yaelingh Uncategorized

Telehealth Sessions Now Available in 35 States

Why remote therapy sessions?

Many people are in locations or situations where in-person therapy sessions are not available or not practical. If you are in a state that is a member of PsyPact, you may use telehealth (video sessions) to access therapy services from therapists across the United States who are certified by PsyPact.

What are PsyPact therapists?

PsyPact therapists are doctoral-level mental health professionals who are fully licensed to practice within their home states and have also been vetted and accepted by PsyPact to practice interjurisdictionally (in other member states) via telehealth.

What state laws apply to my therapy?

The laws of the state where YOU are located during your session are the laws under which your therapy operates.

Is my state a PsyPact member state?

Currently 35 states are active members, with four more states slated to activate later this year. Yet others are in the legislation process. You can view the map and the list here.

How do I get started if I want to see Dr. Liz?

Please email IntersectionalLife@gmail.com with questions or to ask about scheduling. You may also use the sliding-scale calculator to see for yourself if you qualify for a discount (most will). You can also look through the website to get an idea about Intersectional Life Counseling and Psychology.

Talk with you soon. ❤️

Covid Conscious Therapist Directory – therapists sensitive to the realities of living through COVID-19

Thriving Campus Directory – therapists serving college campus communities

We offer remote therapy sessions anywhere within PsyPact member states. Most people qualify for a sliding-scale discount; use the calculator to instantly see what your fee would be. Email IntersectionalLife@gmail.com to schedule a session.

yaelingh Uncategorized

Telehealth Sessions Now Available in 35 States

Why remote therapy sessions?

Many people are in locations or situations where in-person therapy sessions are not available or not practical. If you are in a state that is a member of PsyPact, you may use telehealth (video sessions) to access therapy services from therapists across the United States who are certified by PsyPact.

What are PsyPact therapists?

PsyPact therapists are doctoral-level mental health professionals who are fully licensed to practice within their home states and have also been vetted and accepted by PsyPact to practice interjurisdictionally (in other member states) via telehealth.

What state laws apply to my therapy?

The laws of the state where YOU are located during your session are the laws under which your therapy operates.

Is my state a PsyPact member state?

Currently 35 states are active members, with four more states slated to activate later this year. Yet others are in the legislation process. You can view the map and the list here.

How do I get started if I want to see Dr. Liz?

Please email IntersectionalLife@gmail.com with questions or to ask about scheduling. You may also use the sliding-scale calculator to see for yourself if you qualify for a discount (most will). You can also look through the website to get an idea about Intersectional Life Counseling and Psychology.

Talk with you soon. ❤️

Covid Conscious Therapist Directory – therapists sensitive to the realities of living through COVID-19

Thriving Campus Directory – therapists serving college campus communities

We offer remote therapy sessions anywhere within PsyPact member states. Most people qualify for a sliding-scale discount; use the calculator to instantly see what your fee would be. Email IntersectionalLife@gmail.com to schedule a session.

yaelingh Uncategorized

Don’t Push Through It!

Bouncing back ain’t what it used to be

Has it been taking you longer to recover lately, from…literally everything? In the past few years, a lot more of us have used up our bandwidth, yet we expect to be able to “push through” in the same way we used to. It may be that the pushing through itself was always bad for us, but we didn’t feel the effects until we used up everything we had. We hear a lot about resilience, but the fact is, we live in a culture that glorifies crunch and encourages pushing through to the detriment of physical and mental health, and it’s killing us. While there are certainly ways to increase resilience, we are finite. There are already enough external things killing us; we need to stop the self-destruction and learn to treat ourselves sustainably.

What does “pushing through” mean?

“Pushing through” is forcing yourself to function past your physical or emotional limits, past capacity: Staying up all night to finish a task. Working week after week without a day off until you feel numb. Exercising until you throw up. Prioritizing others’ feelings and keeping silent when your own heart is breaking. Ignoring hunger, thirst, or the need to go to the bathroom for just another hour and then another hour. Staying in an intolerable situation and telling yourself you “should” just be able to tolerate it. Often needing caffeine, aspirin, or alcohol to tolerate the situation. Do any of those sound familiar?

