Child Abuse & Neglect

Note: This piece was very hard for me to write so it might be hard for someone to read. If you start feeling upset, anxious, etc. while reading this, please take a break to love on yourself before coming back to this. If you aren’t sure how to tell when you need to take a break, the right mindfulness technique could help with that. You might see yourself in this piece. Life is complicated so you might see yourself as someone who has received abuse/neglect and/or as a parent who has done some of these things. Life is complicated like that. And all that can be hard to see. Here are some related pieces that might be helpful to read before or afterwards:
 
 
Like I’ve mentioned before in the Intro to Boundaries piece, many people have long histories in dealing with toxic people and situations that never respected them and/or their boundaries. And because of this, they could have a harder time empathizing and caring about other people’s pain. They might be thinking, “Well, I had to deal with it.” Or “I’ve dealt with worse so why should I care?” There might not have been anyone around modeling better interpersonal skills and teaching them how to have empathy for others. And that’s not even counting the role socialization plays in stunting people’s connection to their own emotions in order to benefit the status quo (white supremacy, systemic oppression, capitalism, etc.). People, who struggle to empathize with others, especially others who are different from them, tend to silence people (telling people to “suck it up”, or bragging that they’ve been through worse, etc.). Instead of giving everyone their space to tell their story, be heard, and have the opportunity to work towards healing. When child abuse and neglect is made normal, trauma is passed generation to generation and hurt children grow into hurt adults who fail to protect and nurture the next generation.
The goal of this piece to explain as clearly as possible what child abuse and neglect is and what it can look like while also helping y’all start to recognize it in the real world. I want us to start seeing this as part of community accountability: How can we support parents and our youth while beginning to limit our involvement in systems that harm our communities?
 

What Exactly Are We Talking About Here?

I want to take this time to define child physical abuse, child psychological/emotional abuse, child sexual abuse, and child neglect. Just to make sure we’re on the same page. Legal definitions vary by state in the US (legal doesn’t always mean ethical or moral) so I’m gonna to define it so we’re all on the same page. I’ll be using some information from the US Department of Health and Human Services:
 

What is Child Physical Abuse?

Definition: When adults act in ways (unintentionally and/or on purpose) that end up with the physical pain, injury, and/or sickness of a child/teen.
Some Examples: 
  • Hitting the child/teen with hands or objects
  • Slapping and punching the child/teen
  • Kicking the child/teen
  • Shaking the child/teen
  • Throwing things at and/or near/around the child/teen
  • Poisoning the child/teen
  • Burning and/or scalding the child/teen
  • Bruising the child/teen
  • Biting and/or scratching the child/teen
  • Spraining and/or breaking the child/teen’s bones
  • Drowning the child/teen
 

What is Child Emotional/Psychological Abuse?

 
Definition: Behaviors and speech that have a negative impact on the child’s development, mental health, and/or emotional wellness.
 
Some Examples:
  • Name calling
  • Insults/teasing
  • Public shaming
  • Threatening
  • Pressuring
  • Terrorizing, frightening, and/or bullying
  • Allowing kids to witness the physical, emotional, and/or sexual abuse of others
  • Holding back love, guidance, attention, and/or support
  • Isolating the child/teen from social experiences
  • Encouraging the child/teen to engage in age-inappropriate and/or destructive behavior
  • Forcing a trans child/teen to de-transition or blocking them from transitioning at all
  • Forcing a lesbian, gay, bi, queer, etc. child/teen into “conversion therapy” or other efforts to make them straight
 

What is Child Sexual Abuse?

 
Definition: Adults engaging in sexual activity with minors. Minors cannot consent to sexual activity with adults. Due to the severe power dynamics and differences in both cognitive abilities and capacities for judgment at play here, any sexual activity between adults and minors is nonconsensual. It is rape. 
 
Some Examples: 
  • Exhibitionism, or exposing oneself to a child/teen
  • Fondling a child/teen
  • Intercourse with a child/teen of any kind, including vaginal, oral, and/or anal, etc
  • Masturbation in the presence of a child/teen or forcing and/or encouraging the child/teen to masturbate
  • Sexual phone calls, text messages, and/or other kinds of digital interaction with child/teen
  • Creating, owning, and/or sharing pornographic images and/or movies of children/teens
  • Sex trafficking minors
  • Any other sexual conduct that is harmful to a child/teen’s mental, emotional, and/or physical welfare
 

What is Neglect?

 
Definition: When a parent/guardian/adult-in-charge fails to provide for the child’s basic needs (food, clothing, shelter, medical care, supervision) to the point that the child’s health, safety, etc. are threatened and/or harmed.
 
Some Examples: 

Physical neglect: Abandoning the child/teen, refusing to accept custody of the child/teen, not providing for basic needs like nutrition, hygiene, and/or appropriate clothing

Medical neglect: Delaying or denying recommended quality comprehensive health care (by licensed providers) for the child/teen

Inadequate supervision: Leaving the child unsupervised (this depends on length of time and child’s age/maturity at the time), not protecting the child from safety hazards, not providing adequate caregivers, and/or engaging in harmful/dangerous behavior around the child/teen

Emotional neglect: Isolating the child/teen, not providing affection or emotional support to the child/teen, and/or exposing the child/teen to domestic violence or chaotic substance use

Educational neglect: Failing to enroll the child/teen in school and/or homeschool, ignoring the child/teen’s special education needs, and/or allowing for continued interruptions in the child/teen’s education

 

How Can You Tell?

 

Physical Signs of Physical Abuse

  • Bruises
  • Welts
  • Burns/scalds
  • Fractures
  • Cuts
  • Scarring
  • Bite marks
  • Effects of poisoning, like vomiting, seizures, etc.
  • Breathing issues from drowning, choking, etc.
 

Changes in Behavior as *Possible* Signs of Physical Abuse

  • Child/teen is wary of adults or a certain adult
  • Child/teen is violent to other children/teens and/or animals
  • Child/teen is aggressive and/or emotionally distant
  • Child/teen can’t remember or can’t explain how they got injured
 

Physical Signs of Emotional/Psychological Abuse

  • Bed wetting
  • Physical complaints, like headaches, nausea, etc. without physical causes
  • Delays in the child/teen’s physical and/or mental growth and development 

Changes in Behavior as *Possible* Signs of Emotional/Psychological Abuse

  • Increased risk for self-harm, eating disorders, anxiety, and/or depression
  • Unusual attachments: overly friendly to adults they don’t know, detached from parents, etc.
  • Child/teen is overly compliant with no boundaries
  • Child/teen is aggressive to other children and/or animals
  • Child/teen has unusual emotional outbursts
  • Child/teen has issues with social skills
  • Child/teen is scared/afraid of their parent(s)/guardian(s)
  • Child/teen has negative internal monologue (talks down to themselves, is mean in their own heads, overly high self-expectations, etc)
  • Sudden changes in speech and speech pattern, like stuttering or not talking at all

Physical Signs of Sexual Abuse

  • Torn bloody clothes
  • Bruises
  • Redness, swelling, and/or bleeding in genital/anal area
  • Blood in urine and/or feces
  • STDs/STIs
  • Excessive itching and/or pain in genital and/or anal area
 

Changes in Behavior as *Possible* Signs of Sexual Abuse

  • Child/teen engages in age-inappropriate sexual play with toys and/or other children/teens
  • Child/teen has unusual/age-inappropriate sexual knowledge and/or behavior
  • Child/teen makes comments about secrets: having them, keeping them, etc.
  • Child/teen develops an eating disorder
 

Physical Signs of Neglect

  • Child/teen is not appropriately dressed for the weather outside (no winter clothes, etc.)
  • Child/teen does not seem to have socially-appropriate grooming/hygiene habits
  • Child/teen is left alone to the point that their physical, emotional, educational, social, etc child development needs are not met
  • Child/teen appears to be malnourished
  • Child/teen has current or chronic skin issues and/or rashes
  • Child/teen’s medical needs are not being handled
 

Changes in Behavior as *Possible* Signs of Neglect

  • Child/teen steals food and/or other necessities due to need
  • Child/teen appears overly hungry for attention based on what’s usual behavior for their age group and/or cultural background
  • Child/teen forms unusual attachments: overly friendly to adults they don’t know, detached from parents, etc.
  • Child/teen has poorly developed social skills
  • Child/teen has issues with personal hygiene/grooming

The Role of Community Accountability Here

 
A solid community has a shared set of values, boundaries, etc that are mutually created in order to serve everyone in that community especially the most marginalized. Strength comes from a shared vision that includes everyone equally. Like I’ve said before in my last piece on community accountability, a community that does not encourage each other to grow and push each other towards positive change is a community that will rot from the inside out. This individualistic mess isn’t healthy. Obviously.
A lot of what many of us think about doing in response to child abuse and neglect is after the fact and doesn’t actually deal with the systemic roots of the issue.
 

What Am I Supposed to Do?

(Reminder that my main focus is Black people.)
 
Some suggestions:

Having an awareness of socialization and the various systemic oppressions (not just race). Read Black political theories from all backgrounds, genders, sexualities, etc. Learn about child development, mental health wellness, sociology, public health, etc. from Black writers/thinkers with an awareness of various systemic oppressions

Using that awareness to inform your politics, how you move in the world, the kinds of support you give, etc. That awareness not only helps us address current abuse and neglect, but also guides us in figuring out how to provide support to families who are strained and are at risk of repeating intergenerational traumas

Changing the narrative about what is “normal” in our communities, giving parents other alternatives for discipline (for example) and connecting with their children from within our cultures, encouraging healthier dynamics in interpersonal relationships, and encouraging activities that push personal growth like psychotherapy, etc.

Donating money, giving out resources, sharing paid opportunities if possible, etc. directly to individuals in your communities who need it

Listening to what the people in those situations say they need and providing just that kinds of support

Consider how you can support the youth in your communities. Find a way to ask them what they need and how you and other adults can help.

Consider how you can support the families and parents in your communities even with basic things like clothing swaps (when it’s safe), giving money for food or laundry, rent parties (again, when it’s safe)

……………………………………………………………………..

 
When we live in a society that so used to being reactionary and responding after something negative has already happened, it may seem very anti-climatic to talk about interpersonal and community-level support as solutions for child abuse and neglect. But it’s actually much more effective to lead more with prevention and then some reactionary actions as needed. Starting with support addresses roots of the issue and is something everyone in the community can participate in. Making the lives of stressed and struggling Black parents, families, and/or youth in the face of systemic oppression easier will only make our lives and futures easier. Like I’ve said before, there are so many adults walking around with unhealed pain and traumas, affecting their adult lives, because they were once Black children who were forced to deal with it alone. Returning to a community-minded/village-minded way of viewing our relationships with each other is key. And everyone has their specific role to play. Some of us are good with kids and know people with children who could use some babysitting help. But that’s not everyone’s bag and that’s ok. You could give money directly to families in need via crowdfunding. You could buy school supplies for people. You could post healthcare resources. Or help someone get a better job so the money situation isn’t as strained. You could link people to free (ideally) or affordable legal services. When all the children/teens are everyone’s kids, it’s possible that people would start to pay closer attention to the laws being passed that affect them, even the LGBTQAI kids. The path to freedom includes working through our own pain/traumas, unpacking socializations, and making sure that we support future generations, not passing our pain for them to carry on.
It’s easier said than done. And it’s years and years and year of work and personal growth. But it’s worth it.

