Therapist are Humans Too – Licensed Mental Health Counselor

Stop Obsessing Over Your Ex

29 Jan 2020by Torey C. Richards, LMHC1 Comment

I used to have a really hard time getting over past relationships. I would find myself ruminating over the person, wondering if our breakup was a mistake and contemplating reaching out to see if we could try again.

That same thinking kept me in bad relationships for far too long and kept me stuck when I should have been moving on.

It wasn’t until I started doing therapy with clients who were in various degrees of anxiety and depression due to a break up that I started to realize that it’s not usually the person I was missing, but the idea of that person, the experiences and the feelings.

You Don’t Miss Them, You Miss The Idea of the Person

A woman once told me, and it was such a great line I don’t doubt that she heard it somewhere else before, perhaps in a movie, “You don’t want me, you want the idea of me.” At the time I thought she was totally wrong, but as I’ve grown and learned to understand myself and other people, I now know that she was absolutely right. I didn’t really know her, but I was attracted to her physically and had already become attracted to the idea of her being my person.

I was doing what most of us do subconsciously. We meet people and then make certain believes and assumptions about that person.

When we like someone, we tend to make them out to be this impossibly perfect person. Even when we notice their flaws we tend to justify, minimize or downright ignore them. This explains why we often ignore many red flags that signal someone isn’t good for us early in the dating process.

When this person starts not living up to who we created them to be in our minds, we tend to grow disappointed, unhappy and fall out of love because we start seeing the person for who they really are which often is in stark comparison to who we made them out to be.

Once the relationship ends, often we start remembering that person, not as the person they really were, but as the idealized person we created. We like to romanticize and we pick and choose memories that have strong, happy emotions over more unpleasant ones. We start missing that person, not as he or she was, but our idea of that person. Sometimes we even start missing the person we felt they could have been and not who they really were.

You Don’t Miss Them, You Miss The Way They Made You Feel

In our minds, we tend to downplay the more negative experiences and feelings. “Our fights weren’t that bad.” “Maybe I was just sensitive and he wasn’t a womanizer”. “He only yelled at me because he loved.”

This kind of thinking is sometimes called the Halo Effect. When you remember the good qualities of a person and minimize the negative. It’s partly why many people stay or go back to abusive relationships. It’s what makes it hard to separate from toxic people because they are usually really good at treating you special and then treating you like crap, putting you on a roller-coaster ride that can make you question your own sanity.

We start looking at pictures and remembering times when we were happy, smiling, having fun and madly in love with the person and pushing aside the things that weren’t so good and maybe were even awful about being with that person.

We miss the feeling of flutters in our heart that comes with being in love, of laying next to someone and talking all night long or holding hands, kissing and going out on dates. Suddenly, all the heartache they may have caused us doesn’t seem to hurt so bad.

If you don’t have friends or a journal to remind you of how terrible they treated you most of the time, it’s easy to fall back into missing how well they treated you every now and then.

It’s okay to miss people, but it’s not okay to miss anyone who used, abused or mistreated you. If you do, it means you need to take time for self-care and learn to embrace reality. You’re awesome and deserving of someone who will treat you better. It’s something I struggled to learn for a long time. It took understanding codependency and detachment for me to break that cycle.

You Don’t Miss Them, You’re Just Lonely

If you only miss the person when you’re lonely, then you don’t really miss the person. When we’re lonely, sometimes we think back to our past and wish we could lean on someone who isn’t there any more. We may even think we still love that person, but it’s not love it’s loneliness.

As humans, we don’t like to be alone, especially when we are dealing with problems. Sure, most of us like to have our space and time apart and some of us are really good at being alone, but most of us crave bonding, relating and socializing with other people from time to time. When you’re lonely, it’s easy to start longing for an ex because we wished we had someone.

Before you know it, you’re calling or texting that former flame or perhaps even worse, crying over that person, or should I say, the idea of that person.

If you don’t think about that person when you’re happy and having fun, perhaps wishing they were there to share the experience with, then you’re not still in love with them, you’re lonely.

You Don’t Miss Them, You Miss Who You Were With Them

When we think about our past with that person, the experiences and feelings we had together, it’s easy to believe that we are missing them when really we are missing the person we were when we were with them.

Just like we tend to idealize people and create versions of them that probably never existed, we do the same with our memories of them. Often, when we miss a person, what we really miss is how they affected us.

I used to ruminate on a particular woman I was in a relationship with and often times I missed the way she would make me laugh, or how we would go out on the weekend and paint the town red and I’d miss how we would sing love songs to each other. I minimized how drunk she sometimes go, how reckless she could be and how scarily volatile her moods were.

Once our relationship ended, I no longer had anyone to do those things with. I missed those feelings and I missed the person I was during those times because that person was a happier, more out going person than I was in reality.

I would find myself alone on a Friday night wishing I had someone to go out with and when I was out, I wished I had someone to sing off key love songs to. I didn’t really miss that particular woman, but the experiences, feelings and person I was in that relationship.

It is definitely possible to miss a person, but that is rarely the case. As humans, we’re so complicated with the way we torture ourselves by creating people, memories and emotions that aren’t always based on reality.

Often we ruminate on people who don’t deserve our attention or energy.

Those same feelings and experiences we had with an ex, we can and will have with someone else if we allow ourselves to move on. .

Don’t Be Afraid of Being a Beginner

31 Mar 201931 Mar 2019by Torey C. Richards, LMHC1 Comment

Many people I know allow the fear of looking awkward or silly prevent them from trying something new. It could be anything from karaoke to going to their first yoga class. Just the thought of failing or looking like they have no clue what they are doing is enough to prevent them from ever trying things they have dreamt about doing.

