The Benefits of Narrative Story Telling for Cancer Survivors, Caregivers and the Bereaved

For those who do not know, I am a contributor for the innovative online support network "Their Story is our Story," a unique way to connect to others who are cancer survivors, fighters, caregivers, supporters and bereaved. TSOS is story driven; healing is promoted through telling one's story. A bevy of research has shown the physical, emotional, and psychological benefits of writing out one's story. In this way, TSOS is a groundbreaking resource for anyone wishing to gain support. Read my article below:

“I’m just so scared right now, and you know, I’ve got no one to talk to about it.” It was my final day at my internship with St. Barnabas Hospice, and although I had just dropped in to finalize paperwork with my supervisor, I ended up talking to one new patient before I left. These were the words of a 57 year old man dying from lung cancer and unsure if hospice care was right for him.

Among his many concerns about his failing health, more than anything he wanted to have someone to talk to, to reflect with on his experience. As a hospice patient/family volunteer, I visited with individuals who were dying and work with family members living with a loved one with a terminal illness. At the heart of my visits was one simple sentence: “I’m here to listen.” Here was a man facing terminal cancer, and he realized that he had a story he wanted to tell before it was too late; the story of his life. All he wanted was an audience.

This is the message behind “Their Story is Our Story;” we each have a story to tell, whether we are survivors, currently diagnosed, care giving for a loved one, or grieving the loss of a family member or friend due to cancer. TSOS allows everyone to share their narrative of the events leading up to and including diagnosis, treatment, and everyday life. Most often, people wonder what will happen to them, why this is happening to them, and for those that survive their loved one, they wonder what the future will be like after his or her death. These are questions that, when addressed and explored with an empathetic listener, can lead to redefinition of oneself and strength in a community of others with the same struggles, and allowing everyone to put the experience in a context of their lives.

The process of creating a narrative story about cancer is not easy to do in our society. Traditionally speaking, our society does not want to hear about the harsh realities of cancer as they are often hard to hear. For those not involved directly, it is easier to deny or misunderstand the struggles one with cancer experiences. This attitude is extremely counterproductive to those who would benefit from support, understanding, and empathy. In a society that turns away from illness and death, it is difficult for those with cancer and death related stories to share them. TSOS is a safe place for everyone to share their stories and be heard.

The act of writing itself has therapeutic value as it allows a person to organize thoughts and emotions in a coherent story. Narrative story telling through writing gives an individual the opportunity to put his or her story into a framework of who he or she is, allowing him or her to explore his or her situation without risking social stigmatization, and producing a sense of manageability. Some narratives are motivated by restoration or the hope to regain normalcy. For others in a state of turmoil, narratives serve as an outlet for their emotions. Other narratives take the form of a journey in which the individual comes to term with their illness, making sense and meaning from his or her experience.  What can be perhaps most helpful is the opportunity to create a resolution to one’s story, which can be particularly important for life events which are emotionally distressing; a sense of resolution discourages rumination and puts an end to a cycle of negative thoughts.

TSOS is a unique place where people living with cancer, or those living with the aftermath of the devastating illness can share their stories in a safe and caring environment. Joining TSOS will provide you and your loved ones a sense of community through a virtual support group and sharing ground. Find comfort in knowing that you are not alone, and enhance your life through the benefits of sharing your story. We are here to listen.

Vicarious Trauma and Self Care

Vicarious trauma describes the fatigue felt by overextending oneself to be a help to others, particularly in working with or listening to trauma stories. This is most common in the helping professions such as counseling and social work, though when a national disaster occurs, this can also be felt by the public exposed to images and stories related to the event. 

Such can be the case with the one year anniversary of Hurricane Sandy. In my previous post, I discussed post traumatic stress disorder, and the common signs and symptoms. Those who experienced PTSD in the weeks and months following Sandy may still feel the lingering effects of those trying weeks. But what about those who were not as deeply affected? What about those who weren't impacted at all by the storm? These individuals, farther removed from the event, who are finding themselves feeling uneasy during this anniversary time are experiencing a normal response to exposure to graphic and emotional stimuli. Just as a counselor who spends hours a day hearing and empathizing with trauma survivors internalizes these struggles, so too can the person who is exposed to a barrage of news stories recounting the horror of last year's storm. 