How to Tell if This the Right Therapist for You in 3-ish Sessions

Let’s say it how it is: it is ridiculously hard to find a decent therapist. As someone who has been a psychotherapy client before and as a therapist myself, trust and believe I fully know and understand that it’s needle and haystack-levels out there. And don’t let you have 1 or more marginalized identities and kinds of oppressions you are dealing with. In their article, ““Sorry, I’m Not Accepting New Patients”: An Audit Study of Access to Mental Health Care,” (Email queeringpsychology.com for access to the full article) Heather Kugelmass discusses how hard it is for Black people to find a therapist. According to the study, a working class Black man would have to call 80 different therapists before 1 therapist calls them back. Who has the time for that seriously? Queer and transgender people of color, especially, also have seriously difficult time finding a competent therapist because many graduate programs do not teach how to provide care to LGBTQAI clients. The better programs will have 2 courses at the very most AND transgender and intersex people are barely an uncomfortable whisper throughout the entire course(s). Not only are people of color, especially LGBQTAI people of color, systemically kept out of counseling and psychology fields, but many actual, real life therapists are scarily unprepared to deal with clients who aren’t White, well-off cisgender heterosexual able-bodied men who are just need temporary assistance going through a difficult life transition like a divorce. So needless to say, Kegelmass’s study did not surprise me. In fact, the study continues to say that “despite health care providers’s explicit endorsement of racial equity, they have a strong pro white implicit (i.e. non conscious) bias […] These stereotypes and other sources of bias, in turn, influence their decision about whether to extend offers of care” (Kegelmass, Heather. (2016). “Sorry I’m Not Accepting New Patients”: An Audit Study of Access to Mental Health Care. Journal of Health and Social Behavior, 57(2), 2. https://doi.org/10.1177/0022146516647098).

Now, let’s take this to the next logical conclusion. We’re grown. If the pro-white biases are keeping many therapists from calling people of color back, what other actions are being influenced by their biases? With all that as background and context, how does somebody even find a therapist worth a damn in the usually little bit of time they have? Especially if you are using insurance, you may have a limited amount of sessions you can have in a certain timeframe so being able to quickly and efficiently shop for therapists is an important skill to have. It is so important to remember that a therapist is providing a service to you and if things don’t feel right, it’s not worth staying. Life is far too short and you have healing work to get done. You and the therapist have to be compatible enough so the both of you can work effectively towards your goals. If there isn’t a good fit between y’all, you will probably become distracted from the work and/or otherwise won’t be able to focus on yourself and your goals. So this isn’t the time to “be nice”. If you don’t feel good chemistry and the fit between you, the client, and a therapist isn’t working for you, it’s time to move on. The purpose of this piece is to help people figure out if a therapist has the right fit/chemistry for them in 1-3 counseling sessions. After you went and called 50-11 therapists, who has the extra energy/spoons to waste dealing with a therapist who can’t really do much for you?

Self-Reflection

A colleague, Kiya Black, artfully describes the work to find the right therapist as searching for the right pair of jeans: “Finding the right therapist is like finding the perfect pair of jeans. Sometimes you get lucky, and the first pair fits JUST right. Most of the time though, you don’t. The waist don’t fit. The leg too long. The fabric is just – crunchy. And on a bad day? You might think that means something is wrong/flawed with you. Nawh. Nawh. That ain’t it. It’s just NOT the right pair of jeans. You might have to try a different brand. A different size. A different model. But – eventually – you’ll find the PERFECT pair of jeans. Cloth like yes. Ass like WHAT. Cozy like perfect. And that’s how the right therapist will fit too – they’ll make you realize just how wonderful YOU are.” I love this metaphor because it perfectly describes the work it can take for many people, especially marginalized people, to find the right therapist for them. As Ms. Black describes, if you and the therapist don’t have the right fit, it’s probably time to try another therapist. It’s not you. It’s not all jeans (therapists). It’s the fit. And even though it may take a lot of work to find the right therapist for you, it’s so worth it.

Before you even make the phone call and/or walk into an office, the work starts at home and in your head. What do you want? Walk in knowing that. Using Ms Black’s metaphor, when people go shopping, they usually have a general idea of what you are looking for and work from there. Shopping for a therapist works in a similar way. It will save you so much time and effort to be intentional with your hunt. You are a client looking for quality service. You should take some time to think about you are looking for before walking in. 

Some questions to think about before starting to schedule appointments: 

  • What kind of therapeutic relationship/dynamic are you looking for? Do you want them to be your equal who provides a service to you? Do you want them to be a teacher and you the student (peep the change in power dynamics here)? Do you want a therapist whose style is more about collaboration or do you want a therapist whose style is more them feeding you information?

  • What part(s) of your life do you want to focus on and/or what are you willing to talk about in therapy? 

  • What is making you want to start/restart therapy? What are some of your goals for therapy? What do you want to get out of this? How will you know when you have achieved these goals?

  • What values do you want to grow and foster in yourself? Look for those values in the therapist

Intake

First of all, congratulations for coming to the intake. That’s huge. The work continues at your intake appointment. Even if you end up doing the intake with someone who is not going to be your therapist, there are still things you can learn about the agency, hospital, private practice, etc. from the intake session. And that information is important. You need to figure out if this is a space where you want to receive therapy (and if the workers can create a safe space here for you).  How does the person doing your intake treat you? Do they make you feel welcome and/or comfortable potentially receiving mental health services here? What kind of questions are you asked during the intake? Do the questions make you feel included? If the questions and the whole process makes you feel like they’ve barely worked with people of color, disabled people, LGBQTAI people, etc., that’s worth noticing and keeping in mind. All of this is information that will help you make your final decision later.

Counseling Session #1

Introductions:

Every therapist is different, but there are certain things that you should be able to expect from a first therapy session. Like the start of any relationship, there is a get to know you phase between therapist and client. Both you and the therapist are trying to see if this will be a good fit for the work you need to do. The therapist should take this time during the 1st session to explain who they are and what they are bringing to the table, i.e. their name, credentials, experience, and theoretical orientation.

It always bothered me how many people see a therapist, but don’t know their credentials or what qualifies them to be working with you. Are they a mental health counselor, social worker, psychologist, etc.? What kinds of experience and training do they have that qualifies them to be working with you? Just like you wouldn’t go to an eye & ear Dr to remove your wisdom teeth, it’s important to pay attention to a therapist’s specialties and their experience with working with people like you and/or your specific issues. 

Also what is their theoretical orientation? And does that match what you want in a therapist? A therapist’s theoretical orientation determines how a therapist sees themselves, how they see you the client, how they see your psychotherapeutic relationship, the tools and strategies they will use, and the parts of your life they want to focus on. Usually on therapists’ websites, they list their theoretical orientations in their descriptions or by their contact information. Take a little time and google their theoretical orientation. Google the tools/strategies they use in their work and see if any of that appeals to you and what you wanna do. If you still aren’t sure by the first session, ask the therapist to describe their theoretical orientation in more detail so that it makes sense to you. They should be able to break this down no problem. If they struggle to explain this to you or don’t want to explain it, that’s something else to keep in mind. You really should be able to walk out of the office able to describe, in your own words, who the therapist is, how they are qualified to help you, and the perspective they work from.

Confidentiality

Another IMPORTANT thing that a therapist should have a conversation with you about in the 1st session is confidentiality. You might have filled out and signed a confidentiality agreement during the intake, but just reading and signing a document isn’t enough. When you, the client, leave the 1st or 2nd session, you should be able to answer the question: What is the therapist’s POV on the limits of confidentiality in therapy? Usually, with a few exceptions, whatever clients talk about in session is confidential and most of the time is legally protected client private health information (aka between you and the therapist). The exceptions are usually for 1)sharing info coordinate the best care with other providers in the client’s healthcare team (which the client gives permission for), 2)speaking with parents and other people cleared by clients, 3)reporting child abuse/neglect, 4)calling emergency services in case a client is a danger to themselves/others, and 5)reporting when a client is at risk of harming someone else (duty to warn others at risk). The therapist should explain their usual limits of confidentiality, what makes the limits important, and why it’s important for therapists to discuss with clients ASAP (in the 1st 2 sessions aka informed consent). Confidentiality and the limits of confidentiality are part of the therapist’s role of protecting the client and the wider community. Did the therapist fully explain confidentiality to you and invite you to ask any questions? If not, see if they bring it up during the 2nd session (and if they don’t, bring it up yourself).

“So What Brings You to Therapy Today?” 

After you and the therapist introduce yourselves and discuss confidentiality, the final part of a 1st session usually involves talking about why you’re here. Before this point, your therapist has probably been doing most of the talking. It’s important for the therapist to set the tone, set some boundaries, and start to show you the kind of therapeutic space they can create for you. But now, it’s the client’s time, your time, to talk briefly about what made you decide to come to therapy. All the self-reflection you did up to this moment will come in handy because you will be able to explain the reason(s) you want therapy and the kind of relationship/energy you want with your therapist. This will also be a great time for you and the therapist to start thinking about what your goals for therapy might be. Usually this is the last part of a first session so congratulations, you made it.

Some questions to think about before before the 2nd session:

  • How was this therapist with setting boundaries?

  • How confident do you feel in their ability to create a safe space for you to do the work of therapy?

  • How comfortable do you feel coming out to this therapist (as LGBTQAI, as polyamorous, as into BDSM/kink, etc. if that’s related to your reason(s) for therapy)?

Counseling Session #2

Walking Into This Session

Bring questions or anything you need more understanding on. This isn’t the time to be shy. Reminder: you are shopping for a therapist and your insurance company may have placed limits on the number of sessions you get so we gotta take a step back, really look at the board, and strategize here. Ask any questions. Anything that will help you get a better and deeper understanding of this therapist, how they work, and the kinds of things they’d want to do with you to address the reason(s) you want therapy. Speaking of which, has the therapist mentioned your treatment plan yet? Now that the introductions are over, it’s about that time to start talking seriously about your therapy goals and what needs to be done to get you there.

And that’s where a treatment plan of goals (what you want our of therapy in the short term and long term), objectives (the smaller things you need to do to get to your goals), and interventions (what you and the therapist will do to get you closer to your objectives) comes in to help you map out how to make the best use of therapy. A well-written treatment plan (aka service plan, care plan, etc) is the compass to your work in therapy and it is something that you and therapy should brainstorm together. The treatment plan isn’t going to be a good, realistic fit for you if you don’t have a serious hand in it. It is a collaboration between you and your therapist to work out how to get the most of what you need out of therapy. Pay attention to how open this therapist is to collaborate with you and how they react to areas of your life that they have less experience working with.  

