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Six Week Class: Adventures in Eldercare
Starting September 10th, I will be leading a six week Sunday School Class on Eldercare. I hope to help people learn, share, and support each other as we explore the unique experience of caring for loved ones during this stage of life. Please feel free to join us!
September 10th: Developmental Perspectives
September 17th: Legacy Work ****We do not meet on 9/24/23
October 1st: Avoiding Power Struggles
October 8th: Hard Conversations
October 15th: Grief
October 22nd: Self-care
Location: Arvada United Methodist Church: 6750 Carr St. Arvada https://www.arvadaumc.org/
Time: 9:10-9:50 a.m.
Healthcare: Challenges for Women
Awhile back, I was sitting in my OBGYN’s office, anxious to hear what could be done about the night sweats that were significantly impacting my sleep. (One night with interrupted sleep is enough to make me grumpy. A few nights in a row, I may be found growling in the corner with a box of Nutterbutter cookies held protectively in my lap). I will never forget HER words…. “Welcome to your forties.” There were no blood tests conducted, nor an exploration of nutrition or behavioral changes that could be contributing factors. If she had dug a little deeper, she would have been able to identify side effects from a medication that could easily be addressed with a few tweaks. Instead, my plea for help was simply brushed off, told this is the inevitable suffering women must endure in their midlife. In utter shock, I realized I had just been given a cold blast of reality- women’s health is notoriously not taken seriously and it only gets worse with age.
For some reason, science and medicine have largely ignored half of the human population. According to an article in Women’s Health, they found a pattern of women feeling their symptoms are minimized, they feel judged by staff, language is used by providers that does not ensure understanding, and they are given recommendations without discussing the full range of options and the pros/cons involved. How does a woman advocate for herself when there is so much working against her?
Behind the scenes, this experience is the outcome of many factors and attitudes. Here are a few examples:
- Women have been excluded in higher education and research, removing the very voices who would speak to this gap and have a vested interest in learning how to address and care for women’s needs. **If you are interested in reading a fictional story highlighting roadblocks female researchers experience, read, “Lessens in Chemistry” by Bonnie Garmus.
- Researchers have shared concerns about impacts on fertility or the possibility that hormones could impact the results. The latter is particularly confusing because these elements need to be included in data if we want to understand women. For example, the Food and Drug Administration (FDA) excluded females of “child-bearing potential” from clinical trials from 1977 through 1993. This even extended to mice.
- Contradictorily, researchers have also assumed that women basically share the same anatomy as men. Never mind major differences in bone structure, center of gravity, sex organs, distributions of weight and strength, etc. This has major implications. When studying for car safety, for example, crash dummies have largely had a male physique. This has been seen as a major contributor to the statistic that women are 73% more likely to be injured and 17% more likely to die in vehicular crashes. (See link below)
- Women’s experience has been pathologized. In mental health, Freud labeled the distress his female clients described as “hysteria”. This comes from the Greek word meaning “uterus” and refers to ungovernable emotional excess. Despite repeatedly hearing about traumatic experiences, he chose not to trust their reports. Instead, he developed theoretical ideas like “penis envy” to explain what he was seeing.
We have some major challenges ahead of us, so let’s face them head on!!!! Let’s claim a major role in our health, seeing ourselves as part of a team and not just the passive recipients of care. For women and people with uteri, the stats show this is especially true. You are your greatest advocate! Here are a few ways you can do this:
- If you have any hunches about what is going on, do your research. Find out about the diagnoses, what symptoms and severities exist, and treatment options are available. Include holistic treatments (ex: acupuncture, exercise, diet, lifestyle) and services (ex: case management, support groups). Pay special attention to recent developments to ensure you know all you can. I love this quote, “An educated patient is an empowered patient.” (Source unknown)
- Compile a list of questions before your visit. Don’t be afraid to have articles at the ready or at least sources to reference when you bring up something from #1.
- Consider an online or in-person support group. They may have suggestions or experiences with insider intel that may be invaluable.
- When you talk with your provider, consider the quality of the interaction and relationship. Do they ask questions to get a good understanding of your experience? Do they invite collaboration? Do you feel heard? Do you feel your knowledge and boundaries are respected? Do they talk to you in a way you can understand? If you have concerns, take this seriously. Even if they are experts in the field, a problematic relationship will impact the care you receive.
