A thank you and a recap of Kate Daigle Counseling, LLC Open House!

Kate Daigle Counseling had its Open House yesterday, November 7th, and it was a invigorating and rewarding day for the practice!  I want to extend a personal thank-you to all that attended and showed support.

Here are a few pictures from the event:

Kate and her friend Roger

Friends and family checking out Kate Daigle Counseling’s brochures…

So grateful for all of the support!

Other pictures of the office can be found on all of the pages of Kate Daigle Counseling’s website.

Upcoming events with Kate Daigle Counseling:

-Blog post topics: Surviving the emotional roller coaster of the holidays; PTSD, mental health and War Veterans; the implications of the FREED Act; helping children of divorce cope; the mystery and debates over Autism; the healing presence of animals in therapy; radical acceptance; the stages of grief; men and eating disorders; unlocking the reasons that drive self-harming behaviors; and many more! Please write to me with new ideas that you would like me to write about in my blogs.

-COMING IN DECEMBER! Body-centered therapy group, held weekly at the office of Kate Daigle Counseling.  More information about this will be coming out VERY soon so please keep your eyes open!

-Seminars in schools, recreation centers, and with parent groups: Kate offers talks about the symptoms of eating disorders, some of the causes, and how you can help a child/parent/friend/family member who might be dealing with an eating disorder or other form of emotionally destructive eating pattern.

Thank you for your support of Kate Daigle Counseling!!

Extending a hand to male survivors of childhood sexual abuse

Females are not the only victims of childhood sexual abuse, and now is the time to embrace males who are survivors and who are coming forward in their healing journey.  The trauma that hundreds to thousands of young males endure has been in the shadows and only recently have support groups and researchers begun to focus treatment on this population.  Why?  This is a complicated question, but some of the answers may be found in the messages sent to men about masculinity and what it “means to be a man”.  It might be thought that to be vulnerable and victimized is not a “manly thing” and therefore should not be exposed.

A blog that I was reading talks extensively about the pressures put upon men in this society. Cultural standards (in the United States, and in other countries such as Mexico and the United Kingdom) dictate that a man must “prove his masculinity” consistently throughout his life because he is supposed to be the “protector, strong, devoid of soft and feminine emotions, and overall a stoic presence”.  This brings up images of John Wayne and the Marlboro Man – a man you can trust to keep you safe.  If this man’s own personal safety and boundaries are violated, is he “still a protector, still a man??”  This masculine drive is referred to as machismo in the Mexican American culture.  I also reflect on bullying and the way that bullies can make you feel like you are not “okay as you are — whether that is a man that is not manly enough”….and also makes me wonder what the bullies are protecting about themselves in their mission to tell others that there is something wrong with them.

A man who is sexually assaulted or who is a victim of incest may feel that his masculinity is at stake and may question his sexuality.  This can lead to denial and other defense mechanisms to protect their “abominable secret – that they were not strong enough to be the man they should be”.  The truth is that there is NOTHING to be ashamed about and that addressing these issues in no way makes the survivor “less of a man”.  Studies have shown that men who were abused might take on one (or several) of three roles: 1) Perpetrator – he feels he must victimize others in order to protect himself from more pain and hurt; 2) Victim – he believes he will always be a victim and that he does not have the power to openly heal his wounds, or that he “shouldn’t try”; 3) Protector – he might feel that every child is at risk for being abused and will go out of his way to make children safe.

I have deep and insurmountable respect for Tyler Perry, an actor, writer and director who recently revealed a horrendous personal history of childhood abuse at the hands of his father.  He is making his story public and opening a door for thousands of other adult males to feel safe and free to talk about their own trauma.  Tyler went on Oprah’s show to process this devastating aspect in his life, and tomorrow he will return to her show to support 200 adult men who were molested as children and who are now (many of them for the first time) disclosing their history on national television. I am in awe of the bravery and courage of Tyler and the men coming on the show, men who are comfortable and willing to show that they can be survivors of childhood sexual abuse and still be strong men.  Tyler is a hero for adult male survivors everywhere, and I know that there are hundreds of other heros, heros who have moved forward in their lives and made a difference in the world through advocating for sexual abuse survivors.

