Diagnoses, Therapy, and the Person That Sits in Front of You

I have a client right now who reminds me of a lot of the other clients that I have had.  He is one of many with a severe trauma and abuse history.  After seeing countless kids, teens, and adults with similar backgrounds, you almost start to think that this sort of life must be normal.  But you have to remind yourself that it is anything but.  I especially feel for some of my younger clients who have had such an unfair start in life.  As clinicians, we are quick to put labels and diagnoses on a problem when half the time, clients’ experiences with these things and current symptoms have served a purpose.  If holding onto depression,  anxiety, PTSD, or some sort of attachment problem serves a purpose (which they all do), we have to be careful not to pull that immediately away.

What’s always troubled me more than a “typical” Axis I disorder is any of the personality traits/disorders you get on Axis II.  It bothers me that we already start putting down things like “Borderline Traits” in a teen’s medical chart.  Who knows how long some of that can follow someone? Most teenagers are still figuring out who they are and their place in the world, many clients have the added burden of just trying to make it through each day given the experiences they have been through.

I don’t think it inaccurate to describe what you see but the trouble with diagnoses is once it’s written in a client’s chart, it starts to form your impression of someone before you’ve even met them.  It becomes hard NOT to see them through that lens.  And I don’t like that.  It makes us as clinicians anything but impartial observers to the clinical picture we see.  We might then behave in ways that serve to mold and reinforce the very same behaviors we are pathologizing, albeit unwittingly.

I am not sure of any particular miraculous way to fix this, I just find it unfair to be imposing so many labels and disorders on clients so young.  Even my first practicum in the Master’s program, that was on a dual diagnosis inpatient unit (substance abuse and mental health), I remember hearing some of their stories and thinking “It’s amazing that they’re even still standing here today.  The fact that they even made it another day and are here in this moment is remarkable.”  I guess what I’m saying is it’s also important to remember a client’s strengths and not be too quick to see them as the sum of their history and “problems.”  Given some of the stories I have heard over the years, I am not so sure I would have done any better myself.  Sometimes, it’s amazing that that person got out of bed and made it to your office that day.  Let alone the fact that they were willing to share a little bit of their world with you.  I don’t ever want to forget that or take for granted the special gift that that is.  Someone is trusting me with one of the most precious parts of themselves and I am privileged enough to be able to hear it.

Reflection

A lot can change in a year.  I mostly started this blog to express my opinions and concerns in regards to mental health/stigma and the tragic loss of someone like Robin Williams.  Then, a friend passed away unexpectedly in a very similar fashion.  Now, I am about to move across the country in a few days to a large city in the Midwest.

I’m excited at what the future holds, eager to explore a new city, but sad to leave behind loved ones and my dog Ella.  The death of Robin Williams is still just as sad, albeit a little more bearable.  I would say the same about my friend, the only difference being I miss C. on a much more personal level, anytime my husband and I experience something we know he would have liked it is especially difficult and we imagine what it would have been like if he were there with us in person.

I don’t have any good answers for why someone chooses to end their life or magic ways to try and stop it.  Unfortunately, if someone is committed to hurting themselves they will ultimately find a way.  But I’d like to think by showing someone love and support it might help them to feel heard and understood, if only for a moment.  Whether they simply need to vent some of the painful emotions they are feeling or just need the listening ear of a friend, I think it is essential that we all try and be as kind as we are able to one another.  We are human, so of course we are not perfect and will have slip-ups, but at the end of the day we are all more human than otherwise.  People need love, support, and kindness (with or without mental illness), the more we show this kind of affection to others the greater the ripple effect will be.  How wonderful it would be if we created a society in which it was okay for someone to admit they are feeling depressed, anxious, psychotic and maybe even suicidal and not have our first reaction be to judge them but to try and help in whatever small way we can.  Something as simple as a smile and a few minutes of your time can do more than you’ll ever know.

Carpe Diem

“Nothing haunts us like the things we don’t say.” -Mitch Albom

What an inspirational and profoundly accurate quote.  Whether it be through writing, with loved ones, or in therapy, if there are things that are still forefront in your mind that prevent you from living well – Get them out! Part of life is love and loss.  It is how you handle the loss, the dark times, the difficult moments that ultimately defines you.  We all have our crosses to bear, but it is important to always have faith.

Faith that things will get better.  Faith that things can be better.  Whether it be a faith in God, science, or a purple donkey… It is crucial that you believe in something.  “If you can’t have faith in what is held up to you for faith, you must find things to believe in yourself, for a life without faith in something is to narrow a space to live.” –George Woodbury

Let your past help mold you into the person you want to be.  If you’re unhappy with how things are currently, make a change! Nothing is stagnant in life, unless you choose to be.  Live the life you’ve imagined.  Cast doubt behind you and embrace who you are meant to be.  Find joy in the mundane.  Follow what speaks to you.  Live!

Dreams

“Dreams are like stars… you can’t touch them, but you can follow them to your destiny.”

Go for your dreams.  Dream BIG.  Who cares if they don’t work out? Or you fall flat on your face? At least you can say you tried.  And even if you have some difficulty the first time around, keep after it.  Whether it be starting your own business, changing careers, going back to school, etc… Do what makes you happy.

