Do Not Suffer in Silence

Too many times people feel alone in their darkest times and never receive the support that they need. COVID-19 brought to light for many the importance of social interaction as a human being. I want you to know that you never have to be alone.

An important part of the therapy process is safety planning for those dark moments. A safety plan is not a guarantee of safety, but when practiced regularly and incorporated into day-to-day life, it can be an important way of minimizing harm. Safety plans often have 5 steps: Identifying triggers, using coping skills, reaching out to supportive friends/family, utilizing warmlines/crisis lines, and calling emergency services.

When you are able to identify the things that ignite dark thoughts or feelings, you are able to recognize what coping skills to utilize. Sometimes that isn’t enough though. I encourage those with a safety plan to really lean into those support persons. Notifying them when you originally make your safety plan with your therapist that you are identifying them as a support person. Talk to those individuals about how they may support you during a difficult moment. What can they do/say to help increase your safety. You could even supply them with a copy of your safety plan. Having a “safe word/phrase” so you can quickly and discretely notify them that you need assistance (the “notOK” app is a free application that can do this for you). This prepares both yourself and your loved ones for a crisis situation.

There are lots of ways to access mental health resources in a time of need…

Therapy Apps:

oscER San Diego

Headspace

Ayana Therapy

It is also important to be aware of crisis resources in your community. Below I have provided a list of warmline/hotline numbers for various crises:

National Suicide Prevention Lifeline: 1-800-273-8255

National Domestic Violence Hotline: 1-800-799-7233

National Trans Lifeline: 1-877-565-8860

Crisis Text Line: Text “HOME” to 741741

California Warmline: 855-845-7415

Trevor Project (LGBTQ Youth Lifeline): 1-866- 488-7386 or Text “START” to 678678

National Child Abuse Hotline: 800-422-4453

If your crisis has elevated to an Emergency situation please contact 9-1-1 or head straight to your local Emergency Room.

Teletherapy: Reasons to Offer and Participate in Virtual Mental Health Services

Being quarantined means being open to alternative forms of everything you normally do outside of your home. Trips to the gym are now Youtube workouts, brunch with friends is now group texts with an exponential amount of emojis, and trips to your therapist’s office is now teletherapy from the comfort of your couch. For therapists and those participating in mental health services, this can be an unwanted, but necessary shift. Participating in teletherapy services (aka telemedicine) is a great way to connect however, and access mental health services for both the professional and the client.

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Reasons Why Teletherapy is a Positive Alternative

  1. Ease of Access: Utilizing teletherapy means you can access therapy appointments from virtually anywhere. For mental health professionals licensed in California, that means being able to provide mental health services to any resident in California from Sacramento down to San Diego. It also means clients don’t have to travel too and from an appointment or find parking or hit traffic or miss their appointment all together.
  2. Best Fit with Therapist: Over the years, I have had many clients move to find better opportunities for their life, but a sense of continuity was felt when they knew they could continue seeing me from their new location within the state. Teletherapy also allows you a wider selection of therapists/clients to work with as you are not confined to those located within a 30 mile radius. Having options means being able to find the therapist that can best understand your story and guide you to the change you want to see in your life.
  3. Feeling Comfortable: Being able to talk to your therapist/client from the space that is most comfortable for you can make a huge difference. Having control over your space can be a invaluable part of being able to open up in your therapeutic process. I have personally noticed that from my first sessions with a client to my closing session with a client, there is definitely a difference in how they and I dress (yoga pants make a regular appearance) due to finally feeling more comfortable in that therapeutic relationship. Utilizing teletherapy means having some of that comfort on the front end of your journey and meeting your goals on your terms.

The Downside of Teletherapy

As with anything there are pros and cons to teletherapy, and highlighting one side with out the other would be unfair to you. Fortunately, the major cons of teletherapy have less to do with the therapeutic process and more to do with technology’s short comings. At the end of the day, teletherapy is a fancy term for Facetime with your therapist. Although, teletherapy should be used on a HIPAA compliant platform (such as doxy.me, Simple Practice, Vsee, etc.), if you’ve ever used a video conferencing application you know that poor connections, cyber security, and “hello. hellloo?” moments can all be a damper on a good conversation. Making sure you are in a safe space with a good connection is an easy fix to this problem however.

