counseling – Licensed Mental Health Counselor

“I’m Good Bro”: Men and Mental Health

16 Sep 201916 Sep 2019by Torey C. Richards, LMHC1 Comment

Like most people, there have been times in my life where I was really down, even depressed. Things in my life just weren’t going the way I wanted them to go and most often for me, that boiled down to my love life.

I remember one time in particular when I was going through a break up and was battling anxiety and depression to the point where I couldn’t concentrate on much nor could I eat or sleep much at all. It felt like the emotional pain would never go away and I just continued to isolate myself and ruminate on my problems more and more.

Finally, my best friend called me and asked me if I were okay. My response was, “I’m good bro.”

I’m good bro? Why in the hell did I say that when I clearly wasn’t good. As a matter of fact, I was at one of the lowest points in my life. I had lost several pounds from not eating, laid in bed praying for sleep to take the pain away, but the anxiety kept me awake with racing thoughts and fear. I was in pretty bad shape, yet my response was, I’m good bro.

Even then I wondered, why did I say that? Why didn’t I just tell him what was going on with me? The answer was because I didn’t want to appear weak. I didn’t want to appear emasculated. I didn’t want to burden anyone. I didn’t want anyone, especially another man to know that I was depressed. I felt shame in that. That shame kept me from asking for help. It nearly killed me.

From my experience, depression has a way of sneaking in, unassuming and nonthreatening. It has a way of making you feel comfortable with it, almost like an old friend or warm blanket, until it starts to suffocate you. Only then do most people realize that they are in danger and need help. Sadly, too many people realize it too late and pay the ultimate price.

Still as I was getting suffocated by depression, I muttered, “I’m good bro”, and effectively rejected any help my friend could have offered.

As a mental health professional, what I have learned over the years is that most men who suffer from anxiety, depression and stress will also respond “I’m good bro” when they really aren’t.

Men don’t like to talk about their feelings and are slow to ask for help. For many men it takes thoughts of suicide to compel them to reach out for help which usually means they have been suffering alone for quite a while.

While these men are suffering and attempting to “hold it together”, their suffering not only has negatively affects on them, but also on their work performance, parenting ability and relationships in general.

Men like to think of depression and anxiety as problems women have, but men and women both suffer from these common problems. It may look differently in men than it does in women as men tend to isolate themselves more, become less motivated, become angry, aggressive or turn to drugs and alcohol more.

Reasons Men Don’t Talk About Their Mental Health

There are many reasons men don’t talk about their mental health issues, but according to one study, the top reasons are:

‘I’ve learnt to deal with it’ (40%)
‘I don’t wish to be a burden to anyone’ (36%)
‘I’m too embarrassed’ (29%)
‘There’s negative stigma around this type of thing’ (20%)
‘I don’t want to admit I need support’ (17%)
‘I don’t want to appear weak’ (16%)
‘I have no one to talk to’ (14%)

When men do want to talk about their feelings, most report that they would prefer to talk to their romantic partner, but not everyone has a romantic partner and even those who do may be uncomfortable feeling vulnerable. That’s why it is important that men feel comfortable asking for professional help if needed.

In order for us to get men to feel comfortable seeking help, it’s important that we normalize men’s mental health problems much in the way that we have normalized treatment for erectile dysfunction problems. When we do this we remove the stigma surrounding men’s mental health problems. By helping men feel comfortable talking about their thoughts and feelings, we not only positively impact their lives, but the lives of everyone around them.

10 Happiness Tips

10 Jul 201810 Jul 2018by Torey C. Richards, LMHCLeave a Comment

It’s common for everyone to struggle time to time with being happy. We all have bad days, days when we may get frustrated, feel insecure or anxious for whatever reason. There is an infinite amount of things we can do when we need to pull ourselves out of the funk and practice self care.

It’s not a bad idea to list some of your favorites BEFORE you actually need them, that way you can easily pull them out of your tool box.

What works for one person may not work for another, but here are 10 of my favorites to get your started.

Set Healthy Boundaries

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Often we give people too much access to our time and peace. This sometimes includes friends and family who may be overbearing, controlling, draining or negative. By setting healthy boundaries, we limit how much access those people have to us.

