Month: August 2021

The “Nice” Heterosexual Parenting Education Class Mandated for Divorcing Parents and My Non-hetero Feelings About It…(there are many feelings)
Divorce and Separation · homophobia · lesbian mom

The “Nice” Heterosexual Parenting Education Class Mandated for Divorcing Parents and My Non-hetero Feelings About It…(there are many feelings)

lesbehonest20171 Comment

Per the state when two people divorce with children there is a mandatory “Parenting Education Class” that you both have to take. It’s six hours long. In my case taught by two LCSW’s. I’ve talked about sexual orientation as it pertains to me (lesbian mom more hetero-bendable identifying) and I’ll admit I was already salty going into this course because I had recently filled out after school program paperwork where by the end I ripped through the paper when I crossed out “Father’s name” so hard with the pen.

Really. You can’t just put Parent 1 and Parent 2? Really?!

Again, I was already salty. Then I come into this six hour hellacious class where I am taught basic concepts of being nice to the co-parent. And literally it’s a watered down version of what I council clients about daily. Not to say I knew all the content. But let’s say I didn’t learn anything new of value.

However, I will say I was also annoyed the entire six hours because the opener was as follows, “We will be referring to two parents as ‘Mom’ and ‘Dad’. We know there can be other ways that families are made and different parenting situations but in our course this is the vocabulary we will use.” That was as close as they came to acknowledging LGBTQ+ parents. EVER. In six hours.

So literally in the first two minutes of the next six hours of my life I’m already told 1. You’re not important enough for us to use gender neutral language 2. There will be absolutely nothing in this course pertaining to LGBTQ parents and families 3. You are not seen by this course and the state of CT that mandates you take this course. Because w cannot even say the words “Two mom or two dad families” and God forbid anyone uses the word transgender.

I wanted the class to end. I wanted to be done before it even began because I felt like I shouldn’t be there taking up space with all the nice straight people. I may not identify as a lesbian but I sure as hell am a lesbian mom because my co-parent from conception is a woman. And you literally in six hours cannot even once use vocabulary that might validate my existence as a two mom family.

I had a lot of feelings. Clearly. Still do. One of the feelings that generally angers me is shame. In those moments I feel myself looking left and right like does any one know I’m a two mom parent? Can they tell? Because in that opener it was made very clear this is not a safe space for me to be.

I was calming down a bit toward the end counting the seconds. When he used an example that drove me right back up to eye twitching insanity.

“…What would be great in that moment is for the Dad to show up and support the Mom. The kid is being disrespectful and really unruly to Mom, Dad shows up and says, ‘you can’t talk to your mother that way’ dad lays down the discipline and takes a stand. That is what a Dad should do in that instance because the kid will really respect the Dad for stepping in for Mom and Mom will appreciate you too dad, you will win big points for this.”

Dude. Not only can you not acknowledge anything other than heterosexual parents but your example is literally the most gendered inaccurate stereotype I have ever heard. It took a lot. I mean A. LOT. to sit there and not 1. chew my lip off 2. keep my big mouth shut.

I needed to take some space. I needed to take a little walk. It didn’t help I had spent the better part of the day also on the phone fighting with my nemesis Anthem. I was wired to fight dirty after dealing with those heinous people all day.

So I didn’t say anything. I’m taking time to reflect. I’m going to say something. I may send a link to this blog. Because I don’t like the feelings I’m having. I don’t like feeling ashamed of the make up of my family because it seems like you are uncomfortable even saying the word lesbian let alone lesbian Moms and gay dads and trans dads and trans Moms. How about acknowledging that some of these divorces are happening because people in heterosexual marriages now want to explore their sexuality and you’ve just shamed them hardcore.

I have feelings of pain because it just feels like the micro aggressions and overt aggressions will never go away and my sons are going into kindergarten and I’m terrified that they will now be exposed to homophobia. As a lesbian mom you do a disservice by pretending we don’t exist. You lumped me in with the hetero mom’s in that class. You made analogies, jokes, and statements geared toward me that had no meaning and were absolutely useless to my lived experience. And you could not even say the words “two mom’s”.

