I’ve been offering video sessions for years now, and so when I made the move to mostly telehealth services this week, I knew I’d be in my comfort zone. I already know what wonderful connections can be made this way, and the deep work that can be done. As a somatic practitioner, I’ve been pleased to receive reminders about the ways we can work with the body. It feels like so much is possible. I know we wouldn’t have chosen the situation we’re in now, but given what’s going on, I’ve been thinking of a few of the benefits to telehealth services, and wanted to share what I came up with.
1. Accessibility. I’ve always thought that telehealth would be ideal for people who are otherwise unable to come into the office but still want to prioritize their mental health and access services. It could be transportation issues like you’re in a small Albertan town and the commute is just a bit too far, or you’re here in Edmonton winter and the roads are not worth driving on, or you don’t have access to a reliable vehicle but you still want to access services. I also think about accessibility in terms of chronic pain where sometimes it’s better not to leave the house because you’re more able to take care of yourself at home, and part of taking care of yourself is still having a session. Or maybe you’re sick and staying at home to take care of your health and the health of others, but you really still wanted to connect about that anxiety and depression you’re working through. Or, you’re taking care of young children and today you have no other childcare options. For me, this one is all about reducing barriers.
2. Comfort. Some people really like having the comforts of home around them – like an important animal, a blanket they can curl up with, and being in their most relaxed clothes. When our nervous system can begin from a more settled place, there’s already room for more of a shift to occur. When we’re done the session, you can stay in that comfort and continue to relax into it, rather than worry about dealing with traffic on your commute home.
3. Bravery. This one’s kind of interesting. Over video, sometimes people find themselves able to be a bit braver with what they share or are willing to try out. I’m not sitting in the room staring straight at you (okay, I try not to do that anyway), and sometimes that bit of distance allows people to feel like they can actually be more vulnerable. Also when I invite people to do something they feel silly about, they can move offscreen to do it. Tada!
4. Integration. Sometimes people feel like my office is a magical place where they can self-regulate and feel their boundaries and all sorts of good stuff, but have a hard time translating those skills to home. Doing a session from your home space may allow you to embody self-regulation and other skills into areas of your life that you’re most hoping to take them into.
In light of Alberta being in a declared state of public health emergency, I have made an update in my policies on seeing clients in person at this time. I am deeply confident that we all want to take care of each other at this time and in this spirit, I'm now moving to video as my preference for connecting with clients, with in-person appointments reserved only for those unable to find a private and secure space to connect from. I am also reserving a few spots for those actively engaged in EMDR, who desire to continue meeting in person. Please email me directly if you would like one of these spots to be reserved for you. I have been thoughtful in making this move. Given our current situation with COVID-19, I'm anticipating that this will be a long term solution rather than a short term fix. It looks like this will be our new normal for a few months at least.
I am happy to offer online sessions via Doxy, a confidential online telehealth platform. I often do online sessions for clients if a need arises, and believe I can confidently offer my support through these means.
I recognize that this may feel like a daunting time for some of you. I appreciated your understanding of the importance of collective effort.
There are a few things to keep in mind with any technology that I do want to remind everyone of:
• It is important to be in a quiet, private space that is free of distractions (including cell phone or other devices) during the session.
• It is important to use a secure internet connection rather than free/public WiFi.
• You may want to use earbuds/headphones to help with privacy and reduce feedback noise.
• Confidentiality still applies to online services, so no one is to record the session.
• It can help to make sure you're prepared ahead of time as much as possible by making sure you have a power cord, testing out your camera and microphone etc. At the same time, technology isn't perfect. Therefore, a telephone backup may need to be used, which can result in a temporary disruption to the session and some reduced effectiveness in communication.
To connect at our scheduled meeting time, simply login to my “waiting room” (I'll send you the link), type in your name, and wait for me to begin the session. It’s helpful if you’re able to arrive there 5-10 minutes in advance of the session in order to make sure that your audio/visual is working. If you’re connecting via a laptop, you won’t need to download anything, though if you’re using a tablet or mobile, you may need to download an app.
If Doxy is down, I will send you a Zoom link in order to connect. Zoom is also free to use, but it does require a download, so you may want to do this in advance.
If the case of all technology failure, I will call you. Please ensure that I have your current phone number on file.
What Our Office is Doing - A Note from Transcend and Blossom
In an effort to minimize the spread of COVID-19 we are taking extra precautions at the office by:
• Disinfecting door knobs, chairs, desks, other touchable surfaces throughout the day in individual offices and common areas.
• The building is also taking extra disinfecting measures throughout the day including placing hand sanitizer dispensers at points of entry to the main building.
• Removing magazines / puzzle books from the waiting room. Until further notice please bring your own entertainment.
• Reducing the availability of beverages and snacks in the waiting area, so as to discourage common contact points.
