Archive of ‘Texas Legislature’ category

This Pathology is Not All Yours… And Why Therapy Must Consider The Cultural Milieu

Psychotherapeutic training generally includes something called Universality as a healing technique. It stems from Irvin Yalom’s germinal Therapeutic Factors for facilitating group therapy. It basically means that when humans get to hear and witness another human facing something similar to their own experience, this communality engenders a sense of validation and fosters healing. Universality, with its relational delivery, inherently addresses the isolation any human can feel amidst a problem that had felt singular.

Normalizing Responses to Societal Issues

As a trauma-informed and relational therapist who specializes in climate change grief and disaster trauma; this is of interest to me for several reasons. A dominant one is that grief and anxiety created by several ongoing collective traumas are hard to separate from their myriad effects on a single person’s psyche, which at times is simply responding to these threats, pressures, and perils. Living within a colonial, imperialistic, and capitalistic society under threat of both climate change and continual pandemic pressures is not a cakewalk. Even that sentence stresses me out! The waters we swim in matter. Our collective ills contaminate human psyches and can show up as pain, depression, anxiety, panic, and the like. Our collective diseases become individuals’ problems.

And yet, as universality would have it, a clinician understanding these ills—as best they can from the purview of the client—is paramount to good treatment. Coping strategies alone are not sufficient, normalizing the client’s response to the collective deficiencies is part of alleviation of these pressures. Normalizing in this way may look like: “yeah, this is not, or should not be, normal.” This is a bit of disclosure from the therapist– a human to a human, both part of the same culture admitting where things stand.

I don’t think I am going out on a limb to note that our culture is currently struggling. As I write this, in Texas, transgender citizens’ rights are on the line. Gender-affirming care is slated to become criminalized, at times targeting trans children’s parents with threats of abuse. Recently, trans adults were added to the list with SB1029, which targets insurance companies and providers. Abortion is banned, though it is a medical intervention that can be lifesaving. To make matters worse, bounty laws that enforce this are creating an environment that is truculent and dangerously paternalistic. Books are being banned, and educators censored. A new Don’t-Say-Gay-esque bill was proposed just last week, modeled after Florida’s, which threatens an outright book ban around anything mentioning LGBTQ+, as well as censoring classroom discussions around the same. And the effects and human impacts of a climate changed are palpable and ever-increasing–in our area, we are recenrtly off the heels of another freeze. All of this on top of year three of the pandemic and its longstanding disruptions on learning, isolation, mental health, and physical health.

When Diagnostics Are Not Enough

And listen, I am not against diagnosing one’s mental health issues. Diagnostics as a part of comprehensive therapeutic treatment can be incredibly beneficial. They can certainly aid in devising and guiding successful treatment within the therapeutic consulting room. For the client who has been struggling with symptoms; a diagnosis can provide relief, an explanation, and a framework to describe their internal state or external behavior to themselves, family, classmates, work colleagues, and friends. Diagnostics on the whole can open up lines of communication within a treatment team, creating access to intervention avenues at the school level, or equally, funnel information to a psychiatrist who can better medicate. A correct diagnosis can create ease within a family system to remove the label of Identified Patient (IP) from a child’s role and help the system see their child or sibling from a more educated and supportive perspective. 

So- we can diagnose the person inside of the room however, we must also pay mind to the collective upheavals, distresses, and systemic issues that contextualize this individual. The medical equivalent might be something like this: we have a town next to a factory that is seeping toxic waste into the town’s water supply–a large and suspicious portion of the town comes down with a respiratory disease. Diagnostics alone would create a closed loop within the local medical system, with continuous siloed individual diagnoses reporting the disease created by this substance. AND/OR; the water supply could be addressed, and toxin mitigated. This is made more complex when we consider mental health as things tend to be created by many factors– and it can be tricky to suss out the causes, and the collective fixes. But complexifying our solutions, and as collectively as possible, is exactly the medicine called for in this era.

