People come to therapy for lots of reasons, but many wait until a crisis is looming. If you really want therapy to be effective, I highly recommend coming in sooner rather than later. Rather than thinking of therapy as a way to deal with crises, think of it as a tool that can help you avoid crisis situations. When you can’t avoid them, therapy can help you prepare and cope more effectively when one does arise.
Years ago we took a family trip to Yellowstone. A couple months before the trip I stopped by the public library and checked out a park guide written by an experienced Yellowstone traveler. This book led me to the best hiking paths for families with young kids, the least crowded time of day to visit Old Faithful, and unearthed a whole list of “can’t miss sights.”
Tanya Thompson is a Licensed Clinical Social Worker who joined Generations in November 2021 and is a welcomed member of our team. She works out of our northwest Indianapolis office, located at 9001 N Wesleyan Road in the Parkstone office complex.
Let’s get to know Tanya!
Tanya is native to Indiana, though she spent several of her childhood years in Sierra Leone, West Africa where her parents were missionaries. As a child, Tanya wanted to be a missionary nurse like her mother, then a physician, but when she took sociology in high school, she decided she wanted to work in the social sciences.
Tanya graduated from Indiana Wesleyan University with dual degrees in psychology and social work and after a short period of working in residential care, she went on to earn her Master of Social Work degree at University of Denver.
Since then, Tanya has spent the majority of her professional career at what was first Midtown Community Mental Health Center and then became Sandra Eskenazi Mental Health Center. Tanya worked for several years in the addictions clinic and then moved to the Borderline Awareness Skills and Empowerment program working with Borderline Personality Disorder, Dissociative Disorders and mood disorders. Tanya is also EMDR trained and has experience working with trauma.
In her free time, Tanya enjoys reading, hanging out with friends and family and volunteering at her church. Tanya has two adult children and one cat.
Tanya is motivated to work hard because she knows that other people are depending on her.
One of Tanya’s favorite books is The Lion, The Witch and The Wardrobe by CS Lewis. She reads most genres, but typically enjoys mysteries or adventure thrillers. Something that always makes Tanya smile is her son’s enthusiastic joy when he accomplishes something. So does seeing a client have a breakthrough in insight and behavior change. Something Tanya frequently says to her clients is “Happiness is measured in moments, not years.”
Tanya is available for in person sessions at our Indianapolis location as well as virtual sessions. Give Tanya a call at 317-360-5768 to schedule an appointment.
A few years ago, I was on the standby list trying to catch a flight home from Las Vegas to Chicago. My chances didn’t look good, so I decided to go through San Francisco, hoping for a few more options. It was a LONG day. I’d missed several flights, but finally my name was called and I got on a plane bound for O’Hare. When you fly standby, you never completely relax until the door is closed and the plane leaves the ground. As we sailed above the clouds and neared the Rocky Mountains, I finally breathed a sigh of relief. I’d be home soon.
Then, the unimaginable happened. The pilot told us over the intercom that WE WOULD BE TURNING AROUND. I can’t remember what the situation was in Chicago, probably weather, but we were simply turning around and going back to San Francisco. As the plane circled west, the stages of grief fast-tracked their way through my psyche. Denial, anger, bargaining, depression (that one actually settled in for a while). I wanted to scream and yell and talk to the manager. But there was nothing to be done. I had absolutely ZERO control over this situation.
Acceptance didn’t show its face until late that night when I finally resigned myself to finding a hotel room near the airport and trying for the first flight Monday morning. It wasn’t ideal, but no amount of screaming or yelling or fighting the reality of my plight was going to change it.
I imagine we have all felt very similarly in the past few weeks. Every day the news brings us fresh data and dismal reports of physical and economic turmoil. We are trapped on a plane headed for an unknown destination with an unknown landing date.
We humans are used to fixing things. We are very good at combining our creative thinking with the right Google searches and hard work and persistence and coming up with solutions to all the problems that ail us. (And if we can’t solve them, we are also experts at denying them or numbing them with all kinds of stuff and substances.)
