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!

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:

 


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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! ❤

 

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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!

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.

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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!

 

Holocaust Remembrance Day

“How wonderful it is that nobody need wait a single moment before starting to improve the world.” (– Attributed to Anne Frank)

Stanton’s 10 Stages of Genocide and how the US stacks up:

 

Reflect on your own values, and see what you may do to “start to improve the world.” ❤

Anti-Semitism Still Active

 

In 2019 in the United States of America, the Jewish community still experiences life-threatening anti-Semitism:

We don’t want more people to have to die singing.

Antisemitism is real and being stirred.

If the Jewish and Muslim communities can support one another, then others can–and must–also learn to de-escalate.

Rabbi Yisroel Goldstein, of Chabad of Poway, who was injured in the shooting today, wrote this post in March:

Yisroel

If you would like to help in a concrete way, donations are being collected:

Be mindful of neighbors and coworkers who may be very affected by these events and check in with them if you can.

Be safe, and help others feel safe, too. ❤

Targeted Violence in New Zealand Shatters the Peace for All

 

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We are saddened and outraged to hear of the deaths of 49 Muslim worshippers at the mosques in Christchurch, New Zealand. We extend our condolences to the Muslim community in New Zealand and also our Muslim neighbors locally.

A reminder to all that it is important to avoid sharing harmful imagery and materials that primarily publicize terrorist acts and terrorists. This includes the video livestreamed by the shooter, but also stills from the video. One reason is to avoid giving terrorists the publicity they crave, which can also encourage terrorist acts by others.

Another reason is to minimize traumatizing people by making exposure to images of actual violence and killings practically unavoidable as they go about their everyday lives. Traumatic material can severely affect not only those in the specific target group of the violence, but many others as well.

As the above Twitter user has pointed out, instead of giving terrorists free publicity, find ways to help, locally and internationally. Some ideas from others include: showing support and solidarity online or in person, contacting local Muslim organizations to offer help, or donating to specific victim aid.

For Muslims anywhere,

Be mindful of neighbors and coworkers who may be very affected by these events and check in with them if you can.

Be safe, and help others feel safe, too. ❤

Supporting Vulnerable Friends and Acquaintances During Violent News Cycles

Above, Header Photo: Ryan Loew/PublicSource

dpac20memorial13_1466116283934_4884595_ver1.0_640_360   Muslim Women talking

Above Photo: Cox Media/WFTV9

Violence is committed every day, but people in marginalized groups experience violence at considerably higher rates than majority group members, and more often simply because of who they are. For minority group members, this can lead to a pervasive (and frankly, realistic) sense of vulnerability that causes increased symptoms of anxiety, depression, and PTSD, especially when hate-based violence is a news event.

Jeffrey Marsh has some gentle suggestions for being supportive:

Checking in and validating–without pressuring someone to talk or to help you to process–can be helpful, especially if you are willing to simply allow your friend or loved one to have the space to manage their feelings.

Publicly speaking out to or among other majority group members can also be helpful: for example, share a supportive post. But consider sharing a post that does NOT include graphic images or footage of violence. People who live with the threat of violence daily don’t need further exposure and may feel even more vulnerable.

It is common for PTSD symptoms to spike during times of social upheaval, especially for those who are in marginalized groups or who have abuse histories.

Nicole Sanchez, a lecturer at UC UC Berkeley Haas School of Business, has some useful insights about how we can support marginalized friends and coworkers during critical events. She’s talking about race, but much of the dynamics also apply to events affecting LGBTQ folks (and other marginalized groups).

 

(Threadreader compiled version here.)

 

Let people know they are loved and valued and that you want them to be safe, happy, and thriving! ❤