Guest Blogger: Anne Miller-Uueda, LCSW
Taking care of Emotional and Spiritual Needs
Do something you like. A lot of activities are restricted right now, but not all. Maybe re-read your favorite book, have a dance party in your kitchen to your favorite song, do a puzzle, knit, take a bath, listen to music, sit on your front steps and listen to the birds, write, create art, cook, bake, play with your pet or child, color, read poetry…
Laugh! If you can, find something that always makes you laugh. It could be clips of your favorite late-night host or comedian on YouTube, your favorite Shakespeare comedy, your favorite video of your two-year-old imitating your partner, a comedy podcast – anything!
Practice self-compassion. Try to talk to yourself as kindly as you would talk to a friend. We can often be much harder on ourselves than others.
Practice mindfulness. Mindfulness is simply being in the moment. This is much easier said than done, and it is often so worth the practice it takes. Focusing on your breath or engaging with your senses are a couple ways to do this. There are many other ways to practice mindfulness and many mindfulness resources are making some of their content free right now (see the resources at the bottom of this blog for a few suggestions).
Get outside and notice nature. There are many places that you can be outside and stay 6 feet from others. If you are having difficulty accessing outdoor spaces, you can sit on your front steps or even be by an open window for 15 minutes a day.
Access your spirituality. This can look different for everyone but try to be in touch with your higher power or access your version of spirituality. You know your belief system best, so you know how to best do this.
Guest Blogger: Anne Miller-Uueda, LCSW
Basic self-care essentials
As public health officials and healthcare providers around the country and the world try to slow the spread of COVID-19, most Philadelphians, indeed most Americans, have been told to stay at home. While this is so important for public health, it can be hard on an individual’s mental health. For those who have pre-existing anxiety or depression, or a history of trauma, staying at home and interacting with the realities of this crisis can exacerbate symptoms. Self-care, while not a cure-all, can certainly decrease vulnerability to increased anxiety, depression, and trauma symptoms, as well as help us manage some of the intense emotions that are coming up for so many people right now.
Self-care during this time may look different than it used to. Prior to this crisis, many people would go to the gym, socialize with friends, participate in recreational sports, sing in community choirs, and other out-of-the-home activities. While we are being asked to engage in social distancing, these things may not be possible. That does not mean self-care is not possible. The rest of this blog will provide some ideas about ways to engage in self-care right now. However, remember, self-care is a personal thing and it is important to experiment to find out what works for you.
Move. As much as you are able, be intentional about moving every day. This could be going for a walk or run outside (while trying your best to stay 6 feet from other walkers and runners of course!), doing an exercise video, engaging in some self-guided yoga or stretching, walking up and down your stairs, chasing your kids around the living room – anything that gets your body moving within your ability.
Eat healthy. Try to pay attention to what you are putting into your body. Boredom can be a trigger for many people to eat, drink alcohol, or use other substances. Experiment with noticing if you are eating or drinking in ways that are different. Try to keep healthy food in your home so that when you are hungry you have a healthy option available.
Sleep. If you can, try to keep a regular sleep schedule (I recognize this is difficult for folks doing shift work). Even though many people’s schedules have gone out the window being at home, as much as you can try to stick to a regular bedtime and wake up time. We sleep best when our body knows what time we are going to bed and waking up each day. In addition to keeping a regular schedule, sleep is improved by:
Limit news and social media. It is imperative to know what is going on right now and the current recommendations. At the same time, it is generally not helpful for people to spend several hours a day reading the news. Try to pick one or two places you will get your updates. There has also been a lot of misinformation being circulated on social media, so check your sources.
Pay attention to your thoughts and feelings. When you are able, check in with yourself – notice what you are thinking and what you are feeling. Try naming your feelings. If you are having thoughts that are leading to anxiety or depressed feelings, ask yourself:
Practice gratitude. Explore noticing that for which you feel grateful every day. You might even consider starting a gratitude journal – just write down three things a day for which you are grateful.
Shower and get dressed every day. It can really help your mood to get out of your pajamas, even if you are not putting on normal work clothes, or at least not normal work pants.
