Sunday, June 1, 2014

"Snapping"

In the wake of yet another mass killing in the United States and also as a therapist that at times has very tough calls to make regarding whether a client will "snap" by homicidal means, it is my hope that the media will stop with sensationalism and focus on becoming a part of the solution instead of capitalizing on what are essentially red herrings to a much more complicated and deeply entrenched issue that is mental illness and how and when to intervene when a mentally ill individual verbalizes threats to the public/humanity. How many more tragedies have to occur before police, mental health professionals, and politicians can put their ideologies aside and use their collective emotional and social intelligence to cultivate a systemic change in how we heal or improve the brokeness of emotional stability and wellness in the USA? I would love to see some mental health workshops on crisis intervention/duty to warn with clients who express homicidal ideation because as far as I know this isn't out there and needs just as much attention as suicide prevention training. I'd be curious to hear what other therapists think about this. With the way our mental health system is currently set up, our hands are tied to intervene unless there's imminent threat and yet there's no solid definitive boundary on what constitutes threat....and people are being killed in part because of this ambiguity in mental health and police intervention.

Friday, October 4, 2013

The best "teachers"

Sometimes the best "teachers" in life are those individuals that challenge and remind you of your integrity, kindness, and compassion in the face of their lack of humanity. Resentment, nasty criticism, and self-righteousness make for the perfect cocktail of the ego's dark side. I've never really understood why people hold on ever so tightly to resentment when it's counterproductive to their own sense of well-being and overall happiness in life. Granted, resentments can pop up for anyone (myself included) at times in life...but what makes a difference is whether you allow them to fester or examine it, work through it...and let it go, for your own sanity and well-being above all else. It's just not worth it. Yet so many are stuck in their ego (being "right" or "better than" another infallible human being). For the person on the receiving end of a "grudge" or a resentment that cannot or will not be forgiven, this can trigger uncomfortable and unpleasant feelings. One may feel angry, guilty, unworthy, maybe even "attacked." Depending on experiences you've gone through in life and grown from (or not), you can choose to take it personally or move forward (preferably without those toxic people and situations).

I got to thinking about this "perfect cocktail" tonight as I reflected on how that truly has been the theme of the day. Maybe there's a lesson in there for me. I had a client talking at length about anger and resentment he harbors against a family member. He acknowledges that she may never change but has been unable to let go of it, so much so that his resentment triggers self-destructive behaviors and sometimes leads to a drinking relapse. His resentment hurts him more than it hurts the family member.

Interestingly, I was on the receiving end of some nasty criticism and resentment tonight. Last night I had emailed someone from my past that I had not communicated with in quite some time. I won't go into the specifics here because it's too personal to blog about, but basically the only reason I contacted this person was to let him know about a friend's death. I felt compelled to let him know because if it wasn't for him, I never would have known this friend who was such a huge, loving presence in my life. My email was well-written, informative and to the point. Nothing was brought up about the past. I even expressed gratitude for having met my friend because of him. I was pleased with what I expressed.

The response I received, however, was completely opposite. It was fraught with resentments from the past, fueled by his judgments of both myself and my friend with an incredibly self-righteous demeaning tone. Even in light of my friend's death, this individual still chose to hold on tightly to his ego and discard any sense of humanity. Some people just never learn. Some people would rather be assholes and say or act somewhat abusively to puff up their own sense of "power" than be kind, forgiving, and compassionate. I've encountered this same M.O. from a few other individuals over the years and while in the past I felt very emotionally wounded by this kind of viciousness (for lack of a better description or interpretation), I quickly bounced back from this particular incident tonight. I was shocked and slightly upset by the unexpected harsh words for a short time, but in the overall scheme of things I chose to not take it personally nor embrace his words as truth or reality.

This is is what I have learned from the best unkind "teachers:" Life is too short to hold onto the bullshit. I don't know about you, but I'd rather hold onto the good: kindness, love, compassion, gratitude, peace, and self-acceptance.

With that said, I'd like to make a shout-out to all the assholes that have been a part of my life. Thank you very much for teaching me to not be like you.