Some questions to think about before before the 3rd session:

  • How did the therapist respond to your questions/concerns?

  • How open do they seem to learning new things? A therapist should be able to admit when they are not knowledgeable about something and should be willing to put in some work for the sake of the therapeutic relationship.

Counseling Session #3

During The Session

The 3rd session should be about continued discussions about goals, treatment planning, and the next steps to starting this work with your therapist. If you have questions or if there’s anything from last session you want to talk more about, this is a great time to bring it up. Especially at the beginning so the therapist can fit it into the agenda for the session. Take note of how they responded to your questions and/or feedback for your self-reflection time later. What do you think about the treatment plan so far? How would you describe the treatment plan in your own words? The treatment plan should address the reason(s) you decided to come to therapy and give you a sense of what you will be doing in therapy for usually the next 6 months. If you are having a hard time describing the treatment plan, it means that the plan probably isn’t clear enough and needs more work. 

3rd Session Reflections

  • How does the therapist match up with what you are looking for?

  • How do you feel about the way the therapist makes you feel or the energy in the space while you are in session with them?

  • How productive do you feel like you are going to be with them? What kind of team do you think the two of you will be?

  • Where do you think you will be with this therapist in 6 months?

It is so hard to find a good therapist. I see the struggle. I really do. That’s why I wanted to write this to help y’all on this difficult search. Like my colleague Ms. Kiya Black described in her jeans analogy, it’s not your fault for having such a hard time finding the right therapist and you don’t have to keep working with someone who isn’t right for you. Unless you are mandated, you are not locked into this therapist. You are shopping around. You are interviewing. The therapeutic relationship is a professional working relationship that needs chemistry. Y’all need to be able to work well together. Switch therapists if you don’t feel that there’s chemistry and/or if you’re not looking forward to working with this person. This is about your growth and healing. And you need everyone on your team to be A1.

Thanks for reading. The next piece on Sunday 6/9/19 will be a continuation of “The Process of Change” series, covering community accountability: how community accountability is an important part of healing and growth for and by the community when there’s been harm done.

Reflecting After the End of a Romantic Relationship

Maybe you did your life reassessment, looked at your whole life, and you realized that it was time to end a romantic relationship. Or maybe you already ended the relationship and are now trying to decide what your next move will be. The most common advice I hear given to people, especially cis men, after a relationship ends is, “The best way to get over someone is to get under someone else”. And…nah. Whether you are monogamous, in an open relationship, polyamorous, a relationship anarchist, etc., the end of any kind of romantic relationship is still a loss that has some kind of effect on you. And this kind of effect on any level is worth dealing with as soon as possible. This piece is about the next steps after a romantic relationship ends, whether that is taking a break before moving onto the next relationship and/or taking some time to yourself periodically (and/or with trusted loved ones, a therapist, etc.) to reflect and process what happened and how it affected you. Many people seem to think that closure comes from talking to an ex-partner and coming to some kind of total, complete (and honestly idealistic) understanding. That kind of closure is a myth, to be real, and I mentioned some reasons before (See this short Twitter THREAD about closure in romantic relationships) for why looking for that kind of closure isn’t helpful. Instead, find closure, understanding, and peace within yourself by taking time to work through how you feel, what you’ve learned, and how you can grow from what you have experienced.

How do you know when it is time to take a break and/or reflect?

In general, I’d suggest taking a little time to yourself after every end to a relationship, if anything, just to reflect. You just experienced a loss. Acknowledge that. Your first steps after a relationship ends are important. Any lessons you don’t learn and any wounds you don’t heal are not just gonna go away or heal itself with just time alone. Don’t let the often-repeated lie fool you: Time does not heal all wounds…especially not all by itself. Healing is never passive. It’s never something that just happens to you somehow over time. Healing takes active work. And life lessons have a way of coming back around the longer you are alive. It’s better to take the time and learn the lessons sooner rather than later. No one likes to be stuck in a rut: Repeating similar scenarios, similar relationships, similar dynamics, etc. for years, wondering why you always seem to date the same kinds of people or find yourself in similar situations. That’s a sign that it’s time for you to stop, check in with yourself, and figure out what you need to do to make some active changes in your life.

Again, the ending of any kind of relationship is a kind of loss and with loss comes grief. Grief is a normal response to loss and, like I mentioned in my piece on grief, it looks different for each person depending on the specifics of the situation and the kind of relationship you had with your partner. Grief is also affected by any history of trauma, history of abandonment, other stressful things going on in your life, physical and/or mental health symptoms, etc. And factors like these make no 2 people’s grief look exactly the same. And because humans are complicated and life is complicated, so are the feelings one can feel while grieving. You could feel sad, angry, lonely, relieved that it’s over, glad the partner is out of your life, nostalgic for the good times, etc. Like I mention in the grief post, these feelings are a normal part of the grieving process and they are important to feel/process because “un-dealt with grief can build up inside someone and then come out in other, less healthy ways.” Generally speaking: The worse the break up (meaning the more complicated, the more emotional, the less friendly of a breakup, etc.) the more likely you will need more time/effort to reflect and learn/heal and that’s ok. Scrapes, cuts, and wounds need their right time to heal, even emotional and psychological ones. 

You Know What They Say…”

Do NOT use another person as an object to “get over” a past partner. First of all, it’s a messed up thing to do to someone else. It’s 1 thing if the person actively consents to being your “rebound,” but using people like objects is not how healing works at all. And “getting over someone by getting under someone else” doesn’t actually work. You never actually deal with whatever the problem was. It’s a distraction. In counseling, that would be an example of avoidance. And avoidance almost always makes things worse. It’s like seeing a water leak in your home and “fixing” it by renting a hotel room for a couple weeks. The feelings you try to push away will always come back in some way, usually stronger. Unhandled emotions and psychological unfinished business can come out in your body so you might start to feel achy, sick or drained all the time. You might start treating your other romantic or sexual partners, your friends, your children, and other relationships in your life like crap. You might start believing that you deserve to be treated badly in relationships or that you aren’t meant for real love or relationships. Like a physical injury, emotional wounds shouldn’t be ignored. 

Time for growth

Sex, casually dating, and new romantic relationships are great as long as you are also taking care of yourself in the process. Relationships are not tools for healing. They are relationships. The other person(s) isn’t your therapist. They are your partner(s). This is another example of the need for firm boundaries and an example of how firm boundaries are nurturing for you as an individual and for your relationships. Check out my introduction to boundaries piece here for basic information on setting and maintaining firm boundaries with people and why it’s even important. And here’s the Part 2 of boundaries 201 2-part series where I explain how strong, clear boundaries can be used to make relationships even stronger and more fulfilling. Those boundaries will also give you the time to dive deeply in your search for awareness and understanding. Mindfulness techniques (as I describe and explain in this intro piece to Mindfulness here) can be very helpful for tapping into yourself and getting to know yourself. Take some time to focus on you. Don’t rush or let anyone else rush your healing. Take however long you need. It’s better to be really ready than to be fast with the process. You wanna focus on quality here. Kind of like how I mentioned in the unemployment piece here, people of all genders should take the time to grow yourself after a loss, whether we are talking about losing a job or a relationship. If you don’t grow yourself, you will never learn from your past. Look at yourself. What lessons do you need to learn? Talk to your friends. And if you figure out that you might be stuck in a relationship rut, maybe talking to your friends isn’t enough. It might be time to talk to a mental health professional. 

A lot of the time the messages we get from society around love, relationships, and dating are incredibly toxic. There’s always someone in your life or some self-help book ready to tell you the fastest way to get over someone. However, at the end of the day, motivation and the juice for change is already in you. It’s just a matter of taking some time to yourself and doing some serious reflecting and going through your feelings, etc. It’s pretty easy to bounce from relationship to relationship. It takes a lot of strength to pause and take some time to look into yourself and to be honest about what you see. And it’s powerful to take what you’ve learned about yourself and use this information to begin to do whatever you need to heal and learn from those life lessons. 

Thanks for reading. The next piece will cover how to help friends come back to baseline (meaning how they normally used to live their lives) after a trauma/crisis and how to conduct crisis intervention in the mean time and in between time while y’all are looking for/waiting for professional help.

Boundaries 201: Bringing the Skills Home Part 2

So this piece is both 1)a part 2 to a 2-part series about setting boundaries around family and other people close to you in your life (Here’s a link to Part 1 here) and 2)a sequel to the intro to setting boundaries post I wrote in August (Intro piece here). Please take a chance to check those 2 out just to make sure we’re all on the same page about what boundaries are and how they can improve your personal and professional life generally. Part 1 focused on setting boundaries in regards to letting go of and/or limiting time around toxic people. This part 2 focuses on using boundaries as tools to build and make all the relationships in your life even stronger. Again, setting clear, firm boundaries is a way to take care of yourself. Strong boundaries are both a sign of and what happens when you start to truly know yourself. Building self awareness is key to setting boundaries. Boundaries are also about building community and your social support system. Having a solid set of people who you really trust and who’s really for you is key to having good mental health and life satisfaction. Especially for Black and brown people and ESPECIALLY for LGBTQAI people of color. Community (safe, strong, healthy community) is life.

Like I mentioned in the first part: strong, clear boundaries can be like emotional and psychological armor. Acting as protection and as a way to save your energy levels and your physical and mental health. Weak, vague boundaries are draining. Firm boundaries keep you going for longer, like fixing a leak in the gas tank so you can keep doing what you need to do. Boundaries aren’t always about separating yourself from or limiting time around things and people. They are also about building and nurturing families (blood and chosen) and other relationships/connections in your life. Boundaries are 1 huge part of the foundation of stable, healthy relationships whether we are talking about relationships with family, friends, coworkers/colleagues, romantic relationships, etc. They aren’t just things you set up when times are bad/rough though. Clear, strong boundaries on the regular protect the relationship like watering and caring for a plant and watching it grow. Healthy relationships don’t just grow on their own. People always say relationships take work without really describing the kind of work that needs to be done. Setting clear, strong boundaries and maintaining them together in each relationship is part of that work. Boundaries are about having compassion and respect for 1)your limits and the limits of other people, 2)everyone’s needs for stability and safety, and 3) each other’s wants and goals, etc. Life is hard. Being with the people close to you should be a peaceful break from all the nonsense, not a part of the stress.

Y’all remember my self care piece from earlier this year in March? In that piece, I’ll link it here, I talked about Spoon Theory and I added a quote from the creator of Spoon Theory, Christine Miserandino, as she explains the concept of Spoon Theory to a friend: “I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.” In this quote, she is aware of her limitations (how many spoons she has) so she sets boundaries to avoid draining time/energy AND to stay connected to people she chooses. Again, life is so hard, especially living in a bigoted society that wants you dead/disappeared. Every breath is revolutionary, but it is still draining. Part of self care is being kind to yourself and being aware of the energy you have and how you spend it. Boundaries help you turn your close relationships into mobile safe spaces. They allow you to be more able to open up and to have times in your life where you can really be yourself. Knowing what your limits are, clearly expressing them to people, and then having those limits respected can make spending time with the people closest to you even better.

