Tag: stopthestigma

Therapy for the Therapist
Mental Health Stigma Suicide

Therapy for the Therapist

lesbehonest2017Leave a comment

I did a couple years of therapy when I was getting my master’s in psychiatry. It was helpful. Then I felt rather done with it. My therapist agreed. We had done a lot of work and covered a lot of ground and I was much better after I graduated and started working in mental health and out of the emergency department.

I’m generally quite open with my own clients about my therapy experience- not the actual content- but the process; especially when trying to talk people into therapy who are reluctant. Essentially I relate that I found it helpful,  that it can be time limited, and it’s important to find some one you vibe with and it may take a few tries to find that “right fit”. My first therapist was nuts- I didn’t see her for very long.

My second one was awesome. I actually sent him a birth announcement when I had the boys with a little note thanking him for all the work we did together as I felt I would not have made it through the fertility treatments without having gone into it in the best mental state of my life.

After my Dad died last April and I was coping with significant stressors at work I started feeling like I didn’t get to grieve my Dad. I also felt like I was becoming generally more depressed and less motivated. I knew the cause was the death of my Dad and generally watching his decline over the last two years.

I also knew it was time for me to go back to therapy. The issue became finding a therapist who could see some one in a Queer marriage, because trust me heterosexual therapists just are not the same. I say that with love for all the straight therapists out there. It’s just easier for me to talk to some one who is Queer because they get it.

So Queer competent at the least and some one I didn’t share a ton of patient’s with and who takes my insurance and who could accommodate my schedule. Yeah. That task was daunting to me. I talked to a couple of my therapist friends and got some recommendations. Waited a few months. Talked to them again. Got different recommendations.

Then made the call. It’s always good for me to do something like this because it makes me appreciate how nervous clients must be when they are calling me for an intake. I went to the intake, and am super happy with my decision to go back to therapy.

I forgot how nice it is to have a space to break down. I needed to break down. I needed to grieve and discuss my grief with a neutral third party. It’s been incredibly validating and empowering. I also needed to talk to some one who didn’t know my Dad so I could tell stories about him and describe him in detail.

After three or four sessions I felt great. I was thinking, I think I’m done with therapy. Then the non-crazy side of my brain was like, uh no. You don’t fix two years of watching your Dad decline and die after four sessions. We were just scratching the surface.

I also knew of my own clients who felt like they were “done” with therapy, who really weren’t, and who needed to go out and suffer and realize they weren’t done and call a month later for an appointment.

I’ve been open with my family and friends about going back to therapy as I work in mental health and want to #stopthestigma.

I’m not crazy. I was mildly dysregulated due to unresolved and unprocessed grief. I’m working on it. I told my therapist about my impulse to stop coming when I felt so much better and then the reality check I gave myself about it. He laughed and agreed that it’s a thing. People feel better initially and drop out of treatment too early before getting to the real issues.

He also agreed I don’t need to be in therapy forever. But likely a 3-6 more months is realistic. For an hour a week I get to take up space in a way that allows me to be vulnerable and process the death of my Dad. It’s important that I do this work. Unresolved grief can lead to many other sequelae none of which I want to experience.

I also feel it’s important that I practice what I preach. If I’m struggling I need to recognize that and seek treatment. I tell clients every day that they need therapy. I also always say it’s not going to be life long but it takes time to work through complex emotional issues.

I’m giving myself that time. I’m making myself and my feelings a priority.

At the intake he asked me what was the tipping point that made me schedule an appointment. I told him that I now have two extended family members who committed suicide. One was a teenager several years ago, and one was a grown adult earlier this year. Both very different scenarios and both highly functional people one with a bright future snuffed out too soon, and one with a very successful career and family.

I told him that I have been touched by suicide. That I don’t feel suicidal or depressed to that degree at all, but that if I didn’t intervene for my emotional health now I didn’t want to wait until I was at the point of either of these relatives. I’ve seen the worst possible outcomes of untreated mental illness in my own extended family. I don’t want that to be me. I don’t want that to be anyone else in my family or among my clients so I have to walk the walk and not just talk the talk.

I didn’t say it quite that cogently in fact I said it through tears because I feel a deep pain for these family members who took their own lives.

I am a mental health professional and I am in therapy for the second time in my life. I am working out grief related to the loss of my Dad.

I hope any one struggling with mental illness in any way shape or form has the strength and ability to reach out for help when you need it. I hope no one else I know ever commits suicide again. I hope for a future without stigma for my clients and for myself.

I hope if you’re reading this you feel empowered to reach out for the help you need.

National Suicide Hotline: 1-800-273-8255

 

“That could have been me,” One teenager’s response to suicide.
Mental Health Stigma Suicide

“That could have been me,” One teenager’s response to suicide.

lesbehonest20173 Comments

I see a lot of teenagers in my practice. I actually really enjoy working with teenagers. I often have parents in the room for most of the visit because it helps me see the family dynamic for one, and two I want parents to know how their kids are actually doing.

I want them to hear how their child is still struggling or not because they need to know. I am often surprised at the number of parents who I have to practically glue to the chair to get them to stay in my office. They seem skittish when we talk about depression and suicidal ideation. They will often ask to leave or if we can talk separately or not talk at all about suicide.