Wednesday, September 25, 2013

Interview with a high school student

Last week a good friend of mine (a high school English teacher) asked me if I would be willing to help out one of her students by allowing the young girl to interview me for a research paper assignment on a career path she is interested in pursuing (counseling, possibly in drug and alcohol addiction). Never having been interviewed before other than for job interviews, it was an interesting experience. I had much more to say than I would have thought...and I could have said even more. Here's my one hour of professional "fame:"

How long have you been in this career?
I started my first job working with heroin addicts at a methadone clinic in Chicago, IL in June 2005. I worked there until March 2008. I moved to Washington at that time and got a job working at a community mental health agency that provides counseling and case management services to low income individuals who struggle with mental health and/or chemical dependency, which is where I still currently work (I mainly do mental health counseling now, but I have several clients that struggle with addiction as well/are in recovery so I still do some addiction/recovery counseling as part of my work).

What education did you need/have to take?
Well, I'm not sure how to answer this question because it really varies depending on whether you want to pursue something very specialized (such as to specifically do chemical dependency counseling only) or if you aren't sure yet and want to see what's out there. If you are wanting to do work in chemical dependency, more than likely you will need at least a BA degree in social services and most places will require a MA in Substance Abuse/Chemical Dependency. In the state of WA you may be able to complete a certificate program to be a chemical dependency counselor without having to obtain a master's degree. Regardless of whether you decide to pursue a master's degree or a certificate program, you will need to study and pass a licensing exam so that you can do that kind of counseling/apply for jobs in the chemical dependency field. It's important to note too that the requirements can vary depending on the state. Unfortunately, the requirements to practice (nor the educational requirements) are not exactly the same in every state....so if you think you'd like to move out of state one day, keep this in mind for your career choices.

What college did you go to?
I got my BA in Psychology at Texas State University for undergrad and got my MA degree in Marriage and Family Therapy at the Adler School of Professional Psychology in Chicago, IL.

Why did you pick this profession?

I was always a "helper" when I was younger, but there were a few experiences that started steering me more in that direction when I reached high school and then college. I took a psychology class my senior year of high school and was intrigued by the subject matter...what makes people tick, why they do what they do...and how it's tied into how they make sense (or not) of their experience in the world. Then in college I took a sociology class (I think it was called "Love, Romance, and Marriage" or something like that). We had a marriage and family counselor come to the class one day as a speaker to talk to us about her job as a therapist. That's when I started thinking it sounded like something I could see myself doing. I was always trying to figure out the relationship dynamics in my family and if it was possible for people to be happy and healthier in relationships. After I graduated college, I searched online for graduate schools and came across the Adler School. I saw they offered an MFT program and I made my decision. Although I don't do marriage and family counseling with that degree, I love being a therapist. I love being a part of people's journey...helping them with their struggles and being a part of their healing process/personal growth.

What are your hours?

As I work in an agency setting, I work 9am-5pm Monday through Friday.

What would you recommend to another future therapist for their hours to be?

It really just depends on whether you plan on working for yourself (in a private practice) or if you'll be working for someone else (agency/company). There's more flexibility if you have your own private practice, although you may not be guaranteed financial security/stability if you have to find clients on your own.

Do you have vacation time? If so, how much vacation time do you take throughout the year and how do you separate the vacation time?

Yes. I try to space out my vacation time evenly throughout the year, typically every 2-3 months. I try to take some vacation time with holiday time that way I can give myself a longer vacation without using all my 'vacation' days, especially during the winter months. The longer I've been in the profession, the more I'm aware of how long I can go before reaching "burn out" phase...which is why I like to take time off for myself every 2-3 months, usually 4-5 days (including weekends that I already have off).

What is your salary range?

$30,000-40,000

Has your salary increased or decreased through the years?

Increased, although not enough. Good thing I'm not in it for the money. :)

Do you have any physical/emotional stress? If so, how do you deal with the stress so that you don't take none of your patients' problems?

