An Inviting Look at Overcoming Despair and Living with Hope

When you're living with mental illness, the world can seem like a dark and hopeless place. As a therapist, I find inspiration in the stories of resilience in not only my own clients, but in others who share with the world at large. It is this kind of sharing that helps to chip away at the crippling stigma that any of us feel when we struggle to say, "I am not okay."

This sense of despair and lack of hope is somethings that's so appropriately engaged in Dennis C. Miller's memoir, Moppin' Floors to CEO: From Hopelessness and Failure to Happiness and Success.As the title suggest, this book is an epic story of odyssean proportions. As a young man living in New Jersey, Miller struggled with an abusive father. As is often the case with children of abuse, Miller struggled with depression in his younger years, trying his best to move throughout live despite his tumultuous family life. He suffered to feel good about himself and struggled in school. Many didn't notice that he was suffering. It was the abuse that also led Miller trying to kill his father.  The depression led him to hospitalization at the age of 20.  This intervention, it seems, was the moment in which Miller's life changed forever.

This doesn't mean that Miller's life was without more bumps in the road. Further self-deprecation and difficulties at work are hallmarks of Miller's story. Through it all, he somehow powers his way through all life's challenges.In Moppin' Floors to CEO, Miller talks openly about his time in treatment. Throughout his life, he comes to terms with the value of therapy and credits his investment in therapy as critical to his success. He reminisces fondly of his therapists, the people who served as beacons of light throughout his various life stages. For Miller, it seems there is no place in stigma when it comes to mental health care. He has lived and reaped the benefits of engaging in therapy and he has a successful career and loving family to show for it.

The beauty in Miller's story is not just the trajectory of his life and the bumps in the road, it is also his simplicity and undeniable charm that makes Moppin' Floors to CEO such a gem. Miller's story is accessible.  It is a new, untold American story that few have heard before.Through it all, the journey with Miller is an enjoyable one and the pay off is powerful. In the end pages of his incredible story, it's easy to feel the reality of a man musing about his life's work and his family. His revelations about hope and health are compelling, even when they are not explicitly expressed.  Miller's voice is strikingly clear and for anyone who is seeking hope in living a full life when faced with mental illness, Miller's story is a much-needed antidote to shame and hopelessness.

You can learn more about Dennis C. Miller and his work at his website DennisCMiller.com. 

Why I Think the University of Chicago Got it All Wrong on Trigger Warnings

Note: This post includes discussion about the topics of sexual assault and consent. There are no graphic images or descriptions of sexual violence. If you are a survivor and looking for support, please visit RAINN.

Last month, the University of Chicago sent a letter to incoming students which included discussion on the university's stance on both trigger warnings and safe spaces. In the letter, Dean of Students in The College John Jay Ellison states:

"Our commitment to academic freedom means that we do not support so called ‘trigger warnings,’ we do not cancel invited speakers because their topics might prove controversial, and we do not condone the creation of intellectual ‘safe spaces’ where individuals can retreat from ideas and perspectives at odds with their own.Fostering the free exchange of ideas reinforces a related University priority—building a campus that welcomes people of all backgrounds. Diversity of opinion and background is a fundamental strength of our community. The members of our community must have the freedom to espouse and explore a wide range of ideas."

 I agree that universities and institutions of higher learning should foster a diversity of thoughts and ideas. After all, that allows for the most well-rounded kind of education. But, I think that the university’s stance on this is misguided, if not downright insensitive. We’re not talking about preserving the right to academic “discomfort” here. We’re talking about the potential benefit of limiting further psychological damage in a patriarchal, misogynist and sexist culture.The folks at the University of Chicago seemed to be conflating the ideas of free speech and reasonable access. Trigger warnings aren't about giving in to "PC culture". They're about showing compassion to another's pain and suffering.Trigger warnings aren't about limiting speech in the slightest. I see trigger warnings as being about two chief ideas:

1. Accessibility

2. Compassion

Accessibility

For those who have experienced traumatic events, such as sexual assault or abuse, the effects can be longstanding. Some go on to develop Posttraumatic Stress Disorder, though not all survivors do.  Engaging in a culture which allows for trigger warnings means that before involved discussion about the ideas of consent and sexual assault, students would have the opportunity to not take part or emotionally prepare themselves for such a discussion.  A notification of the impending discussion doesn’t mean that there will be no discussion, it simply gives a survivor the opportunity to exit or prepare from psychologically damaging material.  For those in recovery, the power to opt out can not be overstated.