I wanted to stand up and say I am here. I. AM. HERE. SEE. ME. But I didn’t. Because it’s a stupid class that I have to get through to finalize the divorce. But a class meant to support and empower positive coparenting should not overtly state they will be ignoring the entire population of LGBTQ+ parents who are legally required to take it.

Yeah I have a lot of feelings about this. Including but not limited to:

And by the way. Two Mom’s can actually effectively discipline their child without a man. I’ve never needed to be rescued by a man to step in and discipline my son if he’s being “unruly”. My sons live with a healthy dose of fear of me and I’ve never laid a finger on them in terms of spanking or any physical punishments.

I’m consistent. I follow through on what I say I’m going to do. Expectations are clear and I know my sons.

I will be writing a follow up letter to the organization who organizes these classes. The year is 2021. There are many different family make-ups and you do a disservice to people who are being forced to pay for and take this class by just a blanket statement that you recognize we exist somewhere out on earth but we won’t exist in the context of your six hour class.

Because that my friends is homophobia. Big bad homophobia. It’s micro aggressions and it’s shaming and it’s a symptom of minority stress where we know we are in an unsafe space and we struggle the entire six hours with do we tell them or do we not. Are we physically safe if we tell them. Etc. Etc. I’ll say it again for friends in the back- not acknowledging us is homophobic. Not acknowledging that our coparenting is going to be maybe different from heterosexuals that’s also a micro aggression and just plain ignorant.

Do better. Be better. And be the voice in the crowd saying I AM HERE. Even if it’s after the fact. Because in the moment I would have been unpleasant. Afterward with time space and objectivity is totally fine. I’ll keep y’all posted.

Stacking Firewood Before the Storm
lesbian mom · mom of boys

Stacking Firewood Before the Storm

lesbehonest20171 Comment

I get two cords of firewood delivered every November. Then it takes me a month or so to stack it all. It’s usually thirty degrees or less and some times it snows. This year the two cords were delivered on Monday. I thought “This is great, I’ll have all Fall to stack it, it won’t be snowing, I won’t be cold, no rush. Great!”

Thursday we start hearing about a hurricane. Friday we are told a cat 1 will make landfall and there will be “rain of biblical proportions” and to “protect life and property at all costs”. I mean the drama.

I take in all my pool furniture and I stand staring at the wood pile. It’s taller than me. By a lot. And then I’m picturing logs becoming torpedoes in 80 mph winds. So Friday I start stacking.

It was 88 degrees and what felt like 100% humidity here. I was dripping sweat. My sons came out and helped. It was honestly the cutest freaking thing. Those little dudes walked dutifully with me back and forth with the wheelbarrow as we filled it with logs then stacked the logs in the garage and on our stands outside.

I did promise them money and they negotiated up to 20$ “paper money Mama, not the coins”. At one point one of them stopped and looked at me and said, “You’re a good Mama, you’re doing a good job.” Through my huffing and puffing I tried to smile and say thank you. At the end of Friday’s stacking we jumped into the pool and I took them for ice cream. At some point my neighbor stopped over with his wheelbarrow and helped with a few loads. Unasked and purely because he’s kind.

The boys asked if I was paying him. We laughed, and I said no, sometimes people are just kind. He has daughters in their 20’s and I think he was imagining them attacking that woodpile by themselves.

Saturday came and it wasn’t any cooler or less humid or less dramatic with the forecasts. Back and forth we went some more. The boys still helping, and trying to angle for more cash. I mean they are good at bargaining maybe law school is in their futures.

By Saturday evening there was less than 1/2 cord left on the driveway which was secured under a tarp with stakes and 80 lb deck umbrella stands.

By Sunday night we had received a lot of rain, a few gusts maybe up to 40 mph, and otherwise a dreary day. No firewood torpedoes thank goodness and no cat 1 hurricane in sight. So that was anti-climatic but I’ll take it because I wasn’t looking forward to no power for a week.

Sometimes it is in the monotony of a task like stacking firewood that we have the most meaningful times with our children. In a simple act they were taught many lessons.

