Licensed Mental Health Counselor

We Need These Five Things To Find Well-being in Life

3 Mar 2023by Torey C. Richards, LMHCLeave a Comment

The other day I took an interesting seminar on positive psychology and in particular, the PERMA Model. The PERMA Model was developed by positive psychologist, Martin Seligman. “PERMA” stands for the five elements he believes we need to have in our lives to experience lasting well-being and to flourish.

What Does PEMRA stand for anyway?

(P) Positive Emotion
In order for us to experience long lasting well-being we need to have positive emotions in our lives. Positive emotion can come from a variety of things such as having gratitude, being at peace, being satisfied, inspired, in love or having hope are just a few examples. Enjoying ourselves in the here and now is essential as long as we also have the other components of PERMA in place.
(E) Engagement
Think about when you are truly engaged in something you find interesting. It can be an activity, reading a book, watching a movie or working on a project. When we are truly engaged, we experience a since of flow where we lose our sense of self. Time seems to sit still, and we are engaged intensely on the present. It’s a beautiful thing. The more we experience this type of engagement, the more we will experience happiness and well-being. It’s important that we find things that allow us to experience this since of flow on a regular basis.
(R) Positive Relationships
Humans are social creatures and the more we have good, meaningful, positive relationships, the happier we tend to be. In order to achieve long-lasting well-being, it’s important that we have positive relationships. It doesn’t mean you have to be an extrovert or social butterfly. We all have our own unique ways of building and engaging in healthy relationships.
(M) Meaning
Meaning happens when we are doing something that is bigger than ourselves. This could be serving a religious or spiritual cause, a humanitarian cause or being a part of something that gives you a sense of purpose. Finding meaning in our lives help gives us a sense of well-being.
(A) Accomplishment/Achievement
Most of us want to grow and improve ourselves in some way. It could be learning a new skill, losing weight or challenging ourselves to get over a fear. Accomplishing things is important in helping us flourish and giving our lives a since of well-being. They can be small or big goals.

How to Use the PERMA Model in Your Life

Happiness can be an elusive goal and somethings we focus too much on trying to be happy when instead we should focus more on finding a sense of well-being and living a rich, meaningful life. We can do this by utilizing the PERMA model to start improving your lives.

Start by looking at your life. Look at what you already have that give you the five elements of PERMA. What can you do to improve those things if you already have them or to create them if you don’t?

Positive Emotions: Look for opportunities to have more positive emotions by looking at the people, things and events that bring you happiness. Find ways to bring some positive emotions and joy into your daily routine instead of waiting for the weekend or vacation time to feel enjoyment. It could be finding time to enjoy a cup of coffee in the morning or bringing in plants for your desk at work.

Engagement: Find ways to become engaged with the things you like. That can be a hobby or spending time with friends or working on a project. It can be your work If it brings you happiness. Try to find ways to limit distractions so that you can get into a state of flow. Find activities that make you feel engaged and happy.

Positive Relationships: Do you have enough positive relationships in your life? It could be with friends, family or co-workers. Many of us spend most of our waking hours at work so it may be important to build quality work relationships. Outside of work is just as important. If you can work on improving your current relationships than do it. Commit to spending more time with a friend or family member on a regular basis. Often times we are all busy with our individual lives, but It takes effort to connect and strengthen relationships. If however you don’t have any positive relationships don’t waste too much time trying to build something that isn’t there or worse, something that is toxic. Be open to building new positive relationships with people that make you feel good.

Meaning: Do you feel like you’re connected to something bigger than you? You can get that feeling from your work, your hobbies, charities or your religious or spiritual connections. Finding meaning is important to our sense of well-being and we can find that by performing acts of kindness, being part of a group, volunteering or even just being connected more with those close to us.

Accomplishments/Achievement
Are you devoting enough time to achieving and accomplishing your goals and dreams? Identify what it is you want to accomplish in life. You don’t have to start with huge goals, but you can start with small ones and each time you achieve one, celebrate, even if it’s by yourself and privately. Accomplishing things help us feel fulfilled and increasing our sense of well-being.

For more information on PERMA check out “Flourish: A Visionary New Understanding of Happiness and Well-Being” by Martin E. P. Seligman. Published by Free Press, 2011.

Popular Psychology

What You Need to Know About Stealthing

11 Jan 2023by Torey C. Richards, LMHCLeave a Comment

Okay, so maybe I’ve been in a committed relationship for so long that I haven’t kept up with some of the new terms in the dating and sex lexicon. When a client of mine told me last week that she was upset with her new boyfriend because he kept “Stealthing her”, I had no idea what she was talking about. I had to ask her what Stealthing was. In her words, she said “It’s when someone takes off a condom during sex without you knowing”. I wasn’t completely shocked by this. I have heard of this happening when I was a teenager and even in my college years, but my patient and her boyfriend are both fully grown adults and even more surprisingly, they both work in the medical field. This prompted me to do more research on Stealthing because apparently it is a bigger thing than I had realized.

What is Stealthing?

I had to turn to the internet for a clearer definitely of stealthing, although my client’s definition was pretty right on. Stealthing is the non-consensual act of removing a condom during sex without the consent or knowledge of the other person.