Stay connected. Friendships and connection enhance well-being. Socializing during this time is difficult. As you are able, try to keep your connections and friendships alive, even while you cannot be face-to-face. Call, video chat, write letters, play virtual boardgames, listen to the same radio station and dance to the same songs, text, send smoke signals (ok – maybe not the last one, but try to keep in touch).
Engage in meaningful activity every day. Many people have a lot of extra time on their hands right now (many other people have a lot less extra time on their hands). If you do have a lot of extra time, it can be easy to sink into a bog of mindlessly watching Netflix. Experiment with being intentional about doing something meaningful every day. For some people this could be their work or the parenting they are already doing. For others this could be learning something new, creating art, writing, dropping off groceries for an elderly neighbor, or volunteering to help keep non-profits running through the city of Philadelphia (https://www.phila.gov/2020-03-19-philadelphias-response-to-covid-19-how-you-can-help/ ).
Written by: Kaycee Beglau, PsyD
As the coronavirus continues to spread across the United States and the world, many of us are left looking towards the internet for creative ways to meet some of our physical, emotional, and social needs. With the growing government restrictions and orders for social distancing, sheltering in place, and the closing of all non-life sustaining businesses, the opportunity to begin in-person therapy is likely to be extremely limited. This is, of course, occurring during a time when many of us are experiencing unprecedentedly high levels of fear, panic, anxiety and worry, isolation, loneliness, sadness, grief and loss, among other overwhelming and complicated emotional reactions. Under more typical circumstances, I imagine many folks would be quickly trying to find a new therapist to help them process and cope during these overwhelming times.
As it currently stands, if someone wants to begin therapy, they are left with understandable questions or concerns about what it would mean to meet a new therapist for the first time online and to begin working with them in this manner without ever having met them in person, or wondering if this is even a realistic possibility at all. Let me start by saying that, yes, it is possible to begin a new therapy remotely or online.
Although online therapy (also referred to as telehealth, telemedicine, virtual therapy, distance therapy, telepsychology, web therapy) has been around for many years, it has recently been growing in popularity among some office-based therapists, and also because of the development of several text-based or app-based companies offering only distance therapy options. Even so, I believe most people (both therapists and clients alike) would agree there are potential downsides and costs to receiving therapy in this format, with something being “lost” without the ability to be physically in the same room with one another in a fully embodied way. While downsides to online therapy will not diminish during the coronavirus crisis, the potential benefits of starting to work with a therapist remotely, will likely outweigh the costs, particularly if you can begin working with a local therapist who can eventually transition into in-person therapy once it is deemed safe for everyone to do so.
Some of these potential benefits may seem rather obvious, such as having increased contact with another human being, being able to receive support, and learning new ways of coping with overwhelming feelings. However, there are many other potential benefits, that may include:
If you are emotionally struggling or suffering, or could even just use some more support, please do not hesitate to contact local therapists and inquire about their current procedures for beginning therapy remotely. It may be helpful to write down a list of questions or concerns ahead of time, so that you get a chance to discuss these prior to your first session. I know this may seem like a lot of work during an already overwhelming time, but many therapists have already made this transition successfully and are eager to help provide support during this time when it is needed the most.
Guest Blogger: Anne Miller-Uueda, LCSW
The aftermath of trauma is often isolating. There may be emotional, cognitive, physical, and behavioral changes that seem confusing. For folks who experienced trauma as a young child, these impacts are at times a part of life as far back as they can remember. Sometimes it can be hard to believe that others who have not experienced these effects can truly understand what you are experiencing as a survivor. Individual therapy is hugely impactful, if not vital, to help heal from trauma. However, having an individual therapist tell you that what you are experiencing is a normal reaction to trauma feels different than hearing another person describe an experience you recognize. This is one of the reasons that group therapy can be so impactful for survivors.
One of the best-known writers on group therapy is Irvin Yalom. He identified 11 curative factors in group therapy. All of these factors have a deep, resounding impact on trauma healing in the group setting. However, I want to focus on just 2 in this post: instillation of hope and universality.
