The last few months have been overwhelming, haven’t they?. With the pandemic and the murder of George Floyd, it’s a challenge adjusting to the new normal.

First we find ourselves in the midst of a pandemic. The media and interwebs are full of contradictory information and conspiracy theories, and you could be excused if you’re not quite sure who or what to believe. You may have been laid off from your job. Or perhaps you’ve had to close down a business, Now there’s pressure to reopen, and many businesses and workers are facing a stark choice between earning a living and risking their health and even lives. Adjusting to the new normal would be difficult under these circumstances.

The African-American community has been hit harder by COVID-19 than any other community. But the murder of George Floyd highlighted another frightening issue. It’s one that the community has had to deal with every day for a very long time. A lot of people across the U.S. are waking up to the harsh reality of racism against the African-American community. But there is unfortunately some backlash as well.

Adjusting to the new normal means that every White person needs to examine themselves. We need to catch where racist or dehumanizing thoughts about people of color might be popping up. I have often done work on myself regarding my own racism. Racism isn’t inherent to us—it’s taught to us starting from early ages as children. And even as someone who grew up in a racially and economically diverse neighborhood, I realized that I still had to look critically at my often subconscious thoughts.

I’m still a work in progress, but I have made changes and will continue to do so. We are all the same inside, and race is a social construct—there is no genetic basis for determining race. But despite our similarities, this social construct of race has usually made the life circumstances for Blacks and Whites quite different. An interracial relationship I had many years ago with someone who had an otherwise similar educational and socioeconomic background brought that to my attention in a clear and surprising way. So it’s incumbent on us Whites to listen to Blacks without our own filters. We need to realize that we likely have had different circumstances. We need to put ourselves in the shoes of Black people so that we can see the changes that need to be made.

It’s normal to feel stress at this time, or feel like things might be spinning out of control. Some of the suggestions I made in the last blog post—limiting exposure to mass media and social media, and reach out to others—are still valid. And while not highlighted as much in the mass media, people are still struggling to pay rent and bills.

This is a time to highlight the good things that are happening. Many people are waking up. It’s easy to think that the world is full of uncaring and hateful people. Realize that people who are and being helpful to others don’t usually making the front pages of the news. Across most of Wisconsin, people outside often aren’t wearing masks. But realize, too, that you aren’t seeing the people who are inside right now and taking all necessary precautions for themselves and others.

And don’t be afraid to seek help from a mental health professional. For many people, these times can be quite triggering. Financial uncertainty is downright scary and its easy to feel alone in such circumstances. I do continue to offer sliding scale fees. My decision not to take insurance means that the only people involved with your mental health care are you and I.

Meditations / Pixabay

For the entire time I’ve been a therapist, I have always taken a strong interest in life transitions. As someone who has gone through many such transitions myself, I have been well aware of how people going through big changes can get stuck.

Over time, however, I have begun to realize more and more how one of the big sticking points has been trauma. As such, I found that I could not effectively address life transitions without looking at traumatic experiences. I also began to realize that trauma was affecting other aspects of life besides life transitions. Because of this, my specialty has broadened from life transitions to treating all kinds of trauma.

All of us have dealt with trauma on one level or another, though we might not always call it “trauma.” I look at trauma as a “Great Interruptor.” I define trauma as a event that is so severe that it causes a person to go into “survival mode.” In such cases, our minds put all focus on responding to a perceived threat to our existence, at the expense of being able to think about a situation rationally. This threat might trigger a “flight or fight response,” which is a physical reaction involving the release of stress hormones. Such responses can be the result of perceived threats, regardless of how real they might actually be. Similar events that come up later can re-trigger such responses, thereby acting as a barrier to responding to the event in a rational and productive way.

Because of this, trauma can act as an enormous stumbling block to solving many sorts of problems. I kept encountering this in the therapy sessions I offered, I realized I needed to find ways to address trauma.

At the same time, I realized that my mother, who herself was a therapist and social worker (but who passed away a few years before I myself decided to become a therapist) had become a practitioner of EMDR. Standing for Eye Movement Desensitization and Reprocessing, EMDR seeks to overcome the crippling effects of trauma by reconnecting our rational mind with the part of our mind that has a survival/fight or flight response to past events. An EMDR treatment has many aspects, but a big part of the treatment involves revisiting the traumatic events by using a series of eye movements (or other types of stimulation) while going over past events that are often triggering.

While the treatment doesn’t require any equipment per se, I was surprised to discover in a Christmas visit to my father that he had my mother’s old light tablet and audio/tactile pulser (sometimes affectionately referred to as “tappers” or “buzzies”) still in a hallway closet eleven years after her passing. (He was happy to clear out the space in his closet).

That sealed the deal for me and I became determined to learn EMDR. As I went through the training, I I discovered to my pleasant surprise that EMDR fit neatly into my own experiences and beliefs about what can cause psychological distress. I have now completed the training and I am ready to offer it to anyone who wants to try it as a means to overcome past traumas.

geralt / Pixabay

As such, I now want to focus more on trauma. I have restructured my website to reflect this change in focus. Life transitions are but one area of life that can be stymied by past trauma. According to the EMDR International Association, EMDR can treat anxiety, grief, Post-Traumatic Stress Disorder, addictions, phobias, and disturbing and intrusive memories, as well as other issues.  So if you are dealing with any of these issues and want to try EMDR, contact me!

geralt / Pixabay

A class action lawsuit has been filed against Stanford University by students alleging that the university discriminated against them due to mental health status. Many students said that they were forced to take leaves of absence from the university rather than have their needs addressed on campus.