Consequences of pushing through

Here’s the thing. Any time you push through your limits–physical or emotional–you are borrowing from your future self. You are eating your seed corn. You are going in debt to your own physical and mental health. You are spending resources you don’t have! The discomfort is there for a reason. It tells you when you have reached your limit, when to stop spending yourself, when you are tapped out and used up. The discomfort is the sign to stop.

When people say “listen to your body,” what that means is if it hurts, stop doing it. If you are tired, rest. If you are sad, cry. If you are hungry, eat. This sounds simplistic, but many of us have been conditioned since childhood to ignore or “push through” our limits. We may have a high tolerance for physical and emotional discomfort. Well, guess what? That’s often harmful. It may be lifesaving in a situation of desperate crisis, but it’s not sustainable. You can tolerate the situations causing the discomfort for the short term, but you are spending yourself to do so. You are spending your future self for today’s emergency. Burning out is the direct result of pushing through too many times. It means the future self you spent is today’s self.

Why do we overspend ourselves?

Many of us have been taught that we are expendable, and that discomfort is always something to be ignored as we push through it to a goal. We learn that spending ourselves recklessly is okay or even admirable as long as it’s in service of a worthy goal. Sometimes it’s a goal we want to reach, but often it’s a goal others have set for us, a social expectation, a “should.”

You may be fighting to not feel your reactions to a given situation, when what really needs to happen is for you to leave or change the situation. The reactions you’re experiencing are an important indicator of how the situation is affecting you, rather than a distraction to be ignored or suppressed.

Learning to respect your own limits

Before you can set limits, you need to know what your limits are. When you push through, what is it you are pushing through? Is it exhaustion? Fatigue is a sign you need to rest. Pain? Pain is a sign that something may be injuring you. Is it fear? Fear is a sign that something may hurt you. Is it resentment? Resentment is a sign that you are giving more than you can afford to give. These are important indicators of how you are being affected.

What if you don’t know your limits? In particular, survivors of abuse or neglect are vulnerable to not having well-developed boundaries, that is: knowing your limits. That’s because in an important part of your development, you were taught that how you felt about things was not important. You were not allowed to develop boundaries or learn your limits, so you developed a high tolerance for discomfort. Too high, in fact! As a result, what often happens is you don’t realize that your limits have been reached until they are surpassed, and then you are utterly overwhelmed.

Therefore, your task in adulthood is to lower your tolerance for discomfort. We want you to learn to stop what you’re doing before the discomfort gets to the point of overwhelm, by reducing your threshold of tolerance for discomfort. Notice which feelings indicate things are too much for you. (Exhaustion? Pain? Fear? Resentment?) The goal is to start noticing and paying actual attention to discomforts when they are still small, taking them seriously while they are still small. Initially this will feel selfish or silly or spoiled. You will feel guilty! But in fact it is solid progress.

Does this mean we should strive to never feel discomfort? Of course not. Discomfort is an integral part of being human, part of progressing, part of growing and living with others. But we can learn to discern between the discomfort of healthy growth, and discomfort that is an indicator that we aren’t taking care of ourselves or are actively being harmed. There is no need to valorize discomfort for the sake of discomfort.

Is it ever okay to push through?

There are exceptions where it’s okay to intentionally, consciously push your limits or overspend yourself. Maybe you’re doing physical therapy to recover from a surgery and the exercises hurt. This is for a very specific recovery goal and it’s under the supervision of an expert; the point is not to just do something very hard that hurts, it’s to heal. Or maybe you have a phobia and you know a particular fear is irrational and you want to overcome it. But again, this is a very specific exception and you can engage carefully knowing that you’re actually safe; the point is not to just ignore fear.