Remember when you first learned to walk or ride a bike? You probably don’t because it’s quite natural to you now, but if you see any old videos of yourself you would see how unbalanced you were and how many times you fell, but never gave up. That’s what it is like trying something new. We can’t let the fear of looking stupid, like we don’t know what we are doing or even failing, rob us of the joy mastering (or at least being competent) in that area will bring.

Recently I started training in Brazilian Jiu Jitsu and one of the hardest things I have done so far was to walk through that door and start my first class. I had so much anxiety about it and most of my anxieties revolved around how silly I would look attempting to perform exercises and maneuvers I had never performed In my life.

I was worried about my conditioning because while I consider myself to be in somewhat decent shape, I knew I was not in the type of shape I thought I needed to be in for Jiu Jitsu. I was mostly worried about my conditioning (or lack thereof). I go to the gym often and lift weights, but I rarely do aerobic activity. I also knew that I could find a thousand excuses to keep putting off starting the class if I didn’t push myself to go despite those anxieties.

During my first few classes, I was really self-conscious and compared myself to the rest of the class. Most of the other guys were in better shape, quicker and more coordinated. I did feel like an awkward gorilla when we did many of the warm up exercises that required flexibility I didn’t have and left me sucking in air before the class even really begun. All of that started pushing doubt and excuses in my mind. “You’re too out of shape”, my inner critic said, “You’re too old, too tired, too busy” it added.

I live in my head, which isn’t always a good thing if you can’t master it. I had to quickly get out of my head. I did this by reminding myself that I was a beginner and it was okay to look and feel like a beginner.

I had to tell myself that it was okay if I looked and felt awkward during the exercises, if I couldn’t perform some moves right, if at all. I told myself that it was okay if I got gassed during class and had to take a break. I was a beginner, and if there is ever a time to look awkward while trying your best, it’s when you’re a beginner.

Instead of being worried about being a beginner take advantage of it, embrace it.

When I started focusing more on myself and not on the other people in class things became easier. I had taken the pressure off of myself to be better than I reasonably could be. I pushed myself of course, but took breaks when I needed to and learned to be unapologetic about it (by the way, no one ever made me feel bad about having to take a breather). I modified moves I couldn’t do until I could do them instead of getting upset, hurting myself or giving up out of frustration.

I worked on not caring about other people’s opinions.

So what if other guys in the class made fun of me or snickered about how this middle aged, muscular but uncoordinated guy flopped around class like a fish out of water. They weren’t paying for my classes, I was. They weren’t in my shoes. We all have different lives and different goals. While some guys were there to someday compete for medals, I was there to get in shape and learn a martial art I had been curious about for over a decade. While some guys live to train, I have a full-time, stressful job, commute 144 miles to and from work each day and have a family to divide my time with. Our goals and drives are completely different, and that’s okay.

Once I got out of my own head, allowed myself to be a beginner and stopped being concerned about what other people may think about me, things became fun! It helps that most people who train Jiu Jitsu seem to be non-judgmental and encouraging. You’ll hear them say, “We all started at the same point, don’t give up, just keep showing up”.

I don’t think anyone ever looked at me and thought about how awkward I looked or how much my conditioning sucked. It was all in my head. Once I got out of my head and really focused on being mindful and present in the moment, I quickly realized I very rarely even thought about my weight, my clumsiness or my fitness level that much. As a matter of fact, Jiu Jitsu class became one of the few places I didn’t think too much about those things or other life problems at all. It became a stress reliever.

I’m still extremely new in Brazilian Jiu Jitsu and in every class I am learning something new and attempting to perform it for the first time. I am still a beginner and I allow myself to be a beginner, unapologetic ally.

A Personal Note On Suicide

10 Dec 2018by Torey C. Richards, LMHCLeave a Comment

***TRIGGER WARNING- This article contains information about suicide which may be upsetting to some people. If you or anyone you know is struggling with thoughts of suicide please call your local suicide hotline or visit http://www.iasp.info/resources/Crisis_Centres/

Suicide sucks. Plan and simple. It always seems to hit us when we least expect it and it always hurts. It doesn’t matter the age, the circumstance. It always feel like a life was taking before its time.

The last half of 2018 has been a helluva time for me. Over the past 6 months I have dealt with the deaths of five people who were either directly or indirectly under my care. One died of an accidental heroin overdose, the other four were suicides by hanging.

I have seen CPR performed heroically and tirelessly, but in vain on two of those deaths and it is an indescribable feeling to see someone I knew, someone I had spoken to earlier that day, laying on the ground motionless. Someone so young (one was in her twenties, the other in her thirties) and so full of life at one point, now lifeless.

Suicide is an unfortunate evil we have to deal with in the mental health field. My current job puts me in the role of dealing with suicidal patients all day long.

I am used to dealing with suicidal patients, even patients who attempt suicide or self-injure, but I am and never will be used to dealing with completed suicides. I take each death personally, even if professionally and ethically my staff and myself did everything we could to prevent it.

Suicide is often an impulsive act. At least one of the suicides appears to have been the result of rage. Suicide is often thought of as anger turned inward.

Suicide sometimes builds overtime and is the result of unbearable psyche pain. Three of the suicides, at least on the surface, appear to have been thought out. One woman was grieving over the loss of her sister and blaming herself for her sisters death. She was filled with depression and guilt she found insufferable. Another man was facing a lengthy prison sentence and decided he would rather die than go back to prison and spent years locked away. He was the only one who left a suicide letter behind. It was obviously something he had given some thought to.

