Navigating the Holidays Therapeutically

We know that the clinical data and real life clinical experience clearly support the unfortunate truth that these seasonal holidays bring many clients heightened anxiety, depression, and thoughts and actions of harm to self and others. This phenomenon has been occurring regularly for decades, if not centuries. While we know that some is related to the nature of the actual season itself (i.e. the shorter days of daylight), it is thought that the holidays themselves also contribute to this rough period of time experienced by so many. The expectations of joy and giving often becomes burdensome to those who feel limited on material funds or sources of happiness in their personal lives.

Another area that creates tension for many is the interpersonal context of the season, or more specifically, family. The holidays bring with them some Hollywood, picture-perfect ideals of family get-togethers and, as we know all too well, they’re not always that way. Conflicts and feuds, old and new collectively, intensify and heighten the probability and noted occurrences of domestic violence in the midst of attempted festivities. Illness, physical or mental, or losses, such as divorce or death of a loved one, in the family can produce clouds of sadness and despair. Many do not have any family at all. So trying to create joy around these real life situations are increasingly challenging, if not seemingly impossible, depending on the freshness and intensity of the circumstances.

So therapists have a greater responsibility during these times. It rests upon us to have keener awareness to the possibilities of more difficult and, perhaps, more dangerous times for our clients. We need to more diligently assess for suicidal and/or violent ideations and be prepared to intervene swiftly and effectively as needed. Obviously, this season can and does also cause more stress for us as healers. Therefore our wellbeing is even more vitally significant than usual. As we teach our clients how to be more kind and gentle to themselves and those they love, so should we carefully listen to our own words of wisdom. May this season bring all of us peace and calm reassurance that we are valued.

 

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Exploring Beneath Addiction

In the last several years it has become more and more clear in the media as well as within the mental health profession that addiction has become an out-of-control epidemic, especially addictions to meth, opioids, and heroin.

I supervise post-grad interns who work with this population (addicts of all substances), many of whom are homeless and/or ex-incarcerated. Most of these clients have years, if not decades, of addictive patterns of behavior well established, such as lying, cheating, and portraying some level of aggression or passive-aggressive behavior. Many are dually diagnosed with other mental illnesses and have suffered various traumas during the course of their lives.

These entrenched behaviors often become like masks or shields for the people living inside of them, seemingly impenetrable to those working with them. So many layers of harm from others, self harm, and harm done to others are woven into the horrific disease of addiction, that it seems extremely difficult to unravel and find the human being strangling inside.

Exploring beneath this quagmire of addiction requires the willingness to suspend judgment and presumptions about the limitations of hope placed on or by this person. Societal norms and personal records of misconduct have put boxes of low expectations on addicts. To find the real people hiding in these boxes is the primary challenge of therapy, as I see it. As we go about the careful process of doing so, we need to help that person exposed learn to not be afraid of who he or she really is, but to have the courage to heal and embrace the broken goodness within.

 

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Disasters and Mental Health

I live in Austin, Texas, and we just got our toes dipped in a small part of Hurricane Harvey, but we also watched from the sidelines as our friends and family in Houston and coastal areas were slammed by the terror of the possibility, if not the reality, of losing everything—homes, cars, and belongings, along with memories and a sense of security and safety.

It is this latter concept of losing security and safety which I think is the hardest to cope with psychologically. Having experienced such devastation in such short order is clearly and literally “having the rug pulled out from beneath your feet.” To have this done in such a large scale is further disorientating and catastrophic. Fear and shock dominate the psyche. Knowing where, or having the capacity, to begin to move forward is blocked by the enormity of insecurity.

Will life move on? Of course. But it will not look or feel the same for a very long time. That’s where mental health professionals come in. The trauma endured by so many in these circumstances is much more indelible, beyond the first few weeks or months. PTSD will be prevalent for many for years to come.

Recovery mentally will be a much slower process than regaining physical and financial losses. Feeling safe again is the struggle. The job for therapists, therefore, is to begin the process of recreating safety and security for our clients who have had such trauma.

It is my belief that we can best do that by honoring them as full human beings who have lost so much, rather than just “refugees.” The differentiation I’m making here at first glance may seem subtle, but categorization and labeling is an easy pitfall. This is even more pronounced when we are working with the poor or indigent. Human nature can often trick us into the trap of stereotyping, albeit unwittingly. But intentional acceptance and focusing on a respectful framework allows us to move in a way that can create safety for everyone we serve.

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.