Pop Up Mental Health Clinics

Pop Up Mental Health Clinic
Pop Up Mental Health Care Clinics

A pop up mental health clinic? Never heard of it? Nor had I until recently when I read an article on how pharmacies are getting into the game of mental health care. Soon, it seems, we will all be able to roll up to our local pharmacy and not only pick up our prescriptions, but see a therapist on site as well.

As a therapist myself I wondered what does this mean for not only me as a provider, but also for the patient. Certainly the pandemic over this past year has taught all of us that access to mental health care is not only necessary for everyone, but also needs to be accessible with few barriers to receiving treatment. In terms of access, rolling up to your pharmacy and having access to a therapist on the spot feels like this need is being met.

However, I have my questions. Therapy is broad with many therapists offering a range of different types of care for many different types of symptoms and upset. From anxiety to depression to severe illness such as schizophrenia, therapists treat people suffering from all of these and much much more. Given this broad range of mental health ailments, most therapists specialize in an area. The specialization comes from study, their experiences, and their interests. When someone is looking for a therapist, they are often trying to find someone who matches what their needs are.

Walking into a pharmacy, I wonder how people will be matched up. Will it run like a crisis line where whomever walks in gets the next available therapist and the meeting is for the therapy hour (45 to 50 minutes) and then the person gets up and walks away and hopefully feels better with no charge or is it going to operate like a low fee clinic, charging a low fee, and patients have a choice of whom they see and have the option of returning and seeing the therapist on a regular basis?

I also wonder will pharmacies tie people to a therapist based on their prescriptions. Let’s say someone is picking up an anti-anxiety medication and the pharmacy staff not only gives the patients their script, but also the names of therapists in their clinic that they encourage you to see alongside taking your medication. The flip side of this is a therapist who sees someone for anxiety and then sends them to an in-house medical doctor who then prescribes anti-anxiety meds that get filled right at the counter. Convenient one-stop mental health help.

Those two points, i.e. that therapists seeing patients in such pop up mental health clinics, actually have the experience to support whom they are seeing in the pharmacy and that this is not just a grab to prescribe more meds to the public, are the places where I feel concern. This article does not disclose the details of these plans, just to say this fad is coming our way.

The article lists out questions that patients should hold in mind when they meet a therapist, but, truth be told, when people want to talk to somebody such questions often go out the window as their distress is so keen, it is difficult to hold in mind who is this therapist and do I feel comfortable with her? It is then on the therapist to hold on to their minds to decide if they can serve a potential patient or not. If a therapist does not think she can, does she have the ability to not take someone on? In community mental health, that choice is often not there for the clinicians, but will it be in corporate America?

Mental health is serious and corporate America is seeing it as its own power play and grab. Ethically one needs to safe guard themselves from a fast food approach to mental health care. Yes, something is better than nothing, but sometimes fast therapy does little to change anything.

As a practicing therapist, I believe mental health care should be available to all, but in a responsible way. There are low cost clinics and websites where Clinicians offer their services at a deep sliding scale. Finding this type of therapist for a long-term relationship feels important as the therapist can then track alongside you your progress, setbacks, and provide a containing space that is ongoing and built on trust. I believe in this type of approach for the work we do together.

Yet! I won’t be surprised to walk into a pharmacy next time and see a line of therapists waiting to see you and me.

A Time to Languish

A Time To Languish
Languishing

Is this a time to languish?

According to the New York Times, it is! Last week, I was perusing the paper and there it was — an article on languishing. First off, this is a very old fashioned word. I had originally thought it meant to take one’s time, but the more I read the article, I knew I was wrong. When I looked the word up in the dictionary, it means “To grow weak or feeble and (2) to suffer from being forced to remain in an unpleasant place or situation.”

Aha! Now I had something to think about. Given we all seem to be stuck in the pandemic that just won’t take her leave, we are stuck in a situation that is joyless and aimless. The article points out we still have energy, but it’s just being used in mindless, unenergetic, stuck, and listless ways.