They were taught the importance of preparing for a storm, they were taught we don’t quit at something even when we are dripping sweat, cranky from the heat, and our muscles are screaming. They learned the kindness of neighbors can be just that. Kindness. Without motive. They learned that Mama can handle a pending crisis with general calm and determination.

They were told at one point they had reached their maximum reimbursement of 20.00 each and they could stop or not it was up to them. They both went silent with their bargaining and trudged onward with me even though they wanted to come inside and watch tv. I told them they could and I wouldn’t be upset with them. It had been a long hot couple days, and I sincerely told them they could go inside and be done. But they knew I wasn’t done and didn’t want me to be alone.

They could have stayed inside watching tv. They could have played in the yard with the sprinkler. They could have ridden their bikes on the driveway. But they worked hard. They took pride in their work, and I praised them constantly for how well they were doing.

Stacking firewood is not sexy or glamorous. I broke a fingernail. My hands and arms and abs and legs are sore. I literally was soaked with sweat. Dripping like at hot yoga. I smelled. They smelled. There were ants. Pincher bugs. Spiders.

Kids watch us. They see us. When Declan told me I was a good Mama I melted inside. I don’t think he was saying I’m a good Mama because I stack firewood. He said it because he knew it was miserable but I persevered. I didn’t complain. I stayed positive and kept talking about how great it will be to jump in the pool. He said it because in that moment he admired me.

Now that I’m not dripping sweat and trudging through flying ants with wheelbarrows full of firewood I think back to that moment when we made eye contact and he said that and I smiled and said “Thanks bud. I love you.” And Jackson said, “What about me Mama?” and we laughed and I said, “Love you too buddy”. Then we had a second where we all just beamed at each other then I leaned over to throw another log into the wheelbarrow.

It was less than five seconds. That one moment. Treasure the moments. Teach through experiences. If parenting has taught me anything it’s to appreciate the moments. Because in the next moment I was probably yelling at them to stop fighting. Parenting also has taught me how much they see us. For some one who likes to remain on the periphery and not be the center of attention, it’s taken some getting use to for me. Two humans have their eyes and ears on me at. all. times. It can be a lot for an introvert.

Stacking wood can seem unimportant but they learn lessons from everything we do. Everything we prioritize and don’t; they see. It’s a huge responsibility- these little humans. Sometimes I feel like I’m doing everything wrong. But in that moment, by the woodpile, seeking their admiration even if just for a second, I felt like yes! Mom win.

(The meme/title picture is just because it made me laugh. Jackson in particular and I have had that exact scene regarding dinner. I told him he didn’t need to eat it but that it would be there in the morning for breakfast. It was there in the morning for breakfast. He ate it.)

How I Sew My 5 yr Old Sons Favorite Masks
#COVID-19 · Uncategorized

How I Sew My 5 yr Old Sons Favorite Masks

lesbehonest20171 Comment

I taught myself to sew when I was in high school and college. During a lonely Summer when I was doing an internship in nursing I spent my days with my cats sewing curtains for my apartment. I’ve sewn scrub tops when I worked in the emergency department and fleece tops and bottoms. Never did I think I would be sewing masks.

Obviously March 2020 threw me for a loop. I hauled out my sewing machine and every scrap of fabric I’d saved over the last ten years suddenly made sense. Perfect sizes for masks. I also started saving Joann Fabric coupons and buying kid friendly fabric with Frozen themes, Spiderman, Paw Patrol, etc. I ordered a lot of elastic. Some from sketchy places. I have to say though the sketchiest order I placed is the one that pulled through and delivered a large spool of elastic six weeks later.

I watched a lot of YouTube videos and read a lot of articles. I tried multiple patterns and had multiple failures. When I perfected the cotton with elastic mask I watched videos on how the filtration effectiveness of rayon blends aka chiffon are significantly higher than cotton and the closest to an N95 that fabric can make.

I bought more fabric. I had one lovely cashier who gave me 60% off my entire purchase. So much fabric.

I struggled with the chiffon. I had many failures. I actually stopped trying with two particular fabric patterns because I think they are bad luck. I literally could never make a functional mask from them. Eventually I got it though. I watched a youtube video on making a single layer chiffon mask and looked all over the craft passion website at the many mask patterns. I found that my way works best for my now 5 year olds, then 4 year olds which is a combination of many instructional videos and patterns.