If you find yourself annoyed or aggravated over the onslaught of images of destruction, or resistant to watching interviews of mothers who lost their children, and families who lost their homes, know that you are not being insensitive, but are rather having a very normal reaction. In the days to come, local news stations will continue to recount the events of last year in great detail, and we all may find ourselves thinking, "enough already."

How can you shield yourself from this vicarious trauma? For starters, not spending hours in front of your television or computer can be a powerful tool. Though this may seem common sense, it is often difficult to pull oneself away from graphic images, much like rubber necking on a highway. No one really wants to see others suffer, but a morbid curiosity inherent in us all keeps us pulled in. If media cannot be avoided entirely, either feasibly or logistically, be sure to take breaks in between your exposure to images, videos, and interviews. Take this time to focus on something completely different; engage in a manual activity, such as cleaning, to change gears from sitting and thinking to moving and doing. Take care of yourself in whatever way is most helpful; for some this is exercise, for others it is reading, maybe a hot shower or bath would help you feel relaxed and less stressed.

Again, while these suggestions may seem obvious, in times of stress we often forget to do the most basic things that keep us happy and healthy. As always, Current Counseling is here as a powerful tool for reframing, redirection, and information regarding your mental and emotional health.

Resiliency after Sandy

“Coming up on an anniversary of something like a traumatic event can ramp things up and people can feel highly anxious and depressed,” Dr. Rachel Yehuda, director of the traumatic stress studies division at the Mount Sinai School of Medicine in New York City, told FoxNews.com. “It’s a time where there is a natural spike in symptoms, especially on a first year anniversary.” (read full article here)

This day marks the one year anniversary of Hurricane Sandy, a massive storm that ravaged the east coast, primarily New York and New Jersey. The devastation was unforeseen, and images of the wreckage barely did justice to the true reality of the storm's destruction. Without electricity and heat for over two weeks, many people experienced traumatic events such as having to evacuate their homes, loss or damage to property, inability to leave their homes, and a dramatic change in lifestyle. For several, going to work was an impossibility, and the few routines that we use as anchors for stability were not feasible. In Staten Island, you could see people siphoning gas from others' cars, and across New York and New Jersey cars stretched out for miles at gas stations. An alien sight to many, people stood on lines with handfuls of plastic gas containers, hoping to get gas before it ran out. In the chilly October weather, thousands went without heat, many in flooded homes. And as soon as we began to recover, we were hit by a tremendous snowstorm, adding further insult to injury.

Given the dramatic images and experiences of Sandy, it is not uncommon that many people also experienced acute or post-traumatic stress disorder. In fact, vicarious stress was also common, as the images of the damage were quite shocking. Both acute and post-traumatic stress disorder (PTSD) share signs and symptoms. Acute traumatic stress disorder lasts for two weeks before resolving, whereas PTSD is considered if symptoms last beyond that. Some common symptoms of PTSD include:

• Be-experiencing the event through flashbacks, bad dreams, intruding thoughts
• Avoidance symptoms; staying away from places or events that are reminders of the experience, feelings of numbness, depression, or worry, difficulty remembering the event
• Hyper-arousal symptoms; being easily startled, feelings of tension, difficulty concentrating or sleeping
• In children, these symptoms may manifest in the form of bed-wetting, being unusually clingy, and acting out the event during play.

While a year has passed and many of us have gotten back to our normal lives, it is difficult to forget how badly Sandy impacted our lives. Despite restoration and rebuilding, the toll from the aftermath on our everyday lives even today is staggering. 

So how do we continue to take care of ourselves in the wake of tragedy, even into the future? It is important to be aware of any symptoms and/or emotions you may feel at this time. Heightened arousal and intrusive thoughts and memories are common during anniversaries of traumatic events. Some may experience a resurgence of sad or depressive symptoms which can range from mild to severe. Although this is a time in which bad memories may come back, it is also an opportunity to revel in our resilience. Despite the damage and continual losses faced, we have come together as families, friends, neighbors, and even strangers, to help one another in any way we can. Through the destruction, there was a common bond that was felt among the survivors, a bond that helped heal fresh wounds then and can support us now.

Countless research has shown that sharing our stories, particularly in writing, is incredibly therapeutic and useful in the healing process. With that in mind, over the next few days I am making myself available for anyone who wishes to talk about their Sandy Story. We can talk about what happened, how you made it through those troubling weeks, and how you continue to move forward. The comment section of this blog will also be used as a way for us to reach out to one another. If you wish to talk with me directly, you can email me at: jm18893p@pace.edu.