Suicide, as we have seen too often lately, is sometimes the result of bullying, which appears to have been the case in the last suicide and another serious suicide attempt a couple of weeks after that one. Adults in correctional settings who are exposed to bullying are at high risk for suicide.

There weren’t any obvious warning signs that could have prevented any of these deaths. Accept for the accidental heroin overdose, these individuals seemed to have been determined, in those moments, to end their lives. I wish I could have saved them. I wish I could have saved them all. I cried after each of those suicides because I knew those individuals, maybe not terribly intimately, but as close as you can professionally under these circumstances.

I even thought about resigning because I felt like we failed them although multiple internal and external reviews showed that we did not. However, I know that for these five lives lost, there a countless numbers of suicides we have prevented. And that’s what keeps me going. That’s what keeps us all going.

#orlandostrong

14 Jun 201623 Jun 2016by Torey C. Richards, LMHCLeave a Comment

Orlando_Strong_1

I’ve spent the last couple of weeks undergoing two courses in trauma therapy, not realizing that an incredibly traumatic event would hit the city I live in. What happened in my city of Orlando in the early morning hours of 6/12/2016 was an unimaginable tragedy.

I woke up that morning and saw all the commotion on the news and in my disoriented state, I was trying to figure out part of the world this tragedy had occurred in, not realizing that it was happening in my city, just fifteen minutes from where I live.

Just hours earlier I was on my way home from a night out on the town, not far from where the shooting happened, when I saw all the rescue vehicles headed in the opposite direction. I had no idea that they were going to what would turn out to be the largest mass shooting in recent United States history.

This touched me. It hurts me, not just because so many people got killed, but that it happened in my backyard. It makes me angry. It touched everyone in the city somehow someway. I had never been to Pulse night club, but knew people who did. My nephew knew two of the victims that got killed.

My sister, the Fire Marshall for the City of Orlando got called to that horrific scene and was shaken by the cell phones ringing on the bodies still inside of the club.

I watched on Facebook as many people I knew; fellow therapists and friends, shared pictures of people they knew and loved who were now gone.

Later that day, I was standing in line at the convenience store when the person in front of me found out that one of her friends was among the dead and right there in front of everyone she broke down in sadness and anger. I was caught off guard. I had just gone out to buy some milk and there I was face to face with the impact of such a senseless crime.

I did the best I could verbally to console her so that she could get herself together enough to drive home, but it was an instant reminder of the many families and friends that were impacted by this man-made disaster.

Thinking about this tragedy, the nonsense of it all, the loss of life and the amount of trauma that will affect not only the surviving victims, but also the victims’ families, friends, first responders and the residence of the City Beautiful disheartens me.

This was a hate crime no matter how you slice it. Hatred of Americans, hatred of homosexuals, hatred of religious freedom, etc. We can’t let hate win.

No one should have to go through this. I could go on and write about gun control laws, terrorism, homophobia, religion or even post-traumatic stress disorder since this is a mental health blog, but I won’t.

I could go on about how the killer himself was probably struggling with his sexuality and hated that so many people could live freely and comfortably in their own identity, but I won’t give him that much of my energy .

What I want is this: for everyone to take some time to visit with and get to know someone of a different culture, race, ethnicity, sexual orientation, religion, age, whatever.

Get to know people who may seem different from you.

A few months ago I went to a gay nightclub for the first time just because it was the closes club in walking distance in downtown Minneapolis in negative ten degrees weather and I had a blast! It was something I thought I would never do and was initially uncomfortable with, but I had so much fun I went again the next night.

Stop being xenophobic!

Also take a moment and show love to those you love. My nephew just today told me that if he had not ran into me that Saturday night he had plans on going to that same nightclub and could have been among the dead or injured. Tomorrow is not promised for any of us.

There’s a lot of #prayfororlando going around, but besides praying, do something. If you can’t give blood or contribute to the GoFundMe platform, then at least learn to embrace other human beings and end xenophobia, racism, sexism, religism and any other B.S. that contributes to hate.

On an end note, I am very proud of the way my city, my country and my world are banding together to show support and love for both the LBGTQ community and Orlando as a whole. That’s what love is and that’s the way it should be at all times, not just during times of tragedy.

Being A Psychotherapist: Things School and Books Can’t Really Prepare You For Part Two: Suicidal Clients

3 Feb 2015by Torey C. Richards, LMHC2 Comments

Another thing school and books can’t really prepare you for are suicidal clients. Sure they cover the subject of suicide in graduate school, but the training of dealing with suicidal patients is usually very brief. There are many great books on working with suicidal clients and I have read a few, but I don’t think anything can really prepare you for sitting face to face with and working with a suicidal patient.

From my experiences, there are many types of suicidal clients and they all have to be taken seriously.

There’s the client who doesn’t really want to commit suicide, but they like to self-injure and that self-injurious behavior may lead to an accidental suicide. These are often the most common types of clients, often called “cutters” and they tend to be the most frustrating since a lot of them have cluster b type personality disorders such as borderline personality disorder.

When I worked in a high school I had a whole group full of students who self-injured and ended up involuntarily hospitalizing at least one every month because while they said they weren’t suicidal, they were definitely at times flirting with death.

This picture was taken of one of my former students who likes to cut. The next day she had twice as many cuts on her arm and I was forced to involuntarily hospitalize her.

There’s also the suicidal client who is extremely depressed or emotionally unstable and talks about death and suicide a lot. They typically don’t self-injure and have never tried to commit suicide and don’t think they ever would, but they talk about it so often and their emotional pain is so deep that when they leave your office you often wonder if this will be the last time you ever see them.

These type of clients can also be very stressful to deal with. Often when I have had clients like this I found myself worrying about them when I wasn’t even at work, when I was on vacation, when they didn’t show up for an appointment and sometimes I even dreamt about them.