To protect yourself and others, we encourage the following guidelines from Alberta Health Services:
• Use good hygiene practices such as frequent and thorough hand washing
• Cover coughs and sneezes
• Avoid touching eyes, nose, and mouth with unwashed hands
• Stay at home and away from others if you are feeling ill
If you have symptoms such as fever, cough, or shortness of breath, please do not go to a health care facility. Instead, call Health Link 811 for assessment and testing.
Please feel free to contact me if you have any questions or require further information. Thank you.
Currently, the risk level in Alberta is low for COVID-19. At this time, I can continue to provide therapeutic counselling in person if you are feeling healthy. I can also arrange for your sessions to be completed online using a secure video counselling platform called doxy.me. Phone appointments are also possible for those who would prefer this option.
I ask you to request sessions via online counselling if you have symptoms such as:
• Any signs of a cold or flu
Please also inform me and I can arrange online sessions if you have:
• Travelled outside of Canada in the last 14 days
• Had contact with someone who was suspected or confirmed to have COVID-19
If you’re unsure as to whether you should come in or not, it’s best to be cautious, stay home, and do online counselling. Voluntary social distancing may end up protecting other clients in the office with compromised immune systems.
I will inform you if there is a need to move all clients to an online counselling option.
My goal is to help everyone stay healthy and safe and for my clients to continue to receive uninterrupted psychological support, as much as is possible.
Please email Nicole@feministcounselloredmonton.com to arrange for online counselling or if you have any questions or concerns. Thank you.
Photo by Brene Brown.
Note: This was originally published in A Liberated Heart in 2018.
Ask almost anyone to name the biggest area we’re taught to put others before ourselves, and the answer will be mothering. It begins with the pressure to become a mother, to do so in a particular timeframe, and then to parent in particular ways that can feel practically impossible to live up to. Women in our culture are expected to give 100% of our time and energy to mothering, and, here’s the crucial part – we’re expected to do all with complete satisfaction and enjoyment, as if it’s our only life purpose.
We’re also set up with a lot of expectations about the ways we should mother – from how our own birth experience should happen, what the names of our child should be, whether or not we should breastfeed (and how long we should try if it’s not working), to a thousand other decisions around mothering that can leave us feeling lost in a sea of other people’s opinions. We can also get lost in other people’s expectations about their own involvement – whether that’s how much access they get to the baby and what that will look like, or how much decision-making they’ll be part of when it comes to parenting.
Set Up To Struggle
One of the things that makes it especially hard for us during this time is that we’ve also been taught it’s not polite (or acceptable, or nice) to set boundaries with other people about their involvement in our child’s life or decisions related to mothering. So when our mother in law tells us she’s going to be present in the birthing room with us, are we allowed to tell her no? When visitors come over to see the new baby, is it okay to ask them to leave after an hour? What if we really want our sister to stay with us after the baby is born, but she hasn’t offered yet? Are we allowed to ask her? What if we really don’t want her to, but she hasn’t asked our permission before making plans to stay in our spare bedroom? Is it reasonable to talk to her about wanting something different?
Maybe we feel guilty, like we’re being too needy or demanding. We don’t want to seem rude or ungrateful. We don’t want to cause waves, or unnecessary tension. We want the important people in our lives to feel like they can have a relationship with our child.
The difficulty is, when we bend over backwards trying to make sure everyone else is okay, we end up exhausted and burnt out, and we may be at higher risk for postpartum depression and anxiety.
One of the big lines we’ve been taught as women is that everyone else should come before us. But at this crucial time in our lives, what’s best for us and as an extension, for our baby, may not be what our extended family prefers. And so, we find ourselves in a bind. How can we prioritize our own needs while still making everyone else happy?
The short answer is we can’t. For possibly the first time in our lives, we need to turn our attention toward ourselves, and ask ourselves what’s truly best for us. This is not the same as figuring out what other people want that we can also live with. We need to ask ourselves what’s best for us. Once we understand this truth, and acknowledge it, we need to find a way to honor it.
Boundaries for the First Time
Often, women I work with on setting boundaries around birth and motherhood are setting boundaries for the first time in their lives.
As may already be clear, we can learn pretty early on in our lives (through a variety of experiences) to put the emotional needs of others before ourselves. Many women have found themselves in caregiving roles, whether in their first families or in other relationships since, and it can be difficult to recon with the notion that we might need to put ourselves first. For a lot of women, pregnancy is the first time they’re forced to act in ways others might see as selfish and make decisions that others may not agree with.
Below, I wanted to share some of the big ideas I talk about with my clients when it comes to setting boundaries for the first time.
You're Allowed to Want Something Other than What Other People Want
Yep, I said it. You’re allowed to want something different. You’re even allowed to make decisions in accordance with those desires. Boundaries are connected to our values, and since we each have different values, what makes sense for us may not seem logical to other people. I know it’s hard. But wanting something different than someone else doesn’t have to put you at odds with each other. Most healthy adults are able to hold different opinions about important matters while still holding each other in high regard. We can understand that disagreeing with someone about an issue and still caring deeply for them aren’t mutually exclusive.