Let’s say you have a friend who only calls to complain about her day, maybe you limit her by not always answering her phone calls or giving her only five minutes of your time before you have to go do something else.

Take a look at your life and see where you can eliminate some unnecessary stress by cutting back on the amount of your time you allow to be taking up by other, especially negative or draining people.

Learn To Say No

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It’s okay to say no without an explanation to people and things you don’t feel like doing or being bothered with. Sometimes we feel obligated to do things we don’t enjoy or feel comfortable doing and find it hard to say “no” for a variety of reasons. However, learning to say no without explanation not only helps establish boundaries, it will help build up self-confidence and self-respect when it comes to your precious time, space and peace of mind.

Learn to Make Decisions Quickly

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If you’ve never heard of Mel Robbins “Five Second Rule” then I suggest you look it up quickly. Part of her theory is that the longer you wait to make a decision and act on it, the less likely you are to make the decision that will move you to where you need to be.

If you’re the type of person who takes a long time to make a decision or hates making decisions so you allow others to make decisions for you, then what you are unconsciously conditioning and reinforcing within yourself is a fear of failure and of being imperfect which Sanam Hafeez, Psy.D., says keeps us small and dis-empowered. By learning to make decisions quickly we will build confidence and learn to trust ourselves.

Take Full Responsibility For Yourself

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We can’t control others and often we can’t control other factors in our lives. What we can control is ourselves, our responses, thoughts and feelings. If we stop trying to control other people so much, it frees us to dictate our own happiness and take complete control of our lives. When our feelings about ourselves are no longer controlled by external conditions, we will realize how much happier we can actually be.

We can’t make someone treat us better, but we can choose to allow them to be who they are without us there to abuse. We can’t make it stop raining, but we can choose to enjoy the sound of rain or even dance in it.

Have Appreciation And Gratitude For What You Currently Have

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It’s easy to want more and to not be satisfied with what we have. The problem is, if you think like that, you’ll always want more and you’ll never genuinely be happy. You don’t have to be filthy rich and have the most expensive accessories in order to be happy. Look at what you have now. Try to find three things everyday to be grateful for. Today, for me, it’s my family, my job and my health. No, none of those things are perfect, all of them are actually quite flawed, but I am appreciative and grateful for them because they could be worse or none existent.

Travel/Spend Time in Nature

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This one is a two for one. Take time to travel or get out in nature. Allow yourself to see that there are bigger things out there than just ourselves and whatever we may be dealing with, or just to relax and take in new sights, sounds and experiences.

Being in nature in particular can help bring a sense of peace and awe. Whatever you do, just get away from our ordinary routine and allow yourself to become a tourist and explore, even if it’s just in your own backyard.

Take Time To Relax With Zero Guilt

We work hard. Even when we aren’t working we seem to always be on the go. There is always something to do or something we should be doing. We may even feel guilty when we aren’t doing something, but it’s okay to unplug from everything and everyone and do absolutely nothing every now and then. As a matter of fact, it’s good for your sanity. You can watch Netflix, read a book, listen to music, meditate or do whatever brings you back to yourself.

Be Mindful

Following up on the last tip, take time to actually take in what is going on around you. So often we are so busy that we aren’t aware of the simple, yet beautiful or important things going on around us everyday.

Multitasking is something else we do that robs us of truly taking in what we are doing. Research suggests that we don’t even actually multitask, but our brain just switches quickly between doing one thing and then the next. I know for myself, I often watch TV while looking through messages, social media or email on my phone. Now when I find myself doing that, I consciously make the decision to put my phone away so I can truly take in whatever I am watching. A lot of us do the same things when we are hanging out with friends and family. We’re there, but we’re not fully there because we are browsing through our phones. Break that habit and you’ll realize how much you’ve been missing out by not being truly present and in the moment.

Smile

There is research that suggests that the act of smiling by itself can help us begin to feel happier. Your mind can either control your body or be a slave to it. Your body often doesn’t know why it is acting or responding in a certain way and it’s waiting for your mind to tell it why. By smiling, you can trick your mind into thinking that it is happy and your body will respond by beginning to release endorphins that will actually make you feel happier.