The pattern is the Olsen pattern found on craft passion website.

Outside of Mask after long edges are sewn

The wire is roughly 10 or 12 gauge framing wire. About 4-6″ pieces. I cut scraps of fabric into 4-6″ rectangular strips. Then I iron them in a trifold pattern. Then I sew the piece of wire into the trifold cotton strip. If you angle the pouch correctly you can do the whole thing in one go, you kind of curve around the wire. Make sure both ends are solidly sealed because you don’t want the wire poking out. (pictures are below)

I like to sew several wire pouches at once so I have a nice stash of them. It is more efficient in the long run.

I do a double sided mask. One layer is a chiffon (rayon blend) and one layer is a character cotton fabric such as Spiderman or Frozen. For Halloween I used a pumpkin/witch fabric on top with a brown chiffon/jersey type fabric on the back.

I cut a bunch at once. I fold the fabric twice so I can cut four pieces at once- right side together. (picture below)

Then I sew along the curve of the mask pieces- 2 right sides together (pic below).

Then I take two of the sewn pieces and put right sides together, make sure center seams are aligned, and I sew the top and bottoms together. When I sew the top pieces I hold a wire pouch on and sew it onto the two pieces.

Then I turn it right side out, and fold over the edges to cover the raw edge, and form a channel that the straps will go through. Make the channel wide enough to get a safety pin through. I sew it so the “inside” of the mask is the jersey fabric, as that will be softest against the face.

The nice part about these is they are very forgiving. You don’t have to sew a perfect seam in a perfectly straight line. The more you do the faster you will be able to go, and the straighter the lines become.

So I take a safety pin, pin it through some of the chiffon/jersey fabric that I cut in thin strips along the edge of the fabric and run it through the now sewn channel. Up from the bottom for both ends. Then you should have a neck strap, and two ends at the top that can be tied around the head or I use the black buttons so kids don’t have to tie a bow they can just tighten or loosen as needed.

I’ll add a video to this. If you have questions just ask.

Below you can see finished products- I make them for me and my family and I wear mine as a double mask/top layer when I work at the hospital. Declan is running in the arcade with it hanging around his neck- that’s one of the nice parts is it doesn’t fall off. Declan as Batman has his on inside out so you can see the under seam where I lace in the fabric for around the head. My sister prefers the ear piece be around the ear with an adjuster there, so I do that kind for her and my niece and sister-in-law. My son’s and I like it around our head so it doesn’t bother our ears. You can see in yoga class I have mine tied on the back of my head, as I said the boys I use a button.

All the Socks Everywhere (Single Mom-ing Adventures)
Divorce and Separation · lesbian mom · mom of boys

All the Socks Everywhere (Single Mom-ing Adventures)

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My sons wear mismatching socks. Well one son in particular will purposely mismatch his socks. So I never have great success matching them when I fold laundry at baseline. But in the past few weeks I noticed I was finding single socks all over the house. They were everywhere. I would bring both my sons to where the offending sock was and ask how it got there, why it was there and not in the laundry, and they both swore up and down it was not them.

It was getting ridiculous. Why was I finding socks literally everywhere? We had lectures that ensued about putting our dirty clothes in the laundry.

There were several reasons to assume it was my sons. Starting with we are the only three people living in the house. We also have a pool and they seem to undress wherever they are standing at the very moment I ask if they want to go in the pool. Often it is in their playroom, the family room, kitchen, etc. Basically everywhere but in their room next to their hamper. We have a hamper on the main floor for this very reason.

I was getting annoyed. At first it was one sock randomly. Now it was socks everywhere all the time. And the worst of it was the boys were adamantly denying it was them.

We were all watching tv one night on the couch and I heard Scooby making a weird meow. The meow she makes when she’s trying to kill a bug. Minutes later I heard her hop slowly down the stairs meaning she had something in her mouth. I got up to investigate dreading what present she would have for me.

