How Our Isolation Is Affecting Our Teens

Once upon a time, teens were warriors. I already wrote about that here and here. So let me try a different story. A sequel you could say.

Once upon a time, teens were expected to be productive. With a short life expectancy, and fertility approaching, teens were recognized as old enough to contribute. After all, they were strong, full of energy and passion, virile and idealistic. That's quite a force of nature packed into a young body.

They were meant to push away from the home life they have always known. They were programmed to do it for the advancement of humanity. After all, teens who rest on their laurels don't really ensure species survival. Right? (Read more about this in the excellent book by Dr. Siegel: Brainstorm)

This means that (I believe) every teen's parent has probably experienced this similar thing since the dawn of time- this painful, forceful separation as the teen experiments with emerging separate identity. It is normal (read: "What It's Like Parenting Teens and Tweens"). And you (as a parent) are in good company.

You know who isn't in good company? Your teen.

Because once upon a time there was a village of elders. There were apprenticeships of all kinds (formal and informal). Whether you were learning to be a mother, or a soldier, or a woodworker, or a shaman, you had someone older than you to guide you in that effort. Someone who likely knew your family. Someone who likely knew the teen since they were born. Someone who had a good idea of your family and tribal values, your culture and belief system. Someone who (likely without thinking much about it) ushered them across the threshold from childhood into adulthood. What a brilliant idea!

And (due to that pesky biological programming) it couldn't be their parent. The parent had their childhood, but someone else was the field guide who put the learning into practice. Any basic study of anthropology will tell you that most cultures had very sacred practices around this "emerging adulthood" idea. Coming-of-age ceremonies and excursions have been a part of the fabric of almost every people-group.

And then there's us. Our teens are in school and won't expect to begin learning about their chosen field until at least age 18 (often later). They are not surrounded by trustworthy elders, but by fellow peers. Just as lost as they are. Instead of building a civilization or stretching their muscles, they are told to sit and listen in a fluorescent-lit classroom and then sit and do homework later (which I think contributes to school shootings, but I digress.) And while I get the importance of formal education (obviously!) I also think it is worth asking ourselves what we ought to preserve from our heritage.

This is where I love my job. When I work with teens, I get to be a *small* part of repairing what was lost. I get to be a stand-in for that "village elder"- an adult who can be trusted by parents, but one who belongs to the teen alone. An adult who can be there for the duration- their threshold of adulthood. One who knows the values of their family. One who respects the teens emerging separate identity enough to encourage it.

I often have parents in my office who are playfully exasperated because they've "said that to their teen a million times" before I did! Why does their teen listen to me? And I have to smile and remind them that I have a fundamental advantage. They are not programmed to push away from me. They are programmed to hear me! 

It is a role I feel privileged to play. The guide along an important path. The confidante. Support system. Cheerleader. Clear-eyed adult (who is not their parent, lucky me!)

If your teen doesn't have an adult they trust, consider how you might foster that. There are so many options in coaches, teachers, pastors, relatives, and even therapists. By building a village for your teen, the pressure is off! By intentionally creating a community of truth-tellers and advocates, you have created a web of support for you and your teen. When they push away from you, they have the arms of someone else to run to. Someone you can trust. Whew!

Wishing you support, community and a good sense of humor. Solidarity parents-of-teens!


Whose Body Is It?

I recently read the article "Moms Put On That Swimsuit" in which the author Jessica Turner talks about her very real struggle to put aside her self-consciousness and put on a swimsuit to join her kids in the waves at the beach.

It was awesome. I recommend it.

And (of course, because this is how I do) I have something to add.

Jayneboo Photo Source Here
You know, in a lifetime of wining and losing possessions. In a world where everything, and I mean EVERYTHING can be taken from you. In a world where you will gain and lose homes, friendships, perhaps even marriages. In a world where your favorite belongings will change over the years (as will your size, sense of style, and preference). There is but one thing that you will have forever: your body.

