Silly Diagnostic Labels

As a Licensed Professional Clinical Counselor, I am expected to assign labels to clients based on their “symptoms.” I put that word in quotes, because the bulk of my counseling hours are spent helping people navigate their way through situations. The “symptoms” are their perfectly normal responses to abnormal circumstances. Did you suffer abuse as a child and now have issues with trust, and/or PostTraumatic Stress? Sounds like a normal reaction to me, though the diagnostic label would likely be PostTraumatic Stress Disorder. Seriously, is it a disorder or a normal reaction you would like to mitigate or overcome?
Of course you want to feel better. I am here to help you process your issues so you can do exactly that. I’m just not sure how helpful a label is in that process. After all, each of you is unique, and though some labels may apply to you, they certainly do not define you.
To be fair, these diagnostic categories do give us a better feel for what we are dealing with, which of course leads to better ideas as to what approach will be most helpful. Just as a reputable medical person would never suggest treating asthma the same way they would a broken bone, I would never advocate that all clients be treated in an identical manner.
As I write this, I am reminded that there is valid overlap. I was about to bring addictions into the previous paragraph, when I was pretty much gobsmacked by the thought that there is almost invariably a link between addictions and previous trauma.
In one of my more rebellious moods, I came up with my own diagnostic system—one which is definitely not validated by any professional research. But in some ways it does cut to the chase. It refers to everyone being on a continuum, between NWC and JFN. NWC is my shorthand for Nothing’s Wrong wit Choo—you are unhappy and want to feel better, but you are mentally stable so there is that. JFN, my shorthand for Just Flippin’ Nuts, is not one I have given anyone; it is just there for comparison. My clients are not crazy, and I don’t say that to be facetious. If someone comes to me with a pervasive problem, such as psychosis of any type, I am likely to refer them to someone with a specialty in that area. This is not to be critical of that client; they simply deserve a therapist who specializes in their specific issue. I do not have enough experience in those areas and attempting to treat those potential clients would be doing them a disservice.
So here is my final word: We are all on the continuum between NWC and JFN, and in any normal lifespan we will move around a bit on the continuum, depending on our current situations and stressors.
Will it pass academic muster? Probably not, but I still like it and I hope you do too.

Righteous Anger

Whenever I hear “That is one angry woman,” I get—you guessed it—angry. It’s as if anger is an aberration, something to be ashamed of. And of course that “one angry woman” expression induces fury in those of us who see it for what it is: an instrument of control.
I certainly agree that misdirected or purely aimless anger is problematic. That does not mean all anger should be suppressed, though. It is just one of our many emotions, which can offer guidance for how we live our lives.
Let’s consider a day in which nothing angers us. We turn on the news, learn of the latest bombings of civilians overseas and yet another mass shooting, and we likely react with a mixture of emotions—which have admittedly been tamped down in order to keep them to tolerable levels. We are sad, heartbroken really, that these things are continuing on such a frequent basis. We are likely incensed for the same reasons. Frustration is likely part of the mix, because wouldn’t we all love to be able to stop this carnage singlehandedly, yet that goal is blocked every single day. There may be several more emotions depending on your own life experience and emotional makeup, and these all deserve our attention.
Suppose you have encountered someone who keeps crossing obvious boundaries—making sexual or threatening comments, touching you despite your constant backing off—if you downplay anger in such a situation, you may reduce your awareness to the point where you fail to recognize the potential danger. Clearly, that is not a great idea.
No, I am not suggesting that you nurture every bit of your anger; it can become so overwhelming that it interferes with your physical and mental well-being, and could even lead you to act out in ways you could later regret. But it does deserve to be noted, attended to.
And of course, how you handle your anger is another matter. If I feel wronged, it does no good to cuss out the offender; in cases where they may not realize what they did, it could be helpful to point out “This is a problem because…” It is a learning opportunity they may or may not take advantage of. If you have a knee-jerk reaction to attack verbally—or worse yet, physically—following every affront, it is far more likely that the offender will feel justified and learn nothing.
So many social movements have taken hold because of anger that was well directed. Not only would we not have benefited from the Civil Rights movement, there would likely still be slaves on plantations south of the Mason-Dixon Line. Martin Luther King was noted for his emphasis on loving “our white brothers and sisters” while continuing the various protests that would bring change. John Lewis, who, on Bloody Sunday, famously suffered a cracked skull on the bridge that may soon be named after him, went on to devote the rest of his life to improving conditions in this country and was a congressional representative for several years.
Following Germaine Greer’s publication of The Feminine Mystique way back in the 1960s, a huge number of women began acknowledging their anger at the lack of opportunities for women, and thus the feminist movement took hold. Again, well directed anger.
There are clearly times when anger is inappropriate, and we would be wise to assess situations to decide when it is time to just let that go. It serves no purpose to just let it fester. But it can be a signal.
Rather than just dismiss anger out of hand, maybe we should all try our best to take a look at each situation and act accordingly.

