A Conversation on the Pandemic: Part 3

PC: Hian Oliveira

We have been asked to practice social distancing to protect not only ourselves but also our families, friends, and community (-ies). However, just because you have to keep your distance from other human beings does not meet that you cannot practice and keep social connectedness. Practice physical distancing, not social distancing. Reframe that thinking.

  • Have a picnic outside. Bring your own food!
  • Schedule time to catch over over the phone, video chat, text, whatever work for you.
  • Look into apps like Marco Polo (“video walkie talkie”) that allow you to have video chats with others. If you are wanting to feel connected, but are struggling to have the energy to engage in a full on phone conversation, apps like this will allow you to choose when to send a video, when to watch someone’s update, how long you want your update to be, etc.
  • Plan to watch a movie or a show at the same time at your own respective homes and chat about it.
  • Share how you are doing through artwork, memes, articles, etc.
  • Have a small bookclub within your group.
  • Plan to check in with each other if you don’t hear from one another for a while.
  • If you can afford to, send care-baskets, cards, books, new snacks, activity ideas/items, etc.
  • Talk about difficulties and challenges, but also share things that are bringing you joy, your small and big acomplishments, and things you are excited about.
  • Tell each other how much you mean to one another. Remind each other that you are loved.
  • Join an online group or community, be it a therapy group, book club, or one that revolves around an activity or a topic.

But what about the lack of physical intimacy if you are living alone or are in a living situation where physical affection is not possible or safe for any reason?

  • Check in with yourself for any difficult emotion you are feeling, notice where it shows up in your body, and just place a hand there as you breathe gently. You don’t have to try to change anything.
  • Give yourself a massage.
  • Give yourself a hug; squeeze yourself tightly and hold yourself.
  • Cuddle your pet(s); express how much you love them. If you don’t have a pet but are able to, adopt a pet or two. The companionship you derive from a pet can go a long way towards alleviating some of the loneliness you may be feeling.
  • Lie down and take deep, belly breaths. Place your hands on your stomach and notice it rising and falling.
  • Hold a pillow or a stuffed animal when you go to bed.

What ideas do you have for coping with physical distancing and/or the lack of physical closeness? What’s worked for you and what hasn’t, and what did you learn in the process?

A Conversation on the Pandemic: Part 2

PC: Thomas de LUZE

This pandemic may come with many tough experiences and feelings, such as anxiety, a sense of sadness, fatigue, overwhelm, a sense of doom, feeling of isolation, etc. On top of all this, most of us are separated from our support system(s) and may also be experiencing severe financial reprecussions, so what I can say with certainty is that you are doing the best you can with the abilities and the resources you have. The difficult feelings you are experiencing are also completely normal reactions to a novel and unexpected situation.

You may also be experiencing a lack of control, which can be scary. So, here are a few things you can manage and find some control over:

  1. News – It may be helpful to create a routine around how much news you consume in a day, what time of day you do so, and which outlets you trust. It can be overwhelming to get lots of information from lots of sources that may not even have been verified! Creating a routine and scheduling time for the news will allow you to have space for other things in your life. This goes for social media too!
  2. Sleep – Practicing sleep hygiene, getting sufficient sleep, and perhaps even napping, are great ways to ensure you are rested and have energy for the next day.
  3. Food and Water Intake – Ensuring you are eating and drinking water at regular intervals throughout the day can act as a break and also be another source of energy to get through this tough time. It’s about getting through the day sometimes.
  4. Movement – Whether it is dancing, walking, running, swimming, hopping, or skipping, bringing in movement in to your daily life will release feel-good neurotransmitters.
  5. Sunlight – Not only is this a good source of getting Vitamin D, but it’s also another source of getting some of that feel-good neurotransmitter, serotonin.
  6. Distraction – When you are really struggling, it is okay to distract yourself. It can a good way of coping with the pain and fear from the pandemic. This means when you notice painful thoughts, do something to take your mind off of it. You can go biking, watch a show, cook up a storm, do dishes, nothing is small enough. Try something.
  7. Helping Others – If you have the resources and time, supporting community members who are struggling may help you feel more engaged and less alone, especially as many individuals have been stripped of resources at this time and may also be struggling with loneliness. It’s not about losing yourself in any one activity – or most importantly, “saving” people – but it’s about creating a helpful, regular practice.
  8. A Coping Skill Toolbox – What are a few things you can put in your toolbox that you can use when you are feeling anxious, stressed out, angry, sad, disappointed, etc.? Napping, deep and slow belly breathing, going on walks, stretching, talking to someone, distracting yourself, writing things down, labeling and noticing your emotions, expressing your feelings and thoughts through art, petting your animal companion, taking a bath, giving yourself a massage, all of these are things you can try when you are struggling. Can you think of other coping/self-soothing activities to add to your toolbox?