Physical/emotional stress from the job or my own stress? There's always a fluctuating level of both personal and work related stress that I constantly have to be aware of and keep in check. It was very hard when I first started my career as I had to learn how to manage stress and wasn't very balanced about it. I've definitely cultivated a much more balanced approach now that I've been a therapist for over 8 years now. It depends on whether the stress is physical or emotional. If it's physical, I make sure to eat healthy, exercise, consistently get enough sleep, and if I don't feel well most times I will not go to work because I notice I'm not able to be an effective therapist if I'm not well/can't focus on my client due to my own pain/ailments. For awhile I also used to get regular massages (covered by my insurance, so I only had a $20 copay, which was great!) and that helped with both physical and emotional/mental stress. For emotional stress, I ask for help and support if I need it...whether it's talking to or spending time with family or friends or getting extra support with my own therapist. I also remind myself that as much as I enjoy helping people, I cannot make changes for them and can only guide them, give suggestions, feedback,etc. I leave work at work. Rarely do I spend time thinking about work stuff outside of work and rarely do any work paperwork at home. Keeps me sane!

Do you have any coworkers? If so, are they also drug and alcohol counselors too?

Yes, I do have coworkers. There are three other therapists in my office that are part of the counseling "team," but they only do mental health counseling.

How are you evaluated on your job and how you do with your patients?

I have a supervisor that I meet with regularly for 30-60 minutes twice a month. Once a year (around the time of year that I was hired) she completes an evaluation based on my performance for that year, which is largely based on what she observes that I'm doing and/or what I share (about my clients, my workload, issues that come up,etc) during our supervision meetings. I'm evaluated on various aspects of the job....my strengths as well as areas for improvement. As part of the evaluation, goals set for the year are reviewed to see if I've accomplished/completed the listed goals as well as coming up with goals for the new year ahead.

What are the advantages and disadvantages of this job?

This is a great and also hard question to answer. There are alot of complexities to being a therapist, which can be both an advantage and disadvantage....an advantage in that it pushes you out of your comfort zone and can motivate you to always try something new, be creative, and really be present with each unique client that comes to you for help. This can be both scary, anxiety producing, and also interesting. If you like people and like being the person they turn to for help, it can be very rewarding. The cool thing about being a therapist is that I sometimes learn things from my clients and am also constantly pushing myself to grow too.

The disadvantages can be numerous, so you really must have a passion for this kind of work in order for the advantages to outweigh the disadvantages. Disadvantages: Not everyone that comes to you wants help nor is always necessarily ready to be helped/make changes (patience and compassion is essential for the therapist). You can't expect to be appreciated/thanked. The pay isn't great. There's a high risk for burn out and health problems if you don't find balance with self-care and separation between work and personal life. Sometimes you will have things going on in your own life that may make it very hard at times to "give"/help effectively at work and you still have to go to work/do your job even when you have your own problems (again, this is why self-care is a must!). You will see the best in people as well as the worst/dark sides (advantage and disadvantage, depending on what's going on and your perspective on humanity).

What options or other job opportunities has this job opened up for you?

My current job has allowed me to learn and gain significant experience in trauma work as most of my clients have an extensive history of trauma (physical, sexual, and or emotional abuse). I knew almost nothing about mental health disorders (especially PTSD) prior to my current job. My first job working in addictions actually opened up doors as far as helping me get the job I have now as there is an increasing need/demand for chemical dependency counselors. It's easier to find a job if you have experience working in addictions as there aren't enough people trained to do it as there are mental health counselors (at least that was the case when I was looking for a job back in 2008 when I moved to WA).

What are the skills required for this job?

You must be compassionate/have empathy for people, be a great listener, have a thick skin (learn not to take things personally), have healthy professional boundaries, and have a reasonable knowledge/understanding of addiction/mental health (with the help of what you learn in school and doing a clinical internship before you start your first professional job). I'm sure there are more skills but that's all that immediately comes to my mind.

What training did you have to take for job in high school, college, and any other extra thing?

