Current Events, Mental Health, Practice News

So, here’s another truth about being a therapist at this particular moment in human history (last week’s behind the curtain view was a humorous one; this one’s a little more serious). Most therapists work from what’s called a “trauma-informed” perspective, meaning we are “treating a whole person, taking into account past trauma and the resulting coping mechanisms when attempting to understand [current] behaviors and treat the patient.” We also take into account the differences between trauma as a disruptive event, and complex trauma, which is “a psychological disorder that can develop in response to prolonged, repeated experience of interpersonal trauma in a context in which the individual has little or no chance of escape.”. In other words, we’re good at coming in when the client is ready to do the work of unpacking or changing the way past events have, or continue to disrupt their current life.

…AFTER THE FACT.

We sometimes get lucky enough to be available as someone is processing an event in progress, like working to escape an abusive relationship or dealing with a loved one as they are dying. But even in those circumstances, we’re on the outside of the experience looking inward, a stable neutral presence that can help anchor and support clients in distress.

Hard truth time: ain’t none of us trained to deal with global epidemics and crises on this scale AS THEY ARE HAPPENING and AS THEY ARE ALSO HUGELY IMPACTING *US*.

We sometimes get called in very soon or immediately after a crisis event happens, but we’re not usually enmeshed in it ourselves. Right now, however, we’re supporting our clients and colleagues (many of whom are themselves in identical unfamiliar circumstances) in working through virtual channels, working from home, dealing with children and partners underfoot all the time in quarantine… while dealing with exactly those same issues ourselves. As I wrote last week, we’re all in this together, but like medical health professionals, having been determined by the government to be “essential services” therapists are ALSO working long hours to make sure we keep our own shit under wraps enough to be an effective support for our clients right now.

I don’t tell you this to make us seem like superheroes, because I can assure, we’re still pretty human (see last week’s post for proof of that). I tell you this because there’s a need to understand that while we’re doing the best that we can, we’re really not trained for this, either. Many of us are cobbling together what we know of trauma care with what we know of working with high anxiety and (where appropriate) basic CBT tactics to hold the intrusive, fear-laden thoughts at bay. The problem is, when we’re living through an honest-to-god global pandemic, the actual worst-case fears and risks are both absolutely legitimate, and pretty terrible… and the clients aren’t the only ones seeing that. The therapists are living and breathing those concerns and fears right alongside you.

The definition of complex PTSD keeps coming back to me as I watch people adjust to the new normal, including a persistently-high state of stress/worry/concern/anxiety/fear about the what-ifs. When you’re living in a dangerous time, there isn’t any form of escape other than to just “live through it”, no matter how long it takes. And being in that persistent state over the longterm always exacts a toll; it’s not going to be the same for everyone, nor will it manifest in the same timeframe for everyone. But it’s there. And we have to take that into account when we’re dealing with ourselves and our clients, not just in the future and after the fact, but right now. Today. In this moment.

The best tool I’ve got right now is working with people to normalize and validate everything in their maelstrom of feelings; to shorten down their personal event horizons and look specifically, and exclusively, at what is in their power to do TODAY? What will make them feel better TODAY? It’s not that I don’t want to sustain a sense of hope for the future, but we have to keep hope in the context of daily-fluctuating uncertainty. We need to frame it in an understanding that our current heightened state of curve-flattening mitigation tactics will take WEEKS yet, if not MONTHS, to drop the infection rate back to near-zero (because as long as there IS a new-case reporting rate, we ALL remain at risk; that’s just how viral pandemics work). I’m watching friends and clients intellectualize that timetable, but the truth of what their lives will look like is barely just starting to take hold on an emotional level, especially knowing that the pandemic is only the trigger for an economic crisis of equally epic proportions to come. This kind of uncertainty really eats away at a person’s sense of grounding and control.

It eats away at ours, too. Trust me on that.

We’re in a high-stress, high-uncertainty scenario not of our own making and even less under our control. The odds of this crisis *creating* complex trauma responses for a large number of individuals is likely high, because it’s a longterm situation and it’s inescapable. The challenge for us as therapists is that we can’t wait for this scenario to be over before we’re needing to put boots on the ground and be effective. We can’t wait until we get ourselves clear of this scenario before we wade in to offer support to others. When I say, “we’re all in this together”, I mean it quite literally. As therapists, for once we are not apart from your crisis; we may have our own responses to what’s going on, but we are also up to our eyeballs in it. We’re as uncertain, as stressed, as anxious, as terrified, as exhausted as you may be.

And we’re still here. If you need us, we’re keeping the lights on for you as long as we can, and hopefully all the way through.

(Both my home office and Bliss Counselling are still open and seeing clients, BTW. We’re only doing virtual sessions via Zoom or phone for the duration, but WE ARE OPEN!)

Current Events, Mental Health, Practice News, Self-care

People keep asking why I’m continuing to see clients in person both uptown and at the home office. It’s simple, really: the therapist’s office is the only safe space some people have. Many who might have used work to escape volatile, toxic, abusive, or outright dangerous home situations are now being told to stay home and not come to work — meaning they are trapped in the very situations that threaten them the most.