Maybe you intentionally incur short-term temporary debts to your future self: you occasionally stay up to finish a paper or meet a work deadline, you’re training for a special sports event that you enjoy, you’re taking care of a loved one who is ill. In those cases you support your well-being, you plan how to “pay it back” to yourself immediately by taking a few days to catch up on sleep, do stretches, feed yourself well, socialize, do your journaling, relax. Then you’ve repaid yourself and repaired your body and emotions. And in each case, these are goals that you have chosen because you value them yourself.

But all too often, what we’re doing is not one of these exceptions. Instead, we’re relying on emergency spending as a way of life. We are pushing through important warnings to stop!

Spend yourself less and pay yourself back more

Learn your limits. What tires you out? What hurts physically? What interactions leave you emotionally derailed or spent? There was a point where the discomfort began–did you notice it then, or not until it became overwhelming?

Choose your goals. Spend yourself intentionally on the things that really matter to you, instead of habitually overspending yourself on things that don’t help you survive or make you happy.

Respect your limits. Stop doing the things that always lead to those feelings! Either stop doing them entirely, or stop doing them while the discomfort is still mild. Stop when you only feel a little tired, not when you’re already exhausted. Or stop when you’re just a little sore, not when you can’t stand because you overworked your muscles. Or end a phone conversation when you’re only a little antsy, instead of staying on the line until you feel resentful.

Pay yourself back. This sounds so simple, yet it’s not easy. Rest, eat, comfort and entertain yourself after spending yourself. Restore yourself! You cannot simply jump back into routine without restoring whatever you have overspent, or you’ll be running at a deficit. Do not allow a self-care deficit to become chronic–that leads to illness.

What if I just can’t

In some cases, there are times we know we are beyond capacity, but we are running ourselves ragged just to make ends meet or keep our lives holding together. This unfortunately and unfairly contributes to illness and even shorter lifespan for those in marginalized groups: racialized groups, those who are poor, and disabled people, for example.

In that situation, I encourage you to let go of tasks that are not an absolute necessity. Do what you must and do what you want, but let go of doing what you “should.” By this I mean, prioritize the tasks that will get your bills paid, and prioritize the things that will help you stay functioning (make you happy or relax you). However, let go of things you’re doing because it’s a “should” instead of a need or a want. De-prioritize things that you’re mainly doing because of the judgments, habits, or opinions of others.

You are a finite resource

A big part of increasing resilience is learning what our limits are and respecting them, instead of pushing through them. Learn to stop when discomfort is small, not after it becomes overwhelming. Some goals may be worth temporarily overspending ourselves, but we must choose those goals carefully and with intention, and then make sure to pay ourselves back. Do not let a deficit become chronic: you are borrowing from your future self. Stop pushing through the warnings. You are a finite resource. You are irreplaceable.

Become sustainable. ❤️

We offer remote therapy sessions anywhere within Pennsylvania. Most people qualify for a sliding-scale discount; use the calculator to instantly see what your fee would be. Email IntersectionalLife@gmail.com to schedule a session.

yaelingh Uncategorized

Recognize Depression by the Lies it Tells

I wonder if you’ve noticed some negative thoughts about yourself lately. These might be something like:

“Nobody really likes me.”

“I’m not good at anything.”

“I’m not loveable.”

“Nothing I do works.”

“I have nothing to look forward to.”

If these sound familiar, there’s a good chance you’re experiencing some depression. Depression often generates these kind of negative, judgmental thoughts. There are a couple of important things to remember about depressive thoughts.

  1. Thoughts are not facts! We can have thoughts that are true or false. In fact, thoughts generated by depression are often false (or greatly exaggerated). Just because a thought pops into your head does not make it true. Depression is a really good liar! So when you recognize that you’re having a bout of depressive thoughts, remember not to buy into the content.