High school and college I took psychology courses to get a basic understanding of psychology and the human mind. Graduate school focused specifically on courses that would help me learn "how to be a therapist." After I got my master's degree I studied and took an exam to get my counseling license. I currently have a license as a mental health counselor ("LMHC) and as part of maintaining my license, I have to complete 34 or 36 credits of continuing education (by attending seminars, workshops,etc) every two years. Chemical dependency counselors have their own licensing requirements. I'm not sure what their requirements are, but you can find them listed on the Washington Department of Health website for details.

Monday, July 8, 2013

Book therapy

This book literally moved me to tears on at least a few occasions. Having lost someone as close and dear to me as the author did, I could relate all too well to the magnitude of all encompassing seesaw of emotions and existential questioning that follows. I enjoyed reading how Sankovitch transformed her pain with the healing salve of her most reliable of "saviors:" books. I can wholeheartedly identify with the healing power of books, which has always been my most comforting of friends during not only the best times of my life but also during painful times, lonely times, and times of challenging transitions. Sankovitch takes readers on a one year journey, reading one whole book for each day of the year. As she reads, she also reflects and finds connection that leads her to a place of gratitude, joy, and a sense of purpose.

With that said, I highly recommend this book to everyone (especially bibliophiles) and leave you with the following quotes that really spoke to me:

"For years, books had offered to me a window into how other people deal with life, its sorrows and joys and monotonies and frustrations. I would look there again for empathy, guidance, fellowship, and experience. Books would give me all that, and more."

"The world shifts, and lives change. Without warning or reason, someone who was healthy becomes sick and dies. An onslaught of sorrow, regret, anger, and fear buries those of us left behind. Hopelessness and helplessness follow. But then the world shifts again--rolling on as it does--and with it, lives change again. A new day comes, offering all kinds of possibilities. Even with the experience of pain and sorrow set deep within me and never to be forgotten, I recognize the potent offerings of my unknown future. I live in a weird world, shifting and unpredictable, but also bountiful and surprising. There is joy in acknowledging that both the weirdness and the world roll on but even more, there is resilience."

"Words are witness to life: they record what has happened, and they make it all real. Words create the stories that become history and become unforgettable. Even fiction portrays truth: good fiction IS truth. Stories about our lives remembered bring us backward while allowing us to move forward."

"The only balm to sorrow is memory; the only salve for the pain of losing someone to death is acknowledging the life that existed before."

"The purpose of great literature is to reveal what is hidden and to illuminate what is in darkness."

"Sharing a love of books and of one particular book is a good thing. But is is also a tricky maneuver, for both sides. The giver of the book is not exactly ripping open her soul for a free look, but when she hands over the book with the comment that it is one of her favorites, such an admission is very close to the baring of the soul. We are what we love to read, and when we admit to loving a book, we admit that the book represents some aspect of ourselves truly, whether it is that we are suckers for romance or pining for adventure or secretly fascinated by crime."

"In reading about experiences both light and dark, I would find the wisdom to get through my own dark times."

"Maybe that is what love is: the taming of desire into something solid and sustainable."

"We all face mysteries--'Why did that have to happen?'--that we will never be able to understand. But we can, and we do, find order somewhere, whether it be in our books, our friends, our family, or our faith. Order is defined by how we live our lives. Order is created by how we respond to what life dishes out to us. Order is found in accepting that not all questions can be answered."

Thursday, May 23, 2013

Healing through Grief

During a Skype conversation between my best friend and I (he was in India and I was in the US) in September 2012, my best friend of 6 years told me "Katie, no matter what happens, I will love you forever." The second most heartbreaking phone call I've received in my adult life came just two months later when my other best friend called me on a Monday morning in mid November. "Katie, he's gone."

I've experienced deaths of loved ones in my life (one of the most painful of my childhood occurred when I was just 11 years old)....but none of them have been quite as emotionally painful as the sudden, unexpected loss of my young, kind, and loving best friend. One day while talking about the difficulties of managing my grief/loss while still going to work and trying to be a good therapist to my clients, an intern whom has been doing clinical assessment training with me told me about this book.