On the other hand, having your boundaries constantly ignored and/or disrespected weakens and damages relationships after awhile on top of hurting your physical and mental health. There’s a reason so many people feel like they have no one they can really talk to or really trust/be real with. There’s a reason so many people feel like they have to front all the time. Or why there’s this running “joke” of tweeting about depression/suicidal feelings on the TL and then acting like they are “just tweets” when someone asks you about it privately. That’s a clear sign that so many people don’t have real support systems and don’t feel comfortable being real and/or vulnerable with the people around them. That’s how you can feel lonely surrounded by a crowd of people. Clear, firm, mutually respected boundaries between you and your people create an environment where all the fronts can be dropped at the door.

Let’s talk about some specific ways to nourish the relationships in your life through setting and maintaining clear, strong boundaries. All relationships take work. In this society, people are pressured to focus all their efforts and energies into romantic relationships and all the other kinds of relationships in our lives are just supposed to work themselves out somehow. Like I’ve mentioned before in the Part 4 of the parenting series here and in my piece on suicide (link here), it’s “very Western, very colonizer, to rely on a nuclear family (spouse and kids) for everything”. We have all been taught that romantic connections and the relationships we have with spouses are the ultimate relationships to search our whole lives for. That way of thinking is very limiting. When we only focus on 1 type of connection in our lives and that relationship ends or that person dies, what is left? Many of our elders are vulnerable and many people generally feel unfulfilled because this society teaches us to put all of our future plans, hopes, and dreams on 1 person. Some people won’t even go places and will pause whole areas of their lives so they can do it with a romantic partner. A lot of the time, that seems to lead to regrets and resentments for many people in the long run. I’ve noticed that people have stronger support systems and feel like more people truly got their back when they start to give the other kinds of relationships in their lives a similar kind of effort.

Some Basic Suggestions for Boundaries that Strengthen Connections:

Being honest and clear about your needs/wants
  • Even if that honesty feels awkward, etc. It might feel uncomfortable at first because you aren’t used to it, but it will get easier for everyone after awhile.

  • “I feel [xyz] right now and I need to [abc].”

  • “I need time to think about this, let me get back to you in an hour/tomorrow, etc” – Always give a specific time and keep that appt, being respectful of everyone’s time.
Checking in with loved ones

Check in with your homies in general (We good?)


  • Avoid surface level bs. This isn’t like the “How are you?” “I’m good. Chilling. Just trying to be like you” lie we all do. This is about asking and actually wanting to know the real answer. And being ready to really do something if there is something that needs to be handled in y’all’s relationship.

  • It’s better to check in as you go and get in the habit of asking each other “Yo, we good? In general, how we doing on your end?” Again, this kind of thing isn’t just for romantic relationships. Many of you and your homies would feel closer if you were able to talk about the little things you might be keeping inside over the years. Little things add up. Misunderstandings, crossed wires, other not exactly arguments, etc. all add up. Wouldn’t hurt to get it out there and always be on the same page

Or checking in after a disagreement

  • Avoid snark/sarcasm. If you are feeling some type of way, this isn’t the time for a check in. This is where knowing yourself and being accurately aware of your own emotions is key (Check out Mindfulness post here for some suggestions on how to be more attuned with yourself and your emotions. It’s hard to check in with another person and talk to them about what’s going on for you if you don’t know what to look for in yourself. So start there, within yourself.

  • After you take the time to get a clear understanding of your emotions, check in. And if you need to apologize, don’t focus on wanting the person forgive you. Focus on what you can do or not do to help the other person heal in their own time from what you did.

  • “I hear you want x and I’ll respect that.” If you start to slip back into old habits, checking in with yourself regularly will help you keep a handle on that for yourself. Checking in with people does not take the place of doing the work yourself to be self aware. Self awareness makes checking in with people easier.

Checking in as a chance to update old boundaries if necessary

  • People change and our situations in life change so boundaries will probably need to get updated from time to time. Listen to your mind/body and to the people in your lives to know when it’s time for an update.
Respecting physical and psychological limits
  • Ask if people want to be touched.

  • Ask if people want to talk right now and if they don’t, scheduling a time that works for the both of you and keeping to that time out of respect for each other.

  • Gain consent even from people who you have history with, you never know someone too much to seek out enthusiastic consent.


Learning how to set clear and firm boundaries is 1 of the most important skills one can learn in life. The benefits strong boundaries have on life satisfaction, personal happiness, and one’s mental health is amazing. And being able to not only use boundaries for your personal mental health and building your social support system, but also to use boundaries as tools to make all the relationships in your life even stronger/better is a serious pro-tip. Taking care of yourself, your loved ones, and your community all with the same skill.


Thanks for reading. The next post will be after the holidays on Sunday 1/13/19 about checking in with yourself  and reassessing your whole life for the new year.

Reader Request: Explaining Mental Health Status to Parents

This is a reader request (Thank you again, by the way). This post will cover 1)Doing some self-reflection to sort out what is making you want to talk to your parents about your mental health status, 2)Figuring out how safe the situation is for this, 3)Preparing for the talk, 4)Ways to go about having this kind of conversation with your parents, and 5)How to make your own safety plan in case things don’t go as well as you’d like. I want to make sure that whatever you decide to do, it is a decision that you thought all the way through, that was not made in a rush or impulsively, and that your safety and health is a priority.

#1: Self-Reflection  

What is making you want to tell your parents about your mental health status? This is a great time to reflect on what is motivating you to want to make this decision. It’s hard to figure out what to say if you don’t have a clear idea of what the end goal is here. Like writing an essay or making any persuasive argument, it’s always good to have your goal in mind from the very beginning. That will be your compass in navigating this whole thing. Are you telling your parents so they understand why you need money/financial assistance/health insurance (for medication, therapy, etc)? Or maybe because you need emotional support and/or to fit them into your social supports/safety planning? Or you want to tell them so you can set better boundaries with them? Whatever your reasons are and whatever your end goal is, you should hash that out 1st. Mindfulness techniques [101 post here] could be key here if you aren’t sure how to tap into yourself and figure out what your needs specifically are. Talk to your friends and other people you trust to get their perspective too if that will help you look at this situation from every angle possible.

#2: Assess the Situation 

How much do you rely on your parents? Are you a minor/dependent? Are they paying for your college or do you need them to fill out your FAFSA? Are you under their insurance? Do you live with them or rely on them for money? These kinds of things are what you are potentially risking if things don’t go exactly as you hope. This isn’t to scare you. This is to help you plan while looking at the pros and cons of each decision you make. The cons would be what you could be risking here by sharing your mental health status with your parents, who, depending on the situation, could have a lot of power over you. What are the realistic chances they will support you? How did they respond in similar situations in the past and what kind of support did they give you? How did you feel about the support they gave you back then? Do you have any worries that they might not support you or that they might try to harm you? My point here is to help you reflect on what they could probably do according to evidence based in what they have already said and done in their past…not what you hope they could do. 

#3: Prepping for the Talk 

Okay so you’re taking the time to do some self-reflection and you’re assessing your situation for risks and any safety concerns. Great. Now, it’s time to start getting ready for any response, including acceptance, rejection, gaslighting (A type of psychological abuse where someone manipulates another person until they start to question reality or their mental health. The word “gaslighting” was inspired by a 1938 play/1944 movie called “Gas Light”.), or silencing. Some things you can do to prepare for this talk (or any major talk) include:

  1. Safety planning: So what is the worst case scenario? No one likes to think about the worst case scenarios, but it’s important to plan for the worst (while hoping for the best). You’ve already assessed the situation and have a solid idea of the risks here. Now that you have that awareness, how can you protect yourself from those risks the best you can. Like wearing protective gear or like coming up with a Plan B in case things go left. In psychotherapy, therapists and clients work together on creating formal and informal safety plans whenever a client is in a risky situation. See my post on Suicide here for a more detailed description of a safety plan and for questions to get you started on creating your own plan. 

  2. Self Care. Self Care. Self Care. I don’t think y’all hearing me…SELF CARE. If you have not read my piece on self care here before this point, please time a couple mins to check it out. Definitely pay special attention to the reflection questions I asked in the 2nd half for help figuring out which self care strategies and habits work best for you. Self care is about being compassionate and loving to yourself in a harsh world. It is about taking the time to learn yourself and your needs and investing in yourself and in your future health. Not only is self care important for this talk, but it is key for your mental health and general life satisfaction.

  3. It’s also time to revisit the boundaries 101 piece here. I also suggest checking out Part 1 here of a 2-part boundaries 201 piece I wrote for the holidays: the setting boundaries with toxic loved ones. Just like self care, clear strong boundaries are so incredibly important for good whole body health and personal happiness. Like I’ve said before, learning how to set and maintain clear, firm boundaries is 1 of the most important skills to learn in life. Solid boundaries are armor/protection and they are permission/freedom to really be yourself with people in those relationships. Boundaries keep everyone on the same page, nurture the connection you have with them, and can bring you closer. Remember that you cannot control other people’s behavior, but you can control your behavior and, to different degrees, you can control what you tolerate in your life. Firm boundaries are an important part of self care and part of your safety plan. Regardless of how your parents react, your top priority is the protection of your mental health. And this is all easier said than done. It can be hard to set boundaries at home, especially when setting boundaries was never taught at home and/or your parents have fragile, vague boundaries themselves or even no boundaries at all. But this is worth it. Again, you are worth the effort.

  4. You could practice what you want to say and/or role-play with friends or any other trusted person in your life. This could be helpful to make sure that you are getting your point across in a clear, easy-to-understand way. In therapy, therapists and clients also role-play to help clients work through any anxiety they might feel leading up to a talk like this. Or practice by writing down everything you want to say in advance and reading it out loud and/or emailing it to a friend.

#4: The Conversation 

Ultimately, how you want to do this is up to you. No one knows your life like you do. You are an expert on your life and your situation. That’s why I put so much emphasis and went so hard on the importance of self-reflection, mindfulness, setting boundaries, talking/reflecting with people you trust, and self care earlier. Tapping into yourself and digging deeper is going show more revelations and pieces of wisdom than I think a lot of people would give themselves credit for. What I do want to cover here is some suggestions I have for when you are finally ready to have the first actual conversation with your parents about your mental health status:

When?

  • I’d suggest having a private conversation ideally when no one is in a rush to be somewhere else. You want as much of the focus and attention to be on you as possible.

  • If the person isn’t reasonably making time for you, that already says a lot about where their priorities are at (And if people tell you who they are…). That’s new information added to your situation right there. Assessing your situation is never a 1-time thing. Your plan, etc. can always be updated with any new information.

How?