  2. Depressive thoughts are a useful indicator! When you learn to recognize that these kind of thoughts are generated by depression, it lets you know that you’re experiencing a bout of depression. That will allow you to take care of yourself properly so you can get through the depression, instead of making it worse by ignoring it.

This may sound simplistic, but many times we do not recognize we’re experiencing a depressive episode until it’s been going on for a while. And during that time, we may be buying into the content of depressive thoughts, berating ourselves for not functioning normally, self-medicating or making other bad choices in an effort to cope, wondering why we’re exhausted or down, and generally making the depression worse. This happens surprisingly often, even for people who have known for years that they are susceptible to depression.

So the key is: notice your depressive thoughts. And instead of simply believing them (buying into the content) and spiraling, mentally “step back” from the thoughts. Notice how you’ve been feeling overall. Take the thoughts as an indicator that you may be having a depressive episode that needs to be managed.

It’s never too late to stop believing the lies. ❤️

We offer remote therapy sessions anywhere within Pennsylvania. Most people qualify for a sliding-scale discount; use the calculator to instantly see what your fee would be. Email IntersectionalLife@gmail.com to schedule a session.

yaelingh Uncategorized

Letting Go of “Unlikeability”

You Have Been Good Enough All Along – by @tlkateart
 
 
You may have recently seen some discussions about a post online stating that trauma survivors are “fundamentally unlikeable.” I hope it has not been too derailing to your healing.
 
If it has been derailing or activating to you, it may help if you can step back mentally and see the statement for what it is: a cognitive distortion arising from PTSD. It is also an expression of internalized ableism.
 
Remember, when you have feelings of depression or anxiety, your feelings are understandable and deserve compassion. AND–you also do not have to buy into the cognitions or judgments that arise from these feelings!
 
In Radical Acceptance, Tara Brach talks about the “trance of unworthiness” that is engendered by trauma. This is also called “SHAME.” This kind of shame is the deep sense that one is fundamentally unworthy of love. (It is different from guilt, which is a pain from hurting someone and a motivator to do better next time.)
 
In my experience as a clinician and also as a trauma survivor, shame is pretty well universal among trauma survivors and it is easy to get sucked into. But you can remember not to buy into it. You do not have to buy into internalized ableism.
 
If someone dislikes you because you have trauma symptoms, that has more to do with who they are than who you are. If you feel unlikeable because of your trauma, that has more to do with trauma symptoms than with your actual likeability.
 
Another important aspect of this is that you do not owe anyone a performance of likeability. You yourself may want or need to be liked, for your own reasons: psychological, social, practical, or safety reasons. But likeability is not something you owe to others. You don’t have to be likeable for the sake of others’ comfort.
 
 
You are not a burden, you are carrying a burden. 
 
You are not a burden, we are lucky to have you
You Are Not a Burden by @tlkateart
 
 
You might also find it useful to listen to the following meditation from Tara Brach*: Healing Shame
 

(Note: Dr. Brach uses “toxic shame” vs. “healthy shame” to refer to what I would call “shame” vs. “guilt.”)

 

You are already fundamentally likeable, just as you are. ❤️

 

yaelingh Uncategorized

A Worldwide Traumaversary

Things are looking up, why do I feel bad?

By now it is not news that many of us have experienced mental health challenges over the past year. For most of us, every life domain has been affected in some way by the pandemic and by social unrest: physical, mental, social, professional, financial, and even existential. Even those who somehow escaped the worst of the harm have been affected. For those still experiencing loss, violence, work and housing instability, illness, or financial crisis, there is a clear reason for ongoing distress and symptoms. But lately I’ve been seeing that even those whose lives are beginning to stabilize are discouraged because they are experiencing a fresh wave of symptoms of depression or anxiety.

Many times when someone comes in with unexplained symptoms of depression or anxiety, I ask what was going on this time of year last year. And very frequently, it turns out to be a leadup to the anniversary of a traumatic or painful event: a “traumaversary.” Experiencing a resurgence of symptoms at the anniversary of an event is also known as “anniversary effect.”

