#to stop doing them we can explore new coping skills - AND if the distress from these coping skills is shame related we can work through it

[bunnyboy-juice]

honestly. being able to be honest with my loved ones about when i am Mentally Unwell but also Dont Want To Talk About It has done wonders for my mental health

[destinationhope]

What Is Cognitive Behavioral Therapy?

What Is CBT And Does It Work? 

Cognitive behavioral therapy (CBT) is one of the most popular forms of psychotherapy and has become increasingly more prevalent in recent years. It’s used to treat a wide range of mental health issues, such as anxiety, depression and substance abuse. 

But what exactly is CBT? In this blog post, we will discuss what cognitive behavioral therapy is and how it can help people manage their mental health. We’ll also explore the different types of benefits and potential drawbacks.

As noted by the prominent journal Frontiers In Psychiatry, Cognitive Behavioral Therapy is the “gold standard” in therapy today. So, let’s learn a bit more about this type of therapy and how it can help people like you and your loved ones. 

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a type of psychotherapy that helps people to change their thinking and behavior. CBT is based on the idea that our thoughts, feelings, and behaviors are all connected. This means that the way we think about things can affect the way we feel and what we do. CBT is a short-term, goal-oriented therapy that focuses on helping people to change their thinking and behavior in order to improve their quality of life.

How Does Cognitive Behavioral Therapy Work?

CBT works by helping people identify and change negative or unhealthy patterns of thought and behavior. This process can help people to feel better and function better in their everyday lives.

CBT typically involves meeting with a therapist for weekly sessions. During these sessions, you will work together to identify your negative thoughts and beliefs. Once you are aware of these thoughts, you can start to challenge and change them. You will also learn new skills and techniques to help you cope with difficult situations in a more positive way.

If you are interested in trying CBT, it is important to find a therapist who is experienced in this type of treatment.

What Are The Benefits Of Cognitive Behavioral Therapy?

CBT has been shown to be effective in treating a variety of mental health conditions, including depression, anxiety, eating disorders, and substance abuse.

The benefits of CBT include:

Relief from symptoms: CBT can help reduce or eliminate the symptoms of mental health conditions like depression, anxiety, and post-traumatic stress disorder and addictions.

Improved functioning: CBT can help people with mental health conditions function better in their daily lives. For example, CBT may help people with anxiety disorders learn how to manage their fear and worry so they can participate in activities they enjoy without feeling anxious.

Long-term effects: The effects of CBT last long after treatment ends. This means that people who receive CBT are less likely to experience a relapse of their symptoms than those who do not receive CBT.

Are there any risks to CBT, and how are they mitigated?

The risks associated with CBT are limited, but the process can sometimes be uncomfortable. When the plan is followed and the therapist is good, CBT is a great way to improve mental health as well as improve mental health disorders. 

However, there are a few things to watch out for: 

Worsening of symptoms: In some cases, CBT may actually worsen the symptoms of the condition being treated. This is most likely to occur if the individual does not follow through with the recommended treatment plan or if they stop taking their medication (if prescribed).

Side effects from medication: If medication is prescribed as part of the CBT treatment plan, there is a risk of experiencing side effects from the medication. These side effects can range from mild to severe and may include headaches, nausea, and fatigue. However, there are many medications out there to treat various psychological conditions, and usually a therapist can find one that is right for each individual. 

Emotional distress: Some people may experience emotional distress during CBT, particularly if they are discussing difficult memories or events. This distress should be temporary and should lessen as the individual continues with treatment.

Help for Mental Health Disorders, Including Addiction

Cognitive Behavioral Therapy is a powerful form of psychotherapy that has been shown to be effective in treating many psychological issues. It can help individuals address negative thoughts and behaviors, reduce distress, and ultimately lead to improved wellbeing. 

While it may take some time to see the full benefits of this therapeutic approach, those who participate in CBT often experience an improved quality of life as they learn how to cope with difficult emotions and situations more effectively. 

If you are looking for ways to better manage your mental health, then Cognitive Behavioral Therapy might be the right choice for you. Give us a call with any questions you may have about CBT and it’s applications. We utilize CBT at Destination Hope along with other methods and we would be happy to talk about what mental health treatment can do for you and the people you love. We can be reached at (866) 756-4673 and are looking forward to speaking with you further!

[boldlygo-boldlygoing-boldlygone]

And We Do It All Again - Chapter 2

Summary: Jim has two big problems right now. The first is that he is hopelessly in love with his First Officer and his Chief Medical Officer, and neither seems to return his feelings. The second is that he’s stuck in a time loop where his ship is destroyed and his crew killed, over and over again.

Things can never be simple for James T. Kirk, can they?

Warnings: angst, (temporary) character death, swearing, time loops, suicide attempt in a later chapter (again, it’s in a time loop so it doesn’t really work)

Pairing: McSpirk

Chapter 2 of 7

Previous Next

A/N: Can also be read here on AO3!

-

Jim thrashed, legs tangling in his sheets, and ended up on the floor, clutching his chest and sucking in breath. Panicked, he kicked off the sheets and stumbled to his feet.

It was only when he realized he wasn't being sucked into the emptiness of space that he paused.

He stood in his room, blinking and taking deep, plentiful breaths. With a shaky hand, he glanced at the clock. Seeing the date, he exhaled deeply. A dream. It had only been a dream. His eyes turned, pausing on the chess board and glasses. A shiver ran up his spine.

Just a dream.

He rushed through his routine that morning, unwilling to admit even to himself that his hands shook a tad. Seeing them would help, he decided, and the sooner he got to see them, the sooner he'd feel better. Once he was dressed, he headed for the mess hall, trying to keep his face relaxed. Something caught in his chest when Spock was seated in the exact place he'd been in his dream, reading, but Jim pushed it away. Spock sat in roughly the same place every day. And he liked to be productive, so the PADD wasn't strange either. Still, he knew he was tense as he sat across from his First Officer.

"Good morning, captain."

"Morning, Spock."

"Our match last night was quite riveting. Your skill is improving."

Jim blinked, mouth going dry. He just knew Spock well. This wasn't weird, it didn't mean anything. "Thanks, Spock. Glad you had a good time."

The corner of Spock's mouth flickered down. "Are you well, Jim? You seem startled by my comment and you are, as Dr. McCoy says, fidgeting."

"No, I'm okay. Just had a weird dream." Jim threw his friend a reassuring smile and allowed himself to lightly touch his First Officer's forearm. Hands were a whole thing for Vulcans, he knew that, but a forearm should be okay. Besides, the contact made it easier to prove to himself that this was real and that he hadn't just watched the two people he cared about most die. "Anyway, let's have a rematch tonight. Bet you beat me this time."

"Not this again." Bones plopped down beside Jim, scowling. Jim grinned and let his arm- the one not touching Spock- wrap around his friend's shoulders. The contact did wonders in calming his racing heart.

"Yes, this again! You wanna come?"

"Depends. Will there be whiskey?"

"Not tonight. You drank everything I had last night."

Bones snorted and started eating. "Like you didn't help."

"Come on, Bones, it'll be fun!"

"I dunno if I can suffer both of your presence without a drink." Bones smirked, quirking an eyebrow at Jim. "But I can try."

"Great! We can meet in my cabin at 2300."

"Affirmative."

"I can do that."

"Perfect." Jim paused, pushing aside the words that came naturally. "Spock, we outta get to the bridge."

"Correct, captain." Spock stood and nodded at Bones. "Until tonight, Leonard."

"See ya, Bones!" Jim grinned as Bones waved half-heartedly, something fond flickering in his features even as he rolled his eyes.

Jim fell into step with Spock as they headed for the turbolift. Inside, Spock spoke up. "I must admit, I do find the recreational time spent with you and Dr. McCoy quite enjoyable."