  • You could write a letter/send an email or text. I personally prefer looking into someone’s eyes and seeing body language when having serious conversation, but I can definitely understand the necessity for other ways of communication, depending on the situation and your safety.

  • Another option is writing a letter/text/email as a kickstarter to the in-person conversation (“Read this when you get a chance. I wanna talk about it when we’re both free.”). Assuming the person reads it, this can be a great way to get your points across in an organized, lower pressure way with less chances of being interrupted.

  • Talk in person in private with talking points. Have an idea of what you want to say going into the conversation . This is where all that planning and possibly role-playing helps.

  • You don’t have to go it alone. Tell other people in your family who could help you have this conversation. Maybe, for whatever reason, this isn’t a 1-person job. That’s cool. Who are some allies you could get to help you break this down to your parents? I’m assuming these people were on your safety plan so maybe part of the support they could give you is help you speak to your parents in the moment. Try to find a balance between them helping you and them speaking for you. This is your conversation, not theirs. 

  • Talk in person with a medical/mental health provider in the room with you. The provider could help you explain the medical specifics if you personally have trouble with that. Or if your parents value and put a lot of trust in authority figures, you have someone like that in your corner. 

What?

  • Break down your symptoms in basic language and what it means for your everyday life. For example, “I’m dealing with this, that, and the third…and that is why you see me struggle with xyz or that’s why I’ve been doing abc”. The goal here is to help make your symptoms easier to explain, but also putting the focus on you, your health, and how they can support. 

  • Research and/or find supportive quotes from religious texts if you think your parents would be open to that.

  • Be specific about the kind of support you need from them. This is tied to knowing yourself and having clear communication and clear boundaries. If you don’t know what you really need, it’s hard to ask for help from others. 

The Blame Game: A quick note about blame. When dealing with shocking and/or upsetting news, it’s pretty common to cope with the situation by trying to find the first thing to blame.  Feeling out of control in the face of this new information, it’s very human to want to change the focus and energy on something else as a distraction and/or to feel more in control. Parents, the humans that they are, could react to the conversation by looking for someone or something to blame. Whether they chose to blame themselves, something you did or didn’t do, etc., it actually has nothing to do with you. It is how they’re deciding to cope with the update of your mental health status.  Putting it plainly: This is their mess. This isn’t you. This isn’t even for you. This is for THEIR comfort, not yours. The blame game distracts from the real focus of all this: your very real, life experiences and what you need from your parents here and now.

So, how are you feeling about all this? I know this is a lot to think about. I hope with this piece, you can begin to reflect on your situation and make informed decisions. By making time for self-reflection, taking a step back & looking at your situation closely, doing what you need to do to prep for the talk, including making a safety plan in case things aren’t ideal, setting firm boundaries, etc. you are making yourself and your health a high priority. Always weigh the pros and the cons. Study the benefits and the costs. Assess the risks. You are worth the effort.


Thanks for reading. The next piece will be Part 2 of the 2-Part Boundaries 201: Bringing the Skills Home series in time for the holiday season, focusing on using boundaries as tools to build and make all the relationships in your life even stronger on Sunday 12/23/18.

Intro to Self Care

Self care. This word has become popular on social media and in progressive spaces, especially with the new presidential administration, but there’s still a lot of confusion about what it is. Literally self care about taking care of yourself, physically, emotionally, etc. A way I like to think about self care is learning how to be in a relationship with yourself. Learning yourself and what your needs are. Being honest, kind, and considerate to yourself about what you realistically can and cannot do. Our society prides constantly being on the grind and never sleeping to secure the bag, but eventually you’re gonna burn out. Non-stop work is not working smart. Meaning the kingdom you’re trying to build will be made of weak foundations if you do not learn balance. Learning to take care of your body and mind while you are working to achieve your goals will keep you going for longer and healthier. Invest in yourself. Maintain yourself. Burning out after constant grinding is not the wave and repairing yourself from that takes more energy and time than doing things on a regular basis to take care of you.

 Self Care Is…?

There’s a lot of misunderstanding about what self care even is and what it can look like. I asked Twitter for some common misconceptions and I’m gonna take some time to debunk them right here.

Myth: But Ain’t Self Care Like Doing Nothing/Like a Spa Day?

There are many different ways to do self care. When most people think of self care, they think about face masks and drinking lemon water. That works for some people, but that’s not all that self care is. Self care literally depends on each individual person and what they need/want at that given moment.

Some other examples of self care: blocking/muting someone, buying your favorite snack every Tuesday, going for walks alone, going out with friends, reading your favorite fan fiction at home, setting an alarm to take your medication everyday, rock climbing, limiting how much time you spend around certain family members, being kind to yourself when you feel like a failure, etc.

Myth: But Ain’t Self Care Selfish?

Nah, it’s a part of your larger health. No one would call taking care of your physical health being selfish. It’s sad: the way this society treats mental health care. It would be weird and insensitive to call someone selfish for walking away from a stressful situation because of their high blood pressure or heart issues. Or if they cancelled hanging out because they caught the flu. Also mental health and physical health are connected. You, your mind, and body need some love to function. Taking care of yourself will affect your whole body and make you stronger. And if you’re worried about looking or feeling selfish while you also deal with all your other obligations: How can you take care of others if you’re running on fumes? Take care of yourself.

Myth: But Ain’t Self Care Like a Cure-All?

Self care isn’t magical. It isn’t a cure. You might not notice huge changes in your life after a few weeks or even a month. It’s an investment in yourself. Like brushing your teeth. It doesn’t exactly cure dental problems, but it prevents larger issues from happening if you take care of your teeth little by little every day. Slowly, over time you’ll see changes in your mood, ability to sleep, life satisfaction, etc. The impact depends on the kind of self care you decide to do.

Myth: But Ain’t Self Care Always Easy to Do and/or Always Fun? 

Sometimes self care is boring and monotonous. Sometimes it’s not easy to do. But at the end of the day, self care is always good for you. Some examples of times when self care is more for the greater good and less because it’s fun to do: taking some time to sit in your feelings/self-reflect, doing homework earlier, cutting ppl off, drinking more water, getting tested for STIs every 3-6 months if you are at all sexually active with anybody, flossing your teeth, etc. Again, you do it because it is an investment in yourself and you’ll feel better in the long run.

Myth: But Ain’t Self Care Expensive?

Self care ain’t just for those with extra money to spend. Self care doesn’t have to cost money because you decide what self care looks like for you. It’s interesting that taking care of yourself is seen as something that has to cost money and has to be expensive. That says a lot about capitalism and our society that people think being able to take care of oneself is only for those with money. Self care can be going to bed on time. That’s free & priceless at the same time.

Doing For You

Y’all should know by now that I’m Team Self-Reflection. Learn yourself. Ask yourself some questions. Know yourself. Here are some questions to get you started:

Relationship with yourself:
  1. How often do you do stuff for you? Just for you?
  2. How much sleep are you getting? What’s the quality of your sleep?
  3. How is your appetite? How does what your eating make you feel?
  4. How are your boundaries? How easy is it to say “No” when you need to?
  5. What are 5 small things you could do today that would make tomorrow a little easier?
  6. How’s your health? Are you taking your medication regularly as prescribed? Do you have a primary doctor? How often do you go get checked? How often do you get tested for STIs?

All sexually active adults need to get tested for all bacterial & viral sexually transmitted infections every 3-6 months. 1 more time: if you are “sucking and/or fucking” someone, you need to be getting tested every 3-6 months.

Social circle:
  1. Who can you call if something popped off right now?
  2. What kind of support do you need? How are you getting those needs met?
Coped in the past by:
  1. Being alone?
  2. Being with loved ones?
  3. Distracting yourself with activities, events, school, work, etc?
  4. Using relaxation exercises (deep breathing, meditation, etc.)?
  5. Using substances (marijuana, coke, coffee, cigarettes, adderall, etc.)?

I don’t judge. Substance use in and of itself isn’t a problem (it being illegal aside). If the substance use is stopping you from functioning (EG: can’t pay rent and/or severe difficulties raising children) and/or if it causes you distress then it becomes a substance use disorder. A substance use disorder is a symptom of a larger issue and how someone is coping with a deeper problem. Trying to deal with the substance use disorder without dealing with the root issue is cruel because you would be leaving the person with the original problem AND 1 less coping skill to deal with that problem. Long-lasting change happens when you address the root problem first. Generally, the person will use substances less over time until it is no longer a substance use disorder.

Pros and Cons:
  1. Compare the risks and benefits of each coping skill and order them by the ones with most benefits to least. It would be real useful to get rid of the ones that are the least beneficial and replace them with new ones with less negative side effects.

Example: Drinking when you have diabetes. Even though alcohol is legal and even if you may be technically drinking a relatively average amount of, let’s say, beer with your friends. Your health (i.e. diabetes) means your body cannot process glucose (sugar) in your body and alcohol turns into glucose and will raise your sugar levels. Having a couple beers a night might be cool for other people’s lifestyles, but for you, it could mean serious health issues (kidney issues, loss of limbs, teeth issues, etc). So you could weigh the pros and cons and decide that the potential negative effects of alcohol on your body outweigh the social or numbing benefits of drinking.

Think about your life. Think about what you can do to show yourself some love. Think about the people and things that drain energy without giving anything back. Think about the things that bring growth into your life. Think about the things in yourself that you wish were different or about the life lessons you have a hard time learning. These are the areas where you should focus on taking care of yourself. The world is harsh enough. You don’t need to be hard on yourself too. It won’t actually make you stronger. It will eventually burn you out though. In these days and times we’re living in, burning out should be avoided. Take care of yourself now for whatever will be coming later.

Thanks for reading. Next post will be the part 2 of the corporal punishment/public shaming 2-part series on 3/25/18.

How to Know If/When You’re Depressed

Before I start I wanna say that it’s legit ok to feel sad sometimes. Humans are not supposed to be happy all the time. That’s impossible. Humans are supposed to feel a wide range of emotions. Even emotions that can be very uncomfortable or just plain suck to feel. That’s life. Hiding from those emotions or pretending you don’t feel certain emotions doesn’t fix a damn thing or make you a more evolved person (but that’s another post for another time). So what’s the difference between being sad and being depressed? Mental disorders, in many cases, are more extreme/intense (aka outside of the average person’s experiences) versions of everyday emotions and experiences. Anyone who has ever taken an abnormal psychology course probably has heard of the 4 Ds method of thinking about mental disorders: Deviance, Distress, Dysfunction, and Danger.