The article calls languishing the “middle child” of mental health — you aren’t thriving and you aren’t depressed. You are languishing on the vine of life going along at best. Is this you? Is this me? You may not even realize you are suffering from languishing as when you are in this state your mind is in a fog and cannot discern what you are feeling or not feeling. The article goes on to point out naming it may be a way to start normalizing this feeling. It even encourages people to answer the question, “How are you?” with the word — “I’m languishing.”

How would you respond?

Of course, the article goes on to giving some good tips — try to get into one’s flow, focus on small goals, and give yourself some uninterrupted time — all ideas that can help any number of mental health conditions that cause us to not be at our peak on any given day. So, the article is sound, but it is also general.

To languish now calls to mind rotten fruit withering on the vine of one’s life. That’s harsh, but it feels like the truth. One needs water and nourishment for growth — how can we gain this for ourselves when we are forced to continue in the pandemic. I know so many people who have booked travel for later this year to favorite destinations. Will they get to have the experience they desire or to return to those days do we have to wait longer?

Some of my own tips for dealing with the state of languishing includes:

Cultivating the long breath — the pandemic is not over yet. Being present to life and making it good in the here and now in the circumstances we are in is what we are each called to do. Figuring that out seems critical to growth at this time.

Pick up something new to do — that you can do without the pandemic constraints. Some people are tired of masks and social distancing. Give yourself activities that are safe to do without these constraints on you — i.e. a new exercise at home, a new hobby at home. I know you may be tired of home, but it is a place where freedom from these constraints can live.

Fully vaccinated? Get out and do old new things with the safety measures in place. Go out to eat, head to the local museum, take a weekend away — refresh yourself in ways that you haven’t touched since the pandemic began. Even little things can become big helping you to thrive.

Be in touch with your family and friends in new ways — perhaps that is once again being together as everyone is vaccinated or just remembering people through kind words and gestures. Holding others in mind can often get ourselves out of our own minds and languishing there.

It seems to me that straddling the middle to the end of the pandemic is about naming our mental state — are you thriving, languishing, anxious or depressed? Once one can name her feelings and actually feel them, one can act to lift the fog and take steps toward thriving.

May you not languish a moment longer than you need to!

Moving through Grief

Moving through Grief

Moving through grief. What does this even mean?

As a therapist in training I ran a small grief group. The weekly meetings across ten weeks were meaningful and significant — for the participants. Not to say those meetings were not important to me — I was learning, I was training, I was in the work. Yet, I was not in grief. For me, I understood and yet I did not understand at all what people were feeling. I could be present, empathize, hold space and contain feelings — but I could not move through grief that was not my own.

I realize this now as I have been experiencing a significant season of grief. I lost my Scottish Terrier on Thursday, February 4th 2021 around noon. Even eleven weeks later – notice how I still count the weeks from that week – I still mark the days of that week by how my Pepper walked through his final days and how I walked alongside him.

To say it has been a mysterious time is an understatement. I suppose my unique journey of moving through grief has been largely to dwell in the mystery and to go slow with myself feeling what I feel in the moment. Over this period of time I would often break out into tears as I listened to a song, saw him in my memory in all of his favorite places, felt robbed that he was gone so young and so fast. I didn’t bottle it up — all of my tears – instead I have let them flow.

Moving through grief has been marking his passing in significant ways — framing his paw print with a friend’s little memorial drawing of the letter “P” for his name — taking his hair clipping and making a piece of memorial jewelry that I wear close to my heart each day – creating a plan to scatter his ashes in his favorite place – being open to talking with him on a regular basis. I have my most favorite picture of him on my vanity table and I sit each morning there putting on my makeup and tell him about my day. Sometimes I light a Glassy Baby candle that captures my feeling toward him for that day — like Honor, Thank You, and To The Moon.

For a long time I was quiet. I was able to thank people through handwritten notes for their kindness of holding me in their thoughts, but for a long while I could not speak to anyone. Nor did I want to. I wanted to be quiet and hold him all to myself. These days I find I am having people over to my home and I show them where Bubby died and I can talk about how painful this season has been for me. I am finding my words. Also, I am learning that there are friends who will hold space for my pain and be present to me.