As the saying goes, the subconscious may experience all times as one, but it sure keeps an accurate calendar. This makes sense from a survival standpoint. Part of trauma response is an attempt to save us from further traumatization by avoiding similar situations. The subconscious may tell us, “last time I was in this situation, something harmful or threatening occurred, so be on the lookout for danger!” Whether consciously or not, we remember situational cues such as what time of year it was, the quality of the light, the smell of the air, the temperature, what seasonal events were happening, what landscape we were in, and numerous other aspects.

What we are seeing now is a mass-scale traumaversary. A year ago we were all plunged into a worldwide nightmare that went from bad to worse, and from which we have largely not yet recovered. Contagion, social strife and violence, financial crisis, medical nightmares, and other sources of fear and powerlessness, if not outright terror. And we are still incurring losses.

You may not even realize how much you’ve been through! This mental health status chart can help you to assess how you’ve been affected. Were you feeling worse than you realized? Are you still in red or orange? Are you moving towards green?

Thriving, Surviving, Struggling, In Crisis
Credit: National Fallen Firefighters Foundation

The fact is, we have been through mass trauma on an unparalleled scale. In part because internet access has allowed us to share everyone’s moment-to-moment feelings and reactions all day, every day, all over the world. In one sense that can be good, because it validates our experiences to see others having similar reactions. But in another sense, immersion in everyone else’s trauma can increase your own trauma. Also, having to go about everyday routine as though things are “normal” can make things worse.

What can we do about traumaversary?

For any kind of trauma, recognizing when symptoms may activate is very useful. Many times we do not recognize why we are feeling bad until it’s already been going on for a while, or perhaps even in hindsight. If we know in advance that a certain time of year may be especially hard, that can help to reduce the severity. Not knowing what’s happening can make it worse.

Anticipate symptoms and stressors

What kind of symptoms are you experiencing now? When you think back, are they similar or related to what you were experiencing last year? Is there any pattern to when they occur, such as being at home, at work, around certain people, doing certain activities? Here are some common symptoms I’ve been seeing:

Discouragement: pushing so hard, for so long, and although there is hope for improvement, it’s far  slower in coming than we may have hoped.
Burnout/malaise: stress is cumulative, and it takes time and energy to heal from it. Many have not had the opportunity to recover from each day before the next day comes, let alone the opportunity to recover from a year’s worth of constant stress. It’s hard to stay engaged and interested without stress recovery.
Exhaustion: many are exhausted from unceasing exertion: physical, cognitive, and emotional. We may be sleeping a lot more, not feeling restored after sleep, and too drained to participate in our usual tasks and activities.
Impaired executive function: forgetfulness, loss of concentration, unusual time perception (speeding up or slowing down), difficulty planning and implementing activities. Not being able to “get things done.”
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.
Sleep issues: insomnia, exhaustion, hypersomnia. While many have gotten some relief from the insomnia of the past year, hypersomnia is still prevalent. It’s not surprising considering the cumulative stress and burnout we’re experiencing!

 

 

Find ways to support and care for yourself

Recognizing how much you’ve been going through may already be enough to mitigate some of your symptoms, because they will feel less inexplicable. This may also make it easier to allow your reactions instead of telling yourself you “should” be able to function. Acknowledge to yourself how hard this has been and continues to be! We can’t truly heal from a trauma that is ongoing, though we can find ways to cope.

Remember the basics of caring for your body:  sleep, nutrition, exercise, and social interaction. It’s unreasonable to expect yourself to feel okay emotionally if your basic needs aren’t being met. Go through each one and see what can be improved, even in a small way.

Also, allow yourself to experience enjoyment! Sometimes when everything has been terrible for a long time, we feel wrong or guilty enjoying anything. But joy helps us to stay mentally healthy and balanced. It doesn’t mean you aren’t serious or you don’t care about others.

Back to “normal”?