But what about the unfixable problems? What about the ones over which we have no control? Despite our best efforts, some problems simply can’t be fixed (at least not in the time or the way we would like them to) and numbing or denying them just creates a host of other problems.
It is called radical acceptance. Psychologist and author Marsha Linehan is most widely credited to developing our understanding of this concept, which refers to the ability to accept the current situation as it is.* Radical acceptance says, “It is what it is. I didn’t choose it, I don’t want it and I don’t agree with it, but it’s happening, and I need to somehow figure out how to make the best of it.”
When we practice radical acceptance, we look for ways to co-exist with unpleasant or unwanted circumstances. Although we can’t necessarily change the situation, we can find ways to bear the pain. Often this comes in looking for meaning or purpose or new opportunities in the midst of terrible circumstances. There are so many bright spots in this dark pandemic and quarantine.
Here are a few I’ve noticed recently:
Ordinary people, athletes and celebrities are stepping up to give what they can during this dark time. People are finding creative ways to enjoy family time, connect with others, start new businesses and pass time wisely.
Radical acceptance doesn’t make the pain go away, but it can make it more bearable. It also serves as a protective factor. If we are busy doing things to radically accept our circumstances, we have less time to feel anxious and depressed. Radical acceptance increases our ability to be resilient in the face of difficulty and helps us weather the storm with less damage.
No matter what happens in the days and weeks to come, know that we will get through this. This crisis will end. In the meantime, we want to help you in any way we can. We are available for video sessions and most insurances are covering them, even if you don’t normally have teletherapy benefits.
You can reach us by phone at 317-743-8202 or email: [email protected]. You can also stay connected with us on social media: Facebook, Instagram – @generationsindy and Pinterest.
Until next time,
Joanna
*Radical acceptance is a core principle of a therapy we use at Generations called Dialectical Behavior Therapy, or DBT. Dr. Linehan created this therapy to help people better manage their emotions, moods and behaviors. For more about DBT, click here.
Photo by Eduardo Velazco Guart on Unsplash
Photo by Steve Johnson on Unsplash
If I’d have asked you in December what you were going to be doing in April, what are the odds you’d have said “making masks, washing off my groceries and Googling DIY haircuts”?
And yet, here we are.
While some are faring better than others, regardless of our circumstances, COVID-19 has impacted all of us in ways we couldn’t have imagined just a few short months ago.
Even though most of us are in survival mode — just doing what we need to do to get through the day—we’re probably not necessarily thinking of this as a traumatic event. Trauma is life and death, right? Exposure to violence, living in a war-torn country, impending physical danger.
The COVID-19 pandemic and subsequent quarantine has threatened our physical safety, economic well-being and psychological health. And according to experts, these are exactly the conditions needed for an event to be considered traumatic.*
Just as we are doing what we can to mitigate the physical danger (wearing masks, washing hands and staying home); and (hopefully) getting the help we need to avoid economic catastrophe, we also need to take active steps to protect our psychological health.
Traumatic reactions may not surface right away. They can linger after the danger is over and may be manifested by fear — avoiding public places, excessive worry or anxiety about getting sick; emotional shut-down—the inability to show feelings or connect with others or the tendency to numb-out; and physiological and psychological symptoms — recurring nightmares, difficulty sleeping, panic attacks and other stress-related symptoms such as trouble breathing, racing thoughts and increased heart rate.
Fortunately, there are things we can do now to protect ourselves and our families from having traumatic reactions down the road.
These suggestions will be familiar, as experts have recommended them from the start. But they can take on a whole new meaning as we understand how far they will go in protecting our emotional and psychological health in the months and years to come.
No matter what happens in the days and weeks to come, know that we will get through this. This crisis will end. In the meantime, we want to help you in any way we can. We are available for video sessions for people in Indiana and Illinois, and most insurances are covering these sessions, even if you don’t normally have teletherapy benefits. You can reach us via phone at 317-743-8202 or email: [email protected].