Compassion

What I find most incredulous about the whole controversy about trigger warnings is how difficult it seems to be for people to step outside of themselves and think with their hearts instead of their minds.  It may take 5-10 seconds to issue a trigger warning about a certain topic, so I think that it’s fair to say that it’s a pretty minor inconvenience for most.  What if that minor inconvenience for you enabled someone the ability to avoid further psychological pain?  Why wouldn’t you want to help someone in that way?You may have noticed that there was a small notation at the beginning of this post. In essence it was a trigger warning about this post's content.  That's really what we're talking about here.

I question any institution of higher learning that doesn’t seriously take into the account, or prioritize,  the mental health of its students. And given the rate of sexual assaults on campus, particularly among first semester women, it is astounding to me that the University of Chicago would not be more compassionate about such an issue.Some may argue that participating in these discussions is somehow “good” for survivors as it desensitizes them to the language and content. In essence, some argue that this “no trigger warning, no safe space” policy enables survivors the opportunity to heal.  Well, they’re wrong.  Only in the context of a safe and controlled environment, such as a therapy hour, can that kind of systematic healing begin. It takes a highly experienced and trained mental health professional to foster that kind of trauma recovery experience.   The classroom is no place for that.By giving trigger warnings, what do you really have to lose?

You may view a sample of the letter sent to incoming freshman of The University of Chicago at this link.

What is online counseling?

Health care has entered the age of technology. Telehealth services are on the rise and companies like Pager, Oscar and Talkspace (among many others) are disrupting the current insurance company standard and instead focusing on client (or patient) experiences. As a provider of online services, I find that there is a lot of confusion about what online counseling is and can be, so I thought I would share some thoughts with you with the hopes of clearing up any confusion.

Traditional counseling takes place in an office setting where you sit face-to-face with a therapist or counselor who talks you through your concerns and helps you explore solutions.  With online counseling, you can have a very similar experience. For example, if you contact me we will start with a free consultation where we can begin to discuss what's been going on for you lately and what you may be looking for in terms of support. From there we collaborate on a plan that meets your needs and then we're off to the races!

Online counseling services can include things like text based conversations and video or audio calls. It's very flexible based on your needs, budget and lifestyle. One of the great things I love about online counseling is the flexibility for both the therapist and client. With my online practice work, we talk through your concerns openly just like you would in a face to face setting. There are some obvious limitations as it relates to crisis care, but online counseling isn't built for that, at least not just yet. Video sessions are great for those who travel often or are otherwise unable to meet with a therapist.  

If you're looking to speak with a licensed therapist on a consistent basis but find traditional counseling too inaccessible or too hard to schedule then online counseling might just be a good fit for you.Whether you are trying to work through relationship concerns, work issues, depression or anxiety, or identity related (race, immigration, LGBTQ) concerns I can help. Submit an inquiry to begin your free consultation where you can learn about how online counseling could be beneficial for you.

"Frozen" Star Kristen Bell talks Living with Anxiety and Depression

It's not often that we see  celebrities speak openly and candidly about their experiences with mental health issues. That's why I was surprised to hear actress Kristen Bell recently talk about living with anxiety and depression.In a recent interview with "Off Camera" show host Sam Jones, Bell talked about her family's history of anxiety and depression. She made note of a conversation her mother had with her about the family's struggle with mental health issues:

"[My mom's] a nurse and she had the wherewithal to recognize that in herself when she was feeling it and when I was 18 said, 'If you start to feel like you are twisting things around you, and you start to feel like there is no sunlight around you, and you are paralyzed with fear, this is what it is and here's how you can help yourself."

What I found so remarkable about this part of the interview is that Bell's mother talked about their family's history with mental health issues which ultimately helped Bell seek out support when she needed it. I think that's a particularly powerful example and message to all of us, especially as May is Mental Health Awareness Month.  I think it gives us all pause to have these kind of discussions in our families to reduce the stigma related to mental health issues. This greatly increases the likelihood of seeking out treatment support when we need it.

It was also interesting to hear Bell speak about how she struggles with perfectionism, a desire she has to fight against, to make herself likable and sunny to everyone. It's something I have seen both in my clients and at times, with my own self. Striving to be seen as perfect can create a never-ending cycle of anxiety as well as set a precedence of ignoring one's own needs and values.For those who also struggle with persistent social anxiety, the combination of trying to be perfect and ignoring one's own needs can be debilitating. It's incredibly powerful for a popular actress like Kristen Bell to talk so openly about these feelings because it helps reduce the stigma around mental health issues, social anxiety and the pressure to be perfect with which many people struggle. We certainly need more public figures to talk openly about mental and emotional health. The acknowledgement that we all struggle from time to time is an important message that we all need to hear.

The Impact of Legislating Discrimination

Representatives in the House and Senate in Tennessee have moved to implement Bill 1840 (Amended Senate Bill 1556) which has far-reaching consequences for consumers seeking mental health services in the state. This marks an ongoing trend of anti-LGBT and so-called "religious freedom" efforts across the United States.