It is the only thing that we can say truly belongs to you, and no one else.
It is the only thing that you will have your entire life.
It is the only companion that brought you into this world and will see you out of it.
It is the only witness to your every moment, your every scrape, your every tear, your every laugh.

It will endure the test of time. It will be with you always. You can never have another. You can never lose the one you have.

Think about this.
Your body can become damaged, injured, broken, burned, scarred, limited... but never taken from you.

There will never be another. There has never been another.

It is your chaperone through life. Your vehicle to connect with the outside world. Your literal mouthpiece. Your outstretched hand. Your wellspring of life itself.

Karla. Photo source here
Now tell me again how you should hide under a blanket instead of run in the sand?
Tell me again how your body isn't fit to be seen, so it should be hidden in shame?
Tell me again how you don't deserve to swim in the water because you're fat?
Tell me again how the very breath you breathe and blood you pump isn't "good enough" and so you ought to miss out on your one and only precious life?


I long for a day when women will become more connected to their experience inside their body than they are to their assumptions of what other people think. After all, your body was never meant to serve anyone else's satisfaction. It was made to serve yours. And its the only thing that was.

You are not the sum total of a wandering eye's appraisal. You are not an object to be appraised; judged for value. 

Your body has no value to anyone else. It is yours. They can't use it anyway!

To me, it's not about how you look. It's not even about "ignoring others' judgement". It's about a profound and sacred connection to the one beautiful body you will ever have. It was never about someone else liking the way it fits a bathing suit. That is cheap and silly and fleeting. It is about your body carrying you through life. A benefactor. And you, as its fortunate recipient.

Rick Elkins Photo Source Here
So dance mamas, dance! And swim! Climb! Run! Jump! Fall! Leap! Stumble! But please run in the waves. The waves that (like our bodies) are each one unique and never repeated.


I love this photo for so many reasons
Fonsico Photo Source Here

How To Stop School Shootings

Image credit here
Well I'm going to venture into gray area today: school shootings

And you know what's sad? I can write this today and know with certainty it will become timely again and again.

And while politicians and talking heads will yell at one another about this issue, I have my own take on it. As a mother and therapist to families and adolescents. I have my own perspective on what is happening here.

We have a mental health crisis in the country. We are failing ourselves and our young people.

Let me lay this out for you. Your brain is an organ. 
Your organs are biological.
They are susceptible to disease.
They are injured by trauma.
They are affected by your health.

Your brain (the thing that runs your decisions, your feelings, your moods, your actions) is a flesh and blood organ that is made better or worse by your life choices. Just like your heart.

Here's the difference. If your heart stops beating it only hurts you and those you love. If your brain stops working you can become deadly.

In my professional opinion- this is not about video games. It is not about a justified rage. It is not about bullying. It is about mental illness. Pure and simple. How do I know?
- Do you watch movies or play games with violent actions in them?
- Do you feel rejected by others sometimes?
- Did you ever feel bullied or unliked by peers?
- Are people ever mean to you?
- Do you write manifestos and go on killing sprees?

See my point?

We have a mental health epidemic. We prescribe more and more psychotropic medication every year. Last statistic I read placed parents at about 1/5 that are currently on some form of mood medication. We are not well. And we are raising our kids to be unwell.

If I had a magic wand here's what I would do.
1. Move back school start times to 9:30 am for adolescents (read latest research on how circadian rhythyms and sleep deprivation affect adolescents. It is frightening). This is proven to lower the incidence of depression and school dropouts significantly within one year's time.
2. Create health classes in school that educate young people on the following:
     How sleep affects your body
     How technology affects your body
     How light exposure affects mood and circadian rhythms
     How nutrition affects the brain
    What are the warning signs of depression, anxiety and psychosis?
3. Staff every high school with mental health professionals. (I'm not talking about guidance counselors. I am talking about licensed mental health providers who have constant access to kids.) Give them the authority to
     Screen every kid every year for mental health issues
     Jointly work with the teen's family support to address mental health issues.
     See a teen regularly who is going through mental health issues.
     Pull any child at any time that they feel is in crisis, without academic repercussions.
     Make referrals and fast-track kids they feel are in crisis
4. Only give a teen antidepressants if they will see a mental health provider at least 2x a week for at least 8 weeks following the new prescription. (Read up on antidepressant use in teens and its ridiculously high rate of suicide and manic behavior. Teen bodies don't respond like adults do).
5. Structure school activities so that teens see sunlight before noon every day to regulate their circadian rhythms and lower incidence of mood disorders.
6. Structure school activities so that teens are moving their bodies every day, outdoors if possible for the same reason.

