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.

20200427_111412

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!

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

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.

Illness2_258-ted6683-jite

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!

 

It Takes Courage to Overcome a Phobia

Image: Courage the Cowardly Dog

Phobias are irrational or excessive fears. If a phobia interferes with someone’s everyday life, it may be anywhere from annoying to debilitating. Other phobias will only come up once every so often, so they are less intrusive.

If a phobia interferes with an everyday or essential activity–such as dental work, flying, or animals–a person might choose to get treatment in order to overcome it. Phobias can be treated by exposure treatment, an intervention in which the person is exposed to tolerable aspects of the phobia in a safe environment until their anxiety diminishes.

First, the treatment focuses on exposure to the least anxiety provoking aspects of the phobia, as determined by the patient in a “hierarchy of fear.” The accompanying anxiety is addressed until it diminishes to tolerable levels, however long that takes.

Then, and only then, does the exposure move to increasingly more anxiety provoking aspects of the phobia. This may take days, weeks, or even months, depending on the nature of the phobia and the person’s level of anxiety.

An example of a phobia hierarchy based on items generated by clients working in exposure treatment:

Hierarchy Example

Just thinking about exposure treatment may be anxiety provoking enough to count as exposure!

As a certain little pink dog has taught us, it takes courage to face your fears. Being courageous doesn’t mean not being afraid, it means taking action, even if it feels scary to begin.

Know Your Personal Rights: With Explanations!

Based on the Personal Bill of Rights from The Anxiety and Phobia Workbook (Edmund J. Bourne):

 

