Monday, July 30, 2012

Recovery Checklist

The Empowerment and Recovery Model assumes that we are ALL in recovery from something at some point in our lives - illness, trauma, childhood abuse, mental illness, addictions, multiple stressors, etc.  Growth in recovery is possible by sticking to concepts like honesty, acceptance, nurturing, affirmation, approval, empowerment and love.

Review this recovery checklist to identify your strengths and weaknesses.  Use it to set your own recovery goals.

  • Maintaining appropriate daily routine
  • Setting and achieving daily and long-term goals
  • Personal care
  • Setting and sticking to limits with children and others
  • Constructive planning
  • Appropriate decision-making and problem-solving efforts
  • Choosing behaviors
  • Well-rested
  • Resentment-free
  • Accepting (versus denying)
  • Not controlling others nor feeling controlled by them
  • Open to appropriate criticism and feedback
  • Free of excessive criticism of self and others
  • Gratitude versus self-pity and deprivation
  • Responsible financial decisions (not over- or under-spending)
  • Not escaping or avoiding through work or sex
  • Self-responsibility (versus scapegoating and blaming)
  • Valuing wants and needs
  • Free of victim self-image
  • Free of fear and anxiety
  • Free of guilt and shame
  • Free of worry and obsession
  • Not feeling excessively responsible for others
  • Faith in Higher Power
  • Trusting and valuing self
  • Making appropriate decisions about trusting others
  • Maintaining recovery routine (attending support groups, et cetera)
  • Mind clear and peaceful; logical thinking; free of confusion
  • Feeling and dealing appropriately with feelings, including anger
  • Appropriately disclosing
  • Reasonable expectations of self and others
  • Needing people versus NEEDING them
  • Feeling secure with self; self-affirming
  • Communicating clearly, directly, and honestly
  • Balanced mood
  • Maintaining contact with friends
  • Feeling connected and close to people versus lonely and isolated
  • Healthy perspective; life looks worth living
  • Not using alcohol and medication to cope
  • Having fun, relaxing during leisure activities, enjoying daily routine
  • Giving appropriate positive feedback to self and others
  • Getting - and allowing self to believe - positive feedback


from Beyond Co-dependency: and getting better all the time by Melody Beattie

Rules for Self-Care (vs. Co-dependency)

In order to be a healthy person, in order to be who we are - to embrace our God-given personal power and protect our human, mental, emotional, physical and spiritual rights, we may need to replace "rules" that keep us co-dependent (to our partner, family, job or friends) and practice new rules for self-care:

  • It's okay to feel my feelings and talk about them when it's safe and appropriate, and I want to.
  • I can think, make good decisions, and figure things out.
  • I can have, talk about, and solve my problems.
  • It's okay for me to be who I am.
  • I can make mistakes, be imperfect, sometimes be weak, sometimes be not so good, sometimes be better, and occasionally be great.
  • It's okay to be selfish sometimes, put myself first sometimes, and say what I want and need.
  • It's okay to give to others, but it's okay to keep some for myself too.
  • It's okay for me to take care of me.  I can say no and set boundaries.
  • It's okay to have fun, be silly sometimes, and enjoy life.
  • I can make good decisions about who I trust.  I can trust myself.  I can trust God, even when it looks like I can't.
  • I can be appropriately vulnerable.
  • I can be direct and honest.
  • It's okay for me to be close to some people.
  • I can grow and change, even if that means rocking a bunch of boats.
  • I can grow at my own pace.
  • I can love and be loved.  And I can love me, because I am lovable.  And I'm good enough.


from Beyond Co-dependency: and getting better all the time by Melody Beattie

Thursday, July 26, 2012

Evidence-Based & Empirically Supported

I am reading journal articles again!  I came across these helpful definitions.  I will refer to them again and again and watch as they change.  That's how it is when we are trying to understand reality.

Empirically supported treatment (EST) - The criteria for EST have been established by the American Psychological Association (APA).  The APA defined EST as possessing the following criteria:
The treatment must:
(a) possess a no-treatment control group, alternative treatment group or placebo and
(b) include a treatment manual, treatment for a specific population, outcome measures, and data analysis.
Three possible types of EST:
1) "Efficacious" is defined as any EST "superior in two or more independent research settings
2) "Possibly efficacious" is used when one study shows superiority as long as conflicting evidence fails to exist
3) "Efficacious and specific" means the treatment is "statistically significantly superior to placebo or alternative bona fide treatment in two or more independent studies"
Empirically based treatment (EBT) - A more recently labeled term connotes specific interventions or techniques that have proven effective with specifically defined symptoms or syndromes. For example, the use of cognitive-behavioral therapy to treat generalized anxiety disorder has been found through outcome data to be effective.