- When you leave, there should be “next steps” outlined. Sometimes providers rule things out but do not state how to move forward. Other times, the provider may have done all they can and feel their work is done. Push for direction so you do not have constant dead ends to contend with.
- Do not be afraid to ask for a second opinion. Doctors are human and can make mistakes. When you are uncertain, it is better to be safe than sorry.
We are blessed to have so much knowledge and treatments available like never before. Yet it is so important to not forget that human beings are a major part of the equation. To ensure you get the care you need, advocate! We are still dealing with inequalities, so let’s use our spunk, fortitude, and voices to make sure we are always taken seriously!
“Each time a woman stands up for herself, without knowing it possibly, without claiming it, she stands up for all women.” -Maya Angelou
Resources
https://fortune.com/2021/03/09/womens-health-research-fda-trials/
https://amp.cnn.com/cnn/2022/12/15/world/female-car-crash-test-dummy-spc-intl/index.html://forthttps://psychnews.psychiatryonline.org/doi/full/10.1176/pn.36.14.0009
Happy Pride Month!!!
This is a time when we get to celebrate sexual and gender diversity, a reminder that human beings embody rich varieties of experiences and identities. The community also invites reconsideration of norms; norms that are so embedded in our culture that they are largely invisible. For the LGBTQ+ community, this process requires breathtaking courage, especially now. There is a surge of hostility in our society that is moving into public policy. According to the Human Rights Campaign, there have been more than 400 anti-LGBTQ+ bills introduced this year in states across the country. If I look beyond the political benefits of energizing groups through scapegoating, I genuinely cannot understand the fervor around restricting rights and rendering an entire group of people invisible. These bills remove freedoms, meddle with evidence-based medical treatments, restrict self-expression, ban literature, and even forbid schools from acknowledging the existence of LGBTQ+ families.
My friend also showed breathtaking ignorance that sexual orientation in the form of heteronormativity is taught from the moment we are born. Rather than give a list of examples, please watch this youtube video. Through an exercise in empathy, the segment highlights what it means to grow up in our society and the myriad of ways someone is required to hide, pretend, and feel shame about themselves if they do not fit into what is deemed the “norm.” (If you wonder what kind of impacts this has, here is a glimpse: mental health impacts).
Regarding HB 1557, there is no question that it is a barely concealed attack on the LGBTQ+ community since its nickname is the “Don’t Say Gay Bill.” Florida’s ACLU chapter writes:
[The Parental Rights in Education Bill] is a government censorship bill that would ban classroom discussions related to sexual orientation and gender identity in schools. It would silence students from speaking about their LGBTQ+ family members, friends, neighbors, and icons. It would also bar LGBTQ+ students from talking about their own lives, experiences, and families and would deny their very existence. The dangerously vague provisions in the bill would have a chilling effect on support for LGBTQ+ youth by creating new costly liabilities for school districts. Under the bill’s provisions, parents unsupportive of a district’s policies would be given broad powers to sue for damages and attorney’s fees.
What is not included in the ACLU’s statement are the dangers that emerge within the school community. What might happen if a homophobic/transphobic parent gets wind of any student, family, or teacher who has a different sexual orientation or gender identity from them? What kind of hostility might emerge? How might the community turn on them? What if that student ends up being the child of that parent? Ironically, HB 1557 gives us a taste…
I stated earlier that Pride Month is a time to celebrate, but it is more than that. It will hopefully be the continuation or the beginning of the time to take a stand: stand with our LGBTQ+ friends and their right to live full, rich lives; stand against the efforts to vilify and oppress the community; and stand tall when anyone tries to diminish you for your advocacy.
Definition
Heteronormativity- a set of assumptions that suggest that what is normal and natural is heterosexuality. Heterosexuality is deemed superior to other sexual orientations and can lead to the actions that restrict, shame, and dehumanize anyone who does not fit into this category.
https://www.hrc.org/campaigns/the-state-legislative-attack-on-lgbtq-people
Changing Minds Part 3: Time to Engage
It’s time to get back to discussing strategies to use when we disagree with others and when the outcome of a discussion has huge implications. In part 1, we explored our position and why a topic matters to us. In part 2, core principles were introduced to promote openness and respect in the interaction. This last section is about the all-important conversation we’ve been working towards. The following are the specific steps to take, putting together all of the prep work.
- Ask them to identify their beliefs. It is important to be clear about the topic since the rest of the conversation requires mutual understanding of what is being discussed.