For therapists, our number one priority is always your safety, so it is smart to go over the nearest emergency room, emergency contacts, crisis line numbers, and any other safety precautions that can be made prior to starting your mental health journey.

With all this in mind, feel free to reach out for a 15 minute phone consultation, so you can see if teletherapy will be a helpful tool on your therapeutic journey!

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Engagement Anxiety: How You Really Feel After They Pop The Question

Did you get proposed to at Christmas? New Year? Your birthday? Or are you expecting a proposal on Valentine’s Day or at another upcoming celebration? Whether you were recently proposed to or hoping to take your relationship to the next level, here’s some ways to manage the anxiety that often follows…

There are a lot of big moments in your life, and getting proposed to is arguably in the top 5. The society we live in has created a billion dollar business off of couples committing themselves to one another. You may be knees deep in bridal magazines, color swatches, Instagram feeds of brides and grooms and venues…oh my! And although everyone may ask you, “How did they propose??”, very few may ask, “How are you feeling about getting married?”

Cue the engagement anxiety.

Everyone expects you to be smiling from ear to ear for the next year or two as you plan the “biggest day of your life”, but you may feel as if nothing but stress and worry and doubt are flooding over you. Some brides-to-be (or Grooms-to-be) may start finding small things to nit-pick about their partner…”His teeth aren’t white enough.”, “Her toes are strange”, “They don’t understand me!” Things you didn’t even notice before become these huge question marks looming over your relationship.

Where does this anxiety come from? Is it normal? And what do you do about it?? Here’s 5 steps to resolving your engagement anxiety…

black girl1. Be Aware That You Are Not Alone

Engaged women all over the world are panicking at this very moment about whether they should get married or not…they just aren’t telling anyone (other than their therapist). So you are not alone. You are allowed to have some anxiety about a new life transition and how your role in your relationship might change as a fiancé or spouse. There is no other time in life when you make a commitment to stay with one thing/person, literally forever…even kids leave the nest after 18 years. If there was a list of “legitimate reasons to be anxious”, this would definitely be on that list.

2. Recognize What Role Anxiety has Played in Your Life

Step 2 is to realize that anxiousness is present for different people at different times. Some people have dealt with crippling anxiety their entire lives, and are not surprised when this anxiety shows up in the middle of the proposal. Others have never felt anxious at all, so anxiety about their engagement feels extremely scary and completely new. Recognizing other times you have felt anxious allows you to recognize what skills you used to calm yourself down, and also allows you to recognize what may have been a trigger for this bout of anxiety. These questions you ask yourself may very likely be questions you also hear in a therapy session with your counselor.

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3. Do Some #SimpleSelfCare

When people hear “Self Care” they often think of a day at the spa or a vacation, but the key to good self care is consistency and small doses. Doing something as simple as buying your favorite coffee creamer to put in your instant coffee in the morning, or setting your alarm 10 minutes early so you can cuddle with your partner in the morning before you start your busy days. Those are the most effective ways to take care of yourself…what I call #SimpleSelfCare. Doing these little things will help reduce your level of anxiety and remind you that you are in control of how you feel. Being mindful of your breathing is another small adjustment that can have a big impact.

Some practice…breathe in (hold it)…1…2…3…4…5…breathe out. *Repeat until anxiety has subsided*

4. Communicate with Your Fiancé

Let’s be honest all this engagement anxiety is your partner’s fault. They just had to divulge their undying love for you in the form of a proposal. But really, if your anxiety is truly wrapped up in the engagement it is very important to talk with your partner about how you are feeling. Chances are they may already have noticed a shift in your demeanor or behaviors due to the anxiety. Discuss with them what is triggering to your anxiety and give suggestions on how they can help make you feel more comfortable. Whether that means them rubbing your back if you have a small panic attack or them chiming in when another person asks, “Have you set a date??” (*Side Note* that is honestly the most annoying question). Cluing your partner in to how you are feeling is a skill that is important now, and will be important for the rest of your relationship, so might as well get in some practice.