Wear Bright Colors

This is definitely one of my favorites. Sometimes at work I have been known to wear pink, yellow or bright red colored dress shirts. It’s easy when you’re feeling down to wear dark, drab colors, but they won’t do much for brightening up your spirits. Surround yourself with bright, vivid colors and you will see that it not only brightens your mood, makes you feel more positive and productive, but it can also brighten other peoples moods around you. It’s even been given the name, “Color Therapy”.

Popular Psychology

Learning From Someone Who Tried To Commit Suicide

10 Jul 2017by Torey C. Richards, LMHCLeave a Comment

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The other day I was speaking with a man in his early twenties who had nearly died from a suicide attempt. I mean, he was on the brink of death, unconscious and had to be resuscitated. I had spoken with him a couple of hours before the incident and what I saw was a young man going through a rough patch in his life, not someone who would hours later decide to end it all.

After he was saved from death, I spoke with him again because I wanted to understand what had driven him to that point. I wanted to know if there was anything I had missed earlier and I wanted to learn from what could have easily turned out to be a tragedy.

Several factors played a role in why this man felt his life was a failure and no longer worth living. I’m sure there are more, but this is what I gathered our conversation.

Egoic Mindset

Talking to this man what I learned was, that besides his pending and ongoing legal issues, he was trapped in his “egoic mind”. In our egoic mind, our thoughts are in control, not us. As many of use know, our thoughts, when left unchecked can cause us to suffer in many ways.

Our minds are extremely powerful. They can catapult us into greatness or they can hold us hostage in a hell we create.

If we do not control our thoughts and believe our thoughts that tell us we aren’t good enough, that this person must do this for us or that this must happen in order for us to be happy, then we will live a live full of anguish.

This young man’s thoughts had not only created his depressive state, but also had driven him to attempt to take his own life. They had convinced him that he was such a screw up that his life was not worth living.

Society

Society tries to force us down similar paths, even when most of us are meant to go down very different paths. When we resist that push by society or simply don’t fit in, many of us start to feel abnormal, different or even broken. The harder we try to fit in, the more insecure, uncomfortable and unbalanced we feel. The more we resist society’s pull, the more we may feel ostracized, rejected or even unsafe.

We start to compare ourselves with other people. Our peers, our siblings and even people we don’t know. We start thinking that we are not as happy as our friends appear on social media, not as successful as our brother who went to law school. In comparison, we start to feel like failures.

As people we always seem to look up, meaning we always compare ourselves to those who are in higher positions. The person with the masters degree compares himself to the person with the doctorates. The person making $75,000 compares himself to the one making $100,000. The person living in an apartment compares himself to someone living in a small house and the person in the small house compares himself to someone living in a larger house.

There’s nothing wrong with striving to improve yourself, but when we get locked into this type of thinking we tend to not appreciate where we are right now which keeps us from being genuinely happy. We start to think that we will not be happy until we reach the next level, and then the next level and so on. What this does is keeps us from enjoying life right now for what it is, as it is.

This is the kind of thinking that caused this young man to suffer. His internal thoughts told him that despite what I saw as his successes and strengths, he saw himself as a failure. He wasn’t even close to 30 and had already given up on life, assuming that he was so off track in comparison to other people his age that he could never get back on.

If we compared down sometimes, then maybe he wouldn’t feel so bad about himself. Maybe he didn’t have a house, but he had a place to stay, he wasn’t homeless. Maybe he had dropped out of college, again, but at lease he had some college under his belt. And yes, maybe he was in jail, but it was for a misdemeanor and not a felony and he was facing months, not years.

Not Taking Responsibility

Another thing that helped create the situation was that he didn’t take total responsibility for his life. As an adult, he had created nearly all the obstacles in his life, yet he wanted someone else to magically make them go away.

He was hoping that his girlfriend would do certain things, that his parents rescue him. This caused him to live in a state of helplessness because he allowed other people to control the way his life was going and it wasn’t going in the direction he wanted it.