It can also include damaging the condom on purpose without the other person knowing so that it becomes less effective at its job of preventing pregnancy and sexually transmitted infections (STI).

While Stealthing usually involves removing a condom in the middle of a sexual act, it can also mean the removing of any agreed upon barrier in the middle of sexual activity without the other person’s consent.

When I was younger and I would hear guys talk about this, it didn’t seem as bad as it does now that I’m older. Back then the guys I know who did it would say that they didn’t like the feel of sex with a condom on. They’re intent didn’t seem terribly malicious, but in actuality, Stealthing is a form of sexual assault.

Consent is an informed, specific, and ongoing negotiation of enthusiastic desire.

When someone consents to having sex with another person(s) with the use of a condom, dental dam or any other protective barrier, when the other person purposely removes or damages that barrier, the consent of the other person has been broken which then turns the consensual sex into assault.

How Common is Stealthing?

One study I read says that about 12% of women have experienced Stealthing. I asked my client why she thought her new boyfriend was doing this to her (she had caught him multiple times). I even asked if she thought he was trying to get her pregnant as using condoms was the only form of birth control they were using, but she said that he simply didn’t like to use condoms. According to her, he never wanted to use condoms from the first time they engaged in sex, but she insisted. She wanted to protect her body from pregnancy and STIs.

There’s some thought that Stealthing is rooted in misogyny where men who do it believe that their pleasure is more important than the desires, wishes and consent of their partner.

A lot of these men have been raised by society to believe that a man’s happiness and sexual pleasure supersedes that of their partner, especially when it comes to heterosexual men.

I even recommended to my partner that they try different brands and types of condoms such as polyurethane or lambskin, but she didn’t think that would make a difference. Unfortunately, many people believe that condoms ruin sex for the man that is wearing it.

Because of these combined factors, many men believe that it’s okay to remove a condom if it’s getting in the way of their pleasure. Most likely, in their opinion, they are doing no real harm, not realizing that they are not only exposing themselves and the person they are having sex with to STis, unwanted pregnancy and sexual assault.

Stealthing Is Sexual Abuse

The reason why my client’s boyfriend, or anyone would remove or damage an agreed upon sexual barrier doesn’t really matter. At the end of the day, it’s sexual abuse and it harms the victim.

Stealthing can be done as a form of physical or emotional abuse. It can be done because someone is purposely trying to pass on a STI or impregnate another person without their consent. Why would someone want to do those things? Manipulation for one. The person who is doing the Stealthing may be trying to trap the other person into being in a relationship with them through getting them pregnant or giving them a STI. They may feel like the other person would have to stay with them because no one else is going to want or love them which of course is not true.

My client was left feeling betrayed, scared and depressed because she can’t trust this guy she really likes. He has shown that he doesn’t respect her or her body and continues to put her at risk despite her telling him multiple times not to. The last time we met she had agreed to not be intimate with him until he shows that he is going to respect her and her desires.

Because of this violation of trust and bodily autonomy, my client has had increased anxiety and depression. She really likes this guy, and it seems as if his only flaw which is a critical flaw, is that he doesn’t respect her when it comes to sex and I can only imagine that if he isn’t respecting her that way then it’s only a matter of time before he shows he doesn’t’ respect her in many other ways, if at all.

What to do if You’ve been Stealthed

California actually made stealthing illegal in 2021 and I believe other states will slowly follow. For now, if you think you’ve been Stealthed, it’s okay to ask your partner “Did you remove the condom (or whatever barrier) while we were having sex” or ask them to squeeze the condom afterwards to make sure there are no holes in it.

It can be hard to know if you were Stealthed, but always trust your gut and if something feels off, proceed as if you had been Stealthed so that you can protect yourself.

Use emergency contraception- something like Plan B, but time is of the essence as most emergency contraception have to be taken within 3 to 5 days of the incident.
Take the antiretroviral PEP– if you don’t know your partners STI status or don’t trust that they are being honest about it, you can take PEP but it must be taken within 72 hours of potential exposure to HIV to be effective. If you know that your partner is HIV positive, go see a medical professional immediately about post exposure prophylaxis .
Take a pregnancy test- you have to wait a couple of weeks or so for this one, but taking a pregnancy test or two (one a week after the first one) can help you either relax or know your options depending on the results.
Get tested for STIs- unless you know the status of the person you were intimate with, you should plan on getting tested for STIs for both your health and the health of your future partners.
Get support- being Stealthed can be dehumanizing and traumatizing, but there’s no reason to feel embarrassed. Reach out to family, friends, a counselor or anyone you feel comfortable talking to.

The bottom line is, Stealthing is sexual assault and abuse. The only person to blame is the person doing the stealthing and the only way to stop stealthing from happening is the person who is doing it has to respect the consent and desires of the other person.

If the other person truly doesn’t want to use protection, then they either need to move on or have an open dialogue with their partner and only engage in non-protective sex when both parties fully agree and understand the potential consequences. Some ways of bringing this up include asking if the other person would be interested in having sex without a condom if they got tested for STIs together, or if the other person is open to sex without protection if they used another birth control method. Having an open dialogue, respect and consent are the keys.

Stealthing is not harmless. It’s abusive and potentially dangerous.