We might hear from some family members ideas about what’s best (from how often we hold our baby to what our sleeping arrangements should be), but we can remind ourselves that these statements are just that person’s ideas about what’s best. And we’re allowed to have own ideas, developed from our very unique experiences and values. Ideas that we don’t need to justify or make other people understand. As I’ve talked about elsewhere, “People don’t need to understand our boundaries in order to respect them. We can state our needs and desires without explanation or apology.” If someone in your life pushes you to explain yourself, that says way more about them than it does about you, and it might also be an indicator that some healthy distance is in order.
It's Okay to Protect Yourself from Unwanted Influence
In those first weeks and months (and years) of motherhood, we’re very much still finding our feet as parents, and that means it’s easy to doubt what we’re doing. The parenting strategy that seemed great on paper can feel shaky when it’s time to implement. The bedtime routine that worked last month has suddenly stopped working. In times like these, I often encourage my clients to protect themselves from people who’ll just add to the doubt they’re already feeling.
I’m all for learning from the women who’ve come before us, but I also think we need to be careful about who we turn to, when, and what we share. Sometimes when we’re unsure of a parenting decision we’re making, it’s not the best idea to turn to the person in our life with the strongest opinion on the subject. Instead, we want to turn to the person who can bring out our own wisdom. The person who can help us connect to our truth, our body knowledge, and find our confidence again. The person who will ask us good questions with the intent on helping us find what’s right for us (not enforcing their own view on ours).
When turning to others for guidance around parenting, ask yourself, are they:
• Someone whose parenting style you seek to emulate?
• Able to listen and support you, even if your experiences and decisions are different than theirs?
• Able to come from a position of “this is what worked for me” rather than “this is what everyone should do”?
• Someone who is nonjudgmental and compassionate?
• Someone who you can admit mistakes and uncertainties to without fear of judgment?
If we’re speaking with someone who tends to be more pushy, judgmental, or opinionated, it’s okay to hold back, and wait until we’re feeling more certain about what we’re doing before we share with them. Even then, we may choose the types of things we want to share with them, reminding ourselves that we don’t need their blessing or their permission to parent in the way we see fit.
Be Prepared for Pushback
As Harriet Lerner helps us understand in “The Dance of Intimacy”, the work of boundaries is really about managing other people’s reactions to our boundaries without getting pulled back into old patterns (blaming, cutting off, or appeasing, for example). Change is hard, and if we’re speaking up or standing our ground in a new way, others may have difficulty adjusting to this. It’s pretty common for even the most loving relatives to push back a little when we do something different. We need to anticipate this pushback and plan how we’re going to manage our own reactions in the face of them. One way we can do this is to learn to hold our ground without becoming defensive, explaining, or justifying.
Just how do we do this? It might involve getting rooted in our own values, and surrounding ourselves with the people, items, and practices that help us stay connected to those values.
For me, it sometimes means connecting with other attachment therapists so that I can talk with someone who understands my worldview and speaks the same language. It means getting on the same page as my partner as much as possible so that we can handle difficult situations as a team. It means taking care of my health so that I can make decisions from a grounded place (and make less decisions out of scarcity, desperation, and exhaustion).
Where does this lead? Ideally, we can practice turning toward ourselves and continue building a trust in our own voice. We can let go of old beliefs that we have to be pleasing, or agreeable, or understood to other people.
Putting it All Together
Those first years of parenting (pregnancy included!) are tough – we’re forced to confront the reality that our desires are sometimes in conflict with other people’s. For the first time we may have to use our voice, stick with our limits, and find a way to do what’s best for ourselves even in the face of other people’s disappointment. I’m often reminding my clients that we don’t need to make other people understand our parenting decisions or agree with us.
What we do need to do is continue turning toward ourselves. We need to continue listening to our heads, hearts, and bodies, so that we can make conscious decisions about our mothering based on what’s the best fit for us. We will make mistakes along the way, and we’ll lose touch with ourselves from time to time, but we can trust that asking ourselves what we really need and trying to find a way to honor that will never be the wrong thing to do.
1. Perry, N. (2017). 5 Beliefs to Support You in Setting Boundaries [Ebook]. Edmonton.
2. Lerner, H. G. (1985). The dance of anger: A woman's guide to changing the patterns of intimate relationships. New York: Harper & Row.
I think it's so neat that in addition to the amazing local, in-person resources I often share with clients, there's a ton of really cool online offerings these days. From my perspective, these can be a great adjunct to therapy or a standalone resource, depending on what you're looking for. I think these resources look amazing and hope you will too.
There’s a theme that’s been coming up in my office for years now. It might have started soon after I started naming myself as a feminist therapist. Maybe people felt safe enough to talk about some of the issues that were haunting them on a deeper level. Then there was that summer when the smell of smoke was everywhere. I think most of us remember waking up to a yellow sky, and it’s hard to ignore what’s happening outside when you’re sitting in my office looking out the window. The things we had been talking about every once in awhile were now very much front of mind. And what’s happening to our earth is just one of those things.