Evidence-based practice (EBP) - this term is often used in the discussion of the link between research and clinical practice, describes a broader process of using research findings, client needs and preferences, and therapist skills and training to plan the treatment of a specific client presenting with a specific set of problems.

Kim, J.S., Smock, S., Trepper, T.S., McCollum, E.E., Franklin, C. (2010).  Is Solution-Focused Brief Therapy Evidence-Based?  Families In Society:  The Journal of Contemporary Social Services, 91(3), 300-306.

Wednesday, July 25, 2012

Recovery & Love

Recovery (from co-dependency) is a healing and spiritual process.  It's also a journey, not a destination.  We travel a path from self-neglect into self-responsibility, self-care, and self-love.

I've learned that self-care isn't narcissistic or indulgent.  Self-care is the one thing I can do that most helps me and others too.

My relationships have improved with family, friends, other people, myself and God.  Right now, I'm working on the toughest lesson I've ever had to master.  I'm learning how to let others love me, and how to allow the "good stuff" to happen in my life.  I'm learning how to let God love me.  And I'm learning to love, really love, myself.

--Melody Beattie

Energy Healing

I have benefited greatly from Energy Healers.  I can't explain how this works but I stumbled on this description of the benefits and share them with you now.  I have provided contact information to an excellent healer in the tab on this blog above called, "Referrals."  You deserve to be well. Take care of yourself.
1. Brings about a state of deep relaxation and relief from stress.
2. Calms the mind, the nervous system, balances the subtle energy body and clears the auric field.
3. Assists the physical body's natural self-correcting healing mechanism in the release of stress.
4. Stimulates the immune response in the body.
5. Creates a state of openhearted receptivity and mental clarity.
6. Eases emotional trauma.
7. Can act as a preventative measure to physical illness and facilitates healing of illness and surgery.
8. Provides a sense of holistic wellbeing and integration of the body, mind and spirit.
9. Stimulates the nervous system and the subtle nervous system.
10. Clears blocked and stagnant energy from chi meridians facilitating health.

Sunday, July 22, 2012

Too Much, Too Soon

In our rush to connect,  we may try to get the client to reveal themselves and tell their story - too early. 

"We'll get to know your story over time."  This is what my gifted therapist friend, Michelle Post, says to her clients.

If we allow or urge our clients to open up too much, it may leave them feeling too vulnerable and embarrassed.  So much so, that they may not even return.  Or we may find them acting out after our tell-it-all session.

As beginners, we may feel a satisfaction in getting our clients to trust us so much and so early on.  As if it were a sign of our skills or successful engagement with them.  But it is not all about us. It does not have to be the way we feel good about ourselves as (anxious) beginning clinicians. 

As tempting as it may be to get to catharsis and insight in the first session, please resist.  Baby steps.  Pace yourself.  All in due time.  Rome was not built in a day and all that jazz.   Make sure there is plenty of support both in the therapeutic relationship and in the client's relationships outside of the therapy session.  It takes a lot of resources to heal.  This is not a race. Build up first.

About Relationships

“We’re all seeking that special person who is right for us.

But if you’ve been through enough relationships, you begin to suspect there’s no right person, just different flavors of wrong.

Why is this? Because you yourself are wrong in some way, and you seek out partners who are wrong in some complementary way.

But it takes a lot of living to grow fully into your own wrongness.

And it isn’t until you finally run up against your deepest demons, your unsolvable problems—the ones that make you truly who you are—that we’re ready to find a lifelong mate.

Only then do you finally know what you’re looking for.

You’re looking for the wrong person.

But not just any wrong person: the right wrong person—someone you lovingly gaze upon and think, 'This is the problem I want to have.'”

 -- Galway Kinnell

Saturday, July 21, 2012

Economic Self-Care


I know we give a lot of lip service to self-care.  The rationale for self-care is commonly accepted, for the most part.  There is still some resistance to the idea – it seems “selfish” vs. “selfless.”  Balance and moderation is a good guide.



I have written many posts about my particular recipe or routine for self-care - hard-won knowledge from trial and error experience.  My self-care efforts have kept me in the field – fresh and strong – since 1989.



