The Role of Anxiety in Living an Authentic Life

By Concentric Counselor Christian Younginer, LPC, NCC

To be brief, anxiety can suck. The persistent worry of imagined scenarios can plague the mind and exhaust the body. It can manifest as brief periods of pronounced worry, a baseline worry for all things, and even panic attacks. But I would like to offer a perspective that may be overlooked in coping with anxiety. That is, can my anxiety teach me something?

Specifically, can my anxiety teach me how to live an authentic, meaningful life? This question shapes Existential Therapy. At its broadest, existential therapy is the endeavor of understanding one’s existence in a therapeutic setting. This is done via an honest exploration of one’s freedom, choice, responsibility, meaning, and inevitable death. Existential psychotherapist Irvin Yalom conceptualizes much of anxiety as death-anxiety (Existential Psychotherapy, p.189). That is, persistent anxiety can be explained as an underlying worry about a life without meaning in the face of approaching death. Death is what allows life to have meaning. If there were no end, then for what should we live? The finiteness of life can motivate, intimidate, and terrify. However, it is this anxiety that can be the canary in the mine of our life.

As we work, study, sleep, parent, eat, play, drive, and journey through life, meaning and purpose can slip through the cracks. Anxiety can creep in, seeming to have no definable impetus. Often enough the death of a loved one, or a diagnostic medical scare can bring perspective -- wherein we confront our death. But one does not need to wait for such a moment to ask these questions, such as “Why am I here?”, “What does it mean to exist?”, and “What is my purpose?”.

Anxiety can be that canary that alerts us of an inauthentic life. It warns of the finiteness of life, and the importance of living a life with meaning. This often manifests as a vague sensation of “running out of time”. Without meaning, one can find life pointless or trite. The finiteness of life no longer motivates, it terrifies. But if we listen to what our anxiety is telling us, perhaps we can redirect our lives towards meaning.

How does one do this?

An example from philosophy may be of use. In Frederick Nietzsche’s The Gay Science, Nietzsche offers the reader an aphorism he titles ‘The Heaviest Burden’. He proceeds to ask the reader: if a demon were to order that you must live this life in eternal recurrence, every moment, detail, pain, and triumph- would you thank him or curse him? (The Gay Science, Aphorism #341). So, do I live my life in such a way that were I to re-live this life on repeat, I would praise the demon with gratitude for the opportunity? Or would this prospect bring about the abysmal dread of re-living a meaningless life? It is this precise idea where anxiety comes into play. Am I experiencing the anxiety and dread of a life not worth re-living?

It is this question that can help steer us towards meaning. Do I live in such a way that were I to re-live this life on repeat, would I be in joyful contentment or in abysmal dread? This is a tough question with which to be confronted. However, we can use this question as a beginning: the moment one begins to ask “does my life have meaning?”. Rather than be frozen by the possible dread this question instills, one can frame this as the moment in which a new life begins. As always, Confucius said it best, “ We have two lives, and the second begins when we realize we only have one.”

Determining WHAT is meaningful is a personal journey that can take time to uncover. But knowing thyself was important to Plato for a reason. It is this existential journey of a human confronted with death, through anxiety, uncovering that which gives their life meaning.

To conclude, yes, anxiety does suck. But as we work to cope with it, let us ask -- What is this anxiety trying to teach me?  Anxiety very well may lead us away from the existential dread of an unexamined life, and instead towards finding a meaningful life worthy of repeating.

Sexual Trauma, Triggers, & The 24-Hour News Cycle

By Concentric Counselor Katie Ho, LPC, NCC

You can hardly escape today’s current social and political climate - it’s on the news, in your social media, overheard at lunch, and even for therapists, themes in session. For those who have experienced trauma in their lifetime, past or ongoing, navigating topics like sexual assault can be overwhelming, scary, complicated and sometimes even powerful. How we take care of ourselves and the people around us who may be struggling with the complexity of their emotions has to be part of the larger conversation. It’s clear that avoiding or minimizing discussions on sexual violence and quieting the stories of survivors is not the path to atonement and reconciliation. But as we create space and lift up the voices of those who have suffered, we must also take inventory of what comes up in us and tend to those parts with kindness, care and nurturing.

