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The interwebs loves to throw around terms for mental health diagnoses all the time and what armchair podcasters think they mean, but a hallmark of every mental health diagnosis is distress or impaired functioning. Impaired daily functioning can take many forms, but one issue that we see on the rise is difficulty opening your mail, email, texts, or phone messages resulting in enormous backlogs of unanswered messages, unpaid bills, and full voicemail boxes that can no longer take messages.
The end result? Friends and family that are frustrated or feel rejected by the lack of response, which may end up in them no longer attempting to contact you, interpreting your behavior as no longer being invested in the relationship. Or it may result in fines, overdue fees, missed appointments, missed court dates, missed tax filing deadlines which in turn may result in more bad news- losing access to your doctor/therapist/psychiatrist/case manager, losing child custody rights, losing a legal battle, or even eviction. Unfortunately, many people who are struggling get caught in a shame spiral and don't disclose what is going on to their loved ones and the problem continues to grow and sometimes involves them too. Some years ago the movie The House of Sand and Fog came out giving a great example of the perils of not opening your mail after a mental health crisis. The movie begins with the main character suffering a loss and going into a deep paralyzing depression. She has difficulty getting out of bed or functioning and stops opening her mail. As a result, she doesn’t realize that she has stopped paying her mortgage and her home is foreclosed on. She is forced out and another family moves in. In her loss, she ends up pulling the new family into further crisis and tragedy. Thankfully, most people’s situations aren’t as bad as the film depicts, but variations of this issue show up in the therapy room on a regular basis. What does this mean? If you see someone you love, or see yourself having difficulty opening the mail, texts, returning calls - recognize it for what it is, possibly an early sign of a mental health crisis or unmanaged ADHD. The person may be struggling with depression or anxiety or psychosis or substance abuse, a financial crisis, or just generally overwhelmed with the demands of life. Their daily lives have gotten unmanageable. They are overly stressed and under-skilled and under-resourced. They have started to use avoidance as a tactic to manage their distress, only ignoring these demons doesn’t make them go away, it just creates a bigger army of them. What do you do about it?
If you are needing help, reach out to us at Healing Reflections Therapy. We have therapists who are ready to help. Author: Megan Garza, MA, LMFT is therapist and co-owner of Healing Reflections Therapy Photo by Chris Scarberry It is disability pride month, and while a lot of disabilities have outward signs, disabilities such as chronic illness and chronic pain are not always visible. How can you help those close to you who suffer from chronic illness and chronic pain? Invisible Chronic Illness and Chronic Pain Chronic illness can come with invisible sources of pain and discomfort. For example, arthritis comes with pain in the joints, and asthma leaves individuals with difficulty breathing and challenges catching their breath after exercise or even minor activities. Some chronic illnesses, such as autoimmune diseases, lead to reduced overall capacity, high levels of fatigue, and daily body aches. In addition to their symptoms, those with chronic illness face increased difficulty completing tasks, have the additional responsibility of balancing and managing medication, and have to rearrange priorities daily. Oftentimes, their illness may prohibit them from fulfilling certain expectations and obligations. Some chronic illnesses and chronic pain conditions may not be visible but are still affecting those with these conditions on a day-to-day basis. In order to understand how someone is feeling, communication is key! Say No to Toxic Positivity. Toxic Positivity is the misplaced over-promotion of the good in the given event while ignoring that the person is facing tragedy, trauma, or chronic difficulties. These phrases usually start with “At least” or “Well, it could be worse” and lead to minimized emotion and empathy for what the person is struggling through. Using toxic positivity is invalidating and not supportive. Listen with compassion and empathy. Managing chronic pain and maintaining a chronic illness comes with surprising challenges at all stages. Having someone to listen to can help alleviate stress and manage larger emotions that come with a lifelong diagnosis. It's helpful to ask questions about the pain and Illness, and to try to understand what the person is going through. By listening with empathy, you can help them feel validated and supported. Ask how you can help. Due to fatigue, pain, and the overall stress of having a chronic illness, it could be helpful to ask if there is anything you can do to help them. Whether it be helping them keep their space clean, running errands, or sitting and chatting, having someone to help relieve the demands on their time and energy can help them later be present with family and friends. When pain flares and fatigue increases, it can be hard for someone to complete the tasks they set out to do for the day, week, or month. Some tasks are not completed at all, as they try to meet the hierarchy of their needs. All they can do is the essentials to survive. If there is something that you can do to help alleviate the constant pressure, it could be very helpful not only in the moment but in the future for that person. Written by Jordan Langley, BA, BS, MA, SMFT Jordan is a Therapist at Healing Reflections Therapy. She is currently accepting clients. Summertime is full of excitement, vacations, outdoor activities, festivals, and celebrations- things that keep us so busy that we don’t seem to have time for that weekly or bi-weekly therapy session.