Psychologist James Hillman said (and of note, before the internet took hold):

“Of course I am in mourning for the land and water and my fellow beings. If this were not felt, I would be so defended and so in denial, so anesthetized, I would be insane. Yet this condition of mourning and grieving going on in my soul, this level of continuous sadness is a reflection of what is going on in the world and becomes internalized and called “depression”, a state altogether in me ─ my serotonin levels, my personal history, my problem…”

(Hillman, 1996)

Trauma-Informed Care as a Path Toward Healing

I know I am outting my politics, but alas—my last two blogs have been about porn and fairy tales so that cat is already out of the bag. Let’s take the example of gun violence. I see teens and work often with parents with young children. Both demographics are widely impacted by the nations’ lack of legislation on guns and are moreover the compensatorily-devised adaptation techniques that infiltrate our learning institutions instead of real action. If a teen client comes in saying; “I have had [X many] years of Active Shooter Drills at school and I am experiencing nightmares.” Yes, we can work to shift the nightmares, ameliorate the residual fear and treat the existence of such symptoms. But resounding data is against these drills and particular practices within. Why would I simply normalize them? 

A study quoted by Everytown bleakly reports:

“Active shooter drills in schools are associated with increases in depression (39%), stress and anxiety (42%), and physiological health problems (23%) overall, including children from as young as five years old up to high schoolers, their parents, and teachers. Concerns over death increased by 22 percent, with words like blood, pain, clinics, and pills becoming a consistent feature of social media posts in school communities in the 90 days after a school drill.”

Similarly, if a parent comes in citing concern their little one is going to be soon introduced to this practice at their new school, it would be wholly inauthentic of me to ignore not just the upset this future event is inciting but to not also see this concern within the structure of the collective climate. 

I speak here from a position of activism, allyship, and a desire to move forward as clinicians with eyes open, and as collectively aware as possible. No matter the source, symptoms and their manifestations are treatable. Therapy can provide meaning-making, the healing relationships can be sturdy-ing, and its structure and techniques can actively reify the resilience, connectivity, and vibrancy of the Self. If you love data, therapy has been shown in many forms to change the brain’s structure, namely in the frontal and temporal cortex, which enables more integration, processing capacity, and regulation of neural symptoms. When under the care of a trauma-focused and trained practitioner; trauma can be reprocessed to repair mental injuries from not only the initial trauma(s) but also any newer experiences that have been neuropsychologically linked up with the traumatic experience. EMDR, for example, uses bilateral stimulation as an adaptive information processing technique to reprocess and restore improperly stored, fragmented memories that can otherwise create interruptive and discontented states. The de-fragmentation and integration it engenders can be deeply impactful.

Therapy is helpful, and it is more helpful when it considers itself as a tool within a structure, that keeps in mind the structure’s influence on the clients it is aiming to help. I would be doing a disservice to clients to ignore the wider lens, and I hope that in and of itself is a helping technique. 

Resources

Clients

I am not telling you to do or not do anything, but here is a list of books that have been banned in Texas.

Other clinicians

Dr. Jennifer Mullan’s Decolonizing Therapy model provides trainings for Politicizing your Practice



When Thoughts and Prayers Aren’t Enough – Self-Care in the Aftermath of Tragedy

A personal note from the author: As I was writing this piece in the aftermath of the school shooting in Uvalde, TX, the gravity of the situation at hand sat heavy on my soul. The weight of the tragedies that inspired this piece is not lost on me. Over 336,000 students have experienced gun violence at school since the shooting at Columbine High School in 1999 (source). In an average year, over 10,300 hate crimes in the US involve a firearm – more than 28 each day (source). For decades, gun violence has reached every pocket, nook, and cranny of our country, and as a result millions of lives have been irrevocably changed. 

I feel called to name this as a preface to this blog: There is no amount of journaling, self-care, compassion, protesting, meditating, senator calling, donating, or volunteering that can take away or fix the deep wells of grief and despair felt by the survivors of those who have lost their lives to gun violence. 