We're living in a time where there's a lot that's not right in the world, and it's hard to make sense of how unjust it can be. A lot of us are working so hard and feeling overwhelmed because we're feeling the heaviness of all the work that has yet to be done. I've had many conversations in my office about what it's like to live with uncertainty about the future.
With my clients, we always start with making space to compassionately feel whatever emotions arise with the state of what is happening in our communities - like grief, fear, or anger. I ask my clients to notice what they’re feeling emotionally, and where they’re noticing it in their bodies. This is often the first time they really acknowledge the weight of what they’re carrying. From my experience, noticing and naming what we’re experiencing has immense power. It allows our emotions to begin moving. It allows them to inform us, and transform us. (On this note, my colleague Dr. Lauren Johnson wrote a lovely article about making space for grief last year, which I hope you'll find time to read). As we listen to our emotions, we also hear their wisdom, and what they need from us.
Sometimes when we listen inward, what we feel is despair, and it’s hard to know what to do with that. It can feel like there’s just too much to do, and we’re exhausted trying to tend to it all. I wanted to share another small idea that's been growing in my office. I've been talking to people about listening inward to find their one, unique gift that they can offer during this difficult time. The one thing that they can give generously without immediately burning out. The one thing where the benefit to others actually outweighs the toll it takes on them to provide it.
The easiest example I always come back to is my own gift - I offer therapy. I'm not out there leading marches or running for political office, even though I absolutely see the value in those things. I'm an introvert, an empath, and I thrive on routine. I'd burn out within a week of trying to do work that asked me to be someone other than who I am. So I found the way I could show up for my community that most aligned with who I am, and did that. I truly believe there's a place for all of us in social change work, and this is my way.
And, even though I always look for hopeful stories of positive change, I also know that the world isn't going to be fixed in the next year and so. I think many of us will do "whatever it takes" because we're trying to run a sprint. I've started to talk to more people about seeing the work we do as a marathon. With that in mind, can you imagine a pace that would be sustainable for you over a lifetime?
I hope you may be able to take some time to reflect on your own unique gift. And to stop feeling bad that you're not doing it all. Let's all just to what we can, with sustainability in mind.
On My "To-Read" List
I know I’m not the only one who has been thinking about and writing about this, and currently I have a few books on my “to-read” list that I’m happy to share. Currently I’m still on a fiction bender, and I know that when the time is right, I’ll be able to turn to other writers as a source of guidance.
Emotional Resiliency in the Era of Climate Change: A Clinician’s Guide (Leslie Davenport)
"Although the environmental and physical effects of climate change have long been recognised, little attention has been given to the profound negative impact on mental health. Leslie Davenport presents comprehensive theory, strategies and resources for addressing key clinical themes specific to the psychological impact of climate change.
She explores the psychological underpinnings that have contributed to the current global crisis, and offers robust therapeutic interventions for dealing with anxiety, stress, depression, trauma and other clinical mental health conditions resulting from environmental damage and disaster. She emphasizes the importance of developing resilience and shows how to utilise the many benefits of guided imagery and mindful presence techniques, and carry out interventions that draw on expert research into ecopsychology, wisdom traditions, earth-based indigenous practices and positive psychology. The strategies in this book will cultivate transformative, person-centred ways of being, resulting in regenerative lifestyles that benefit both the individual and the planet."
Emergent Strategy: Shaping Change, Changing Worlds (adrienne maree brown)
"Inspired by Octavia Butler's explorations of our human relationship to change, Emergent Strategy is radical self-help, society-help, and planet-help designed to shape the futures we want to live. Change is constant. The world is in a continual state of flux. It is a stream of ever-mutating, emergent patterns. Rather than steel ourselves against such change, this book invites us to feel, map, assess, and learn from the swirling patterns around us in order to better understand and influence them as they happen. This is a resolutely materialist 'spirituality' based equally on science andscience fiction, a visionary incantation to transform that which ultimately transforms us."
Our Entangled Future: Stories to Empower Quantum Social Change (Edited by Karen O'Brien Ann El Khoury and Nicole Schafenacker).
We live our lives through stories. They shape how we see the world, how we relate to it, and not the least, how we engage with it. Now more than ever, we need compelling stories that inspire both individual and collective action. The nine short stories presented in Our Entangled Future are rooted in the complex reality of the climate crisis. Rather than painting a dystopic future, they present agency-driven characters whose insights will inspire readers to contemplate and realize the potential for quantum social change.
Oh, I just thought of one book I read a few years ago and really enjoyed, that I'm going to add to this list.
“The Green Boat: Reviving Ourselves in Our Capsized Culture” (Mary Pipher)
Pipher emphasizes the importance of taking small, positive steps to preserve what’s important, drawing from her own experiences as part of a group fighting energy company TransCanada’s installation of the Keystone XL oil pipeline across the Midwest, which will sit atop the Ogallala Aquifer, the source of 40% of the United States’ fresh water. The challenges she confronts reveal surprising answers to the critical questions we face: How do we mobilize ourselves and our communities to work together to solve global problems? How do we stay happy amid very difficult situations? And what is the true meaning of hope? Both profound and practical, The Green Boat explains how we can attend to the world around us with calmness, balance, and great love.