(Photo credit: Peggy and Marco Lachman-Anke from Pixabay)

Ask Everyone

Ask everyone

You all know I have a Masters Degree, since that is required for me to get my license. What you may not all know is that I was in my 50s before that degree was conferred. I would be a liar if I said I knew from the age of 5 that I wanted to be a counselor. I started my freshman year of college with only very vague goals, and that is surely part of why it took me so long to complete even my Bachelor’s degree. Any excuse to drop out and I took it, until I didn’t.
I was 32 years old when I got my Bachelor of Arts Degree, and a divorce. Once I found a counselor I really liked (to process the divorce), I started thinking how much I would like to go into that same field. Then I quickly started un-thinking that, because I could not see my way clear to how I would ever pay tuition while I raised my child. I didn’t even tell anyone my goal; I just fumbled along the best I could with the generalized degree I had, working at jobs I didn’t much like but that I was pretty good at. There was also the one job I did like, self-employed, performing personalized singing telegrams. It required my creative side, which was what I loved about it.
Even after my son was fully grown, I would take stabs at figuring out how to finance graduate school, but I kept looking in the wrong places. It is especially curious that I never darkened the door of a college Financial Aid office. Now wouldn’t that seem like a logical place to go?
My mistake was simple: I thought I should be able to figure it out for myself, so I did very little asking for advice, even from experts. Blaming myself for not knowing what I had not been told, I just kept fumbling along without that degree. After enough years passed, I decided it just wasn’t in the stars. One favorite excuse? I won’t have enough working years left to justify the investment.
Then an opportunity pretty much smacked me in the face. I took it, started classes, and learned by Week 2 how most of my fellow students were funded: They had jobs in social service fields, with companies that paid for graduate school as an inducement. These were all companies I had been perfectly well qualified to work for; it just had never occurred to me to even try.
The point of this vignette is simple: Don’t follow my example. Had I swallowed my pride just the teensy amount it would take to ask questions, I would have either gotten into graduate school sooner or made an informed and rational decision to be content with the formal education I already had.
I doubt I would have started graduate school the minute the ink on my divorce papers was dry. Working full time while attending classes part time would mean I would miss out on too much of my child’s growing up. The years running the singing telegram company gave me plenty of latitude to be a more involved parent, for which I will always be grateful. But it would have been nice to have a plan for following a new career path when the time was right.
The short version of all this? Ask around. A lot. And read. And brainstorm, accepting even the worst ideas as ideas that may lead to better ones. There is no shame in not knowing, only in not bothering to learn. Whatever your age, you still have all the years ahead of you to change your path or just tweak the one you are on, to evaluate and re-evaluate your direction in life. The embarrassment of asking for advice and information pales next to the frustration of continuously thinking “If only.”