I think that openness and sensitivity are truly honorable marks of both femininity and masculinity and that the more that our culture opens up to diverse types of people (whether in terms of sexuality, personality, ethnicity, backgrounds, etc), the more peace and healing will come to our community as a whole.

I will be sure to tune in tomorrow to Oprah, and hope you do too.  More resources and information about male survivors of childhood sexual abuse can be found at:  www.malesurvivor.org and www.wingsfound.org.

Working with clients with somatic symptoms: how can we be effective?

First of all, what are somatoform disorders?  This is a topic that was roughly covered in my training but that I have not seen often as presenting issues in clients, but I feel it is important to raise awareness about these issues.  Somatoform disorders are defined as “physical symptoms that seems as if they are a part of a general medical condition, other mental disorder, or substance is present.  It is thought that psychological and mental issues are translated into presenting as physical medical problems or complaints.  This type of disorder is typically first found in a medical setting, as clients come in initially complaining of physical distress.

Somatoform disorders are categorized into several types: Somatization disorder (or Briquet’s Disorder); Pain disorder (complaining of pain, seen most often in the older generation); Conversion disorder (the client’s sense of mobility is impaired with no real cause other than stress); Hypochondriasis (marked by fear of sickness or injury and a lack of assurance that they are okay); Body Dysmorphic Disorder (fear of or irrational exaggeration of a certain part or parts of a body — this is often tied with eating disordered symptoms); and Somatoform Disorder Not Otherwise Specified.  Given these differing types, it appears that the factors that qualify a Somatic Disorder can vary widely and do not necessarily fit into neat categories (as is the case with many types of mental issues).  It seems that the underlying factor for many of these types is a projection of mental distress onto the body, with it manifesting in physical symptoms.  As mentioned earlier, clients often first present at doctor’s offices, because this chronic hip pain must be a purely physical ailment.  However, if the doctor tries varying treatment approaches and the pain still remains, the client might be referred to a mental health counselor.  I have known counselors who meet such clients, and they have related that sometimes the clients do not see a reason for therapy — the issue is IN HER HIP! NOT HER HEAD!  This makes for a careful assessment on the part of the therapist, and patience and dedication by both parties.  It is amazing when clients suddenly feel less pain in their shoulders or an improvement in their chronic headaches as they work with a therapist to address stress-related mental health concerns.

I once had a client who was dealing with an eating disorder and she told me about experiencing chest pains and a tingly feeling in her left hand.  She went to the doctor (without disclosing her eating disorder) and he took an EKG, did full-body x-rays, prescribed Vicodin, and read her vitals — all to find that she was perfectly healthy (as healthy as you can be with a serious ED).  He could have referred her to a mental health counselor, but he did not (she found her way to me anyway)…though he did talk to her about stressors in her life.  As I worked with this client and her eating disorder got better, she experienced less and less of the chest pains and tingly feeling in her arms.  Were those symptoms part of a somatic issue or were they the effect of an ED?  Obviously, her body was stressed by the medical effects of the ED and could have presented that stress in the form of chest pains and arm tingling…but the doctor could not find anything to put his finger on in terms of diagnosing the physical issues, so is it purely mental distress projected upon the body in the way that somatic disorders do?

Somatic symptoms can be challenging for therapists as well as doctors because the client might not know (or want to talk about, in the case of the ED) why this is occuring and it could take leg work on the part of all parties to get to the deeper issues.  Somatic Experiencing is a type of therapy designed to help relieve and resolve the symptoms of Post-Traumatic Stress Disorder (PTSD) and other mental and physical trauma-related health problems by focusing on the client’s somatic symptoms.  Clients who have suffered trauma or abuse can exhibit somatic symptoms as a way to express the pain of the trauma in a physical capacity.  Dr. Peter Levine’s book Waking the Tiger talks extensively about Dr. Levine’s observations of wild animals and how they cope and recover from physical traumas.  Therapists using this approach work with the mind and the body to regulate the autonomic nervous system, defining the ways the mind affects the body and vice versa, and healing those connections.