  • Deviance: Whether someone’s behavior is acceptable in their specific culture (or cultures) and society. For example, “disorganized speech” (where someone is impossible to understand due to a disorder in how their thoughts are put together) is a symptom of schizophrenia. It is incredibly important for therapists (and all mental health professionals) to understand someone’s background/context before diagnosing them. The situation changes completely if the person was speaking in tongues while praying. In that case, speaking in tongues would not be considered disorganized speech aka a symptom of a mental disorder because it is an appropriate part of that religion/culture. See what I mean?
  • Distress: Do the symptoms this person is experiencing cause them (or the people around them) clinically significant distress (EG: a lot of anxiety, sadness, pain, etc)? If you’re wondering why causing other people clinically significant distress in written into the diagnosis: For certain mental disorders (personality disorders, etc) and in other situations, a client may not notice their symptoms or the impact these symptoms have. This is called having “poor insight”. But just because the person can’t tell that anything is off/wrong, doesn’t mean that their loved ones and others around them aren’t affected. Example: A spouse who is currently having a manic episode and impulsively spending all the rent money. A therapist could still use this information to diagnose their client.
  • Dysfunction: Do the person’s symptoms affect their ability to function in society (hold a job, pay bills, maintain social relationships/obligations, personal hygiene, etc). This does not mean the person’s whole life has to be dysfunctional. Symptoms could affect 1 area of someone’s life so much that it qualifies. For example, social anxiety symptoms that affect a person’s ability to go on successful job interviews, but don’t come up when hanging out with friends would still count.
  • Danger: And finally, do the person’s symptoms cause them to be a danger to themselves or others. [Note: Danger alone does not mean someone has a mental illness. Lemme say that again: violence, abuse, and any other kind of danger (emotional, physical or otherwise) alone does not mean someone has a mental illness. So stop saying every person who is engaging in violence has a mental disorder. That’s NOT true at all. It adds to the stigma against people living with mental disorders (who are more likely to be victims of crimes/violence/abuse/neglect and therefore are always shafted in terms of healthcare and treatment because of this stigma). And it lets people who engage in violence, and this society that enables them, off the hook instead of really addressing root causes of violent behavior.

A given mental disorder does not have to have all 4 Ds, but usually will have at least one. The 4 Ds method is a nice guideline/tool for thinking about what makes something a mental disorder.

So what is Depression? Because I refer to the kitchen in my home as “my kitchen”, I find it the easiest to think about mental health disorder diagnoses like recipes. Every recipe needs ingredients and these ingredients have to cook for a certain amount of time before the meal is ready. To make a major depressive disorder, you need to cook at least 5 of the following “ingredients” for at least 2 weeks [These symptoms must cause distress or dysfunction and the symptoms must not be caused by anything else like medication/drugs or another medical condition]:
Must Have At Least 1 From Here:
  • Feeling depressed (or other people think you look depressed) nearly every day; Kids might look irritable instead of depressed
    • Translation: Feeling shitty, cranky/irritable, down, etc so intensely that it causes distress and/or dysfunction, etc
  • No longer interested or no longer enjoying all or almost all activities most of the day, nearly every day
    • Translation: You just don’t care about the stuff you used to or the same stuff doesn’t make you feel good anymore. You might find yourself pulling away from people and being social
And At Least 3-4 From Here To Meet The 5-Ingredient Minimum:
  • Huge weight loss/gain or appetite decrease/increase
    • Translation: Eating can either feel like a chore, be your new best friend, or all of the above depending on the context. The important part here is that your usual behavior has changed
  • Insomnia or hypersomnia nearly every day
    • Translation: You have problems falling sleep and/or staying asleep or you sleep for hours more than you usually do
  • Psychomotor agitation or retardation nearly every day that other people gotta be able to see
    • Translation: Agitation – Looking agitated (think restless movements like nail-biting, skin-picking, pacing, fidgeting, etc) to people or Retardation – Looking as if your speech, thoughts, and physical movements have slowed down, taking longer than usual to react, and/or you are talking much less, much quieter or with much less feeling. Psychomotor retardation is what can make doing every day activities (showering, cooking, household chores, paying bills, answering emails, doing homework, work, etc) feel impossible to do because it feels like you are physically incapable, almost like there are invisible weights/pressure on and all around you.
  • Feeling fatigue or loss of energy nearly every day
    • Translation: Feeling tired to the bone. Even the smallest activities might make you feel exhausted and you don’t get shit done the way you usually do
  • Feeling worthless or excessively/inappropriately guilty nearly every day
    • Translation: Holding yourself to unrealistic expectations, constantly ruminating/reviewing past mistakes, and/or seeing everything as evidence that you ain’t shit or blaming yourself for things that couldn’t possibly be your fault
  • Difficulties concentrating or indecisiveness nearly every day
    • Translation: Feeling distracted often, having trouble remembering things, and/or making even small decisions feels incredibly hard
  • Repeatedly thinking about death, thinking about suicide, thinking about suicide with a specific plan on how to do it, or attempting suicide
    • Translation: Passively wishing you could go to sleep and not wake up and believing that others would be better off if you weren’t alive on the lower risk end of the spectrum and constantly thinking about committing suicide, having a specific plan of how to do it, and/or attempting suicide would be on the higher risk end of the spectrum

I’m telling you all this, not so y’all can run around diagnosing people on the internet or IRL. Diagnosing a whole human being is not something you can do after reading a few pages in a manual. There’s so much work that goes into diagnosing a client: proper information gathering, taking into account the many parts of what makes each disorder, how the disorder develops in theory and in real life, risk factors, cultural issues, gender-related issues, and then comparing similar symptoms within multiple disorders to make sure that the diagnosis is as accurate as possible, etc. Basically, y’all, what I’m saying is take these good tips I’m giving you at face value and stay in your lane before you cause damage trying to diagnose or read someone’s mental status. Thanks!

This information is to build self-awareness so you can recognize possible signs and symptoms in yourself. Having a clear understanding of the symptoms and what makes those symptoms flare up is key. This post does NOT give you the ability to self-diagnose a major depressive disorder. Unless you have been diagnosed by a mental health professional, you cannot say you are clinically depressed (I should write a post about the overuse/inappropriate use of mental diagnostic labels & how it’s used as a shortcut to actually using more accurate/descriptive words for how you feel. And how people being uncomfortable delving too deep leads to using labels that don’t fit…). Again, what this post does do is help you identify any potential symptoms and give you a basic level of understanding. The first steps to healing are education and awareness. From there you can think about your options: using coping skills, asking for support from loved ones, looking for treatment, etc.

If you are experiencing these symptoms and want to access mental health treatment, places to start could include calling your insurance company to see what is covered, going Open Path Collective‘s website, filling out an intake for free/low-cost mental health services at nearby nonprofit organizations/community-based organizations, speak to your doctor about referrals, or checking directories like Psychology TodayNational Queer and Trans Therapists of Color Network, Therapy For Black Girls, etc.

 

If you feel like you want to hurt yourself and need someone to talk to, here are a few suicide hotlines (in the United States):
  1. National Suicide Prevention Lifeline – 1-800-273-8255 (1-800-273-TALK); Available 24/7
  2. The Trevor Project Hotline (LGBTQ youth) – 1-866-488-7386; Available 24/7; TrevorText: Text the word “Trevor” to 1-202-304-1200; 7 days a week 3pm-10pm EST; TrevorChat: Click this link for the chat portal; 7 days a week 3pm-10pm EST
  3. Trans Lifeline – 1-877-565-8860; Available 24/7
  4. Mental Health Hotline – 866-677-5924
Depression doesn’t make you a failure. You aren’t a bad person. You aren’t weak. You aren’t a sinner. You just going through some shit right now. You don’t have to go through it alone. Hope this helps. Let me know if y’all want more of these kinds of posts in the future. Thanks for reading.
Next post will be about workplace relationships among coworkers and employers “dating” employees on 2/11/18.

 

Making the Most of Your Time While Unemployed

So you lost your job. Whether you were fired, quit, asked to resign, etc., loss of a job is still a significant, routine-altering change. I mean you already had your lunch spot set up for months, even years. Even if your workplace was toxic, you were sipping the poison slowly and what didn’t kill you…made you incredibly unhappy, but let’s move on. Well, regardless, it is finally over and you might be wondering what to do next. For many, sudden unemployment is a life or death situation in this economy, especially for marginalized people struggling with low incomes, no generational wealth, debt, and job discrimination. Hopefully, you are able to secure unemployment insurance (for as long as it exists). And to be real, until you make sure you have stable housing, finances, and food situation, it’s gonna be very hard to focus on anything else. So I’m moving forward with this post, assuming that your basic survival needs are being met and you are able to focus on other needs.

Loss of a job is like any other kind of loss. You now have to adjust to this change and move forward. I would like to offer some suggestions on how to make the most of your time while unemployed:

Allow yourself some time to get your bearings.

This is especially the case if the way you left your former job was rocky or if the job was overall a toxic place to be. In many ways, it may feel like leaving an abusive relationship and you may have to heal from that. Or if you had to leave a job you enjoyed, you may need space to mourn that loss. Some people have to leave due to an injury or disability and that is another kind of loss and huge change to deal with. Many people are also living with depression, anxiety and/or many other mental health concerns and the stresses of unemployment can heighten these symptoms. I would suggest at least week or 2 of just letting yourself be. No pressure to accomplish anything (beyond applying for unemployment or whatever other social service benefits you might need while unemployed). Take this time and do some emergency healing. What helps you escape significant stress? How do you cope? Do you like to hide away? Cool, stay home, hibernate, text your friends, and watch movies until you feel more like yourself. Do you need a change in scenery? Maybe sleep over at a friend’s place for a week, like you’re on a vacation. Whatever you choose to do for at least a week or 2, do it for you with no shame. Giving yourself time to rest and recover from your last job is not only good for your mental health, but it will also strengthen you for the job hunt ahead.

Process what happened.

Whether you were fired or quit, having to leave a job unplanned sucks at best. Whether you feel relieved, overjoyed, angry, sad, resentful, exhausted, etc., there is nothing wrong with wanting to talk about it. Find consenting people to vent to about this or write about it in a journal, on your blog, etc. You’ll feel a lot better once you get some time to talk through what happened. And depending on how things at your job ended, you might need to talk about it a lot while you are adjusting to this change. That’s ok.

Structure Your Days

Part of what makes being unemployed difficult is the psychological piece. In this capitalistic society, work gives people a sense of purpose and on a basic level, work literally sets the schedule for people’s lives. It can be comforting and comfortable for many people to wake up at the same time everyday and know exactly what you have to do. Once you lose your job, that piece of comfort and certainty disappears. Now, you (and your body) have to figure out when to sleep, when to eat, and how to spend all the hours in the day. In the first few weeks, it is very easy to fall into an unemployment blackhole, especially if the situation at the last job did not end on good terms. Many of us have found ourselves laying on the bed/couch, feeling without direction. Fill up your day with stuff that feels fulfilling & healing. Set an alarm, apply for jobs, pick up hobbies, clear up your Netflix queue, maybe make a checklist, but be careful that it doesn’t become an obligation.

Go Outside

This can be really hard for more introverted people or people dealing with depression symptoms for example. However, finding a reason to get out at least 1-2x a week is medicine for the mind and body. Even if it’s taking an extra long walk back from the corner store or doing laundry. Some other suggestions: go to the gym, visit friends, go to the library, check out any free/low cost activities in your area, etc.

Ok…Now, What’s Next?