The #MeToo movement, local and national advocacy groups and social justice organizations have been and continue to create a platform for those who have been victim to sexual harassment and assault. While the stories and accounts of these traumas seem to be daunting all of the sudden for those who have been unaware, statistics and experts have known for some time of these experiences. The National Sexual Violence Resource Center (NSVRC) estimates that 1 in 5 women will be raped in the United States in their lifetime, and that 1 in 3 women will experience some form of sexual violence. The majority of these acts are committed by acquaintances, partners or people who are known by the victim, and according to the Rape, Abuse & Incest National Network (RAINN), the majority of these events occur at or near the victim’s home. These of course are statistics, data and research gathered through reports from multidisciplinary agencies. There is undeniable value in knowing these numbers. And just as much, there is value in hearing the experiences and seeing the faces of survivors who have chosen to come forward.

As allegations and reports of sexual assault make the news, we are bombarded with information, opinions, commentary and even jokes on the matter. Survivors are subject to their own re-traumatization, which has an impact on psychological and physical health, triggered by both the details of these publicized allegations of assaults and non-believers who dismiss them.

In knowing that a trigger is a psychological stimulus that can be evoked through anything from sights, smells or sounds, it’s no wonder that the 24-hour news cycle is affecting so many people. Survivors are not alone in their strong reactions to the constant replaying and subsequent criticism, shaming or dismissing of survivor stories. Those who feel a connection or calling to the cause, whether it be through their empathic attunement or knowing a survivor, may also experience the distress and burnout that comes with the current climate.

So how do we take care? How do we balance the righteous anger and complexity of our other emotions, promote advocacy and change, all while healing and taking gentle care of ourselves? In doing this, one of the most important things to know is nothing can replace the support of others. So find someone, or a group of someones, who can help to support, validate and foster a safe environment for processing.

Find a tribe, or maybe even create one. Pay attention to your body, as our physical being can often tell us when stress is increasing and it’s time for tending and healing. Maybe that means physical exercise, movement, touch or a practice of progressive muscle relaxation (a quick YouTube search is all you need!). Set boundaries. Limit your intake of news and dialogue on the topic by knowing how much mental and emotional labor you’re able to give without overextending yourself. And if you find yourself overwhelmed, triggered or lost, use mindful grounding techniques to bring yourself back into your here and now. Feel your feet on the floor, describe and notice something around you, use your five senses to bring a consciousness into your physical environment and current moment in time and add in a quick reminder - “I am safe. I am in control. I am okay.”

Is Your Saw Dull? A Self-Care Mandate Is Your Sharpening Tool→

By Concentric Counselor Stacey Kiran, LSW

This blog post goes out to anyone who has said to themselves recently, “I really need a break.” or “I have no time to relax!” I am here to tell you – Your time has come! Huzzah! I am going to provide all readers with a Relax and Self-Care Mandate.  My purpose for this mandate stems from learning the importance of self-care in graduate school. During grad school, students are told to 'take care of yourself' so often, it felt like a mandate.  And I often found myself thinking, “I wish someone would have forced me to take care of myself before grad school, I could’ve used it then, too!”

Are you feeling burnt out from the grind of work and life?  Noticing negative effects of this routine in your personal or even work relationships? Do you feel you are missing out on some understanding of your your family or friends' experiences? If you answered yes, you may be experiencing empathy-deficit for others.  Also known as compassion fatigue in the field of counseling and therapy.  

Maybe you will need to first ask yourself “Is empathy important to my relationships?” If that is a question that is hard for you to answer, I am going to point you to the Queen of Empathy, Dr. Brene Brown. She has a short, fun cartoon for you to watch on the importance of empathy, check it out here. 

The article Self Care as an Ethical Imperative offers the story of a person sawing down a tree with a dull saw. Try to tell that person to take a moment to sharpen their knife and they say “I don’t have time to sharpen it! I am too busy sawing!” Well, you can easily imagine using a dull saw will wear on that person, making that person feel depleted and disconnected. This same story applies to many people.  I am sure you may feel like you are a personal or professional lumberjack in your life.  For example, caregivers (including therapists) are in the role of taking care of others, but may feel too busy to take of oneself.  Or people who are not necessarily in the helping role, but who go through the daily grind may feel there is not enough time to nourish oneself. 

So, I ask you, "How's your saw?" Finding yourself too busy or depleted to pause and sharpen your saw?  In graduate school, I was taught the role of a therapist needs to take time for self-nourishment. If you don't take care of yourself, you can't responsibly help others.  Relax and Self-Care Mandate. 

