Book Review: The Blue Day Book

The Blue Day Book

Do you have blue days? Those days where it’s difficult to get out of bed, where it’s hard to rally a smile, or to even see anything as positive in your life.

We all have these days — I don’t think we would be human if we didn’t feel blue. And that’s why I love this little book from the 1990s that is called The Blue Day Book. It’s a quick read with lots of pictures of animals with a few words meant to cheer you. What I love is it takes less than five minutes to read and just gives a jolt of something funny and fun to lift one’s spirits on blue days.

I keep this little book on my bedside just so I can reach for it for a laugh or a positive message that cheers me up with some lighthearted humor and animals that make me smile. Often a bad day can just turn on something as simple as a Blue Day Book. We often forget to reach for simple things like this thinking it cannot help.

However, being able to do this simple act – like reading this book – can actually open you up and out of singing the blues and into a more positive frame of mind. Laughter can also do this and this book invokes laughter. Sometimes when we are feeling depressed though it is beyond difficult to reach for a book or a laugh. That is why it is no easy step to take.

However, I do recommend having a few fun and funny books within easy reach on any given day to lift your spirits in case you need them. It may not completely cure your blues, but it may take your mind away from them and allow something new to come in to feel during the day.

All these old books I am reaching for this summer learning that these oldies still offer a lot of wisdom for today’s pressures and feelings. Some days and things do not change.

Dear Therapist: Birthday Blues

Birthday Blues

Dear Therapist:

My Birthday is coming up and perhaps its the pandemic or other issues going on in society, but I don’t feel in the mood to celebrate — at all. I think I may have the Birthday blues. Any thoughts on how to get into the mood to celebrate and look forward to my new year?

Sincerely, Singing the Birthday Blues

Although it may feel strange to have a Birthday coming up and not be that excited for your day, it is more common than you may think — even without the pandemic and societal unrest. A Birthday comes around and it is supposed to be a time to celebrate big and be happy and often it can feel like a moment to look back and be disappointed in the past year or worry about the upcoming year. Finally, it can just be a reminder that you are another year older without much having changed in life.

Now, add in the pandemic and the social unrest and I certainly can see why you may be singing the Birthday Blues this year. And if that is how you feel, letting that be OK is key. Think of it as a gift you can give yourself this year. If you are not in the mood to celebrate your big day, that is fine. Let it be fine.

At the same time, others may still want to celebrate you. Feel free to let them know you aren’t feeling it too much this year, but allow people to celebrate you if they want to. Who knows? Although you may not feel in the mood to celebrate, someone bringing a cake and candles over may lighten your mood and cause a shift in your mood. Being open to this shift can be difficult when we are not in a celebratory mood, but holding space for a little something positive can prove beneficial as well.

The truth is Birthday Blues are real. Society and friends and family often ask us to push these feelings away as we are “supposed” to be happy on our Birthday, but letting it be OK to not be in a great mood, accepting it, remaining open to some surprises that may still arise, and moving on from your day without anticipation of the next one being bad are all ways to manage feeling a little depressed on your Birthday.

Although I hear you are not in the mood to celebrate, Happy Birthday to you!

Mental Health Crisis in America

Mental Health Crisis in America
Mental Health Crisis Brews in America

I read an interesting article the other day in the Washington Post regarding how the current COVID-19 pandemic is pushing America to the brink of a mental health crisis. I cannot even believe it has taken a severe public health crisis like this one for the media to begin to pick up on how difficult it is for Americans to find and receive quality mental health care today.

Sitting from the vantage point of a therapist, I know this to be true for many reasons. While most articles, like the one in the Post above, focus on access to mental health care, there is something else one has to first realize. Access to mental health care starts with clinicians who are in training to work in the field and serve people in need of mental health services.

It is an unfortunate truth and one not often discussed in the media that to do the work of a therapist, or, as the traditional license is called, a Licensed Mental Health Counselor, is a costly and time-consuming journey. One cannot clinically practice one-on-one therapy with individuals without holding a Master’s Degree in counseling, social work, or marriage and family work. This type of degree takes 3-5 years to complete with significant amounts of debt taken on to complete the degree, upwards and over $100,000.

Along this journey, graduate students in training are called to do an internship with a significant number of clinical hours and supervision time spent in order to earn one’s degree. Although a person may have at least 2-3 years of training experience in school, one’s internship is unpaid. People must find paid jobs as they juggle their internship demands.