On some level, I hate to see the weeks roll on by. It adds up to more days without Pepper. He surely would have loved the sunshine and warm temperatures. He ruled his corner of the world and would be out all day long keeping guard over the neighborhood. He loved his walks — rain or shine — and always was up to play tug. The days keep moving forward and there is nothing I can do to stop time. I can only continue to hold close to myself and my memories as I move forward.

I love Maira Kalman and she has a book titled Beloved Dog that looks at dogs through her own whimsical lens. She had a dog whom she loved and lost, but in this book she also talks about losing her husband and she wrote something profound on a page that continues to stay with me during this period:

When Tibor died, the world came to an end. And the world did not come to an end. That is something to learn.

Indeed, I have so much to learn moving through grief.

A Pandemic Ending

Pandemic Ending

A pandemic ending. Can it even be possible?

Only a year ago, the entire world was going into lockdown. True lockdown days where the government actually counted cars on the road to see if we were doing a good job in WA State of staying home. Except for a trip to the grocery store every now and again, you were meant to stay inside.

Although life became strange, the lockdown provided many with a reprieve from having to be social. Many who feel pressure to live up to others’ expectations no longer need worry about it. Family occasions came and went and there was no need to make uneasy excuses as to why you didn’t want to attend.

The pandemic of course. It allowed for many to have breathing room to slow down, not care so much, and be true to themselves.

A pandemic ending? Now what?

All of a sudden, with everyone soon vaccinated, people are going to be out and about wanting to gather socially. All of a sudden the pressure to keep up, discuss post-pandemic plans, and be with others is on. Even before it actually is over, everyone is chomping at the bit to make plans. It’s no longer a long breath moment of silence and hunkering down. Now it is all about the other and getting out into life.

But what if you aren’t ready? What if you want to stay in lock down a little bit longer or even a lot longer. What to do? Perhaps all of us found a space that felt new and different that we don’t quite want to give up as the pandemic ends. Perhaps you love cooking more or family game nights have become a tradition or working on your creative projects deserve your time. These all feel like easier things to keep as a part of your life even as life resumes to normalcy.

How about drawing boundaries with friends and family? Now that everyone is going to be able to actually see their dear ones without a pandemic looming over us, what if you don’t feel like rushing out to be with everyone? How to handle? Being honest with one’s self seems to be the start. On your own, what did you learn about yourself as far as the others you share time with? Perhaps this is the time to put in motion how to be with others and be true to yourself. Perhaps that is not seeing people, perhaps it is not spending as much time, perhaps it is saying no, perhaps it is saying yes. Having courage to interact with others out of new knowledge garnered while in lockdown feels important as the pandemic ending is about to unfold.

If you are grieving the end of the pandemic, it is perfectly normal. For over a year, we have found a new way to live life that was quite different than life before. Taking some time to think about the losses that you will endure as life resumes also feels important at this time. As we went into lockdown, I don’t think anyone saw that this was going to go on for over a year. We lived into it as it unfolded.

As we have more notice of the pandemic ending, grieving what is over and lost, preparing how you want to engage with the other, and determining what parts of your lockdown life you want to keep are all ways to prepare for coming out of lockdown and engaging in normal life over the next few months.

Bravery

Bravery

Bravery.

I don’t often think about this characteristic in myself or in others and yet it is one of those that seems to either drive one’s entire life or is left out altogether. What does it even mean to be brave? I am sure the dictionary has a clever definition of this substantive word, but I often like to ask myself what does the word mean to me — or to turn and ask what it means to you?

For me, bravery means you are “out on the edge of the branch” with yourself. You recognize what is safe and what is risky and, if it really means a lot to yourself, you take the chance and risk into something that is out of one’s comfort zone — that takes bravery. That takes leading life “out there” not know what will happen, but also knowing you have your own back to catch yourself if you fall rather than fly.

Is that how you would define bravery? I would be curious to hear your definition.

How do you know when you are being brave? Well, when you are scared to speak a truth or have a conversation at all — that is brave. If you are doing something for the first time that is uncomfortable and unfamiliar — that is brave. If you are risking a part of yourself to love, to create, to enjoy, and to do just about anything else — that is brave. Breaking a pattern or a way of being — that is brave.