There is hope and solid progress towards restoring a robust and healthy society. But life has changed forever in some ways. Sociopolitical rifts have become stark. Lives have been lost, homes have been lost, jobs have been derailed. And most of all, safety has been lost. In truth, we are all vulnerable to illness, we are all vulnerable to violence, we are all vulnerable to want and instability, but the past year has made this truth concrete to many who felt safe before. We can’t put this back in the box. These are real losses, and if grief comes up, it’s okay to allow it.

One sure-fire approach to help restore your own sense of agency and safety in the world is to contribute to making it safer for everyone, whether that means protecting others simply by following pandemic guidelines, supporting causes that help the community, or speaking out in helpful ways. You’re still part of a living, hopeful world that many people are working on improving. ❤

 

Intersectional Life Counseling and Psychology offers remote video sessions for PA residents, as well as SLIDING-SCALE RATES FROM $72. Please EMAIL if you would like to schedule or have any questions!

yaelingh Uncategorized

We All Live in the Same House

Dear Friends,

I know this is a stressful, even traumatic time for many. Uncertainty increases anxiety, and there is so much uncertainty. Discouragement worsens depression, and there are many discouraging events. Fearsome news and social targeting increase PTSD symptoms, and there are fearsome events and targeted attacks happening, up to and including violence.

So I will not say “everything will be fine regardless of the outcome.” Because there will be many uphill battles regardless of the outcome, and those in marginalized groups will be bearing the brunt of those uphill battles. The lid has been ripped off a great deal of ugliness in our society, and the ugliness will not go back into that can regardless.

So instead of saying “everything will be okay,” I will say, what really keeps you okay will remain intact despite the outcome. Because what keeps you okay, what has kept you alive so far, is people taking care of each other.

Electing supportive, fair government is ONE of the ways we take care of each other, but it is not the only way. Sometimes it is not even the most important way! Remember, power comes from the people. That means you!

You, and supportive family. Close friends. Colleagues. Fellowships and congregations. Mentors. Neighbors. Even people you don’t know personally, working to keep things together and moving: Postal and delivery workers, health care workers, grocery workers, movement members, clergy, poll workers! Thousands upon thousands of people like you are invested in keeping life going and helping others be okay, too, regardless of what happens in any election.

We don’t get to choose what arc of history we occupy, only what role we play in that arc. You are living through historical events that you did not choose. So let this radicalize you, rather than lead you into despair (–Mariame Kaba).

Survive, help others survive, thrive, help others thrive. ❤

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!

yaelingh Uncategorized

Managing Vicarious Trauma Across Professions

Archivist, oral historian, and genocide scholar Tim Hensley discusses his approach to managing traumatic material in the workplace:

Most caregiving and reporting professionals (health care providers, reporters, first responders, clergy, social workers, legal aid, and many more) interact directly or indirectly with the traumatic experiences of others at some point in our careers. But events of the past few months have increased this likelihood for all of us, in some cases with the force of a fire hose.

Furthermore, we are all dealing with our own increased stress and trauma, which leaves us with less bandwidth available to absorb the anguish of others.

In order for you to stay afloat and continue your trauma-oriented work, it is necessary to limit your amount of exposure to your carrying capacity.

This excerpt shows Tim’s method, which is organized, structured, and visual:

 

20200525_233237

 

While I personally don’t categorize sessions and activities visually in the  way Tim does, I do always maintain an idea of which sessions and activities are likely to contain material and experiences that are heavier to carry, and I spread my scheduling out in a similar way across a given week.

If you are in a caregiving or reporting profession, you may already be using a similar approach, whether explicitly or intuitively. If not, you might wish to examine your own process and how it is affecting you.

How can you know when it’s too much to carry? You have to notice how you’re feeling! This sounds incredibly simple, and yet many of us frequently push past our actual capacity into burnout territory. This can lead to illness, injury, depression, suicidality, and other life-disrupting outcomes. You may think it’s okay to push on–until it’s suddenly not.