"Healing Through the Dark Emotions" salved the emotional pain in my psyche like nothing or no one else could during these last 6 months, for which I'm incredibly grateful. Miriam Greenspan is not only a therapist whom offers professional insights, she has been through her own personal battles with grief and loss as well. Instead of perceiving it as a hopeless negative, however, Greenspan seizes the pain as an opportunity for potential growth. She encourages readers to look deeply within themselves with compassion and curiosity, urging them to surrender to the pain instead of resist it....because as painful as it feels to do so, it is more fruitful to embrace it than let it fester into destructive pain that leads to addiction and overall health dis-ease.

If you're looking for a meaningful (possibly life changing)grief and loss book that strays off the beaten path (ie, one that is not pop psychology-ish), this is the one for you.

Sunday, February 10, 2013

Along the axis of Time

If time was relative to a particular person, place, or situation.....would we go about our lives any differently? Would we feel more free to do as we please or more anxiety if the concept of "future" did not exist in our minds? Would our relationships be more meaningful or would we feel hopeless that anything could change without the passage of time? Would our mental health be better with no memory of painful events from our past? What if time wasn't constant but broken up into episodes with the ability to hit 'pause' buttons in between? What if there was nothing to 'measure' time? Would we be more productive? Would we be more creative and carefree....or lazy with no goals, nothing to show for? Would we experience beauty more vividly and more appreciation if time was a quality and not a quantity?

Such questions are asked by Alan Lightman in "Einstein's Dreams," an incredibly beautiful poetic novel that curiously and creatively explores the precious value of 'time' in our lives. A good friend of mine suggested this book to me years ago and I finally got around to reading it. I'm glad I did as it is by far the best fiction novel I've ever read. It touched me deeply on a mental, emotional, and spiritual level. It's resonated with me on such a visceral level that I'm having a difficult time articulating it into words.

Coincidentally enough, I started reading the book as 'time' became more present on my mind and in my life....though more from a negative standpoint. I've been feeling annoyed and pissed off at Time these last few months, particularly when it comes to time zones (don't even get me started on how challenging it is to coordinate talking on the phone with family and friends because of this pesky concept) and that feeling of constantly being busy yet not having enough Time to do all that I would like to do....or Time to 'just be.' Or the yearning to hit the 'rewind' button and relive those past episodes with the knowledge (from the future) that I will not see a particular person in a year's time because he will have died by then, thus savoring every moment with him. This excerpt from "Einstein's Dreams" resonates so true:  "In a world without future, each parting of friends is a death. In a world without future, each loneliness is final. In a world without future, each laugh is the last laugh. In a world without future, beyond the present lies nothingness, and people cling to the present as if hanging from a cliff."

I cannot recommend this book enough. I'd even go so far as to say it should be required reading. The world might be a little brighter and joyful if people took these concepts to heart and somehow integrated it into living a meaningful and purposeful life....

Here's a teaser of my favorite excerpts:

"In a world where time is a sense, like sight or like taste, a sequence of episodes may be quick or may be slow, dim or intense, salty or sweet, causal or without cause, orderly or random, depending on the prior history of the viewer." 

"Suppose that time is not a quantity but a quality, like the luminescence of the night above the trees just when a rising moon has touched the treeline. Time exists, but it cannot be measured."

"In a world where time cannot be measured, there are no clocks, no calendars, no definite appointments. Events are triggered by other events, not by time."

"In a world where time is a quality, events are recorded by the color of the sky, the tone of the boatman's call on the Aare, the feeling or happiness or fear when a person comes into a room. The birth of a baby, the patent of an invention, the meeting of two people are not fixed points in time, held down by hours and minutes. Instead, events glide through the space of imagination, materialized by a look, a desire. Likewise, the time between two events is long or short, depending on the background of contrasting events, the intensity of illumination, the degree of light and shadow, the view of the participants."

"In this world, time is a visible dimension. Just as one may looks off in the distance and see houses, trees, mountain peaks that are landmarks in space, so one may look out in another direction and see births, marriages, deaths that are signposts in time, stretching off dimly in the far future. And just as one may choose whether to stay in one place or run to another, so one may choose his motion along the axis of time. Some people fear traveling far from a comfortable moment. They remain close to one temporal location, barely crawling past a familiar occasion. Others gallop recklessly into the future, without preparation for the rapid sequence of passing events."