Somatoform disorders can present when a client has experienced trauma, abuse, or devastation (such as a natural disaster) and may not know how to safely express the feelings they have inside.  Perhaps they do not even realize they have those feelings and their bodies relocate the pain to a physical sensation, which might be more natural to experience.  Some cultures, such as Southeast Asian cultures, often present with somatic symptoms to their doctors, who then refer them to therapists.  It is essential that counselors recognize the signs of Somatoform disorders and become knowledgeable about the populations and situations in which they most commonly are seen.

Removing the problem from the relationship: narrative couples therapy

I was excited to find a blog post that focused on how couples can benefit from narrative therapy.  I have always been intrigued by narrative therapy and use it often in my practice, but my couples therapy training had never specifically touched on how to integrate this post-modern approach with relationship work.  Narrative therapy is an innovative and collaborative therapeutic approach that is intrigued by the stories of people’s lives.  It focuses on understanding how the stories our lives lead are based on influences from society, culture and politics and how these factors can create problems in relationships with ourselves and others.  Integrating the postmodern approach of “there is no objective truth”, narrative therapy believes that our lives are built of many stories that interact with each other and form a network of experiences and memories.  In individual and family therapy, I might work with a client on “rewriting her life story”, either literally or figuratively, so that she feels she has the power to direct her life in a healthier, more peaceful route.

Narrative therapy also uses the technique of “externalizing the problem”, which is a way of removing the problem from within ourselves and seeing it as a separate thing that influences us and interacts with us in ways we might not even realize.  I find this to be one of the most dynamic and healing aspects of narrative therapy: how many of us feel as if we are the problem?  As if it is a part of us that we cannot do anything about and it therefore gains control and makes us miserable? I sure know the feeling.  In relationships, each partner’s life stories interacting with each other, multiplying the complexity and depth of the ways that each partner has chosen to live his or her life thus far.  How does your story impact the way you relate to your partner?  For example, if your family struggled with financial security for many years of your young life and you survived by learning how to budget and live modestly, you might have a story that is written about survival, responsibility with money, and thinking very hard about each decision you make.  Your partner may have had a completely different background and his life story may never had the chapter of needing to learn how to manage money in a careful manner.  These backgrounds, ingrained in us, might navigate the ways that we talk to our adult partners about money.  Using narrative approaches, the couple could explore the influences of society and culture on money management as they grew up, and they could collaborate to write a new story on how they would like to approach money management as a couple.

Often times, couples come to therapy focused on a problem.  They have already “tried everything” and therapy is a last gasp at saving the relationship.  A popular marriage therapy blog offers a very honest account from the perspective of one partner as the couple enters marriage therapy at this stage.  Using narrative therapy to externalize the problem can be a very powerful intervention that makes the blame game completely disappear.  Through exploring the couple’s story, I learn what the underlying issue is (*note: this is not often the first thing they present with.  Couples often present with issues surrounding sex, money, in-laws, and parenting responsibilities and it takes a lot of work to find the raw feelings that lie underneath these).  Perhaps the couple presents with issues of jealousy and dishonesty in being accountable to their partner.  After exploring for a session or two, I am able to fish out that each partner is feeling lonely in the relationship.  By removing “lonely” and using it as a separate entity in their relationship, both partners can see it as something they do not own and thus do not need to feel guilty or ashamed about.  I might ask them “how is loneliness affecting your ability to relate to one another on an intimate level?”.  Or “in what was does jealousy harm the relationship?”.  And, further down the line, we could work on figuring out “What steps can you take as a couple to lessen the powerful and dangerous effects of ‘withdrawal’ on your relationship?”

This is just a taste of some of the interesting facets of narrative therapy, as I begin to dabble in ways that it can effectively help couples heal wounds and start writing new and liberating life stories together.  When we are able to feel that we are not the problem, that we do not own it and it is not a deficit of ours or our relationship’s, I think that partners can start to adopt a solution focused outlook instead of a toxic problem-infused mentality.

Night eating syndrome, morning anorexia: how do we qualify an eating disorder and where do we draw the line?

Last week, I wrote about the rising new “rexias” in the eating disorder epidemic and based on the interest and comments on this topic, I have decided to dedicate today’s blog to an encore of the subject of eating disorder classification.  While this is the area of expertise in my counseling practice, it also is noted in a blog I was reading that the public has a “fascination” with eating disorders and the terrifying rate at which they are growing and mutating.  This blog brought up some interesting points as to which types of eating disorders should be classified in the DSM-V, the Diagnostic and Statistical Manual of Mental Disorders, the most recent edition of which is expected to be coming out in May 2013.  I say: why focus on the details?  If someone is exhibiting self harm in the form of eating disorders or other ways, this is a not-so-silent cry for help!

