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.

Moms -- You Hold the Key to Your Daughter's Healthy Body Image

By Concentric Counselor Michelle Taufmann, LCSW

Excerpt from Neighborhood Parents Network (NPN) blog: Moms, You're The Key To Your Daughters' Positive Body Image

How do we equip girls with a positive body image? It’s a never-ending question that doesn’t seem to wane no matter the advances of women in society. Articles in the press in recent years suggest that mothers are the most influential when it comes to girls’ attitudes toward their bodies. While societal messages, stereotypes and peers are influential forces, mothers are their daughters' primary teacher when it comes to beliefs toward body and physical mage. 

How do mothers influence their daughters’ body image a healthy way? Focus your attention on the function and ability of body. When mothers appreciate their own and their daughters’ bodies for what they are capable of— resilience, flexibility, strength, and endurance —they help their daughters develop a positive perspective on their bodies. This one may be obvious, but is worth saying for those who have any doubts: Do not make negative comments or claims about your daughter’s body (e.g., “Wow, you sure got my thick ankles, didn’t you?"). It’s even best to keep favorable comments about your daughter's image to a minimum in effort to prevent over-identification with the body. Another “no-no” is supporting your daughter to diet or “watch her weight” (unless it’s medically necessary). Even if dieting is her idea or because her friends are doing it.  Discourage it and take some time to have a healthy discussion about it.

Want to know more about how to be how you can help your daugther have a positive body image?  The entire blog can be found by clicking here.

How To Talk to Your Child About Sexuality and Gender Identity

By Concentric Counselor Myron Nelson, LCPC

Excerpt from Neighborhood Parents Network (NPN) blog: Is Your Child Questioning Sexuality or Gender? 

You have noticed that your child is becoming attracted to a child of the same sex or is engaging in cross-dressing.  Possibly your child is asking you questions about your own gender or sexual orientation.  You're probably wondering, Is this just a phase? Buckle up, because it’s not simple.

The answer is yes and no. Some children have a clear sense whether they’re lesbian, gay, bisexual, transgender or queer (LGBTQ) from an early age and it never changes, while others might question and experiment with those identities only for a period of time. Most people report they have a sense of their sexual orientation and gender identity around 10–13 years old. But that does not mean several people won’t experience periods of time where they may be attracted to someone of the same sex or wish to express their gender differently at any age.

Thinking about whether these changes are temporary is really just the beginning step to asking, What should I do? And luckily that answer is simple and can be summed up in 3 tactics: Be loving, ask questions and educate yourself. Before I explain the benefits of following these 3 important steps, I’ll make a case against why not.

Want to know more about how to these 3 steps as well as what to avoid saying or doing with your child?  The entire blog can be found by clicking here.    

A Window Into Helping You Understand Boys And Emotions

By Concentric Counselor Myron Nelson, LPC, LCPC

Excerpt from Neighborhood Parents Network (NPN) blog: Help Your Boy Express All of His Emotions  

The contributing factors and consequences on why boys are viewed as less emotional is an area worth consideration, but for purposes of this post, it is simply for those who see it as an issue and yearn to address it. I want to share some helpful and practical ways for you to improve young boys’ emotional IQ.

The best kind of care is preventative.  A good starting point is helping boys explore emotions by starting with what they know. Look to the people they interact with regularly —in person or in fantasy—as a way to talk about emotions and feelings. Bring up emotions in their space and domain. Books, video games, and movies are all driven by character interactions and are full of openings to begin conversing about feelings, especially if there is a mismatch and incongruency between what someone is saying and what someone is doing.

If boys mention that someone was angry or nervous, you could ask, “How did you know?” Inquire about what cues they observed: Was it their body language?  Facial expression? Words they verbalized?  It can often feel safer to talk about other people’s experiences and emotions instead of ourselves.

To read the full blog, please go to Help Your Boy Express All of His Emotions post.

Parenting Advice in 4 Words: Be Calm, Be Present

By Concentric Counselor Michelle Taufmann, LCSW

Excerpt from Neighborhood Parents Network (NPN) blog:  "The Only Parenting Advise You Need in 4 Words"  

Over a dozen years of parenting and dozens of books on parenting later, my advice to parents out there is: Forget about it. 

We are bombarded by so much advice, it is difficult to retrieve “to do's” from our cluttered memory banks especially when faced with parenting challenges. We absorb on a daily basis a litany of advise —advice on how to get fit, how to save for retirement, what to put in our bodies, how to keep our homes maintained, how to manage office politics, etc.  It’s advice overload. And if the adage “keep it simple” applies to anything in our lives, it’s parenting.

I say the only advice parents need comes down to 4 word: Be calm, be present.

Want to know more about how to be calm and present when parenting?  The entire blog can be found by clicking here.    

