Last Saturday I was so fortunate to take part in a Pure Barre class at the Jacksonville Jaguars Flex Field. The class was led by the owners of the Jacksonville and Ponte Vedra Beach Pure Barre studios and the field was packed! Pure Barre among other activities such as looking for shark teeth, surfing, are just some of the ways I nourish my own wellness. When I am well, I am able to connect with my clients, be more attentive and creative in my work. In taking time to prioritize my own wellness, I am able to be authentic and nurture my razor-sharp ability to attune to the needs of my clients.
Wellness is one of the critical factors in being a mental health care provider. Wellness is especially important because mental health providers are one of the primary instruments in their own work. I feel it is incredibly important to walk the talk when it comes to offering a model of wellness or self care for clients.
There are a variety of existing methods already in place to improve self-care. However, self-awareness is the first step to identify and configure a formula that will work best to create homeostasis between work, play, giving and receiving, accomplishing tasks, and doing absolutely nothing. The key to ongoing and lasting change is to pay attention to you and your body. Whatever profession you are in, the work itself can get in the way of your own wellness. And although you may be full of wellness tips for others, knowledge doesn't always translate into action for yourself. Awareness is the catalyst to change and if you can give yourself permission to change one thing, start small. Perhaps you will decide to change routine on your way home from work by practicing sets of deep breathing at each red light. Or take a moment to go outside just to feel the warmth of your sun on your skin during a bathroom break. How do you incorporate wellness into your routine? Share by leaving a comment below!
Take a moment to scroll through these photos I took at the Jacksonville Zoo last weekend. And as you scroll through the photos, take just one moment to find one thing you notice about the tiger. Yes, just ONE thing...
Maybe your attention goes to the color of his fur, the detail in his stripes, or maybe you notice your own feelings about the tiger surfacing...
Perhaps by the time you get to the third image and you see the tiger practicing some mindfulness of his own, you will notice that this exercise took less than three swipes and a total of five minutes to do.
Therapy isn't meant to be a life sentence. Learning skills and techniques that you can apply to the real world is what I feel makes therapy a powerful investment.
Hope you are having a great week so far. Regardless if you are struggling or like Lil' Duval says, "living your best life", use this moment to take a step back, pause, and try to view your situation the way you would look at a painting in a museum.
Sometimes we can get so involved and caught up in our own story that we can forget to take a step back and see the bigger picture.
If you are at an art museum and come across a painting, you might go over to the canvas and inspect the painting from a close up angle. However, I doubt you could truly appreciate the piece of art just by studying it nose to canvas. In that case, you would be likely to take a step back and look at the painting as a whole and allowing whatever thought or emotion to surface as you stand and look at it from a distance. Why not do the same for your own story?
Taking a moment to pause, reflect, and appreciate just how far you have come isn't selfish. Gratitude is a nutrient that helps nourish the soul. *Ezekiel Elliot feed me motion*
Grief is not a linear process. Grief changes the various ways we make sense of our world with one less important person in it. When I encounter things such as these John Lennon stamps, I don't think back to the Beatles themselves. My thoughts take me back to warm memories of a beloved best friend and our connection that was founded on the Beatles and their music and I am so grateful for receiving this random yet powerful reminder of her. Find what soothes you and connect to that. Find refuse in your memories.
Generally speaking, Cognitive Behavioral Therapy (CBT) works by breaking down the thoughts, images, beliefs and attitudes and how these processes relate to how a person behaves (and emotionally responds).
Let’s look at this model from a different lens, or a somatic lens: you experience an event your BODY responds with a feeling (e.g danger, fear, excitement, happiness, pain) feeling gets translated into thought/opinion/memory (e.g Is it safe? Is it going to be painful? Can I get hurt from it? Maybe I should post that selfie to show my ex how I’m thriving) you respond and go from there (aka your behavior)
What’s my point? I hear A LOT of horror stories of folks having their feelings invalidated. Your feelings are so important. YOU are important. And when you are able to identify what you FEEL you can identify the thought and if you can do that, you can do ANYTHING.
Today we will go a little deeper in trauma. Dr. Stephen Porges developed Polyvagal theory to expand our understanding of how the nervous system responds to threat and trauma.
In our last post we briefly talked about the nervous system and it's role in trauma. Dr. Porges added a third factor: the vagus nerve. The vagal nerve plays a role in regulating the heart, face, stomach, and breath. The nerve also communicates with the brain. When talking about the nervous system, we will need to use some anatomical terms to orient ourselves:
Ventral: towards the front of the torso. The navel (belly button) is on the ventral or anterior part of the body.
Dorsal: towards the back of the torso. For example, the shoulder blades are dorsal or posterior to the ribs.
The vagus nerve, or more specifically the ventral branch of the vagus nerve, controls the muscles of the face. The face, heart, and lungs are all used when we interact with others (e.g. smiling or making eye contact, feeling our heart beating faster, using our lungs to speak and breathe). This is what Dr. Porges calls "social engagement". In other words, it is through our face, heart, and brain connection that we learn to respond to interpersonal threats and challenges. Let's use a worst-case scenario as an example of how this works. Imagine this: you are walking down a dark alley alone and you see a dark shadow in the distance approaching you. Your face (eyes, nose, and ears) capture the image, hear the footsteps, and smell any scents or aromas in the air. Your brain takes in all the information your sensory organs are sending and tries to make sense of the shadowy figure. As this takes place, your heart begins pumping a lot harder to disperse blood flow to your muscles just in case you need to fight or make a run for it (flee/flight) from this unfamiliar and potentially dangerous shadowy figure. So what just happened? Your vagal nerve was working in overdrive, working hard as gatekeeper of your body's responses to the environment, moderating a conversation between your brain and body during a moment of possible danger. Another branch of the vagus, the dorsal vagus, regulates organs below the diaphragm (e.g. stomach, intestines). The dorsal vagus activates what we call "shutting down" during overwhelming trauma.