"I'm glad, Spock. It's- It's quite enjoyable for me too."

He felt Spock glance at him from the corner of his eye, but he didn't comment further. They stepped on the bridge together, then separated for their respective stations.

"Captain on the bridge!"

"Status report, Mr. Sulu?" Jim asked, a strange nervousness crawling over him as his pilot responded.

"Starfleet sent us new orders this morning. There's a planet in our sector they want us to check out."

"Okay." Jim hesitated. It had only been a dream. They were on an exploration mission, after all. It was a common enough command, it wasn't surprising.

"Sir?" Sulu glanced at Chekov, then back at him. "Shall I set the course?"

Jim cleared his throat. "Yes, Mr. Sulu. Thank you."

"Yes, sir."

He forced his attention to turn to his paperwork (paperwork that felt too familiar, too much the same as before), though was unable to keep from occasionally glancing out at the stars. Time crawled by and he found himself painfully tense, worry circling his mind. It had just been a dream. A frighteningly realistic one, but a dream all the same. After his shift, he'd head to his room, meet Bones and Spock, and tell them about it. They'd calm his fears and assure him that he was, in fact, being ridiculous. It'd be okay. He just had to finish this shift.

Then Sulu spoke and he felt as though all the air had left the room. "Sir, there's an unidentified ship approaching."

Jim sucked in a breath and ground his teeth, forcing his shaking hands to steady. "Hail them."

"They're not responding."

"Shields up. Then try again."

"Yes, sir." As Sulu moved to act, the entire ship jolted.

"We've been hit, captain! Damage to engine one!"

Jim swore, a cold panic washing over him. "Are the shields up?"

"Yes, sir, but the hit came while I was putting them up. They didn't block the entire blast."

"Fire back immediately!"

"Shields at twenty percent!" Chekov called.

"Firing now!" Sulu tensed. "It didn't even dent their shields!"

"Get us out of here, Mr. Sulu!"

"Yes, sir. I need-" The ship shook again. The hit took the lights with this time.

"Shields at ten percent!"

"Sulu, can you get us out?"

"The engine is too damaged, sir, I can't warp!"

"Damn it! Evacuate the ship!" He commanded, slamming the button. Red light flooded the room and Jim strode to the console, already pulling Sulu up.

"The autopilot is down, sir, I need to stay and-"

"Get out of here, Hikaru! That's an order!"

"But sir-" The ship rocked again.

"Think of Demora!"

Sulu's eyes went wide. Jim felt guilty for the bluntness, but it got the man moving, and that was what mattered. Jim turned his attention to Spock immediately.

"I need to find Bones."

"I will accompany you, captain."

Jim nodded sharply, not bothering to argue. The memory from yesterday- the dream, the damn dream- rose, but he pushed it down and pressed on.

"Bones!" The ship shook, more violently this time. The shields were down.

"I need to get my patients off this ship. Go without me!" Bones barked, not even looking at Jim.

"Come on, Bones, we can't stay!" Jim insisted, even as he pulled a patient out of bed and helped Nurse Chapel get a grip on him. She dragged the man- the last patient, he realized, as Bones helped Dr. M'Benga with another.

"Alright, alright. Lead the way."

Jim moved, knowing the two were behind him. Fear gripped him as the world exploded again, however, and he was thrown into Bones' office.

"No!"

Spock and Bones, clinging for dear life.

"Bones! Spock!"

Spock's eyes rolling. Bones' face going blue.

"No! No!"

Spock let go. Jim screamed. The world exploded.

. . .

This time, he shot out of bed, eyes fearful as they found the clock.

Same time. Same day.

He wanted to believe to it was a bad dream. That he was stressed and his brain had come up with some weird situation to cope with that. But it had all been too real for that. He didn't know what was happening, but he had to stop it.

He barely pulled on appropriate clothing before taking off, sprinting for Spock's room. He pounded on the door as soon as he arrived, heart racing.

"Jim. It is quite early, is all well?"

"No. You have to listen to me. I dunno what's going on, but I've been through this day twice now and both times, the Enterprise has been blown up and we all die. I need your help stopping it." As soon as it was out, he knew how insane it sounded. He was certain Spock thought he had lost it, but he was simply staring. When he spoke, his voice was void of emotion.

"Why don't you come inside?" Jim blinked, confused, but let Spock usher him inside. "Were you able to sleep last night, Jim?"

"What? Yeah, I guess. Spock, you're missing the point!"

"I am not. I am simply assessing the situation. You are certain these events were real?"

"Yes. Like I said, I don't know how, but they were! We have to do something!"

"Indeed." Spock looked at him a moment longer, then cautiously raised his arms. "You are shaking. May I hug you?"

Jim blinked. "Uh- what?"

"Hugs are customary means of comfort in Earth culture, correct?"

"Well- yeah."

"Then I wish to comfort you. This has clearly caused you great distress."

"I guess." Jim was still confused as Spock hugged him. He couldn't recall if Spock had ever hugged him. "I'm just glad you aren't calling me crazy. I thought you'd think I lost it."

"Believe me, Jim. I do not think you 'crazy,' as you say." Spock released him, sincerity in his eyes even as his features remained neutral. "I do apologize, however."

"What? What are you-" He didn't have a chance to finish as he felt Spock's fingers at his neck. The world was black before he even hit the ground.

The first thing he registered when he came to were voices, low and worried.

"-clearly believed these events to be real."

"Jesus, Spock. You did the right thing bringing him here."

"Will you be able to determine what is wrong?"

"Yeah, I should. He's probably just been pushing himself too much. You saw how tired he was last night."

"Exhaustion could cause delusions."

Delusions? "Bones. Spock!" Jim forced his heavy eyes open and tried to sit up. He found he couldn't.

"Woah, Jimmy, relax." Their faces appeared in his vision.

"Spock, what the hell!?"

"I apologize, captain. You were clearly in a state of panic and I believed Dr. McCoy could best assist you."

"I'm not having delusions! The ship is going to get attacked! Let me up so I can stop it!"

Bones frowned, eyes worried. "Kid, calm down. We're gonna figure out what's wrong, okay? You're gonna be fine." He was being gentle. Bones was never gentle.

He really thought Jim had lost it. He struggled harder against the restraints, anger and despair and betrayal flowing through his system. "Damn it, Bones! Just listen to me!"

"You're not makin any sense, kid. The ship is fine."

"Yeah, now! But we're gonna get attacked!"

"Jim-"

"I saw the crew dying! I saw you both die! I need to save you, let me save you!"

Spock and Bones exchanged a look. A hand closed around his and squeezed. "We're right here, Jimmy."

"Don't touch me, damn it!" Jim thrashed violently, too angry to properly appreciate the gesture. "Listen!"

"I'm gonna put you to sleep again, kid. We'll figure this out, I promise."

"No, Bones, don't! Please, don't!" But it was too late. Jim glowered at Bones, then Spock, as he felt the hypo kicking in. "Damn you both!" He snarled before his body relaxed on its own account and he fell unconscious again.

When he woke the second time, the world was red. Bones was beside him, yanking his limp body- still weak from the sedative- off the biobed. Jim leaned again Bones, groaning as the doctor practically dragged him to the door.

"Leonard!" Spock skidded to a halt in front of them, then grabbed Jim's other arm and helped drag him towards the door.

"What the hell is going on?" Bones hissed as they stumbled to the door.

"We are being attacked." Spock explained shortly. Jim was too weak to say 'I told you so.'

"What? By who?"

"I do not-"

The explosion cut him off. This time, Jim watched, horrified, as Bones was sucked out of the ship. The only thing keeping him from the same fate was Spock's strong arm, his grip painful on Jim's bicep.

"BONES!"