Then from Mandate to Practice.  Let me get to the point here - I am talking about moving away from a Mandate to a Practice. It’s not like I never heard the term Self-Care before grad school. But, in grad school, the phrase Self-Care began to mean something much more to me than “Go to an exercise class.” It meant ask yourself, "Am I feeling okay?"  "What is my body telling me I need?" And, be honest. Because if you are not feeling okay and you ignore it, you could burn out at work or at home or burn the candle at both ends. What is the cost of you continuing your life while still burnt out? The cost is the energy you could be curating and nurturing that can go in to a better tomorrow, a better you, and better relationships.

Many people reach out to therapy to improve themselves and their relationships.  If you want to better your relationships– start by relaxing. Sounds counterintuitive? Well, like non-nourished therapists who cannot responsibly help their clients, can you take care of your loved ones if you are depleted?  Be fully present?  Can you be empathetic towards the people you care about? 

In grad school, I kept finding myself think I want empathy in my personal life, not just my professional. I want to be present in my personal relationships.  I want my loved ones to present to me!  Why should this only be taught to grad students in the field of social work or counseling?  Or to therapists? It shouldn't be reserved for a select few.

So, I want to pass along this important information by first giving you a Relax and Self-Care Mandate.  Followed by a simple, but yet effective step-by-step guide to help you move into Relax and Self-Care Practice.                                                                                                            

1. Ask yourself, “How do I feel?” – You can ask yourself this question at anytime: every morning, or when you notice yourself doing something you don’t particularly like (i.e. eating an entire large pizza), or when you are doing something or know you will soon be doing something that is stressful (visiting family, perhaps). And this is a good one, if you find yourself fighting against something that usually helps you (i.e. listening to music when sad or going to yoga after work – be aware of those feelings! Listen to them!)

2. Listen to yourself. Closely. Carefully. With compassion and non-judgment. Judging yourself will only prolong your path to feeling good or better. (Hint – You can tell that your Critic is speaking in this part of the Practice if you feel small. Your truest, most helpful answers here will always make you feel more open, not smaller.)

3. Ask yourself, “What do I need?” – non-judging is the name of the game. And dare to dream! You can also pose the question “What is standing in my way of feeling however you want to feel. (This is a concept from the book I recommend, Focusing by Eugene Gendlin, Ph.D.).

4. If you can’t hear the answer, then close your eyes. Often when I cannot hear an answer, I just need a break to think about it and to listen, carefully. Think about it. If you can’t hear an answer about what you need for yourself, then chances are that you can’t hear others’ needs. And, you can't be as present in life. So take a break until you can get an answer.

5. Follow through. Your answer appears to you, and now you need to connect, commit and follow through. For instance you find yourself wanting or needing a break or vacation. Let's say you have no PTO. Find a way to give yourself the break, even if it's taking an afternoon off.

And, in closing, I want to remind you – when things get shaken up (could be due to a stressful life event, positive transition, recurrent memories, trouble in relationships), our Relax and Self-Care Practice may need to begin to include the use of a professional therapist.  I invite you to utilize the tools and guide I have learned for my own Relax and Self-Care Practice. Following your internal instincts of what you need is not just good Self-Care, it is, ultimately, being true to yourself, which may feel foreign in a life of meeting others’ expectations.

It is possible to follow your own voice, meet your own needs, and be true to yourself in a life of others’ needs. And, if you have children, loved ones, or employees looking to you for example or direction, you may model to those little ones, loved ones, or employees that it is OK and appropriate for them, too, to take care of themselves. So, get out there and sharpen your knife.  Engage in your Relax and Self-Care Practice.  And, start enjoying your life!  

A Therapist's New Year's Resolution

By Concentric Owner & Counselor Jennifer Larson, LCPC, NCC

In only a few more days, 2017 will come to a close.  It will be a time to think ahead – many will ignite their New Year’s resolutions.  While I may not routinely come up with New Year’s resolutions, I do think about and write down my personal desires and goals throughout the year.  And, I have decided that I will come up with a New Year’s resolution for 2018.  Before I share my resolution, I would like to share part of my roadmap that has led me to this juncture.