I stand by the information collected and presented in this piece. However, I am fully aware that this is not nearly encompassing enough to soothe the collective grief we are all experiencing, nor will it ever touch the amount of support needed by the families and loved ones who have lost someone to gun violence. This blog is meant to be a consideration and a supplement for those who are struggling to bear witness to the pain we are subjected to on an almost daily basis as Americans living among two simultaneous crises in this country – the gun violence crisis, and the mental health crisis. They both demand our urgent attention. 

I plead with you to seek resources, gather support, and educate yourself on the subjects at hand. I plead with you to connect with your neighbors, contact your senators, and demand something be done to change the course of gun violence and mental health care in this country. Most of all, I deeply plead with you to take care of yourselves, so we can finally begin to take better care of each other. Thank you for your consideration – Sara

Self-Care in the Aftermath of Tragedy

“Every one of us needs to show how much we care for one another and, in the process, care for ourselves.”

Princess Diana

The last several years, as a nation, we have seen unspeakable tragedy unfold. The near constant continuation of mass shootings is wreaking havoc across our society. With the rise and spread of social media, we now have a front row seat to these tragedies in a way we never have before. These events permeate our newsfeeds, our conversations, our brains, and most importantly our hearts. Feelings of hopelessness, exhaustion, and fear are running rampant between us and within us due to neurobiological responses to trauma. While tensions are at an all-time high, our need for compassion, connection, and support is greater than ever. Self-care is a valuable necessity in meeting these needs. Let’s explore how to lean into these self-care needs, and the importance of caring for ourselves so we can care for each other.

“Love and compassion are necessities, not luxuries. Without them, humanity cannot survive.”

Dalai Lama XIV

The root of the word compassion comes from the Latin phrase compati, which means “suffer with”. Compassion is what drives us to see other people’s pain and deeply identify with it. Compassion holds evolutionary neurological purposes. Compassion developed as an emotion within the brain to help us to identify and bond with others, thus creating safety amongst groups of humans. As humans experience compassion, our heart rate slows, our breathing deepens, and oxytocin (the bonding/love neurotransmitter) is released. Often this is demonstrated as an outward, other-oriented experience – we give or show compassion to others who are suffering. But what would it be like to turn this inward? We are worthy of giving ourselves compassion. Our bodies and brains have gone through so much over the last few years, and yet we are often expected to maintain the same level of productivity, health, and well-being as years prior. If we practice the gift of self-compassion, we can allow for the same neurobiological response to heal and soothe ourselves in the same way it does for others.

Practice quietly speaking to yourself as you would a friend or a child – I know this is so painful for you. It is difficult to understand and comprehend. People are suffering and it is hard to watch. It is ok to be sad, angry, and fearful. You are allowed to cry, self, it is okay. You are struggling in the midst of this, and you have every right to be. Providing yourself with the permission and allowance to comfort and soothe yourself is self-care. When we develop more compassion for ourselves, we also deepen the compassion we can have for others. Self-compassion and compassion for others are woven like a braid to form the fabric of empathy. 

“Get yourself grounded, and you can navigate even the stormiest roads in peace.”

Steve Goodier

As the shooting in Uvalde, Texas unfolded on May 24th, 2022, we all watched from near and far in horror. Social media has created a nearly instantaneous avenue of communication and consumption of information. Neurobiologically, our brains are simply not evolved enough to withstand this level of information. As we watch the chaos unfold through Facebook live feeds, or hear the screams of the families through TikTok, we are giving our brains a hefty dose of secondary trauma. Although logically we know we are absorbing this information second hand through a screen, our brains don’t actually know that this is a second-hand experience. Our brains are wired to react and respond to threat and danger; thus, our trauma response begins through what is commonly known as fight/flight/freeze/fawn. As we watch these videos, our brains release cortisol and adrenaline, preparing our bodies for the danger at hand. As a result, this translates to overwhelming feelings of anxiety/restlessness (fight/fight) or depressive/hopelessness (freeze/fawn). The longer we engage with the secondary trauma, the longer this neurobiological response continues. 