As I noted in my previous post, I wonder if the “rexias” such as pregorexia and drunkorexia are terms that are borne out of situational descriptions: a woman or man who is already dealing with an eating disorder or who is vulnerable to one finds himself using alcohol as an inhibitor to an eating disorder, or a woman becomes pregnant who has had disordered eating or body image problems for years.  To me, these are new mutations of anorexia or bulimia (or a combination of both), which are the two “classic” types of eating disorders in the DSM.  Binge Eating Disorder (BED) is a definite shoo-in for the DSM V, but counselors and practitioners in the field are wondering what other types of eating issues could make the cut…and I wonder how one decides what qualifies a “diagnostic” eating disorder — one clinical enough to make it in the mental health professional’s bible?

Blogs are talking about Night Eating Disorder (NES), which is qualified as a “disordered eating pattern in which an individual eats large quantities of food only at night.”  A study performed by Striegel-Moore and colleagues (2006) defined NES as “evening hyperphagia” (an abnormally increased appetite in the evening and consumption of food, after the evening meal, in which the majority of the day’s calories are consumed).  This may cause insomnia and “morning anorexia”.  This seems to me to be similar in criteria for Binge Eating Disorder, though NES appears only at night.  Binge Eating Disorder is defined as when someone frequently eats large quantities of food and feels a loss of control and an emotional response to their eating habits.  This does not involve the purging qualifier that bulimia nervosa does.  As mental health professionals, doctors, and psychologists meet to try to determine what types of behaviors make a disorder and what type of mental issues fall in line with which disorder, many questions come to surface — not only on the eating disorder front but across the mental health and physical health spectrum.  How do we decide what should be included in the newest version of the DSM so that proper diagnoses can be made and clients can be helped in the most efficient and adept way possible?  Is it better to have more probable diagnoses to look at when treating a client, or is less more?

As a counselor who treats individuals, couples, and families affected by eating disorders and as a woman who has dealt with emotional eating issues myself, I wonder if there is a trickle-down effect in handling the broadening scope of eating disorders.  As technology gets more advanced and as society grows larger and more complicated, the types of things that we can struggle with increase (alcohol, drugs, family pressures, wedding pressures, grief and loss, war casualties, and many more) as we cope with the overload of information we are given each day.  But underneath the surface, the river all runs to the same place or few places: the want to be accepted, loved, healed.  Maybe we eat uncontrollably at night because we cannot control our parents’ imminent divorce and the pain that causes.  Maybe we try to starve ourselves so that we fade away to nothing because the feeling of hunger is welcomed compared with the feeling of rejection from a group of peers.

I support incorporating as many words or classifications as possible in the DSM because the more attention we can bring to the dangerous epidemic of eating disorders, the more we can align into one solid voice advocating prevention and elimination.

Self care – it’s no joke!

I have been under the weather since Sunday afternoon.  It started as “allergies”, and has now progressed to a full blown chest cold.  I am not accustomed to having to slow down my daily pace due to unforeseen sickness, and it has really made me look at the way that I make choices and take care of myself (the short answer is: often, not very well!!).

When we are forced to “stop and smell the roses” (bad metaphor…I can’t smell anything!), we must take a look at our lifestyle choices in ways that we might feel we don’t have time for in our daily busy schedule.  For instance, sleep has been an important factor in trying to battle this body-invading cold.  I realize that I often glaze over the healing powers of sleep, because somewhere along the way I got the idea that taking naps was a “waste of time”.  By listening to my body’s strong urges to get some rest this week, I have benefitted from the rejuvenating and invigorating healing powers that something as natural as sleep has gifted me.  I was also forced to call in sick to an important job this week, and I went through the usual feelings of guilt that typically accompany my saying “no”.  However, when the reason that I needed to say no was to take the time to relax and give myself a break, why must I feel guilty about that?