Now I realize that none of those wonderful things on my list are possible without attending to economic and spiritual self-care.  Ultimately, self-care is about attending to our mind-body-spirit.  How we make and spend money is a reflection of the state of our mind-body-spirit – it is a bidirectional relationship (goes both ways).


Living below my means and doing what I am passionate about have been some of the most valuable self-care decisions.

I don’t compete with the Jones’s – I don’t give a care what they buy or rack up on their credit card.  God bless them.  I’d rather sleep well at night (body care) than worry (mind care) about bills - it’s better for my skin even (body care).  I drive a 12 year-old economy car with great gas mileage.  Who cares?  It gets the job done with no car payment (haven’t had one of those in 8 years).  Insurance, registration, gas, maintenance is also cheaper.  It all adds up.  I spend it on massages and working less (mind-body-spirit care).

If I can’t afford it, then I don’t buy it.  That’s more honest – a true reflection of me to the world (spirit care).  I got nothing to prove.  Those that love me will love me regardless.  Those that don’t love me will judge me regardless.  I don’t chase shadows.  I don’t collect status symbols.  I am worthy because God loves me.  God loves you too, by the way.

I don’t strive to have what others have.  I listen to my inner voice and that voice is not particularly greedy or covetous.  It is pretty satisfied to love and be loved, rest in joy, peace and freedom.  You can’t charge those things to your credit card.  I’ve tried.  The effect is very temporary – not real.

As a professional social worker right out of grad school, I worked at a county agency for the protection of children and families.  Most of my co-workers were middle aged or near retirement.  Some looked pretty miserable to be doing this work. 

Naively, I asked them:  Why don’t you quit? Do something else? 
Most answered:  My mortgage.
I remember thinking:  Well, I will never get one of those if it means being forever locked into a job that I hate!  What unnecessary torture!

It is because I haven’t accumulated debt that I was able to go back to school.  It is why I was able to be choosier about the type of work I took on.  It is why I have freedom to choose.

I had a boss who wanted me to work extra hours.  Working extra hours meant more money.  It also meant less time with my young daughter.  I was not having it. Duh.  She tried to entice me with visions of buying a new couch.  Huh?  Seriously?  Time with my young daughter or a mofo couch?  How is this a dilemma?

I don’t worry about money.  I know how to earn it.  I know how to manage it.  I have read and learned and practiced.  I can add and subtract.  It used to be said that 30% of our salary should go toward mortgage/rent.  Now most of us spend above 50%.  Our budget balance is becoming precarious because of our choices or lack thereof.  It all comes with a cost. 

I read somewhere that after $75,000, quality of life doesn’t vary much – so why strive and sacrifice self and family to make more?  I am on a mission but I am not ambitious.  There is something that I came here to do but “make more money than you” is not on my list.

I started saving for retirement at age 21 (with my first job right out of college).  I wonder how much the average social worker saves for retirement?  How long can we do this work well?  Will we have choices about when to stop working if we haven't saved?

I have faith so I don't worry about money.  I have sought out skills to earn and manage money so I don't worry about money.  It makes a difference.

I recommend books like:  "How to get out of debt, stay out of debt and live prosperously" and anything by Suzy Ormon.  I used to read a column in the business section of the LA Times every Tuesday about financial makeovers.  That's how I learn.  I've been to workshops at non-profit organizations specializing in consumer credit counseling.  I think about, talk about, and make plans about my spending, budget, financial goals, priorities, values.  It all helps.  Where would you like to start today?  Baby steps are best.  What's your next baby step?

Thursday, July 19, 2012

The Universe is Conspiring

It is the fourth and final year of my doctoral program (!).

I applied and was awarded a fellowship.  This means I don't have to work as much as I'd planned.

CSULA has offered me the opportunity to teach 1-2 classes per quarter.  El Nido Family Centers has offered me part-time consultant work.

My time and energy will be focused on (1) revising and submitting my publishable paper, (2) completing and defending my dissertation proposal, and (3) conducting a study on the relationship between posttraumatic resilience and parent-child communication about trauma (as a form of exposure therapy).  I may throw in questions about cultural/traditional healing practices as moderators/mediators too.  I can't help myself sometimes.  I hope to complete and defend my dissertation at the end of the school year.