These Times Change Us

Moving Along

This pandemic has changed us all, and some of the changes will be permanent. In my own case, I am obsessively following the news, especially about COVID-19 and the political scene in general. Prior to this—and especially prior to the last administration—I didn’t much bother with following anything beyond the highlights.
Why the difference?
You are probably well aware that children who grow up in abusive homes tend to be hypervigilant. It is a matter of survival; they need to know what is coming their way in order to best protect themselves against it. My household is fine. But my I worry about my broader surroundings. When the Capitol building can become the site of a rioting crowd attempting to overthrow an election, I suspect a lot more of us are going through our days with our eyes wide open for whatever may happen next.
And of course there is the pandemic. I have been less impacted by it than many, and sometimes I think of it as “noise”. It is always lurking in the background, and I am always wondering who it will strike next. A few weeks ago, I had an appointment cancelled because the professional I was scheduled to see had just come down with COVID. I was quickly doing the math in my head to make sure I had not seen that person in over two weeks. (I hadn’t.) And of course I breathed a sigh of relief, because the timing working in my favor was purely a matter of dumb luck.
The disruptions this has created in the lives of so many, likely has led a number of people to re-think their life goals: career, friendships, possibly even spiritual and religious beliefs. Even those who are young enough to feel, under normal conditions, that their time is pretty much unlimited—are suddenly brought face to face with their own mortality. If they are extremely lucky, it is the cases they read or hear about in news reports. If they are not so lucky, it can be their grandfather, their sister, their uncle, their very best friend…And of course some among us have directly suffered from COVID-19, and many survivors report it is the worst thing they have ever experienced. Some even become “long haulers,” suffering aftereffects such as breathing problems and brain fog that may wind up lasting throughout their lives.
We have, all of us, been handed an opportunity—or maybe more like a mandate—to take our own lives seriously and think hard about the direction we want that life to follow. I hope for all of you that the mark you wish to leave in this world doesn’t leave out critical elements like friendships, and laughter, and lots of fun. We all deserve joy.

Grieving During a Pandemic

I was only five days old when my maternal grandfather died, the result of a heart attack he suffered while shoveling snow. During that era, women were presumed to be compromised by normal childbirth for at least a week and a half. Consequently, my father took my brothers to the funeral and left my mother home to take care of me. At that time, he was following standard medical advice. Today, I feel that was a very poor decision, likely making it more difficult for my mother to mourn her own father’s death.
Now that we have COVID getting in the way of standard mourning rituals, my mother’s missing of her father’s funeral seems like a trifle. Services and/or visiting hours, when held, present a major decision. Do you want to physically be there to support the bereaved? Is it more important to ensure you don’t risk exposing them (or yourself) to any possible contagion?
One thing I take comfort from, is a feeling that funerals are for the living, that we do not fail our deceased loved one by not attending. (We may, however, fail our surviving loved ones.). My maternal grandmother suffered a long illness, and when one of my mother’s sisters visited from out of state, she announced “I will not be here for the funeral. I feel it is more important for me to see her now.” Thank you, Aunt Mary; I have held that thought through all these intervening years.
My pandemic life has not managed to proceed without some people dying, though none so far were extremely close to me. Some of the things I have done, in no particular order, include posting to the person’s funeral home memorial page, sending a card—yes, an actual paper card, sending flowers, providing help while the person was failing…I have talked to random people about each death, though that is a far cry from joining the crowd and sharing memories. Were I the person who had just lost a very close loved one, I would certainly prefer those somewhat disjointed responses to the non-response that results when someone declares “I just don’t know what to do.”
When we no longer have to fear this for-now new disease, my hope is we will carry some of these lessons into our future. After all, even in the best of times, it will not always be possible to pay our respects and find out comfort in the most traditional ways. Dealing with others’ deaths, as we deal with our own lives, mostly means we just have to muddle through.