Go, do the things, enjoy the sunshine! Also, don’t forget to keep up those healthy therapeutic habits and skills in all the excitement! Remember: Therapy happens outside of sessions too.
We are here when summer winds down, but we’re here before then as well. Don’t stress about needing an earlier appointment. In the meantime, check out the article below for some helpful tools our therapists use and recommend. Written by McKayla Robinson, MS, PLMFT McKayla is a Therapist at Healing Reflections Therapy. Schedule with her today. Many problems in work, school, with roommates, relationships, friendships, and families come down to one issue- Boundaries. Boundaries are the invisible lines that define where you end and another person begins. They protect your physical space, emotional safety, and personal identity. Healthy boundaries allow closeness without losing individuality. Healthy Boundaries can sound like: “I am responsible for my own feelings, needs, and actions. Others are responsible for theirs.” Setting boundaries is an act of self respect, not selfishness. It communicates your worth and protects your peace. This table below provides an outline of what different forms of boundaries look like and how it can be problematic when boundaries in those areas are crossed. Setting Boundaries with Family Members
Sometimes when folks are struggling with relationships with their family members they have a difficult time setting boundaries. You cannot control other people, you can only control yourself, but you can request that others be considerate of your feelings. Here are some important key point to consider when setting boundaries with Family Members:
Remember- A boundary without a follow-through becomes a wish, not a boundary. Examples: • If they continue yelling → “I’m going to step away now.” • If they push for personal details → “I’m not discussing that. Let’s change the subject.” Consistency teaches people how to treat you. Focus on What You Can Control You can’t control: •Their reactions •Their opinions •Whether they change You can control: •Your boundaries •Your emotional energy •Your responses •How much access they have to you If you are struggling with setting boundaries with someone in your life, consider working with a therapist to help you develop your skills. We have multiple therapists at Healing Reflections Therapy available to meet your needs. Author: Megan Garza, MA, LMFT Therapist & Co-Owner of Healing Reflections Therapy Here at Healing Reflections Therapy, as we continue to celebrate Pride Month and reflect on the current political climate in our state, nation, and world, we continue to be certain that services from specialized clinicians provided to LGBTQ+ clients continue to be just as if not more necessary and relevant than they were in the past. The statement, “Pride was a riot,” is meant to highlight the fact that the community resistance at the Stonewall Tavern that gave rise to the first Pride events and parades was initiated and encouraged by a brick rumored to have been thrown by a trans woman and by the specific trans women: Stormé DeLarverie, Marsha Johnson, and Sylvia Rivera. The significance of this being two fold, that, although many may assume that only gay men were involved in the events of Stonewall, the entire community was both targeted for oppression in public spaces and showed out to face down police brutality and aggression and also that Pride is not only about celebrating, dressing up, consuming alcohol, but also has a deep historical significance.