Dealing with a sinus infection over the last few weeks has me once again thinking about sustainability as a therapist. I was thinking how glad I was that I had room in my calendar to reschedule clients. I was thinking about how gracious everyone was being when I did have to move things around. And this got me thinking about some of the things I’ve done to make all of this possible. For all you emerging therapists out there (and curious cats), please read on…
Schedule for a Realistic Week
There have definitely been times in the past where my schedule has been much more full. I’ve been booked solid for a month in advance, with no room to add in an extra client here or there. I know a lot of emerging therapists who will do this too – we fit in the most clients possible, leaving practically no room for flexibility. I think we plan for the “ideal scenario”, meaning, “if all goes as planned for me, then this number of sessions I’ve booked will be fine”. What we may not always consider is the “realistic scenario”. In a realistic week, I often end up getting an emergency request from a client to book a session because they’re really in crisis. I sometimes get a letter from a lawyer, insurance company, or Victims Services requesting forms to be filled out or paperwork to be put together. I have clients who I need to do research for, make referrals on behalf of, consult regarding, or make ethical decisions about. I also sometimes have sessions that knock me off my feet for one reason or another. I also get sick sometimes, or get stuck on Edmonton winter roads. If there’s no room in my week to recover, fit in, or move around, what do we do?
For awhile, I think the mistake that we make is just to keep adding on to an already full schedule. Many new therapists will work through their lunch hours, stay late to complete their notes and letters, or do the extra work on what should be days off.
I believe all the work I described above is an important part of being a therapist, and so we need to start making room for it within our schedules, not leave it as an extra that can be appended on to a full week. I’ll give you an example. I have about 25 client spots open per week. It used to be that I would open all of those to be filled, banking on the fact that I would get one or two cancellations. But, it just so happened that the cancellations wouldn’t always come when I needed it, and 25 client hours a week every week left me very little room for all those other parts of being a therapist I already described above. Now, I’m leaving 22 spots open on my online calendar. I know it doesn’t sound like much of a difference, but those extra three hours are now mine to be flexible with. I can go home early, add in an extra client if I need to, catch up on client notes, or anything else I need.
Stop Seeing New Clients
In order to have this kind of room in the calendar, I stopped seeing new clients a year ago. I added people to a waiting list if they wanted to wait. In order to feel less guilty about not being able to accept new appointments, I provided them with a list of other therapists in the area who were accepting new clients, as I just couldn’t predict how long it might take for things to slow down. It turns out it took about a year, and things are finally becoming more balanced.
Remember that Being Emotionally Well is Part of the Work
Within my work week, I also had to consider what helps me stay emotionally well. I now see this as a foundational part of being a good therapist, rather than an extra to hope to fit in outside of my work hours. From my perspective, being emotionally well involves seeing a therapist to work through issues that come up in my life and in the therapy room, it involves somatic practices to help nourish my body throughout the day, and it involves connecting with colleagues and peers in consultation and support. In order to provide the emotional care for my clients that my job entails, I need to be present, attuned, and grounded. I take this seriously and I know it’s not just going to happen on its own.
Take Sustainability Seriously
What this brings me back to is what eventually happens when we don’t keep sustainability in mind. I’ve watched some emerging therapists power through very full schedules, and I know that on top of the client hours, they’re also studying for licensing exams and dealing with a steep learning curve.
When we have so much on our plates, we will eventually make mistakes. I have, and I try to remind all the new therapists I supervise that we all will. It’s part of the work. What I have found that clients are generally forgiving if mistakes are made in good faith (accidentally double booking a client because brains are just like that). I think it gets harder when mistakes are made because we’re not caring well enough for ourselves (not consulting when we should have because we ran out of time, overbooking ourselves and then being shorter with a client than intended because we’re emotionally exhausted, or showing up late because we haven’t been getting enough sleep).
By no means is this a call for perfection or a public shaming for those inevitable mistakes we all make. Instead, I’m offering a moment to pause. As we continue in this field, we can ask ourselves if the foundation we’re laying has a strong foundation for sustainability, or if we’re leaning in the direction of burnout. We can notice if what we’re doing has room for our own humanity. We all know that doing this work requires being deeply connected with ourselves so that we can connect with the person in front of us. I continue to believe that the biggest gift we bring as therapists is our own aliveness. So, I’m rooting for that.