It’s a case of “simple but not easy,” especially if you have always been taught to push through physical or mental discomfort in order to complete tasks. It’s considerably worse if you’ve always been taught you must put your own needs dead last after others’ needs.

Now is the time to de-condition that harmful approach!

You have gone beyond your carrying capacity if you are feeling:

  • Exhausted
  • Irritable
  • Weepy
  • Resentful
  • Stress-headachey
  • Pessimistic
  • Hopeless
  • Angry
  • Anxious
  • Disconnected
  • Dissociated
  • Craving substances

Once you are able to determine which pieces of your work tend to make these kinds of symptoms worse, that is when you can plan how to schedule your heaviest interactions such that you can recover in between.

Keep in mind, what may be light for someone else may sink you, and vice versa. This is never about what you “should” be able to carry–it’s about how it actually affects you in practice. No one can tell someone else what they “should” be able to bear.

Which brings me to the next difficulty for many: what if you are not the one doing the scheduling? What if the fire hose is never turned off? This is a physically and emotionally dangerous situation. It means that you’re in an environment that does not allow you to protect yourself, recover from injury, steward your health. If you are able to seriously discuss the issue with someone in charge, that may be helpful. But if they are dismissive, it is likely a situation that will be harmful to you in the long or not-so-long run.

What does it mean to recover in between? Again, this sounds simple but it is not always easy. You do things that help you feel better!

  • Sleep! And more sleep!
  • Basic exercise: walking, biking, yard work
  • Adequate nutrition
  • Enjoyable “vegging”
  • Creative outlet: music, gardening, knitting, hobby electronics, baking
  • And most important of all: someone supportive to tell about your experiences

This does not mean you must violate confidentiality or your HIPAA obligations or the sanctity of the confessional. It means to have someone with whom you can exchange understanding of how hard it is to do what you do, and express honestly how it’s affecting you. This may be a coworker ally,  spouse, friend, clergy, or therapist. But it’s very important and a big part of lightening the heaviness.

If you are not used to taking care of yourself “like you matter,” it is time to start practicing that skill right now, so you do not fall into burnout and illness.

Remember, you can’t give to others from an empty well! ❤

 

depositphotos_15861195-stock-photo-water-well

 

yaelingh Uncategorized

About Those “Pandemic Pounds”

In the past few weeks, I’ve seen an increase in people discussing and writing about having gained weight since the event of the pandemic. Many of us have turned a corner from “acute crisis” to “settling in for the long haul,” and we’re taking stock now. We’ve also recently heard some public figures make critical remarks and references to others’ weight, which has only increased pressure on everyone who already struggles with body image or who experiences criticism about their bodies.

Just so you know, this is not a post about how to lose weight. This is a post about some steps to take if you are thinking about losing weight. This is because the first thing we often jump to when feeling unhappy about our bodies is restricting food intake (“dieting”). But that’s often literally the last thing to do! So please remember to consider these other factors FIRST before jumping to food restriction.

Sleep

Sleep is often one of the biggest factors in weight changes. Have you been struggling with sleep the past few months? Many people have, whether because of anxiety, depression, or change in routine. Sleep deprivation can change hormones: it reduces leptin and increases ghrelin, which can dramatically disrupt both appetite and metabolism. This can mean experiencing intense cravings and processing fuel differently.

Sleep deprivation also interferes with executive function, which means both cognitive and emotional processes are harder to manage. That can mean it’s hard to plan for and prepare the food you’d like to eat. It can also mean increased emotional eating, or in some cases loss of appetite because of anxiety or depression.

So first of all, make sure to prioritize sleeping enough and sleeping regularly before addressing your eating.

Exercise

After getting your sleep on track, next consider how you’ve been exercising (or not!)

Whether you’re an essential worker who’s been stressed and working extra hours, or you’ve been working from home, or you’ve been unemployed and out of your normal routine, your body needs the stress outlet of some kind of movement.