Sometimes it is important to remind one’s self all the ways you’ve been brave in your life to date. My guess is you are already braver than you think. Make sure to take the long inventory of your life to think through how bravery has played into your life in so many of the decisions you have made. For me, I have a laundry list — heading to India on an intuitive notion and giving up my whole world to reconcile my bi-racial identity, meeting a man and moving countries to find out what we may be to one another and ending up marrying him 18 years ago, creating a start-up business out of pure passion and riding her to the end and letting go when it was long past time, facing myself both the good and bad parts and extending compassion to both.

I am thinking you have your own unique bravery list, but I also want to shine the spotlight on people who don’t care to be brave. For some, this is not how they want to lead life. Instead they value safety, familiarity, patterns and rhythms that are abiding through the ages personally and across time. This may take the shape of someone who accepts things at status quo, lives the life that was laid before them as a child and walked on through, and does not break out or away from the known throughout life. I don’t necessarily think these people are not brave, I just don’t think they prize this as a desirable characteristic.

Yet, even then, to live is brave. Even if we are to go forward with no abrupt changes or departures, we will grow up, grow old, lose loved ones, make decisions related to our careers, perhaps meet and marry and maybe raise a family. Even in the mundane, bravery is brimming over the cup. To be human, to live is to be brave. It does not have to be any extraordinary journey that we need embrace to claim it for ourselves.

To live is to be brave.If you were to define bravery, how would you frame it for yourself? From there, what has been your bravest moment in this life?

Cheers to you and your bravery.

Losing A Beloved Pet

Losing a Beloved Pet

Losing a beloved pet.

The idea has always felt so far away to me — until one week ago when I lost my beloved pet,

Pepper was a spunky, courageous, forward-looking pet who lived and moved with purpose. He was also a dog who allowed me to own him — which is often the case with a Scottish Terrier. The Scottie dog is about having an independent life even as he shares his life with you. I had them all my life as I grew up and I guess it was always my fate to have a wee lad as an adult.

Pepper hailed from Utah — one of five in a litter that summer of 2010 — he was the last of the litter to be taken from the breeder at 14 weeks old, which is kind of late to get a puppy. Yet, when I called I wanted a brindle Scottie dog that was 14 weeks old and I told the breeder his name would be Pepper. She said his Grandma and Mom were named Piper and Poppy — this dog is yours.

And was he ever. We were independent of one another and yet completely in sync. For the first five years of Pepper’s life, I walked him four times per day. We would walk and walk and walk. From there, we moved and he had a small urban oasis backyard where he ruled the corner of our neighborhood. Nothing got past him – and he always was chasing squirrels and looking for kitty cats. At night, he came inside and took his place on his window bench and would rule the other end of the corner keeping guard nightly.

When the time came, I lost Pepper quickly. Apparently he had cancerous tumor in his spleen that was causing him to bleed into his abdomen. This went on for quite awhile and we thought these were gastro episodes as he always had a weak constitution, most likely he was the runt of his litter. After treating him with some pain meds, he would be back to himself in a day.

Until the day came last week when the pain was not taken away no matter how much pain meds we gave to him. I always knew I did not want Pepper to suffer and would let him go before that truly took hold of his entire being. And so the hospice vet came in and we euthanized him in our home in his favorite spot. There was no real ceremony — I know many people make a loving plan. For us, it was just apparent that morning and we needed to help him out of his pain as quickly as possible.

And so I ended up holding him close to me as I said all the favorite phrases he loved and then laid him down and I saw his beautiful brown eyes sweep his corner one last time — and then he was gone. Just like that.

I am a childless woman and I suppose that makes me – like many others – turn to my pets to take on the role of children in my life. With our pets, they are only with us for a short amount of years and Pepper was no exception taking his leave at the age of 10. However, for me he was 2 forever. In this way Pepper’s loss feels like the loss of my second child. He was mine and I was his — all the years.