Taking Control of Your LIfe

Celebrate Yourself in 2023

2 Jan 2023by Torey C. Richards, LMHCLeave a Comment

Last year I achieved a major accomplishment. I trained hard for several months and competed in a Jiu Jitsu competition I had wanted to compete in for years. I pushed myself out of my comfort zone and forced myself to out in front of hundreds of strangers, my team and my coaches and compete. And you know what? It was great! I came in second place, I felt good about myself, and I was proud of having put myself out there to compete with some younger guys. That whole night felt magical… until I got home.

When I got home it was like someone had let all of the air out of my balloon. My significant other didn’t even ask me how it went and when I told her, she didn’t seem to care. There was no celebration. I felt heartbroken. Although she knew how hard I trained and how nervous I was for this particular event, she did not acknowledge it at all once I got home. I felt a little defeated. I realized that something that meant a lot to me meant absolutely nothing to her and while ideally, our friends, family and significant others would want to celebrate our accomplishments, at the end of the day they may not totally understand what it means to us, so we have to be able to celebrate ourselves regardless of if others want to celebrate with us or not.

How Do You Learn To Celebrate Yourself

Unfortunately, many of us do not know how to celebrate ourselves. Some of us don’t do it out of fear of appearing conceited or boastful. Many of us have even been taught to not celebrate ourselves, but it’s important to recognize and celebrate our achievements, especially for ourselves, but it may even encourage or inspire others as well.

You can start by celebrating small achievements. Many of us like to wait until we accomplish a big goal before we celebrate, but often times those big goals take along time to achieve and we can get discouraged along the way. That’s why it’s important to celebrate the small accomplishments as well. Let’s say that your New Years resolution is to lose 50 pounds. You don’t have to wait until you lose all 50 to celebrate. You can celebrate losing five pounds, then ten or even celebrate when you make it through a whole week sticking to your diet and/or exercise plan. Those little celebrations can help motivate you to keep going and accomplishing your goal.

Start small.

Even if you don’t have any big goals coming up, it is good to get into the habit of reflecting back on your accomplishments at the end of the week. Did you clean that garage? Did you meet your steps goals more days than not? Did you cut back on sugar like you had planned? Sometimes you have to celebrate things such as just making it to the gym on a day when you really didn’t want to go, or writing a few sentences on a day when writers block felt particularly crippling.

Ways to Celebrate Yourself

Give yourself a break. Take a day off work and do something special just for yourself. That may mean lying in bed binge watching your favorite TV show, hanging out with a friend you haven’t seen in a while, enjoying a nature walk or all three. Just make sure whatever you do is for you. If you can’t carve out a whole day, carve out a couple of hours. Get a babysitter and give yourself some “me time” or turn off all of your electronic devices and enjoy an hour to yourself.
Share your success with others. You can celebrate privately or you can share your accomplishments with others. Yes, some of your friends may not care that you lost 5 pounds this week, but I am willing to bet that many more of your family and friends would love to hear about your accomplishments and are willing to be supportive. Share your accomplishments rather it’s privately with a few close friends and family or on social media and accept the compliments. Remember, sharing an accomplishment you’re proud of is not bragging or boasting.
Dress up to celebrate yourself. You don’t have to be going anywhere special, but the way we dress can influence the way we feel. If we want to celebrate ourselves, sometimes it’s good to dress the part. You don’t have to save your fancy clothes or the clothes that make you feel special for those special occasions when celebrating yourself is a special occasion. This is one way I used to privately celebrate myself and yet everyone I came in contact with would notice and some would even ask what the special occasion was.
Buy yourself something special. I’m a big proponent on buying gifts for myself. Celebrate yourself by buying yourself something you want and if it’s something that may cost a lot of money, celebrate yourself buy saving towards it. It could be a new pair of shoes, a trip to Vegas or something as simple as a book you’ve been wanting to read. I celebrated myself last month by buying myself a watch I really wanted but knew no one else would ever by me.

I really hope this year is full of joy, love, good health and many celebrations for you!

Taking Control of Your LIfe

Mental Health Struggles After a Hurricane

6 Oct 20226 Oct 2022by Torey C. Richards, LMHCLeave a Comment

I live in “The Sunshine State”, but unfortunately, it’s not always sunny herein Florida especially during hurricane season. Just last week many Floridians, including myself, were affected by hurricane Ian. While my house in suffered no damage other than to the fence and being out of power for three days, many others faired far worse. Many people lost their homes to the winds and floods. Sadly, many people also lost their lives. At the time of this writing, 103 people in Florida had died from the storm and recovery efforts are still ongoing. I work at a level 3 trauma hospital and have seen patients with injuries indirectly related to the storm such as burn injuries related to generator fires and electrocutions caused by down power lines. Being in a major storm can be terrifying and even after the storm has passed, it’s effects can still linger not just with the damage to the community, but mentally with those who survived.

For many, such natural disasters can trigger a continuing sense of anxiety and depression or worsen long-simmering mental illnesses, mental health experts say. The effects, if left untreated, can linger for years.