This is where it strikes me that the mental health system is failing at its core. Community Mental Health Agencies that serve the poor and mentally unwell, a segment of the population that would have very little access to mental health services, are staffed with interns from graduate schools who are seeing these people for free. The core of the mental health services offered to thousands of Americans is valued at an intern level who earn nothing.

From there, graduate students leave school and are permitted their first license. Where I live it is an Associate’s license, which means you have the ability to see patients, but you must be supervised for a set amount of hours as you work toward full licensure, which is additional hours. Often Associate Mental Health Counselors use this period of time to take clinician positions in mental health agencies. Now they are no longer serving for free, but for $17 to $23 per hour. The average case load for a new Clinician is upwards to 100 clients. Then add in the math of $100,000 of student loan debt.

It is from this vantage point that I see our mental health system failing in America. From the start, when people seek to train to become a mental health clinician, no value is given to the skills that they are learning and employing to help people with their mental health needs. From weighting people down with student loan debt, to not providing any value to the intern seeing clients, and then providing a very low income to the new clinician with a caseload that no one can keep up with — not only are the clinicians burned out, but the system is overwrought with little to no support for people who need tremendous care.

What happens after one has completed her Associate’s license requirements and you are now a fully licensed therapist? Unfortunately, most clinicians leave Community Mental Health and set up their own private practice. Even if the clinician charges a reduced fee, it is often three times the amount one was earning at the mental health agencies. It is unfortunate that the very poor and mentally unwell people in America are left to be churned through by clinicians who are in some training phase of their career burning out without proper care, support, or caseload numbers.

Insurance also plays a roll in the inequity of the Mental Health system in America. Are you in network and, if you are, your patients may benefit, but the Clinician will likely make very little money for their services when all is said and done. If you are out of network, then the Clinician works with the patient to determine the fee. A patient may submit a receipt to their insurance company which may provide them with a portion of the fee they have paid. In this way, the patient has to decide what can they afford given the insurance company will only be reimbursing some of the full fee and that is often after deductibles are met.

All of this to say that when we look at the mental health crisis in America, we need to critically think about how we value our clinicians in training as well as how we value the services provided to the mentally unwell, especially those accessing care through the community mental health agencies. It begins with both parties being valued and supported in terms of money and care.

Until this happens, the system is on crumbling crutches which is going to further lead to the black hole of inadequate care, funding, and a lack of people to serve during crisis such as the one we are in currently.

Do You Feel Alone or Lonely?

Woman alone or lonely
Are you alone or lonely?

Do you feel alone or lonely these days?

Well, for many people we are going either into Day 1, Week 1, Week 4 or more under a “Shelter in Place” order by our Governors across the United States and for many abroad where the entire countries in Europe and beyond are also indoors — staying put to slow down a virus and save lives. For now, we are all in this together — but on our own. Meaning, you are basically with who you live with — no more, no less.

This may mean a houseful of people, a couple and a child, a couple, or one person on her own. Regardless of who you are at home with these days, it can be difficult. Even if you are an introvert, it may be easier to be home in isolation with yourself or others, but when it is not a choice it can be difficult for you as well.

Thus begs the question in these days whether we feel alone or lonely. Sometimes we can feel both.

To be alone is not necessarily a bad state to be in. How often do we yearn for time to be alone with our thoughts or to spend time exactly as we want to spend it without concern for others. Being alone opens a gateway to engaging with one’s self without any distractions. To be alone can be wonderful.

To be lonely is an entirely different matter. Loneliness can make one feel empty and unwanted and may also lead to depression. Being alone is not a time to recharge, but rather time to move into a low place of feeling about one’s self. In these times of “sheltering in place” many people are not only alone, but are also feeling lonely. And even if you are not alone as you are living with your family, you can feel utterly lonely.

Normally one of the antidotes to loneliness is to reach out and be with others. However, in our current circumstances that is near impossible. So, how do we combat loneliness during these extraordinary times?