With increased visibility often comes increased hate and backlash. Many states have started to bring up bills to vote based on fear and ignorance under the guise of religious freedom. Most notable as of late are Mississippi and North Carolina's so-called "bathroom bills". Both are based on the egregious and uninformed notion that trans people are sexual predators who will sexually prey on women and children in public restrooms (favor for such bills ignores the potential of male victims altogether).  Never mind that most sexual abusers are known to the victim and have regular access to the people that they abuse.  According to the U.S. Department of Justice's 2013 National Crime Victimization Study 82% of sexual assaults were perpetrated by a non-stranger. Given that, it seems like there's no real need for so-called bathroom/locker room "protection".

Recently, Tennessee decided to allow professional counselors to deny services to consumers whose views oppose the counselor's own "sincerely held principles" (originally worded "religious beliefs"). This bill, to my understanding, has been given to the governor for approval. You wouldn't want to work with a counselor who doesn't support who you are or your identity, right? Sure. But what if your options were limited and you needed help now? Where would you turn?This kind of legislation may pose a bigger problem than you think. Here are some startling statistics to consider:

• In 2014, approximately 43 million Americans lived with a diagnosable mental illness (SAMHSA, 2014).

• The economic impact of untreated mental illness in any given year in the United States is in excess of 100 Billion Dollars (NAMI, 2006).

• As of 2010, approximately 246,000 adults live with serious mental illness in the state of Tennessee (NAMI State Advocacy 2010).

• According to McIntosh (2009) 874 Tennesseans died by suicide in 2006 (NAMI State Advocacy 2010).

• According to "Grading the States 2009: A Report on America's Health Care System for Adults with Serious Mental Illness", public emotional health services only treat 34% of adults in the state of Tennessee who live with serious mental illness (NAMI State Advocacy 2010).

What does this all mean? With about 20% of Americans dealing with mental health issues every year, you can imagine the impact of a bill like 1840 in Tennessee which allows for counselors to deny services based on "sincerely held principles". Many who need licensed professional help and may be living in crisis aren't being reached. Those not in crisis, with limited support options may go untreated. Legislation such as Tennessee Bill 1840 (Senate Bill 1556) only serves to add yet another barrier to those in need of support.

Consider this scenario:  You're a 19-year-old young man living in small, rural Tennessee town.  You've recently come to terms with your being gay and feel very isolated in your community. You have limited access to finances and transportation and your parents are unsupportive.  You realize that you need someone to speak to. You reach out to a licensed counselor in your area for help because lately you have been having thoughts of suicide.  You call this counselor and let him or her know what you're struggling with and they say, "I don't believe in homosexuality so I'm afraid I can't help you."' You can imagine that impact on those words on a depressed man. There is no hope that you can get the help that you need.  There is no escape to your suffering, not even from a person whose mission is to help. You have may no other options.Lives are at stake here. The quality of someone's life is at stake when they're reaching out to mental health services like therapy.  Without ongoing support they may continue to struggle in isolation, see their health and conditions worsen and possibly even resort to suicide. This is the impact of legalizing discrimination. It should be noted that the current version of the bill prohibits counselors from denying services to someone who is actively suicidal.

Not only does 1840 violate the ethics of most professional counseling associations, it also opens up concerns of liability and complications for issues of malpractice if laws like this stand. That's not to mention that this new proposed law would even go as far as to also bar the counselor's professional body, such as the American Counseling Association, from holding the counselor responsible for an ethics violation. Of course, you wouldn't want for a young gay man to be working with someone who doesn't "agree" with his sexuality. That's obviously not ideal for that client. However, if your options are limited and your mental health is a matter of life and death immediate support and intervention can be critical to someone who is otherwise isolated and struggling. My fear is that legalizing these kind of efforts allows for a very slippery slope in the high standard which we should hold fellow counselors. Mental health issues are a public epidemic and with bills like 1840 in Tennessee coming to fruition, I can only imagine how dire circumstances may become for so many who are struggling day in and day out to live healthier lives. Bills like these also further contribute to the ongoing stigma that many oppressed communities face, especially when trying to seek care.

With increased mainstream visibility of LGBTQ issues, it seems that some are dedicated to promoting legislation that not only promotes discrimination, but like Tennessee, limit care to those who truly need it. Please urge your local legislators to take mental health care seriously and make a conscious decision to make supportive care MORE accessible and affordable. Without our unified voices, I fear that the state of the country's mental health will only worsen and we simply can't afford that to happen.

There are many more bills popping up across the country with reference LGBTQ communities. Huffington Post's "Everything You Need To Know About The Wave Of 100+ Anti-LGBT Bills Pending In States" provides a lot of great insight on the status of such bills.