative Identity Disorder?

If you have a loved one who has Dissociative Identity Disorder (AKA “multiple personalities”), you may have felt uneasy or even frightened at times. It can be disconcerting to think you do not really know who they are. It may be awful to think of the traumatic experiences they survived that led to the dissociation.

This is partly because for many people, the only understanding they have of Dissociative Identity Disorder comes from sensationalized depictions in movies or TV, showing DID experiencers as unpredictable, deceptive, violent–nearly supernaturally so!

But it’s important to take a pragmatic approach to understanding this experience and not to exoticize or blame your loved one.

In other words, they are not an exotic disorder. They are not their traumatic experiences. They are not possessed. They did not “cause” the disorder. They did not ask for nor deserve the trauma during which it developed. They aren’t “faking.” They are not a case for you to manage. They are a regular person who needs love, acceptance, and healing.

Everyone has “parts” –different personality presentations and experiences that are expressed in different situations. We all act at least somewhat differently at a job interview than at the club, or at church, or with a close friend who is very accepting, or in class, or around a judgmental neighbor, or around a secret crush.

The main difference is that for those who have DID, those different presentations have become dissociated from each other: there is a disruption of the underlying thread of memory and consciousness that most of us have between all our parts.

An important thing to remember is that while you may not like one or some of your loved one’s parts (and you don’t have to!), there are no “bad” parts. Every part’s feelings are a valid expression, even if not every part’s wishes should be acted on.

Nothing your loved one experiences is beyond the understanding of humans generally. You don’t need to be an expert in Internal Family Systems to connect with them. It’s useful to have some information, but primarily, just be a human with a loving connection. ❤

If you are interested in reading more in-depth about Dissociative Identity Disorder from someone who experiences it, here is an essay that is addressed to therapists but may also be useful for others who have loved ones with this type of dissociation:

TEN STEPS TO BECOMING A DISSOCIATION-FRIENDLY THERAPIST

 

 

Honoring 60 Years of Black Activism

Lancaster Black History Month Celebration!

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Depression Part 4: Just do the little bit that you can.

Part 1: Is It Depression?  Part 2: When Depressed   Part 3: Nurture Yourself Back to Life

Part 4:

Exercise: We’ve been told so often that we must exercise, that now we may hear it as a burden. Who can carry any more burdens when severely depressed? Who can go lift weights when it’s a struggle to get the bathroom and brush their teeth? But exercise is not supposed to be horrible. You can’t go wrong if you focus on exercise primarily as a way to make your body feel a bit better. It’s not some kind of punishment for resting, or for eating, or for existing in a body of any shape or size. It does not have to be within a contest. It is not a “cure” for mental illness, though it can help to improve your mood. It is an activity your body can like if done in a pleasant, kind way!

I often suggest to clients that if they are too exhausted to go to the gym or whatever their preferred exercise may be, just walk around the block. If that is still too much for right now, then just go outside and walk around the house and back in! Just do the little bit that you can.

There are very few texts that “get” how to approach exercise when you’re experiencing severe depression, but this excellent article really helps when you need to ramp up from zero: “Depression-Busting Exercise Tips For People Too Depressed To Exercise” (Sarah Kurchak)

Social Interaction: Maintaining social interaction can be a tricky aspect of depression. You need some level of social interaction to help stabilize your emotions and keep you woven into reality. If you are in a marginalized group, it is especially important to have supportive others to validate your experiences and keep you feeling sane, cared for, and safe. However, there is a HUGE difference between how much social interaction you need if you are more extroverted versus the amount you need if you are more introverted.

Extroverts can more easily harness the power of friends and family to help recover from a depressive episode: being around others will energize you and give you a bit of motivation. It’s straightforward. Seek out others to talk to daily and if possible, to see in person. It may be hard to ask for help, but see if you can ask for help with something simple. This could be something like dishes, child care, or taking you to the grocery store. You can also just ask someone to watch a movie with you or go for a walk. Ask several different people to do several different things. Being able to be in supportive company will be very useful in your recovery.