Often when people are worried about weight, they focus on exercise as a method of “burning calories.” There are a lot of good reasons to exercise, but “burning calories” is usually an unhealthy way to approach exercise. It’s often an approach that is self-punishing (“I must do an unpleasant activity because of my size!”) or contains elements of bargaining or paying for eating (“I can eat this food I like if I ‘pay’ for it by exercising!”) You don’t have to “pay” for eating with exercise.

A healthy exercise approach is to focus on improving heart function, improving lung capacity, gaining flexibility, metabolizing cortisol to decrease anxiety and regulate sleep, and attenuating depression. In other words, exercise to improve your physical and mental health. Not as a way to neutralize eating.

Nutrition

If you are not satisfied with the overall nutritional balance of foods you are eating, then you are certainly allowed to modify what you’re eating. But when changing your diet, it is important to remember that the goal is to first ADD components you believe you are not getting enough of. Maybe you feel you’re not getting enough leafy greens, or enough legumes, or protein, or calcium. Search out foods that will help to add those elements to the overall balance of your diet! It is acceptable to still eat other foods for enjoyment.

It can be hard to prioritize “adding in” foods, partly because we are constantly bombarded by puritanical, perfectionistic messages that we should be removing or restricting foods.

Checking in with Your Emotional Side

So you’ve stabilized your sleep, you’ve improved your relationship with exercise, you’re getting a better balance of the nutrients you need, and maybe that’s enough! Maybe you’re back to feeling okay!

–Or, maybe you still feel you’re eating more than you want to, or more than you think you “should.” What then? You’re doing all the “right stuff!” Why are you still eating more! Well, this is the hard part, as the emotional component of any behavior change usually is.

Whenever a behavior is difficult to change, there is usually some part of you that is using the behavior to feel okay. To feel safe, comforted, entertained, loved, awake, valued, to feel pleasure. Eating is such an emotionally layered action. We are not simply input/output mechanisms for fuel and activity.

What emotional need has food been fulfilling for you while you’ve been dealing with stress? Until you can find another satisfactory way to fulfill that emotional need, you will continue to use eating behavior as an emotional tool. No amount of calorie tracking, substitute sweeteners, or rigid meal-planning will sustainably alter that dynamic.

Something to keep in mind is that you can’t fool yourself about your own motives. What I mean by this is, you may be saying to others or to yourself, “I’m doing this for my own good! I need to restrict my food for my health!” but meanwhile there is part of you thinking “I’m going to restrict food because I should be punished [for existing, for taking up space, for using any resources, for having the “wrong” appearance].”  Or maybe there is a part telling you that it’s not okay to be fat, or maybe it’s calling yourself names.

Guess what? Until you can keep that part of you from bullying the part that is using food to feel better, it will only make things worse for all parts of you.

Ironically, the bullying part needs patience and tenderness to change, too. That bully part is usually trying to protect you from the criticism of important others. “If I criticize me first, then I won’t get criticism from others.” Let the bullying part of you know that you truly appreciate the protection, but that it’s not necessary any longer. You don’t need it to call you names or harass you.

When you are able to pacify the bullying part, then you will be able to more clearly hear the part using food as an emotional tool.

If that part of you is using food for comfort or safety, is there something else you can use sometimes to feel comforted or safe? If that part is using food to feel loved or valued, can you find some other ways to remind yourself you are loved and valuable? If that part has been using food to quell boredom, can it tell you some other things that might help you feel interested and alive?

Once you have examined the emotional underpinnings of your eating habits and your body image, then you can find more acceptance for yourself, and you can choose whether you want to change your behaviors. But in the meanwhile, remember that this body has carried you, and helped you survive and overcome everything that you have lived through so far. It deserves gratitude and care from you! And so do you, yourself.  ❤

The article linked below has more discussion about an emotionally balanced approach to eating:

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!

 

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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!