Do Values have any Value in this Country?

High School Student Suspended for being Designated Driver


A Massachusetts high school student had just finished her shift when a friend sent her a text messaging asking if she would pick her up from a party. The girl realized she was drunk, and had the wherewithal to ask a friend for a ride home. The driver, Erin Cox, picked up her friend as the police arrived to bust the party. Her high school has suspended Erin for even appearing at this party; despite the fact that she did not have any alcohol and that the police have corroborated her story, and despite the fact that she was not there as a party goer but rather a designated driver, the school recognizes no difference in her actions or the actions of those students who partook in underage drinking. As a school with a zero tolerance policy, there is no grey area.

When I first read this story, I was reminded of "The Heinz Dilemma" posed by noted psychologist Lawrence Kohlberg. Kohlberg held that there are three levels of moral thought, with a total of six steps from the first level to the highest level. He posed this scenario:

"A woman was near death from a special kind of cancer. There was one drug that the doctors thought might save her. It was a form of radium that a druggist in the same town had recently discovered. The drug was expensive to make, but the druggist was charging ten times what the drug cost him to produce. He paid $200 for the radium and charged $2,000 for a small dose of the drug. The sick woman's husband, Heinz, went to everyone he knew to borrow the money, but he could only get together about $ 1,000, which is half of what it cost. He told the druggist that his wife was dying and asked him to sell it cheaper or let him pay later. But the druggist said, "No, I discovered the drug and I'm going to make money from it." So Heinz got desperate and broke into the man's store to steal the drug for his wife.

Should Heinz have broken into the laboratory to steal the drug for his wife? Why or why not?^"

Kohlberg argued that whether a participant believed Heinz was justified in his actions or not was not important. What was truly important was why the participant believed this. It was the reasoning that participants came up with that was telling of their levels of moral thought. In a nutshell, Kohlberg devised three levels: Pre-conventional is best thought of as basing actions on rewards and consequences; "I will do this because I will be rewarded, I will not do this because only bad people do that." Conventional thought can be conceptualized as a dualistic view of behaviors; "Things are either right or they are wrong, and if the action is wrong, then it should never be committed." The final level is called Post-conventional thought, and is described as a means of thinking in terms of one's own moral and ethical values as opposed to what society deems as right or wrong.

Why should you know this? Well, for anyone who has young children in their lives, teaching children appropriate from inappropriate behaviors is very important. However, we also know that behavior typically not allowed is allowed in certain situations. You may tell a young child that she is not permitted to use the phone without permission, but in the event of an emergency she should absolutely call 9-1-1. And so as responsible adults we hope to guide younger generations away from an dichotomous view of absolute right and wrong, and foster an ability to decide what is right for themselves (when they are old enough, of course).

This brings us to Ms. Erin Cox. Her high school's zero tolerance policy holds that any activity related to underage drinking is wrong and will not be tolerated. This means that the girl who offered a sober driver is as guilty as the teenagers engaging in underage drinking. Regardless of her actions, Erin would have been engaging in some undesirable behavior and have to deal with certain consequences; breaking a school rule will result in suspension, loss of honors and privileges that she has worked hard to earn. Should she have knowingly allowing an intoxicated young girl to remain at a party with other drunk teens?  What would you have told your child to do?

I am seriously troubled at where our society is going. On the west coast we have teenagers (with adults in their lives who allow them to) get drunk and destroy a man's home without repercussion, and on the other side of the country a school punishes a girl for acting responsibly. While it's nice that some of us recognize the absurdity of these situations, acknowledging these issues alone is not stopping them. This is a very disturbing trend that seems to be pervasive on even small levels. When was the last time you went to a store and saw a young child behave inappropriately and wonder to yourself how his/her parent just allows the child to act out in that way without saying anything? How many entitled teenagers and young adults do you know that just expect the world to be handed to them? Is there a place for values in today's America?

Navy Yard Shooter Suspected of Mental Illness

Aaron Alexis Heard Voices

As my essay in "Counseling Today" noted, perpetrators of heinous shootings are often confirmed or suspected of having a mental illness. This raises many questions about what it means to be mentally ill, and the possibility of legislation that will require greater surveillance on individuals who are deemed potential threats. With every new tragedy that rattles this country, the sense of urgency to act grows immensely. Is the answer to separate the mentally ill from the rest of society? Do we force everyone to have psychiatric evaluations? Do you force doctors, teachers, and other professionals to report to the government any suspicions of troubled individuals? And what will be done with that information? Will these individuals lose their right to privacy? Will their freedoms be limited in order to ward off potential harm? Do we further stigmatize an already vulnerable population without any substantial threats, but rather hunches that are made by people who are not trained to recognize true mental illness?