- Repeat their viewpoint and confirm understanding. One of the greatest diffusors in uncomfortable conversations is ensuring the other person feels heard. Provide frequent summaries and ask if you have it right. Do not move onto the next step until not only you know, but they know you know what they are trying to say. (Good luck making sense of that sentence!)
- Identify their definitions and use their terminology. It is a common assumption that because we speak the same language and use the same words, we are on the same page. You’d be surprised how often this is far from accurate. Double check!
- On a scale of 0-10, ask how confident they feel about their position . This has two primary benefits. First, it lets you know where you are starting from. Even if there is not total alignment by the end, any shift in thinking says this interaction has made a difference. Second, it helps them transition into the next stage, when there is a shift into the way they are thinking rather than what they are thinking. Called “metacognition, it is when we get out of the weeds of entrenched positions and look at things from an observer standpoint.
- Ask the other person to articulate their position. Ask the other person to name what they think, feel, and believe. Discover, often together, their true motivations and goals. Identify what makes them feel confident in their position. Explore vulnerable personal experiences that can turn a talking point into something specific and meaningful. If they offer several reasons, look for themes. Their reasons initially might look obvious but lack the deeper motivations that capture the degree of passion you see. If the emotional energy displayed and the reasons do not seem to match, continue digging. If they are using talking points or generalities, keep digging. Spend more time listening than speaking and go slow! As Wil Rogers’ stated, “Never miss a good chance to shut up.”
- Ask questions that encourage reflection, using the Socratic Method. Now that the position is clear, it’s time to test the quality of their methods for arriving at certainty on the issue. Many times, the person begins to move away from the black/white position and see the complexities that may not have been clear or well-articulated. The goal is to help the other person judge the quality of their reasoning process and encourage increasing levels of discernment. It is common for counterarguments to surface. When they find these perspectives through their own inquiries rather than having them stated by someone else, it avoids power-struggles. There is a great example of this in the first third of the show: Podcast You Are Not So Smart Episode 236
- Clarify, repeat, and connect to their values and needs. Much like step four, this is a way to let both of you know that your understanding matches what they were trying to say. Feel free, when appropriate, to share your experiences so they are not the only vulnerable person in the room. If they are not open to it, move to the final step.
- Re-evaluate where the person lies on the scale of 0-10 you asked in step four. That identifies any shift, even if there is not full agreement.
- Close with appreciation for their openness. Thank them for their time and try to part company in a way that is kind and warm.
No matter what the outcome, you have just engaged in the much-needed activity of meaningful conversation. You will not always get the change you hope for, but there is still value in this three-part process. Your efforts exercise critical thinking muscles, ensuring that positions are based on facts, expertise, values, and a clear understanding of the potential impacts (which our good intentions may not readily reveal). It creates room for external input, providing a safety against certainty and my-side biases. Most importantly, it allows room for disagreement without resorting to the all-too-easy seduction of labels that serve to break down relationships rather than build bridges. It is a foundational activity that helps a democracy thrive. Here’s to many rich conversations that inform, persuade, and inspire!
Changing Minds: Part 2 Build Rapport
It’s time to get back to strategies for engaging in tough conversations. Using the basic principles of deep canvasing, the previous article focused on step 1, becoming curious about ourselves and our motivations to engage. This time, the focus is on the approach, working towards a respectful exchange. The tone for the conversation will be set in just three seconds. Three seconds! Therefore, it’s imperative to be careful because we will either open up dialogue or shut the conversation down.
- This is about exploring ideas and experiences. Keep the topic away from someone’s character so there is no need for defensiveness.
- Remove the goal to win because it means someone has to lose. In the podcast the Hidden Brain, they highlighted research that showed it is less painful to be in denial than think you are right and be proven wrong. Recognize that examining beliefs is uncomfortable and must be addressed with care.
- Move away from seeing the other as an adversary. A huge hint that you need to check yourself is when you utter the words, “Yeah, but….” We need to be open to the fact that they might have something to teach us. The following quote, although binary, highlights the importance of being clear on your position without the danger of certainty: “Talk like your right; listen like you’re wrong.”
- Consider the qualities that are inviting: tone, word choice, body language, and facial expressions. Starting off with a smile and a request to talk(rather than an expectation or command) goes a long way.