Introverts, however, may have a harder time with this. Since interacting with others can drain you of energy, you may need to be choosy about whom you contact and how you interact with them. It’s still a good goal to speak with another human at least once a day. But it’s okay if this is just talking to a friend on the phone, getting your change from the clerk at the corner store, or even calling a help line. If you have the energy to tolerate having someone in your space, it’s good to ask a friend for a little help. But make sure it’s someone who understands your limits and does not expect you to be entertaining or emotionally fulfilling to them. You can offer that later when you are not in a depressive episode! If it is still very hard to see people or even to just talk on the phone, you can start with just texting or emailing with someone(s) daily. But try not to let a day go by without communicating with others. And keep doing it.

Furthermore, you may also be considering medication.

Medications: There are a lot of non-medical things you can do to manage your depression, and medication is certainly not mandatory. However, medications can be a useful part of managing depression. They will not make you immune to sadness, but if you are especially low or “flat” or suicidal they may pull you up enough to get to your self-management.

Other people in your life may have a lot of strong opinions about medications, but this is your decision, not someone else’s. If someone tells you that you should take medication but you don’t want to, you do not have to. If someone tells you that you should not take medication but you want to try it, you may try it. That decision is between you and your physician, and you need to do what will help YOU to recover.

Most antidepressants and anti-anxiety medications are prescribed by people’s primary care physicians, though often your PCP will require that you are also seeing a therapist if they are to prescribe psychoactive medications. A psychiatrist can address more complex psychoactive medication issues than your primary care physician. A psychiatrist may be necessary if you have resistant depression or other mental health issues, such as hypomania or psychosis. It may take up to three months to get an appointment with a psychiatrist, since they are in short supply everywhere. So if you think you may want a psychiatrist, don’t wait to start looking.

Now you have stabilized yourself as best you can! You have examined the four crucial life aspects influencing mental health (sleep, nutrition, exercise, and social interaction), you have considered whether you’re interested in medication, and you have begun doing what you can to develop a healthy rhythm in those areas.

For today, you are doing the little bit that you can. And you will keep doing it. It’s very hard to manage your mood at all when even one of these aspects is disrupted, so stabilizing them all is the basis of recovery.

Next part: Emotional Aspects: Mood Management

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Just do the little bit that you can. And keep doing it.

 

~You may qualify for our new sliding-scale fee discount.~
~Please contact us for an application.~

Choosing What Kind of Therapy to Seek

We receive a lot of mixed messages about what it means to “talk to someone” when experiencing distress. Does it mean going to a hospital? The ER? Inpatient? Outpatient? Is it mostly for people who are suicidal or experiencing hallucinations? Is it really just for rich people who don’t have survival stress? Where should you even start looking?

Call me biased, but I truly believe that in fact most people could really use some kind of therapy at some point in their lives!

The Anxiety and Depression Association of America (ADAA) has a useful graphic (below) to help figure out which path might be the most useful for you to pursue, based on your own preferences and needs.

To be clear, this is primarily about psychology / counseling, which most therapy falls under, rather than psychiatry, despite how therapy is portrayed in most movies and TV shows. (To better understand the general difference between seeing a psychologist versus seeing a psychiatrist, ADAA has a useful explainer here.)

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Did you find an approach that sounds like it might work for you? I hope so!

Intersectional Life Counseling and Therapy offers nearly all of these options: in-person sessions (individual and groups when available, and even outdoors!) as well as teletherapy sessions by video. (We do not offer text-based interventions.) See the chart below to compare them!

Compare Session options:

In Office Sessions Video Session Hiking (In Season)
Standard Rates

Discounts Apply

Pre-pay required

X

Open Path (limited means) Availability

Client Location Lancaster Service Area Outside of Lancaster Service Area (PA only) Lancaster Service Area
Intake Process Set up in-office intake assessment session via phone or email. Intake determines acceptance for therapy or referral. Set up video intake assessment session via phone or email. Intake determines acceptance for therapy or referral. Set up in-office intake assessment session via phone or email. Intake session MUST BE IN OFFICE.

If accepted for therapy may schedule for hiking or in-office sessions as desired.

Insurance Reimburses Depends on insurance plan Depends on insurance plan Depends on insurance plan
EAPs cover (Quest/M&S)

TBD

TBD

Helps you get out of the house!

X

Please contact us today by email or phone to schedule!