*This information came from a video presentation by Bessel van der Kolk, retrieved from www.pesi.com and viewed on 4/3/20.
Stay connected with us on social media for more ideas and information. You can find us on
Instagram – @generationsindy
The Bottom Line
Very simply, Dialectical Behavior Therapy, or DBT, is about learning to live a balanced life. More technically, it is an evidence-based therapy designed to help people manage intense emotions, impulsive behaviors and difficult relationships. It was originally developed to help individuals who were suicidal or self-injured, but since then we have learned that DBT skills can help people with a lot of different problems, including those with addiction, eating disorders and emotional dysregulation. DBT skills are practical strategies to help people settle down, communicate more effectively, tolerate distress or discomfort, and better manage their emotions. DBT skills fall under core areas:
Mindfulness – Mindfulness skills teach us to be fully present in the current moment and help us learn to non-judgmentally observe what is happening in and around us.
Distress tolerance – Distress tolerance skills help us to “bear pain skillfully.” They help us manage our emotions and behaviors when we don’t get what we want, or can’t get our needs met right away. These skills are also thought of as “coping skills.”
Emotion Regulation – Emotion regulation skills are those that help us manage our internal and external circumstances, and keep us from being vulnerable to stress and pain. These skills involve getting enough rest, taking medications, eating right, exercising, etc.
Interpersonal Effectiveness – Interpersonal effectiveness skills enable us to communicate our feelings and needs to others in an appropriate and effective way. These skills can improve our relationships and help us feel more connected to other people.
DBT Skills can be taught in individual and group settings. Ideally, people who need to learn these skills will have an individual therapist and a group in which to learn and practice. Generations Counseling Services offers a group in their Greenwood, Indiana office. For more details, call us at 317-743-8202, or email us at: [email protected].
Digging Deeper
While you may not be familiar with Dialectical Behavior Therapy, or DBT, you may have heard of Cognitive Behavior Therapy (CBT). The basic idea of CBT is that our thoughts, feelings and behaviors are interrelated, and if we change one, it will impact the others.
Individuals who use CBT learn to identify negative thinking patterns and core beliefs (called schemas) and then find ways to behave differently. Or, a person decides to behave differently (“fake it ‘til you make it”). These new behaviors create better feelings which result in more effective thinking. Regardless of the order, new ways of thinking and behaving inevitably have an impact on the way we feel.
Here’s an example: let’s say I’m in bed at 6am on a rainy Monday morning. I lay there thinking about how busy my day is and how much I hate the rain outside. I think about how hard it’s raining and I start feeling depressed. The more depressed I feel, the deeper I burrow under the covers. The more I burrow, the worse I feel. The cycle could continue all morning, but let’s say I pick up my phone and read a text message from my Aunt Martha, who’s been confined to bed for a couple weeks. I start thinking about poor Aunt Martha, and my attitude shifts. I think about how grateful I am to be healthy, and how happy I am that both my legs work. I look outside at the rain and think about how green the grass is going to get and how much I enjoy hearing the pitter-patter on my window.
That shift in thinking motivates me to sit up and plop my feet on the floor. I decide to take a shower, and before I know it, I’m feeling more hopeful and positive about my day.
Changing my thinking from dread to gratitude gives me motivation to make a small change in my behavior, which results in a drastic improvement in my feelings. This is an over-simplification, of course, but it is CBT in a nutshell.
DBT is a cousin of CBT. It was originally developed to treat chronically suicidal individuals, many of whom were diagnosed with Borderline Personality Disorder (BPD), and has since become the gold-standard treatment for this population.