- Ask clarifying versus leading questions. The former is a request for additional information to further understanding. The latter has an underlying agenda that pushes someone into a specific answer. Leading questions commonly have conjecture and assumptions embedded within them and rightly evoke suspicion. Choosing the former may sound straightforward and easy to implement. In reality, most of us sneak in our viewpoints without even knowing it.
- It is tempting to see the other person as “less than”. Less educated. Less compassionate. Less informed, etc. This lens is the very foundation behind a sense of superiority. Deliberately look for the person’s humanity and the context that informs their views.
I’m going to share a story I read that shows exactly what not to do. Maybe it is an “if you can’t be a good example, then be a warning to others.” Frankly, I just love the message and it fits perfectly with what we are talking about.
The Dinner Conversation
We were all sitting around the dinner table discussing life and the man across from me decided to show his brains. He says the problem with teachers is “What’s a kid going to learn from someone who decided his best option in life was to become a teacher?” He reminds the other dinner guests that it’s true what they say about teachers: Those who can, do; those who can’t, teach. “I mean, you’re a teacher, Taylor,” he says. “Be honest. What do you make?” And I wish he hadn’t done that (asked me to be honest) because, you see, I have a policy about honesty: if you ask for it, I have to let you have it.
You want to know what I make? I make kids work harder than they ever thought they could. I can make a C+ feel like a congressional Medal of Honor, and an A- feel like a slap in the face. How dare you waste my time with anything less than your very best!
I make parents tremble in fear when I call home: I hope I haven’t called at a bad time, I just wanted to talk to you about something Billy said today. Billy said, “Leave the kid alone. I still cry sometimes, don’t you?” And it was the noblest act of courage I have ever seen.
I make parents see their children for who they are and what they can be. You want to know what I make? I make kids wonder; I make them question. I make them criticize. I make them apologize and mean it. I make them write. I make them read, read, read. I make them spell definitely beautiful, definitely beautiful, definitely beautiful over and over and over again until they will never misspell either one of those words again. I make them show all their work in math. And hide it on their final drafts in English. I make them understand that if you have brains then you follow your heart and if someone ever tries to judge you by what you make, you pay them NO attention.
Let me break it down for you, so you know what I say is true: I make a difference in the lives of hundreds of children. Now what about you? What do you make?
Psychedelics and Mental Health
I was recently asked about a piece on psychedelics from the television show, “Last Week Tonight.” The host, John Oliver, did a great job talking about the complicated history around these chemicals in a therapeutic setting. For example, there are places where psychedelics have been considered an integral part of a community (ex: spiritual practices), political policies that have shaped their use, fabricated research used to promote a given stance, and active campaigns to scare people away. So, what do we make of all this?
While I am no expert in this area, I have an opinion (probably a surprise to no one). In the field of psychiatry and psychology, there is definitely growing openness to this form of treatment. Efforts are underway to determine efficacy, particularly in the ability to create relief for those suffering from PTSD. The Daily just aired a podcast that featured a veteran who was haunted by the symptoms of PTSD until she received psychedelic treatment. After her experience, she has become a passionate advocate, hoping more people will find relief.
I look forward to hearing more about the psychological benefits and the sense of calm that some have reported. It will be fascinating to learn about the biological impacts of treatment, established through measurements like brain scans and neurological testing. If research points to noticeable changes in turning off the fight-or-flight response and addressing the structural changes trauma creates, it will show psychedelics to be a potent option for enduring change. Meanwhile, I remain cautious. Here are a few reasons:
- There are training programs that certify therapists in this area. Therapists are not medical providers. Comprehensive coursework around the complexities of biochemistry is not part of a counseling program. We have no ability to assess contra-indicators such as the way psychedelics mix with other medications/drugs or how physical health issues like brain injuries/heart conditions/hypertension could be impacted. I also wonder how therapists are instructed to handle a bad experience. There are no guarantees this treatment will create the healing we hope for. It is important to make damn sure we know the right conditions to promote a positive experience and how to handle a situation should the trip go to unintended places.
- It is important to allow a body of research to emerge that demonstrates statistically significant trends. In undergrad, there was literally a requirement to be a subject of some professor’s research project. I can only imagine what conclusions were drawn based on a bunch of privileged, white, 19-year-olds. Yikes! Good research should include exploring a variety of groupings such as sex, race, age, physical size, diagnoses, etc. That will take some time and careful parameters.