"Jim!" Spock pulled at him, but it was obvious the lack of atmosphere was affecting him. Jim himself already felt lightheaded. Black spots filled his vision and he passed out before Spock's grip failed.

[hjertetssunnegalskap1]

HOW TO PLAY WITH TROPES AND CLICHÉ CHARACTERS/ STEREOTYPES

One of the ways I get ideas to write, is that I take some characters I love and mix them with a trope I want to try out. Tropes are common expected plot devices. Some typical fanfic examples are Friends To Lovers, Fake Dating, Bed Sharing, Enemies to Lovers, Aliens Made Them Do It, Fuck or Die, sex pollen, etc. Tropes don’t always have to be cliched like these examples. But that’s how the term is used most often, I believe.

Trope inversion occurs when an existing trope is used in a story, but flipped on its head, defying the audience's expectations. Trope subversion is when the elements of the original trope might all still be present, but deconstructed. I haven’t really subverted or inverted many of tropes , and I would love to know more about how to do that. So I have picked up some tips and tricks. To be honest, I will probably mix the terms here. 

Now, I’m going to rant a bit about different terms, attempts at definitions and examples, so jump to my pretty awesome list of tips below if you don’t want to read all of this. 

Tropes are often based in archetypes - very broad, typical examples of a certain person or thing. Can be found in all cultures. Western descriptions of archetypes are King, Queen, Witch, Wise man, Joker, Hero/ Prince etc. More general descriptions are Sage, Innocent, Explorer, Ruler, Creator, Caregiver, Magician, Hero, Outlaw, Lover, Jester, and Regular Person. I have also seen the term used to describe elements/ roles in the hero’s journey. We have a Hero, a Mentor, an Ally, a Herald, a Trickster, Shapeshifter, Guardian and Shadow. I suspect that the suggestion that we only have 7 types of stories to tell, like Overcoming the Monster, Rags to Riches, The Quest, Voyage and Return, Rebirth, Comedy  and Tragedy, implies that these story types also are archetypical. We all use them, all the time.

Tropes often end up as stereotypes, that are very typical oversimplified ideas of a particular type of character/ thing. Clichés, basically. So when I talk about tropes I suppose I mostly talk about stereotypical tropes. Since the term tropes often are used to describe typical plots and storylines, I’ll sometimes talk about stereotypes when I describe commonly expected or cliched characters. Like The Chosen One, Damsel in distress, Manic Pixie Dream Girl. All of these things are basically tropes. Hell, I will probably throw around these terms and mix them horribly. Sorry about that.

Example: The Geek meets the Manic Pixie Dream, falls hard, and grows to appreciate more in life

Let’s say you have a character who is based in the Thinker/Scholar archetype, a person who is constantly in search of knowledge, who meets a Creator, a person who wants to make things. 

The thinker can easily become a Geek, and that’s a typical western trope. And we have stereotypes about the Geek having poor social skills, being serious and wise etc. and these ideas can become cliched, boring and overdone. Just like the Creator stereotype often can become the Manic Pixie Dream Girl. The stereotypical trope would be that the Geek meets the Manic Pixie Dream Girl, falls for this person against his best intentions and grows to see more to life than facts. 

Example: Isak and Even from Skam

You can write Isak from Skam as this Geek meeting this brighter than life Even, falling for him against his will and growing from that. In a way, Skam starts out a bit like that. Isak has expressed prejudices as “hipster wannabe movie makers” like Even before, but then he sees this gorgeous Even and falls hard. However, in Skam, Isak was never written as a pure Geek role. He was more a Geek/Hero/Jester with internalised toxic masculinity, forced independence and abandonment issues based in his Christian upbringing, friend group, being left by his father etc etc. 

While Even appeared at first glance as a Lover/Creator/ Hero or Manic Pixie Dream Girl, he gradually showed more and more cracks in the facade, tricking the viewers to think he was more a Shadow/Trickster character, or a possible Fuckboy, until it was revealed that he  was a more rounded character with a troubling background, mental health issues, fears and insecurities. To be fair, Skam did follow a trope of Isak growing as a person because he met Even. They got their romantic happy ending and the viewers got what they wanted. 

It was everything but boring, though.

When trope subversions or inversions don’t work

There’s a price to pay if you subvert a trope, especially if you do it at all costs - like when they they subverted 5 years of character building in the last season of Game of Thrones. The first season has an example of excellent trope subversion (Stark). However, to pull out the rug at the end like they did in the last season, and disappoint the viewers’ trust, is probably not the best way to do this. 

Twists and turns can fail if they seem to come out of the blue. It can be smart to add some small hints of novelty from early on in the story, especially if you’re writing tropes that people find a bit boring. You won’t lose bored readers and you will prepare them that something is going on. Also, it can be good to do the subversion early enough in the story to be able to make interesting changes. 

If you choose to subvert a trope it can sometimes be wise to show why you do something differently. Like, if you write a female character who turns out to not fit the norm in the Victorian era, for instance, it could be smart to explain how this character has become who she is. If she’s this badass character fighting for equality, where do these ideas come from? Or if you have this character surviving traumas, abuse and lack of love, how does he turn into an empathic, more or less likable hero?

A lot of disappointment with trope subversions, like in Avengers Endgame or the last season of GoT, feel worse because the the characters act out of character. If you try to write something true, with characters that seem real, consistent and believable, that helps.  

If you play with a trope it helps if you manage not to make it too pretentious. I can’t think of any examples right now, but I know I have experienced it. Trope subversions often have a hint of nod to the trope itself, and humour can help making the subversion work. Like if the villain comments on how villains typically loses, before actually killing the hero. Or kissing the hero, lol, but that’s another trope.

A lot of build up that fizzles out can be disappointing. If our Victorian badass character has, say, superpowers, she also should have a reason (a way to use them). The readers expect that. So if you play with that and she fails using them, they probably should end up important in the story in some other, surprising way. Same goes with a romance where there’s a lot of pining, tension, heartache and misunderstandings and these are not addressed. If you choose to subvert this trope, it’s probably smart to address these things in a new way. 

All in all, when you subvert a trope you often will have to tread carefully to balance between meeting the readers’ expectations and not meeting them. Remember that the story always needs a satisfying conclusion.  

Then again, some say even trope subversions are becoming new tropes, and that there’s no reason to subvert them. Could be.

No matter what, I like to play with stuff like this. So. Here are some ways you can play with tropes and archetypes and maybe get some story ideas. 

MY PRETTY AWESOME LIST OF HOW TO PLAY WITH TROPES

1 Subvert clichéd characters

You can keep some parts of the wise man archetype, for instance, and change other parts of it. Instead of writing a “wise old wizard” (like Merlin, Gandalf or Dumbledore) you can make the old wizard into a cowardly old idiot. Instead of writing the love interest as a hot hero-type, you can make him more of a charming dork who is impulsive but also smart, intuitive, caring and with insecurities (Even from Skam). Another typical example from fanworks is to subvert typical gender norm characterisation or typical top/bottom or dom/sub characterisation.   

2 Parody the clichéd character

Write the typical “Hero/Warrior” character and take it almost too far - like with Thor in the Avengers, or even better, Thor in the Sandman series. In Skam, several characters are taken almost too far like this - up until a certain point. Eskild is written as the “funny gay” until he gives Isak some serious advice, Magnus is basically written as a typical horny idiot until he tells Isak some truths about bipolar disorder. Vilde becomes a parody at times, as well, as several of the other characters. 

3 Deconstruct the cliché/ stereotype

Why is the villain a villain? Why is the comic relief a comic relief? Identify the attributes of a character type - say, the likable and frivolous Comic Relief character. For instance Chris Berg in Skam. Explain her in a surprising way - perhaps she’s not just a clown or a funny sidekick, but uses humor as a coping mechanism. Reveal something deeper and true about the character (Chris wants to be a good friend but doesn’t know how to do this because of reasons, clowns are often sad behind the joker mask, etc). Make readers wonder if they’ve misjudged the stereotype. This can sometimes work with typical fandom clichés as well. 