If there was an attempt in the past I can’t tell you the number of times I’ve been told that we need to discuss it without the kid in the room. I always respond with, “Well if they want to leave that’s fine, but they were there, so I’m pretty sure they are actually the best person to ask about it.” I’ve never had a kid leave. I’ve never had a kid not tell me what happened.

What’s fascinating about this interaction is that if I ignore the parent the child does too, and we continue to talk about their current and past mental health status. If a kid asks to talk to me alone or declines to answer something I always respect that. But over and over I see kids decline to have their parent leave and then talk openly about their depression and suicidal ideation.

Kids want their parents to know. I want their parents to know. Why do parents not want to know? It’s so rare for us to be let into the world of our teenagers- because they have their own world- so why would you run from that opportunity to be let in?

Don’t run. Sit your butt in that chair.

Recently it was one such moment. I was checking in with a kid I knew had been affected by the death of a classmate. The parents were sitting there after I ignored their questions about leaving. The teen and I kept eye contact and they said, “This may sound weird, but I just keep thinking, that could have been me.” 

I nodded my head, and said yes I can see that you’d have a lot in common. Both are/were very successful, hard working, and both wear/wore facades so bright that no one would think they are depressed and struggling to live.

It’s important to keep eye contact in that moment. To let them know I can handle them. I can handle the darkness of that thought. I see them. Eventually we moved on in the conversation and I looked at the parents.

They both had silent tears streaming down their faces.

That’s why I make them stay. They needed to hear that. They needed to know how badly their child struggles with the day to day that they identify more with a child who committed suicide than with anyone else.

I wasn’t going to write this post. But it’s been bouncing around my head since that visit. That very clear and distinct voice, “That could have been me.” The insight and wisdom of that one little statement said so meekly and with such fear. The way it tore through me and their parents.

I hugged my sons a little tighter that night. I maybe cried a little harder than I should have at Frozen 2 because I was thinking of all the teenagers who reach a point of wanting to die.

In 2017 suicide was the second leading cause of death in kids ages 15-24. Specifically ages 14-19 there was a 47% increase in suicide from 2000 to 2017 (Harvard study published in June JAMA).

I grew up in that space where kids are dying. Because this last wasn’t the first suicide in my hometown. When I was in high school 1999-2003…yes that means I’m 34…it wasn’t exactly an accepting culture. It’s been 16 years. I sorta hoped it changed in that time. But I don’t think it has based on what I see in my private practice.

Kids are still bullied. There are still mean girls. Athletes are still allowed to get away with more than non-athletes. I’m hoping there aren’t any teachers still having sex with students, but who knows.  

I don’t know what the answer is. But it’s not a coincidence that I opened a mental health practice and am known for taking teenagers just a few exits down.

I see all kinds. The weird artsy quiet ones. The high achieving three sport scholar athlete. The bullied. The bullies. They all struggle with their own demons.

We’ve lost so many children to mental illness. We will lose many more if there are not kids who are willing and brave enough to ask for help. To speak their truths.

We will lose many more if there are not adults and parents willing to listen and willing to start the conversation. Even if it hurts. Even if it feels uncomfortable and awkward. Because if you walk out of the office, you will miss that moment when they choose to let you in. And that moment can lead to more moments. Those moments can be the difference between life and death.

 

***** This is in no way meant to take the place of actual mental health advice/treatment from a licensed provider.

***** This is in no way meant to detract or cause pain to families who have lost their child to suicide. Even with treatment. Even with open conversations and a loving open supportive family there is still a mortality rate to mental illness.

Suicide Hotline: 1-800-273-8255

Translifeline: 1-877-565-8860

 

 

 

 

 

 

 

 

 

 

Working in Mental Health Must be Crazy.
Uncategorized

Working in Mental Health Must be Crazy.

lesbehonest2017Leave a comment

I generally don’t tell people my profession right away. If they ask what I do I say “I’m a nurse,” that’s usually enough. If they ask further I say I work in mental health. If they ask further I say “I own my own practice.” I try to keep it short and simple.

People’s general response is “Wow that must be crazy,” or they ask what kind of people I treat, like the people I treat are some sort of sideshow freak. I always respond that I treat many different people. Again to just close the subject.

A couple reasons: I don’t think discussing my work is appropriate in most situations. All of what I am told is confidential and protected. I work hard to protect my client’s privacy. Basically any discussion about them could be perceived as disclosing too much.

I don’t know what everyone’s story is. I could say that I treat a lot of sexual assault victims, and trigger the person I’m talking to who may be a survivor of sexual assault.

I don’t want to hear about everyone’s story. If I’m at the grocery store or at the gym I don’t want to know your mental health history. I just want to exist in the world in that moment without bearing other people’s shit.

So yes. I can be rather closed off about my profession. Not because I’m not proud of it and the work I do. Because I am. I love my work. I love that it’s unpredictable. I love that my long term clients trust me and look forward to seeing me. I love getting referrals from my clients because I know they trust me to see their friends and family.