Pride was a riot because at the time, members of the LGBTQ+ community did not have body autonomy or control over their own treatment and healthcare. Queer and trans identities were marginalized to such an extent that no one could be out and get proper checkups, STD testing, gender-affirming medical care At the beginning of the AIDS crisis, people were forced to take poisonous meds and obtain them through creative and non medically-sanctioned means. As we know, although strides have been made such as one pill/day HIV meds and hormone replacement therapy (HRT)being readily available on an informed consent basis, there are now constant attacks on Ryan White HIV federal funding and gender affirming care for both minors and adults with state coverage or VA benefits. There have been multiple attempts to ban trans soldiers from serving in the military and take their retirements. Pride was a riot because gatherings of LGBTQ+ folx were criminalized and romantic relationships were not broadly seen as legitimate. Stonewall happened in part because it was illegal for gay and trans people to be drinking at a bar together as well as it being illegal for any sexual activity to happen between anyone and the police response mirrored those prohibitions. How do you connect if you cannot build community? How do you feel safe when there is nowhere at home or in public that you can be yourself and not be arrested. Obergefell Hodges went through in 2015, so gay marriage has only been legal for 11 years. As with all other LGBTQ+ rights, there have already been multiple attempts to take Obergefell to the Supreme Court and have it overturned. This in addition to dozens of anti-LGBTQ+ bills being debated and sometimes passed into law in many states in their country in the past 2 years. Murders of Trans people continue to be so prolific that they are actively tracked and memorialized on Trans Day of Remembrance. Pride was a riot because the Queer and Trans community was being treated as less than human. One need look no further than the plethora of bathroom bills meant to strip Trans people of the dignity to use public facilities and anecdotal examples of strangers policing the genders of others in the restroom with them and making demands to see that it is not safe to be Trans and use the bathroom or even to be someone that anyone things looks different than their assigned sex and corresponding gender role. Policies criminalizing gender affirming care for minors in some states have caused youth and their parents to lose care, have to move to other states, have side effects and poor outcomes from going off of needed medications. Trans adults we see worry that they will need to stockpile their hormones in order to continue to be on HRT once all gender affirming care could conceivable be banned. In some ways, now more than ever, being Queer or Trans means having a target on your back and being unsafe in public, private, even in previously thought of safe spaces. It is almost worse that some headway had been made, rights were conferred and and are now under attack in a manner worse than ever before. As LGBT!+ affirming therapists, we know not just the terminology, relationship structures, and social norms that exist in our clents’ lives, we also realize that they currently fear for their lives, relationships, healthcare and employment. That is why it is more important than ever to stand in solidarity with them and provide one of the only safe holding environments they may currently have in our office and virtually. We see you, we value you, the world is so much better and brighter with you in it! We are blessed to hear about your stories, strengths, and resilience every day. There is nothing else we would rather do. Author: Chris Scarberry, LPC Chris is a Therapist accepting clients at Healing Reflections Therapy Summer is a great time for social events like Pride and Juneteenth festivals, 4th of July celebrations, family BBQs and reunions, weddings, concerts, and camping trips. But for those with social anxiety, PTSD, and agoraphobia, these events can be the source of worry, stress, dread, shame, guilt, and relationship conflict.
I often have clients lamenting that they want a more enriched life beyond their bed or home, but don’t know how to strike a balance with their fear and nervous system dysregulation. They realize that they are missing out on potentially beneficial experiences but are unsure how to best cope with their social anxiety and challenge themselves. One thing that surprises people who have lifelong struggles with anxiety is that it is one of the mental health areas that is highly amenable to treatment when given the right combination of resources and approaches. Does that mean a type A person can become a type B person, probably not, but for those whose lives feel unmanageable, science has proven that collaborative therapy along with the appropriate medications can make a substantial difference in someone's baseline anxiety levels. The bad news is that in order for things to get better, you usually have to get a little bit uncomfortable first; usually through a series of small dose exposures to the situation that causes anxiety and pairing it with relaxation strategies to regulate the nervous system. So what does that mean for managing these big summer events? What can you do to make things better?
Authors: Megan Garza, MA, LMFT, Chris Scarberry, MA, LPC Megan is a Therapist at Healing Reflections Therapy I’m willing to bet that, at some point, someone has suggested that you try journaling as a coping skill. I know I’ve recommended it to nearly every client I’ve had at some point, and I often get a disappointed look and a series of reasons why they don’t or don’t want to.