This leads me to wonder why self care has gotten so far down on my list of time-worthy tasks.  As a counselor, I have learned through coursework and through the guidance of teachers and supervisors that self care is a MUST in this profession.  Burn out, soaring levels of stress and anxiety, and decreasing levels of mental health are only a few of the consequences that may occur when therapists do not offer themselves the same care and affirmation that they gives their clients.  It seems simple: in order to be able to help clients find their way to happiness and change through acceptance and support, a therapist should be able to model those very qualities him or herself.  But all too often, we overlook our own needs in the face of demanding jobs, competitive markets, and devaluing our own desire for peace.  This week I have found that in order to get past this and to move forward with my career and my life, I must take the time to care for myself.  It is ironic in a way, that my body should physically break down before I notice this, and that when I push myself too far it definitely lets me know that I need to slow down.

Why can’t we slow down and listen to what we need?  Not only therapists, but doctors, lawyers, health care workers, teachers, parents, and anyone who meets high demands each and every day — we all struggle to put our self care high on the list.  I think that a big piece of this puzzle is being able to listen to your body.  As I have written before, the mind and the body are deeply connected and they will tell us when we need to turn our attention inward.  Last week a friend was celebrating her birthday and when I called her to wish her a happy birthday, she told me that she was having a good day but that her shoulders were very tight and tense.  I suggested that she get a massage, and it took me several minutes of convincing her that she deserved to do this (her body was yelling at her to get one!)….not just because it was her birthday but because her muscles were carrying all of the stress that she was feeling.  We don’t have to wait for the “excuse” of a special day to allow ourselves a kind break.

I think that sometimes self care can take on the pretense of feeling indulgent or selfish.  I argue the exact opposite.  When we are in the helping profession, it may be unethical to meet our clients in a state of anxiety, stress and tension.  What would we be modeling to them?  Not only is it healthy to take baths, take vacations, go out for a celebratory dinner, or whatever else you like to do for self care, our jobs require that we do these things because of the challenging subject matter that we work with every day.  We are in our profession because we live to help people, to listen to their stories and to support them in finding peace and love in their own lives.  However, we cannot help them to the best of our ability if the problems we hear each day weigh us down.

So, as I have learned this week (it took a debilitating cold to teach me!), it is a necessity that we engage in self care activities.  We must put ourselves as a priority and be comfortable with saying no when need be.  Schedule at least thirty minutes of self care each day.  Read a book that you love, take a walk with your partner, go to the park and admire the changing leaves, take a hike in the mountains, go out to dinner with your sister.  Our families, clients, partners, and most importantly – YOU – depend on it!!

…I’m going to go spend some time with my dog now 🙂

Drunkorexia, pregorexia — the rise of new “rexias” in the eating disorder epidemic

Today is the start of “Fat Talk Free Week”, which is a national campaign that visits college campuses, does presentations, and encourages women and men to eliminate conversations that reinforce the thin ideal and that contribute to dissatisfaction in one’s body.  October 18-25, 2010 is a week set aside for motivating positive body image and educating the country about the dangers of disordered eating and negative body image.  I am doing my part to spread the word about the beauty and vitality of our healthy bodies, and encourage you to do so too!

Newspapers, magazines, and internet blogs are bringing focus to this topic in some of their writings this week.  As I was reading an article in the Denver Post this morning about a shocking new eating disorder called “drunkorexia”, it struck me how many different kinds of eating disorders are in development and how there are many diverging opinions about the “trendiness” of these “rexias”.  I wanted to learn more, so I looked online for what people are saying about the “rexia” trend.  The two most talked-about types are “drunkorexia”, which is a sensational term for when (most commonly) college aged women limit their food intake and “drink” their calories instead.  This often involves binge drinking on an empty stomach, which causes ulcers, black-outs, and the lack of nutrients can lead to serious medical concerns.  On the other extreme, the Denver Post article talks about students binge-drinking and then consuming massive amounts of “drunk food” such as hamburgers, pizza, and ice cream and then throwing them up later after feeling guilty.