 Is the answer to ban guns in totality? Some argue that without guns, these types of mass murders will not happen. This begs the question of whether or not it was the access to guns in particular that preceded such acts, or whether these acts are more of a result of the illness itself; would individuals who are very sick still act out if guns were not so accessible? Would they turn to other lethal methods such as homemade explosives, which have been used with some ease by others in the past? What is the overlap between those exercising the right to bear arms, and those who are likely to commit murder based on a mental illness? How many individuals out of the entire population of the mentally ill have committed murder? Despite the severity and seemingly frequent occurrence of these acts, with 1 in every 100 citizens being diagnosed with Schizophrenia, and roughly 25 in every 100 meeting the criteria for Depression (the two most frequently cited mental illnesses when these murders have been committed), it is clear that the diagnosis of mental illness alone is not enough to accurately describe those who would commit such horrendous shoot outs.

So what is the answer? I do not know, and it is safe to say that in realizing how many questions are raised for both of these popular solutions, this area is severely bereft of research. Acting on emotions rather than facts run very serious risks whether it is limiting the civil liberties of the mentally ill in particular, or taking away liberties of an entire nation.

I want your opinion. If you were in power, what would you do? What would you like to see happen?

A Day of Rememberance.

For many of us, this day always brings back visceral memories of where we were when we heard, how we spent the following hours, days, weeks, and a deep sense of pain and humility. Who among us was not affected by the events on that day? How did we cope, as individuals, as families, as communities, with the unimaginable death toll and reality of horror? On that day 12 years ago, it might have been impossible to imagine a future. However, here we are, together, continuing to make the lives of those lost a blessing.

This day undoubtedly impacts us each in different ways. Some people may feel a sense of anxiety or heightened awareness as they go about their daily routine. Others may feel sad, or confused. Some people may glue themselves to the television and news websites, soaking in every report, every testimonial, every memory. And others still may wish to avoid this topic all together.

However this day affects you, let yourself feel it. Do not fight against your feelings, even if you feel nothing; you do not need to break down and cry as a sign of respect for those we've lost. You may show your support by continuing to live your life and enjoy the freedom that our country stands for. If you or someone you know is feeling particularly emotional, make yourself available to release these emotions, whatever they be. There is no right or wrong way to feel today, there is only the opportunity to support one another as old and nightmarish memories resurface.

It has been shown through narrative therapy that the retelling of one's story is particularly helpful in processing traumatic events. No matter where you were, how old you were, or how personally you were affected, I invite you to share your stories here, in a safe and comforting space.

You can read more about the counseling for 9/11 related issues here.


God Bless America.

Breaking Stigma: Depression

How many times have you heard a friend say, "I feel so depressed," when describing an unfortunate situation? Have you ever used this term to describe yourself? The frequent use of the word "depression" as a feeling or emotion has lead to a misconception of the seriousness of this mental illness. In this part of the "Breaking the Stigma" series, I will focus on clinical depression, and my thoughts on why it can be so difficult to understand why people can't just snap out of it.

Quite often people will say that they feel "depressed" when they are really sad, upset, down in the dumps, etc. What distinguishes depression from these feeling words are clinical symptoms that, when recognized by a professional, leads to a diagnosis and (hopefully) course of treatment. That being said, it is estimated that 10% of Americans are currently suffering from clinical depression. Take a look at how the Diagnostic and Statistical Manual (DSM-IV) outlines the symptoms of clinical depression*:

• Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.
• Mood represents a change from the person's baseline.
• Impaired function: social, occupational, educational.
• Specific symptoms, at least 5 of these 9, present nearly every day:
      1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective         report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
      2. Decreased interest or pleasure in most activities, most of each day
      3. Significant weight change (5%) or change in appetite
      4. Change in sleep: Insomnia or hypersomnia
      5. Change in activity: Psychomotor agitation or retardation
      6. Fatigue or loss of energy
      7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
      8. Concentration: diminished ability to think or concentrate, or more indecisiveness
      9. Suicidality: Thoughts of death or suicide, or has suicide plan
*taken from this rating scale

Clinical depression and depressive episodes are much more serious and pervasive than deep sadness. Oftentimes, people suffering from depression need professional help in the form of counseling and/or medication, and in extreme cases, electroconvulsive therapy (ECT). Now, before you get the image of Jack Nicholson in "One Flew Over the Cuckoos Nest," let me assure you that ECT is not at all what it was decades ago. This life saving treatment is painless and can be done on an inpatient or outpatient basis. I tell you this to further indicate how serious depression really is, and why it is so important for us to take it in earnest.