What have you done/what are you doing/what would you like to do with this powerful and beautiful Time?

Tuesday, January 22, 2013

Sliding doors

As I was driving home from my boyfriend's place tonight, I got to thinking how much my life feels a bit like the movie "Sliding Doors" the last two months....except instead of seeing two alternate realities of life based on choices made or not made, my alternate realities exist because of life circumstances that happened within close proximity to another. One amazing door opened shortly before another heartbreaking, tragic door closed.

I met my future boyfriend on October 23, 2012 and the best most loving friend I've ever had in my 35 years on this planet died November 19, 2012. As you may imagine, this turned my world completely upside down. I thought, "What the hell, universe? How could you open such an exciting door of possibility at the same time you took away the one person who often knew me and loved me better than I knew and loved myself?" This made absolutely no sense and totally fucked with my head, more so my heart. I felt angry. I felt confused. I felt guilty for focusing so much on this new man in my life and more so for being happy in his presence when I *should* have been in mourning 24/7 after Rajiv's death (or so that critical side of me told myself).

Two months later and it still feels weird, though I'm not going through extreme emotions anymore. Now I just find myself thinking of my life experiences and memories in terms of two significant time periods: "Before Dragos" and "After Rajiv." In order to understand the significance of these time periods, I must explain why I see my life via these 'sliding doors.'

Door #1, "Before Dragos" (there was Rajiv)

Anyone who knows me well knows that I have relationship issues (or lack thereof would be more apropos). One would think that most 35 year old women have had a plethora of significant other relationships, including even being married by that age. Not me.There have been men I briefly dated, exciting crushes that fizzled out/went nowhere, and developing feelings for male friends. All of them had two things in common: emotional unavailability and no prospect for long term potential.

Though I met my best friend Rajiv a year or two prior to approaching my 30's, he knew my terrible romantic history all too well. Not only did he know my history well, he had this almost magical power of predicting my romantic future (for good or bad) when I'd give him a snapshot of my experiences with a particular guy I was feeling unsure about at the time during our six and a half years of friendship. He was almost always right, my magic 8 ball best friend. "Outlook not so good." "Most likely." "Don't count on it."

While I usually felt clueless when it came to men romantically, Rajiv grounded me and brought me back to reality. His perspective always helped me in some way, even when he said something I didn't want to hear. In some strange way too, I feel like I got 'practice' to completely be myself with a man....open, honest, and intimately knowing one other (minus the romance/sex aspect). He didn't know it, but he was "preparing" me for an emotional intimacy I would soon also share with Dragos.

Here's where the sliding doors emerge.

Door #2 "After Rajiv" (Taking risks without my magic 8 ball)

It's now been 3 months since Dragos and I started dating, 3 weeks now into the 'in a relationship' stage. Rajiv died before I even had a chance to tell him about Dragos. The first man with whom I'm truly embarking on a new and exciting relationship (and chapter in my life) and the man whom loved me so completely unconditionally for the good, bad, ugly and everything in between....these two will never meet, will never know each other, will never know me through the eyes of the other. I will never get to share with Rajiv all the exciting "firsts" I have experienced or will experience with Dragos....or the various thoughts and feelings I have as the relationship progresses. I'll never have my magic 8 ball to give me the thumbs up or thumbs down on this man, though sometimes in my mind (when I'm spending time with Dragos) I picture Rajiv smiling at me or laughing with me.

Dragos will never know what a gift Rajiv gave me....that of feeling worthy of a caring, intimate relationship and capable of going beyond my comfort zone despite how scary it feels because the rewards far outweigh the perceived costs. Dragos will also never know how little things he says or does at times remind me of Rajiv in a funny or comforting way.

These sliding doors that initially gave me an existential crisis now give me an abundance of opportunities....that of love, meaning, growth, and most especially the confidence to become my own magic 8 ball.

Love you always and forever, Rajiv. "It is decidedly so."