Once you realize that you are 100% responsible for your life, including your mistakes, your happiness, your future and your present, you’ll realize how much power and freedom you really have. You realize that once you learn how to control your thoughts, that yes life will happen, certain events will happen, but it’s our thoughts that determine how we feel about them and our actions or inaction that will determine how we experience life.

This young man is in jail. He can blame his girlfriend for his current situation, his parents, his up bringing or whatever. He can stay in jail depressed because his girlfriend isn’t answering his phone calls or waiting for his parents to stop showing tough love and come bail him out. He can be waiting forever on all of that, but the moment he starts taking responsibility and control of his thoughts and feelings, his life can change in an instant.

He can say, yes I am in jail and it’s my fault. I did something stupid, how can I avoid doing that again? How can I use this time to improve myself? What lesson am I meant to learn from this?

Or he can continue to blame his girlfriend and his parents, be miserable in jail and come out the same person or worse than he was before going to jail.

Not taking responsibility for creating the life you want will leave you in a perpetual state of uneasiness which will keep you from ever reaching your full potential.

Attachment To Rigid Expectations

This man, like a lot of us, has high and rigid expectations. What I mean is that he expected by his age (although he is still very young) that he would have to accomplish several things in order to be happy or successful and when that didn’t happen, he deemed himself a total failure and didn’t know how to cope with that.

Suppose for example that you expected to be married by 25, have 2 kids and be living joyfully in a house on the beach. Yet, here you are at 35, divorced with no kids and living in a small apartment.

You can reflect on life and feel like you’ve failed and of course you’ll become unhappy and maybe even depressed. You can blame life and the things that happened in your life for keeping you from meeting those expectations and again, you’ll be miserable. Or you can take control of your thoughts, take responsibility and learn to flow with life and say “I would have preferred not to be divorced, have 2 kids by now and living on the beach, but that didn’t happen, what do I do now? What can I do with what I have to create the life I want?”

If however you are attached to rigid expectations, you’ll create misery for yourself. There’s nothing wrong with having expectations, but don’t be so attached to them that when life happens and things don’t go as planned, you fall apart. There are no guarantees in life.

Tony Robbins says that it’s our expectations that make us unhappy and to trade your expectations for appreciation. This is something I have been working on hard over the last several months.

Trying to control or change things that are out of our control will always cause us pain. That’s part of the egoic mind. Instead, we need to learn to accept what is, embrace reality and adjust to life as it happens.

When we can’t do that, we may find ourselves in some degree, like this young man and millions of others who suffer needlessly in life. For most of us, life really isn’t all that bad, but we create our own suffering. By taking control of our thoughts we can end that.

If you are anyone you know are struggling with suicide please call The National Suicide Prevention Hotline: 1-800-273-8255.

Popular Psychology

10 Tips For Dealing With Depression

23 Nov 201623 Nov 2016by Torey C. Richards, LMHC1 Comment

There is a lot of stigma when it comes to mental health issues, even common ones like depression. Often times when people feel depressed they feel ashamed, as if they don’t have the right to feel depressed. Many will attempt to hide the way they feel and just say they are doing “ok”. Many more will try to drown their depression with alcohol, drugs and even other people.

It’s okay to be depressed. When you’re depressed that means something in your life is not going the way you want it to go and you need to sit down and evaluate your life so that you can move in a different direction. That may mean making small changes, big changes or accepting something for what it is if you can’t change it at all.

These are some of my favorite tips on dealing with depression:

You’re not alone. Many people go through depression at some point in their lives. Some people suffer from clinical and chronic depression while others seem to bounce out of it pretty quickly. If you’re feeling down, just know that you’re not the only person who feels that way and it’s actually pretty common.
It’s okay to seek professional help. Sometimes family and friends just don’t understand why you’re not happy. They’ll say that your life isn’t “that bad” and that there are many people out there who have it worse. Most of them are trying to be helpful even when they leave you feeling like crap. People like me are trained and paid to listen and can help you maneuver your way through the pain.
Medications can help if needed, but they are not the only answer. When people start feeling depressed, many of them will immediately want medication to make the bad feelings go away. Most people going through depression do not need antidepressants, but even if you do, they may only help so much. Antidepressants are good for getting people out of deep depression so that they can intellectually and physically function enough to actually process what’s going on in their lives and attempt to make changes to feel better.
Remember to take care of yourself. Even if that means writing notes to remind yourself to do simple things such as taking a bath or eating nutritious meals. Doing the self-care things you don’t feel like doing will make you feel better in the end.
If you really don’t know what might be making you depressed consider getting some blood work done. Anything from vitamin D deficiency, low iron and hormonal issues to blood sugar problems can cause you to feel depressed and lethargic. Curing your depression can be as simple as correcting an imbalance in your body.
Learn and practice daily mindfulness and meditation. Start with something as simple as focusing on your breathing. Imagine breathing in slowly through your nose to smell a birthday cake and exhaling slowly through your mouth to blow out the candle. Focus on your breathing, try to keep your mind from wandering to all the bullshit and just be in the present moment.
Stay away from emotional vampires. You need all your energy when you’re going through the depression. You don’t have any to spare so stay away from anyone who will drain what little you have left. Instead, try to surround yourself with people who can help you refuel your energy.
Don’t envy others. Everyone is, has or will go through their stuff. You’re just going through yours. Even if someone looks happy, well put together or whatever, they still have things they are dealing with that you might not know about. The grass is not always, or even usually greener on the other side.
If you can find the energy, go for a walk. Exercise, fresh air and sunlight are great for depression. Even small steps help.
Learn to let go. A lot of times depression is about the past. Past guilt. Past disappointments. Past hurts. Learn to let go and you will reclaim so much of the strength and energy you are given up. As the saying goes, let go or be dragged.

There are so many great tips out there on dealing with depression. Hopefully this will get you started, but definitely find tips that work for you and know that you can come out of depression a stronger person.

#orlandostrong

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

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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.

Why I Became A Certified E-Therapist

26 May 201628 May 2016by Torey C. Richards, LMHCLeave a Comment

Young Man Using Laptop At Home — embracingyourinnerpower.org

When I first started this blog, I had no idea the number of people I would be reaching from not only across the country, but across the world! It wasn’t long before I started getting comments and emails asking for help with a multitude of issues.

As I started to answer questions and provide guidance and referrals, I realized that many people wanted more than a onetime interaction.

Many of them had situational problems and wanted help to solve that problem over the course of a few email exchanges. Others had more in-depth concerns and wanted ongoing contact with me to help move them to a better place.

It literally became overwhelming trying to keep up with all of the inquires, but at the same time, it was some of the most rewarding work I had done.

For instance, I found myself helping a man and his wife in England who didn’t live near any licensed psychotherapists. I found myself helping people who were too ashamed to go to face-to-face counseling or who just wanted the convenience of talking to a professional therapist from their living room.

Just the yesterday I helped a mother and grandmother get their daughter/grand daughter involuntarily hospitalized due to frequent suicide attempts when they were frustrated and thought they had ran out of options. It felt good to be able to do the research, make the contacts and guide them to a resolution even though it was all through telephone contact and they didn’t live anywhere near me.

I realized through helping so many people that I needed to do something that gave these readers turned clients more. That’s why I started Embracing Your Inner Power, LLC (www.embracingyourinnerpower.org) and became a Certified E-Therapist.

E-therapy (electronic therapy/online therapy) is a growing form of delivering therapy that is just as effective as traditional in-office therapy in most cases, while being more convenient.

I had heard about e-therapy several years ago and over the years it has become more and more accepted and I can easily see why.

The family I helped just yesterday lived in a rural area, didn’t know where to turn or even really what they were asking for. I was able to not only help them identify what they needed, but I was also able to help walk them through the steps as they were driving to a graduation.

I’ve found and research suggests that online counseling can be even MORE effective than face-to-face counseling because clients are more relaxed and feel less intimidated than they would in traditional settings.

Don’t get me wrong, I still prefer face-to-face counseling when possible, but I have also embraced technology and the way people are interacting more and more today through social media, chat, email and text messages. People are also becoming more comfortable with technology assisted care.

I’ve helped people with anxiety disorders, social phobias, people who were too busy to drive to a counseling session or just not motivated enough to go to face-to-face therapy, but were willing to turn on their computer and communicate with me. Because of this, the missed appointment rates for online counseling is less than that of traditional counseling.