Maybe some of these sound like you: “I tried journaling, but I couldn’t keep up with it.” “There is too much to write, and I get overwhelmed.” “I’m not Anne Frank, I don’t have anything interesting to write about, so what is the point?” “I don’t want anyone to find my journal and read what I write.” “How is writing down what I ate for lunch and how boring my meetings were going to help me?” Good news! You don’t have to be Anne Frank to journal, and that is not all that journaling is! There Are No Rules
What rules have you put on journaling? Are they holding you back from a potentially helpful coping skill or therapeutic tool? Potentially therapeutic journal techniques include but are not limited to: gratitude journaling, writing about what went well in your day, “thorns and roses,” venting, reflections on your day, insights from your therapy session, notes for things you want to talk about in sessions, processing and exploring a difficult experience or emotion, writing a trauma narrative, stream of consciousness, mood and emotion tracking, art or collage journaling, photo journaling, autobiographical writing, composing a letter to someone you’ll never send, or writing from a prompt. Reevaluate your relationship with journaling and give it another shot. It is one of many ways that can further our therapeutic skills and keep us focused on our goals between sessions. Find what works for you! Author: McKayla Kagie Robinson, MS, PLMFT McKayla is a Therapist at Healing Reflections Therapist. Contact her to set up an appointment. With the days getting longer and the sun rising earlier, now is a great time to evaluate your sleep hygiene. If you’re struggling to get a good nights rest the some of these tips might be for you!
Get up at the same time EVERY morning, regardless of how much sleep you got the night before. Use an alarm clock. A regular wake-up time will help set your biological clock. If you feel you must sleep in on weekends or holidays, allow yourself up to 1 extra hour. Restrict your time in bed. Only go to bed when you are drowsy. Get up if you are not feeling close to sleep within 20 minutes. Likewise, when you wake up in the morning, get up. Do not lie awake in bed. You want to consolidate and deepen your sleep by sleeping only as much as you need and not spending too much time awake in bed. You cannot make yourself fall asleep. If you are in bed 20 minutes and you are still not close to falling asleep, get out of bed, go to another room, engage in a quiet activity (read, listen to music or a podcast, watch a soothing TV show, watch or listen to ASMR) until you feel drowsy, and then return to bed. Do not fall asleep on the couch or in your recliner, but rather return to bed when you feel drowsy. You want to make your bed the place or cue for sleep (not the couch or recliner). You may need to repeat this step more than once throughout the night. Quiet activities and soothing audio can help your body and brain get ready for sleep. You can try a guided meditation on the Calm app or a music streaming app. On Spotify, check out Sleep Cove or Caverncast podcasts for soothing voices. Look up Restful Rambles or ATMOSPHERE for ASMR on tiktok or youtube. You can also find white noise on most platforms or buy a noise machine. Use the bed only for sleep and sex. Do not read, watch TV, eat, scroll social media, play video games, worry, talk on the phone, or plan your day in bed. You want to establish the bed as a cue for sleep and not as a cue for other activities that are incompatible with sleep. Establish a pre-sleep ritual. Schedule some "down" time right before bed. This is not the time to check your email or have that heart-to-heart talk with your partner. Those things need to be done earlier. Schedule time early in the evening for working on problems or planning the next day's "to-do" list. Right before bedtime is the time to relax, calm down, and let your body and mind slow down before hitting the bed. Set up a regular routine before bed: brush teeth, put the dog out, lock the doors, set the alarm, etc. Do not nap during the day. Sleeping during the day disrupts sleep at night. If you must nap, try to keep naps to less than one hour and finish them by 3 p.m. Exercise regularly: For insomniacs, the best time to exercise is in the late afternoon or early evening, but not within 3 hours of bedtime. Exercise helps deepen sleep and reduce stress. Food and Fluids: Do not go to bed hungry; however, avoid a heavy meal before bed. Finish eating your evening meal at least 3 hours before bedtime. Do not snack in the middle of the night, or you may encourage nightly awakenings for food. Decreasing liquids close to bedtime will minimize nighttime bathroom trips. Caffeine has a half-life of 3-7 hours and interferes with everyone's sleep, even those who deny it. Discontinue caffeine 4-6 hours before bedtime. This includes iced tea, colas, Dr. Pepper, Excedrin, chocolate, Sudafed, and all sorts of other things you never suspected. Read the label. Alcohol or cannabis near bedtime may help you sleep in the first part of the night, but causes multiple awakenings later in the night and shortens sleep overall. Try to avoid alcohol 2 hours before bedtime. Nicotine