Going through a natural disaster like a hurricane can be very traumatic. Thousands of people had to evacuate their homes, and some had no home to return to, losing all of their possessions and some even their businesses and jobs in the process. In Orange County where I live, schools were closed for several days, and one elementary school is damaged so badly because flooding that those kids are now being taught at a high school. Imagine how traumatizing that is for elementary age kids to suddenly lose their school and have to adjust to a whole new environment that no one could have prepared them for. While children are known for being resilient, I have no doubt that many of them will need additional emotional support at this time.

Often people who suffer from a mental health issue will have a worsening of symptoms especially because they tend to lack adequate coping skills as it is. Even those who don’t suffer from mental health issues may find themselves struggling weeks to months later when they realize how difficult it may be to rebuild, the financial toll the storm has taken on them or anxiety whenever another storm may be headed their way. Once power got restored at my house I had to go through my refrigerator and freezer and throw away almost everything which in itself could cause someone on a limited income anxiety and depression as that food has to be replaced somehow. Luckily there are government assisted programs like FEMA that are offering aid to those in need.

Here are some tips for coping with natural disasters like hurricanes from The Anxiety and Depression Association of America:

Create a plan: Being prepared can help reduce anxiety before, during and after a big storm. Make a plan to evacuate and put together preparedness kits.
Be informed: Keep a close eye on weather information and warnings. That may help you gain a sense of control over the situation.
Talk it out: Don’t be afraid to talk about your fears with family members, friends, a counselor, or others who can offer emotional support.
Accept what you can’t control: Nobody can control the path of a storm or its damage. Excessive worry will not change anything except your emotional well-being.

Some people may need to stay away from watching too much news coverage of the storm as it can be upsetting. Trying to get back to your normal daily activities as soon as possible can be helpful as well as exercising, sleeping and eating right. It’s really hard to manage your mental health when you’re mentally and physically exhausted.

If you can, after the disasters has passed, consider doing something that may make you feel good such as donating food, money or your time. If, however, you feel extremely overwhelmed, depressed and your symptoms don’t improve in a few weeks, it may be time to seek professional help.

Often people think after a storm or natural disaster only about the clean-up and rebuilding, but it’s important that we don’t neglect the survivor’s mental health.

I’ve attached some personal pictures to show just some of the damage Ian caused across central Florida. Things are much worse in certain areas, especially where the storm made landfall.

View from my old house in Orlando the day after Ian passed through.

A picture a friend of mine who is a fire fighter sent me while rescuing people from flooded houses the day after hurricane Ian

The food from my refrigerator and freezer that had to be thrown away due to not having power for over three days

Popular Psychology

100 Tips for Bipolar Disorder

17 Aug 2022by Torey C. Richards, LMHCLeave a Comment

Introduction

Small things help. When Sir Clive Woodward was asked how England won the Rugby World Cup in 2003 he said “Winning… was not about doing one thing 100% better, but about doing 100 things 1% better”.

Making small changes can really help improve your quality of life as a bipolar sufferer. The cullmative effect of developing a few good habits can help you manage your disorder better and create a more balanced life. Whether you’re just beginning to realise that you have a problem or you’ve been diagnosed for many years, these tips could help you feel just a little bit better everyday.

Some of these ideas will make a lot of sense to you. Some of them you will be doing already. Some will not suit you at all. Start with one or two of these tips that seem achievable, but try to avoid doing it all too quickly as it could trigger an episode.

In a few months hopefully you’ll be doing a number of things 1% better.

N.B. This is a collection of tips gleaned from my own experiences and research. It is not exhaustive or in anyway scientific. You should always consult your doctor regarding your bipolar disorder.

What is Bipolar Disorder?

Bipolar Disorder is a physical disease where one experiences low and high moods. It used to be called manic depression, which is a good title because the disorder is a mixture of mania and depression.

Depression can have the following symptoms:
• Low mood
• Intense sadness
• Lack of motivation
• Crying
• Low self worth
• Low energy
• Disinterest
• Anxiety
• Indifference
• Physical pain

Mania can have the following symptoms:
• Lots of energy
• Rapid speech
• Racing thoughts
• Aggression
• Grandiose ideas
• Self confidence
• Dangerous behaviour
• Irritability
• Anxiety
• Overspending
• Starting over-ambitious projects

A sufferer can also have rapid cycling – cycling through your mania and depression rapidly. This can happen several times a year through to several times a day.

The most dangerous type of Bipolar disorder is the mixed state. It has a very high risk of suicide. Sufferers have the energy and racing thoughts associated with mania alongside the feelings of worthlessness which come with depression.

Sufferers may have periods of feeling fine in between these episodes or it may be a continual cycle.

Go to School

1 Take an online bipolar test.

2 Learn from other people’s experiences.

3 Learn from the experts.

4 Look at websites that offer advice and revisit them from time to time.

5 Get familiar with the symptoms of depression.

6 Get familiar with the symptoms of mania.

7 Get familiar with the symptoms of rapid cycling.

8 Get familiar with the symptoms of the mixed state.

9 Get familiar with what it is like to be fine.

10 Understand that this disorder can make you feel things that are not real.

11 Learn the language of the disorder.

Know Thyself

12 Observe your moods.

13 Record your moods using tracking software, chart or a diary.

14 Identify what feelings are genuine and which are symptoms.

15 Learn your cycles.

16 Get somebody else to give you feedback on your moods.

17 Work out what keeps you calm.

18 Work out what your stressors and triggers are.

Trigger Happy

19 Work out what causes you stress – these factors will be unique to you, don’t worry if they seem petty or weird – you don’t have to tell anybody.