In my work, I have frequently heard clients say that they just don't know how to "snap out of it," and why, despite many blessings in their lives, they still feel hollow and sad. They come in for treatment because their loved ones "don't want to hear it anymore, they just don't understand." Allie, the author/creator of Hyperbole and a Half** writes a strikingly accurate depiction of what an individual with depression goes through. Her illustrations for "Adventures in Depression" parts one and two reflect her own experiences with depression. Part one poignantly shows the self-hatred many people with depression feel, along with amotivation, feeling "sad and hopeless for no reason," and the internal monologue filled with put downs. In part two, her example of growing out of playing with toys is an excellent metaphor for the emptiness that comes with depression, the feeling of nothingness, the absence of feelings. She also shows her loved one's reactions towards her depression, again, hitting the nail right on the head with the frustration one feels when he or she is not understood. Her humorous depiction of how people offered her solutions to a problem she didn't have again is reflective of the things we tell depressed people; "You have so much to be happy about, just focus on that...just force yourself to get out more...why not have a positive mantra to repeat every morning..." While these may be helpful suggestions to some, to someone in the depths of depression, these statements come across as not understanding. She writes, "Hating everything made all the positivity and hope feel even more unpalatable. The syrupy, over-simplified optimism started to feel almost offensive." 

 So why can't people just snap out of it? It's because often the depression is not related to or goes beyond a sad event; depression isn't about being sad something happened, it is a complete disconnection from the world of the living. There can even be a resistance to getting well: think of quick sand. Once a person is in a depressive episode, there is a strong undercurrent of hopelessness, apathy, and sadness. This makes for a dangerous combination, and a difficult barrier to break. It can lead to suicidality. The topic of suicidality is too indepth to explore in this entry, but suffice it to say that all thoughts of suicide or self harm should always be taken seriously. In Allie's story, her depression is resolved with talk therapy and medication. Anyone who is feeling depressed should seek professional treatment, and not rely on suggestions from non-professionals. 

How can we be helpful to those who suffer from depression? Remember the earlier statistic that about 1 in 10 adults in this country are currently struggling with some of these issues. Chances are you know someone who is or who has struggled, or perhaps you have battled depression yourself. It is my belief that having loved ones who are unfamiliar with depression can be a barrier to treatment. In my previous entry in the "Breaking the Stigma" series, I discussed the importance of self-awareness and compassion in those who know someone with a substance abuse problem. The same goes for depression; when everyone is on the same page regarding treatment, everyone does better. It can be very difficult to understand why someone who seems to have everything going for them suddenly is depressed. Maybe it's a genetic predisposition, maybe they are always putting themselves down, maybe it's something else that preceded the depression. Do not focus on that! That is not helpful to the person suffering, and those questions are best left to professionals.

What May be Helpful:

Listening, validating the individual's feelings; indicate that you hear the pain they are going through and acknowledge it as a legitimate struggle. 

Encourage the individual to seek professional treatment and maintain treatment once it has started.

Be patient with those who have depression, even with treatment the symptoms may not subside for weeks. 

Do not ignore the person because you don't want to hear them. It is understandable that you may feel burnt out or brought down by spending a significant amount of time with someone who is depressed. Remember that this individual has come to you because he or she trusts you. To cut off that person all together can be further stigmatizing. 

 Do not force your loved one to do anything he or she does not want to do. Treatment planning should always be done with a professional, not done to a person. While medication may be the most popular treatment currently, there are specialized therapies and other treatments that he or she may want to utilize. Allow him or her to explore all options, and be supportive of his or her decision.

Do not ignore any indications of self-harm, harm to others, or thoughts of suicide regardless of your belief of their truthfulness. 