It’s unclear what protocols local shelters are enacting in a time of pandemic, but the anxiety levels around exposure and uncertain shelter occupancy arrangements will also serve to keep the vulnerable from getting clear of a dangerous home environment.

It’s the darker side of quarantine, isolation, and the desperately-needed social distancing practices: yes, we’re trying to flatten a curve and spare hospitals and treatment centres from overloading, but we’re also trapping some of the most vulnerable people in their own worst nightmares, caging them with their abusers for an indefinite period of time.

So yes, if my office is the one safe space that remains open to them, then I will take every precaution I can to protect us all for as long as I can. I will disinfect everything I can and keep to a reasonable distance across the room, but come hell or high water, for those that need us — we’ll keep the lights on for you as long as we safely can.

Practice News

Big change-ups are coming for me in the new year!

A local colleague of mine, Laurie of www.LaurieBlaikie.com, and I have promised ourselves weekly work-dates so we can each *finally* get some consistent writing done for our respective blogs. It’s the peril of being self-employed (or dual-employed): so busy running the business and seeing clients and trying to work on profession development, that oft-times the general work of blogging is what falls through the cracks. so we’re going to fix that. Or else. No, really this time. We promise!

And the biggest news for my practice is: as of the end of January I will be joining the wonderful team of therapists at Bliss Counselling in uptown Waterloo! I will still continue to see current or new clients in my own home-based practice in the evenings, but I can now also offer day-time hours to new clients through Bliss’ office uptown. This may lead to a slow migration out of the home office to Bliss’ location, so conveniently close to the incoming LRT, but I promise nothing will impact existing clients in the foreseeable future, and there will be plenty of advance notice should things start to shift that way.

So as horrible a year as 2016 was for so many of us, I’m taking to heart even the smallest indications of better things (or even just *different* things) ahead in 2017. A new year is a good time for change, and even if you’re not inclined towards resolutions, January 1 is as good an arbitrary marker for changing things up as any. I may be wincing a bit in the harsh, residual glare of 2016, but I’m still looking ahead to 2017 with an open mind and a bruised but open heart. Hopefully many of you will find a way to do the same.

Merry Christmas and safe & happy holidays to you all!

Practice News

Most of my active clients know I split my work time between the private practice and a day-job, working as a technical writer for the high tech industry in Waterloo Region As of this past Friday I just wrapped up a fifteen month contract with BlackBerry, meaning I’m back down to just the ONE job for a little while, which is a great deal of relief. It’s not a lot of fun trying to sustain the kind of lifestyle that includes working seven days in every five!

I’m using this time to rest and regroup, and work on some long-overdue professional development. This is partly in response to CRPO’s pilot QA project for its registrants, to make sure as practitioners we’re providing the best quality of care possible to our clients, and partly because I have been itching to dig deeper into theories and treatment approach for attachment style issues. I’m also seeking supervision around better educating myself on PTSD and C-PTSD issues, since trauma and trauma histories are an increasing part of the stories my clients bring into the counselling room, and I want to make sure I’m prepared to meet them in their experiences as best I can.

The fee change announced at the beginning of January takes effect today; full fee individual sessions are now $100/hr, couples and poly groups are $125/hr, and I am regretfully discontinuing the sliding scale for new intakes. We’re hearing stories that some insurance companies are beginning to accept CRPO registration for benefits coverage, but it’s not consistent at all. I continue to advise new and current clients who do have benefits provision for psychotherapy, to continue asking or pressuring their providers to consider CRPO registrants as accepted service providers. Calling your provider and asking *if* they accept CRPO members, and if not, when do they plan to, is the only real form of pressure we can apply directly. So please keep asking! And we’ll keep working inside the College to guarantee the services we provide *ARE* the kind of quality that the insurance companies want.

At this time I am not immediately planning to expand available hours into the day-time slots; I may reconsider this idea later in the year but for now it’s unfair to clients to start them on day-time scheduling only to potentially have to claw that back when a new day-job arrives somewhere down the timeline. If there is sufficient demand to reconsider that, however, I will. And int he short term, I can always make exceptions for one-off or infrequent bookings as needed, beyond the regular evening schedule.

So it’s good to be back in a more focused, single-career mien again, for however long it lasts. I have a stack of books and online courses awaiting my attention!

Practice News

The short answer is, as the Cool Kids these days say, “TB;DP” (Too Busy; Didn’t Post). There was a theatre production, with a lot of overflow into non-client time from that. There’s been some business development work, and especially since the show closed, simply a lot of catching up on every non-show aspect of my life. Now we’re into the muggy thickness of summer, and it seems like there’s always gardening to care for, or a lawn that needs cutting, or things that require me to simply be not-home more often than in the frigid confines of the winter months…

I have a backlog of links to post. I still read online most days, and I collect the links to articles that are especially thought-provoking in areas related to the practice, or specific communities I support, or even just ideas I think sound neat and seem worth exploring. The time-consuming part comes from trying to write wrappers around the links to provide some context on why I think the link is worth your time and effort to click through, gentle readers. I’m getting there; at the very least I need to clear out my OneTab listing so the browser stops choking every time I open Chrome… (little bit of my inner geek fell out there, sorry).