One of the best ways to relieve ourselves of this cycle is grounding ourselves. Grounding refers to an increase in radical acceptance, mindfulness, and re-connection to the present. There are many ways to practice grounding, and no way is right or wrong. Sensory based grounding techniques are always a go-to in my practice simply because they are easy and reliable. Try taking deep belly breaths and exploring the following – 5 things you can see, 4 things you can feel/touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Reflect on the physical sensations that come up for you, as well as the feelings that arise during this exercise. I also love incorporating grounding during regular every day activities. Cooking meals, walking my dogs, playing with my crystals, taking a shower – these are all rich with sensory input that we can tune ourselves into to get back to our present body and mind. 

Another great way to ground ourselves is through a creative outlet. Journaling is an amazing resource that we all have access to. Journaling helps us process our experience both internally and externally. In addition, think of all of the sensory based aspects of journaling. The smell of the paper, maybe the sound of the clicking as you type on your phone, what it looks like to see your words out in front of you. There are so many opportunities to check in with your body, mind, and soul in the midst of journaling. This also applies to other forms of creative outlets including painting, sculpting, drawing, and creating music. Anything that allows the charge of energy and emotion to move through us also provides us with an opportunity to check in with our own experience and utilize grounding to soothe ourselves. Things are treacherous in the outside world, but here in our body and mind we can create a peaceful, compassionate, and loving reprieve from what we are absorbing every day. 

Grounding is important for self-care, but it is also important for a larger purpose in solving the challenges we are faced with today. The greater the activation of our trauma response, the less access we have to our prefrontal cortex. This is the part of our brain that we need for decision making, problem solving, consequential thinking, rationalization, and impulse control. These are ALL things we need to have access to in order to begin to solve the problem of mass shootings in our country. We cannot begin to solve this problem when we are all operating from a place without access to the parts of our brain needed most. Individually and collectively, grounding is becoming increasingly more of a necessity in today’s world to solve the complex problems we are faced with as a society. 

“What I try to tell young people is that if you come together with a mission, and it’s grounded with love and a sense of community, you can make the impossible possible.”

John Lewis

Self-care is a crucial part of healing from tragedy. Although self-care can be relaxing and soothing, there are also forms of self-care that are more active and intentional. In light of large-scale events, some folks respond with a more intense drive to do something to prevent this from happening in the future. The lack of control and helplessness we feel bearing witness to these events pushes us to action. Finding a balance between grounding-based self-care and actionable steps is so crucial. One must occur alongside the other. We have to ensure we are in a healthy regulated mental space in addition to engaging with the resources available to help and create change.

One of the best ways to heal, feel connected, and process tragedy is in the company of your community. Community engagement is incredibly useful in creating a sense of togetherness, connection, and unity in the face of devastation. This large-scale form of co-regulation allows for us to think clearer, develop our compassion for others, and empowers us to seek the change we wish to see. When we all come together, strides can be made towards our end goal. 

There are so many ways to get involved with the community to enact change to end gun violence and increase access to mental health care. Here are a few ideas: 

  • Call Your Representatives – Contact your local and federal representatives to let them know you would like to see change to ensure the safety of you and your neighbors. The League of Women Voters has a great website that helps you find your elected officials and their contact information. 
    • If you are unsure of what to say when you call or email, review this script: “Hello, my name is NAME. I’m a constituent from STATE, ZIP CODE. I don’t need a response. I am concerned about the rise of gun violence and lack of mental health care funding in our communities. I strongly encourage the senator to please vote for legislation that solves this situation. Thank you for your hard work!”
  • Review Volunteer Opportunities – There are so many ways to volunteer in crisis. Organize a blood drive with your colleagues, gather donations (see below) to support the families and survivors, or find organizations such as Moms Demand Action or Everytown that support policy change and provide opportunity for connection and action. 
  • Donate – One of the best ways to assist is to provide monetary donations if you are able to. It is so important to do research on the legitimacy of donation sites to ensure your money is going to directly benefit families and survivors. 
    • To donate to the survivors of the Uvalde, TX school shooting, please CLICK HERE
    • To donate to the survivors of the Buffalo, NY supermarket shooting, please CLICK HERE