I encourage you to first begin this practice with noticing. Simply notice what’s happening in all of these areas right now, what they are bringing in to your life, and what you want to keep and what you want to remove/manage. You don’t have to rush to change everything at once; that by itself may become overwhelming. It’s okay to start slow and focus on one thing at a time.

Some of you may be needing more support and structure at this time depending on your mental health, physical health, or financial health, so don’t hesitate to reach out to a therapist, a psychiatrist, a medical provider, your chiropractor or massage therapist, your spiritual leader/group, agencies and programs that support with financial resources, or your family and friends. There is no shame in seeking support when you need it; as human beings, we need social connection to remain healthy and well.

Finally, while we may be physically distancing, it does not have to mean social distancing. I’ll talk about a a few ways to remain socially connected even in the midst of physical distancing next week.

The Point of the First Few Posts

You may be wondering why someone would bother breaking down each process of looking for a therapist; after all, isn’t it pretty straightforward?

PC: Marco CBosio

Before I entered the mental health field, I was unfamiliar with the logistics of finding a therapist. I didn’t even know where to start. The only piece of knowledge I had was that as long as I was a student at a university, a few sessions would be free.

My first experience in therapy wasn’t so great. First, I was assigned a therapist, then a few sessions in, I realized that my therapist didn’t see me as a whole person and would not recognize my cultural and familial context despite my bringing it up. I was further confounded by her lack of follow up about the tasks she assigned to me. I found myself to be generally frustrated and anxious about upcoming sessions. I eventually stopped going and didn’t again engage in therapy until approximately a decade later.

Since my first foray into the role of a therapy client, I have come to realize that many people of color, immigrants, refugees, and individuals who have been disenfranchised in their respective communities have had similar – and generally worse – experiences. Young folx, immigrants and refugees of color may not even know how to go about looking for a therapist if they so desire, and when they do show up, they may be gaslighted or their experiences diminished by the use of therapeutic theories and modalities inappropriate to their experiences.

To destigmatize therapy and to make it more accessible, we need to first shed light on exactly what it is and how it looks. We need to make client rights available so that people can make choices appropriate to themselves even before they enter a therapist’s office.

What are other ways we can make therapy accessible and destigmatize it?

What to Expect at Your First Session

PC: Tim Chow

We have established by now that all therapists are not the same, so it only makes sense that your first session (or your first couple of sessions) will differ based on who you end up working with.

Some therapists use the first few sessions to go over their policies and documents indicating agreement with their policies. These policies generally focus on confidentiality, limits to confidentiality, disclosure of the therapist’s background, agreement to payment, policies around scheduling and canceling appointments, and the process of ending therapeutic relationship. If you are doing tele-therapy, policies on online counseling will also be included.

Your therapist may choose to have a structured or a semi-structured interview with you in order to get a better idea of who you are, why you are seeking therapy, what goals for therapy you have, information on your psychical and mental health, etc. They may work on a treatment plan collaboratively with you that you sign as an agreement of the objectives and goals you have for your work together – this is especially true if your insurance will cover your therapy sessions.

Or, your therapist may ask you to sign all the policy-related documents beforehand and welcome questions about them during your first session. They may also provide an intake document – essentially a questionnaire about the topics listed on the third paragraph – that they ask you to send over as soon as you can so that they can review the information before your first meeting. This way, you are free to start the session with any subject, concern, issue, questions you have that day.

It is important for you to know and understand exactly what you are signing. If you are unclear on anything, ask for clarification. You have the right to have a signed copy of all the documents you sign (if you so choose). You have the right to documents pertaining to you as well as to know your diagnosis if there is one.