Mask Etiquette

Masks in Waiting

Who ever dreamed a year or so ago, that Mask Etiquette would be a thing? But here we are, and it matters a lot. You are probably already aware that I seldom see clients in my office these days, and when I do—well, the office is set up for maximum safety and minimum contagion. I have arranged seating so the client and I are over six feet apart, windows are open whenever weather permits, there is an air filter, and hand sanitizer is available in the event anyone chooses to utilize it. And I keep extra masks on hand in case a client forgets.
So that covers how things work in my office, where I have control. When I am out in public, though, the control is no longer mine. Not to worry, I am not out in public much these days, having decided that the best way to avoid exposure to COVID-19 is to just stay as isolated as possible. So far, so good.
Of course, no matter how I try to isolate myself, there are those times I wind up at a store or yes, even the occasional restaurant (but only those with plexiglas barriers), or even out walking the dog. Okay, technically I don’t need a mask when I walk the dog—at least provided I am in a location where the nearest person is a couple hundred feet away—but the times we are at OSU/Newark I mask because it is a rule on that campus and I intend to respect that.
Now that I am doing my share, at least to the best of my ability, I hope you can humor me while I crab about the “mask errors” that drive me to distraction.
One of the big ones is restaurants, where the Ohio Department of Health officially requires that people be masked except when they are eating or drinking. Somehow this gets translated to “As long as I am sitting down, I don’t need to mask.” So people will sit for a two-hour meal with no mask and somehow think there is no way they can share any virus. In my opinion, keeping a mask on at least until the server has brought your order is common courtesy. The mask is to protect the other person, after all, and servers need to be protected from an awful lot of people’s germs.
Another is people who pull the mask below their noses. You do know that air you breathe through your nose eventually winds up in the lungs, and vice versa, right? Between my teeth grinding and my eye rolling, it would be pretty nearly impossible for anyone to look my way and not realize I am way beyond annoyed at this total lack of concern about potential contagion.
Then there are the people who work in tiny settings where people come in from time to time, and you see the employees grab their masks when they see a customer enter. Better that than nothing, but…You do realize you breathe when there are no customers, and that those droplets don’t disappear in the mere seconds between your masking up and the customer entering the store.
For those among you who are doing your best to stop the spread of COVID—and I suspect most of us are—do you ever feel like you take precautions so others don’t have to? Yeah, so do I. Once this crisis has passed, I fear there will be friends and acquaintances I feel uneasy around and businesses I will prefer to avoid. When there is a crisis that threatens all our lives, I have a long memory.
On the flip side, I will always remember those who have gone out of their way to minimize any chance of sharing whatever viruses they could possibly be carrying.

COVID-19 and Education

The Pleasure of Reading Alone

COVID-19 has put such a dent in people’s plans for education. If I were currently the parent of a school age child, I would likely spend approximately 97.5 percent of my time being frantic. There are no good answers.
Way back in the winter of 1977, the local schools closed for around a month due to fuel shortages, fearing they would be unable to keep the buildings heated. My recollection is that we didn’t act like the children would fail in life due to this time off. A lot of parents plopped their children in front of educational TV shows, likely in order to keep those brain cells functioning. Granted, it was a month and not the several months and counting that we are dealing with now. We did not have internet available then, so Zoom sessions were not an option. And those Zoom sessions, for all their advantages, contribute to a digital divide that could have lingering effects for those without internet access.
What might be a viable alternative? Worksheets and/or being delivered to the students’ homes? Radio shows? Accessibility for all is so important.
Many children are currently missing out on a lot of services that schools have been providing, including guidance counselors, school nurses, teachers seeing children physically so they can know and report if the child is being abused or neglected…. I didn’t mention food because so many are working so hard to fill that gap. And of course these children get lonely without the same-age friends they would come in contact with during a normal school day.
Then there is college, which is attracting a lot of attention in the media these days. If someone contracts COVID while living on campus, many schools send them home. Worst thing to do, in my opinion, because you are now spreading the virus from campus to the student’s home location. I hope colleges start just quarantining these students.
Many students are taking their courses online, which is of course better than nothing but often feels less than satisfactory. Labs, etc. cannot be conducted online. Plus there is the social experience of being a college student. I cannot fathom what it would have been like had this pandemic occurred when I was headed off for my freshman year.
I do know I would not have been headed off anywhere, and would have spent the next several months arguing with my parents. But they were footing the bill and I was not on scholarship, so they had the power and they would have used it by informing me that there was no way their money was being used to send me into a highly infectious environment. It would have been a challenging “gap year.”
Students paying their own way and/or on scholarship are another matter. What parent is willing to have their child lose a scholarship out of fear of infection? Again, I cannot imagine being in that position: No good answers here. If a student is paying their own way, they have the power to decide what risks to take. My own experience with students who pay their own way is, they are very measured in their decision making process. I would be curious to know how many of the self-payers forestall their education compared to those whose parents have agreed to foot the bill.
Like probably about 110 percent of the population, I look forward to the day this is no longer an issue.