It Starts with Connecting to Our Bodies
There’s a theme in my work of connecting back to the body (which I think is already a feminist idea), and I wanted to describe one of the modalities I use to do that. I think a lot of people are used to the idea of therapy as talk therapy, and may not realize that there are other, more body-based forms of healing that can be used by trained trauma specialists to allow clients to move through their traumatic symptoms. I think this can be especially helpful when clients are dealing with more body-based symptoms like hypervigilance, a more sensitive startle response, freeze responses, dissociation, chronic tightness, tension, or pain they feel is related to the trauma, and so on. It may help clients who feel they have already told their story and and looking for the next layer of healing, along with clients who don’t want to have to share the details of what happened to them with anyone.
A Quick Synopsis of Somatic Experiencing
Somatic Experiencing is based on the work of Peter Levine. He wrote Healing Trauma, Trauma and Memory, and a few other books of a similar vein. His work is based on this idea that when we go through a traumatic experience – which could be anything from a sexual assault, childhood abuse, to a car accident or fall, for example– our nervous system responds. It goes into fight flight or freeze – a natural, survival response that allows us to live through a situation. And here, especially coming from a feminist lens (where I recognize that clients can be blamed for their experiences and their survival responses) I want to reiterate that all of these survival responses are equally valid. In less than a second, our body reads a situation as life-threatening and does whatever it needs to do to survive. The body also doesn’t judge one way of surviving as better than another – it just does what it needs to in order to get through. I spend a lot of time working on this with my clients and helping them recognize the ways in which their bodies actually protected them (even when it doesn’t feel like it).
Levine recognizes that sometimes, even after the traumatic event is over, all that nervous system energy gets stuck, or thwarted, and we’re not able to come back down into feeling re-regulated again. Maybe there wasn’t someone safe to run to, or it all happened so quickly. We may end up left feeling still frozen, still stuck. Or constantly vigilant, like there’s something terrible about to happen. Or consistently angry, in fight mode all the time.
When that happens, which is more common for humans than it is for animals in the wild, the therapy is that we slowly, safely, and through containment make space to go back and process those past events. We release any activation so that our traumatic symptoms no longer have such a hold over our current lives.
What Somatic Work Looks Like in the Therapy Room
The way I typically use Somatic Experiencing, if clients want to give it a try, is to start with some grounding and resourcing activities. We could end up spending one session on this, or three, or ten, all depending on each person and what their body needs in order to feel safe. Really important here as a feminist therapist is offering somatic work with consent (“would you like to give this a try?”) and working at the client’s pace.
Once we’re both feeling confident that they’re ready to begin processing the traumatic event, we take the time to ground ourselves, then begin with the part of the experience that is least activating for them. This is known as titration. It basically means doing a little bit at a time (the smallest amount that the client can stay present to) and not just overwhelming the nervous system by diving into the most difficult part of the trauma. Once we’ve processed the least activating part, we move a little further in, and so on, and so on. The entire process can take five sessions, or ten, or …. You get the idea.
That’s my attempt at describing Somatic Experiencing for tonight. Please note I have taken the Beginner and Intermediate trainings but not the advance, which means that though I of course integrate everything I've learned into my work, and do so often, I am not an official Somatic Experiencing Practitioner (SEP). If you’d like to learn more about Somatic Experiencing, Peter Levine has been interviewed a number of times about his work and he's shared some fantastic stories, metaphors, and wisdom, a lot of which is available for free on YouTube.
Medication is a topic that's come up a lot in the last few months, and I wanted to put my thoughts to paper. A lot of people have been wondering if it's time for them to try anti-depressants, and my thought is this: it's okay to try. You're allowed to ask for help. Doing so doesn't mean you're "giving up" and it definitely doesn't mean you failed.
A little bit of history: As a feminist therapist I've often tried to help look for the broader contextual reasons that people are feeling depressed (traumatic experiences from the past, current job situations, difficult relationships, state of the world, etc). In traditional therapies, this has sometimes been overlooked. Instead, psychologists of the past have honed in too much on the individual and forgotten the broader social context we live in. Way too many people (women and marginalized individuals particularly) were left feeling as though how they were responding to unjust situations was somehow wrong, or pathological.
At the same time, addressing the social context is just one way of working with depression. Since it's typically been an overlooked area, it's one that I as a feminist therapist tend to focus on. But there are also other, totally important management strategies that we can still use for depression. Medication can be one of those strategies some people use part of managing their depression. I also think it's important to say that trying medication is totally valid EVEN IF depression can be traced back to contextual factors. It might be that thing to help someone get out of bed in the morning and be able to do all the other things they know help them.
It's not the right fit for everyone, and I know it's important that it's part of a bigger depression management plan, but let's start here: it's okay to try.
ps. Let's be super clear: I'm not a doctor! I can't give medical advice and I get no benefit at all from pharmaceutical companies, which is why I didn't name any. If you're curious about medication, please talk to an actual doctor. One that you trust. And make sure they know about any other substances you're taking including over the counter, naturopathic stuff, and any other drugs you might use.