When I first met Pepper at the Salt Lake City airport, I looked at him in my arms and said to him, “You are going to break my heart.” And he did. But that day one week ago, I know my broken heart was so worth it. We had such a fun ride together. I really wouldn’t trade it for the world. I wouldn’t trade it for not feeling the pain I feel today.

Now is the time for grief, for remembering, for hurting, for being with myself and extending compassion to myself. I know he had an amazing life and I still have regrets. I have a new puppy, who came in before Pepper departed, and I wonder is my love for him taking away from my fidelity to Pepper? This is the complexity of grief. In time, I will sort it out and come out the other side.

For now, I remember and love on my Pepper.

Hello February

Hello February

Hello February!

And where exactly did January go to? I know life in many ways is still very limited due to the COVID pandemic, particularly in states like WA, but it feels like time is still flying by even as lockdowns continue.

I always look forward to February. First it is a short and sweet month — four perfect weeks made up of 28 days. When Leap Year falls every four years it is also quite unusual. February also bridges the seasons between winter and early spring. Once March rolls around we know we are going to have longer days, bulbs blooming, and some warmer days. So, February is that short bridge to early spring. Ah!

And then there is the sweetness that comes from chocolates, flowers, and Valentine cards. Do you celebrate? Granted this is often noted as a “Hallmark Holiday,” but I love to show my family and friends how much I love them with special cards and candies. I make sure to have fresh flowers on hand and chocolate of all types for a sweet treat here and there. I know it can often feel bittersweet if we are single or recently broken up with, but I believe there is still the opportunity to spread and receive all types of love if we put ourselves in the space of love — just love.

Finally, this is a month to learn as we celebrate Black History Month. And all of us have so much to learn about black history that is rich and enlightening to the historical context of our nation and how the past history is shedding light and perspective on today. This is the perfect month to pick up a book on a black historical figure or event and to grow in understanding. And don’t stop there with your own understanding. Seek to pass along what you learn to your family and friends – perhaps have a group of your friends and family commit to learning about black history and at the end of the month hold a Zoom discussion to learn from one another.

February is whisked in after the very first month of the year has taken its bow. It’s up to each one of us to make the most of the next 28 days that are ours to spend in many different ways. Here’s to learning, love, and hopping the bridge to early spring.

Happy New Year

Happy New Year

Happy New Year! How did it feel for you to turn the calendar from 2020 to 2021?

Most people I know felt a whole lot of relief and happiness as they saw the end of 2020 – a year that was full if unexpected challenged from public health to job insecurity to financial hardship to isolation and more. Even worse? It was all unexpected — a complete shock to ourselves as things unfolded and then dragged on and on — still actually dragging.

However, there was hope in turning the calendar a few days ago. We did end 2020 with seeing our healthcare workers getting vaccinated. Wow! Our US healthcare system may soon be completely secured from the pandemic. That is definitely hopeful — and we all know that we will have out turn sometime in the New Year.

With the vaccine there is also the hope that our lives will resume to normality — but I am left to wonder will it be a new normal? The pandemic has gone on long enough that people are making new habits, living their lives along different rhythms, and orientating meaning in a different way. Dare I say it almost feels like a return to olden day ways. We are at home most of the time, cooking our own food, spending time with our family constantly – not just quality time – discerning who we really want to share time with via Zoom, engaging with our children on a deeper level, and more. Life has shifted and it’s not all been bad — the break from our break-neck, fast-paced lives has provided us with a different way to live our lives.

How often do we get such a reset in our modern day?

Having had the reset, what will you keep and what will you discard when we are all vaccinated and life is ready to return to “normal?”

As we enter 2021, I am hoping a new normal takes hold that honors the best of who we found ourselves to be in 2020 under extraordinary circumstances and also allows us to bring these parts of ourselves to our lives as we resume normality.

Here’s to it!

A Writing Break

A Writing Break
I Took A Writing Break

I am a therapist. And I am also a writer. Are there two different professional paths that you embody? For me, my work is about seeing my patients as well as writing on a fairly continual basis. It may be a screenplay, a non-fiction book, or this blog — but I write and always have. Somebody once said to me, “If you write, you’re a writer. Own it.”

Why is it so different to own something like writing?