September 16, 2020 | Posted in: Uncategorized | Comments Closed

Isolation vs. Connection

It’s all a puzzle

If you have read many of my former posts, you are already well aware that I am firm in my belief that when people come into my office, those with good support systems tend to fare better. Which is a not-so-roundabout way of stating that we all need one another. Some of us are more introverted, preferring a smaller social circle, while others cannot get enough of meeting new people and being in crowds.
Generally speaking, I would guess the introverts are faring better with the isolation that comes for many of us with this pandemic. But no one is unscathed. After all, the most introverted among us simply have a smaller circle; introversion is not an indication of wanting to be with no one. It is my guess that even total hermits need some outside contact, if only to have someone with whom to argue.
Sitting on the coffee table in front of me is a copy of Dr. Vivek Murthy’s recent book Together: The Healing Power of Human Connection in a Sometimes Lonely World. Interesting that this book was published just as the COVID-19 pandemic was unleashing its damage in this country. The best defense we have is isolation, which will help us physically and hurt us mentally. People are using social media to help offset this, but we all realize it is not enough.
I keep thinking, if we had a timeline for this it would be so much easier. Even if we knew it would go one for another year or two, it would be a known instead of an unknown. But here we are, all of us fumbling along and doing the best we can.
One of the things that has grabbed my attention is the way it has spread through nursing homes and assisted living centers. We do have one assisted living center nearby that has had zero COVID-19 cases to date, partly due to some of their staff literally living there for a little over two months so as to not bring the virus into the facility. Despite their heroics, we cannot be sure this can go on forever—though I did say “If I ever have to go into assisted living, that is where I want to be.”
Assisted living in general has been quite successful financially. I have personally resisted the concept because it appears to me they are charging higher and higher fees to put people into smaller and smaller spaces. It is meeting a big demand, though: Community. As people age (and yes, I am in that age group, though on the lower end), there are a lot of losses: friends, spouses, professional connections…and we do get tired of having to go to so much effort to make new connections. With assisted living, it is more or less built in.
Here is the rub: These places can easily become petri dishes for a pandemic. I am guessing their popularity will decline drastically as a result of COVID. I know that I, for one, am trying to figure out what my backup plan is in the event I lose my spouse and/or my health. I will definitely use my phone and social media. And I have an extremely good support system, so I will be okay. But what of the people who are struggling in that area already?
The questions are clear. The answers? It will be an adventure. That is the one and only certainty.