What is instillation of hope? It is the process of increasing belief that life can be better, or even good. This process is driven by watching the successes of other group members and having one’s own accomplishments recognized by the group. When you bear witness to the healing of others it can help you truly know that healing is possible.
Universality is the concept that you are not alone in your suffering. Being in a group with other survivors normalizes your experiences and helps people to feel less alone. When isolation is a part of your daily existence, it can be monumental to be truly seen and heard by another person with a similar experience of walking through the world.
So, at what point in the healing journey does it make sense to participate in group therapy? Groups can play a role at all points in the healing journey, but different types of groups work better at different stages of healing. Acute debriefing groups give opportunities to share experiences of trauma directly after the fact and are most often offered when a community has experienced some type of disaster that impacts many of its members. Support groups are generally time-limited, help survivors cope with the impacts of trauma, and begin to establish safety. Support groups can be found at many agencies in Philadelphia, such as WOAR Philadelphia’s Center Against Sexual Violence. There are also longer-term processing groups. These groups are most helpful later in the trauma healing journey when some baseline ability to handle anxiety and stress has been established. They can provide a space for members to reconnect to the here and now, reconnect to community, further understand and change the way trauma is carried within the self, and make meaning of the traumatic experiences. If this sounds like a good fit for you at this point in your healing journey, you may want to consider joining our Trauma Healing Group here at Turning Leaf Therapy by filling out our interest form.
Guest Blogger: Emily Potter Cox, MA, LPC, CYT
Howard Stern shares why he avoided and then embraced therapy
A LOT of people have reservations about going to therapy.
What really happens when you sit and talk with someone, anyway? Does it work? Do they just want to take your money? It is not uncommon to have fears and reservations about starting or continuing with therapy, ESPECIALLY if you have seen a crappy therapist in the past. If you have---I’m so sorry. Like all professions, some of the practitioners are not as competent as others. BUT-- when you find that right person and you get that *click*, it is worth it!
Have you been thinking about therapy for a few years? Perhaps you want to make some changes in your life, but are unsure if therapy is the right step? Your fears and hesitations are normal! If you have been thinking about therapy for a few years, perhaps you want to make some changes in your life but are not sure if therapy is the right step--your fears and hesitations are normal. Many people have hesitations and reservations about going to therapy. Here, Howard Stern shares what kept him from therapy, why he finally started it, and what he got out of it. Hint—He’s a fan.
I’ve listed TWO podcasts below. If you are generally offended by Howard Stern, I recommend his interview with Teri Gross in Fresh Air. You are least likely to be offended listening to that one. If you don’t find Howard Stern offensive, I recommend his interview with Conan O’Brien on the podcast Conan Needs a Friend. It is 3 hours long, but in between penis jokes, he talks about his experience in therapy. They discuss a number of themes, including depression, but if you want to skip to where they discuss therapy, it is around the 50:00 min mark.
See the links to the podcasts below:
Fresh Air with Teri Gross Interview with Howard:
Conan interview with Howard:
Written by: Kaycee Beglau, PsyD
Whether it’s a friend, relative, or partner, we sometimes find ourselves with someone who suddenly begins to experience the acute effects of trauma. This typically presents as sudden fear or panic, flashbacks, intrusive negative thoughts related to the trauma, or dissociative states where the person appears to “not really be there” anymore. Of course, these experiences may be frightening, confusing, and overwhelming for the person experiencing them, and they may also be for the person witnessing them as well. If you are in a relationship with someone who frequently experiences these symptoms in your presence, it may be beneficial and empowering to have a sense of what might be helpful for the person in that situation.
However, it is important to note that the purpose of this article is to highlight some quick and concrete strategies to help the person re-orient or “ground” during or after an acute trauma reaction, and it is not intended to imply that anyone in a personal relationship with another trauma survivor should take on the role of being an actual therapist. Think of the information in this article as a “first aid kit” for flashbacks – it’s to help you when you need it and should not be used in place of actual treatment from a trained professional.