One patient in particular was diagnosed with a terminal disease and she didn’t want to die a slow death. She didn’t think she would kill herself, but all she talked about was death and dying and her depression was so deep that it was hard to not be concerned about her when she missed an appointment. Eventually I had to hospitalize her after one particularly draining and emotional session when she couldn’t promise me she wasn’t going to go home and try to kill herself. Everything inside of me was screaming she would. She was angry that I hospitalized her against her will, but told me in later sessions that she had every intent of going home and killing herself that day and thanked me.

Another type of suicidal client is the one who never talks about suicide. Some are impulsive, but many just keep their thoughts and feelings buried deep inside. They may never even tell anyone that they are in pain. They just attempt or commit suicide without any real warning signs. These clients take not only you by surprise, but everyone else in their lives too.

I once worked with a student for two years dealing with the grief of a parent and then one day he gave me a card thanking me for helping him. It was our last session, he was doing great. Less than a week later I got a call from his family telling me he had attempted suicide and was in critical condition at a local hospital. I was stunned. I rushed to the hospital and nearly broke down in tears as I looked down at his lifeless body. I kept replaying our last sessions together, our last interactions, his last words to me, trying to figure out what did I miss. Thank goodness he came out of his comatose state after a few days and I was grateful that he not only lived, but that I had the opportunity to process his suicide attempt with him. I didn’t miss anything. He had suddenly decided he didn’t want to live any more and wanted to be with his deceased parent.

A couple of years before that I had been part of a crisis team that was sent to two different schools after two students had killed themselves apparently out of the blue. One was a popular jock that killed himself and stunned the whole community because no one, not even his closes friends knew that he was in so much emotional and psychological pain. His friends, family and even school staff members were blaming themselves for not seeing signs that weren’t even there.

The other student apparently killed himself on impulse in the midst of an angry dispute with his girlfriend. He told her he was going to hang himself. She didn’t believe him, but that’s exactly what he did. He had no history of being suicidal and no one saw it coming.

In my nearly 8 year career as a psychotherapist I’ve dealt with hundreds of suicidal clients. My main job right now is interacting with inmates who have been flagged as suicidal. Luckily I have not had one client commit suicide although I have had a few who have made serious suicide attempts landing them in the emergency room.

Studies suggest that:

1 in 4 interns/trainees will have a patient who attempts suicide at some point during their training and 1 in 9 will experience a completed patient’s suicide.
25% of psychologists and 50% of psychiatrists will experience a patient’s suicide.
1 in 6 psychiatric patients who die by suicide die in active treatment with a healthcare provider.
Approximately 50% of those who die by suicide in America will have seen a mental health provider at some time in their life.
Work with suicidal patients is considered the most stressful of all clinical endeavors. One third of psychotherapists who experienced a patient’s suicide subsequently suffer from severe emotional distress. Several factors may contribute to such severe distress including failure to hospitalize a suicidal patient who then died; a treatment decision that the therapist may feel contributed to the suicide; negative reactions from the therapist’s institution; and the fear of a lawsuit by the patient’s relatives.
25 % of family members of suicidal patients take legal actions against the patient’s mental health treatment team.

As a coincidence, just as I was finishing this post I was informed that an inmate just purposely swallowed 18 Ativan pills in an attempted suicide and is being rushed to the hospital.

Abnormal Psychology, Taking Control of Your LIfe, Therapist are Humans Too

Sensitive People: Absorbing Other People Emotions

22 Sep 2013by Torey C. Richards, LMHCLeave a Comment

I’m highly sensitive to other people emotions and energy. I have been for probably all of my life, but it is something I have just become aware of in the past few years. I can be having a good day, feeling happy and all it can take is an interaction without someone close to me, to bring me down.

When I discovered this sensitivity, it was quite alarming. It seemed like my mood and even the way I felt about myself were dependent on how the people around me were feeling and even how they felt towards me at that moment. You can imagine the amount of stress, anxiety and uncertainty it would cause me and often times I didn’t understand why. Looking back I think I thought that they’re mood and feelings had something to do with me. It took a lot of introspection before I realized a few things:

Rarely if ever did the other persons mood, feelings or behavior have absolutely anything to do with me and,
I can not control other people’s feelings.

A large part of it boiled down to control. I wanted everyone around me to be happy, to like me, to treat me the way I would treat them, and when they didn’t, I automatically assumed it was my fault and whatever joy or happiness I had would go away and turn into either self-blame, dysthymia or anger, especially when the people were close to me such as a girlfriend or close friend.

It took a long time for me to start working on not allowing other people emotions to affect mine, and honestly it is something I still struggle with on nearly a daily basis. Some days are better than others and when I do find myself losing my inner peace to someone else’s energy, I get discouraged because I know it’s not about me and that I can’t control their emotions nor should I allow them to have power over mine.

I learned however that if I beat myself up too bad for allowing someone to move me from my inner peace, I end up doing more emotional harm than good because I become negative towards myself for being “weak” or even “stupid” (negative self-talk never helps and is almost always a recipe for increased anxiety and depression).

I’m starting to realize that one way to stop giving so much power to other people over my emotions is by not expecting things from them that they can not give me, such as unconditional love, unconditional positive regard or fulfilling any of my various needs that can only be filled by me and God. By not expecting those needs to be met by others I have taken back much of my power, but still at times, it’s a struggle just like when trying to undo any bad habit physically or mentally.