Think about where do you wanna go from here. Did you learn anything from your last job experience? What do you want to leave behind or take with you for the next job?

This is a great time to reflect on the choices you’ve made up to this point. Is there anything you’d do differently? Do you need to refocus/regroup?

With self-reflection, comes growth, y’all.

Maintenance

Once you give yourself time to heal, took some time to process your emotions until you feel lighter, got your schedule down, and find time to go outside at least 1-2x a week, now you’re ready for the hardest part of unemployment: maintenance. It could take months for you to find a new job in this economy. There could be days when you feel more hopeful than others. There could be days where you feel hopeless or lose confidence in your skills. Or days where you feel so frustrated and angry that you feel like doing something reckless. It could help to plan for those days. In therapy, this is called a safety plan. You hope for the best, but it’s always good to have your backup plan in place for when something pops off.

Some questions to ask yourself when planning for the worst:

  • What are some signs that let you know you’re starting to feel hopeless, sad, frustrated, etc? Do you feel it in your body? Do you get headaches? Do your hands shake? Or is it more in your head/thoughts? Do you get racing thoughts, for example? It’s good to be aware of yourself.
  • What are some things you can do to cope with these feelings/this situation? What are some barriers to (aka what stops you from) you using these coping skills and how could you overcome those barriers?
  • Who can you contact for support?
  • What kind of support do you want from them?
  • Do you feel comfortable calling emergency services? What hospital would you want to go to in a worst case scenario? Do you have any suicide hotlines handy?

Unemployment does not have to be a hellscape. Just like after any other loss, there’s room for healing and change. Following these suggestions can help you proactively make the most of your free time, focusing on healing and personal growth. Changing this usually unpleasant experience into a period of transformation also allows you to reflect on any lessons learned and re-examine your wants/expectations while you’re in the process of figuring out your next move.

Be kind to yourself. Invest in yourself. You might be surprised by all the things you are capable of.

Thanks for reading. Next post: “How to Know If/When You’re Depressed” on 1/28/18.

Finding the Right Therapist for You – Part 2: Your Role as a Client (Written in 2014)

Please check out Part One of this two-part series. This post is about your role and rights as a client. As I said in the previous post: therapy should not be something that is done to you. Rather, it should be something you do together with your therapist. For the sake of self-disclosure, I will remind you of my personal theoretical approach. My approach to therapy mainly comes from a postmodern client-centered approach (with some cognitive therapy interventions). If you remember from the first post, my theoretical approach dictates how I see a client, how I see my role as the therapist and what kind of techniques and methods I will use in therapy. My belief that clients should be active co-participants in a therapeutic relationship is influenced by my theoretical orientation. Basically, keep in mind throughout this post that not all therapists will agree with everything I say here. These are my beliefs and these are the things I stand for.

As clients, I believe that you are the consumer and the therapist is providing a service for you. Therefore, it is important to find a therapist that is best suited to be able to provide the best possible service for you. Finding the right therapist is like finding a partner. There should be chemistry. This potential therapist should work to gain your trust and create a safe space for you. And the both of you should be compatible enough that it is possible for the both of you to effectively work together to accomplish your therapeutic goals. As stated previously, this is the time to pay attention to the therapist’s theoretical orientation. Additionally, there is another factor to focus on: the therapist’s personality. Therapists are humans with all the accompanying strengths and flaws. If the therapist’s personality grates on your nerves or simply does not complement yours, you’re going to be distracted from accomplishing your goals in therapy.

Relatedly, think about coming out to the therapist during the intake process, aka that first meeting where the therapist asks you a lot of questions about your past, your personal life and the reasons why you decided to seek therapy. I know the idea of coming out to a therapist as queer, trans*, polyamourous, kinky, etc. may feel nerve-wracking and scary as all hell, but it is actually very helpful in the long-run. A therapist cannot provide care that is designed for you if they do not know enough about you. It is important to ensure that a therapist has the experience and the skills necessary to help someone from your community or communities. Even if, let’s say, your gender does not play a role in the presenting problem (the problem you are coming to therapy to deal with), if a therapist has negative biases or is ignorant about these issues, their ignorance may block them from being able to provide effective therapy. It would be hard to feel comfortable discussing your phobia of talking on the phone if your therapist somehow blames every problem you’ve ever had on the fact that you are genderqueer. Also it is impossible to provide effective therapy to a client without understanding them in their proper context. How can I possibly fully understand a client’s needs and goals if I don’t understand how being Chinese, queer or an immigrant interacts and influences their perspective? How would I be able to tell the difference between reasonable anxiety that comes from being a person of color in a racist society from a maladaptive anxiety that comes from an anxiety disorder without understanding their subjective reality? That said, your potential therapist does not have to be an expert on everything. That would be impossible. A therapist just needs to be open-minded and empathic. Your potential therapist may not know everything there is to know about being polyamourous and that’s fine. However, this therapist should be willing to do some research. You are not obligated to school your therapist on poly-101. It really is not that hard to go look it up on the internet and it would distract from therapy if your therapist kept asking you to explain how you can possibly date more than one person every other session. A therapist should be able to admit when they are not knowledgeable about something and should be willing to put in some work for the sake of the therapeutic relationship.

So congratulations, you bravely walked into their office, filled out the intake forms and then came back a second time for a therapy session. Damn right, good for you. Now that you have chosen a therapist, don’t feel like you are locked in. Do not be afraid to switch therapists and walk away from one if they are not meeting your needs. I have talked to some people who stick with incompatible therapists for much longer than they should because they feel as if they can’t leave. Your therapist is not your parent. You have power. You are the consumer. You can always find someone else if this therapeutic relationship isn’t working out. That’s not to say that you should just leave if there’s a bump in the road. Therapists are not perfect. I’ve bumped heads with my former therapist a couple times. The sign of a good therapist is their willingness to be flexible and their ability to apologize if they have made a mistake. Another thing to keep in mind is that there is a difference between feeling uncomfortable because you are dealing with your issues in therapy and discomfort because a technique or therapist simply is not working for you. If you are feeling uncomfortable or upset, talk it out with your therapist. They should be willing to talk about what is going on between the two of you in session (aka metacommunication). If a technique isn’t working for you, your therapist should be willing to modify it or scrap it altogether. A therapist that is not willing to be flexible and talk to you as if you are a competent adult isn’t a therapist that I would want personally.

Another thing to keep in mind: a therapist is not supposed to give you advice. It is not their place. A therapist is supposed to help you become independent by, for example, providing you with coping skills, teaching you techniques, and/or making you aware of your own inner strengths. Giving a client advice fosters dependence on the therapist by creating a situation in which the client feels like the therapist has all the answers. The client may not think they can come up with answers to their problems on their own and feel as if they would be incompetent without their therapist. This is not the kind of situation a therapist should encourage. If a client has a problem, an effective therapist would help the client brainstorm ways to resolve the situation on their own so that if they ever find themselves in a similar situation, they will be able to handle it without their therapist’s help. I would be incredibly wary of a therapist who dispenses advice or tries to “fix” your life.

Again, please don’t forget that, as the client, you have agency. The therapist is not your lord and master. They are not better than you. They are not smarter than you. You are the expert on your own life experiences and they are the expert on therapeutic approaches/techniques. You deserve respect for your expertise. In my opinion, a therapeutic relationship should be based on mutual respect, collaboration and trust. Don’t be afraid to stand up for yourself and seek out what is best for you. You are important and you deserve the best.

If you have questions or suggestions for future topics, please feel free to send an email to me at queeringpsychology@gmail.com or tweet to @QueeringPsych on Twitter.

Finding the Right Therapist For You – Part 1: Theoretical Approaches (Written in 2014)

This is part one of a two-part series regarding how to find the right therapist for you. A number of people have been requesting these posts for months and I am finally able to put this up. In this post, I will give very brief and basic descriptions of some of the more prevalent theoretical approaches that therapists work from. Knowing a therapist’s theoretical orientation/approach is incredibly important. All therapists are not the same. I have heard the following statements countless times from people: “My therapist is so awful! This proves therapy just doesn’t work for me!” Then I usually say, “Damn, I’m really sorry your therapist didn’t work out for you. What theoretical approach was your therapist working from?” And then I usually get a blank stare. Theoretical approaches determine how a therapist views you as a client, their role as a therapist, their relationship with you and what techniques they will and will not use. Think of theoretical approaches like a pair of glasses with which your therapist views the world. As a client, I think it is very important for you to know the theoretical orientation of a potential therapist. It is something that you really should consider when you are trying to figure out if a specific therapist is right for you. Do you want to simply focus on your anxiety symptoms? Do you want to talk extensively about your childhood? Do you want to figure out your place in the world? Different approaches focus on different aspects of life and different aspects of human psychology. Finding a therapist whose theoretical approach fits with what you are looking for can help avoid being with a therapist who simply is not compatible with you.

In this post, I will describe each approach by asking the following questions: “How Does This Approach View Clients and/or Humanity?,” “How Does This Approach View the Role of the Therapist?,” “How Does This Approach View the Therapeutic Relationship?,” and “What Are the Overall Goals of This Approach?”. I am only describing some of the many approaches and, as stated earlier, these descriptions are basic. This post is meant to serve as a diving-board for your own research.

Classical Freudian Psychoanalytic Therapy and Modern Psychodynamic Therapy

Psychoanalytic therapy is basically what first pops into everyone’s head when they think about therapy. Sigmund Freud is the founder of psychoanalytic therapy and his work influenced all of modern psychotherapy. Every theory that came after Freud’s was either inspired by or in retaliation of psychoanalytic theory. Psychodynamic therapy is the more modern version of Freud’s classical psychoanalysis.

How Does This Approach View Clients and Humanity?

  • In Freudian psychoanalytic therapy, human behavior is motivated by unconscious and irrational urges. Freud believed that humans are inherently savages that were reined in by society.
  • Human psychology can be split between things we are aware of about ourselves (the conscious) and things we are unaware of (the unconscious). Becoming aware of the unconscious parts of ourselves is the main goal of psychoanalytic therapy because with this awareness comes choice and change.
  • The experiences people have early on in their childhood have a huge impact on who they are as adults.

How Does This Approach View the Role of the Therapist?

  • The therapist is the expert and is the one who will provide the insight. The therapist makes insightful interpretations based on what the client has told them so the client can grow and change. Interpretations include calling attention to and explaining the meaning behind a client’s behavior.
  • In classical Freudian psychoanalysis, the therapist tries to remain anonymous and emotionally detached from clients to encourage transference (a client’s unconscious rehashing of old feelings and reactions from past significant others onto the therapist). The therapist explores these feelings and reactions as a window into the client’s unconscious thoughts and feelings. This approach assumes that the client acts in similar dysfunctional ways with the therapist as they do with other people in their lives.

How Does This Approach View the Therapeutic Relationship?