There she was. Sock in mouth. Dropped it at the bottom of the stairs as I approached.

She progressed to leaving socks in her water bowl. The socks sop up all the water so she has nothing left to drink and I have a sopping wet sock to deal with.

Understanding dawned. They were always present after I got home from work. I hadn’t worked from home in a few weeks and since getting the kittens last July I worked from home exclusively. The boys came running over in time to see the offending sock. We all started laughing and I apologized for blaming them for all the socks.

Yesterday, “Jackson, why is your outfit still in the entryway? I asked you to put it in the hamper!” his response was a shrug and, “Musta been Scooby Mama.”

Sometimes as a single mom and business owner and mental health practitioner during a pandemic I feel like I am running and running but it’s a treadmill because I feel like I’m working so hard but frustratingly stationary. It feels like the hamster on its wheel.

I feel like I’m being punk’d at all times because seriously. The damn cat outsmarted me for several weeks. Not just once or twice. Weeks. Every day. And literally as I wrote this she put a damn sock in her water bowl because it’s almost time for them to eat and she’s annoyed with me for not feeding her immediately.

Where she gets the socks I have no clue. But I won’t be surprised if she found a way to open our sock drawers. Because it’s not like we leave them all over our rooms for her to nab.

The days can seem repetitive and yet just as intensely hard as the day before which leads to sometimes a sense of dread or just odd acceptance that tomorrow will have hard moments too or rarely hope that tomorrow may be a little easier.

People say things to me like, “I could never do that,” “You are so motivated,” “I would never have been able to paint the fence…be a single parent…do it alone…work so late on at night” etc. etc.

I know these statements are meant in admiration but I have started replying with more than a polite smile and nod. Because there’s a part of me inside that is screaming. I got a quote to paint my fence and deck…four thousand dollars. I’m paying for a divorce, the pool needs a new cover, and ya know a mortgage and bills that I entered into with dual incomes is down to one.

So I painted the fence and the deck. I’m not done yet. But July it rained every day. I will finish it. I don’t have a choice. It has to get done so I do it. I couldn’t stay in a marriage any longer that was bad. So here I am a single parent. Did I have kids expecting this to happen? No. Can I just stop parenting because I’m in the middle of a divorce? No. I love my kids. I would never let them suffer because of my choices.

Working late is not a hallmark of how hard I work. I mean I work my ass off. But if I had something else to do on a Saturday night I would do it. But lately, my sons get picked up at 5:30 pm and I feel like I just crash and burn. A friend texted me the other night and I was doing work and she said she was so proud for how hard I work and I cried.

It’s a lonely business this divorce single parenting stuff.

Sundays I started booking a couple therapy clients. I tell NO. ONE. Because then the floodgates would open of patients wanting weekend appointments. But it’s two hours and it forces me out of the house. I hit hot yoga in the morning before the clients. Then I’ve got half my day done. Laundry and house stuff usually takes up the afternoon. Distraction is key to being away from my kids.

I check in with friends. I make plans. I stack firewood. Hang new curtain rods. Hang blinds. Next on my list is replacing the lightbulbs in the entryway. I think I may need scaffolding to reach it…so that will be interesting. My friend recently reminded me of all the color in my old house. This house has remained cream and light colors. I may start painting it. I am planning and preparing mentally for Winter number 2 of pandemic isolation.

Rationally I know life is good right now. I have so much to be grateful for. My sons and I got stuck in the rain yesterday and we laughed and played (until the clap of thunder directly over our heads) at which point we screamed and wildly ran back to the car. And I am grateful for them so much. I know I’m not on a wheel. I’m on a path. I just wish I could see past the horizon sometimes.

(You can end here. The rest is an aside. But I was too lazy to make a second post. I mean it’s still a good read though.)

I was doing therapy today with a client, and I was on my A-game. We had just had a session mid-week and there was something about it that kept nagging at me. I opened with that, and my suspicions were confirmed which led me down the path of leading the client to cathartic tears. (It wasn’t my intent to make client cry, never is, but we had some stuff to unpack so it happens). As client cried, I sat, waiting, and doing cheers in my head for getting us there, (I know it’s weird that in my field it’s sometimes a win when people cry), and we were both sitting with the clients realization and then I heard a pecking at the window. I looked over and there was a little bird pecking on the window. I’ve been in the office since June, and have never had that happen. The client laughed through tears and was touched by the bird’s presence. It stayed for under a minute, but long enough we got to really see it.