Polyvagal theory emphasizes that our nervous system has more than one defense strategy and whether we use fight-or-fight or shut down, is not a decision we actively decide to use. But if we are trapped, or feel unsafe, our nervous system reads those cues and makes a decision from there. I should note these responses were adaptive to the environment or situation that an event or trauma occurred at a moment in time. This is where Somatic and Attachment-focused EMDR (Eye Movement Desensitization Reprocessing) can really help clients identify these patterns and work WITH the vagal responses to process painful memories and heal. Somatic and Attachment-Focused EMDR or SAFE EMDR model is compatible in treating most psychiatric diagnoses including but not limited to PTSD, trauma, anxiety, and depression.
This concludes our discussion about the neurobiology of trauma. If you or a loved one have any questions, would like further information on EMDR, or would like to set up an appointment. Please feel free to give me a call at 904.404.1763.
When telling people about the counseling services I offer I am often asked if I accept health insurance as a means of payment for my services. The response I tend to get when I say "No" is the question, "You don't take insurance?"
It's true, I do no not take insurance. Why?
There are a number of reasons for which I do not directly accept and bill insurance. When a mental health provider directly bills your insurance for counseling or psychotherapy services, your insurance requires a lot of personal information about you to ensure that you have a "medical necessity" which requires the need for mental health and counseling services.
"Medical necessity" means that you have a mental health diagnosis that is severe enough to be impacting your daily functioning, meaning your ability to get your day to day things done (eg. work, school, social interactions, activities of daily living such as bathing, eating, etc.). This means that a therapist directly billing your insurance needs to make a strong justification what your diagnosis is and how it impairs you from being a functional individual. Also, most insurance companies require treatment plans which itemize the issues we are working on in therapy and the goals we have set to help you resolve the issues you are working on in therapy. Some insurance carriers only authorize a certain number of visits and require reauthorization by asking the therapist to share more of your personal information with the health insurance provider each time you need more sessions.
Sound complicated and intrusive enough yet? It is.
One primary reason I don't accept insurance is due to my desire to protect my clients' privacy as much as possible. A second reason is because my clients are not so sick that their day to day functioning is impaired in a significant way. Most of my clients are educated, high functioning, successful people who are simply having a hard time right now and just need a caring, neutral, third-party to meet with to discuss their thoughts and feelings, and with whom to uncover other underlying hidden strengths.
However, I know that using insurance can really help the financial aspect of any type of treatment. Therefore, most therapists, myself included, offer a monthly Super Bill to their clients who request them for reimbursement purposes.
A Super Bill itemizes the services rendered, how much you paid for your services, and a diagnosis that is sufficient enough for the insurance carrier to pay you back a portion of the fees you paid for your services. As an "Out of Network" provider, I am outside of your insurance company's preferred provider network, meaning that some of the fees for mental health services might be reimbursable to you through your insurance provider.
If you are considering counseling services, don't let the cost of the services scare you away. Insurance is a great resource to have, and can be helpful, but in reality, investing in our overall wellbeing is a more cost effective way of managing our health. A part of that wellbeing includes investing in a really good therapist with whom you connect who can help you on your current journey through life.
Above all, if you are interested in counseling services and would like to use a preferred "In Network" therapist, I encourage you to lean on that. You could ask your insurance carrier to refer you to someone who is covered by your insurance plan, but remember, that therapist will have to share a lot of personal information about you to justify your need for counseling services. Keep in mind, sometimes paying more out of pocket for someone who you really connect with that is outside of your network can really make a big difference in how the therapeutic process works for you.
So, find out what your benefits are, crunch the numbers, and then, go out and pick that really amazing therapist with whom you really connect and let your healing process begin.
If you have any questions or would like to schedule an appointment, give me a call for a free phone consultation: 904.404.1763
Take just one moment of your day to look around and intentionally look at each object in your surroundings. As you focus on one object at a time, see if you can just notice the shape, the color, the size, the texture, maybe even sound.
This is the fun part: as you look at each object individually ask yourself "how would I describe this object to a toddler or to a visitor from a foreign country who does not speak or understand my language?"
It can be an uncomfortable feeling not knowing how to show you care and support a friend or loved one when he or she is in a dark place, whether it be depression, PTSD, anxiety, or anything else.
It's important to point out that support can look different for everyone. However, sometimes support is simply listening and validating feelings. Telling someone what they feel isn't real or isn't important may help you feel like you're doing due diligence encouraging someone to keep going but spoiler alert: it doesn't.
Validating feelings, whether or not you understand them, is SO important. Let compassion, kindness, and awareness be your guide to responding.
Remember: being present is sometimes the greatest present you can give.
Amy Pope-Latham, LCSW is a clinical psychotherapist in Ponte Vedra Beach, FL.