#1: I have the right to ask for what I want.
You are allowed to ask. You don’t have to mind-read beforehand to make sure the answer will be yes. You don’t have to swallow everything you want or like or need. Sure, it’s possible the answer will be “no,” but you can prepare for that possibility. It’s not wrong to ask.
#2: I have the right to say no to requests or demands I can’t meet.
Just because someone asks (or demands) something, you are not obligated to do what they want. You are also not required to come up with justifications, apologies, or rationalizations for saying no. It’s okay to just say, “No, I’m sorry, but I’m not going to be able to do that.”
#2 is also the corollary to #1. If at some level you believe people are not “allowed” to say no, you may feel guilty asking for anything because it feels like you are “forcing” someone to do what you want. (And you may resent others asking anything of you for the same reason.)
You are allowed to say no to others, and others are allowed to say no to you. (That’s how autonomy works.)
#3: I have the right to express all of my feelings, positive or negative.
You are allowed to have feelings, whether you or others think they “make sense” or not. You can acknowledge a feeling to yourself or to others. Emotions are your feedback system about events, whether in the outside world or within your mind. As such, they aren’t “right or wrong.”
Thoughts and judgments generated by feelings can be true or untrue, reasonable or unreasonable, but the feelings themselves are not right or wrong.
For example, you can feel scared about something that wouldn’t scare most others. The fear is still real, even if there is no threat. Likewise, you can be sad, or angry, or even happy about something that doesn’t make sense. The feeling itself is still real.
So it doesn’t make sense for someone to say, for example, “You shouldn’t be sad about that.” If you’re sad, you’re sad. Or, it’s okay to tell someone, “You’re scaring me,” even if they believe they have a right to shout at you, or tell you you “shouldn’t” be scared.
In fact, telling someone your responses to their actions is an important thing for them to know about how their behavior affects others. (If it’s not safe to tell them how you feel, then that relationship is not safe.)
A good formula to express feelings to self or others is “I feel ______________ when ___________ happens.”
“I feel anxious and vulnerable when there’s violence in the news.”
“I feel abandoned and angry when you forget to pick me up.”
#4: I have the right to change my mind.
It’s okay to try something and then realize you don’t like it halfway through. It’s okay to discover your feelings about a person or situation have changed. It’s acceptable to learn and grow and develop new beliefs. You do not have to continue something you don’t like.
#5: I have the right to make mistakes and not have to be perfect.
It’s often much easier to apply “no one is perfect” to others, while still beating yourself up for mistakes or “flaws.” This is usually an internalized voice that is just waiting for any chance to criticize. Whosever voice that was, you don’t have to keep repeating that tape.
It’s certainly valid to try doing something differently if that works better in your life, but you are already acceptable, even as you are “messing up” or being flawed. Too many people are waiting until they achieve perfection to love themselves, and they will wait forever.
It can be invigorating to strive for excellence, but “the perfect is the enemy of the good.” This means that you may end up doing nothing at all if you can’t do it perfectly (which no one can).
#6: I have the right to follow my own values and standards.
You are allowed to wear clothes that others think are too childish, too weird, too sexy, or too boring. It’s really none of their business. It is your choice if you want to eat vegetarian food or to include meat. It’s not wrong to have sex or to completely abstain. YOU choose. If you want to go to church, that’s your business. If you want to not go to church, that is also your business. If you want to be a parent, great! If you want to be child-free, great! You don’t have to legalistically justify your values to someone else.
#7: I have the right to say no to anything when I feel I am not ready, it is unsafe, or it violates my values.
You are allowed to say no when you need to! (See #2.)
#8: I have the right to determine my own priorities.
No one else can live your life for you. It’s not a trial run. Prioritize what is really important to you, which may not be what your friends, parents, or society expect. They get their own turn. This is yours!
#9: I have the right *not* to be responsible for others’ behaviors, actions, feelings, or problems.
This one is tricky. People misinterpret it to mean that it must be fine to be selfish and you should not care how you treat others or how they are affected by you. That is not what it means.
It does mean that you are allowed to take your own side. You are allowed to take care of yourself, physically and mentally. You do not have to set yourself on fire to keep others warm.
It means that ultimately you cannot control how others respond to you. For example, if you are “walking on eggshells” trying not to upset someone, then at some level you believe you can (and must) manage their feelings — to make things okay for them. This is not true!
It means that if someone is abusive to you, you did not “cause” it, because you are not responsible for others’ behaviors — they are. It means that you don’t have to keep rescuing someone, especially from problems they create, because you are not responsible for their problems.
The reverse is also true! If someone is hurtful to you, you are the one responsible for protecting your feelings from further injury, whether by telling the person to change how they treat you, or by ceasing to interact with them (insofar as that is possible) if they do not.
#10: I have the right to expect honesty from others.
A relationship without honesty is not a relationship, but rather a one-sided experience for each partner.
#11: I have the right to be angry at someone I love.
Too often people imagine that love and anger are incompatible. But we can hold many contrasting feelings at once! If someone hurts or disappoints you, it’s natural to feel angry. We don’t want to express anger in an abusive way, but feeling and expressing anger is to be expected.
#12: I have the right to be uniquely myself.
“Wanting to be someone else is a waste of the person you are.” Your individuality is to be celebrated. That doesn’t mean others are wrong to be who they are. It means that you get to be anything from “boring” to “weird” if it makes you happy and fulfilled (and so do others!)
#13: I have the right to feel scared and say “I feel afraid.”
Feelings are not wrong in and of themselves. No one can tell you that you “shouldn’t” feel afraid (not even you). You do not deserve to be mocked into ignoring your vulnerability or your wish to be careful, even if your fear is not based on a reasonable threat.
#14: I have the right to say “I don’t know.”
You don’t need to be pressured into making a decision when you are unsure. And you can’t be expected to know everything — no one knows everything! It’s reasonable to take the time to figure out what you don’t know.
#15: I have the right not to give excuses or reasons for my behavior.
If you want to explain to someone, you certainly may. But too often people feel they *must* come up with scrupulous, legalistic, unbreakable explanations for everything they do.
Who are you allowing to judge you? You don’t have to put yourself one-down to someone else’s judgment. After all, you don’t judge them and argue every little thing they do, right?
#16: I have the right to make decisions based on my feelings.
Pssst! Here’s the big secret: ALL (yes, ALL!) decisions are based on feelings. Someone who tells you otherwise is not very self-aware, and they are rationalizing their own (feelings-based) decisions in hindsight.
What about logic? What about rationality?
Yes, we want people to be rational and to be logical. That’s the best way to get the outcome you want… and “want” is a feeling. Without feelings, there is no reason to do anything at all. You are not an automaton, nor is anyone else. Logic incorporates rationality AND feelings in deciding your path. If you believe something will make you happy and you know (rationally) how to do it, then logic says “try doing that thing.”
There is no such thing as “pure logic” or “pure rationality” in terms of human behavior.
All desired outcomes are feelings. For example: “I want to have a house and a car [because I will feel satisfaction].” or “I want to become a physician [because I will feel better if my parents are pleased].”
So if someone criticizes you for deciding things based on your feelings, they have absolutely no grounds for criticism. It is completely illogical to exclude feelings from decision-making!
#17: I have the right to my own needs for personal space and time.
Whether you need a little or a lot of alone time to recharge, then you are allowed to take that time. Others may *want* more of your time than you have available, but it’s not your responsibility to sacrifice taking care of yourself to fulfill their wishes.
You can’t give to others from an empty well!
#18: I have the right to be playful and frivolous.
It’s okay to have a childlike side. That’s part of what keeps you alive and happy! It doesn’t mean you are are not to be taken seriously, or that your needs should be ignored, and it doesn’t mean you can’t also be a competent adult.
#19: I have the right to be healthier than those around me.
When you begin to set boundaries, take care of yourself, and ask for needs to be met, you may be met with resistance from those still caught in dysfunctional dynamics. You are allowed to take care of yourself even if others aren’t, and you can’t save them by sacrificing yourself.
#20: I have the right to be in a nonabusive environment.
You are not required to tolerate a stressful and abusive environment just because you know how to do so and have done so in the past. A big part of therapy is *lowering* your tolerance for BS so that you will get out of bad situations before they get terrible!
#21: I have the right to make friends and be comfortable around people.
If the atmosphere in your childhood environment was insular and suspicious, you may feel guilty about being social or out in the world. But those are part of your rights as a human — to connect with other humans as you see fit, to like and love those you are drawn to.
In an abusive relationship of whatever kind, someone may seek to make you feel guilty for or afraid of having any connections besides the abuser. This is a control mechanism, and is not healthy.
#22: I have the right to change and grow.
“But you didn’t use to mind when I did X” … It’s okay to say, “Well, now I do mind, so please don’t.”
#23: I have the right to have my needs and wants respected by others.
It’s also okay to limit or cease time spent with those who do not respect your needs, wants, and boundaries. Even if they are loved ones.
#24: I have the right to be treated with dignity and respect.
Again, it’s okay to limit or cease time spent with those who do not treat you with basic human respect. Even if they are loved ones.
And don’t confuse “respect as an authority” with “respect human rights”:
rights_authority
Finally, #25: I have the right to be happy.
The simplest but by no means the easiest to accept.
(Previous post about personal rights here.)

Know Your (Personal) Rights

Most relationship difficulties are a result of some kind of difficulty in setting boundaries. If your childhood environment was chaotic or abusive, you may not have been allowed or encouraged to have personal boundaries, so you may need to learn to develop them in adulthood.

In order to develop good personal boundaries, you need to know what rights those boundaries are defending. If you haven’t thought much about your personal rights, you might not even know what they are! In that case, a good place to start is the Personal Bill of Rights from The Anxiety and Phobia Workbook (Edmund J. Bourne).

Personal Rights

Click here to see further explanation of individual items on the list.