Some Negatives to Being Hypersensitive

As I stated above, being hypersensitive to other people emotions makes it very easy to be affected by others emotions, usually not for the better. This can be very draining and overwhelming and can easily lead to anxiety and depression. This can cause us to withdraw so that we can process and deal with our emotions, which other people may not understand and take it negatively that we need time and space alone, especially since we live in a culture that devalues sensitivity. Lastly, hypersensitive people may have unrealistic expectations of perfectionism towards themselves (i.e., everyone is supposed to like me).

Some Positives About Being Hypersensitive

Just like most things that are negative, there are of course positive things about being hypersensitive emotionally. I think evolutionarily it helps us to pick up slight shifts in someones temperament or even the energy around us. I’ve been in rooms where everyone around me was talking, yet no one noticed the sudden shift in tension, or how someone else became emotional, angry or nervous during a certain topic. I would sometimes leave those situations knowing more about a person I didn’t even talk to just by watching the subtle changes in their expressions.

I think being hypersensitive to other people emotions help me to be more in touch with my own emotions. I’m always amazed at how many people aren’t in touch with their emotions and as a counselor, often it’s my job to help them to get in touch with their true emotions so that they can start living a real, authentic life. We hide from our emotions, mask our emotions (even from ourselves) and often don’t know why we feel or act in certain ways because we are not used to being in touch with that part of us. Hypersensitive people are almost always, sometimes neurotically checking in with their thoughts and emotions.

I think being hypersensitive also leads to being more creative, to being able to express ones emotions more through music, art, dance, poetry and writing for example. It also makes us more empathetic to others which in the field of mental health is a must.

Some Tips for Hypersensitive People

You have to recognize and acknowledge that you are absorbing other people emotions. I’ve been doing it for years and until I actually realized it, I wasn’t doing anything different to try to stop it.
When you start feeling a certain way after an encounter with someone, ask yourself if what you are feeling is really your emotion or theirs. You’ll be surprised to find out that most of the time it’s not yours and if it’s theirs then immediately release it. This alone will make you feel better most of the time.
Remember that you are not responsible for nor can you control other people emotions so don’t worry over it because in doing so, you’ll just be absorbing it into your own emotional state.
Identify what/who is making you feel a certain way and try to distance yourself if you can. If you can’t, go back through steps 1 to 3. Sometimes it’s a particular friend or group of coworkers that are the main source. Putting some distance between you and them can help alleviate the problem.
When you start to feel overwhelmed by other people emotions, even if you can’t get away, try mindfulness or deep breathing techniques to help bring you back to your own inner peace.
Speaking of inner peace, always try to work on building up your own inner peace by being good to yourself, exercising, eating right, maintaining good emotional, physical and mental health and surrounding yourself with people who bring you good and positive energy. BE GOOD TO YOURSELF!

Being hypersensitive to other people emotions is both a gift and a curse, but look at it like a power that you have to master so that you are in control of your emotions and able to use all of the positive qualities that come along with being sensitive to other people emotions.

Therapist are Humans Too

Involuntary Hospitalization

25 Aug 201325 Aug 2013by Torey C. Richards, LMHCLeave a Comment

Last week I did my very first involuntary hospitalization (or as we call it here in Florida, a Baker ACT) of an adult.

Involuntary hospitalization or commitment is actually a legal procedure where an individual who is showing severe signs of a mental illness such as suicidal thoughts, homicidal thoughts, self-neglect or any other potential to intentionally or unintentionally harm themselves or others is placed into a hospital even if they don’t want to go.

Here in Florida it’s generally a 72 hour hold where the person is evaluated by a nurse and other mental health professionals and then a psychiatrist who will decide if that person is well enough to be released or should stay longer. Technically a 72 hour hold can be extended for as long as a week to much longer in severe cases including state hospitalization which is typically months. It’s a major responsiblity because it’s basically taking away part of someone libery and forcing them into treatment.

In Florida, a doctor, a police officer, a physicians assistant and licensed social workers, marriage and family counselors and mental health counselors all have the authority to put someone involuntarily into the hospital if they feel that person is a threat to themselves or someone else.

I personally don’t take this responsibility lightly, especially working in my new job where I work mostly with adults who’s circumstances generally aren’t as black and white when it comes to meeting criteria to be placed into involuntary hospitalization compared to children. However I know that sometimes it is necessary to keep people safe from themselves, other people and even their illness.

Most of the children and adolescents I had to place into involuntary hospitalization were fairly easy decisions for me. They usually came straight out and told me that they wanted to kill themselves, wanted to kill a parent, or was doing something so outrageous that it was obvious they were imminent dangers to themselves. Most of them, once I told them I was going to have to have them put into the hospital for observation didn’t fight it much. Some cried, but most knew it was for their own good.

Adults however are different. Yes there are plenty of adults who are as obvious as the adolescents, but when it comes to adults, most of them won’t say that they want to kill themselves or someone else, but will skate around it and it becomes not black or white, but grey.

Working in a mental hospital makes it even worst because many of the adults present with some signs of psychosis and it’s not illegal to show sings of psychosis or to be symptomatic, meaning, I can’t hospitalize a schizophrenic just because she’s hearing voices and talking to herself, or a manic woman just because she’s speaking at a thousand miles an hour and bouncing from topic to topic driving her husband and kids up the wall, not as long as both of those people aren’t homicidal or suicidal and are oriented which is the majority of the case.

Often times people will want these people placed into the hospital against their will because they are acting “crazy”, but that doesn’t meet criteria to take away someones liberty and placing them into the hospital.