20 Avoid stress as much as you can.

21 Work out what your triggers for going manic are and avoid them.

22 Be aware that your triggers and stressors can change.

23 Allow yourself time to react to things, especially big life events.

24 Avoid stimulants. Smoking, alcohol, caffeine and sugar.

25 If you’re a woman check with your GP that your bipolar is not triggered by your menstrual cycle, if it is then you may be able to reduce your symptoms with medication.

26 Be aware that sexual promiscuity is a symptom of bipolar disorder. Take precautions and stay safe.

27 Avoid recreational drugs and taking over the counter drugs to help with your moods e.g. sleeping pills, St. John’s Wort, antihistamines and painkillers.

28 Try to stay healthy as illness can be a trigger.

29 Avoid going without sleep or sleeping too much.

30 Don’t deliberately make yourself go high.

31 Avoid fighting your depression or trying to avoid it.

32 Be careful when traveling in different time zones. Be aware of the changing seasons and when the clocks go forward/back.

33 Beware that you and those around you may really enjoy your mania and hypomania.

Help!

34 Don’t try to tough it out on your own.

35 Get help as soon as you start getting symptoms.

36 Find a good GP.

37 Get a diagnosis.

38 Communicate with your treatment provider.

39 Take an advocate or loved one with you to appointments.

40 Keep appointments.

41 Don’t skip medication. Take your medication as prescribed.

42 Know the side effects of your medication.

43 Write a list of pros and cons about your medication.

44 Be patient.

45 Get talking therapy.

46 Manage your expectations – there is no magic bullet.

47 Find support support services outside of the medical profession.

48 Be your own advocate.

49 Tell your doctor as soon as you can if you become pregnant and keep in touch with them throughout your term. Some medications are not suitable for pregnant women.

50 Be wary of quick fixes, self help, spiritual and alternative therapies.

Do The Right Thing

51 Try to get the same good amount of sleep every night.

52 Avoid working late or early shifts.

53 Create a good night time routine.

54 Create a good morning routine.

55 Make your bedroom a relaxing place.

56 Give yourself a time out.

57 Create whatever routines you need to get you through the day.

58 Practice meditation or mindfulness.

59 Learn relaxation techniques.

60 If you’re stuck on something don’t force yourself to do it.

61 Don’t hide your feelings.

62 Don’t try to change the way you feel.

63 Have a balanced diet, including Omega 3s and vitamin B rich foods.

64 Go outside at least a couple of times a week.

65 Exercise.

66 Be boring.

67 Take up a hobby.

68 Wash yourself.

69 Relax.

70 Balance work with more enjoyable activities.

71 Find alternatives to self harm.

72 Make your homelife as stable as possible.

73 Don’t avoid people.

74 Cry when you feel like it.

75 Love helps.

76 Breathe.

A Cunning Plan

77 Make a list of symptoms and a plan of action for your family, partner and friends.

78 Plan for mania.

79 Plan for depression.

80 Ask for extra help from family and friends.

81 Make a list of emergency contacts, all medications you are taking, including dosage information and information about any other health problems you have.

82 Make a list of symptoms that you feel would indicate that others need to take responsibility for your care and who those people should be.

83 Decide who is authorised to make decisions on your behalf and inform your doctors.

Straight Talking

84 Find somebody you can talk to about it.

85 Get talking therapy.

86 Tell your story – keep a diary or blog.

87 Join a support group.

88 Connect with people.

89 Ask a loved one to check in with you regularly.

90 Meet new people by taking a class or joining a club.

91 Don’t take it personally if people don’t understand or seem uninterested.

Keep Going

92 You are not alone.

93 Don’t beat yourself up.

94 Don’t apologise for having bipolar.

95 Personal responsibility. Take ownership of your illness.

96 Never think the illness defines you.

97 Don’t underestimate the danger.

98 Remember that it can get better.

99 Remember that one in four people have mental health issues.

100 Don’t give up.

Words and images ©Kate McDonnell 2013.

This article was originally posted on The Bipolar Codex

Taking Control of Your LIfe

Achieve Your Goals Using the GROW Coaching Model

1 Jun 2022by Torey C. Richards, LMHCLeave a Comment

This morning I worked with a patient who unfortunately ended up in the hospital after a near fatal suicide attempt. Honestly when he first came in I didn’t think he was going to make it because his condition was so grim, but over the past several weeks he has made a miraculous recovery although he still faces a long uphill battle.

Today he was given some frustrating news that he is likely going to have to have another surgery after he thought he was done having surgeries. I could hear in his voice that he was upset that this will prolong his hospital stay (he is no longer suicidal, realizes how lucky he is and wants to be home with his family dearly), but also with each surgery there are risks of more complications and possibly even death.

I sat with him, listened to his concerns and offered words of encouragement and validated his feelings. I also reminded him of all the love and support he has of his wife and children. That’s when I decided it would be helpful for us to use the GROW coaching model to help get him through the feelings of hopelessness and negativity he was staring to express as he contemplated on goin through with the surgery or not.