Recommended resources:
NAMI.org for more information
The Dawn Room - A wonderful website for anyone feeling sad
National Suicide Prevention Lifeline

**All rights reserved for the creator of "Hyperbole and  a Half." 
Please remember, as with all posts, this post is not intended to diagnose or treat any mental illness. 

Neurological Responses to Social Media: Implications for the Future

In Buzzfeed's recent post, "How Surfing the Internet Mimics Daydreaming in Your Brain*," Jennifer Malise explores the neurology behind our sometimes euphoric response to browsing the internet. As Malise notes, there is a specific part of the brain known as the basal ganglia that, when activated, releases dopamine. This neurotrasmitter is associated with pleasure and rewards, and when it is released will motivate individuals to repeat the behavior that releases said chemical.  The release of dopamine has been linked to addiction, and Malise postulates that this may be this can result in a desire to continue web browsing. It is my hypothesis that this in fact leads to compulsive checking and rechecking of social media sites that will have a serious impact on our society.

The Link Between Dopamine and Addiction
To illustrate how powerful dopamine is, consider individuals who are addicted to opiates such as heroin, oxycodone, and oxycontin. These drugs release large amounts of dopamine when ingested (up to ten times the normal level), and when those levels begin to subside, there is an overwhelming urge to continue use of the substance in order to regain those levels. When drug addiction is concerned, the continued use of opiates eventually desensitize the neurons in the brain that are affected by dopamine, and increase amounts of the drug are needed.

The Link Between Being Online and Daydreaming
When you let your mind wander and get lost in a daydream, do you often find yourself smiling? Relaxed? Calm? This break we take from the everyday hustle and bustle actually allow us to utilize other areas of the brain (think of the logical left brain versus the creative right brain), and in particular, our basal ganglia is activated. The relaxation we feel when we browse the internet, then, is similar to the serenity we find in daydreaming, and is caused by the release of the pleasure increasing dopamine.

The Potential for Internet and Social Media Addiction
While the levels of dopamine released from internet usage is not nearly as high as that of opiate usage, there is still evidence that enough of this neurotransmitter is released in order to motivate individuals to continue to remain online. And as Malise notes, when those levels begin to decline, we are inspired to act in a way that will again release a happy feeling. For an addict, that action is using. For internet browsers, it is finding a new website, or re-checking already viewed websites.

What are the Implications of All of This: My Opinion
When we consider websites that are updated frequently, social media sites immediately come to mind. These are sites that are updated within seconds of your most recent view. If looking at these sites results in a happy feeling, then re-checking these sites multiple times will lead to more of that happy feeling. We all know someone who is "attached to their phone," constantly checking who has updated their status, who has "liked" their posts, and rushing to update their own site. It is my belief that the "high" felt from this web-surfing is not limited to the internet, but can extend to the use of smartphones, particularly for texting.

Consider the most basic definition of addiction: continued use of a substance or a behavior despite negative consequences.  Many teens and young adults have continued to spend hours of time on social media sites despite declining grades in school, fewer face to face interactions with peers, and impaired social and communication skills. Other negative consequences can include loss of privileges from parents if internet time exceeds an acceptable amount of time. For adults, it is not uncommon for individuals to be written up at work for having their cellphones on them while on the job, despite knowing that this is strictly prohibited. These may seem innocuous, but I encourage you to consider many car accidents have been caused by distracted driving, particularly texting while driving. Furthermore, many recent suicides of young adults have been precipitated by bullying via social media sites. Even those who are victims of cyber-bullying, social media remains a large part of their lives.

We are heading towards a society that is ruled by social media, and those who spend the majority of their day updating and checking these sites have become the norm rather than the exception. The consequences of such a shift in communication and lifestyle can be imagined, but without research, we cannot predicted how we will be effected. Studies in this area are scant, and it is my hope to bring the importance of this topic to the surface with my own research.

I Want to Hear From You!
 Do you know anyone in your life who can't seem to separate from their computer or cell phone? Do you feel as though you yourself have a difficult time walking away from the internet? What consequences, if any, have you experienced? What consequences do you think the frequent use of social media will have on our society?


*This blog is not associated with Buzzfeed. All material referenced in "How Surfing the Internet Mimics Daydreaming in Your Brain" belong to Jennifer Malise.

Breaking Stigma: Substance Abuse

"Image courtesy of Baitong333 / FreeDigitalPhotos.net".