Because adults have been much more complicated than children when it comes down to deciding if they meet criteria for involuntary hospitalization or not, I was always nervous about writing my first adult involuntary hospitalization order, but when I got this current job, I knew it was only a matter of time. At least 2 to 3 times a week I was asked to evaluate an adult to see if they met criteria for involuntary hospitalization, but most of the time the adults were just symptomatic, maybe in need of some medication, but didn’t meet criteria for involuntary hospitalization.

That was until last week. Last week I was in a training when I got asked me to come evaluate a woman because her therapist thought she may need to be placed into the hospital for her safety.

I met with and evaluated the woman who was obviously in distress. Through my evaluation she told me she hadn’t eaten, slept or bathed in days, nor has she taken her medication because “demons” were telling her not to and were physically holding her down at night.

She then started telling me about being commanded by her deceased mother to do things like book an airplane ticket to another state. She also did not know where she was or what year it was. It was obvious to me that she needed to be hospitalized for her own safety so I had to write an involuntary hospitalization order and she was subsequently placed into our hospital where she would be evaluated, stabilized and released to go back home with a follow up plan of both medication and therapy.

I was nervous as I wrote it, but this one was obvious enough where I felt confident that I wasn’t violating anyones rights and where the power I have to place someone in the hospital against their will was being used for the right reason.

So that was my first adult involuntary hospitalization and I know there will be many more to come because as a licensed mental health counselor I evaluate people’s mental state everyday and working in a large mental health hospital where people come for medication appointments and therapy appointments, but sometimes end up presenting in ways that suggests they need to be placed in the hospital for stabilization, writing involuntary hospitalization orders is part of my job and it’s a responsibility I don’t take likely.

Attachments: How Our Very Earliest Relationships Impact Our Current Relationships

7 Aug 20137 Aug 2013by Torey C. Richards, LMHC9 Comments

20130805_194648 — Photo Courtesy of Sylvia Olson

Recently a friend of mine and I had an intellectual and introspective conversation about the way we act when it comes to relationships. We discussed the ways we react to love, to break ups, to trust issues and to abandonment.

It was during this conversation that I started trying to identify our attachment styles because it was clear to me that ours were different, yet neither one of us had what I felt was a healthy attachment style.

As a clinician, I’ve always been aware of attachment styles, especially when it came to attachment disorders like reactive attachment disorder (RAD), but I never really gave them much thought when it came to my own life until I was having this conversation with someone who seemed so opposite, yet familiar.

What Exactly Are Attachment Styles?

Attachment styles are patterns of relating to others that develop early in childhood and they consciously and/or unconsciously continue to play a role in our relationships throughout life. We base much of our attachment style on the very early relationships we had with our parents (especially our mothers) or guardians.

The attachment style we operate from influences how we go about getting our needs met and how we meet or don’t meet the needs of others.

When we have a healthy attachment style we are confident, secure and easily interact with other people in a balanced relationship.

When we have an unhealthy attachment style we tend to be insecure, anxious, and/or detached and tend to find other people who fit into our unhealthy attachment style which generally means making bad choices in relationships because the people we choose tend to lack the capability to be good partners for us in the relationship.

We typically tend to project our sense of how we think relationships are, through our attachment style.

For instance, someone who has an insecure attachment style will likely seek out other relationships that confirm to them that they should be insecure. They will unconsciously seek out people who are unfaithful and friends who aren’t trustworthy, even when those relationships are clearly hurtful and destructive.

It’s helpful to understand what your attachment style is so that you can be aware of some of the unconscious factors that may be playing major roles in your adult relationships.

There are four basic patterns of attachment and we’ll discuss each one briefly in efforts to help you identify which style mostly resembles the way you relate to others, especially in your love life.

Secure Attachment

Lucky, the majority of of us have what is called secure attachment, which means that we grew up seeing our parents or caregiver as a safe and secure place, which allowed us to go out and explore our world as an individual.

People with secure attachment tend to have better relationships compared to the other attachment styles. They tend to find romantic partners who also have secure attachment. They feel connected, secure and do not try to control their partners or cut off their partners independency.

As adults they are supportive and aren’t afraid to ask for support when they feel they need it. Their relationships are generally more open, honest and fair because while they like feeling independent, they also like being connected with those in their life without hampering their independence.

The way they relate and love other people is usually more genuine and they act out of places of love, rather than fear or anger more often than those who have other attachment styles.

Anxious Preoccupied Attachment

People who have this type of attachment are often “starving” for love or attention. They tend to cling to people even when there is no real love and trust isn’t present. These people are usually looking for someone who “completes” them because they don’t feel complete by themselves and feel safer when they are in some sort of relationship. At the same time as they are clinging to others, they tend to do things that push them away.

Because these individuals are afraid of abandonment, they come off as anxious, insecure and desperate and do things to confirm their believe that they should feel this way such as becoming possessive, super clingy, demanding of time and attention and trying to control their partners independence. As a matter of fact, they may see their partners independence as rejection and confirming that they should be feeling anxious and insecure.

They may for instance see their best friends interest in other people as signs that they don’t want to be friends any more and will hurt them or if they’re in a relationship, they may see their partners interest in a “boys night out” as a sign that he doesn’t love her and wants to be with other women, therefor confirming their believes that they should be insecure and anxious.

Dismissive Avoidant Attachment

People who have this type of attachment seem to be emotionally detached, especially when it comes to people they are supposed to love and care about. They tend to isolate themselves and create a false sense of independence, often times isolating themselves from family and friends. These are the people that may seem totally wrapped up in themselves and their own well-being.

However, their false sense of independency is just that, it’s not real and they crave real relationships with others just like all humans do. We are social creature by nature. People with dismissive avoidant attachments will deny the importance of real relationships with family, friends and other loved ones and will detach easily from the people in their lives often for little to no reason at all.