As I have engaged in reflection, I found myself returning back to a perpetual theme that would emerge and re-emerge over this past year.  One particular theme is what I will name as the ‘non-self-disclosing' therapist vs. the 'self-disclosing' therapist wrestling match.  I have no idea when the sport of wrestling season begins and ends, but I can tell you this particular wrestling match has persisted season after season. And, my hope for 2018 is the self-disclosing therapist will take the lead and possibly bring the wrestling match to a close someday soon.     

Let’s start back when these 2 wrestlers first met.  Perhaps they were both first introduced way back when, before the days of graduate school as 'non-self-disclosing' me vs. 'self-disclosing' me.  In my formative years, I grappled with how much to disclose and how much not to disclose my vulnerabilities. And if I did, I chose wisely with a very select few.  Some would say this is normal as we need privacy and boundaries while others may offer a difference of opinion.  Now, let’s fast forward to when I enter into graduate school where I am confronted again with choosing and deciding on how much to disclose.  This time it is focused more on me as an emerging therapist, not me personally.  In the earlier stages of education, students learn about various theoretical orientations and the relevance and implications of non-disclosing and disclosing to one’s clients. 

Just after the start of the millennium, I recall being enthralled with the tug-of-war game that was played during a semester course on ethics.  Our instructor was instrumental in leading the charge on getting all of us graduate students to really explore how to handle ethical dilemmas that can and will mostly likely confront a professional counselor, social worker, or psychologist.  Depending on the topic, some students would sinuously form into 2 teams, tugging and vying for one end (yes, it’s okay to self-disclose to a client; yes, it’s okay to hug certain clients upon closing a session), while the other group pulled and vied in the other direction (no, it’s not okay to self-disclose and hug a client). It was one of my favorite graduate courses as our professor and the course curriculum gave us the space and freedom to think critically and to share our perspectives and beliefs.  Some topics called upon us to unequivocally unite together whereas other topics had students participating in the game of tug-of-war, and well some (ahem) left all of us pooling together in the middle, gray area -- scratching our heads saying, “It just depends, it’s not so black-and-white.”    

Does a therapist merely act as a ‘blank slate’ allowing for one to free associate more easily? Or does a therapist offer some disclosure about their experience and feelings in relation to one’s client (countertransference)?  As therapists, do we divulge some our personal, relatable experiences, such as, “I share the same fear of heights as you do – here are tools that have been helpful to me.”  To disclose or not became even further embedded post graduate school during professional training courses and consultation. And for good reason, this particular topic warrants so much attention in the world of psychotherapy.  I understand the clinical relevance and implications – I get it. 

Over the past 15 years with greater professional and personal life experiences, I have found myself continuing to think about the inquiry of the self-disclosing therapist. At times, I have put forth a tidbit of self-disclosure when I believed it to be ‘clinically appropriate’ or when it simply felt right.  The self-disclosing therapist is not uncommon for some psychotherapists, and it's probably still one of the more debated issues in the field.  Over the past year or so, the inquiry in my mind has expanded beyond the closed doors where therapist-client, supervisor-supervisee, and consultant-consultee relationships are formed, maintained and evolve.  

Questions continue to knock on my door, such as, do I as a therapist share my story (or stories) with others publicly?  Is there value in therapists who choose to open up in a more public forum?  How about us therapists taking our practice even further by exercising vulnerability and using our voice through other outlets?  Are age and credibility in the field some of the salient determinants when choosing to publicly divulge as a professional?  What is too much to self-disclose in written form? Could casting a wider net be detrimental to a therapist’s profession?

While these particular questions have lobbed around in my head for just over a year now; admittedly, they have not been all ‘heady’ taking up rent in my mind.  Sometimes (and many times), I would simply experience this feeling inside of me – near my heart or gut – nudging me to share more and to share with more people.  Stop thinking so much and just take action.  Take the leap and have faith.  Even a call to duty would emerge from within as well.  But why and for what purpose?  The answers didn’t seem readily available to me.  And then over the past few months, it all became clearer.

Earlier in 2017, I learned about On The Table and the #BreakTheSilence initiative by The Kennedy Forum.  I was immediately pulled in as I loved the mission and purpose of this initiative.  Bring people together to give people an opportunity and space to talk about mental health in effort to reduce the stigma that still hovers around and shrouds the already cocoon existence of mental health. The idea is that when more people talk about a topic – in this case mental health and addiction – a positive rippling effect can ensue. 