How to Bring Up an Important or Sensitive Topic to a Person?

By Concentric Counselor Jennifer Larson, LCPC, NCC

It’s been six months since my last blog post, so it’s much overdue.  There has been no shortage of topics to write about as they perpetually swirl around in my head – it’s now just a matter of carving out the time to be intentional about writing again.  So, here I go. 

This is one of my favorite topics as it comes up fairly regularly in sessions, not to mention I love helping people to learn how to establish and maintain boundaries while learning how to be a better communicator. Please know this blog just scratches the surface as there are many facets when it comes to boundaries and communication, but at least these pointers can be the launching pad you need to start. 

People consistently ask how to bring up an important or sensitive topic to a person while at the same time not hurting their feelings, making the situation worse, or coming off as a jerk.  While we cannot ultimately control the outcome of the interaction or the other person’s feelings, we most certainly can prepare and use an approach that can increase the chances of a better outcome keeping in mind integrity, respect, and boundaries. 

For some, it takes a lot of courage and strength to confront a person. So, if this is you, give yourself a pat on the back for taking this difficult step.  Some people may feel somewhat comfortable or even enjoy confronting, but may neglect to do it somewhat well.  Whatever your situation is, just remember it may be awkward to learn something new, it’s okay to make mistakes along the way.  You will get better with further learning and practice.  As we therapists love to say, “It’s a process.” 

One of the first things to consider is what is your intention (or goal) for bringing up an important topic to another.  Is it to clarify a situation, better understand another, ask someone if they can meet a need of yours, or come up with a solution?  For purposes of having this conversation, try to clearly define your intention(s) coming up with only one or two.  If there are more areas to cover with this person, you can parcel out over time with several conversations.  But for this initial conversation, you don’t want to fire off a litany of items all at once. 

Ok, so you now have your 1-2 intentions.  Next, you will want to ‘invite’ the person to have a conversation with you.  You do not want to spring it on this person when he or she least expects it.  You want to be mindful of not only when you are available to provide your full attention, but also when the other person is completely available.  The invite can be, “I would like to talk to you about something that is really important to me, are you around to chat tonight over dinner or tomorrow morning?” 

The day, time and possibly place have been pinned down.  Next is the anticipation of actually having the conversation.  You may be fraught with anxiety, fear, or other unpleasant feelings.  If this is the case, it’s perfectly normal and okay.  Keep in mind, the other person may be just anxious.  Just remember this person and topic are important to you, and you are approaching this person with your best intentions and method of communication. 

The time has come to engage with one another.  You can warm up the interaction by either acknowledging or thanking the person for being open to talking or you can briefly state something that is positive about that person or the two of you.  This warm-up can help ease both of you into the conversation while setting a positive (or even neutral) tone.

After easing in, you will share your thoughts and feelings by speaking from an “I” position versus opening the dialogue with “You.”  Speaking from an “I” position shows accountability and ownership whereas entering the conversation with “You” can put the person on the defense.  For instance, “I have been bothered lately by the lack of connection or sex between us”, “I have concerns about our how you address disciplining our child and want to learn more about your position on this”, “I am feeling overwhelmed and would like some support from you with the household chores" or "I would like to talk about the restaurant incident the other day.”  Remember you are the one who ultimately wants this conversation, so it is up to you to share you (your thoughts, feelings, behaviors, and beliefs). 

Try your best not to blame the other person, be critical or judgmental, talking down to the person or going into demands and commands.  Also, try your best to suspend those pesky loaded terms, such as “always”, “never” or “should."  Use these words judiciously as they often do not depict complete accuracy (e.g. You never compliment me; You are always rude) not to mention these words can convey judgment and criticism (You should want to be a better partner to me; You should know what I want). 

Also, be mindful of your tone, choice of words, body language, including facial expressions.  Eye-rolling, using offensive language, speaking in a patronizing tone or yelling, sitting with your arm crossed are some examples that will undermine the conversation.  You want to work towards conveying both verbally and non-verbally openness, equity, and respect. 

So, you’ve shared your thoughts keeping these key items in mind, now what?  Depending on the topic or person, the conversation can go in a variety of directions.  For brevity sake, let’s say worse-case scenario is this person reacts negatively to you.  Depending on the type of negativity, you may need to remove yourself from the conversation, pause the conversation until both of you are in a better spot to chat constructively or you can redirect the interaction by expressing your overall intention and that you would like to reciprocate by also fully listening and understanding the other person.  You can ask for a commitment that both of you will try your best.  It’s okay if the two of you may not agree or feel the same way.  For you, you are learning how to bring up an important topic to another with a few tools in your bag.  

Go ahead, and give it whirl -- you're on your way to learning how to approach people with topics that matter to you!