This is the first week in three or four where, now that most of the administration work is up to date, I might actually have time to get to those posts. A few people have asked my for my opinion on the whole #notallmen/#yesallwomen debate that rocketed around the internet a few weeks ago. I do have some thoughts but have mostly been keeping my toes out of the water on the grounds that I remember 1st Wave Feminism (barely) and the 2nd Wave that came later, and now that we’re back in the slippery mud again as a culture, we’re not getting anywhere by reactively flinging mud between the genders and trying to Other any side not Our Side. Nobody likes living in a climate of fear, but the way in which we (the broader-spectrum, societal “we”) are engaging the discussion about fears and concerns is perhaps less effective than it needs to be, with no easy road out of the swamp as long as the juggernaut of Media is selling us idealized, if out-dated, imagery of what it means to be “woman” or “man” without any regards to the growing backlash of diversity and lived experience.

So opening that can of worms, while a discussion that happens with increasing frequency in the therapeutic settings on a one-on-one experiential basis, is much harder to step into in the broadcast medium of the internet blog. Doesn’t mean I don’t have opinions, just means I haven’t figured out how best to present them yet.

Please stay tuned while I get back in the saddle and back to work on building the resource links; postings will continue approximately every other day once I get my act together!

Practice News, Relationships

Happy… er, Spring?

Things have been a-bustling quietly here at the practice since I finally cut off the ties to a day-job in IT and moved into the business of being *just* a therapist late last year. Like Spring 2014, this transition feels like it’s been a very long time in coming, and the traffic that finds me by hitting on this website is a big part of what’s making that transition even remotely possible. So if you’re an existing client, or taking a tour of this site for the first time on a current quest for a therapist you might be willing to work with, thanks for taking the time to read, and welcome!

One of the things I’ll be doing in 2014 is making more use of this platform to share what I think are useful articles from (hopefully) reputable sources, about relationships, psychology, families, and mental health. I believe that putting more information into people’s hands is the best way to help you make more informed decisions about getting your needs and wants met, in and outside of relationships, in the most effective ways possible. Some of this will be in the form of links to articles, some of it will be book reviews as I’m reading new material, some of it might be clinical observations from my own work with clients. In all cases, hopefully this information will provide some insight to you, the reader, maybe even permission to think about your own situation in new ways. And if you’d like to continue such ponderings as in-person conversations, then perhaps give me a call or send me an email and we’ll set up a sit-down and see what we can do to get you the information or perspectives you feel you need.

Today’s entry is all about understanding that relationship skills need practice too. So often, we get settled into a relationship and assume that, once we’ve attracted and secured a partner for ourselves, the hard part is done. In truth, more often than not the hard part and the work is just beginning. Empathy, validation, and consideration are just three aspects of intimacy that are critical to its success, but they’re big ones, and good places to start to check in and see how you and your partner are interacting with each other.

Practice News

It’s been crazy-busy here, straddling two professional careers for the past three years as I bring the private practice up to speed and phase down or out the technical writing. The F/T writing contract I began in late May fell between two unexpected expansion booms to the client roster, and it has been a summer of exceedingly long, often challenging days (contract in Guelph from 8am-4pm, seeing clients at the home office four nights a week from 5pm-9pm).

As I finally near the end of the delicate balancing act that was getting through the summer, I’d like to thank my clients for toughing the transition out with me, even when it meant some serious scheduling shenanigans trying to fit everyone on the increasingly solidly-booked client calendar. With the contract finally wrapping at the end of November, I am pleased to reintroduce weekday, day-time hours to those for whom the evening schedules just weren’t working. Standard session times will be:
11am
12:30pm
2pm
3:30pm

(The evening slots will continue at 5pm, 6:30pm, and 8pm.)

2013 was also good for the practice in terms of moving into some greater visibility through the Psychology Today profile, and officially joining the Dalton Associates network. Since the majority of the client contact I receive starts with someone’s web search for a local therapist, these two networked links have been really helpful in connecting people with me or with these resource networks. In addition to continuing to work with Garrett LaFosse, a well-respected local AAMFT supervisor, I’m also now working with two new group supervisors, which is both challenging my own professional development in good ways, and making sure I stay on my best game for my clients by providing me with a support community and network I can tag for information and perspective as needed. I’m definitely looking forward to having a little more time in my own schedule before the end of the year to also get caught up on my reading and research. Why is it that the book stacks never seem to get any shorter??

Stay tuned for more news as the year winds down and the practice ramps up. I’m looking forward to continuing to build the best services I can for my clients and community well into 2014 and beyond!