My main goal as a therapist and my main goal with Embracing Your Inner Power, LLC is to reduce a person’s distress, depression, anxiety or concerns by helping them build on the strengths they already possess.

I’ve found that I am just as effective doing that through online therapy as I am face-to-face. I’ve also found that the people I have helped probably wouldn’t have reached out for help otherwise if it meant physically going somewhere or even inviting a therapist into their home.

Simply put, online counseling works, especially when you’re paired with a therapist who, like myself, works with a limited amount of clients and therefore is able to deliver very professional and personal counseling and not canned or rushed responses and sessions.

Some of the benefits of online counseling include:

Convenience– you can receive counseling from your living room, while on vacation… virtually anytime that is convenient for you.
Affordable– Online therapy is a lot less expensive than face-to-face therapy which averages over $100 per hour easily. Even when paying out of pocket, online therapy is usually cheaper than the deductible would be for traditional counseling.
Licensed– As a Licensed Mental Health Counselor and Certified E-Therapist, I deliver the same professional and high quality service online as I do face-to-face.
Secure– All information is kept secure and confidential.
Sigma Free– You can remain as anonymous as you want through message based, email and telephonic counseling.
Multi-modal– You can choose from video counseling, chat, email or telephone counseling depending on your needs.
Effective– as I stated earlier, online counseling in general is just as effective as face-to-face counseling in most situations.

As a Certified E-Therapist, I am constantly working on making Embracing Your Inner Power, LLC, the best it can be and it is a work in progress. I am dedicated as always to helping individuals discover their true potential and am appreciative that this blog and my readers have allowed me to grow and share so much with them.

I’ve been able to help individuals and families from 6 continents and it’s been an amazing learning experience.

Psychological Truama: A Brief Overview

12 May 2016by Torey C. Richards, LMHC2 Comments

Psychological trauma is sometimes hard to understand. Because of this, many people who have suffered from it do not realize how it affects their lives. More sadly, many parents who have children that have undergone psychological trauma, do not realize the importance of getting them help because they do not realize the damage that has been caused.

They believe that children are resilient and will get over or forget something traumatic that happened to them when they were one, two, three or four yeas old. Depending on the child, the traumatic event and what protective factors were or weren’t available to the child after the event, that child may suffer psychological damage for life.

Psychological trauma is the unique individual experience of an event in which the individual’s ability to integrate his/her emotional experience is overwhelmed or the individual experiences a threat to their life, body or sanity.

A traumatic event creates an overwhelming feeling within a person where they are not able to cope and are left to feel as if they will be killed, seriously injured or psychologically damaged. The person may feel overwhelmed emotionally, cognitively and/or physically. This type of situation is common with abuse, entrapment, helplessness, betrayal, pain, loss and/or confusion.

Trauma is a very broad definition and includes responses to powerful one time events such as natural disasters like Hurricane Katrina and crime, deaths, and even surgeries. It can also include responses to repetitive events such as combat, urban violence, concentration camps and abusive relationships.

The key component in trauma is feeling helpless and endangered. No two people will experience the same traumatic event the same. As a matter of fact, what may be traumatic for one person may not be at all traumatic to the next.

For instance, earlier this week I did crisis counseling with four female inmate workers who were out clearing road debris when a man came out of the woods with a machete and chased them back to the van. The man was apprehended, but the four women were brought to me to be evaluated.

Out of the four women, three appeared to be handling the situation relatively well, even able to laugh and joke about the incident while also describing it as terrifying.

One woman however, was obviously more shaken up. She sat nearly stone faced with tears in her eyes, not saying a word during the counseling session. I quickly learned that she was the last woman to make it safely to the van and was the one whose life was most in danger. She also has a history of mental health problems which may make her predisposed to developing signs of trauma which include:

Shock, denial, or disbelief.
Anger, irritability, mood swings.
Guilt, shame, self-blame.
Feeling sad or hopeless.
Anxiety
Fear
Nightmares
Flashbacks
Avoidant behavior

Out of the four women, she is the one I most worry about and the one I will observe closes during the days to come to see how she processes this trauma and to help walk her through it if needed.