The Most Important Question

PC: Nikita Kachanovsky

The most important question to ask your therapist is, “what is your experience working with people of diverse backgrounds?” Sounds easy enough, but don’t let this question fool you.

So, why is this question so important?

This question is important because, first and foremost, our psychological, emotional, physical, financial, social well-being are directly tied to our community and our status in our society. Without safety and stability in our day-to-day life, we cannot achieve internal safety. Living in a community that disregards us, dehumanizes us, and strips us of our human dignity is traumatizing, and that trauma will most likely be passed down to our future generations (epigenetics). It is therefore imperative that all therapists understand this and hold themselves responsible for providing a healing space.

It is also important that therapists acknowledge that how anyone – including ourselves – engages with their community and are allowed to engage with their community are political statements and a political reality. Thus, our work is always political.

I will explore these topics in more detail in future posts, so hang on.

What are a few problematic responses and perspectives?

  • That they will rely solely on their clients to teach them about their background, culture, identities, etc.
  • That they can only provide full acceptance of who their clients are.
  • That their mere function is to listen or be a listening ear without judgement.
  • That the modality they use works for everyone.
  • That they are not political or that they choose not to be political – this is impossible!.
  • That they have had diversity and/or inclusivity trainings – this is not sufficient.
  • That they practice cultural competency – another impossible thing to achieve. We are never culturally competent; it is actually about our life-long process of learning and unlearning.

While these responses/work are somewhat helpful, they are not close to being sufficient in reducing harm to individuals who have been exploited and marginalized by their society.

So then, what should you be looking for from a therapist?

  • That we understand our privileges as well as our identities that have been marginalized.
  • How we leverage and use our privilege(s).
  • How we engage with anti-oppression in our professional and personal lives.
  • That we have experience working with a diverse population and engaging in social justice work.

It is about our internal work and external actions, not merely our intentions. It is about the impact we have on our clients and our community. It is about being able to center Black, Indigenous, and other people of color. It is about centering LGBTQIA+ folx. It is about de-centering bodies, race, religions, orientation, identities that have benefitted from and practice colonization.

If your therapist is a social worker, remember that social justice is a part of their professional code of ethics. Without social justice, we will end up harming even those individuals who have privileged identities and bodies.

PC: Clay Banks

How to Search for a Therapist

So, you are ready to pursue therapy, but where do you start? Well…let me tell you all about it.

PC: Thomas Kinto

First and foremost, you can search for therapists through websites like Psychology Today or Good Therapy. Depending on where you live, there may also be a local directory of psychotherapists available. You can also obtain a list of therapists through your insurance.

I would highly recommend also looking at the therapist’s personal website if one is available. This will help you find the most updated information, such as a change in hourly rate, modalities offered, a change in office hours, etc.

Most therapists offer a brief consultation over the phone (and sometimes in-person). This is your opportunity to ask questions about the therapist before making a decision and the therapist’s opportunity to do the same. During this conversation, you may jointly come to a conclusion about whether you might be a good fit, or you may even decide to speak to a few other individuals before making a decision.

Here are a few questions to ask to get to you know your therapist –

  1. What is your niche/area of focus?
  2. What is your counseling style?
  3. What modalities do you use? If you are unfamiliar with a modality, ask the therapist to briefly describe it and how it would be implemented for what you are seeking.
  4. What is your hourly rate?
  5. Do you accept insurance? If not, do you offer help with seeking reimbursement?
  6. Do you offer sliding scale?
  7. What are your office hours? When are you available? You may negotiate a weekly schedule at this point or wait to do so until you have had a couple of sessions.

As the first few sessions may focus on gathering information, getting to know each other, discussing policies, and completing paperwork, it may take about 4-6 sessions to get used to and learn about a therapist’s style, and to decide whether they are a good fit for you. Some of you may realize much sooner than the 4-6 weeks whether you want to continue to work together with your therapist. Either way, if you find that a therapist is not a good fit for you, you have the right to end your sessions and look for another individual. I always recommend being clear about wanting to end your work together – you will not hurt your therapist’s feelings. We already know that we aren’t a good fit for everyone!

To learn about the most important question to ask during your therapist search, stay tuned.