I would be willing to bet that if a school were willing and able to make these changes, their risk of a school shooting from a student would be almost nil.

We are unwell. We are not addressing our unwellness.

We think adolescents are meant to be depressed, exhausted, and unwell. This is NOT TRUE. Research proves that it is not true.

We accept sickness because we don't know what health looks like. 

And we accept sickness because we have removed power from anyone who knows how to diagnose a mental health crisis.

I could see a person in my office, be certain that they are danger to themselves or society, but if they are not an imminent threat with an identifiable target... I have no power. Zero. Nothing can be done. They will go back out into the world without a tether. And when they finally do act out, there will be people looking to cast blame. But where can it rest? There is no one to speak for the mentally ill. We have erred on the side of their autonomy because we don't want to make the mistakes of our past. But is this better? The mentally ill make up the majority of our homeless population. The mass shootings are done by the mentally ill. Is this better?

I don't believe it is.

The truth is, this can be changed. But this isn't sexy. It doesn't sound good in clips. It isn't going to be yelled by a talking head. So the necessary changes are ignored.

We have advocates for heart health and against the obesity epidemic. And that's important. Please don't misunderstand me. But if your heart fails or you are overweight- you hurt only yourself and those who love you. Mental illness affects us all. But we are silent about it. That has to change.

PS- If you're new here, I'm a therapist in Roseville, CA
PPS- If you liked this post about teens, try this one.
PPPS- If you like posts about technology and mental health try this one or this one.


Yo, it's not "real"

Remember when you watched the Truman Show and you were all like, "Wow, this place he lives is freaking CREEPY?" *
Look at that creepy smile.
Courtesy of this link
And part of you was kind of like, "Duh Jim Carrey how could anyone accept this washed-out version of life as reality?" But oh yeah, that was the point.

And you were cheering along with him as he searched for the ultimate reality... on his quest to find Truth!?

And then... this moment happened.

A "Whoah" moment
courtesy of this link
His sailboat hits a wall. (Oh yeah, spoiler alert).

Immediately followed by this
A stairway from nowhere, now that's cool.
courtesy of this link
And all of a sudden, his entire WORLD was just busted open. He realized, the reality he had seen and accepted was in fact, manufactured by another. And that a much grittier, more real, more unpredictable reality actually existed. 

Well, I want you to have this moment. Track with me here....

 This is social media. It is contrived. It is a version of reality that other people want you to see. It is a version of reality. Meaning, in its own way, it IS reality. But it is not the whole of reality.

This is your Facebook feed blowing up on holidays with pictures of perfect families doing everything cute. This is your Twitter feed blowing up with pithy comments from everyone who is doing something amazing right now. This is your Instagram account overflowing with photos of hotness, happiness, or cuteness in some way. Sure, it is a real photo. But it is a version of reality that another person wants you to see.

So here is what I propose:

It's enough already. 

As someone who is in the "nitty gritty" with people on a daily basis, take my word on it: their crappy moments look a lot like your crappy moments. Neither of you post them online. 

And oh, for the love of God, can we stop acting like something didn't happen unless it is documented by at least 2 social media sources? The truth is, the moments we are the most fully present are the ones there is no photographic evidence of. Don't misunderstand me, I love posting photos as much as the next person. But its not my reality. It isn't the moments that count for the most. The moment I drink in, is the moment I get out from behind my Iphone, and actually WITNESS the event happening. That is what builds a life. The photos are only a memento. The experience is what counts.

