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.

Response to Johann Tari's TED Talk: What's Really Wrong Here

By Concentric Counselor Jennifer Larson, LCPC, NCC

Admittedly I do not carve enough time to watch or listen to TED talks.  One of my clients referenced how she will listen to them particularly when she’s cooking dinner.  My dinner routine typically entails listening to music in the background, catching glimpses of my son playing a game or doing his homework, or practicing mindfulness to be present when making dinner in effort to de-clutter my head space and take a reprieve from the perpetual tasks of multi-tasking. 

Listening to a TED talk while cooking dinner never dawned on me, and I liked the idea.  So, this past Monday I popped onto TED and scanned the topics.  Everything you think you know about addiction is wrong immediately piqued my interest. 

It jumped out, well because various forms of addiction is all so familiar to me due to my childhood upbringing and how addiction permeated the fabric of my family’s life as well as I am a psychotherapist who helps people to heal and work through their own addictions.  Plus, I was so curious to listen given the title was loaded with terms such as “EVERYTHING you think you know” and “about addiction is WRONG” that I wondered if this somehow applied to my personal experiences and professional knowledge of addictions.  We cannot possible know everything, and I became curious to know if there is information that breaks through the past and current trends about addictions. 

In his TED talk, Johann Tari, a British journalist, speaks about his own relationship to his family members who struggle with addiction, specifically substances.  His thirst for wanting to have a better understanding of what contributes or causes addiction drove him to find the answers.  His journey covers speaking with various people from all walks of life, spanning different cultures.

As I listen to his voyage, I am struck by his journey as he spoke with a street user and a Vancouver Professor of Psychology who conducted experiments with rats in isolation and within a community of rats called “Rat Park” to referencing the Vietnam War and Portuguese approach to decriminalizing drugs. 

In the end, Johann Tari argues it is a lack of human connections that contribute to and maintain addictions.  Conversely, deeper, human individual and societal connections can allay (or treat if you will) addictions. 

While I most certainly agree of the importance of human connections being vital to our biosocial-cognitive-psychological development, overall well-being, and yes, people who suffer from addictions, I have also come to recognize understanding the causes of and treating addictions is far more complex that just forming individual and societal human bonds.  Also, I would like to add we know earlier childhood attachment and social connections play a significant role when understanding addiction, so everything we know about addiction is wrong isn’t entirely accurate. 

Let’s face it, humans and addictions are complex.  We do not know everything there is to understand about the various forms of addictions spanning different social environments and cultures, but we do know quite a bit, and understanding the etiology and treatment of addiction goes beyond just forming human connections.    

Without going into nitty-gritty details, there are many models of addiction.  A few to highlight are the disease model of addiction which looks at the biology, neurobiology, and genetics of an individual as well as his or her social environment.  Some understand addiction by assessing a person’s earlier childhood and developmental attachment with their caregivers, the inherent chemical properties or pharmacology of a substance, and social evolution of groups of people over time (e.g. socio-economic status).  The public health model informs us to look at addiction by understanding the person and his or her vulnerability, the substance and its inherent properties, the vector (who brings the substance in and its incentives), and the social environment that allows and supports the use of substance.  And, the bio-psych-social-spiritual (BPSS) model takes into account the interconnections and interplay of the biology, psychology, social, and spiritual aspects of a person. 

What about process addictions where there is no substance or drug, and subsequently no inherent properties to even consider?  Process addictions are an addiction to an activity or person, such as gambling, spending, Internet, or co-dependency.  And, I have not even touched up treatment and recovery of addiction models which by the way vary depending on who you talk to, the substance or process, the various recovery approaches including 12-step models, and what best fits the individual person within his or her family and community systems. 

So, what started off as a little diversion from my usual dinner preparation routine has prompted me to inform others that we do know a thing or two about addiction and it’s more than just forming human connections.  Some of us may know inherently or through acumen that individual, family, and community connections are necessary and important for our survival, evolution, success, and even recovery, but please know understanding the causes and treatment of addiction go beyond human connections.  Now, that is something we do know.  

Connections Can Be Made

By Jennifer Larson, LCPC, NCC

On July 29th, I wrote a blog, "Can connecting with others through social media really work?"  I wrote this before Larson Counseling & Consultation kicked off its first "Let's Talk" series via Facebook during a specified one hour LIVE time-frame later that evening.

My colleague and I logged on.  The first 15 minutes were quiet -- quiet as a mouse.  Those 15 minutes felt particularly long because we did not know if anyone was present on the other side.  How would one really know when you are on Facebook?  Sure, you can see folks that are online and logged in, but it doesn't give you any more information than that.  It made me think that connecting with others via social media can be experienced -- or in our case during the first 15 minutes, not experienced.

After the lull, people started to 'message' us questions.  Good questions that pertained to the topic for that evening -- Let's Talk Therapy.  It was the first time where we 'connected' in this format.  I have to admit, somewhat reluctantly, that I felt a sense of a connection that took place.  By no means, does connecting via Facebook provide a comprehensive clinical or therapeutic connection, but nonetheless, there was a connection of sorts.  And I thought -- this is worth mentioning.

In the next 10 minutes or so, we are about to start our 2nd series, "Let's Talk Emotions" on our Facebook page. We hope to be able to engage and connect while providing some help. 

Disclaimer:  This 3-part "Let's Talk" Facebook series is not intended to give a diagnosis or provide treatment for a mental health disorder.  But, it may help to start an informal dialogue around possible symptoms associated with mental health disorders and to gather general information pertaining to personal, work, and/or family challenges.  Make sure you see your doctor or mental health provider if you think you may have symptoms of a mental health disorder.

Can Connecting with Others Through Social Media Really Work?

By Jennifer Larson, LCPC, NCC

I am somewhat of a late-bloomer when it comes to certain things, and using social media for my business is one of them. 2014 marked the year for me to jump on the bandwagon and sign up with various social media forums. Folks in the field of psychotherapy and counseling have long shunned away from social media, such as Facebook, for various factors (and with good reason), such as concerns around confidentiality, the inherent barriers that exist with truly connecting to another, and so on.  

When working with my clients, I have long touted the benefits of generating and identifying as many viable options (solutions or coping tools) as possible when facing challenges and obstacles in life. Why not I, as a therapist, consider as many options as possible when it comes to connecting and helping others?

Just minutes away, Ashley and I are taking the first attempt at connecting with others via Facebook by offering a Q&A. It is the start of our "Let's Talk" 3-part series. Tonight, people can ask questions related to counseling and therapy. Examples, such as: Which issues warrant counseling?  What is the difference between individual, couples, child, and family therapy? What can I expect in therapy?  What will it be like for my child or teenager to experience counseling? What are the benefits?

Looking forward to discovering a different way to connect.  

Free "Let's Talk" Series via Facebook

By Jennifer Larson, LCPC, NCC

Please join us for a free "Let's Talk" 3-part series that starts on Tuesday, July 29, 9-10pm CST. IT'S EASY! From your phone, computer, or any other device, 'like' us on Facebook. You ask a question and we provide an answer. For details on how to participate, please read the flyer. We look forward to talking!