My Dad had a tree of life. Big green maple with a ton of bird feeders and suet traps. There were always birds and squirrels and he had bird books and would look them all up. He would run out and yell at the squirrels. I thought, I see you Dad. Thanks. I know you’re checking up on me. Because through all the shit of the last year I still miss my Dad. He would have helped me paint the fence. He would come watch the boys for me. He would tell me not to work so hard and take care of myself. He’d probably annoy me by asking questions I don’t want to talk about and making a mess with the paint somewhere, and feeding the boys crap. He’d ask me to come over on Sundays and make me his eggplant parmigiana which I love or he’d try and make something I detest thinking I actually like it and get annoyed when I remind him for the millionth time I don’t eat mayonnaise or meat.

But I’d take it all.

Mental Illness IS NOT the “Worried Well”
Mental Health Stigma Suicide

Mental Illness IS NOT the “Worried Well”

lesbehonest20172 Comments

I’ve worked in many different aspects of healthcare so I have an understanding of what’s meant by “different level of care”. You probably understand it too but you may not have thought about it.

There are different levels of care for all illnesses and situations. You may understand it better from a medical perspective. Have you ever had a relative who broke a hip? Perhaps they went from their home to an emergency department; the ED triages who needs admission to the hospital and who can be managed acutely and sent home with perhaps more supports in place. From the ED the broken hip is admitted for surgery. Perhaps after surgery they are in the ICU for a day because their vitals are not stable yet. From the ICU they go to a medical/surgical floor. Then from there they are not quite ready to go home but too well for the hospital, so they are sent to a SNF (Skilled nursing facility aka nursing home/rehab). From SNF they are sent home with perhaps in home physical therapy and skilling nursing visits once a day. From there they are then deemed able to go to physical therapy outside of the house and follow up at an office with an orthopedist.

The point of this is to demonstrate the multiple levels of care we have for people suffering from injuries or illness. At any point in that example did you think “Now that this patient is going to outpatient PT they are clearly the worried well”?

No. You didn’t. Because they had a diagnosed injury, surgery, and recovery.

What about the asthmatic who sees their pulmonologist once a year unless they are sick at which time the pulmonologist sees them daily until their 02 sat drops and they are not improving with outpatient care. They send them to the ED. Luckily the ED stabilizes them with IV steroids and they are able to return home and avoid admission.

Again- when the asthmatic is well and seeing their pulmonologist once a year for maintenance visits did you think to yourself, “They don’t need a pulmonologist, they are just the worried well,”?

No. You didn’t. Because they had a diagnosed medical illness, treatment plan, and exacerbation of illness which required an ED visit.

Please explain to me why, when I treat clients at an outpatient level of care in private practice I am told that I treat the “worried well”? A few people have said it to me over the years, more probably think it, but they know I will ask pointed uncomfortable questions and give a lecture on the stigma of mental healthcare.

Mental illness is the ONLY area of our healthcare where people who seek outpatient maintenance treatment are labeled the “Worried well”. Do cardiology patients have to deal with that bullshit? No. Their patient may never be hospitalized. They may never enter an emergency department. They may see their cardiologist once a year for their EKG, Echo, stress test, and renewal of their anti-hypertensives but they are never referred to as the “worried well”.

I’m about to get on my soapbox, in fact I think I’m already there. (But just so you have the mental image: imagine me standing left hand on hip, right hand waving around sometimes pointing and shaking sometimes running through my frizzy crazy hair looking passionate enough that you want to follow me into battle.)

People who seek outpatient psychiatric treatment are many things but they ARE. NOT. THE. WORRIED. WELL.

They are brave. They are survivors. They are people with diagnosed and treatable illnesses that originate in their brains.