4 Lampshading a character or a trope

“Hanging a lampshade” is the technique of countering your reader’s disbelief in a character’s ‘reality’ by acknowledging how blatantly they fit a cliché. The would-be victim in a horror story trips while running away (as they always seem to do) but the would-be killer stops and comments it. Perhaps they say, “Oh, you’re going to trip and make this boring?” Another typical one is when the villain has captured the hero and the hero finds a way to escape while the villain has his big speech. I love subversions of that trope, like in Black Orchid where the villain comments it and shoots the hero without a speech (if I remember correctly). In a way, season 3 in Skam does something similar to lampshading. The season is written as an epic love story, but the characters comment this in different ways, talking about epic love stories, movie references etc. 

5 Turn the plot trope upside down

You can hint about a trope, than turn things around. Sometimes this is called baiting, or showing that the expectation was a red herring. For example, you can write a story where you set up a typical hero story but the hero befriends the dragon instead of killing it. Or maybe the dragon wins. Bed sharing and it leads to nothing. Fake dating where they stop lying.  A setup for a possessive jealous partner who doesn’t get possessive at all. Soulmate story where the heroes aren’t soulmates. An ugly duckling story where the makeover doesn’t really change anything. 

6 Parody the plot trope

Write the plot trope but amp it up and make it extreme. Fake dating going too far (whatever that means), or soulmate story where all the brutal implications are clear. Ending in disaster, most likely. I can’t think of good examples here but I suppose crack fics are a bit like this. Oh, and parodic horror movies. Parodic movies in general, probably.

7 Deconstruct the trope

Somehow make it believable that the story builds as it does, based in the background of this world, or the characters. If I use Skam as an example again, the plot in season 3 is a quite typical boy meets boy trope, strangers to lovers, and it includes tropes like personal growth, miscommunication to communication, but it doesn’t feel forced because the characters feel true and real and their actions make sense based on their backgrounds. We get the feeling that there’s something deep and true behind it all. Isak’s difficulties makes sense, and so do Even’s and it also makes sense that they get each other.  

8 Changing the point of view

This is a neat trick. You can pick any fairytale and make something new if you write it in the pov of the villain, or the jealous hindrance character, or one of the helpers. You can write fake dating viewed from the outside. Or a coffee shop story where you’re the guy washing the dishes, or perhaps the owner of the coffee shop, getting annoyed at the baristas flirting with the guests? Or a cute meeting where you’re a bystander watching someone crash into each other, and you almost piss yourself laughing. 

9 Switch a story element

You can put the whole trope into a new location, like a new time or place, and make a new type of story. For instance, a love story in space can give an interesting twist. You can write a fairytale set in modern time. Most AUs are switched story elements like these. The trope is still being as it is, so this isn’t really a subversion, but the trope is dressed up in a way that's unique.

10 Averting the trope

This isn’t really playing with the trope at all, since it’s just avoiding it. Like, writing an action movie with cars but without a car chase (oh puhlease that’s like a dream, I hate car chases). It is when you would very much expect the trope but despite there being plenty of opportunity for it, it is never used.  

That’s it. I probably mixed a lot of terms and ideas. I still hope you found some interesting ways to play with characters and plots. There are so many more ways to do this, but these are my tips, I sure had a lot of fun writing this. 

[famiina]

Sweet beginnings !

So here's my birth story which I have been wanting to write for so long but never tried to..

I am an amateur blogger and this is my first blog ever. So kindly bear with me. Grab a bite, sit back and have a good read.. :)

Like every other girl, I was always scared of the labour process ever since I was told stories about it from the women who experienced it. I had no idea how my body would react under extreme pain and pressure. But still I preferred a normal delivery over C-section because of the post natal health benefits associated with it. So I started to gather knowledge about the latest pain relief methods from my friends who just delivered lately. From them, I got to know about epidural. I had my pregnancy check ups in Chennai until 8 months. In November 2017, I moved to my mom's place where I was supposed to deliver my first child. My mom, through her contacts,had chosen a doctor who was known for her excellency in gynecology. I was totally blank about how I would cope up with the new doctor as I did not have enough time to build a good rapport with her. But she seemed to be skilled and experienced. So I left the rest to the Almighty and was enjoying the last month of pregnancy with mom. 

In the hospital, there were too many posters all over about painless delivery and epidurals. Whenever I went for check ups, it caught my attention but I did not bother to talk about it to my doctor as I know I will have enough time and will be given a chance to know what options are available for pain management and which one I can opt for once my contractions start. 

Meanwhile, I read about epidural,the effects of it and disadvantages which gave me a better idea and I got convinced that it was worth a try.

I had a healthy pregnancy. I made sure I was at peace, avoided stress, ate healthy, satisfied my cravings and did things I wanted to without hesitation. I was even driving on my own until 8 months inspite of the traffic in Chennai though few of my family members felt it was risky. So I had positive vibrations that my baby will come through happily on earth from the heavens :) My due date was given on December 15th 2017 but I did not feel anything until 9th. I went for my regular check up and doctor asked me to come on 14th to induce pain if the contractions do not start on its own. 

On the night of 9th, I felt unusual and took trips to the loo every now and then. 

Early in the morning, I spotted blood with mucus that is when I informed mom about it. She had the hospital kit packed way earlier. After informing my husband over the phone, mom and I started to the hospital as early as we could. Contractions started lighter and were in the interval of 20 to 25 mins. Around 8 am, I was taken to the labour room. The duty doctor did an internal examination and said my water hasn't broken yet. I was given IV and shifted to room. By then, all of my relatives had arrived and they were excited enough awaiting the good news. Contractions started developing and I had the sensation of vomiting whenever a contraction came. Mean while, my husband and mom asked me if I am sure of handling the labour pain. And I decided to go for an epidural as I did not want to take any chances because I had no idea about the intensity of pain that would come after. One good reason that I chose epidural was that I wanted to actively participate in the birth process instead of lying down on the table unconscious and unbearable of the pain that will take over everything else. By the time the epidural was administered, I had severe contractions in frequent intervals. I was taken to the labour room after that. In sometime, my water broke with full force but from the faces around, I could realize something wasn't right. There was meconium(baby's first poop) in the amniotic fluid. Since I was given epidural, doc wanted to wait for few more hours to see how I am progressing. Epidural started working slowly and I felt lesser pain in the lower part of my body. My contractions were coming every 1 min and I felt like pushing. The nurses told me not to but it was out of control so I kept on pushing with all my strength.

There was this junior nurse who stood by my side throughout pacifying me that it's going to be alright soon. I held her hands tightly as if I had known her for a long time and felt much better that I had a support system. Almost squeezed her hands when I got contractions now and then. 

Hours went by and he wasn't ready to come yet. I had the NST(Non Stress Test) belt wrapped around my tummy to check the baby's heart beat, Blood pressure equipment attached and epidural catheter at the back. I  wasn't allowed to lie on sides as the baby's heart rate will slow down. I was exhausted with everything going on. Mom and mother in law were allowed inside twice to come in and see me for mental support. Mom couldn't hold back her tears seeing me struggling and pushing harder. 

At around 5 am, the chief doctor was expected to arrive as I was nearing the climax. The nurses were asked to keep things ready to welcome the baby. She arrived and told me to give a push with all my strength. I did but no luck because the baby's head was estimated to be larger than the normal, thanks to the scan reports. My anesthetist sat on the bed near me and pushed with all the force but still he dint show up. Finally the doctor decided to do it using forceps.

