Post-Election Depression is Coming, So Be Gentle With Yourself

If you’ve noticed yourself feeling more fatigued, sluggish, numb, or even down since the election, you’re not alone.

For some people, it might come as a surprise that a period of time they associate with feelings of relief, hope, or even joy could also be a time when depression symptoms show up. But it actually makes a lot of sense when you consider one compelling theory for why we get depressed in the first place. [1]

Most people will probably experience depression at some point in their lives. It’s pretty much the common cold of mental illnesses. But unlike the common cold, which is caused by a pathogen that enters the body, depression is something the body does to itself. Given how destructive depression can be, and how it can disrupt just about every facet of human functioning, why would our brains be able to do this shitty thing to us?

Continue reading “Post-Election Depression is Coming, So Be Gentle With Yourself”

Post-Election Depression is Coming, So Be Gentle With Yourself
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One Year, Three Months, and Sixteen Days

Grayscale photo of waves on a beach.
Photo by Gerard Pijoan on Unsplash

One year, eight months, and twenty-eight days ago I unraveled.

Six weeks post-op from my final surgery, I found out that cancer wasn’t quite done with us yet. My mom had it too.

I lost a lot of things that spring—my words, my composure, my pride, my sanity, my optimism, quite a few friends—but thankfully not my mom. Unlike my own cancer, there were no silver linings. I lost a lot but found nothing. I learned nothing, either, least of all how to live in a world without my mom in it. That lesson, I suppose, is for another day, a day I’ll try not to think about much until it comes.

I guess I did discover something about myself, though I’m not sure if I’d call it learning. I found a part of myself that words don’t touch, that speaks no language. Even my own possible death didn’t strike this part of me. But hers did.

Continue reading “One Year, Three Months, and Sixteen Days”

One Year, Three Months, and Sixteen Days

Seven Meditations for Moving Forward

A path through a forest.
Photo by Lukasz Szmigiel on Unsplash

I.

What are you feeling right now? Name it. Name them all–there are probably more than one or two.

A feeling is any word or phrase that can come after the words “I feel” without needing the words “like” or “that” to make it fit. I feel scared, I feel horrified, I feel jealous, I feel hopeful, I feel alone.

Imagine yourself sitting comfortably in a cozy room. Picture whatever makes a space feel safe and accessible to you. Maybe you’re on a beanbag chair, up against the back wall, and on the other side of the room from you is a door.

Imagine that each of the emotions you’re naming is walking through that door and sitting down in the room with you. They’re not coming to fight you, debate you, or do anything other than sit with you, but they all have something to say.

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Seven Meditations for Moving Forward

The Expanding Staircase

Square spiral staircase
Photo by Elena Kuchko on Unsplash

The following is a work of fiction, based on my experiences working with clients but not a reproduction of an actual session with a specific person.

My office, any given day:

— It just feels like I’m not making any progress. I mean, I know I’m making progress, but…it just doesn’t feel like it.

— Yeah. It’s hard to keep going when you can’t tell where you are.

— Yes, it’s like, I keep doing the things that are supposed to help—getting in to see you, getting in to see the psychiatrist, getting the referral for the assessment, starting the medication—but each step takes such a long time, and then that psychiatrist turned out to be unable to do the assessment, and then when I finally got the referral and scheduled it, it turned out they don’t even do those assessments either…

— Does it feel like those steps—for instance, getting in to see the psychiatrist or starting the medication—are getting you to where you want to go?

— Not really, because the psychiatrist couldn’t do the assessment, and the medication isn’t really helping so now I have to try another one.

— Right. It’s frustrating when the steps you take don’t seem to “count.”

— Exactly. Like, if the medication isn’t helping, did that step really take me anywhere?

— What does your gut tell you?

Continue reading “The Expanding Staircase”

The Expanding Staircase

“But You’re a Therapist!”

It can be weird being open and vulnerable with others as a person who also happens to be a therapist. People are sometimes very surprised to hear that their therapist friends also, believe it or not, struggle to understand their partners, get petty or irritated, feel abandoned, lash out at people, avoid flossing or exercising or initiating difficult conversations, or feel judgmental. For example.

I’ve been hearing the refrain “But you’re a therapist!” since—actually—before I even technically became a therapist. (Back then it was, “But you’re going to be a therapist!” Yes, and? You’re apparently going to be a millionaire or a bestselling author one day, and yet.) I even see therapists themselves throwing this at other therapists in some of the Facebook groups I’m in. That, combined with actually becoming a therapist and hearing a lot about how other people think, has given me a lot of opportunities to reflect on what causes people to say this.

People seem to be of two minds about therapists. Either we are fully self-actualized human beings who float through the world with the gravity-defying force of our own impeccable coping skills and preternatural ability to sense others’ thoughts and intentions; or we’re all “crazy” and “broken” and got into this field either to wallow in our misery along with our clients, exploit those clients, or use them to somehow fix our own unusually severe mental issues.

Obviously, I highly dislike both of these stereotypes (though the latter is of course more offensive and ableist). The reality is that most people will experience some sort of significant mental distress at some point in their lives, therapists included, and experiencing it early in one’s life can be a motivating factor when it comes to choosing a career path.

But I think there’s more going on here than just stereotypes about particular professions, and I think it reflects a common misunderstanding of how therapy works. Continue reading ““But You’re a Therapist!””

“But You’re a Therapist!”

A Support Role Taxonomy

Close-up of a life preserver.
Photo by Jametlene Reskp on Unsplash

A universal human dilemma: you need social support, but the type of support you need isn’t the type you’re getting.

You just want to vent, but your partner jumps in with advice. A sick person gets tons of gifts, but all they really want is someone to come over and spend time with them while they’re stuck in bed. Everyone wants to come hold the newborn baby, but nobody’s offering to do the parent’s laundry or make some meals for them.