It’s like parenting. The days are long but the years are short. I have some long ass days. Days I want to cry, scream, and everything else. I hate insurance companies. I hate that they dictate care and reimburse crap. I hate chasing people for money and/or getting screwed and never paid. Because it is my livelihood and it pays my mortgage.

I started keeping a video diary at the end of my days.

Yeah as soon as I figure out how to upgrade my plan that’s happening. I was watching some of them tonight and it’s hilarious. Also sad.

Here’s my point to this rambling blog post. I love working in mental health. It is fucking nuts some days. I’ve had knives drawn in my office. I’ve held people as they cried. I’ve been screamed at, sworn at, quietly glared down, and mildly stalked (yes there are levels). I’ve also been the first one to know about a pregnancy. The first one to know about a marriage proposal. The first one who a person comes out to about their sexuality or gender identity. I’ve watched people literally transition from one gender to another and everywhere in between. I’ve forged relationships with clients who have a deep mistrust of mental health practitioners and I’ve discharged clients and been fired by clients.

I’ve seen people through marriages, divorces, children, high school, college, and first jobs. What’s crazy is not my work. It’s not my clients. What’s crazy is the stigma that still exists around mental healthcare.

What’s crazy is not my clients. 

My clients constantly amaze me. People who make generalizations about mental healthcare do not understand that nothing separates them from my clients. Nothing. I’ve treated the poor, the rich, the middle class, white, Black, gay, straight, old, young, and everything in between.

The need for therapy or psychiatric medication doesn’t make some one crazy.

Denial that one is in need of therapy and/or psychiatric medication defines crazy.

To all my clients and everyone courageous enough to seek mental health treatment for yourselves I see you. I admire you. I don’t think you are crazy. I think you are some of the bravest people I know.

 

 

 

 

Why This Nurse Cares.
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Why This Nurse Cares.

lesbehonest2017Leave a comment

In my time as a psychiatric nurse practitioner I’ve had people react to me in many different ways. I often say people either love me or hate me. There’s not much of an in between. But that’s wrong; I am learning the in between exists.

There’s a gray area where some people live where they just don’t understand me and are scared to hope that I might be real.

It’s taken me some time to recognize this particular response to me as it presents as hate some times. Often times. I’ve had clients scream at me, “BUT WHY ARE YOU BEING SO NICE?! I FUCKED UP!” I’ve had clients say, “BUT WHY DO YOU CARE?! YOU AREN’T MY RELATIVE SO WHY DO YOU FUCKING CARE?”

It surprised me the first couple times. Why would I not care? Why would I be in the profession I’m in if I didn’t give a shit?

I’ve reflected a lot about this particular reaction to me.

Clients that stick with me; who have been with me through divorces, marriages, bearing children, gender changes, sexual orientation changes, sobriety and relapses, and any other major life event you can think of…these clients know that I’ve got their back. They may hate me sometimes. When I’m not doing what they want me to do and I may push them in ways they don’t want to be pushed. But I’m there for them through it all.

I tell clients I don’t get mad at them, I just try and understand where they are struggling and why and work through it with them. And it’s really true. It takes too much energy and would require taking things very personally if I was to get upset with clients and sort of counterproductive to my role.

A client who recently questioned why I cared about them with skepticism said it must be because I have to care because it’s my job because I have to care about everyone who walks through the door. I immediately shook my head no. I do not keep every one who walks through my door. I do not take on everyone who calls. And certainly not everyone keeps me.

It has to be a good fit on both sides. We don’t necessarily have to like each other but we have to have respect for one another and we have to feel safe with one another. I’ve discharged people who threatened me or who were too acute for a private practice. And people have discharged themselves when they don’t get what they want or need from me.

But my peeps, my clients and my patients, yes I care about them. I don’t know any other way to be. I don’t know how to sit with some one and hear their story and try and partner with them to move forward and not feel something toward them. Empathy. Compassion. Because it is from those clients who I learn the most. The clients who take steps forward when the world pushes them back; they are the people who inspire me. They are the stars to see, to feel, to experience, and to be witness to that brings me joy like nothing else.

I saw a client recently and we got in really deep about something and they teared up, and we had this moment, and I’m like you just got therapized. But it’s not just them it’s me who learns from them. Me who learns that it took almost two years to get a tear from them to watch them progress toward feeling the hard mushy feelings.

I care about people because I couldn’t sit in the chair I sit in and not care.

I trained with an APRN who was amazing. She taught me tremendous amounts about everything but mostly she taught me how to see patients as people. She said she did half hour follow-ups instead of the standard fifteen minutes a psychiatrist does because, “Ya know. I like to talk to my people.” I agree with her. I like talking to my people. I like to know them, and although caring about each and every one makes me vulnerable it’s also what makes me good.

It makes people trust me because they know I am prescribing to them in a way that I would prescribe and treat my own family member.

To wonder why some one would care hurts me. Because it means that person has been wounded. Deeply.

Why the fuck do you care?

My answer is because I can. Because I do. Because I see you and you are worthy of being cared about. My question back would be why are you scared of being cared about?

Stop the stigma.