What is the GROW Coaching Model?

GROW stands for goal, reality, options and way forward (or will do). It’s a simple and powerful tool that many business leaders, life coaches and therapist use, but with a little practice, anyone can use it at anytime to help them achieve their goals.

The fist thing is to figure out what is your goal. Your goal should be a SMART goal, meaning it should be specific, measurable, attainable, relevant and timely.

GOAL

This patient stated that his goal is to get well enough to return home with his family as soon as medically possible

REALITY

He acknowledged that while his goal is to get home to his family, the reality is that he is currently stuck in the hospital, still fighting to recover from what should have been an non-survivable injury.

OPTIONS

Looking around the room that his family had decorated with beautifully handmade get well cards and family pictures, I actually told him that he had no other options but to get better, but of course in reality he does. and together we processed those

He mentioned he could refuse to have surgery which would likely worsen his condition and possibly lead to death or more permanent brain damage
He could talk to the medical team for a better understanding of what the surgery entails along with it’s risks and benefits so that he would feel more comfortable making a decision either way
He could have the surgery, which while it comes with risks, has far more potential benefits of helping him recover

Way Forward

Lastly we came up with a plan based on his goal, the reality of his current situation and his options.

He decided he would talk to the medical team and voice his concerns about the surgery

Personally, I wanted him to chose to have the surgery as I think it is the best option, but I’m not the one having the surgery and it’s not my job to give him my opinion. My job is to help guide him to make the best decision possible based on the information available and I think his choice to postpone the surgery until he has a clear understanding from the medical team is the best decision for him.

Once he has met with the medical team I’ll see what his decision is and help him through that as well.

The beauty about using the GROW model to help figure out goals is that you can use it everyday for small goals or use it as for major, life changing goals.

Recently using the GROW model helped me realize that a plan of action one of my clients had was really not going to help him achieve his goal and we were able to use the model for him to see it for himself without me having to directly point it out which was great. This not only helped him achieve his goal, but also saved us a lot of time in helping him to achieve it.

Try the GROW model out for yourself. I personally use it regularly and find it extremely helpful and efficient.

Breadcrumbing

19 May 2022by Torey C. Richards, LMHC1 Comment

It was only recently that I realized I had spent a great deal of time in not one, but two relationships where I was the victim of breadcrumbing. Although the term breadcrumbing is relatively new, the acts behind it are not.

What exactly is breadcrumbing?

Breadcrumbing is basically the act of leading someone on. The person doing the breadcrumbing has no real interest in the same type of commitment to the relationship (romantic, social, intimate, etc) that the other person desires. Still, the breadcrumber enjoys the attention or special favors gained from associating with the other person, so they do just enough to keep that person seeking more through superficial acts of interest and flirtation. In the end however, the breadcrumber never gives the other person the full relationship they are seeking and often ends up hurting them through abandonment, false expectations, and empty promises.

The breadcrumber often shows interest when they want something and once they get it, they go back to being elusive and self-absorbed. Most of the time, the person being breadcrumbed eventually realizes that they are being led on, but often continue to deal with the other person in hopes that eventually the breadcrumbing will stop, and the other person will genuinely desire the same type of relationship with them that they are seeking.

Breadcrumbing happens a lot in dating and relationships where one person is looking for commitment and is being strung along by the breadcrumber who does just enough to give their “victim” hope. It can also happen in other relationships as well such as friendships where one friend is constantly seeking connection while the other entertains the friend when it benefits them and then basically disappears when it doesn’t. It can even happen at work in situations such as a supervisor giving you extra responsibilities and hope saying you’ll get promoted one day, but that day never seems to come.

Breadcrumbing can cause the person being subjected to the breadcrumbing to undergo emotional stress, anxiety and even depression due to breadcrumbing being inconsistent and lacking integrity. More severe forms of breadcrumbing can even border on the lines of manipulation, emotional abuse, and narcissistic behavior.

Sometimes it’s hard to identify if you’re being breadcrumbed because usually the person being breadcrumbed is unsure of how the other person feels about them. They know how they feel about the breadcrumber, but they get mixed signals in return. Often this can make the person feel like they’re on an emotional rollercoaster.

I know in once incident when I was being breadcrumbed, every time I thought this person and I were finally crossing over the line of friendship into a romantic relationship, she’d back off only to come back around again whenever she was going through personal problems and again we’d get close, spend a lot of time together and practically be in a relationship only for her to put distance between us again. It was painful. Sometimes she’d tell me she wasn’t ready for a relationship only to get into a relationship with someone else. Of course when that relationship (and the next, and the next) didn’t work out, she’d come back around and I would hope that this time would be different, but it never was.

This lead to me having a lot of anxiety, self-doubt and insecurity which is a very common experience when you’re being breadcrumbed.

Relationship Dependency

Breadcrumbing can also lead to relationship dependence because of the inconsistency and false hope given to the person being breadcrumbed. They keep showing up and trying in hopes of one day winning the lottery and somedays they feel like they get so close to picking the lucky numbers that it’s hard to stop playing even when it seems hopeless.