This is complicated by the fact that most people find it difficult to articulate exactly what they need in terms of support, especially when they’re already in a rough spot. Even if they do know, and could verbalize it, many people feel like they shouldn’t look a gift horse in the mouth. So, sure, you don’t need all those nauseating frozen meals while you’re dealing with chemo, but at least they were nice enough to think of you, right?

It can help to learn how to identify what it is that you do need and how to communicate that to people. On the flip side, it can also help to learn which types of support you’re best suited to providing and look for opportunities to do those things—as well as to be careful not to push those types of support onto people who don’t need or want them.

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A Support Role Taxonomy

Back Through the Fire

Smoke after a forest fire.
Photo by Joanne Francis on Unsplash

[Content note: cancer, illness, suicide]

In November, I had my last cancer-related surgery. My temporary tissue expanders were replaced with permanent breast implants, and I was instructed to give my body six weeks to recover, after which I could return to my usual activities.

After five weeks and 6 days, I gave in and started exercising. It was almost the New Year. It was deep winter, a time of planning and setting things in motion. I was finally done with treatment, and I was ready to live again.

So for the next six weeks, I lived. I worked out almost daily. I started my private practice. I made plans. I designed a backyard garden. I took classes, learned new things. I took on new roles at work. I returned to freelance writing.

For six weeks, I lived. I was determined to get back everything I’d lost to cancer, and then some. I enjoyed my time with family, unburdened at last by the demands of treatment or recovery. Having emerged unburnt from the fire, I felt that nothing could stand in my way.

For six weeks I lived like a person reborn. This lasted until February 13.

That day my mom told me she had cancer too. That day, my newfound momentum sent me clear off what I now realized was a cliff, and like the coyote in the cartoon, I looked down and found myself unmoored, unsafe, and spiraling down.

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Back Through the Fire

Speaking Gently to My Body

I’ve always criticized what I’ve sometimes called the chocolate-and-bubble-baths model of self-care, where a series of supposedly “pampering” actions is supposed to somehow replenish you and make you ready to face the world again.

But I think I’ve found the usefulness of these types of activities, and the answer, as usual, lies in mindfulness and intentionality rather than escapism and consumerism.

I used to have a lot of body image issues, and then I found feminism and did a lot of personal work and (I thought) resolved them. Then cancer hit and a lot of that work completely undid itself. Suddenly I was standing in front of the mirror saying shit to myself that I hadn’t said for a decade. That was weird.

But by 2019 my body and I had arrived at a sort of uneasy truce, held together by 1) it not having cancer and 2) me practicing intuitive eating and engaging in regular movement that feels good to me.

And then I got a severe flu, went to urgent care, was not diagnosed with the severe bacterial infection I also coincidentally had, and ended up hospitalized for two days on a near-constant drip of IV antibiotics.

Continue reading “Speaking Gently to My Body”

Speaking Gently to My Body

My Zine, “The Girl Survives Cancer in This One,” is Now Available!

Banner for "The Girl Survives Cancer in This One." Visit bit.ly/GirlSurvives

As you may know, I’ve been writing a book of essays about my experience as a breast cancer survivor. Last month, I decided to publish a zine that collects some of the essays I’ve written so far, to put my writing out there and build some interest in my book.

It ended up being a very fun project (my first zine!) and although I didn’t end up with the old-school photo-copied look I originally planned on, it’s very pretty and the writing is very much the focus.

A photo of the inside of my zine.

It’s now available on Etsy in digital format for $4, and as a paperback for $8. You can even get the paperback signed! Who knows, maybe it’ll be worth something one day.

If you want to get updates on my book as it progresses, you should subscribe to my newsletter here.

I hope many of y’all buy it and read it, and don’t forget to leave a review on Etsy!

A photo of the cover of my zine.

My Zine, “The Girl Survives Cancer in This One,” is Now Available!

Building Blocks of Mental Distress: A Dimensional Assessment of Mental Illness

This is a cross-post from my professional blog, where the most updated version of this will be.

The field of mental healthcare has its roots in medicine. The earliest mental health professionals were doctors—psychiatrists. Like medicine, psychiatry and clinical psychology are based on the process of assessing patients’ symptoms, performing some sort of test if needed, assigning a diagnosis, and creating a treatment plan based on that diagnosis.

This is a very sensible approach for most medical issues. If I appear at my primary care doctor’s office complaining of persistent headaches, she shouldn’t just treat the headache by prescribing a painkiller. She should refer me to someone who can figure out what’s causing the headache, and then treat that condition, whether it’s extreme stress, a head injury, a bacterial infection, a brain tumor, or some other problem.

Even though we’ve been treating mental health issues this way for at least a century, it’s not the best way to treat them. And many psychiatrists, therapists, and researchers are starting to realize that.

That’s why we’re finally starting to see approaches to assessment and treatment of mental illness that move away from the much-argued-about diagnoses in the DSM, and sometimes away from the concept of mental illness altogether. Psychologists such as David Barlow, Rochelle Frank, and Joan Davidson have been working on so-called transdiagnostic approaches[1]; the newest edition of the DSM includes a chapter about a proposed new way to diagnose personality disorders that’s based on specific personality traits rather than broad, stigmatized labels[2].

I’m looking forward to the day when the field as a whole has shifted to these types of approaches entirely. For now, I needed a tool I can use with clients to help them (and myself) understand what they’re dealing with and access helpful resources and support. So I created my own informal dimensional assessment.

Continue reading “Building Blocks of Mental Distress: A Dimensional Assessment of Mental Illness”

Building Blocks of Mental Distress: A Dimensional Assessment of Mental Illness