I had heard of drunkorexia before, but pregorexia is a relatively new term which refers to behaviors that seriously concern me as a mental health professional, as a woman, and as a potential future mother.  Pregorexia refers to women who limit or carefully count their food intake, sometimes significantly, during pregnancy so as to not gain very much weight.  Blogs call this “the pregnant woman’s eating disorder”, and a “buzz word” for this type of eating disorder that some believe is inspired by looking at celebrities who remain slim during pregnancy and then lose the baby weight within a matter of weeks after birth.  When I think about this, it is just another version of the same issue that plagues all women and men with eating disorders: comparing themselves to others and feeling inferior.  It scares me to think of the effect this might have on the child growing inside of the mother and it saddens me that women feel that they cannot embrace one of the most natural and beautiful parts of human life: growing a child and giving birth.

Negative messages are sent to pregnant women through the media every day.  A psychology blog explores how women are told that having a c-section can lead to faster weight loss after birth because their metabolism is increased as their body tries to repair itself from the surgery (and the liquid diet the doctor puts women on after a c-section can “help you lose pounds very quickly”).  These messages are unhealthy, as they insinuate that a pregnant woman’s body is not beautiful (unless it’s thin!), that weight loss is the most important thing to focus on after giving birth, and that every woman must be perfect when navigating life transitions.

It makes me wonder in a sort of which came first – the chicken or the egg type way:  do women who are susceptible to eating disorders get triggered by substance use or changes in their body, such as pregnancy?  Are these new “rexias” part of an already-developed eating disorder that presents itself and gets tangled with life transitions?  What is the link between entering a new phase of life (starting college or starting a family) and coping mechanisms like eating disorders and substance abuse?  Much research has been done about ways of coping as life throws us new curves and paths as it tends to do.  I think that the different facets that eating disorders have found all point to the same underlying issues: needing a sense of control, feeling “not good enough”, and desiring a release of anxiety and tension.

The last blog that I found about this topic is one written by those who have (or currently are) suffered from an eating disorder so it can be very real, sometimes triggering, but incredibly insightful.  An author who wrote about “the rise of the rexics” feels that the many new variations on anorexia (including “brideorexia”) makes fun of or minimizes the seriousness of anorexia.  The author argues that the cutesy terms are meaningless and that we need to get down to the real problem: that a bride has anorexia, or a pregnant woman has anorexia.  In order to validate those who suffer, no matter what their circumstances, it must be heard that the psychological, cognitive, and physical devastation is the same for all and that every form of disordered eating needs to be treated with the same amount of care and seriousness.  The consequences of eating disorders affect not only the person exhibiting behaviors, but also affect their family members, their friends, their community, and their children.

So, in honor of Fat Talk Free Week and in honor of our beautiful, natural selves, please be aware of the messages that we send through our actions and words and notice when you are conforming to the thin ideal.  We all deserve to feel happy and accepted just the way that we are!

Connecting with your inner child: comforting and listening to your authentic self

There is a part of us that never forgets.  We are all child-like in some way, and just as a body remembers past events and feelings through emotional muscle memory, our inner child lives on inside of us for our entire lives.  It may come out in ways we react to certain situations, such as how we respond to a new person who reminds us of someone we knew as a child, or it might come out as we go through life cycle transitions.  We grow up, find partners, live on our own or with a partner, have children, get married, develop new patterns and coping mechanisms.  Living independently of our parents physically, financially, and socially can reignite patterns of ways we have managed transitions before, and our inner child might react against a choice we make.  For example, a colleague recently told me about a client she has who exhibits fiercely protective feelings towards her brother.  The client cannot understand why she becomes enraged when she sees him being taken advantage of by his partner.  The woman had been physically assaulted when she was a child and she states that she has always felt like she wanted to protect those she loves because she has been made to feel unsafe in the past.  The client and her therapist are working on expressing the needs, fears, and feelings — perhaps never safely expressed before — of her inner child and understanding how this interacts with her present day life.

Psychotherapists refer to the inner child as the emotional memory and experiences that we have stored in our brains and bodies from our very first memory.  An inner child can come out in playful ways, as grandparents bond with their grandchildren and play in ways they have not engaged in for decades.  I feel that animals have inner children that never lose their light; I have reveled at many dogs who have played with and loved their humans in puppy-like ways until the day they died.  The inner child can be a joyful expression of hidden and forgotten youth; it can also be an expression of trauma and hurt from childhood that has not been healed yet.  Therapists have long studied the inner child and how it affects our personality, functioning, and relationship styles.  In the 1970s, the concept of the inner child developed alongside the concept of codependency, connecting the needs of the inner child to the patterns of relationship formation and behaviors later in life.