For one last time, I cried out and pushed, the nurse pushed, the doctor took his head out using forceps and there he was! Descending down on earth like an angel.! My precious little baby boy weighing 4.2 kgs at the time of birth! 

That was it ! 

That was one unforgettable, life changing moment for me!!

That was the moment I felt proud of myself in delivering a little human !!!

Everyone else including the doctor was shell shocked and surprised because we weren't expecting him to be bigger. 

I do not know how it would have been possible delivering a bigger baby without epidural. The baby was monitored in ICU for a day in the event of fetal distress! There were mixed comments from my circle saying it wasn't right to have waited for so long as the baby would have had distress due to meconium released inside. The other side saying it would have ended up in C-section if not the choice of epidural was opted. 

All I knew was that the doctor was skilled enough to assess all of it and take a risk and was experienced in doing a forceps delivery. 

Above all of it, Allah, the Almighty decided it to happen this way against all odds! 

When Umar was born, the mother in me was born too!

Here we are, mother and baby hale and healthy, my little cub exploring life in his very own way! It surely is a life altering experience for every woman irrespective of what type of delivery she goes through! 

So let us stop judging, respect every mother's decision and celebrate them every day! ️:)

One is not born, but rather becomes, a woman !

More power to all the women ! :)

[biayahlife]

Coping Skills Post-Pandemic

The last year has been a tough one as we all know. This last year has included job transitions, insurance problems, the death of a dear friend, surgery for myself, and surgery for my dog of 10 years. As the year has been difficult for everyone, we all utilize whatever coping skills we have available to us and that we can confidently employ. I’ll admit, most of the easily accessible coping mechanisms I use are not necessarily ones that I would recommend people indulge in. I rely far too heavily on food and drink to escape from my seemingly ever present woes. I’m feeling better here in the last week or so since Cinnamon has been released from captivity. She seems to be doing well, which enables me to find space in which I can practice good coping skills. My therapist tasked me with making a list so I figured I’d share it with y’all.

In no particular order:

Paint something

I would put drawing however, I find drawing to be stressful at times as I have a certain expectation as to how the end result needs to look. I make drawings that are fairly precise and I can be quite critical of how a sketch turns out. Painting doesn’t have the same sort of exacting standards that drawing has. That’s not to say that I don’t want it to look good, but the style of painting I love to do does not have to be perfect. It’s more organic than sketching or digital art. We’ve put some of my paintings on our Instagram feed so if you’d like to check those out it’ll give you a good idea of what I usually make.

Take a shower

Now I don’t know if this would have come to me as a coping skill at all without reading it as a suggestion online. At times it’s quite difficult to muster up the desire to take a shower (baths are impossible) but taking a long, very hot, very unfocused shower is really nice and helps me forget the things that I’m worried about. There’s no stress to hurry because I have to go somewhere, there’s no need to shave if I don’t want to (although I do enjoy this sometimes), and with the new water heater we purchased a year or so ago I can sit under the hot water as long as I desire.

Write a note to someone you care about

Good gravy let me tell you, I like this idea. Expressing my care to people who are important to me is super nice. Even if I didn’t give the note to them, just writing down why they’re amazing, or the things they do for me, or why I like their existence is wonderful. I can remember times I’ve written things about Miayah when explaining my relationship to her to a potential date and it completely takes me out of my head.

Make a gratitude list

I’ve done a version of this in the past. It was many years ago and it was more of a “write things that make me happy” sort of thing. It’s approximately the same sort of exercise. I had a nice notebook and the whole thing was eventually filled out from front to back with things I enjoy. I’d like to employ this again. The things that make me happy can range from things as simple as bubble gum to complex concepts such as Plato’s Allegory of the Cave. This is a great one for a lot of people since it doesn’t take skill or a lot of focus.

Cry

For me, finding a good show to cry to is a great release. This last weekend I cried for two days straight about this super sad show called Navillera, and afterwards I felt much better. Even though I didn’t cry specifically about things happening in my life, the release of tears was very good. It was the pressure valve that I didn’t even know that I needed.

Laugh

Something I used to enjoy was telling very bad jokes and then laughing about it. They were terrible jokes but I found them so weirdly funny that I’d just crack up while or after telling them. After thinking about this I purchased a small journal and have been filling it up with dad jokes. I’ve only got a few pages but they make me stupidly happy. An example: What do you call a fish wearing a bowtie? Sofishticated….. :D.

Go watch the sky

This may seem arbitrary however it falls along the lines of removing myself from the situation that’s causing me distress - whatever the situation may be. I love clouds, I like identifying constellations, I enjoy finding shapes in the clouds, I love meteor showers and seeing shooting stars. Whenever I take time to sit in the reclining chair in the backyard in the dark on a clear night I always feel better when I come inside.

Chase Eebles

She’s always good for entertainment. Going into the yard with her and chasing her around while she darts through the grass like a wild animal is always fun and takes me out of my head. If you have a pet or a child that could provide easy, simple joy with physical activity I strongly recommend it.

Choose an easy win

If things are overwhelming, if anxiety is kicking my ass, or if I can’t decide where to start with my to do list - I’ll choose an easy win. Take a little teeny easy miniscule task that needs to be done and do it. It gives me a sense of accomplishment, takes a tiny bit of stress away because something is crossed off the list, and may lead to feeling like something else on the list can be accomplished.

Inject curiosity into the moment

Let’s say I’m feeling anxious: I can stop and register where the feeling is in the body (I am familiar with this step already) but then inject further investigation - “Is this sensation stronger on my left side or my right side?” “How is this affecting other parts of my body?” “What other physical sensations are happening?” Don’t put off or look away from the sensation - pay attention and explore it immediately as it can ease the stress of whatever was happening in my mind.

Set aside time to think and plan

Instead of getting wrapped up in the what ifs and even ifs, I can set aside a few minutes after becoming aware of the physical sensations, to create a list of how to deal with the trigger of the anxiety. Plans made in the throes of a bad anxiety spike don’t help in the same way as they just feed into what if that plan doesn’t work, as well as they’re not as clearly thought out.

This is the beginning of what I think will end up being a very useful list. It’s been easy to fall into bad mental and physical habits during the pandemic but I’m ready to shake them all off. I’ll remember that I can grow and change and become happier with myself without turning to drastic, crazy, out of my comfort zone measures.

What sorts of coping strategies do you employ in your life?

[abbynormaled]

The existential crises of difference, privilege, and forks

My wife and I visited Thailand many years ago, shortly after we got married. Her parents lived there, part of the U.S. Embassy staff, and so we were able to stay for 3 weeks and see far more of the country than most. 

Bangkok was amazing: so full of people, and smells, and new food, and elephants. It was fabulous. Everything a young person might want in their first trip out of the country.

After a long day at Chatuchak, Bangkok’s enormous weekend market, we were overwhelmed by it all. We were exhausted, not just physically, but psychically. We stopped on the way back to eat and recharge.

At a KFC.

Now, I’m not one to be timid in eating, especially when I get a chance to travel. But we had had too much by that point. Our system couldn’t take any more novelty. KFC was exactly what we needed — a refreshing taste of the familiar — and by the time we were done savoring the Colonel’s 7 herbs & spices, we had the internal wherewithal to continue on exploring and enjoying the rest of the day

This is the fork theory of difference, which is the opposite of having privilege.

You may already be familiar with Spoon Theory: the idea that people with chronic illnesses have a finite amount of energy to do the daily things. Sure, everyone has a finite amount of energy, but for people suffering from chronic pain, mental distress, or physiologically-induced fatigue, it’s so much more.

Even simple acts, such as folding the laundry, take up extra effort, or spoons. Had to go grocery shopping in person? That’s 2 spoons. 

Part of the value of this metaphor is that (too often) a friend of the person will try to encourage them to get out, to do something. “It’s just one evening of drinks.” What the friend doesn’t know is how many spoons that person already expended during the day on just ordinary things.