So for today. Give yourself a break, okay? You only get one crack at this crazy ride called life. (At least, as far as we know). So maybe, just maybe, it can be time to truly and fully inhabit the life that you live. 
And let this:

Become this:

*If your answer is "no" then you're too young. It's probably past your bedtime. If its not past your bedtime I don't want to hear about it because that means that people are old enough to stay up late and STILL not know what the Truman Show is... and that is not a reality *I* am willing to accept.

If you like this post, you might like this one too.


I Knew A Lot More Before...

Photo Credit
I knew a lot more before....

- I got married
- I had a child
- I had a second child
- I found gray hair

.... in that order. Is that a coincidence?

When I first began my career as a therapist, I didn't get it. I mean, I wanted to get it. I got it intellectually. But that's not the same thing.

- I didn't understand the courage it takes to bring your precious child to therapy
- I didn't understand how you could feel so much love and so much numbness for the same person
- I didn't understand how people could let so much time pass, so busy living that they forget to live well
- I didn't understand why money was the #1 reason for divorce in America
- I didn't understand how someone could ignore their own mental health issues because they are too busy caring for everyone else.

... I understand that now.

The best gift of my career is that I get to walk alongside so many different kinds of people. And I've learned over and over (and over!) that someone's life looks so different from the inside. I am honored by the stories we share.

What's funny is, the more I learn the less I know what to write about. Life doesn't seem as easy to contain within black and white letters. The breathless, quiet, fierce and sacred. And after 8 years of formal education and 5 years of a supervised internship and 9 total years of seeing clients.... I find myself more contemplative. More reverent. What do I know?  I ask myself.

Well truthfully, I know a lot.
But I am only growing in understanding.

Thank you for the humbling journey,


I Have A Beef.. With The Word Therapy


It's a loaded word. And what does it even mean?

Depending on what movies, tv shows, stories, experiences you've had... it can wildly vary. And really I blame us, the therapists, for this. If you sat 10 therapists in a room and asked them "What is therapy?" You'd probably get at least 4 vastly different responses.

You see, therapy has different schools of thought (called theoretical orientations). Hundreds actually! (Although many of them group under umbrella headings).

One brilliant therapist could say that therapy ought to be "brief" and "solution-focused" while another therapist could say its an "insight-oriented process" (read: "longer") and still another could brag that their longest client relationship spans decades! (Yes, I have heard this).

So how do you know what you're getting? And how do you know what you need or want up front? If I were a potential client, I'd be confused!

Like many other areas, I find the turf-wars to be tiring. I don't know why we have to act like "effective therapy" can only be one thing.  Actually, recent research suggests that (more than any theoretical orientation) the "goodness of fit" with the therapist is what matters most for a successful outcome.

Highly respected, intelligent, experienced theorists have resorted to screaming matches over this issue. I can't pretend to have The Answer. But I can tell you what I think... and do with it what you will.

I think that it's crazy to act like the same issues bring everyone into therapy... so it's crazy to act like the same kind of therapy will help all clients! (*ducking... as I'm sure I'll take heat somehow*)

If you come in with trauma from a car accident (and had a perfectly functional life before the accident), I don't think it's worthwhile to deeply explore your childhood. I think- lets get this trauma fixed! Let's apply some rapid and research-oriented solutions, like EMDR or Hypnosis. Similarly, simple phobias, chronic pain, or panic disorders are not the same thing as a long-term childhood chaos. And on the flip side, if you are a pretty satisfied and healthy individual who is in a troubled family relationship, my response is going to be different than if you are deeply depressed and dissatisfied with life. 

Sometimes people need a quick solution- either because their problem is specific and acute, or because that is all they have the energy for at the moment. And sometimes people need time, space, processing, and insight. They don't want to be rushed through their process. Much like a spa day for the mind, they enjoy that therapy is a retreat from ordinary life where they are free to focus entirely on their own health. How on earth could one word- therapy- apply to all that!? Who better than the client, to decide what they need?

So I think I'll begin to use different vocabulary. After all, who knows what you need better than you?