What to Look For:
What to Do:
1. DO NOT TOUCH someone (even a loved one) in an active flashback.
This may be extremely triggering for them and the physical touch may inadvertently be experienced as part of the traumatic memory/flashback. As they are starting to come out of it and are becoming more oriented, it’s ok to ask permission to touch them (for example, placing a hand on their shoulder, a safe embrace, or using touch to guide the person to a better location). If they say “no” or appear to shutter or recoil, respect this as an indication the person does not want to be touched at that time.
2. Do not ask them to talk about the flashback details.
It’s ok to ask if they are having a bad memory or if they feel like something bad is happening to them right now. It’s important to keep in mind that if a person is having a flashback, they are overwhelmed and flooded. This is not the time to try to get them to talk about anything related to the trauma. They need help coming back to the present moment, regulating their nervous system, and feeling safe again.
3. Orient to present time and surroundings.
Identify yourself and announce where you are and say something present-oriented, such as your name and relation to the person, even if they know you well. Let them know where you are and remind them they are safe in the present moment. For example: “Laura, this is Sarah, your sister. You are here with me in your house in Florida. It’s May, 2019. It’s just me and you and nothing bad is happening to you right now. You’re safe here with me.”
4. Use a warm, but firm voice to give instructions.
Again, continue to use a warm, but firm voice consistently. The person may be relying on the presence of a supportive voice to “guide” them out of the flashback experience. You can continue to say things like:
Key Points to Keep in Mind:
Guest Blogger: Katie Fries, LCSW, RPT
1. Hold assumptions at the door
It can be very easy (and understandable!) to assume that the struggles you faced in middle school are the same ones your child will experience: mean girls, peer pressure, opening lockers—you name it. And while some of those fears seem to stand the test of time (have they changed those dang padlock lockers?!), others will change based on both new forms of communication (like social media) as well as your child’s individual strengths and challenges. If we assume that children are concerned about peer pressure and talk with them all about how to “say no to drugs” when what they are actually concerned about is where they will sit at the lunch table, they may end up feeling unsupported and be less likely to disclose about the things that are actually stressing them out. A couple of helpful questions to ask are: “What are you most excited about?” and “What are you most nervous about?”. Asking those questions not only normalizes the feelings of excitement and nervousness, but it also gives them the opportunity to express what they need from you. That support may be similar or different from what was originally imagined.
2. Provide opportunities to practice
Often the fears a child holds can be minimized by knowing what to expect. The fear of being late to class because they weren’t able to open their locker can be greatly decreased by becoming an expert at opening a padlock at home. The fear of getting lost in the hallways can be solved by walking from class to class before the first day of school. The fear of knowing how to say no to a party while saving face can be decreased by creating a plan or code word to use if they need you to assert that they’re not allowed to go out. While many schools offer the option of a tour for incoming students, if your child seems particularly anxious about starting somewhere new, it might be worth asking for a private tour of the space to assuage those fears. Again, it is important to attend to your child’s individual needs, as practicing or rehearsing something unnecessarily can unintentionally send the message that you doubt their ability to manage new situations.
3. Take care of yourself!
Having a child transition to a new phase of life can bring up feelings of joy, grief, and uncertainty. Fears can easily arise such as: “Will my child be okay?” “Have I prepared them well enough?” and “What can I do to make sure my child doesn’t have to go through what I did?”. To avoid the trap of projecting anxiety onto your child, it’s a good idea to be curious about and validate any challenges during transitions that come up for you. This way you can accompany your child on their own journey in a way that’s healthy for them. Some of the challenges they will face will mirror your own, and some will be different. Knowing you believe in their capacity to manage stress and navigate this new time in life is the most effective way to help them have that same confidence in themselves!
Written by: Kaycee Beglau, PsyD
Beginning therapy for the first time or with a new therapist can be a scary, terrifying situation. This can be true for anyone, but especially for people who have experienced any kind of abuse or trauma. There may be a part of you that acknowledges you need help, but another part (or parts) of you that are afraid to seek help or believe that it is pointless. Having the ability to trust another person with these deepest, darkest aspects of yourself or your history may seem impossible. Still, it may be terrifying to even think about talking about the trauma or abuse, and you may believe this is what will be required of you in order to be in therapy. Additionally, many people with trauma or abuse histories have, unfortunately, had bad or traumatizing experiences with therapists or other mental health professionals. Of course, if this has happened to you, it understandably makes it even more difficult and scary to make the decision to try therapy again.