It’s helpful for most people, those who don’t have to deal with these very literal pains and stressors, to understand how exhausting it is just being. 

Those of us who don’t experience the pain and fatigue of chronic illness don’t worry about spending spoons on the little things in the same way. 

We get to keep that energy and use it for other things in our lives: social interactions, moving ahead in our career, financial planning, helping kids with homework, etc. 

Having extra resources, like physical and psychic energy, to expend on moving forward and getting ahead is (in at least one respect) the essence of privilege.

Autism and exhaustion

My experience with not having enough energy to use the laundromat had me thinking about the ways in which a version of the spoon theory could help me (and others) understand the small but accretative energy costs that come with being autistic in an NT world (especially when one works to “fit in” as is the case in many undiagnosed autistic women and girls).

I feel it is important to point out that autism is not a disease or disability in itself — if that assertion confuses you, please Google neurodiversity.

Let me share a passage from my novel-in-progress about what it feels like to be autistic:

- - - - - -

When they think about an autistic person, most NT’s (that’s neurotypicals, or non-autistics) think about people who get over-stimulated easily, who don’t like to be touched, and who say socially inappropriate things without realizing it. And that is true for a lot of people on the spectrum. But it is a spectrum, and just like the light spectrum there are all different hues of autism spectrum (AS) and some are more difficult to perceive than others.

Think of it this way: the “typical” autistic person (as portrayed in the media) generally has trouble understanding social norms and behaviors (like unspoken rules, nonverbal communication, and similar). Those social interactions might be like hearing someone sing a song in a foreign language: you can participate in the singing, but you’re not really sure what’s going on.

For me, and I’m what they used to call an Aspie (short for Asperger’s), it’s not nearly that severe. It’s more like hearing a song in your language but the music is really loud or distorted or it’s Bob Dylan and you can’t make out all the words. You get the basic idea of what’s going on in the song most of the time from other context clues (like the tempo and whatnot), but the specific details can be lost on you. And sometimes those context clues aren’t accurate, and you end up looking like a fool because you thought “Gangster’s Paradise” was an inspirational song.

I’ve learned over the years to do the equivalent of looking the lyrics up on the Internet, which is to say that I’ve learned to act neurotypical very well.

In fact, most people have no idea I’m not an NT. The few people I’ve told about my autism are surprised (some even wanted to argue that I don’t act autistic enough to qualify). The truth is that I’m very smart, I have a great imagination and strong language skills, and I enjoy having fun like the next person. Yes, I prefer quieter activities (loud ones are tolerable, but wear me out). Yes, I sometimes don’t behave as expected in stressful or unusual situations. But I do enjoy being touched for the most part — except when someone attractive that I’m not comfortable around yet touches me, in which case I enjoy the physical part of it but get stressed out about how I’m supposed to react.

So, being on the spectrum doesn’t hurt or anything, but it is stressful and tiring from all the work you have to do to fit in. It’s as though every encounter with another person is a puzzle: you can enjoy puzzles, but having to do them ALL THE TIME gets exhausting. It does help when you have the same kinds of interactions again and again, because you know the pattern.

- - - - - - 

Solving the puzzle that is neurotypical social interactions over and over and over again leads to emotional and physical exhaustion: autism fatigue. 

From Neurology Advisor:

Although compensating for their difficulties may help people with ASD connect with others, get jobs, and successfully navigate social situations, accumulating research suggests it can also lead to exhaustion, burnout, anxiety, and depression.

Forks

Forks are a way to account for the amount of social energy an autistic person has to expend throughout the day. As I mentioned at the outset, this really works the same way as spoons, but I thought another utensil was appropriate because:

Spoons are about physical energy. Forks are about psychic energy.

The spoon theory is currently used to describe the difficulty in dealing with disabilities (and I don’t want to appropriate), and

Many autistic people may co-present with a disability, making it difficult for them to cope, as they juggle both spoons and forks.

The basic concept is this: an autistic person has a finite amount of energy (emotional, psychic, energetic, whatever) at the start of a day for working out the social puzzles. Even with activities they love and enjoy, it takes energy.

Social interactions take effort.

The energy a person has is their number of “forks.” There’s only a certain number of them to start with, and different interactions use up different numbers of forks.

Greeting coworkers you’re familiar with at a job you’re used to may only use 1 fork.

Returning an item at the store takes several forks.

Networking events where lots of people are hugging (but not everyone) will probably use up all your forks.

Even activities that you love use up forks. I am enthusiastically absorbed by improv: I love to perform it, to practice it, to teach it, to coach it. But it uses forks. Longer performances use more forks, and classes even more still. A beginner class, which is one of my favorite things in the world, will wipe me flat out.

Once your forks are gone, your ability to “do people things” drops to zero. It’s not that, given an extreme need an autistic person can’t manage to say hello, but it does require pretty significant draw of willpower.

When you’re low on forks, even using the laundromat can be too much.

The forks will come back, with time and an environment where the autistic person can recharge, but in the meantime it’s vital to be aware that we’re not going to act “normally” most likely.

Some of my personal characteristics that manifest when I’m out of forks include:

a flat affect: no emotion in my voice or face

Silence in a conversation

Becoming easily distracted by random tangents from a conversation (this is my normal brain behavior, and it takes effort for me to follow conversations linearly)

Easily annoyed or put out when I haven’t communicated clearly.

Because autistic people engage in non-normative social behavior — especially when they’re out of forks — it’s easy to classify autism as a disability. 

It’s not a disability. It’s a lack of privilege from being outside the cultural expectation that people think and behave IN THIS WAY, and not any other.

It’s the conflict between neurotypical and autistic expectations of normative behavior that causes much of the “dysfunction.” To be sure, there are many people further along the spectrum who face additional hurdles and difficulties, but it’s important to understand that the root issue is this friction between what’s considered normative and where autistic people are.

Setting the table: Beyond Autism

This “foreigner fatigue” — being exhausted by the constant work of moving in a world made for different people — extends to other marginalized groups.

For me, a breakthrough occurred in my coming out as transgender. I went from “being” a white, cis-het male to a trans woman. And because I changed my presentation so suddenly (thanks, autistic mind!), the differences were pretty stark.

Where before I would pop down to the local Food Lion to pick up an item or two for dinner, I now have to balance competing interests:

On the one hand, the Food Lion makes me nervous for my safety. I get constant glares and people muttering under their breath, and the parking lot is dark.

On the other hand, the nearest grocery store that I feel comfortable in is 7 miles further away.

In and of itself, it’s a relatively small, not overwhelming choice to have to make. 

Once.

But these kinds of choices don’t just happen every once in a while. They’re constant. Am I in a restaurant where I feel comfortable using the bathroom? If not, how long will it before before I can find one? When sending out proposals to corporate clients to do improv training, do I pay to have someone accompany me when I know the audience will be a group of all male sales people? If I get into a traffic accident, should I stay in my car with the doors locked until the police arrive?

I realize this kind of thinking isn’t news to anyone who isn’t a cis-het white man. But bear with me a moment.

The worry about safety was something I was expecting. The exhaustion was not.

On top of the exhaustion was the simple opportunity costs: every one of these choices preempted something else I could be doing: finishing up work, coming up with new ideas for the theater, spending time with my kids, etc.

I had lost those opportunities by virtue of no longer operating within the bounds of the normative expectations. I had lost privilege.

A Way to Think About Privilege

This new way of thinking about privilege gave me insight into how to respond to people who reject privilege because they “also work hard” and “have setbacks”.  But one very basic way to understand privilege is to see it as having time opportunity.

While young girls are learning how to dress just so, in order to walk the fine line between too masculine (butch, which could get you beaten up) and too sexual (which could get your rapist acquitted), young boys are learning how to replace an alternator.