Some ideas, and I'm just spit-balling here:

Therapy: Insight-oriented, deeper addressing of complex issues through specific techniques
Strategizing: Solution-oriented, short-term addressing of a specific issue 
Counseling: A longer-term, "walking beside" of a person through life transitions or for support.
Relationship Work: A workshop for a family or couples' systemic issues which focuses on improving connectedness and communication.

I'm wondering if we started teasing out the different reasons people go to therapy then maybe it would become clearer for all involved. Maybe clearer labels would lead to clearer benefits and a better therapy/client fit?

What do you think? What labels would you give to therapy?

Is there a label above that you like better than "therapy"? A label that would convince you to give it a try? Or one you recommend? I'm taking ideas here! Really!

I think the clearer we therapists can be with potential clients, the better. 


Whoah Nelly

Four years ago, I had less wrinkles and brighter eyes.

The End.

.... I love doing that. Okay, not "The End." But that would be funny right? No?

I'm avoiding. Someone please stop me


Four years ago I sat down (as someone with more free time) and wrote an article detailing everything I wished I could tell people before they used insurance. I had sat on the phone far too many times that week, on hold, waiting to be forced to give personal information out on my clients... again. Just so they could get the money they were due.

Idealistic and younger me thought: "Don't you think if you were a client you would want to know this information?"
And I answered myself, "Yes! I would!"
Idealistic and younger me asked, "Well then isn't it like you have a moral imperative to educate the consumer here?"
And (full of hubris and naivete) I answered myself, "YES self! I do!"

And a blog post was born. No biggy. Like 10 people read it and I knew them all.

And I thought THAT was the end. Really.

Then I got clients a few months later (who actually thanked me for the post and said they chose me and chose NOT to bill insurance because of it). That's cool.

Then I got therapists a while later (who secretly said they agreed but would never post it). That should have been my warning sign.
But time passed and I forgot it existed.... until managed care became an even hotter topic. And somehow, due to the gods of google (or Bing, or Yahoo, or If-I-Knew-Why-I'd-Be-Amazing-But-I-Don't) I suddenly started getting eyes. Lots and lots of eyes. Over 3000 and counting to be exact.

And with the eyes, came the hate. Oh yes, lots of that. You're not new to the internet- you know this is something to assume right? Commenters will be harsh! Haters be hatin.... (anyone? no?).

So now I have a debate in my mind. Keep it up? Take it down? Does it help? Does it hurt? Is it relevant? Is it necessary?

And my words haunt me- I would want to know. So... for now it stays.

But geesh! I'm a therapisty type. It means I'm kind of sensitive. Get it? Yikes! Thank goodness for comment moderation.  So mostly, I'm whining here. My apologies! What was my point? Oh yeah, managed care.

2014 has become another huge shift. We don't have to be surprised there. It's on the news 24/7. No one can predict where this journey will take us. No one can even predict what mental health care will look like in 10 years- as there is still debate about what/if it is medical care or not. And since we don't know what medical care will look like... it is anyone's guess.

Articles like this one speculate that private practice therapists will be a thing of the past. They will become one more "office visit" as part of a large HMO or even a state-run institute. With tight time limits and quick diagnosis/treatment timelines.

Is this tragic? Or wonderful? I guess it depends on your view and how it turns out. But for now, I know that my clients and I are in this together. I am doing my darnedest to serve them while protecting the integrity of my care, and the confidentiality of their services. And I am thankful to say, that this has meant a full calendar for the last 4 years. Even though I am not on any insurance panels.

Being able to treat what my client deems important. Being able to treat with skills and tools my client feels are the most helpful. Being able to see a couple or a whole family when my client feels that is necessary... and being able to do all this without reporting it to a database... is so precious to me. That kind of freedom thrills me.

Why speak of this? Partly because I'm a nerd and find this kind of socio-political stuff fascinating. :)
Mostly because I believe you have a right to know. I would want to know. You have choices here. They are not easy ones, but they exist.

So what are your thoughts? Are you glad I told you all this? Would you rather know? Or not? I'm taking your comments!