- The treatment has not been approved on a state or national level so there is no mandated, formal protocol. A client experiences a high degree of vulnerability and suggestibility during a trip. John Oliver’s piece mentions a two-person support team, but this is not a standard by any means. I personally know two clinicians who provide this treatment in a one-on-one setting. While I know there are upstanding ethical providers, it is incredibly risky to rely on trust alone.
Although I am excited about the potential benefits, there is a lot of work ahead before this would be a treatment I would recommend. Even though people have access to psychedelics for recreational use and even though it has been used for mystical/transcendental experiences, turning this into a recognized treatment for mental health issues is not a step that should be lightly taken. Scientific research coupled with safe and ethical practices must be our priority when helping people overcome incredible challenges and pain. I stand with the APA on this one:
Sources
- (2023, February 22) Flashbacks after psychedelics. [Audio podcast episode]. In Research Briefing. Blossom. Reportonpsychedelics.com/category/weekly.
- https://www.counseling.org/news/aca-blogs/aca-counseling-corner/aca-member-blogs/2018/09/20/understanding-psychedelics-and-therapy—dose
- https://microdose.buzz/news/apa-issues-position-statement-on-psychedelics/
- https://www.psychiatry.org/getattachment/d5c13619-ca1f-491f-a7a8-b7141c800904/Position-Use-of-Psychedelic-Empathogenic-Agents.pdf
- Oliver, J. (2023, February 19). Psychedelic assisted therapy [Video]. YouTube: Last Week Tonight. https://www.youtube.com/watch?v=a546lxxJIhE
- Barbaro, M. (Host). (2023, February 22) Podcast: The Daily. The Veterans Fight to Legalize Psychedelics. New York Times Company. https://www.nytimes.com/2023/02/22/podcasts/the-daily/veterans-psychedelics-legalization.html
Happy 20th Birthday, Side-By-Side Counseling!!!!
I was in squishy pants, reading something I know was highly intellectual when it suddenly dawned on me- this month is the twentieth anniversary of Side-by-Side Counseling. Twenty Years!!!! While I am in comfortable denial that I’m two decades older than when I started, I can say it has been a compelling ride full of rich stories, hard work, and fabulous people who have and continue to provoke and inspire. After this much time, I thought it might be fun to sit back and contemplate what has evolved over the years.
You know you’ve worked with me if…
- You use food adjectives to describe your experience. For example, something enjoyable is “yummy” while something upsetting is “spicy”.
- To get rid of uncomfortable energy, you have a specific way of moving your body that is a cross between an excited octopus and a seizure.
- Complex internal experiences have been clarified using stuffed animals. My personal favorite animal friend is the new alley cat, “Nibs” but the chicken is a close second. Please note, I do not do puppet shows… yet.
- You know therapy is made better with a nice cup of tea.
- There is no such thing as a typical therapy session. Perhaps you’ve played follow-the-leader across the room. Perhaps you have hit pillows with a martial arts bat coupled with some great four-letter words. Maybe you’ve used a tennis ball to help manage a panic attack. Clients know- healing can come in many forms.
My five favorite life lessons are…
- “I don’t know how to _________ … yet.” “This is hard/painful/confusing/unfamiliar… for now.” These statements highlight that every moment is a chance to create something new. Over time, our efforts can lead to significant change. Relationships can evolve, skills can be learned, and we can let go of worn-out narratives in exchange for a new story.
- It is always my goal to be honest with people, even when it is hard to hear. However, it must be done with great care. As the Dalai Lama stated, “Truth without kindness is cruel.”
- People make sense when we take the time to figure out the context and go deeper than what is on the surface. I’ve learned to trust that someone’s choice/beliefs/feelings/sensations are there for a reason.
- Be curious. It is far richer than being certain. I chose my theoretical orientation partly because of the emphasis on experimentation. In this mindset, we try things out to see what works and what doesn’t. There is no failure, only information to guide us along our path.
- “It is what it is.” Living in denial or a fantasy means figuring out how to cope without full awareness/understanding of what we are dealing with. When moments of acceptance come, there is often relief because the effort required to pretend is finally over.
- Celebrate positives whenever we can. Ex: I am officially the employee of the month. (It helps when you work for yourself)
I am delighted to say that after twenty years of private practice, I would not trade this adventure for anything. Thank you to my parents, teachers, colleagues, mentors, clients, students, friends, hubby, daughter, and cat- all who have helped make this anniversary possible!