Someone read all of the above thinking I wrote “meditation”, and hey, it still fits! So, there ya go. Meditation and mindfulness practices don’t have to be done in a particular way, in a particular place, or in a particular style. It’s mostly about bringing our attention to the present moment, without judgment. There’s a ton of research these days on the psychological benefits of meditation and mindfulness practices, giving us reason to think that this might benefit a lot of people. It doesn’t have to be your “go to”, but it’s okay to give it a try. It’s okay to give it a try at different times in your life, in different ways, with different people. If you want to.
Take a Break From Work
You're also allowed to take a break from work. Around these parts we call this "stress leave", and my thought? We have stress leave set up for a reason. That reason is so that we can use it when needed. I watch waaaayyyy too many people wait too long to step back from work and by the time they do, they're completely burnt out that even getting out of bed is difficult. At that point, it takes months and months and months to recover, let alone feel rejuvenated and do the healing work that's needed and think about new boundaries going back into work. If you're overwhelmed enough that you're thinking about taking stress leave, chances are you need it. I encourage you talk more to your doctor or mental health professional about your options!
ps. Not sure if I need to say this but what I'm sharing here is not intended to replace the medical advice of your doctor or healthcare provider. Seriously. Go talk to them!
This one may just seem like a plug for my own services, but that’s not my intention. The reason I wanted to include it is that it’s not uncommon in my office for clients to show up and feel bad for “using up my time”. So, I’ll make it clear. You’re not taking a spot from anyone else. I fully consented to being here. I’m 100% okay with doing it. And, I actually appreciate the opportunity to walk through life with you.
People sometimes worry that their problems aren’t bad enough for them to go to therapy. So I’ll be honest: I’m not a fan of waiting until it gets bad enough, if we can help it. Another way to think about it is there’s always going to be someone with “bigger problems”, and it doesn’t serve us to get into the comparison trap. We can recognize our privilege and acknowledge the gifts we’ve been given without dismissing our own pain and hurt.
So here’s my big message here, one more time: you’re allowed. You’re allowed to do the things. You can give yourself the nourishment you need and know that’s not selfish or indulgent. That’s doing the work.
Most of us here can’t help but notice the abrupt change in seasons we experienced at the end of summer. Many people walked into my office feeling “off” – for some, this was a subtle feeling of strangeness, while for others, it was a more profoundly felt environmental grief. We’re a part of nature and so of course, it makes sense that we’re deeply impacted by it, emotionally and physically.
I was sent a beautiful article that touched on environmental grief that you can check out here. For this post, I’m going to focus on how we can cope with change of seasons more generally.
Take the Time to Reflect
For me, fall equinox was a time to slow down and set some new intentions: rest, support, and self-regulate. Not because I’ve met all my goals for the year (that would be nice) or have somehow otherwise “earned” it. I don’t believe that we need to earn rest. I’m listening to my body now because I’m tired. Now is a time for me to keep slowing down, to let extra work fall away (just as the leaves fall...) and focus on these 3 intentions so that I can continue offering the presence of self with my clients that’s so important to my work.
Many of my colleagues who live South of here speak about letting ourselves move with the rhythm of the seasons. For example, there may be a naturally “turning in” or cozying that we do in the winter months. At the same time, this is my perspective: as residents of Edmonton we’re in kind of a unique situation. Yes, it makes sense to move with the seasons to some degree. At the same time, I think we can really start to suffer when we’re alone or in our beds for too long, and the winter IS long here. We miss out on social connection, we miss out on being with nature, and if a lot of that time in our homes is in front of the tv, we can really miss out on being with ourselves.
It seems like a real balance – allowing ourselves to cozy in at times, while also stretching our comfort edges and ensuring we get outside at times too. The change of seasons gives us a clear chance to reflect on what we need and how we want to move into the next few months.
Get Your Routines in Place
Okay, so now you know that winter is coming. Time to get your routines in place. Bring your SAD lamp out of its hiding place. Sign up for the dance class that’s going to get you out of the house over the winter and keep your body warm. Organize that book club that helps you keep connected. Okay serious note. If your depression symptoms are worse over the winter, I’d seriously consider investing in a SAD lamp. If seasonal depression is truly at play, it’s one of the most supported treatments in the research.
And did you catch the three other things I put in there? Movement, being in nature, and social connection. These are often missing in winter and worth thinking about how you might integrate them. Of course, it’s up to you to consider the routines you need in place to feel whole.
I think it’s also super important to actually carve out time for this daunting task. Personally, I spent an entire day getting the routines in place and on the calendar. From my perspective, it’s worth the investment, and best to do early, before it’s hard to find the energy for.
Give Yourself Something to Look Forward to
Okay, while you’re planning all those necessary daily and weekly routines, are there parts of fall and winter you can actually look forward to? Maybe you love making your way through the corn maze and listening to the sound of the leaves crunching under your feet. Perhaps the quiet of the snow is really peaceful for you, and you’re looking forward to some cross-country skiing this year.