In light of the recent death of "Glee" cast member Cory Monteith, the first part in my series of "Breaking Stigma Through Understanding" will focus on substance abuse. Television shows such as Dr. Drew's Celebrity Rehab and Intervention often paint a picture that addicts/alcoholics can be turned around in a short period of time with intense inpatient work.  This is a gross misrepresentation of the story of addicts/alcoholics who struggle to stay sober for years after initial treatment and cause confusion when individuals relapse, sometimes for the very last time. The story of Cory Monteith is not unlike that of many individuals who have struggled with substance abuse. This article hopes to help readers understand the complicated nature of the disease, and address why inpatient treatment alone is not enough for recovery.

The vast majority of research that has been conducted in this field supports the medical model of substance abuse, holding that the disease is not purely psychological, but that this disease is hereditary, has genetic markers, and that individuals with the disease have biological differences in the way their bodies process substances.

Now, imagine your loved one has been diagnosed with diabetes. Due to the nature of this disease, your loved one's body is unable to regulate blood sugar levels without medication and strict dieting. Sugar levels must be monitored daily, and his or her lifestyle has to change forever in order to avoid serious medical complications. Now imagine that you do not help your loved one learn what to eat and what not to eat. You make no changes in your lifestyle; in fact, regardless of knowing that your loved one can't have sugar, you continue to buy sugary foods because that individual is an adult and should be able to control themselves. You bargain with your loved one; "Okay, you can have one night a week where you eat unhealthy foods," but when one night turns into two or three, you are outraged. You are confused by your loved one's behavior...if he or she didn't want to be diabetic anymore, wouldn't they just do what he or she is supposed to?

So many who have never dealt with substance abuse themselves cannot imagine why anyone would continue to use drugs or drink when there are so many negative consequences. In my work at a substance abuse recovery center, I have worked with thousands of individuals and their families. Family members are often stunned when their loved one relapses despite being given tools to help them stay clean while in treatment. A big issue with their mindset is believing that a stay at a rehab is adequate enough to help an individual maintain long lasting sobriety without continuing treatment, and without any lifestyle changes from those around them.

Can you imagine yourself telling your diabetic loved one that he or she should be able to maintain a healthy blood sugar level simply through will power? Can you imagine what your diabetic loved one must think and feel when cakes, cookies, soda, and other non-diabetic foods are easily accessible in his or her own home? For those who have no direct experience with substance abuse, this analogy has been used by many in the field to illustrate the complicated nature of substance abuse. It is not a disease of will power; it is a biological disease, and despite any claims you have seen on television, there is no "cure." Recovery takes a tremendous amount of work to obtain, and an equally demanding effort to maintain. Remember, addiction effects the entire family. At times, the addicted individual distracts the family from larger issues. All members of the family must change along with their loved one; recovery works best when everyone is active.

Individuals who think they may have a loved one dealing with substance abuse can help in the following ways:

-Remaining non-judgmental and not accusatory are very important. Despite undesirable behavior, the individual may be experiencing serious problems emotionally, physically, and psychologically. A gentle and loving approach will be more helpful in working with your loved one. Let him/her know you are on his/her side.

-Examine the ways you may be enabling the drugging/drinking. Do you have substances that are easily accessible? Do you give in to outrageous demands or addictive behaviors to avoid confrontation? Have you gone back on promises designed to help the individual stop using (i.e. have you threatened to not allow the individual to live with you if the behavior continues, but you have not kept to your word)?

-Educate yourself on the nature of substance abuse and codependency. Attending an Alanon/Narcanon meetings have been shown to be helpful for family members dealing with an addict/alcoholic loved one. Carrier Clinic offers a free Codependency program every Saturday and Sunday from 10am - 1:30pm.

-Get help for yourself! Everyone does better when everyone is in treatment. 

- Visit The Substance Abuse and Mental Health Services Administration here for more resources

Breaking Stigma Through Understanding

Roughly 25% of Americans will face a mental illness this year. Mental illness can carry with it a huge stigma. Most often this stigma arises from being labeled as "mentally ill," or having been given a specific diagnosis. Some individuals feel as though a diagnosis is helpful; I have  heard in my work a sense of relief when being diagnosed, as though there is a reason for an individual's inability to control and understand her/his behavior. I have also worked with clients who resented having been diagnosed, and explored with them the consequences of having a "label." In the future, this blog will explore in more detail how diagnoses are made, who is qualified to make such diagnoses, and in what capacity a diagnosis exists in comparison to a physical disease. In celebration over the newly published Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, I will be highlighting some of the more commonly encountered and misunderstood mental illness diagnoses. These posts will not be intended to diagnose individuals, but rather begin to correct misconceptions and myths of mental illness and begin to break down the walls of stigma.