This is a psychological defense that they use to shut off their emotions, usually to prevent from getting hurt, feeling rejected or having to be vulnerable in anyway. For example, even when they are really angry or sad, they may look unfazed. They have an uncanny ability to not react and just shut off all emotions.

They may repeatedly chose relationships with unhealthy people so that they will be forced to detach and affirm that they need to be detached and distant because they will only get hurt if they allow themselves to be vulnerable. Even if they are in a good relationship, they are likely to run or cut off all communication at the slightest hint that they are allowing themselves to be exposed.

Fearful Avoidant Attachment

People who have fearful avoidant attachment are always at a point where they are trying not to be too close to other people and at the same time, they don’t want to be too distant from them either. They try to maintain this balance by hiding their fear, but it’s nearly impossible to do for very long.

These people sometimes come off as unpredictable or even “bipolar” as they try to maintain that balance and often react in overly emotional ways. They usually believe that you have to go towards other people if you want to get your needs met (love, attention, security, etc.), but also believe that if you get too close you will get burned.

The very people they want to run to and turn to for love and support end up being the same people they are extremely afraid of being too close to. You can imagine how this type of attachment would play out in familial and romantic relationships and the turmoil it could cause. Because of this, they usually aren’t very successful at truly getting their needs met by others.

For instance, a wife with this type of attachment may feel like she needs her husband to be more attentive to her, but is too afraid to admit it and therefore never tells him and is bitter when he continues to be inattentive.

In the worse situations, these people tend to be more likely than the other attachment styles to end up in abusive relationships. They tend to like the dramatic type of relationships that are like emotional roller coasters as they fear being abandoned by their partner, but at the same time have difficulty being emotionally available and intimate.

Knowing your attachment style, even understanding some of the dynamics that helped develop it, can help you learn to change the way you relate to others so that you can have more genuine, fulfilling and valuable relationships with others.

I believe my attachment style most closely resembles anxious preoccupied attachment. Now that I know that I can not only analyze my past relationships, but change my future ones for the better.

By recognizing the defenses that we use to avoid being emotionally connected with other people and challenging ourselves to enter into friendships and relationships with people who have secure attachment styles, we can work on our issues in those relationships.

If you want more information, there are plenty of good books on attachment, but I personally recommend Attachments: Why You Love, Feel, and Act the Way You Do by Dr. Tim Clinton and Dr. Gary Sibcy.

Working Around Your Abyss

26 Jul 201328 Jul 2013by Torey C. Richards, LMHC4 Comments

I’m always amazed at the lengths some people will go through to hide their pain. All of us have pain, disappointments, regrets, wounds, and parts of us we wish we could hide forever, but many times those very issues are the things we need to address in order to move on and live truly fulfilled and happy lives.

The other night I was watching Beyond Scared Straight on A&E and there was a kid on there whose father committed suicide when he was younger and it looked like the kid had never really talked to anyone about it or dealt with it in any sort of healthy way. Instead he turned to drugs, violence and other petty criminal behaviors as a way of acting out and dealing with what I believe must be anger towards his dad coupled with immense depression.

Most people would look at this kid and see a juvenile delinquent, but all I saw was a kid crying out for someone to see past the walls he had erected around his pain and help him navigate his way around it.

This young kid wasn’t unlike many of the high school kids I dealt with that teachers thought were just bad apples, but they were really acting out because of the pain they were holding on to, such as coming from poverty stricken, sometimes violent and unstable broken homes. Especially the boys who would hold on to their pain so tight, not wanting to show any weaknesses, and yet the pain was literally destroying them by causing them to constantly get in their own way by fighting, failing out of school or getting involved in illegal activities that were sure to lead to incarceration.

We all have stuff. We all have issues. That is something I say all the time when people open up to me, no matter if they are clients or friends. I always encourage talking about those pains because I believe that talking about them, even just a little bit, helps ease some of the tension, stigma, shame, and fear people attach to their pain.

While some people try drastic measures to consciously or unconsciously hide from, ignore, deny or cover up their pain (sex, drugs, alcohol, cutting, eating disorders, continued bad relationships, etc.), some people are so absorbed in their pain that can’t even enjoy moments of happiness when they happen. They can’t see anything except for their pain. They live in constant depression, anxiety, suspicion, and pessimism.

It may be something that happened a long time ago, yet they are never living in the moment, they are constantly living in the past and their pain. They are constantly unconsciously telling themselves stories which for the most part are untrue. Stories about themselves, their pain and their lives. Stories that hold them hostage to turmoil and they will hold on to those stories with a death grip even in the face of evidence that their stories are at least partially untrue.

The stories we tell ourselves include things such as, “My dad left because I was a bad kid”, or “My husband cheated because I wasn’t enough for him” and “I fail at everything I try”. The list goes on and on, but you can imagine how someone who is telling themselves these stories will live their lives in the present and future if they continue to believe these stories about themselves.

They will hold on to those stories, sometimes because it is the only story that they know and it’s much easier to believe in the story that you know than to try to create a better story where there may be unexpected surprises even if some of the surprises include very pleasant ones.

One of my favorite books is entitled The Inner Voice of Love: A Journey Through Anguish To Freedom by Henri Nouwen. It was given to me as a gift several years ago and I have since given it away, brought it again and given it away again no less than eight times.

The first passage in that book is called Work Around Your Abyss and it says:

There is a deep hole in your being, like an abyss. You
will never succeed in filling that hole, because your
needs are inexhaustible. You have to work around it
so that gradually the abyss closes.
Since the hole is so enormous and your anguish
so deep, you will always be tempted to flee from it.
There are two extremes to avoid: being completely
absorbed in your pain and being distracted by so
many things that you stay far away from the wound
you want to heal.