While young black boys are learning how to dress and move and behave inside almost any retail store so as to not get accused of shoplifting, young white boys are learning financial literacy.

While professional women are expending time and energy on trying to be heard in the office without being “aggressive,” their male counterparts are making moves to get ahead.

I think you get it.

Opportunity costs driven by the effort required to exist within the normative expectations of a white, heterosexual, patriarchal culture mean extra work to keep up. And more fatigue.

Forks that get used up.

And, yes, everyone has setbacks, obstacles, and problems. But when you’re already using your forks just to exist, it’s that much harder to be resilient. Much less to get ahead.

That some groups don’t have to expend forks as part of being who they are is privilege.

Intersectionality

But for many people, forks get used up in multiple ways simultaneously. This is intersectionality.

Any parent of more than one child will probably tell you that having your second child is more than twice as much work as having one. In addition to the regular care and feeding of the second child, you now have the compounding work of dealing with the interactions between the two.

In much the same way, anyone who has to deal with multiple areas of being “foreign” to the normative expectations has compounding difficulty in maintaining their supply of forks. 

Fewer forks = fewer opportunities.

Mine is a simple example. As an autistic person, I have to expend energy to be seen as a neurotypical (and, in case you’re wondering why I do, try getting a job or landing a contract or making friends when you don’t follow social rules). As a transgender person, I have to expend energy to stay safe, to deal with my kid’s  school’s 1990′s mentality about what having 2 parents looks like, etc.

As an autistic transgender person, I am now also having to learn a whole new set of social customs, expectations, cues, responses, and more in order to “fit in” as a woman, not to mention the difficulty of engaging with people who treat me poorly, refuse to recognize my validity, and more.

It’s little wonder I’m exhausted all the time. 

Now think about the incredible amount of work that it takes for a Black, poor, transgender woman to make her way, and you can see how ridiculous the notion of “just work harder” and “make better choices” is. Good choices are easier when you’re not fatigued out of your mind all the time, and working harder is only possible when you have time and space to do so.

Making Space, Making Forks

You hear people talk all the time about how we’re all going through something, whether it’s visible or invisible. And the biggest thing we can do for each other is to make space, so that it’s easier for us all to get around the way that works best for us.

And yet there’s so much anger and pushback against doing the little things to create space. That it’s too much work to recognize that there is no such thing as the EXEMPLARY, TYPICAL HUMAN, one who has no touch of chronic disease, or ADHD, or autism, or BPD, or depression, or anxiety, or isn’t a white, cis-het male. Ultimately, making space isn’t that hard. All it takes is a moment of consideration and listening. Most accommodations aren’t hard to implement.

For example, some things you can do to make space for autistic people (at least, those like me) include:

Leaving a bit of extra time in conversations for the autistic person to chime in. We often feel stressed when encouraged to “jump in.”

Don’t force an autistic person to address your feelings immediately when something has happened. This can be as simple as a spilling a drink on them, or having said something that hurts their feelings. They’re focused on processing the immediate issue first, internally. They’ll need a moment (or several) before they can address you.

Surprise social situations can be very stressful. Be thoughtful before peer-pressuring an autistic person to do something, even “fun” things like dancing or sharing a story with the group. Help them feel welcome to do so, leave space, and they’ll interact when they’re ready.

Don’t ask autistic people to “read between the lines.” If you have an expectation of them, be as explicit as possible.

Communicating complex ideas can be difficult, especially emotions and feelings, and we often feel angry (at ourselves) and frustrated when we’re not understood. Sometimes we “clam up” – which means that we’re running through the conversation in our head over and over again to try and figure out what went “wrong”. 

Several of us went out to a bar after a recent show and some very lovely audience members were there, and they were enjoying as several improvisers would tell a made-up story about the couple. They then turned to me and said, “Now you, Abby.” I demurred. I was worn out from the day and then the show. I love improv, including performing it, but it does come with a cost in forks. And I was now out of them.

Thankfully, a beautiful friend understood what was going on for me and made a very simple deflection on my behalf. By saying with grace and humor, “We’ve already heard several versions of what didn’t happen, I think it’s time you told us what did!” she effectively shielded me from having to use up my last fork explaining why I was too tired. 

It meant so much to me, and I was able to enjoy the rest of the evening.

A Fork-gone Conclusion

The more space we have to interact as ourselves — that is, not conforming to one very specific, very arbitrary understanding of normative behavior — the more forks we can hold on to, and the more energy we have to be in and a part of the world, our communities, and our families.

[londontherapy]

What is Emotional Distress Psychotherapy and how does It Help?

The emotional elements a person contends with can be very different and unique. How they react to them is also different, and that is why some individuals need to see a psychotherapist. They aren’t sure how to get out of a cycle that isn’t working well for them. They need help to make better choices and to move beyond where they are right now.

There are many different concepts that all under this umbrella. They include depression and low self-esteem. Some individuals are in a tangled web of family issues and disputes due to ongoing dysfunction. Breaking away from such toxic relationships isn’t easy, but it may be a necessary step to feeling better emotionally and to stop walking on egg shells day after day.

Identify Feelings

Emotional distress can be trigged by a traumatic event. This can include the loss of a loved one, changes at work, or changes to the status of a relationship. It can also be ongoing such as when a person is in an abusive relationship or they have ongoing issues with anxiety that affect all they do.

Through psychotherapy sessions, those feelings will be explored. They will be isolated and looked at in depth. What is the person feeling and why do they feel that way? What triggers seem to take the biggest toll on them and cause them to regress to poor habits or behaviors? Feeling in control of emotions means identifying them.

Validate Feelings

As a person is able to validate their feelings, it also allows them to regain control. It is acceptable to feel upset at times or to feel angry. Yet it is how you react and how you take care of such negative feelings that will determine the outcome. A plan of action for next steps that is positive is encouraged.

Many patients don’t have a clue how to do that though. Instead, they repeat the cycle again and again that isn’t working for them. Psychotherapy sessions can break that cycle and help someone to make differnet choices. As a result of those changes, they will see a better outcome for their future and that is encouraging.

Coping Skills

Life isn’t perfect for anyone; there are always challenges and concerns along the way. Yet the coping skills someone has will help them to get over those humps and not be held back by them. Through these sessions, a person can feel empowered as they learn various coping skills that allow them to handle triggers and negative issues as they arise.

Many individuals cope through the use of drugs or alcohol. They rely on it as a crutch but that isn’t a good coping option. Through these sessions, the goal will be to remove those addictive habits and replace them with better choices. Sometimes, the use of medication is necessary along with the therapy when there are underlying mental health concerns.

Help Encourage a Better Life

The quality of life a person has starts with their own well-being. This extends to both the physical and mental status. When a person struggles with emotional distress, it can take a toll on them. It makes it hard to work, to find enjoyment in activities, or to maintain healthy relationships. It also causes health problems for many of them.

This type of psychotherapy can help someone to feel better inside and out. It can help them to try new things, to be accountable for their behaviors, and also to set boundaries so they don’t get taken advantage of by others. Understanding self-worth can be very important for someone who has struggled with low self-esteem.

About Us: At https://www.LondonTherapyFoundation.com you can obtain the very best mental health services. You will attend sessions with qualified professionals who have a passion for assisting others. They are able to customise a treatment plan so you can get the best possible help for your needs. They will challenge you, encourage you, and help you to explore a variety of tools and techniques that can help you have the best quality of life possible. We continue to expand our services and we are dedicated to ensuring everyone has access to affordable services. We offer services for individuals, couples, families, and children. 

[newhologram]

New’s Atlas Subluxation and chronic illness timeline

It’s in my nature at this point to document things and it’s smart to keep track of my healing post-procedure anyway, so I might as well make a timeline here and share the experience as usual :p 

Feel free to ask any questions, it doesn’t bother me at all. We need to let patients be teachers too, I think. 