If finding something about fall and winter specifically seems to daunting at the moment, you can still find things over the next 6 months to look forward to. It might be a trip to the mountains, a vacation somewhere warm, tickets to the ballet, or some good local craft shows and holiday festivals. And of course there’s Halloween – a lot of my clients love dressing up, carving pumpkins, and having an excuse to get together with friends. If there’s even one thing a month you can look forward to, that’s wonderful. Again, I really encourage people to take the time to sit down and plan this out. Often, we can fall into a trap where we don’t end up organizing the things we need until we’re already in need of them, and then we’re more likely to run into barriers.
None of the things I’ve suggested are mind-blowing, I realize that. But I wanted to be the Psychologist in your ear saying, “you’re allowed to have things to look forward to. You’re allowed to take this time for yourself.” I hope it helps.
Over the years I’ve worked with a number of people trying to make hard decisions, and these hard decisions usually boil down to this: “should I stay or should I go?” What people struggle with most is knowing whether the situation they’re in (a workplace, a relationship, etc) is one that will get better by working on or not. I watch people struggle for months and sometimes years, caught up in the distress of trying to make a decision that’s best for them.
Hope you're all having a lovely Thursday - just a quick announcement on my end. After much consideration, I wanted to let you all know that I will soon be increasing my rates. As of September 1, 2018, standard fees will be as follows:
The other day I was explaining to my 3 year old why I’m not spending quite as much time outside as I’d like to. I explained to her that there’s a lot of pollen this year and that the pollen can make my nose itchy, and my eyes watery, and it’s not very much fun. “I have allergies,” I told her, “you know, just like how Grandpa gets.” I further explained that’s why I wasn’t using my lawnmower as much this year, and why her dad was doing the lawn instead. Without missing a beat, she asked, “so who mows grandpa’s lawn?”
It’s not uncommon in my therapy office to talk about social media. Specifically, I’ve been having a lot of conversations about wanting to not be on social media but having a hard time stopping.
When people bring up the topic of their social media use, it’s usually said with a bit of a guilty look, and can come across as a shrug off comment. “I really shouldn’t be using my phone so much,” they might say in an off-hand way. But, since people are paying me money to notice things, I don’t just shrug it off. Instead, I invite them to talk about it. So many of my clients are finding that they’re on social media more than they actually want to be, and that it’s causing upset in their lives. These are some of the things we’ve been talking about in those conversations.
It’s hard saying no. For a lot of new therapists, we really struggle with the idea of disappointing someone in our care.
It can be easy to feel that because our clients need something, we need to be the one to give it to them. I hear new therapists say things like “but they need evening hours – they can’t make it during the normal workday“ or “they need a sliding scale – they can’t afford the full fee”.
My good friend Lily recently did an episode on "mom pressures" for her podcast (the fantastic Lady Sh!t with Lily and Britt). She asked to write a few things about the pressures moms face, and I accidentally wrote her a novel about it. Here's what I came up with one evening.
"It's Actually a Good Thing": A Little Reassurance When Your Loved One is Working on Their Boundaries
As a partner/friend/lover/ally of someone who is working on boundaries, you may be noticing some changes. Like most changes, this can feel pretty scary and you might be unsure or hesitant about what’s happening. That’s why I wanted to write you this letter. I think it’s normal to feel afraid in times of change, especially when the change involves something unfamiliar.
Annina Schmid (M.A.) is a feminist counsellor who helps women recover from binge drinking and disordered eating, as well as families with young adults who "failed to launch". Annina employs Solution Focused Dialogue to support and empower her clients in making lasting life changes. She works from a strengths-based harm reduction approach. Annina works with all genders and people on the LGBTTIQQ+ spectrum.
As a counsellor who works mostly with women who struggle with disordered eating and binge drinking, I have started running monthly online support groups at the beginning of the year. Here are the four most important things I have learned from my participants:
Alright y'all, big announcement time! I'M MOVING... UPSTAIRS! I'm excited to share with all of you that as of May 31, I will be relocating upstairs, to the 5th floor of College Plaza. The new space I’ll be practicing out of is located within Transcend Psychological Services and Blossom Counselling, though of course I'll still always be Feminist Counsellor Edmonton. It’s a dedicated therapy office which means I get to work alongside some amazing therapists. It's got some big beautiful windows, a little more space... and I'm so looking forward to sharing it with all of you.
As health professionals in positions of power, we have certain standards of practice we need to adhere to it in order to protect the public. The Standards of Practice of the College of Alberta Psychologists are “the minimum standards of professional behaviour and ethical conduct expected of all regulated members”. These include informed consent, avoiding dual relationships, and acting within our scope, to name a few. These are incredibly important to know and adhere to, and yet it’s not enough to ensure that we’re working in a way that’s ethical and sustainable.
Nicole Perry is a Registered Psychologist and writer with a private practice in Edmonton. Her approach is collaborative and feminist at its heart. She specializes in healing
About the Blog
This space will provide information, stories, and answers to big questions about some of my favorite topics - boundaries, burnout, trauma, self compassion, and shame resilience - all from a feminist counselling perspective. It's also a space I'm exploring and refining new ideas.