is a stimulant, even though smokers claim it helps them relax. If you must smoke, reduce the rate of smoking before bedtime and do not smoke if you wake up in the middle of the night. Noise: Insomniacs are usually hypervigilant and thus are more sensitive to noise. Consider earplugs or a white noise machine (or even a bathroom exhaust fan) to block out noises Temperature in the bedroom: 75° is too hot and increases awakenings; 54° is too cold and can cause bad dreams. Insomniacs often report being hotter than good sleepers. Find a bedroom temperature that works for you. Most people prefer 60°- 68°. Comfort: Make sure your bed is comfortable, and you have the right amount of light/darkness in the bedroom that works for you. Clock Watching: You will either sleep or you won't, and watching the clock does not facilitate sleep. In fact, clock watching usually just causes anger or anxiety, neither of which helps with sleep. Try not to look at the clock if you can't sleep. Exposure to bright light in the morning will help if you have sleep onset insomnia. Sitting in front of a southern exposure window (without sunglasses) for at least 30 minutes every morning should help decrease your time to fall asleep at night. Try this for 5-7 mornings. Using cell phones and other devices can contribute to insomnia by reducing the production of melatonin (due to the blue light) and increasing mental stimulation. Stop using your phone at least 30 minutes before getting into bed and put it into do-not-disturb mode. Consider using a classic alarm clock rather than your phone to wake up in the morning if the distraction is too tempting. Natural sleep aids include melatonin, herbal/sleepy time tea, camomile tea, and valerian root. Some use benzodiazepines (benzos) and THC to induce sleep, but those are habit-forming and can create a dependency. Benzos are not meant for daily use, are highly addictive, and should only be used as prescribed. Prescription meds may be helpful in some cases. Individuals with PTSD can talk to their doctor about trying Trazodone. Sleep tight and may you find good rest tonight! Modernized & Adapted by McKayla Robinson from "Instructions for Better Sleep" by Bertelson Washington University Sleep Center, March 2005 McKayla Kagie Robinson, MS, PLMFT is a therapist at Healing Reflections Therapy, currently accepting clients to help you if you are struggling to manage your sleep challenges. Our day-to-day lives are chaotic and filled with distressing news, world events, and other causes for stress that we have no control over. Meditation practice has long been established as a path towards mental, emotional, and physical healing. The mind-body connection is one that is often neglected. You may have tried meditation before and decided it is not for you for one of the following reasons:
Meditation has a lot of misconceptions tied to it, and a lot of the concerns people have when trying meditation revolve around those misconceptions and set them up for feeling like failures. The goal of meditation does not have to be to reach the point where you can meditate for hours, with no thoughts, and full control over your mind and body to the point where you can levitate off the ground. We’ll save those aspirations for the Monks. The goal of therapeutic meditation is simply to practice. Practice checking in with your body, emotions, and thoughts. Practice slowing down enough to be able to communicate with your body, recognize your emotions, hear out your thoughts, and spend some time addressing the concerns brought to your attention. We are not looking for a blank slate- we are looking for what we have been ignoring or neglecting. Another great benefit to practicing meditation is learning how to engage or disengage with your anxious thoughts. The meditation linked below is called a “Leaves on a Stream” meditation. The idea is to practice observing your thoughts, especially the anxious ones, as they come up, acknowledge them, and then let them continue flowing downstream without attaching any judgment or action to them. I encourage you to try it out! It is less than 10 minutes long and is something you can do from anywhere during your day. Now, it will not be something that you are automatically good at, and it may go differently each time you practice it, depending on your headspace when you start. However, the only objective here is to try. Try it, practice it, and keep practicing it. If you do that, you have succeeded! You will have connected with your mind and body even for just 6 minutes, and that is 6 more minutes of connection that you would otherwise have. Despite my encouragement, you may not believe that meditation can make a difference, but I dare you to try it and be curious about what effects it can have." Author: McKayla Kagie Robinson, MS, PLMFT McKayla is a Therapist at Healing Reflections Therapy. She is currently accepting clients. |
AuthorSMegan Garza, MA, LMFT is a certified Specialist in Treating Trauma at a Supervisory level and is Licensed as a Marriage and Family Therapist. She specializes in work with complex trauma, sexual abuse survivors, and relational therapy. Archives
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