Like I said, the young lady I was being breadcrumbed by often spend so much time together talking, or going out for dinner or drinks that it very often felt like we were a couple, but only when she wanted to. More often than not we’d make plans only for her to cancel them at the last minute.

The breadcrumber has all the power over approval, attention and acceptance which adds to the relationship dependency. The person being breadcrumbed always wants to be in the company of the breadcrumber, but the breadcrumber only comes around when it benefits them in some way. They usually aren’t really there when the person being breadcrumbed needs them, yet the person still holds out hope that one day that will change.

Sadly, often times the breadcrumber doesn’t really care about the person being breadcrumber or they are too emotionally unavailable to offer more than what they are giving. Perhaps they are already in a committed relationship or are holding out for what they perceive is their ideal person and until then, they will take what they can get from you.

Eventually the person being breadcrumbed usually realizes that they have been wasting their time, energy, money and attention on someone who is not going to return it in the way that they desire and deserve.

For me it took years and multiple times being hurt and disappointed before I realize that it was never going to happen. By then I had suffered through bouts of loneliness, low-self esteem and even depression because as much as I wanted our relationship to work, it was always leaving me feeling as if I weren’t good enough.

People who do the breadcrumbing aren’t usually bad people. Yes, sometimes they are narcissistic and just want to hurt and use you (those tend to be bad people), but often they actually like you, just not in the same way you like them or they just can’t give you what you want. They don’t want to totally let you go because they realize you have a lot to offer. Exes often do breadcrumbing because they haven’t really moved on or they don’t want you to move on, for example.

At the end of the day, you have to ask yourself if you deserve to be treated better than the way the breadcrumber is treating you and if that answer is yes, then it’s time to move on from that relationship and seek the fulfilling relationship you deserve with someone who wants the same thing.

Abnormal Psychology

Avoidant Personality Disorder

13 Apr 2022by Torey C. Richards, LMHCLeave a Comment

Recently I had an opportunity to interview a young man who has been diagnosed with avoidant personality disorder (AvPD). AvPD is a personality disorder where the person suffers from high social anxiety and fear of intimacy despite also desiring social interaction and intimacy in most cases.

The person often feel as if they are being judged or ridiculed by others and feel unattractive, uncomfortable, or inept in social interactions. They are usually extremely sensitive to the opinions of others and fear rejection and being judge negatively. To cope they usually withdraw from social interactions as much as possible which while it may help them successfully avoid the things they fear, it also often leaves them feeling more socially inept, lonely, anxious and depressed.

Avoidant personality disorder often results when a child has been rejected by one or both parents or his or her peer group, but it can also be caused by other factors such as a history of abuse and/or neglect.

People with avoidant personality disorder often only socialize with others they feel assured will not reject them. A very small number of people (often only one or two) will usually have gained their trust enough for them to feel confident and secure in their relationship with them.

They often look down upon themselves, minimizing their positive traits while inflating whatever flaws they perceive themselves as having. The person I interviewed is a serial “ghoster”. He would attempt to make friends and do so successfully, just to end up ghosting them. He told me that the fear of pain of what he saw was the inevitable (his friends rejection or abandoning him), was so strong that he would reject them before they had a chance to reject him. He isolated himself. He doesn’t have any current friends, but he does have a longtime girlfriend who is the one person he is closes to. He purposely chose a job where he works from home and has to deal with other people rarely. He has tried in the past to be more social. He went to college, but dropped out because the stress of having to interact with others was unbearable. He eventually went back and completed an online program. He has also often thought about suicide because he often fells anxious, lonely and undesirable and reports that it is a constant battle. He is in ongoing therapy to help keep him grounded.

Is Social Anxiety and Avoidant Personality Disorder the Same?

Avoidant personality disorder shares some of the same characteristics of social anxiety, but is less common. People with AvPD tend to have more severe symptoms of anxiety and depression than people with social anxiety. Also, people with social anxiety tend to fear the social circumstances (i.e., being at a party with a bunch of people judging how they look, act, etc.) while AvPD is more an aversion to intimacy in relationships.

How is Avoidant Personality Disorder Diagnosed?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association has a diagnostic code for avoidant personality disorder diagnosis (301.82) and describes it as a widespread pattern of inhibition around people, feeling inadequate and being very sensitive to negative evaluation. Symptoms begin by early adulthood and occur in a range of situations.

Four of the following seven symptoms have to be present to make a diagnosis of AvPD.

Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social situations
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risk or to engage in any new activities because they may prove embarrassing

Treatments

Some of the treatments for avoidant personality disorder include cognitive therapy, social kills training, group therapy and drug treatments. As I said earlier, this particular young man is actively in therapy with a psychotherapist. He still prefers to isolate himself even making it a point to let me know that the only reason he felt comfortable opening up to me about his experience with AvPD was because he knew he would never talk to me again.

Signs of Narcissistic Abuse

21 Feb 2022by Torey C. Richards, LMHCLeave a Comment

Most people don’t choose to fall in love with a narcissist. Narcissists have an uncanny way of being charming and swooning. Yeah, they may be a little arrogant, but confidence is attractive. What separates someone who is confident from someone who has a Narcissistic Personality Disorder?

Is your partner a narcissist? I know that term gets thrown around a lot out of context, often when someone disagrees with their partners behavior, but if you were in a relationship with a true narcissist you would know it.