How it all began
In the late 70s, a psychologist named Marsha Linehan worked with young women who suffered from chronic suicide attempts, suicidal ideation, and non-suicidal injury (she would later realize these women met the criteria for BPD). Although she was a behaviorist who used the prevailing CBT model at the time, she found traditional treatments to be extremely ineffective for these individuals. They seemed to be getting stuck on the idea of change. This is a problem, because traditional psychotherapy models are focused on helping the client create inner change, which hopefully results in external change. However, when Linehan’s clients were challenged to change their perspective, they reacted by becoming angry or dropping out of treatment. Linehan eventually found that the focus on change was invalidating. Linehan defines invalidation as a childhood environment in which caregiver’s response(s) ignore, minimize, or punish a child’s inner emotional experiences.
Validation is a big deal, because Dr. Linehan found that individuals diagnosed with BPD typically grew up in invalidating environments. (Invalidation can encompass physical, emotional and sexual abuse and neglect, as well as a lack of connection with caregivers. Invalidation can be real or imagined – we know that if a person doesn’t perceive his or her environment as validating, the damage can be just as significant.)
Imagine then, if a therapist (or therapy modality) is invalidating, such as Linehan found CBT to be, the clinician may actually be re-playing childhood trauma in the very environment where the person is supposed to receive help. For obvious reasons, this is not good.
In addition to the invalidation, Linehan also realized that there were some complicated dynamics between the therapist and client. When clients didn’t want to do something, they found a way to get the therapist to “let them off the hook.” Maybe the client would say the work was too difficult, or that no one understood them, or would simply change the subject. Unintentionally, the therapists would stop focusing on change, then the clients would go on having all the same problems. Since chronic suicidal thinking was one of their problems, this was a big deal. In addition to suicidal thinking, Linehan’s clients had a host of other problems as well, and CBT seemed to lack the depth to help them find workable solutions to all these issues.
Thankfully, instead of giving up on these challenging cases, Linehan took the very effective behavioral components of CBT and added two critical concepts: acceptance and dialectical thinking.
Acceptance refers to accepting things as they are, not as we want them to be. It involves learning to accept things we can’t control and accepting the need to change. It also requires a person to learn to be more self-accepting. Practicing self-acceptance, it turns out, is quite validating, and can be a doorway to change.
Dialectical thinking is a philosophical concept that refers to the process of finding truth between two seemingly opposed ideas. Simply put, dialectical thinking allows a person to find a balance between two things that seem like opposites. For example, I can be angry with my best friend for forgetting my birthday, and I can also feel a deep fondness for her at the same time. While these feelings feel like opposites, there are kernels of truth in both. (This is important, because people who have trouble regulating their emotions often think in very “all-or-nothing” ways – they either feel “angry” or “fond of”. It is very difficult for them to feel both, and in fact, trying to manage these opposite feelings tends to create a lot of anxiety.)
Linehan brilliantly integrated acceptance and dialectical thinking into the existing CBT model and created a new treatment model that teaches individuals to think more flexibly and look for ways to solve their own problems.
If you are looking for ways to better manage your emotions, your behaviors and your relationship, DBT may be a great therapy for you. Don’t hesitate to call or email us if we can help.
Need more? If you are feeling stuck and need some outside help in managing your communication, emotions, or relationships, our team at Generations
Counseling is available! Give us a call at 317-743-8202 or email at: [email protected] today.
Photo by Martin Sanchez on Unsplash
As the weather changes and the days get a little darker, a lot of people seem to notice a dip in their mood. Sometimes it can be a fine line between having a down mood and being clinically depressed. Here are some important distinctions:
Types of symptoms – A down mood is generally a temporary feeling of being “bummed out” or discouraged. Usually this is dependent on circumstances, and a down mood often turns around on its own pretty quickly. On the other hand, depression symptoms are less dependent on circumstances, and often are characterized by feelings of helplessness, hopelessness and worthlessness, a lack of enjoyment of things that normally would bring joy, fatigue, changes in sleep or appetite, feelings of guilt and difficulty concentrating. More serious depressed thoughts can include thoughts of suicide, or wishing you could go to sleep and not wake up.
The length of time – A down mood can typically last a few hours or a few days. For a diagnosis of depression, symptoms must be present for at least 2 weeks.