That is the interesting part of trauma and why trauma is defined by the experience of the survivor. We can’t say one event will cause trauma and another will not or that one person will be traumatized by this experience while another will not. Trauma is too broad for such simple explanations.

“Big T” versus “Little T”

It’s hard to go through life without being traumatized in some way. Most of us have experienced some type of event that has affected us either consciously or subconsciously. It could be the divorce of our parents, being bullied in school, seeing a pet die when we were young.

Many of us don’t even know we walk around caring these traumas with us or how they affect our lives.

For instance, a man whose favorite pet died when he was five may never like pets for the rest of his life and grow angry and anxious when his kids ask if they can have a pet.

These types of traumas are called “Little Ts” or “Little Traumas”. They do not have the severe impact that “Big Ts” or “Big Traumas” usually have such as flashbacks, avoidant behavior, severe anxiety and nightmares that lead to a diagnosis of PTSD. Still, “Little Ts” can unconsciously disrupt our lives.

Most men I’ve worked with in anger management don’t even realize why they are so angry, why they hit their wives or bully their children. It’s only after some intense introspection that most of them can identify traumatic events in their childhood such as being bullied by their own father, watching their father beat their mother or watching their mother go through abusive relationship with one man after another, that they realize the reason they carry around so much anger.It’s once we deal with the root causes of their anger that they began to truly heal.

I myself as a child watched as my father often abused my mother. I never had any nightmares, flashbacks or anything that would make it a “Big T”. I never felt that my own life was in danger, but I did feel like my mothers’ life was.

Still, one of the affects it had on me was that for many years I thought that’s what love was. That if you loved someone you fought, made up and then fought again. It wasn’t until I was in college that I learned I was wrong. For many years, that “Little T” of watching my parents fight had me living in a world where fighting verbally and physically meant love.

A woman I counseled with was claustrophobic and afraid of the dark. She had no ideal why until one session we processed the fact that her older siblings used to play a game where they would lock her in a closet when she was very young. They thought it was funny, but she was tormented. She never viewed that as a traumatic event until years later, sitting across from me crying.

Trauma doesn’t have to be a negative word. Often times the way we respond to trauma, the way it changes us, the way we adapt to a traumatic event, is natural given the coping skills, circumstances and knowledge we have at the time.

The topic of trauma is too broad to cover in one post. I’ve actually been on a radio talk show discussing trauma twice within the last two months and will likely be on a third time because it is such a huge topic.

My bottom line for this post is to help others realize that you don’t have to go off to war or survive some horrific event to suffer from the affects of trauma. Even “Little Ts” can rob us of our full quality of life and “Big Ts” can devastate us.

Once we recognize this, we can change it through self help, the help of loved ones and even professional help if needed and reclaim the joy and full life we deserve.

Popular Psychology

You Are A Gift

29 Mar 2016by Torey C. Richards, LMHCLeave a Comment

iStock_000018620938_Medium-500x333 Earlier today I was speaking with a fifteen year old girl in our juvenile detention center. She is experiencing depression and is 6 weeks postpartum so I was concerned about her. As we talked, I started to understand some of the sources of her depression.

During our session, she revealed that her mother also gave birth to her when she was fifteen and that her biological father has been in prison since she was three years old. Her mother is currently married to a verbally and physically abuse man that she feels her mother places before her in order of importance, attention and affection.

As this young lady and I talked, she described how she grew up feeling like a burden to her young, single mother and how after her mother had other children and multiple boyfriends, she was always made to feel like she was “in the way”.

It became very apparent that this young woman, consciously or unconsciously, had a baby at fifteen years old, partly so that she could have someone in her life that didn’t make her feel like a burden, but gave her the unconditional love she has been yearning for. However, due to her own psychological damage, she now sees her 6 week old baby as a burden and if she doesn’t learn to change the way she views herself, she will pass on that damage to her child.

What I discussed with her this morning and will try to instill in her is this:

We are the greatest gifts we can ever give ourselves. We are also gifts to other people and the Universe. Our children, if we have any, are also gifts.