Carl Jung called the inner child the “Divine Child” and Charles Whitfield called it “The Child Within”.  I am fascinated, like many psychotherapists before me, with this concept.  I believe that within each of us is our authentic and true self, and that our inner child is the purest form of who we are.  Throughout our lifetimes (and perhaps even beyond) our inner child stays innocent and true, though it is affected by experiences that we have throughout the years.  I can imagine it as an enormous old tree, the kind that has been around for a hundred years and has grown twisting, gnarling branches and bark all over its form.  It has housed nests, dens, and perches.  It is chipped away at by storms, by humans, by squirrels and birds, and it suffers from disease at times.  But inside, beneath all of that “living”, is the sapling from which it grew.  Trees are resilient things and can withstand many torrents without altering their worth and purpose.

I believe that same thing about humans: we can endure many storms, but inside of us lives an innocent child who, though he or she may have some chips, dents, or knicks, lives on as the inner light and inner child that expresses who we truly are.  Through counseling, support, and love, our inner children can be freed and healed.  How do you connect with your inner child?

Recognizing the importance of National Coming Out Day

Today is National Coming Out day.  I did a little bit of research about this civil holiday and found that it is borne out of the event of the first march on Washington by Lesbian, Gay, Bisexual, Transgender people (LGBT).  The march was on October 11, 1987 and signifies the LGBT community’s struggle for acceptance in society.  Every October 11 since then has recognized this message.  The purpose of National Coming Out Day is to promote honesty and openness about being lesbian, gay, or bisexual (read more: http://www.qrd.org/qrd/www/orgs/avproject/NCOD.htm).  I think this is a courageous, outstanding, and respectable event for all of us to bring to our awareness, especially after the recent tragic deaths of four teenage boys who committed suicide after being bullied for their sexual orientation.

I have written before about the dangers of social media and how this ‘instant connection’ we have through Facebook, LinkedIn, Twitter, and other sites can interrupt honest communication and can promote misunderstanding and bias.  I do have to say that today I am encouraged to see many people post to their Facebook accounts messages about being advocates for the LGBT community: (______) is a straight ally and today is National Coming Out Day. Donate your status and join me in coming out for lesbian, gay, bisexual and transgender equality by clicking here: http://bit.ly/9xGNV2.  I have seen a few people come out today on Facebook, garnering love, support, and empathy from their friends and family.  No matter when or how one decides to come out, it can be risky as you cannot predict the reactions from those you open yourself up to — especially on a social media network.  Brave and confident souls, I commend you and support you!

The New York Times online blog writes today about the challenges of coming out to parents and loved ones…and how it has never been easy, even without social media.  Coming out can be intimidating for the gay/lesbian family member, as they may fear if they will still be accepted and loved after this revelation.  The recipient of the news may also go through emotions, feelings, resentments, regrets, and all sorts of other reactions to the news – especially if their son/daughter/parent had waited many years to open up.  In the NYT blog, an adult daughter talks about her trepidation about coming out to her mother, and how she felt the only way she could do it, at age 28, was to write her mother a letter and mail it across the country.

The uncertainty of being accepted or judged by family members can escalate into anxiety, depression, anger, and sometimes tragedy.  After Tyler Clementi’s suicide last month after his roommates unjustly exposed him to the internet, his parents have come forward and said that they did not know he was gay.  I can only imagine the complexity and anguish that must have been going on in Tyler’s mind and my heart goes out to him and his family.  Perhaps, with the right circumstances, Tyler could have opened up to his family and his path would have shifted from secrecy about who he is to openness and self acceptance.  But we will never know what “could have been”, and it’s tormenting to imagine that now.  We DO have the choice to change the way we judge, treat, and criticize people who are different from “the mainstream” and we CAN make this world a more understanding place for every type of person who lives in this diverse society.