The more people talk about mental health…

• The easier it will be for all of us to talk about it.

• Better yet, the easier it will be for all of us to talk about it without feeling shame, crazy, or embarrassment.

• The more we will feel safe and free of judgment.

The more people talk about mental health, the more…

• People will seek out help.

• We will honor and view mental health as another facet of humanity and life, just as we do with other areas, such as our physical health.

• We will advocate for change across cultures, families, and even within the helping professional field.

• Opportunity for positive changes within the health care insurance industry.

The continual, cascading effect.  The more people talk about mental health and addiction…

• The more we will become intimate and experience love.

• The more we will be empathic and compassionate.

• The more we will be more understood and connected.

• The healthier we will all become and the more lives will be saved.

Who doesn’t want to experience these things for themselves and others? 

Concentric Counseling & Consulting hosted its first On The Table Discussion on May 16, 2017.  The turn out and experience was inspiring and moving. We even shared people’s stories, experiences and solutions for people to read in our blog.  However, the Concentric’s therapists served as hosts and guides – we were not active participants in this discussion.  No self-disclosing.  This is not a terrible thing, but the knocking on my door didn’t go away.  Should we have re-considered actively participating in this dialogue?  Sharing would mean ‘more people’ talked about mental health and addiction, right? 

There have been other initiatives and movements this year, including one of the more recent ones that started in October 2017. The #MeToo movement gained momentum and traction which has given people collective permission to break free of the shackles that have promoted and reinforced silence, inequality, sexual harassment, discrimination, and assault, shame, and for some, the cocoon existence of mental health. The #MeToo movement encouraged women to share their stories in effort to give people permission to break their silence to unite and to bring greater awareness about the prevalence of sexual misconduct.  The more people talk about their experiences and hardships, the same effects will occur as with the more people talk about mental health and addiction.  Movements like these promote the cascade effect which in turn promote movements – a positive feedback loop. 

All of these experiences along my personal roadtrip have touched and impacted me.  And, while I recognize that I am helping people, I have also recognized that choosing (more times than not) the non-self-disclosing therapist may just not be as helpful.  I believe in the importance of using one’s voice, honoring one’s experiences with integrity and respect, and I want to help become a part of the bigger picture.  I want to talk more about mental health and addiction publicly in effort to help achieve with many others a positive cascade effect.  It won’t be easy for me, that I know. Truthfully, I am not quite sure where to start, what I will disclose about and which platforms to traverse.  What I do know is I now have a clearer understanding of the persistent themes that knocked on my door.  My deeper desires and hopes for all by talking about mental health.

So, my New Year’s resolution for 2018 is for me as a therapist is to start leaning in, to become more of a self-disclosing therapist by sharing more publicly some of my own mental health challenges and triumphs.  Happy New Year Everyone! 

Listening to Our Inner Critic

By Guest Blogger Santiago Delboy, MBA, LCSW, S-PSB

Santiago is a bilingual psychotherapist in Chicago, where he works with adults who feel stuck, broken, empty, lonely, or out of control. He uses a relational approach to help people develop self-awareness, understanding, acceptance, and growth. Find more at www.santiagodelboy.com.

Michael is a bright and sensitive man in his 30s. He is the youngest of four siblings and grew up in what, from the outside, seemed like a happy and stable home. In many ways it was indeed happy, but Michael always felt like an after-thought to his parents. He struggled to feel seen and loved, and tried very hard, in many unspoken ways, to find his place in the family. The weight of this longing and the intensity of his efforts became overwhelming as a teenager, when he abruptly fell into a deep depression.

After college he had a number of jobs and romantic relationships, all of which left him feeling drained. For a long time he struggled to recognize his value and skills, doubted his capacity to love and work, and felt flawed and inadequate. Unsurprisingly, Michael felt constantly reminded of all this by a very loud and active inner critic.

We all have a voice in our head that is critical, judgmental, and disapproving of ourselves. That voice can be mild and not always present. We may hear it in specific situations or with specific people. Sometimes, however, that inner voice is constantly giving us unsolicited commentary and incessant chatter, becoming part of what Buddhists would call our Monkey Mind.

A quick Google search for “inner critic” results in advice on how to silence, get rid of, overcome, or ignore this voice. This advice usually entails a number of steps that promise quick relief. They include becoming aware of the self-criticism, conducting reality-testing to check it against the evidence, separating ourselves from the critical voice, replacing negative thoughts with positive ones, and having a realistic appraisal of the criticism’s implications and consequences.