When I first read that passage about six years ago, I almost cried because I felt like it was talking directly to me. I was holding on to a lot of pain and not doing anything about it. Pain about my fathers death, pain about our relationship, pain about the romantic relationship I was in and fear of not being completely loved and fear of failure.

Holding on to and not addressing those pains was leading to anxiety, depression, low self-esteem and agitation. It was until I read this passage that I started to address and work around my abyss which slowly, but surely started to close and this passage is probably the #1 reason I have shared this book so many times with people who have shared some of their pain with me.

All of us have issues, or what I like to call “stuff”, but it doesn’t have to define us and we don’t have to wear it like a scarlet letter nor pretend like it’s not there. We define ourselves and our situations, our situations do not define us. Let’s all make a commitment to start working around our abyss so that we can start living fully and completely, the way we were all meant to live.

Therapist are Humans Too

Change And Inertia: Embarking On A New Adventure

24 Jun 20131 Jul 2013by Torey C. Richards, LMHC2 Comments

I hate change, which I know is probably strange for me to say because during my therapy sessions I do a lot of what is called change talk, which is talking about and encouraging change. I generally consider myself to be an agent of change as I guide my clients through the stages of change, but I myself have always had issues with change. I don’t like it.

Some people love change and I always admire those people. They love new adventures, they adapt quickly, and never seem to get stuck in a rut or dead end job. They seem to just be wired differently and indeed, the ease to which people accept or don’t accept change is a personality trait known as the Openness trait and some people are naturally more open than others to change.

My fear of change over the years has cost me a lot. It has kept me at jobs I should have moved on from for far too long and in relationships I should have left for far too long. It has also kept me from experiencing many pleasures and probably some pains and failures, otherwise known as learning experiences and opportunities to grow.

I, like a lot of people, like being comfortable, playing it safe, even when that inertia isn’t all that great and sometimes downright unpleasant. There’s a popular quote by a late, great female therapist, I couldn’t find it or her name, but it basically says that we prefer the familiar negative to the potential unfamiliar positive, except of course she said it more beautifully.

And this tends to be true, at least for me and the majority of my clients who struggle to make changes in their thinking and interpersonal lives because they are afraid of what the new change will bring, good or bad, but they know exactly what the old thinking and behavior will continue to bring them, both good and bad. This is one of many reasons people resist change.

This is why I think I was so successful at helping people make changes they found difficult to make, because I understood their ambivalence towards change, their desire to both want to change and not want to change at the same time because I’ve experienced it so many times myself, even in ways that bordered being neurotic.

It’s easier to stay the same. Inertia is much easier than movement, especially when that movement has to be sustained, yet inertia robs us of so many experiences, opportunity and growth. A fellow therapist recently old me that if you are comfortable, then you are not growing. You should always be challenging yourself.

It’s that comfort zone I try to push my clients out of because sometimes you have to become a little uncomfortable to truly grow and realize your full potential and the same applies to me.

Some of you who follow my blog may know that the grant that pays for me to serve the students at the inner-city school I work at is coming to an end this Friday. The school has been working really hard to find funding to keep me and they may be close to working something out, but I couldn’t count on that to come through so reluctantly I started looking for another job.

Well an opportunity came up for me to apply for a job as a supervisor at the mental hospital I used to work at fresh out of grad school as a supervisor over the crisis unit I used to work at. I loved working in the mental hospital, I enjoyed dealing with people in various stages of a crisis from emotional and mental break downs to substance withdrawals.

This opportunity would force me to grow, push me out of my comfort zone, pay better and definitely be an upward climb in my professional career, so I applied for the job and got the news Friday that I got it. I should be excited right? But remember, I don’t like change and I do love working at the inner-city school I currently work at even though I potentially won’t be there next school year anyway because of funding.

I love working with the teenagers I work with, helping mold young lives and by taking this job at the mental hospital, I would miss that although in my private practice I would still see a very small number of teenagers. Although I would be taking a pay cut to stay at the school, potentially not have a job this year or next year AND still be stagnant career wise, I seriously thought about turning down the supervisor job to stay where I was comfortable, in a place that would require no effort (inertia) although I know I would love doing my job (compared to the unknown level of satisfaction of a new job).

I’ve had similar opportunities twice in the past two years to make more money and move up professionally and both times I turned it down to stay comfortable. Of course I said I did it because the kids need me, and while I felt like that was true, I also know that a large reason I stayed was fear of change.

Now however, I am pushing myself into change just as I talk to my clients about pushing themselves out of their comfort zones.

It’s with a heavy heart that I took this new job, something I should be extremely happy I got because the chances seemed so slim when I first applied and went through two interviews. After all, I have no real supervisor experience, but I have experience working in a crisis unit and my love and dedication to the mental health field and those who suffer from mental illness is unparalleled.

And it’s with a heavier heart that I have to tell the school tomorrow that I will not be returning for another school year. It’s a tough decision and one I made ultimately not out of where the money was, or where I felt most comfortable, but where I needed to be for both professional and personal growth.

I am pretty sure it won’t feel as rewarding and life changing as working with the high school students I work with, but I think it will allow me to serve people in another way while learning more about myself and the mental health system altogether.

My passion will always be teens and adolescences, and I’ll continue to write a lot about issues that effect that population, but I am sure that naturally I’ll write more and more about issues and situations I encounter working in the mental hospital.

So while I am still anxious and uncomfortable I’m pushing myself towards this change, trying to welcome it and all of the new possibilities that come along with change. After all, how can I promote change in others if I am unwilling to go through the uncomfortableness of change myself?