  • Classical psychoanalytic therapists want to remain emotionally detached from clients in order to provide insights and interpretations. In contrast, modern psychodynamic therapists see a solid and healthy therapeutic relationship as an important part of creating change.
  • The psychodynamic approach views emotional communication with clients as another way to learn more about the client and to build a connection with the client.
  • Sessions are fewer and shorter than traditional Freudian psychoanalysis (nearly every day of the week for many years).
  • In the current psychodynamic approach, clients and therapists sit face-to-face, instead of lying on the couch.

What Are the Overall Goals of This Approach?

  • Making the unconscious conscious (classical Freudian psychoanalysis).
  • Increasing the client’s ability to function in society.
  • Reducing symptoms and resolving internal conflicts.

Adlerian Therapy

How Does This Approach View Clients and Humanity?

  • Human are motivated by their desire to relate to others in society.
  • Humans have agency in their own lives, but their ability to make choices is limited by biological and environmental factors.
  • It is our feelings of inferiority and insecurity that motivate us to become better.
  • Clients are not sick. They are discouraged by life and this discouragement results in dysfunctional behavior.

How Does This Approach View the Role of the Therapist?

  • It is important for a therapist to be able to see the world from the client’s point of view. It is essential that an individual be understood in the full context of their life.
  • The therapist takes on the role of teacher and encourages the client by making them aware of their strengths.
  • The therapist helps the client create goals for therapy.

How Does This Approach View the Therapeutic Relationship?

  • The therapeutic relationship is collaborative, as the client and the therapist work together to create change.

What Are the Overall Goals of This Approach?

  • Encourage discouraged clients.
  • Help clients better understand how they see themselves and the world, which should avoid the repetition of symptoms.

Existential Therapy

How Does This Approach View Clients and Humanity?

  • This approach asks the question: “What does it mean to be human?”
  • Humans are constantly changing in response to the conflicts of life.
  • This approach focuses on how humans deal with being alone in the world and how they handle the anxiety that comes with it.
  • Humans are free to make decisions within the environmental and social limitations of life. Humans may not be able to control exactly what happens to them, but they can control how they deal with it.
  • This freedom comes with responsibility and the choices people make comes with consequences. Trying to avoid one’s responsibilities or trying to avoid making choices results in existential guilt and anxiety.

How Does This Approach View the Role of the Therapist?

  • The therapist helps clients explore their current values to see if these values are benefiting them.
  • The therapist confronts clients with the fact that they must become their own person and not allow others to define who they are. Clients are encouraged to accept responsibility for their actions.

How Does This Approach View the Therapeutic Relationship?

  • The therapeutic relationship is seen as a sample of other relationships in a client’s life.
  • A caring, respectful therapeutic relationship is more important than being an objective, detached professional.

What Are the Overall Goals of This Approach?

  • To help clients see the ways they are not living fully authentic lives full of freedom and responsibility.
  • To help clients face their anxiety and create meaning lives.

Person/Client-Centered Therapy

How Does This Approach View Clients and Humanity?

  • People are trustworthy and are capable of creating constructive change.
  • Clients already have the strengths and assets within them to overcome their problems.

How Does This Approach View the Role of the Therapist?

  • The expertise, clinical knowledge and techniques of the therapist are not as important as the quality of the therapeutic relationship. It is the therapist’s ability to connect with the client as a person and their ability to be present for the client that truly matters.

How Does This Approach View the Therapeutic Relationship?

  • The therapeutic relationship is incredibly essential. A good, solid relationship allows the client to feel safe enough to explore thoughts, feelings and behaviors that they have not been able to express otherwise. This leads to clients being able to become their own healers and create their own positive change.

What Are the Overall Goals of This Approach?

  • Help clients recognize their strengths and become independent so they can handle problems on their own.
  • Create a safe space that will give clients the freedom to explore parts of themselves they may have been too afraid to explore previously so they can live whole and authentic lives.

Gestalt Therapy

How Does This Approach View Clients and Humanity?

  • Clients have the ability to make positive change when they are fully aware of themselves and their environment.
  • Clients have an active role in therapy as they find their own insight.

How Does This Approach View the Role of the Therapist?

  • The therapist is a guide who encourages the client to change by discovering and accepting themselves and their environment.

How Does This Approach View the Therapeutic Relationship?

  • It is a collaborative relationship in which the therapist and client share their experiences in therapy together in the here and now.

What Are the Overall Goals of This Approach?

  • To expand the client’s awareness of themselves and the environment in the current moment because change comes through awareness.
  • To help the client accept themselves.

Cognitive-Behavioral Therapies

Cognitive-Behavioral Therapy is an umbrella term for many different theoretical approaches. All CBTs use techniques/interventions that focus on the cognition (thoughts) and behavior of clients as a way to create positive change. CBTs also tend to be short-term therapies that focus primarily on reducing psychological symptoms. I chose Albert Ellis’s Rational Emotive Behavior Therapy (REBT) and Aaron Beck’s Cognitive Therapy (CT) because they are the most well-known of the CBTs.

How Does This Approach View Clients and Humanity?

  • REBT
    • People are born with the potential for both rational and irrational thinking.
    • They learn irrational beliefs from childhood and actively reinforce these beliefs throughout their lifetime.
    • Blaming the self or the world is the root of emotional problems.
    • Life experiences and events do not cause psychological issues (i.e. anxiety or depression). It is our beliefs about the event that impact our emotions and behaviors. For example, according to REBT, you are not depressed because your father died. You are depressed because of how you perceive your father’s death. Your perception therefore influences how you behave and the emotions you feel. If your perception was changed, you would feel better.
  • CT
    • Humans have core beliefs about themselves and the world that they maintain all throughout their lives. When these beliefs are not accurate, psychological problems occur.

How Does This Approach View the Role of the Therapist?

  • REBT
    • The therapist is the expert and teacher, who models rational behavior for the client.
    • The therapist disputes the client’s irrational thinking and teaches them techniques to independently dispute and replace irrational beliefs with rational ones.
  • CT
    • Therapists encourage clients to turn their core beliefs into hypotheses to be examined. Clients conduct experiments to test the validity of their beliefs.
    • The therapist asks open-ended questions to encourage clients to find their own answers to their problems.

How Does This Approach View the Therapeutic Relationship?

  • REBT
    • According to Albert Ellis, a warm therapeutic relationship is not necessary for success and can actually be harmful to the client. He believed that it could cause clients to become dependent on the therapist.
  • CT
    • A collaborative, empathic relationship is incredibly important, but it is not the only thing needed to create change. Techniques are needed too.

What Are the Overall Goals of This Approach?

  • REBT
    • Teaching clients to accept themselves, flaws and all.
    • Teaching clients how to change dysfunctional thoughts, emotions and behaviors into functional ones.
  • CT
    • Helping clients analyze their core beliefs and change them if necessary.

Postmodern Therapeutic Approaches

Postmodern theory is a reaction to modernism, which believes that there is one true, objective reality that can be studied and known through the scientific method. Theoretical approaches based on modernist thinking are founded in the idea that people who seek therapy have deviated from some objective norm and need to be put back on the right path. Postmodern theory disagrees, believing that there are multiple valid and subjective realities. Each person lives in their own reality that is influenced by the time, place and society in which they live. There is no single objective truth and, following that, there is no single right way to live.

I will describe two postmodern therapeutic approaches: Steve de Shazer and Insoo Kim Berg’s Solution-Focused Brief Therapy (SFBT) and Michael White and David Epston’s Narrative Therapy.

How Does This Approach View Clients and Humanity?

  • Both postmodern approaches agree that clients are the experts of their own lives.
  • SFBT
    • SFBT believes that clients already have the strengths within them to resolve their problems, but sometimes people lose their way.
    • Clients are not reduced to a diagnostic label.
  • Narrative Therapy
    • An individual’s life is made of up stories, regarding how they perceive themselves and the world. These narratives dictate how clients live their lives and shape their realities. Psychological problems can come from the internalization of the narratives from the dominant culture, which takes away the personal agency of the individual. Modernist theoretical approaches would encourage clients to conform to the dominant narrative or simply help them to cope with the socially constructed “truth” imposed upon them by society.
    • Clients are not reduced to a diagnostic label.

How Does This Approach View the Role of the Therapist?

  • SFBT
    • The therapist helps the client become aware of their strengths so they can use these strengths to create their own solutions.
    • The therapist guides and encourages the client towards change, but does not tell the client what to change.
  • Narrative Therapy
    • The therapist has an active role, guiding the client toward change.
    • The therapist helps the client detach themselves from the dominant narratives they have internalized so they can create their own stories.
    • The therapist asks questions to assist clients in coming up with their own answers.
    • The therapist helps the client work through their problems and helps them take steps to solve them.

How Does This Approach View the Therapeutic Relationship?

  • SFBT
    • The relationship is very collaborative. Therapists are not the sole experts in the therapeutic relationship. Clients are the experts in their own lives and therapists are experts in the therapeutic process. Together, they both bring their sources of expertise to the table.
    • The therapist strives to create a relationship based on mutual respect and open communication.
    • The client sets the tone of therapy and of the relationship.
  • Narrative Therapy
    • The client and the therapist work together as experts to solve the client’s problems.

What Are the Overall Goals of This Approach?

  • SFBT
    • Goals are specific to each client and are created collaboratively by the client and therapist.
    • Goals are small and well-defined so clients will not become discouraged.
  • Narrative Therapy
    • To make clients aware of how the dominant culture’s narratives impact their lives.
    • To invite clients to create their own stories and take back their agency.

Integrating Approaches

Some therapists (myself included) prefer an eclectic approach to therapy. Meaning they combine aspects of theoretical approaches and techniques in order to fit who they are as therapists and to do what is best for their clients. Self-disclosure time: I personally work from a postmodern person-centered theoretical approach with some cognitive therapy interventions. Meaning, the way I see the world, my clients and my role as a therapist is influenced by post-modern and person-centered approaches. That said, I also see the value of some of the techniques from cognitive therapy in cases of anxiety, depression and phobias, for example. My specific theoretical orientation gives me a firm foundation to work from while also providing me with enough flexibility to work with clients as complex individuals and not as diagnoses. Integrating theoretical approaches can go wrong if not done properly. A therapist cannot just combine any theoretical approach and technique at random. The approaches and techniques must complement each other. If they conflict at their roots, the therapist does not have a proper clinical compass and is basically a ship lost at sea. No one would want that person to be their therapist.

The point of this post is to show you that all therapists are not alike. Each therapist works from a theoretical framework that seriously determines how they view you as the client, how they view themselves as the therapist and the techniques/interventions they will use. Do they see you, the client, as an equal partner-in-crime, as a student or as a patient who needs their insight? Do not hesitate to ask a potential therapist what their theoretical framework/orientation is. And then do a little research to figure out how this framework dictates the way they do therapy. This may be my personal approach showing, but do not think of therapy as something being done to you. Think of therapy as something you do with your therapist. You have power. You have agency. And I like to think that therapy works the best when both the client and the therapist work towards a common goal. Part two of this series will discuss your rights as a client.