  1. Pose the question to yourself — are you alone, lonely or both?
  2. If you are alone, but not feeling lonely, relish this time. Follow your bliss at home and enjoy the time to recharge alone and/or with your family.
  3. If you are feeling lonely, whether alone or living with others, this is a natural feeling when so much of life has changed and there is forced time to be at home. Ask yourself if you are feeling empty and unwanted? What is this time bringing up for you? Use the feeling of loneliness to learn more about yourself.
  4. From there, think about what you can do to bring yourself out of your lonely state. Although we are in our homes, we are encouraged to go outside and take walks in nature which may help you place yourself in the larger world. Indulge in taking care of yourself at a very high level indulging in things that make you feel good, perhaps a salt bath or a vigorous workout, a favorite show or book to tune into, or a favorite song that will move you to dance.
  5. Of course, connection is key as we are humans and desire to connect with one another. If you are feeling lonely, even as you are living with your family, make time to connect with them in meaningful ways. If you are alone, make video call dates with family and friends. I have also heard of on-line classes taking place where people are making things together or working out together. You may want to look into activities that can be done together on-line. Make sure to keep connecting each day.

To be alone is not synonymous with feeling lonely. During this time of “shelter in place” check in with yourself often to see how you are feeling and make sure to move to take care of yourself during this time. You may be alone or feel alone, but you can combat the feeling of loneliness if you continue to check in and ask yourself what you need in the here and now moment.

My hope is each of us will use this time to nurture ourselves — learning about how we react to such times internally and what we move to do externally to care well for ourselves.

A Heavy Heart

A Heavy Heart

A friend texted me the other day and although, like most texts, it was short with very few words, I could feel the heaviness of the person’s heart in that little note.

Now, how can you actually feel a text? I think the Millenials and those younger than me can read feelings in texts just fine with the help of all of the emojis, but for me (& my generation) there is something that still has to be read between the lines. It is implied, but not a given, unless we have the courage to ask or simply reply, “I feel the heaviness of your heart.”

How to handle a friend or a colleague’s heavy heart? Presence. This seems to be a critical key and one that seems to be lacking for younger generations who basically find presence in the on-line, social media driven world. For me, when I received the text, and felt the heaviness, I replied back by naming what I could read and feel between the lines. The person wrote back a note of thanks for me naming what she was feeling.

However, I made a mental note to myself to check in with this person when I next saw her to really show my presence, my care, my concern over her situation. I knew the immediate text of empathy would help, but I also knew that a heavy heart needs presence, interest, a kind word, a show of care that takes a little more time than sending a sad emoji.

This may fly in the face of our tech world, and may be something you laugh at, but when you think back to your hard moments, what was it that you needed? Even though technology keeps speeding up, human beings still function the old fashioned way, The gift of presence can lend a balm to a heavy heart like none other.

Yes, it is expensive as it is our time and no-one has much of it anymore, but it’s also our fellow family, friends, and community. Taking care of the heavy hearts as they arise is critical to holding on to what we all need as people living together on this planet. Do not let your phone an other tech gadgets fool you. Reach beyond to ease someone’s pain.

Dear Therapist: Now What?

Three Days In, Now What?

Dear Therapist,

We are three days into the New Year…now what? The celebrations are over and the long, cold winter is staring me in the face. What to do?

Breathe and relax is the answer that comes to the top of my mind, but that is anything but easy.

Why does it seem so impossible?

There may be a couple of reasons:

  • A whole new year is staring you in the face – and you have not a clue what to do.
  • The old is very much a part of your life and you feel stuck in it all and there are no holiday distractions to keep the feeling at bay.
  • It’s cold, dark, and the days are super short.
  • You’ve already broken your New Year Resolution

None of these make anyone feel very comfortable – let alone desiring to breathe and relax.

So, what to do? First, remember January is 31 days long. It will be here and gone – nothing lasts forever and neither will this month if it feels bleak to you.

Second, what are some pleasures that you can incorporate into your days. I listed a few of my own yesterday here, but surely you have your own list of ways you care for yourself and things you do to take pleasure in the days no matter the season. Find one or two and bring some pleasure to these days.

Third, although its winter, getting out into nature and witnessing her beautiful nature during this season is also a way to refresh yourself. Perhaps you will take a Forest Bath — perhaps you will just walk your dog around the block. Whenever you are out there, breathe deep and take in the beauty.

Finally, make a plan for the spring! Is there a special outing or trip you would like to take when the days are longer and warmer. Dream on it, armchair travel, and make a plan. You will have something to look forward to and a pleasant way to pass the time.

Yes, the celebrations are over, but a whole new year has dawned to capture your attention and imagination. Live into it and go gently with yourself.