Response to behavior changes – Often with a down mood, a person starts feeling better after going for a walk, taking a shower, talking with a friend, or doing something enjoyable. Depression symptoms tend not to lift after doing these things, or if so, the effect is temporary.
The degree to which symptoms interfere with life – Typically, people with a down mood are able to go about their lives, going to work and keeping up with family responsibilities and self-care. Depressed individuals find that their symptoms cause impairment in their normal activities and have difficulty completing even basic tasks like showering, cleaning, and work activities.
There are some very significant differences between depression and a down mood, and sometimes these can be difficult to distinguish. If you are concerned about yourself or someone you care about, please call us at 317-743-8202 to set up an evaluation. Additionally, remember that suicidal thoughts and behaviors are ALWAYS cause for concern and should be addressed immediately by a mental health professional. Call 911 or the Suicide Crisis Line at 1-800-273-8255 or text 741741.
Need more? If you are feeling stuck and need some outside help in managing your communication, emotions, or relationships, our team at Generations
Counseling is available! Give us a call at 317-743-8202 or email at: [email protected] today.
As parents we want to make all the right decisions for our children. We find the best schools, the most knowledgeable doctors, we try to feed them the healthiest foods, and we can’t forget to outfit them with the “coolest” clothes. But how do we know it’s the right time to take them to counseling?
Mental health awareness is growing, but there are still so many questions left unanswered. We consult with our pediatricians to ensure our children are physically healthy and medical doctors ask if they’ve accomplished certain developmental milestones, but the questions often stop there, and physical exams may not reveal other problems our children may have.
Knowing the right time to take your child to counseling could make all the difference when it comes to identifying and overcoming emotional, relational, and mental developmental delays.
Unfortunately, kids typically don’t have the words or understanding to tell us when they are struggling emotionally. Without their verbal input, we are left with more subtle (and sometimes not so subtle) cues on which to base the decision. The Cleveland Clinic** suggests seeking out additional support through counseling if your child faces any of the following:
Problems in more than one of life, such as in family relationships, academic performance, leisure activities, and friendships;
Transition such as parent divorce, new teachers, or schools;
Demonstrates a decrease in confidence, starts feeling bad about him or herself;
Makes repeated statements such as, “I will just mess up if I do it,” “It’s no use,” “You can’t fix it,”;
Shows excessive worry about the future;
Experiences a sudden “illness” or upset stomach before an event or meeting with someone;
Expresses feelings of hopelessness, helplessness or worthlessness;
Withdraws from family, friends, or activities he or she used to enjoy;
Experiences significant changes in sleep habits or appetite*;
Engages in negative behavior more frequently;
Exhibits repetitive, self-destructive behaviors, or talks about or engages in any kind of self-harm;
Displays behaviors such as hair-pulling, skin-picking, or head-banging;
Makes comments like, “I wish I weren’t here,” or “Nobody would care if I ran away.”
While some of these behaviors can occur in all children from time to time, they are not a part of “normal” child development and should not be ignored, especially if they persist. Learning about healthy mental development at every age is an important part of good parenting, and some problems are just too big for us to handle alone.
If are unsure as to whether your child needs extra support through counseling, we can help. Generations Counseling Services currently has openings available for 30-minute screenings to determine if additional sessions would benefit your child. For more information or to schedule your screening, call us at 317-743-8202.
*According to the American Academy of Pediatrics children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) while children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours
**Information adapted from The Cleveland Clinic.
Counseling isn’t free, and there are good reasons for this (read more about that here). But how will you pay for it? You typically have one of two options.
If you are one of the approximately 300 million Americans who has health insurance coverage, you will likely want to use that. (Read this post for the basics.) However, there may be some instances when you would not use insurance.
If you do not have adequate health insurance, or if your insurance does not offer mental health benefits, self-payment will be the best option for you. Our rates currently start at $125 per session, and we have two therapists who use an income-based sliding fee scale for those who need it. Please call us today at 317-743-8202 and we will make every effort to accommodate your needs.