I share my progress and update as testimony that things do work out and it is possible.  In our darkest hours, what sustains us is hope.  I hope my journey gives witness to the power of love, hope, faith, social support, perseverance, and determination.  I realize that sharing good news may come off as boastful.  My intention is to provide one story of a woman who struggles and overcomes with work, love and faith.

Be well and hopeful.


Sunday, July 15, 2012

My Rights & Responsibilities

I matter.  We all matter.

I get to be happy and I am responsible for my happiness. We all get to be happy. The US Constitution is the only of its kind with that explicit and inalienable right.

I get to be seen, heard and understood in my relationships. We all do. We may expect it.

I get to choose love.

My body is my own.

I get to make mistakes and forgive myself.  It is part of growing and learning.  It is being human.  I get to be loved despite my mistakes.  If my mistakes hurt others repeatedly or if the repeated mistakes of others hurt me, then I can choose to create a healthy distance in those relationships.

I don't owe anyone a relationship - romantic, platonic or familial. Nobody owes me anything either.

I get to choose my friends. Sometimes, they don't choose me. Ni modo (oh well), they can't all be home-runs.

Who I let into my inner circle is one of the most important decisions that I make. I deserve to choose well. I get to choose those few souls that have my best interests at heart, who love and support me, who are spiritual, honest, positive, and hopeful. In return, they will get the same from me.

Everyone else gets my kindness, love and respect, but no one is allowed to take pieces of my soul. I will protect my soul with my voice.

Compassion

People with mental illness are often perceived as very difficult to deal with and therefore marginalized.

I sometimes think: it could have been me with that mental illness.  What if it had been me?  How would I want people to treat me?

Reflecting on those questions helps me to understand how to respond better and not react defensively or out of anger.

Saturday, July 14, 2012

Love

1 Corinthians 13
New International Version (NIV)

13 If I speak in the tongues[a] of men or of angels, but do not have love, I am only a resounding gong or a clanging cymbal.

2 If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but do not have love, I am nothing.

3 If I give all I possess to the poor and give over my body to hardship that I may boast,[b] but do not have love, I gain nothing.

4 Love is patient, love is kind. It does not envy, it does not boast, it is not proud.

5 It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. 

6 Love does not delight in evil but rejoices with the truth. 

7 It always protects, always trusts, always hopes, always perseveres. 

8 Love never fails. But where there are prophecies, they will cease; where there are tongues, they will be stilled; where there is knowledge, it will pass away.

9 For we know in part and we prophesy in part,

10 but when completeness comes, what is in part disappears.

11 When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put the ways of childhood behind me. 

12 For now we see only a reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known.

13 And now these three remain: faith, hope and love. But the greatest of these is love.

Love

Mental health professionals will never be out of business because everyone wonders if their mother loved them.  --Rose Monteiro
Rest assured, whether or not your parent(s) had the capacity to love you, it was your birthright to be loved, cherished, seen, and understood.

In the book, Tattoos on the Heart, Father Greg Boyle writes over and over about the no-matter-what-ness of love and compassion.  Please read it as the love letter to yourself that we all deserve.

Oprah often says that when we know better, we do better.  I have come to learn that when we are happy, that is, feel loved, connected and whole, we do a lot better.

I wish us all a whole lotta love, peace, joy and freedom.

Happy July.

Friday, July 13, 2012

Psalm 23

The Lord is my shepard; I shall not want.

He maketh me to lie down in green pastures: he leadeth me beside the still waters.

He restoreth my soul; he leadeth me in the paths of righteousness for his name's sake.

Yea, though I walk through the valley of the shadow of death, I will fear no evil; for thou art with me; they rod and thy staff they comfort me.

Thou preparest a table before me in the presence of mine enemies; thou anointest my head with oil; my cup runneth over.

Surely goodness and mercy shall follow me all the days of my life: and I will dwell in the house of the Lord for ever.

Psalm 23

Please pray with me.  Thank you.

Thursday, July 12, 2012

Process and Content

There are two types of people, generally speaking of course, Thinkers and Feelers.

We are all thinking and feeling human beings but we tend to lead with our head or our heart when processing information and making decisions.

After age 30, it is said that we become more integrated.  My integration took hold after 40 - late bloomer, I guess.  That is, the best decisions factor in both what we think about things and how we feel about it too - Is it safe? Is it fair? Will it work? How will people feel about it?

In therapy, there is BOTH process and content.  BOTH matter.  Both are important.  Let's attend to BOTH.