If the career you have chosen is not where your heart lies, then you will be a slave to your job.  It is important to care.  It is essential that you have passion for what you do.

Otherwise, what’s the point?

If you feel pulled in another direction, maybe it’s worth exploring.  If you care about what you do, it will always show in your work.  Passion follows career follows success.  Keep after what you want.  Do the things that make you happy at your core.  You’ve only got one life.  Live it! 🙂

Domestic Violence

Domestic violence is never okay.  With the recent release of the Ray Rice video where he knocks his then-fiancé out cold, this issue is being brought to the forefront.  The fact is, the NFL had access to the footage months ago and decided that a two game suspension was adequate punishment for beating your wife.  It was not until the video was made public that the NFL felt compelled to do anything substantial about the incident.

I do not judge what goes on within a marriage.  That is between the two parties involved.  The Ray Rice incident highlights a much larger issue in our culture at large.  I was horrified to read the comments of “Why did she stay?” and then see numerous individuals make a joke out of the abuse.  As if beating another human being is ever funny.

Perhaps the next time an issue like this is brought to the media, the powers that be will increase pressure on the perpetrator of the abuse to get help.  And properly support the victim.  After Ray Rice punched his wife in the face, we saw the elevator doors open to reveal various bystanders looking concerned.  Yet, they all seemed to hesitate.  Concern clearly showed on all of their faces.  But numerous individuals stood around and watched as Ray Rice dragged his fiancé’s unconscious body out of the elevator doors.

Maybe we can all take this as the opportunity to DO something about this.  It is never okay to treat another living being in this manner, whether it be a woman, dog, cat, or monkey.  It is never okay to do harm.

If you are that upset and conflicted within yourself that you feel the need to strike another living creature, maybe you should take a step back and examine why that might be.  As I’ve mentioned in a previous post about anger, it is a secondary emotion.  Typically, there is sadness and hurt underneath.

Finding healthier coping skills from which to channel and properly express this anger benefits everyone involved.  Society, human relationships, and our wellness overall.  I hope for the day that we can all learn to live peacefully amongst one another.  Until that happens, I think we all have a duty to speak out about this kind of thing.

Instead of questioning why an abuse victim stays, we should all be questioning why the abuser abuses.  We all need to help be the voice for those who do not feel empowered or safe enough to use theirs.

A Smile

I regularly frequent a place that has a yoga studio on the second floor.  On my way into the building, the genuine, heartfelt, and happy smiles these yogis greet me with is truly uplifting.  It may sound silly, but you can just feel the happiness and warmth behind many of their smiles.  It helps set the tone for my entire day.

There is something truly wonderful about a smile.  Especially a smile from a stranger.  There is nothing more behind it than kindness… A smile costs us absolutely nothing but can certainly help improve the mood of those around us.  Energies are contagious, is yours worth catching?

The next time you see a stranger or someone who is struggling, try simply offering them a smile.  Peacefully observe the reaction you get, whether positive or negative, and notice the shift within.  The simple act of smiling improves our own happiness as well.

Have a good day! 🙂

Making Happiness a Priority

If you are unhappy, do something about it.  Nothing is worth being unhappy for.  In fact, my favorite quote is “Life’s too short to be anything but happy.”

Take the time to determine what things make you the most happy in life and set out planning a life you enjoy.  One you don’t need a vacation from.  If your job makes you miserable, find a new job.  If you’re unhappy in your relationship, try your best to work on things, and if at the end of the day certain issues are unfixable for what ever the reason – Take stock of things and determine whether or not staying in an unhappy relationship is in your best interest.  In any of your relationships, be they romantic, friendship, familial, etc…, the single most important factor is whether or not you leave feeling happier after you spend time with that person.  Do you genuinely enjoy their company?

The energy you put out there is what you attract.  And in a similar vein, if you are spending time with negative people, whether voluntarily or involuntarily, make sure to make your health and happiness a priority.  We all have certain situations or people we may not enjoy being around, that is life, do your best to recognize this and limit your time with these people if possible.

As someone who is a happy, optimistic person, I am often left feeling drained when I am around negative people for too long.  With clients, I know how to manage this.  In fact, it is part of the reason they are in your office and is something they are usually willing to work on.  That is something to be commended.  Having the foresight to know that you are struggling with a certain issue and to be actively taking steps to change it.

If someone is treating you badly, it is simply a reflection of how they feel inwardly.  It is up to you to choose how you handle it.

And remember, it is often those who are the most difficult to love that need it the most.

So for today, take the time to do something that makes you happy.  Whether it be a walk in nature, reading, or drinking a hot chocolate.  Take time to enjoy the beautiful fall foliage and appreciate the good things in your life.  There is always, always, always something to be grateful for. ❤

Perception is Reality

Here’s the thing about perception: It is YOUR reality.  So it’s not that hard for me to try and understand it.  Yes, I tend to be naive so that is part of it too.  But the only way you are ever going to help someone whose perceptions are off is by loving them and trying to understand them.

Patience and love are all you need.

Whether it be as a clinical psychologist, a friend, a partner, a coworker, a stranger, someone you dislike – Especially someone you dislike.

Have a good day everyone! It is beautiful outside 🙂