In any case, this Autumn I found myself without the impetus to write. My motivation sort of up and left in what seemed like a mere instant. Perhaps it was my own election stress, perhaps being caught up in home projects, or perhaps even the change of seasons. Not sure what happened, but I did not want to write — not even this blog.

I don’t know about you, but when I have something like a blog to write that I have committed to write on a daily basis, I tend to “feel bad” if I don’t meet my own expectations. However, when my motivation to write vanished, I let go. I decided that it was “OK” to not write and to be curious when my desire to write would alight upon me.

How refreshing to not put myself through the ringer for not doing something that I felt I should be doing. I allowed for there to be a pause in my writing on this blog and other projects as well. I just let it be. The longer I let it be, the happier I became with my decision to not write, to not do, and to simply be with this.

And then my writing impetus began to return. Not sure if it is a daily thing, a weekly thing or a monthly thing or if I will switch it up between all three. I am not sure at all. What I am sure of is how awesome it feels to let go of an item on the old “to do” list when it is really not something you want to do. Freedom!

Are you feeling this way as the holiday season kicks in? Is there something you think you should be doing — professionally or personally — that you have no interest in doing? Perhaps the greatest gift you could give to yourself this season is the gift of not doing without guilt or care. Trusting it will return — or not. But whatever the outcome, there is something to become curious about yourself and learn from.

For now, I hope to be back to at least semi-regular posting. After all, I am a writer, even if one who takes breaks.

Election Stress Disorder

Election Stress Disorder

Election Stress Disorder? Is this even a real thing?

Yes it is and is a term was coined by Steven Stosny back during the run up to the 2016 election. From what I read in the NYT about this disorder, it’s back — bigger and badder than ever.

How would you know if you are suffering from it? Well, common symptoms include: doom scrolling, watching polls non-stop, your mind being crowded with election scenarios — who knew there could be so many? (This is probably one of the main reasons why we even have election stress to begin with!) Everybody and everyone is so divided and it feels like it has already been formally announced —

If one side wins, they cheated.

If the other side wins, the vote was suppressed.

Who can win and where does this end? Anticipating this is driving many of us to have Election Stress Disorder. So much information to scroll, so many scenarios to consider, so much worry over where it’ll all end up. Talk about frustration and anger that leads to stress related directly the the election. Often it comes off as feeling and being irritable.

What can be done? Well, first off recognize that the political landscape is causing you stress. Also, be honest — is it just the other side that you are upset with or is it also your own side and the extreme views that lie within? Or even those you respect who may be forwarding or posting news that is not true. If you can answer this question honestly, it can help to create a strategy to combat your Election Stress.

So, what can you do?

First, if you are going to engage in debate try to limit your time arguing with people. Adding to the divisiveness due to your stress simply adds to more discord. Pick and choose who you do battle with and when you engage look first to connect with someone and understand their opinions — listen! — and then bring your own thoughts to the conversation. If the whole engagement stalls, let it be. Find peace within and give yourself credit for trying to understand the other. Make sure to limit the amount of time you engage.

Yes, take time out from the news. Yet, when you do engage make sure you are reading and engaging with sources that are accurate and truthful. It is on all of us to take responsibility for how we are getting our news and where we are spending our time reading news that informs us about the election and beyond. So, yes, limit your time reading the news, but, when you do, make sure it is worth your time and not “fake.”

Take a break. It’s hard to keep all of this in perspective, but it is necessary. Let history be a guide for you in these times. In the past, people have met the challenges of war and racism and pandemics and the world continued to move forward. Some may say that the world no longer has this chance due to man’s impact on the environment. If this is your perspective, take some of your stress and channel it doing something good for whatever cause is near and dear to your heart.

From there, take heart that life will move forward — no matter the election results. Being present, doing what you can do — especially VOTING — and keeping in mind the larger perspective of where this moment in history fits into the greater history of the world can help one see that it is a moment. Yes, there will be impacts, but there is also hope that we can overcome any one moment.

Election Stress Disorder is real, especially with this final lead up to the election on November 3rd in America. Recognize it, take care of yourself, and seek perspective of this moment across the history of time.