The details of this lawsuit is outlined in this New York Times article. The article discusses the question of students mental health needs as a dilemma many universities face, and describes an the number of students facing mental health issues as an “epidemic.” Advocates for students argue that universities underreact or overreact to mental health issues that arise with students.

Universities can sometimes be a rather strange settings for mental health departments. Student services have grown over the last several decades at universities. Universities bolster their services in response to identified student needs, and they probably also do so in order to be competitive with other universities. But being under the administrative structure of a university means that mental health system administrators might find themselves reporting to bosses who have other priorities besides their students’ mental health.

In reading between the lines of the NYT article, one thing I found unsettling was in the way university policy intervened in what should be a decision between the student and their therapist. This type of thinking, to me is a relic of an assembly-line mentality in managing mental health. Unfortunately many social service agencies are structured that way. Such a way of thinking can be very dehumanizing. We are not machines. We are all unique. Each of us is a product of our own experiences and it is unreasonable to think that everyone will respond in the same way to the same kind of treatment

Another disturbing outcome university oversight of student mental health surfaced in 2015 when the University of Oregon successfully accessed a student’s mental health records when she sued the university over mishandling her rape case. The University tried to label the student’s lawsuit “frivolous,” and demanded that she repay legal expenses the university incurred in the suit. Disturbingly, the student’s post-rape counseling records were going to be used as part of a counterclaim against the lawsuit–over the strong objections of her therapist and the senior staff therapist. Ultimately, the university withdrew their counterclaim, perhaps in response to the public outcry over the tactics they were planning to employ.

In a 2008 document, the US Department of Education upheld the right for the university to access those records because they are considered university records, not medical records. While medical records are considered to be protected by HIPAA (Heath Insurance Portability and Accountability Act) university records are protected by FERPA (Family Educational Rights and Privacy Act), a much older, much weaker set of regulations. The DoE explicitly stated that HIPAA does not apply to such records.

Students should keep these negative experiences in mind when seeking mental health assistance. Depending on the university and on the situation, the university may not be the best place to turn to when dealing with mental health issues. These two case studies illustrate what happens when a university uses your own statements against you, even in a setting that is supposedly confidential. Anyone considering seeking mental health services from a university should examine the university’s policies regarding confidentiality.

It’s worth noting that the U of O senior therapist who blew the whistle on the university’s actions engaged in an arguably heroic effort to assert the student’s best interests and that of the psychotherapy profession. Without a doubt, there are good therapists and not so good therapists at many mental health facilities, including universities. The quality of mental health support depends in part on the quality of the therapist and the quality of the administrators above the therapist.

But there is a certain point where student needs may play second fiddle to what the university considers to be its own best interests, and as such buyers should beware.

secondfromthesun0 / Pixabay

I have just started offering online therapy sessions. I started with one client and it went so well, I now want to offer the service to anyone else wanting to receive therapy sessions from me.

I have to admit that I was a bit reluctant to delve into this new technological aspect of therapy. I’m far from being phobic of new technology developments. But new technology developments can often bring both benefits and problems. It’s not always wise to hop on the latest trend, technological or otherwise. I think that it’s important to step back and observe the impacts of the technology and evaluate.

But I think the geography of Wisconsin has me thinking differently about online therapy than before. Wisconsin is a largely rural state, and here in Madison, people often commute from far away for jobs and other services. I had a job here where the person in the cubicle next to me commuted 45 miles each way daily from Dodgeville. Another person in the department commuted 45 miles each way from Beaver Dam. I even knew someone who commuted 71 miles each day from Platteville . This is the reality that many people in Wisconsin deal with every day. Plus, I have even had clients in Madison who have had a difficult time getting to my office on Madison’s west side due to lack of a car and a public transportation system that doesn’t serve all areas of the city well.

I recently took on a new client who travels about 1½ hours each way to see me. They were seeing me every other week. Recently, they asked if they could have sessions every week, with alternate sessions being over video chat. How could I say no?

Before our first session, I decided to do some research. I knew that Skype had some security issues,  and I didn’t want to put my client in a position where their privacy could be violated. Then I found the website Doxy.me and was impressed with what I read. Doxy.me is an online platform designed for all sorts of online health-related and medical consultation. They are HIPAA compliant and don’t keep copies of the sessions. I also like that no one has to download anything, unlike services such as Skype. Each practitioner is able to create a page on the Doxy.me site. Clients can register and the site will notify the practitioner that their client is waiting for them. I found the connection to be remarkably clear.

My first session with a client on Doxy.me went quite well. I think it helped that I’d had a number of in-person sessions with them prior to our online session and already had a well-established counseling relationship. Some people have argued that people might actually feel more comfortable opening up to their therapist online than when their therapist is in the room with them in person. I don’t know if that’s true or not—it may depend on the person, the relationship and the circumstances.

For now, I am going to recommend that any online sessions be accompanied by in-person sessions. I still believe in-person sessions, at the very least, offer something different from video sessions. I am going to continue to closely observe this technology and solicit feedback from my clients to see how well it goes.

But if traveling to my office creates great difficulty, let’s talk. I am open to all suggestions.