Too many people grew up being made to feel, even as children, that they were a burden. Maybe they were born to parents who themselves were brought up in painful situations where they did not truly know how to love and appreciate others.

Maybe their parents conceived them as a resolution to fixing a broken relationship or “save” a troubled marriage. Maybe their parent expects them to be their caretaker, or they were simple born during a difficult time of their parents lives and they were never able to be truly enjoyed, loved, appreciated and viewed as precious gifts as children.

Many of us have grown up never feeling truly accepted and carrying these feelings on unconscious and conscious levels that we were and are a burden.

This is how people can fall into a deep depression or become suicidal, thinking that the World would be better off without them.

This type of thinking is what keeps people from truly connecting with other people on any level or truly enjoying life.

Because of this they end up beating themselves up all the time with negative self-talk, not appreciating themselves, walking around apologizing for themselves, feeling like other people know better and are better than them.

For those of us who have received this terrible message growing up, it’s time to change it.

You are not a mistake. You are not here by accident. You are here because we are supposed to be here.

Our lives have purpose and intention.

We don’t have to apologize for being here or for being ourselves. We don’t have to beat ourselves up over our past mistakes or experiences that have helped create who we are now. We don’t have to be ashamed, apologetic or doubt the beauty that is our unique selves.

We are not a burden and if our parents are the ones who tried to put that on us, it’s time to recognize that it is their issue and not ours. We don’t have to carry that with us. We can let it go.

We are precious gifts and today we will start treating ourselves as gifts to others, the Universe and especially ourselves.

Popular Psychology

We All Need To Practice Emotional First Aid

14 Jul 201514 Jul 2015by Torey C. Richards, LMHCLeave a Comment

As a mental health professional, I have found myself spending a lot of time trying to convince people that they need to take care of themselves mentally and emotionally. Meaning, I run into people who are working two jobs, taking care of their family and everyone else around them, but are letting themselves go mentally and are getting sicker and sicker over time.

Or, I meet someone who is obviously not dealing with various issues in their lives, probably hoping that ignoring them will make them go away, but all the while they are growing emotionally unhealthy.

It reminds me of when a parent would bring a child in to see me for therapy and it would become apparent pretty quickly that it’s the parent that needs therapy, not the the child. Many times the parent would like at me as if I was crazy. They couldn’t see that their own neurotic behavior, substance abuse or even past childhood issues are creating the “problem” they are prescribing to their child.

It’s easy to tell when someone is physically not doing well, but it’s not always easy to tell when someone isn’t mentally doing well, especially when it comes to everyday things like anxiety, depression and self-esteem. Things we all deal with from time to time.

I have a sister who at one point was working a very demanding job, raising a challenging teenager on her own, volunteering her sparse free time to multiple organizations and if that wasn’t enough, she was trying to help every friend that called and needed something from her.

On the outside she looked ambitious, energetic, like a true type A-personality. On the inside she was feeling overwhelmed, flustered and fragile.

One night, while having dinner with our family which should have been relaxing, seemingly out of the blue she had what some would call a nervous breakdown. She started crying, hyperventilating and felt as though she was going to lose control of her mind. I could look at her and tell she was having a classic panic attack, but she was too far gone to hear me and was convinced she needed medical attention.

Soon afterwards she was diagnosed with an anxiety disorder and was told to cut back on the million and one things she did in her day to day life to take care of other people and to start taking care of her own mental health, something many of us don’t do enough of.

Sometimes I even catch myself too caught up in work, life and everything else and before I realize it I am dealing with some type of anxiety, insecurity or dysthmia. I have to slow down, stop myself and figure out a) where is it coming from and b) how do I take care of it. Often times for me the solution is simple awareness and acknowledgement that something is bothering me. Other times it takes journaling, reading something inspirational or processing my feelings with someone I trust. I’m usually that person for everyone, but sometimes I need someone to be that person for me.

It doesn’t always have to be something major and it doesn’t always take a therapist, but sometimes it does. Sometimes it’s simple mindfulness, meditation, or getting out and having some fun, but many of us have no real idea of what it means to administer emotional first aid to ourselves which is why I included this Ted Talk by Guy Winch: Why We All Need To Practice Emotional First Aid

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.