Shortages – Day 83

Photo Credit: Willfried Wende

The shortages we are dealing with during this pandemic are definitely interesting. They do not compare to times like World War II when rationing controlled so much. I remember a friend telling me how she and her husband were able, unlike most people, to make pan of fudge once a month because they did not have children and that left them with enough sugar rations. In this pandemic, the supplies generally exist, but supply chains have been interrupted and some things have just been in such elevated demand that the manufacturers have yet to be able to keep up.
Toilet paper: I hear that one is getting better; I can at least pass the aisle in the grocery store and see it not be completely empty. At first I was baffled, because the shortages seemed beyond what would be created by hoarders. And I was right. Turns out there are two different supply chains, one for home use and one for commercial/industrial use—you know, the kind that comes in huge rolls and shows up in restaurants, gas stations, and many workplaces. The demand for the kind for home use jumped by about 40 percent, and the suppliers weren’t prepared. Beats me why the stores didn’t just add some of the commercial quality to their stock; people were surely desperate enough to buy that.
Soup: I still have trouble getting most of the soups we like. That one baffled me till I started thinking, lots of people now have kids at home and soup is a great go-to that saves money. I was baffled because it is canned and keeps forever, but there is a limit to how much backup supply warehouses will make room for.
Sidewalk chalk: I stumbled on this when I was thinking about how kids are bored and chalking on sidewalks is one good activity. (My mother used to encourage all the neighborhood kids to draw chalk pictures on her sidewalk.) You can still find chalk, but the really good stuff is out of stock everywhere I have looked.
Jigsaw puzzles: Who knew? Suddenly now that so many people have extra time on their hands, they are buying up these puzzles. How do I know? I tried to find one, and about the first ten or so I was interested in, could not be purchased in-store or online. I felt this urge to do a jigsaw puzzle, when the last time I did that was 1995.
Quilting fabric: Long-time quilters have hit the motherlode. Suddenly we all need masks, and quilting fabric is the best thing to make them from. I thought I would make a couple masks, and it was like the jigsaw puzzles. The remaining fabrics were in very short supply.
Hand sanitizer: We all know why that keeps selling out.
Rescue dogs: My dog died in January, and I wanted a little time before picking out another one, and I do like the idea that it’s a rescue. Enough things happened that by the time we started looking it was late March. Humane societies were emptying out. Who could have predicted that one? Family after family decided that now they had the time to properly train an animal…and having pets is also good for anxiety. Which is pretty abundant these days.
It is quite a change from every other time I was looking for a pet; most of the dogs I have had in my life have been offered to me before I had a chance to start looking. One even found me by following my car down the driveway to the street. The problem back then was being able to turn down the excess offers.
Anxiety: No, that is not in short supply; that underlies everything. Don’t know about you, but I feel like I am an actor in a bad movie and I don’t know my lines or anyone else’s or what will happen next or how it will end. I do know that I have good emotional resources, and I do see this bringing out the best in a lot of people. One thing I am certain of: There is and always will be a high degree of kindness in the human race. Hopefully we can all focus on that part, to help us live with the uncertainty.

Day 47

Rainbow = Hope

It is Day 47, and Governor DeWine has announced a slow opening up of Ohio’s businesses. It is really not clear to me whether my office is considered one that can re-open yet, but I am thinking not, because the Board’s web page indicates the Stay at Home orders are extended through May 29. The advantage of self-employment is that, while I do not have the option of bringing clients in before the state allows that, I do have the option of waiting a little longer. I keep hearing from various sources that it really is not a good idea to open up before there has been a two-week period of COVID-19 hospital admissions going down in number. That has not happened yet.
Meantime, I do not want to leave people in the lurch. This is a time of increased mental health challenges, after all. If you tell me that this whole pandemic scenario does not bother you, you are either unbelievably resilient or you are lying. I am going to vote for the latter, because everyone has their limits.
Front-line workers are especially vulnerable. They go into the field in order to help others, and from what I am reading and hearing, these situations are so intense that they often leave the front-line worker instead feeling helpless. I have already read of a couple of suicides of these workers in the crush of this pandemic. This is horrific, and I am so sorry, for the loss of these lives and for the impact their suicides are having and will continue to have on their entire communities, especially those who worked alongside them and those who knew and loved them in their personal lives.
At the moment, I remain open to connecting with clients via phone, e-mail, and internet. At the same time, I realize that I might just tough it out if I were the one needing to talk to a counselor. I am personally a huge proponent of the face to face, and of course that is just not tenable right now. Even without state restrictions, I would not advocate that someone risk this disease in order to talk with me face to face. It is difficult, especially without widespread testing, to even assess what the risk is to any individual. I could be an asymptomatic carrier for all I know; any of us could.
Bottom line: This is scary, and it will continue to be. People are showing huge courage in its face every day: Young people, older people, and those in between. People living with families they adore, people living alone, and people in abusive situations. My greatest prayers go out to those living with abuse, as it gets far worse in isolation.
As a people, we are going to survive this. As a people. As individuals, some of us will succumb, and that is a huge loss.
What kind of world will we emerge into? Things are going to change, probably some for the better and some for the worse. And we won’t all agree about what is better and what is worse. But it will definitely be different. This is not the kind of crisis that leaves anyone untouched. This is a time when we will learn a lot about resilience, when those of us with the best support systems will be able to pass that support along, to give others a hand up.
I have joked that I have to survive this because I want to see how it ends. Hopefully, we can both give and receive emotional support within our communities in the meantime. No one should be expected to navigate this alone.