Today, I embrace each one of my friends and family members who are of the LGBT community, whether they are open about their sexual orientation or not.  I am an ally to each one of you as a friend or as a counselor.  Today, on National Coming Out Day we must all lend our voices in support of the LGBT community, because there are plenty of people who still judge and attack them.  On some message boards today, there are plenty of comments — those supporting National Coming Out Day, and those who believe it should not matter.  There still is bigotry in this society, and it is unfortunate to see.  However, there is also a lot of progress in accepting multiculturalism and diversity.

This day is a chance for those who have never felt safe to embrace who they are, and for those who have confidence to give their hand to those less sure about being out.

Expressing ourselves (or not) in therapy

I have been on both sides of “the couch”.  I have been a client for many years and currently also inhabit the role of therapist with my own clients.  I know how it feels to sit and talk to someone who you do not know on a personal level but still feel this uncanny and close connection to.  I also am familiar with the sensation of sitting down with a client, sensing that certain natural anxiety that accompanies every session (even if I’ve been meeting with that person for a long time).  Both therapists and clients have feelings and reactions.  That is in part why people become therapists: because they can empathize, feel, and connect so deeply with their clients.  Clients come to therapy because they would like to sort through some of the feelings and reactions they have to life circumstances…or to try to understand why they DON’T have feelings or reactions to those circumstances.

Feelings and emotions are natural and normal, and everyone has them.  In therapy, where the room is safe and secure and there is a degree of comfort between client and therapist, emotions can play and explore the open air between the participants.  A psychotherapy blog that I read talks about reactions that clients might have towards their therapists or towards a situation that are really not about that certain thing at all.  Psychodynamic therapists call this projection.  In this blog, the writer talks about feeling angry at her therapist and feeling that “the connection was lost” between them.  As she works through this with her therapist, she realizes that she was upset with him because he was going on vacation for three weeks and she feared being lonely and losing her identity without him.  Through this confrontation, she was able to work with her therapist towards developing more autonomy and she explored defense mechanisms that, according to psychodynamic theory, have been in place since the age of three.

In the above example, we can see how a reaction to a situation brought out some deep-seated feelings that the client was unaware of herself, and processing these with her therapist allowed her more freedom and release.  This is an instance where the timing was right (the client was able and ready to go to the level of processing she needed to) and the relationship was built from enough trust that the two could sort through some uncomfortable feelings.  But those circumstances are not always in place.  Sometimes, the client is not able to yet make the steps towards understanding the deeper levels of his/her reactions and feelings, or the therapist is not prepared to hold the anxiety of such a situation and may allow her own feelings to enter the picture.

I have had clients expose a wide variety of emotions in session, and I am grateful that those clients felt safe enough with me to allow me to see them.  There have been clients who have let me into their deepest thoughts, thoughts that they sometimes do not feel are “okay” to have.  When working through challenging situations, such as when clients are trying to recover from an eating disorder, thoughts and feelings that have not been allowed to come out for fear of rejection can enter the therapy room.  This is a healthy dynamic of the therapeutic process, as clients feel accepted despite their struggles.  It is crucial that both therapist and client are prepared to work with these sensitive emotions when they are expressed, as they could be stuffed back down at any sign of judgment.

Fear of judgment or being unaccepted can be presented in forms of anxiety, withdrawal, dismissal, and aggression.  I had a client that I had been working with for a long time whose eating disorder was spinning out of control.  I could tell that she was terrified of this disorder because she felt torn between two very powerful forces: the temptation and addiction of the eating disordered behaviors, and the desire to be healthy and free.  We worked for months exploring this tug of war and attempting to empower the voice of recovery that was buried inside of her.  When we finally got to the point of challenging the eating disorder, she responded with anger and retreated back inside.  The anger was a natural reaction that, if given the chance to work through it, could have been a tool for her to turn against the disorder.  However, we did not get to explore that possibility and she never returned.

Timing and readiness for change are essential components to progress in therapy.  The therapist must have the tools and experience needed to help support clients as they take steps towards expressing themselves freely and finding those answers that they came into treatment to uncover.  One of the most difficult things for therapists to accept is if their clients are not yet ready for change.  This is something only the client can decide, as it is ultimately their work.  Through my learnings and wanderings as a therapist, I have come to accept that clients will make that commitment when they are ready and that is it my role to support them (and not push them) as they grow.