In the book, The Gift of Therapy:  An Open Letter to a New Generation of Therapists and Their Patients,  Irvin D. Yalom, MD writes:
...one must attend to both "content" and "process," the two major aspects of therapy discourse.  "Content" is just what it says - the precise words spoken, the substantive issues addressed.  "Process" refers to an entirely different and enormously important dimension:  the interpersonal relationship between the patient and therapist. When we ask about the "process" of an interaction, we mean:  What do the words (and the non-verbal behavior as well) tell us about the nature of the relationship between the parties engaged in the interaction?
So is therapy about the relationship or the techniques?  Both.  No "either/or" dilemma here.  No UCLA vs. USC rivalry here (we all know which is the better school, don't we?).  Without relationship, nothing we say or do matters much.  Without the best techniques/interventions/proven strategies, then aren't we just hanging out, being kind and chatting nicely?  No harm in that but you don't need an advanced degree or a license or to charge money for that!  In fact, if goals are not reached, growth and healing is not achieved, symptoms are not reduced, pain is not alleviated - then why would clients return and pay?  I guess they might if they are lonely.  That sucks.  Then we are high priced enabling friends.  I am sure we aim to do better than that.

We can apply empirically supported strategies, research based interventions and cultural/traditional healing practices (you know the kind with a 50,000 year track record) in the context of a warm, caring and genuine relationship.  Sounds good?

Thursday, July 5, 2012

Health Maintenance

In order to be in social work for the long haul, I have become deeply committed to self-care in the intense way that I do everything.

I exercise daily.

I take supplements (salmon oil, b vitamins, etc.) and prescribed medication.

I eat a lot better - protein shakes to replace meals regularly, more fruit and veggies, salads, water, nuts instead of chips, cottage cheese with pineapple instead of ice cream, watermelon instead of pastries, etc.

But one of my favorite new self-care regimens is monthly massage.  I have come back to this tried and true method of releasing accumulated toxins and feeling downright yummy.

There is a spa in Pasadena (you know the one) that offers a deal - $79 is charged to your account every month for a year in exchange for a 50-minute relaxation massage and use of their jacuzzi/steam room/sauna.  Since I don't buy morning lattes or designer shoes or drive a gas guzzler or have a car payment, I can well afford this health maintenance package.  In fact, when I go back to work full-time, I will bump up my monthly massages to weekly.  I think my face and joy will be a walking advertisement for massage.

I like interviewing massage therapists about how they manage to help release the toxins of others without taking them on.  This massage therapist said that she allows the toxins to go into the ground.  I asked, "but, how?"  She said that she visualizes energy coming through her via the crown of her head and the toxins being absorbed into the ground.  She appeared just as friendly, warm and energized after my massage as she had been before.  I can't always say that about myself after meeting with every client.  There is something there, I believe.  Something that social workers need to pay attention to and cultivate, beginning in graduate school.  I wish I had several lifetimes to pursue all my research interests.  

Whatever floats your wagon (I love mixing metaphors - such a faux pas), do it with relish.  Yes, you matter, so enjoy.

Like a Teen

I feel like a newborn Teen.  My daughter and I are dancin to a Wii DVD called, Just Dance, and this song comes on.

I googled the song and discovered that Eminem was involved in the lyrics.  That artist/poet/musician really touches me.  He must be connecting to some greater force when he raps - it's like the poetry of the urban, poor and struggling.

I am so grateful for the artists, poets, musicians, writers, scientists and anyone who dares to use their imagination to discover a bit of truth and add beauty to the world.

Can we pretend that airplanes
In the night sky
Are like shooting stars
I could really use a wish right now (wish right now, wish right now)
 

Can we pretend that airplanes
In the night sky
Are like shooting stars
I could really use a wish right now (wish right now, wish right now)

Tuesday, July 3, 2012

Write it down now!

“The secret of it all, is to write in the gush, the throb, the flood, of the moment – to put things down without deliberation – without worrying about their style – without waiting for a fit time or place. I always worked that way. I took the first scrap of paper, the first doorstep, the first desk, and wrote – wrote, wrote…By writing at the instant the very heartbeat of life is caught.”
― Walt Whitman

Thanks, Claudia, it's my new dissertation-inspiration post-it. I'm putting it up everywhere.

P.S.  Didn't Clinton give his special women a book by Walt Whitman?  I'm blushing, Claudia ;)