If there is a diagnosis or disorder that you have heard of and wish to know more about, please comment below!

Why Must Counselors be Advocates?

"Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net".

Many believe that counselors should be advocates for their clients. However, if this is done, it must be done so in a way that does not impart a counselor's own beliefs, political views, and religious practices onto one or more clients. This can be a challenge as there are many hot-button social issues that have political ramifications in today's America, and many individuals have very strong, yet polarizing beliefs. A counselor who publicly shows support on either side of a political issue at the behest of advocating for a client runs the risk of alienating other clients whose views differ. Though this is the case, counselors must not sit on the sidelines while legislation is proposed and passed that will have an impact on their clients. This was the topic of my first publication, an essay on counselor advocacy.

The following was published in the May 2013 issue of Counseling Today as the grand prize winner of the American Counseling Association's Foundation’s Graduate Student Essay Competition supported by Gerald and Marianne Corey and Allen and Mary Bradford Ivey. 

"Why must professional counselors accept an advocacy role in representing the interests of clients and becoming actively engaged in creating and supporting public policy initiatives that advance the role of counseling in addressing those interests?"

               In the wake of the highly publicized shootings in Connecticut and Colorado, it feels as though we have entered into an era where acts of violence are commonplace. Following such incidents, it is normal for people to search for answers and feel a sense of urgency to act. In response, there have been actions taken by the government in order to prevent future incidents; both firearms and mental health have been the focus of recent legislation. However, focusing policies on a specific group of people runs the risk of turning them into scapegoats.  Sensationalized news stories can create wildfires that paint the mentally ill as dangerous, ticking time bombs that must be closely monitored. Since the perpetrators of many recent shootings have been postulated to have suffered from mental health issues, this characterization of mental illness may seem realistic to the layperson. This in turn can lead to policies and laws being passed at the behest of the uninformed public that alienate those who are mentally ill and those seeking mental health services. In this respect, counselors must play an active role in advocating for this population, ensuring that legislation regarding mental health or illness does not infringe upon their right to privacy.

                Perhaps the biggest concern with recent policies is the ability of mental health providers to assure client confidentiality. The turnkey of the Tarasoff case ruling on duty to warn and protect was that of specific targets being threatened.  A bill recently passed in New York expanded on this mandatory reporting, requiring mental health professionals to report potentially dangerous clients. Additionally, following recent shootings, it was determined that HIPAA allows medical doctors who believe a patient is potentially dangerous are protected and encouraged in disclosing client information, including mental health records, to law enforcement officials. The goal in such legislation is to prevent violence from occurring by screening potential perpetrators. However, what exactly constitutes a potential threat is not clear, and the result of releasing a person’s medical and mental health history are not mentioned. In effect, medical professionals inexperienced in the area of mental health will be asked to make a discretionary decision to release sensitive information to individuals also untrained in the intricacies of mental illness. Furthermore, the potential backlash of not reporting an individual who goes on to commit a crime may encourage over-reporting and result in a prejudice against those with a history of mental illness. While this is being done as a means of prevention, it may discourage anyone with troubling thoughts to seek help. As counselors, we encourage clients to share thoughts and feelings that individuals may not feel safe sharing with anyone else.  While understanding that there are limits to confidentiality, it is not clear where professionals draw the line in regard to the potential for future harm. As professionals, we must advocate for the privacy and protection of our clients and assure that legislation passed will not jeopardize the ability for people with mental illness to receive services in confidence. 

Welcome to Current Counseling!

Welcome to my blog! My name is Jenna Meyerberg, I have my Masters in Mental Health Counseling and am currently pursuing my PhD in Counseling at Pace University in New York. Having worked in the field in various settings, I have seen first hand how people have struggled with stress, depression, and anxiety. These issues are further complicated by the stigma of seeking out services, the regulations imposed on providers, and the restrictions placed on available services by state and federal governing bodies as well as insurance companies. Often times the services that individuals receive take a back seat to advocating for oneself a midst legal and social roadblocks. This blog will serve as your guide to the ever changing field of counseling and the direct impact changes in legislation and social issues will have on your everyday life. Welcome to Current Counseling!