These are basic cognitive-behavioral tools sprinkled with some mindfulness, which can definitely be helpful for some people in certain situations. I understand that if people feel their inner critic is a nuisance, they may want to shut it down. However, there is something about the notion of disproving, silencing, or reasoning away our inner voice that doesn’t feel right to me.

Not all criticism is created equal

When I hear the inner critic from people like Michael, or myself for that matter, I wonder what that voice is really saying. The messages we are aware of might be “I could never start a conversation with a stranger” or “I don’t know how to ask for what I need,” but what they really say is “I am broken and don’t deserve to be loved” or “my needs don’t really matter.” I believe that it makes a big difference whether the judgment is about our actions, or about who we are as human beings.

When the latter happens, the voice in our head is carrying a message of shame. It tells us we are not smart enough, attractive enough, funny enough, or good [fill in the blank] enough. That voice is abundant in “shoulds”, telling us that we should behave, should think, or should feel differently, and that there is something fundamentally wrong about us if we don’t or can’t.

To make things more complicated, our inner critic is not only active when we hear it and it doesn’t only manifest verbally. Michael’s depression during his adolescence, for example, could be understood as a massive expression of his inner critic. Those years were embedded with feelings of helplessness, hopeless, and worthlessness. The connection between depression and self-deprecation is not new; Sigmund Freud discussed it eloquently a hundred years ago, in his paper “Mourning and Melancholia.”

From trauma to self-criticism

I am not sure the messages from Michael’s inner critic, as a teenager and as an adult, were distortions that could be corrected with reality testing and cognitive reframing. Michael tried those things before I became his therapist, and in a way they set him up to feel more shame. There had to be something wrong with him, he told himself, if he couldn’t get better by thinking better. He started developing acceptance and feeling more compassion toward himself once he started understanding that his inner critic was an expression of the trauma he had experienced, and the feelings he had learned to ignore as a result.

The trauma Michael experienced did not require a specific event. His parents had a relatively stable marriage without significant economic difficulties, and he didn’t recall anybody being verbally, physically, or sexually abusive at home or elsewhere. However, he grew up experiencing emotional neglect, not feeling seen or loved unconditionally. He learned that no matter how hard he tried, he would remain invisible and his needs for connection would not be met. As a result, there were parts of himself that remained invisible and disconnected from his own awareness.

This is part of what is called fragmentation, which is one of the key features of trauma. Our sense of self is split and we may lose contact with some parts of who we are. These parts may hold overwhelming feelings that are too hard to tolerate, let alone accept, such as pain, hatred, terror, or desolation. Some of these feelings might turn into anger, which we may then direct at ourselves. That is often times what is behind our inner critic, anger that is really masking sadness, fear, pain, or emptiness.

Move toward, not away

If our inner critic is a part of ourselves that we disowned, seeing it as the enemy means seeing ourselves as the enemy. Trying to silence or ignore that voice means trying to silence or ignore a part of ourselves that is suffering, a part that may have already been struggling to find its own voice for a very long time. Feeling ignored, silenced, or invalidated was precisely part of the problem, as it contributed to give birth to our harsh inner critic in the first place.

Because of this, the question I try to answer with my patients is not so much how to silence that critical voice, although that might be important to address, but why is it there? What happened to them, first to feel so angry, and then to direct that anger to themselves? And, more importantly, is it possible for the two of us to keep a curious stance and an open mind toward his inner critic, to be able to listen to it with compassion and kindness, and to become willing to accept it, embrace it, and love it?

Listening doesn’t mean agreeing with what it says. Accepting it doesn’t mean taking on its criticism. Embracing it doesn’t mean believing that its judgements are fair or accurate. But unless we do those things, that part of us will remain unseen and unheard.

The judgement, criticism, and negative self-talk can be very harsh, cruel, or even hateful, but they are usually symptoms of old wounds that run very deeply. Martin Luther King, Jr. said that hate cannot drive out hate; only love can do that. Within ourselves, only love toward our inner critic can begin to heal the wounds that hide behind its harshness.