They have Major Depressive Disorder Recurrent Moderate without Psychotic features (F33.2). They have Bipolar Disorder (F31.9) They have Postpartum Anxiety/Depression/Psychosis (There are a few codes for this- look it up). They have Generalized Anxiety Disorder (F41.1).They have Post Traumatic Stress Disorder (F43.10). They have Adjustment Disorders (F43.20-F43.24). They have Gender Dysphoria (F64.9). They have Dysthymia (cycling/irritable depression often co-morbid with trauma responds well to Lamotrigine now labeled as Cyclothymia F34.1). They have OCD (Not a billable dx any longer). They have Autism (Anthem BCBS says this is NOT a billable diagnosis. Add it to the list as to why I despise them F84.0).

These are a smattering of the diagnoses I treat on a day to day basis. We have over six hundred clients at my practice and six clinicians. Over six hundred people. But yeah they are totally all the “worried well”. I want to scream when I hear this. Because let me tell you maybe three of them are well enough to go a year without seeing me. A small percentage see me a minimum of every 3-6 months and the rest see me monthly, bi-monthly, and during acute crises weekly or more.

Private practice is the least acute setting. That doesn’t mean we see the least acute patients. And even if we do see the “least acute” that doesn’t make them the worried well. Are all the outpatient patients of every specialty- pulmonology, allergists, immunology, rheumatology, cardiology, endocrinology, etc.- the “worried well”? No. Most of them have moderate sometimes severe illness but they see skilled clinicians who work their butts off to keep them out of the hospital. Even then, some patients will end up hospitalized. Some will die. This is the nature of medicine. Psychiatry is no different.

We work hard to keep our patients out of the hospital, out of intensive outpatient programs, but we recognize when it’s out of our arena and they’ve reached a level of illness that requires a higher level of care.

Calling my clients the “worried well” infuriates me at a visceral level. Because I’ve seen their tears- even wiped them in some cases. I’ve encouraged them, listened to them, adjusted medications, changed medications, initiated, discontinued, met with families, done therapy, done visits in the parking lot for the autistic client who is too agitated to come inside, told them to put their knife away because even with a knife I’m not prescribing Xanax, tried to reason with psychotic people to take their anti-psychotic medication, watched as mania destroyed lives and supported through the first year after a manic episode while we stabilize, manage side effects of medications, and try to pull them out of the deep suicidal depression that follows the epic and destructive mania. I’ve treated during pregnancies that were planned, unplanned, and the result of rape. I’ve treated people postpartum and post-abortions and post-rape.

To call my clients the “worried well” insults them. Insults their illnesses. Insults their journey. Insults their ability to drag themselves into psychiatric treatment when our society and often their family members tell them that they are the damn “worried well” and to just do yoga and they will feel better.

Patients who seek psychiatric treatment and make it to maintenance treatment are not the worried well. They are healing. If they make it there without being hospitalized and without an IOP and they stay there until we get them off medication and they never need it again…they aren’t the worried well. They are lucky. Lucky we found the right medication the first try. Lucky they had a robust response. Lucky they found a good therapist who they engaged with weekly sometimes twice weekly for two years so they could work through all the despair they brought into treatment. They are lucky to live without a relapse in symptoms through acute future stressors. Those patients are rare. In fact I cannot think of one. Because mental illness IS. AN. ILLNESS. Maintenance is the goal. But there is always a risk of relapse and for women it is particularly risky if they have their illness controlled before having children- because having children is a risk for relapse or worsening of symptoms.

People who mention the “worried well” in regards to private practice in mental health brings to mind the term “toxic positivity”. It is always said with a smirk. It is discounting of every person’s journey into mental health treatment. It also discounts the skill of private practice clinicians who keep so many out of higher levels of care through finesse, clinical acumen, long term bonds and trust with patients, and generally being damn good at what we do.

Now you know. Never say this about mental health practices or patients. It is demeaning, inaccurate, and rude.

Sit with that discomfort. Process your emotions. It will help build resilience if you process negative emotions instead of ignore them or sublimate them. (Google toxic positivity). It’s not my job to take away the discomfort with a witty or heartfelt wrap-up. I want you to sit with the discomfort as I have. Examine it. Learn from it.