Perhaps you know that your partner isn’t treating you right and that they are arrogant, seem to have an inflated ego, takes pokes at you that make you feel bad, and they have angry outbursts that are often out of proportion to the situation. You may not realize it, but you may be stuck in what is known as “the narcissistic abuse cycle”.

Narcissists for the most part are not capable of being in a healthy, loving and equal relationship because when it comes to the narcissist, they must always put themselves first. Even when it seems like they’re not, it’s usually because they are planting seeds for something later.

As someone in a relationship with a narcissist, you will feel the relationship is constantly suffering and you might not be quite sure why.

Here are some signs you should look out for to help determine if you’re indeed in a relationship with a narcissist and caught up in the narcissistic abuse cycle.

You Hold Back Constructive Criticism

Do you Feel like you can’t give your partner constructive criticism because they always take it the wrong way? It turns into a fight you weren’t trying to have, or they find a way to turn it around on you? So instead of saying what’s on your mind you tend to bite your tongue more often than you’d like. An example is, if you tell your partner after his fourth beer that maybe he doesn’t need another, he lashes out at you for calling him an alcoholic or he says you’re always breathing down his back and you’re the reason he drinks.

You Come Second Almost All the Time

Do your wants, needs and desires come second to your partners? Does it feel like most of the time they’re not even considered? A narcissist is so focused on themselves that they often don’t even consider what their partner might want or need. For example, your partner knows you’re a vegetarian, but never takes you to a Vegan restaurant, but instead to his favorite Steak House where he insists you can order a salad and veggies there.

You’re Unfairly Labeled

This is a form of gaslighting that narcissist do very well. They dismiss you as being “dramatic’, “silly” or “controlling”. The way a narcissist does this makes you start to question yourself. You start to doubt your own thoughts and believes. What the narcissist is doing is slowly eating away at your worldview while reinforcing theirs. You start wondering, “Maybe I am too sensitive and dramatic”.

You Start Falling for Their Fantasies

Often narcissists live in a fantasy world where they are better at things then they really are. This is especially true when it comes to money. Very often, a narcissist will spend money they don’t have in order to appear more successful than they are, even if that means neglecting their spouse and other priorities. They may not buy you gifts, or buy you gifts that seem not thoughtful, while splurging on gifts for themselves they can show off.

The Relationship Is Unstainable

Being in a relationship with a narcissist is very much like being in a relationship with someone with borderline personality disorder, much of their traits are similar. The only way the relationship has a way of surviving is if you are okay with always putting the other person first and your needs, desires and dreams second if at all. That isn’t a healthy relationship for anyone and yet many people stay in long term relationships with narcist and suffer every day. Their wishes, desires and dreams are constantly being ignored and even extinguished. This can not only cause the person to have low self-esteem, but can actually be traumatic and cause post traumatic stress disorder in some people.

It’s important to recognize if you’re in an unhealthy relationship with someone with a narcissistic personality and start educating yourself and taking the necessary steps to protect your mind and emotions. It’s important that you separate your reality from their fantasy and in the end, it will help you determine to either end the relationship or at least keep you from totally losing yourself while in it.

Popular Psychology

Cheslie Kryst: Rest In Peace

31 Jan 202231 Jan 2022by Torey C. Richards, LMHCLeave a Comment

I was saddened to hear the news yesterday of the apparent suicide of Cheslie Kryst, former Miss USA 2019 . Not only was she a beautiful woman on the outside, she was also intelligent, working as an attorney in North Carolina practicing civil litigation and worked to help prisoners who may have been sentenced unjustly get reduced punishments, free of charge She was also a former Divsion I athlete and work as a corresponded for the show ‘Extra’. She was only 30 years old.

Cheslie served as a role model, inspiration and a light for so many people which is just another reason it’s so disheartening that her light has been extinguished. I have no ideal what her personal struggles were, but I truly wish that the light she gave to others had been bright enough to help see her through those self destructive thoughts.

According to reports, police found her unresponsive on the ground outside of her apartment in New York where she apparently jumped to her death in the early hours of Sunday morning. She left behind a cryptic message on her Instagram page along with a pho of her self, “May this day bring you rest and peace,” .

Suicide is always a tragedy, and many times it’s a mystery. We may look at someone who appears to have it all, their entire future in front of them and wonder what made them decide to take their own lives. We never know what demons someone is grappling with on the inside, despite their outward appearance and the way they portray themselves on social media. That’s why it’s important to remember that we’re all dealing with something and to check in with each other often.

Suicide often comes from profound feelings of hopelessness, the inability to deal with a certain problem or to see an end to a temporary problem. That feeling of hopelessness is so tense that it feels permanent.

As you might expect, depression also plays a major part in suicide as well as substance abuse, psychiatric disorders, chronic pain, impulsivity, a family history of suicide and past history of suicide attempts.

Suicide is complicated by the fact that some people, once they have decided to kill themselves may be at peace, appear happy and show no obvious signs that they are actively suicidal (To learn more about warning signs of suicide, see Signs That Someone Is Contemplating Suicide.).

If you or someone you know is at risk of suicide please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or go to SpeakingOfSuicide.com/resources