It is true that self-criticism can sometimes get in the way of our accomplishments, boycott our relationships, and put a hurdle to our growth. However, the main challenge is not really to eradicate, tame, ignore, or disprove our inner critic, but to be able to hold it with love and make space for the feelings it carries within. The more difficult and upsetting it becomes, the more patience and kindness it probably needs. Our inner critic is a part of who we are and it deserves, like every other part of us, our unconditional love and regard. The journey toward a fulfilling and wholesome life is long and worthwhile, but we cannot really take it if we cut off a part of ourselves.

Your Voice Matters: Honest Discussion about Mental Health and Addiction

By Concentric Counselor Jennifer Larson, LCPC, NCC

It’s been about 3 months since Concentric Counseling & Consulting hosted its first On The Table 2017 conversation, and I am still impacted by the experience.  First let me backpedal to how I first learned about The Kennedy Forum, one of the co-sponsors of On The Table. 

It was the Fall of 2015 and I was having a conversation with my friend Caroline McAteer about various social issues and she had asked me if I heard of The Kennedy Forum.  Much to my chagrin, I had sheepishly told her that I hadn’t.  She told me about The Kennedy Forum’s mission and details of their annual meeting.  I was instantly intrigued and had to dig in.

Of the many things learned, one of them was Patrick Kennedy of The Kennedy Forum and his involvement with The Mental Health and Addiction Parity Act of 2008; he is still putting forth advocacy efforts to have The Act enforced on a national level.  I remember the buzz just before The Act went into federal law as I knew all too well the red tape and consequences people, including my own therapy clients, faced with limited mental health sessions imposed by insurance companies.

Fast forward to Spring 2017, and I learned about On The Table initiatives (co-sponsored by The Kennedy Forum and The Chicago Community Trust). Once again, I was intrigued.  On The Table initiative is about having people host open and honest conversations about mental health and addiction in effort to #BreakTheSilence and eliminate the stigma around mental illness and addiction that still greatly exists. 

As a counselor, I regularly encourage my clients to use their voice whether it is to share, increase vulnerability or intimacy, honor or advocate for oneself, and to work through the shame that often plagues people with mental illness and addiction. 

The focus of psychotherapy with my clients typically entails understanding and resolving challenges with one’s intrapsychic and interpersonal relationships (represented by inner concentric circles, hence the name Concentric) versus the larger, social systems (outer concentric circles).  Participating and joining forces with other hosts to help end the stigma associated with mental health and addiction while giving people an opportunity to use their voice fit Concentric’s mission with helping others to your their voice – but this time on a macro level.    

On May 16, 2017, the therapists at Concentric Counseling & Consulting hosted its first On The Table 2017 conversation in Millennium Park, across the street from our office.  It was an unseasonably warm and windy day, and our topic was "Your Voice Matters: Mental Health and Addiction.  Honest Discussion About Why More People Don't Seek Out Help." 

We had an incredibly diverse group of people who actively participated.  It was such an honor to hear people’s stories and ideas about why more people don’t seek out help.  So many stories and barriers were shared.  Common themes emerged and were extracted.  Follows are some of the common themes people described that either prevented them or others they know from seeking services:

• Stigma, embarrassment, and shame. Seeking help is seen as a weakness. What will my family and friends really think about me? Will I be seen as a ‘nutcase?’ Denial about having a problem or my ego getting in the way.

• Financial burden and obligations. Lacking financial resources all together. Treatment is a privilege for only those who can afford it. Lack or poor insurance coverage. All of the convoluted layers to insurance coverage.

• Lack of information and available resources on how and where to find mental health and addiction services. Example given was local university offered free counseling services to its students but was not aware of services until his senior year of college. Not knowing how to access services or where to start. Location and other barriers to gaining access to solid services.

• Cultural barriers and roadblocks, including families of certain cultures not supportive of mental health services. Experience with providers who lack cultural, gender identity, and sexual orientation competence. Religious barriers and lack of supports within religious communities.

It is a reminder to all of that us that suffering from mental illness and/or addition is hard in of itself, not to mention having to endure additional barriers that get in the way of seeking and accessing help.  Some of the solutions shared were not only to address or remove the aforementioned barriers and roadblocks, but to focus on the equity of mental and physical health. 

People remarked how it is much easier and more acceptable to talk about their physical ailments, but not their mental health.  Let’s look at people wholistically and give the mental health side the same due attention and respect.  Another solution shared was to target childhood prevention. 