These are just a few of the things that can make it difficult and scary to seek help from a therapist. Still, therapy has the potential to offer a healing relationship, increased stability, and hope for the future. Although it may feel like a risk, seeking help from a healthcare professional is a healthy risk.
Here are 5 steps you can take to make finding a new therapist a little less scary.
1. Do Your Research
Chances are, if you are reading this post, you are really good at finding information on the internet. Many people find their therapists online, and are used to reading therapist profiles, websites, blog posts, etc. While this is a great place to start, it doesn’t have to stop there. Feel free to look up the school and program where the therapist graduated from and any trainings attended. If a therapist reports using a specific therapeutic approach or technique that you are not familiar with, take the time to look into it. Make sure it looks like the therapist’s background, training, and approach are consistent with your thoughts and the direction you want to go in therapy. Although this does not ensure a good fit, it can help give you some peace of mind, knowing as much as possible about the potential new therapist.
For people with a history of severe or prolonged childhood abuse, dissociative symptoms, and/or self-injurious or suicidal thoughts/feelings, I highly recommend finding someone who specializes in these problems.
2. Ask for an Initial Consultation
Many people do not realize you can “therapist shop” or meet with multiple therapists to interview them before actually starting therapy. This can help take some of the pressure off and give you some space to get a sense of what might be the most helpful for you and to reflect on your feelings without feeling “trapped” or “obligated” to return. Therapy works best when there is a good fit between the therapist and the client. There is no point in trying to force a good fit, when there is likely a better fit out there.
As a psychologist, if I am aware someone is interested in interviewing me prior to beginning therapy, I often offer a free initial consultation. It is perfectly ok to ask for this option when making the initial contact with a potential new therapist.
3. Listen to Yourself
We often have a little voice inside or a feeling telling us information about what we may need. If you are like me, it is sometimes difficult to trust that voice or that feeling. It is much easier to minimize that, brush it off, or even criticize it. But actually, there is a lot of wisdom in what these experiences tell us and it’s important to not only listen to that, but to also trust it. If there is a part of you saying you don’t want to see a particular kind of therapist or participate in a particular kind of therapy, honor that part of you and try to find a therapist that does not contradict what that important part of you is saying. Also, try not to “should” yourself, (i.e., I should see a male therapist because that will help me get over my past), or follow someone else’s advice at your own expense. Listening deep down and following your own instincts or intuition will help you feel more in control of this process.
4. Ask Questions
You absolutely have the right to interview or question your therapist. It is important you have the opportunity to understand the therapist’s education, level of training, and background. You can ask how many of years of experience he or she has in treating a particular problem or using a particular approach. Questions regarding the therapist’s philosophy or approach to therapy, boundaries, and ways he or she would handle particular problems are completely appropriate. If you struggle with things like self-injury or suicidality, definitely ask up front for the policies and procedures for making crisis calls during times of emergencies. If something is bothering you, making you afraid, or if you have specific needs, ask, ask, ask.
5. Go slow and take control
Therapy is for you, and it is beyond important that you feel as safe and comfortable as possible. I strongly believe that your history belongs to you and you should be in complete control over how and when you share this information, if you chose. As a trauma therapist, I do not believe I need to know the details of anyone’s trauma history at the onset of therapy in order to help them. Although I believe having this information is helpful and being able to tell one’s story is an important part of the therapeutic process, I think it is more important for the person to be in complete control of what information is shared and when. It’s ok to take your time, and you can decide when it feels safe to start talking about your trauma or abuse history.
You do not have to feel pressured by a therapist to talk about it before you are ready and its ok to say you do not want to talk about it. Therapy can focus on managing and coping with trauma symptoms, promoting safety and stabilization, improving quality of life, and building a solid therapeutic relationship without the demand to talk about trauma or abuse details.