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5. Go to Premarital Counseling

Last, but definitely not least…go to premarital counseling! I know that I am biased because as a therapist I recommend therapy for any and all things, BUT this is one of the most ideal times in a relationship to go through couples therapy (it’s also one of therapists’ favorite stages to see a couple in). Premarital counseling is ideal because (hopefully) there aren’t any real problems in the relationship yet. This is the stage that you can really take a look at your partner and say I want to love this person unconditionally, and I’ll take whatever tools necessary to make that happen. When couples come into therapy 4, 7, or 10+ years into a marriage with a laundry list of reasons they want out, therapists often spend most of their time trying to get couples back to this place of wanting to try their hardest. Go now, so you can talk about all those little concerns and start building your tool box of skills that help you communicate with and love on your partner in all the best ways!

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The Mental Health Continuum: Why Mental Health Looks Different for Everyone

Worried Wells to Severe Mental Illness. What is “mental health”? What does it look like? Is it a permanent diagnosis or is it an ever changing state of mind?

The answer is…it depends. I will admit this answer was something I heard a lot as I studied for years to become a therapist. That is the nature of the work however. Mental health is just as important as physical health, but it is not treatable in the same ways. “Mental health” is on a spectrum. Some individuals go to therapy to discuss small issues that come up on a day-to-day basis. While others go to therapy to manage chronic on-going mental illness. Mental illness is a diagnosable, physiological illness that manifests itself in psychological ways, such as clinical depression, bi-polar disorder, schizophrenia, autism spectrum disorders, and many other diagnosis that are manageable with the correct assistance from a professional.

Example time. If you have a common cold, you will most likely be taking the same medicine as someone else who has a cold. And you both will most likely get better in approximately the same amount of time. Now if you are depressed, you may not be utilizing the same treatment as someone else who is depressed. Because each person’s mind thinks differently, handles stress differently, and responds differently to external stimuli. Therapists have the unique job of taking the time to figure out the right treatment for your mind specifically. Therapy is completely individualized.

There are various ways to approach mental health issues including : self care, talk therapy in an outpatient environment, medication management with a psychiatrist or primary care physician, inpatient care at a rehabilitation center or hospital setting, as well as multiple holistic approaches to maintaining a healthy lifestyle.

woman in white tank top standing on concrete surface

Self care can be a simple solution to managing stress and minor mental health concerns on a day-to-day basis. This often emphasizes the holistic approach to maintaining a healthy mental state. A change to your diet, regular exercise, incorporating self care activities, and socializing with trusted family/friends can all help maintain a lifestyle that encourages a healthy mental state. However, for many managing all these aspects of your life can become overwhelming or maybe you have never felt quite balanced in all of these areas of your life.

Seeing a mental health professional in an outpatient environment (such as a private practice setting or local mental health clinic) can help assist you in getting on the right track in all these areas. Mental health professionals include Marriage & Family Therapists, Licensed Professional Clinical Counselors, and Clinical Psychologists. Seeking out one of these professionals allows you to dedicate an allotted amount of time to talking through the aspects of life that are causing stress, anxiety, sadness, anger, and a plethora of other emotions. Exploring with a therapist where these emotions stem from, how they are affecting you, and solutions to managing these feelings better can greatly improve your mental health. You may see a therapist for a few months or a few years, but the ultimate goal is to get you to a place where you can manage on your own with self care techniques and greater knowledge of your emotions. A mental health professional can also help you discover if a mental illness is what is encroaching on your ability to cope with your life.

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When managing a true mental illness, you want to seek out a Psychiatrist, Mental Health Nurse Practitioner, or your Primary Care Physician to consult with your therapist about the possible inclusion of medication in your mental health treatment. These individuals play a vital role in order to coordinate with your team of mental health professionals. This team works with you to find out what methods of treatment will work best for you as an individual. No two mental illnesses look the same or are managed the same way. Whether it is various dosage levels of medication or frequency of therapy appointments, each individual managing a mental illness will have a unique treatment plan. This team will most likely assist you over an extended period of time and teach you how to reach out for additional help when needed, as a mental illness is often chronic and needs to be managed over your life. Remember though that you are the coach of this team, informing your providers of what feels right, what works best, and describing the experience you are having with all aspects of the treatment.