One of the guests remarked in early childhood, we learn the importance of daily hygiene, such as brushing our teeth daily.  Why not introduce conversation around mental health care at an early age or make mental health education mandatory in schools.   Also, when providing education on mental illness and addiction, don’t use extreme or scare tactics, such as the “This is Your Brain” drug campaign did in the 1980s.  Guests remarked it only silences people more. Instead, provide a spectrum of information that can resonate with or speak to a variety of people across all ages and cultures.

My hope is that the information shared from our diverse group in Chicago can continue to be shared with others. And importantly, inspire all of us to participate in more active conversations about mental health and addiction whether it’s in your home, at work, in your community or as an On The Table host.  Because Your Voice Does Matter!      

Is All Drug Use Created Equal?

By Concentric Counselor Myron Nelson, LCPC    Edited by Concentric Counselor Jennifer Larson, LCPC, NCC

All drug use is not created equal.  Take a look at that statement again and see if it contradicts or confirms your views on substance use.  I hope by the end of this post you feel it does both.  As a country, we are simultaneously experiencing an opioid heroin epidemic and progression in the legalization of marijuana. Clearly, drug use is not so black and white.  I aim to gray the edges and disrupt some of your beliefs because critical thinking is needed in these cacophonous times.  

We often tell kids to beware the slippery slope of drugs.  As if smoking marijuana is a banana peel slide away from cocaine or criminal behavior.  Not only does that argument neglect to account for alcohol (being many adolescents first introduction into mind-altering substances), but it also purports that all drug use is inherently related or equal.  To say that one drug can lead to the use of another may be true, but that is because things kept hidden away in the dark tend to be hidden together.  Research debating the effects of the slippery slope can teeter in either side's favor but both sides would agree that every individual person's path does not neatly align one way or the other.  That point should not be ignored.  

If you are concerned about someone's drug use, talk with him or her about it.  There may be underlying mental illness issues or some form of trauma that is being treated by the effects of substances.  Many will turn to substances to self-medicate symptoms of mental illness, neglect or trauma.  Additionally, experimenting with drug use can be a normative behavior for certain subgroups.  That does not mean it is safe or healthy, but it also does not mean its intent is malicious.

When you talk with someone about their behavior, be sure to not talk at them.  Be mindful that attacking or judging their behavior typically is not going to lead to a productive conversation.  Come to them seeking to fully understand them and what is going on.  Coming down with an iron first also spreads the message that substance use is only dangerous.  To pretend that substances or drugs do not produce a euphoric or calming effect creates misconceptions.  

If I were to cite research and share stories about the detriments of TV and forbade you from ever watching it, what might happen if you finally caught a glimpse of some TV show?  You might find it enjoyable and then seek out other people who like to watch it too.  You may then find yourself containing this information for fear of being criticized by others.  So it becomes one of your secrets.  Likewise, what if all you heard about alcohol was that it causes hangovers?  

If you inform people about the benefits and consequences of substance use then they can start to formulate the foundation of decision-making and choices.  If you think it is too dangerous to expose them to that knowledge, you may need to think again.  You cannot stop it as images and scenarios of people enjoying being high on some kind of substance are constant in the media.  Plus, putting up walls of censorship in the Internet era can be futile with certain people.  You do not have to fight a battle against people discovering drugs can have positive effects; you can incorporate that as part of your conversations.  Conversations with a 's' -- it is plural for a reason.  No topic as big as substance use is going to be covered in one sit down.

Given what I've written so far you may imagine that I am an advocate in a way that I am not.  When it comes to most substances and drugs, I take a firm stance that substance dependence is unsafe with detrimental consequences.  I do not think someone's only way to relax after a long day at work should be to drink a beer and I do not think someone who is constantly depressed should seek to escape with substances, such as ecstasy.  How someone is using should be discussed as well as what they are using.  Certain drugs are more associated with images of horror or suffering, sometimes rightfully so, but do not let the name fool you.  

This blog post is one part informative, two parts inquiry.  It is a questioning of the commonplace idea that we have to draw deep lines in the sand about what drugs are not okay and when.  We would all benefit from looking at all use in more detail.  Parting words -- Experimentation is not addiction. Information is not dangerous (taking into account age and other factors).  Open up the conversation and have many of them.  Seek professional help if you believe you or a loved one struggles with substance abuse or dependence.