Self-care comes in many forms, and it looks different for each of us. There is no right or wrong way to self-care. If you are feeling like self-care feels overwhelming, especially in a time of tragedy, that is totally normal and ok. I would like to encourage you to remember to take it one step at a time. One small decision to self-care will add up over time. Maybe that looks like putting your phone down for 10 minutes or going for a small walk to get the mail or taking 30 seconds to practice deep breathing. Any forward movement, no matter how small, is better than no forward movement. Be kind to yourself, be kind to others, and reach out to a trusted therapist if you need extra support on your journey. 


Reparative Therapy?

Savannah Stoute

The Texas GOP recently adopted a party wide platform that includes support for voluntary psychological therapy targeted at converting homosexuals to heterosexuals. This is happening on the heels of a Judge in San Antonio, TX stating that it is unlawful for the state to rule against same sex marriage. Texas Republicans are simply stating that they will not pass any laws that will restrict a person from seeking reparative or conversion therapy. Rick Perry, Governor of Texas, recently equated homosexuals to alcoholics by comparing the genetic coding an alcoholic has to the genetic coding a homosexual has. The important thing to remember is that homosexuality is not a disease and it cannot be cured. There are many different views a person could take on this subject; Political, Religious, and Ethical. I’m not going to take a political or religious stance. However, I will discuss this topic from an ethical standpoint as a Licensed Professional Counselor Intern (LPC-I) in the state of Texas.

Ethical limitations of Reparative Therapy

First, reparative therapy is not a mainstream psychological treatment. There are no professional standards or guidelines that therapists must follow in order to practice reparative therapy. As with any therapeutic approach, there needs to be peer reviewed research studies. In order for a research study to be valid and reliable, other therapists need to be able to repeat those tests and get the exact same results. There has been one study that suggests that it was able to convert homosexuals to heterosexuals, however, even the psychiatrist that performed this study admitted that there was no way to measure his results. He relied solely on interviews with the patients. Robert Spitzer later wrote, “I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy.”

Dangers of Reparative Therapy

If a person is seeking Reparative Therapy, he or she is seeking treatment to “cure” their homosexual feelings and desires. As stated before, homosexuality is not a disease and cannot be cured. When a person seeks reparative therapy and has expectations to never feel attracted to a person of the same sex again, he or she can become severely disappointed with themselves. Feelings of failure, hopelessness, shame, are just a few things that can lead a person to severe depression. Reparative therapy implies there is something wrong with being attracted to the same sex. It’s important to know and accept that a person is born as a homosexual; therefore, there is no way to make a gay person straight. Just like there is no way to make a straight person gay. Learning to accept yourself and/or those around you that are homosexual can lead to a more authentic life.

Alternatives to Reparative Therapy

The only alternative to Reparative Therapy is traditional talk therapy. If a person is struggling with being a homosexual, it’s best that he or she seek counseling from a licensed therapist that practices one of the many available therapeutic approaches that have been proven and are not damaging to clients. Traditional talk therapy can be cathartic for clients. Once a homosexual client learns to accept him or herself, then he or she can begin to feel confident living as a homosexual person. The hope is that a client who was initially interested in reparative therapy will eventually love themselves enough that he or she will no longer feel the need to change.

If you are interested in learning more about the stance that Texas Legislatures are taking on Reparative Therapy, you can find many articles online. Texas Republican’s stance can be found here, while Texas Democrat’s recent stance can be found here. These are both local articles, but you can find varying point of views from national news outlets as well.

 

Guest Blogger:

This week’s guest blog post is by Savannah Stoute, LPC-Intern (Supervised by Leslie Larson, LPC-S). Savannah enjoys working with teens and adults that are experiencing grief and loss as well as the LGBTQ Community. You can learn more about Savannah and her work as a therapist by visiting our Therapists page.