Inpatient care is what mental health professionals often refer to as “the highest level of care”. Some of the autonomy of the individual is lost at this level because it often dwindles down to the safety of the individual and those around them. The treatment is often decided for the individual by a team of professionals trying to diminish the client’s symptoms and protect them from any harm. For some clients this process begins with a threat of harm to themselves or another identifiable person. Police often become a partner in this treatment process, as they are often the first responders when someone calls for assistance during a suicidal or homicidal threat. They are also usually the ones who admit a client to a hospital for psychiatric treatment. Hospital staff at that point become that individual’s treatment team. This is considered a short term treatment option. The goal is to stabilize certain symptoms and identify a “lower level of care” that can help the individual learn how to cope with their symptoms regularly and prevent emergency situations.

This spectrum of mental health is what makes finding the right fit with a therapist so important. Depending on the challenges you face, your background, the level of care needed, and many other factors one mental health professional may be more helpful than another. You walk on a unique mental health path, and must choose the right team to walk alongside you. Where are you on your mental health journey, and how can therapy be of assistance to you?

If you are in a crisis or emergency situation please contact the Access & Crisis Line at 1-888-724-7240 or call 9-1-1.

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6 Easy Ways to Cope with Holiday Stress

The holidays are suppose to be a time filled with joy, love, and cheer! Unfortunately that is not always the case. The holiday season (arguably the day after Halloween to the day after New Year’s) has become one of the most stressful times of year for individuals, couples, and families alike. That’s why it is so important to identify your coping skills (and exit strategies) before participating in all the holiday “cheer”.

holiday stress

Take a Deep Breath

Before you walk into those bustling malls, step into the front door of those relatives hosting dinner, or before any moment of stress…take a deep breath. Slowly breathe in through your nose for 5 seconds, then release slowly through your mouth for 5 seconds. This slows down your heart rate and allows you to step into these spaces feeling calm and prepared for the moment.

Go for a Pre- or Post-Meal Walk

Those big meals can be delicious, but between the extravagant preparation, heated discussions at the table, and the amount of carbs consumed… a walk can be a good way to de-stress. Find your favorite relative and convince them to take a stroll. It’s a great way to quietly catch up with your family and take a break from the kitchen chaos.

Sit at the Kids Table

This may be more stressful for parents, but if your the fun aunt or uncle (or slightly older cousin) it can be a great way to avoid all the “so when are you going to [fill in the blank]?” questions from the adults. When you are anticipating painful conversations, why not save yourself the stress and catch up with the little ones, and learn about the new dances sweeping the nation.

Have Your Comeback Ready

You know all your family’s buttons. You know who is likely to ask those annoying questions or make those slick comments. Do your homework ahead of time and make mental note of all the reasons they shouldn’t be talking. If you aren’t one for comebacks, try some “I statements” at the table. For example: I feel [frustrated, attacked, annoyed, etc.] when I’m asked about [my love life, school, work, etc.] because [it is a private matter, I don’t want to discuss stressful topics, I want to enjoy my dinner, etc.], so please refrain from prying anymore.

Choose to Not Participate

Just because you are invited to events does not mean you have to attend every one. Between festive outings, holiday parties, and family dinners, the holidays can be overwhelming. Choose to attend the events where you will feel most at home, whether that is a friends-giving or a crazy sweater party with your favorite cousins. Choosing to travel on your own or stay close to home are all options that can help replenish your soul for the new year. Figure out what works for you!

Start Your Own Traditions

Last, but not least…create new traditions that are aligned with your own personal values and beliefs. The holidays are about resetting and realigning with those things that drive you everyday. Take some time out for yourself to identify your values and what new traditions you would like to establish to put those on display.

close up of two flute glasses filled with sparkling wine wuth ribbons and christmas decor

All this to say, I hope your holiday season is one filled with peace, love, and happiness in whatever form that finds you. May you find support from those around you and calm in your moments alone. If you are in crisis please reach out to the Access & Crisis Line at 1-888-724-7240 or text “HOME” to 741741.

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