So here is my atlas subluxation and chronic illness timeline with backstory leading up to the procedure before it gets super specific with dates. I will try to update this during my healing as much as I can to document changes. I’m putting lots of links to posts where I talk about things as well, but you can also go into these tags on my blog to find more information: #personal #atlas subluxation #fibromyalgia #chronic pain #chronic illness #invisible illness #narcolepsy #ulcerative colitis  1.16.17 Posted with info up until this day. 4.12.17 3 month update!

1989: Born December 29th at a 3 1/2 lbs. Taken out prematurely because there was a complication with the umbilical cord and I was no longer growing. I had to stay in an incubator for 11 days until I weighed enough to go home, which was 5 1/2 lbs. It’s unclear whether or not the subluxation was present after birth; it’s possibly that I could’ve been pulled out in a way that caused it, but we have the next event as a definite marker for when things started getting worse. 

Summer of 1996, age 6: While playing with sister I accidentally fractured my collar bone. I went up into the air, I remember seeing the ceiling coming closer, and then I fell straight down onto my back pretty hard. I cried and cried and said over and over again, “I broke something, I broke something” until they took me to the hospital. I vividly remember how I shook when they put me on the table to x-ray me. The doctor cheered me up by pointing out the gas in my chest. But basically they were like yep, there’s a fracture right there. And they sent me home with a sling. I remember that it had dinosaurs on it and it made me happy.

1996~2000, age 6 to 10: Always sick. Daily stomach aches, digestive issues leading to restrictive diet, nausea, back pain, bad posture, fatigue, insomnia, nightmares, sleepwalking, always cold, chronic bronchitis, hypersensitivity to stimulus like sound, light, color, taste, smell, temperature, and even experiences whether positive or negative, auditory processing disorder making it hard to understand what people said, problems with being “too excitable” and having intense reactions to rejection which was hard because I was constantly bullied and controlled by peers for being “weird” and “different”. I struggled in most subjects, but especially math, and I could never really handwrite properly, even to this day. School in general was just very hard because I never felt well and couldn’t keep up with others. Crying on the floor meltdowns whenever there are loud sports games or if a friend goes home early from a sleepover or if a parent gets mad at me (or I think they are). These meltdowns persisted into adulthood. I was always just called dramatic for them.

2001~2009, age 11 to 19: Middleschool and highschool were even harder. I struggled in most classes except for creative ones. Health problems persisted: first sleep paralysis with hallucations episode at age 12 or 13 and often had episodes after school that would eat up my early evening and wear me out mentally, still had problems with bronchitis, ovarian cyst caused me a lot of pain and missed classes, then I started having even worse digestive problems. By age 15 I had my first upper endoscopy and colonoscopy where they discovered ulcers in my esophagus, stomach, and intestines. Feelings of isolation, unable to feel like I could connect with people, noticeable depression, loneliness. First vomiting panic attack at age 17. At 19 did a homestay in Japan; an amazing experience but made difficult by vomiting, fatigue, insomnia, anxiety leaving the house and exploring by myself and freaking out when I got lost.

2010~2016, age 20-26: Health problems begin to worsen in early adulthood. Age 21: I’m vomiting a few times a week and having a ton of other problems, diagnosed with ulcerative colitis. Sleep and fatigue problems making it hard to work at my retail job especially while I’m in college. Age 23: suddenly the sleep paralysis and insomnia are impossible to manage and I go several months with very little sleep, getting worse and worse, every day having looong hard sleep paralysis episodes that leave me with horrible headaches and slurring like I’m drunk. I still go to auditions and work jobs I book as best as I can but get a narcolepsy diagnosis after a long process of sleep study and being yanked around by insurance not letting me actually see the neurologist for my diagnosis. Depression is getting to the point where it almost paralyzes me but I do my best. Health problems cause fights with family. Age 24: not long after the narcolepsy diagnosis: the pain and fatigue become excessive and debilitating and I get the fibromyalgia diagnosis. Condition worsens and worsens, a bump forms on my upper spine that causes horrific pain and distress. 2014 I’m in the ER/urgent care 4 times because the pain makes it unable to rest or stop vomiting for days on end (the most being 6 days where I lost 12lbs). I go to an Ayurvedic healing center because the doctors were useless. There is some improvement but I still struggle, at least I had a lot of good coping tools to keep myself a live, if only barely at times. In bed most days in horrible pain and exhausted by simple things such as getting up to use the restroom. Depression is horrible and a cloud of suicidal urges hang over me for almost 2 years because I feel like a failure who is ruining my family’s happiness by being sick and I feel an intense hatred for myself. I try to work a very mellow part time job at a perfumery but the pain makes it too hard and I’m eventually let go.   Age 25: Depression persists but I force myself to start doing background TV/film work on a weekly basis. Making money helps calm me but it’s incredibly difficult with my health problems and I often vomit on set from fatigue and pain. I start seeing a chiropractor to help alleviate the pain and depression. It helps but I have to see him twice a week at first, then once, then every other week, but during a flare up it’s back to once a week. I also start seeing an acupuncturist which helps with organ function and eases some symptoms but I still have to see her regularly and the expenses add up and cause more problems with my family since I’m barely able to afford them on my own.  Age 26: I get a part time job in retail to help supplement me while I do background work. With the skills I learned I’m able to manage things but I still suffer a lot every day and don’t sleep well because of the pain. Later in the year I stop doing bg work and get an additional part time job. I had accepted long ago that I would be in pain for the rest of my life and that all these tiny minimum wage paychecks I worked so hard through agony for would just go straight into managing my symptoms. I accepted that by age 45 I might be bedridden but at least I was doing my best now in my 20′s and I needed to accept whatever time my body had on this planet and do my best to be a source of light for others going through the same thing.

Starting the week of the December 18th, 2016, I have a lot of work days in a row and I’m slammed with auditions. It’s getting colder and colder, my pain is higher, I don’t have much time to rest. By Christmas Eve I’m in bed all the day with only short sporadic moments up to pee or try to soothe the depression with an activity. It’s so bad I can barely last 20 minutes at times before I have to stumble back to bed green in the face and weak.

This flare up continued until Wednesday, January 11th, 2017. 25 days of high pain and fatigue levels and going a few weeks only able to eat yogurt and a few crackers with one or two proper meals a week if I can. Lots of throwing up, usually two nights in a row, maybe a little break, and then back to it, just horrible persistent deep nausea. This is why I got down to 103lbs. Oops.

So, here’s where the timeline of atlas subluxation discovery and treatment starts:

12.18.16 ~ 1.11.17: Flare up from hell that wouldn’t end. It was suddenly back to the intense high levels I had back in 2014 when I didn’t know all these pain management techniques. Naturally, I was terrified and used every possible coping technique possible to get through it. Since it was so high I was just. Hoo. Each day was a rollercoaster. The pain gives me hella moodswings. Zip, zip, had to just keep it zipped as much as I could so I didn’t look like an asshole. If I had to work one shift I basically had to make sure I didn’t do ANYTHING beforehand to save those spoons and keep the pain from spiking, but I didn’t want to pass up auditions so I forced myself to a few. The pain got so bad I couldn’t even sit up in bed most nights. Missed a lot of work. Had to meditate like crazy to keep positive thoughts in the front of my brain but it was very difficult.

1.5.17: Barely clinging to positivity but trying my best, since I’m always in bed I work up the strength with a LOT of rest and pain management to play a little Pokemon. Meanwhile I’m trying to work on gross crunchy calcium in the back of my neck (yeah, it’s nasty) and this huge chunk comes off inside my neck, like just... a crunchy chip floating in there that I could move and scrape against my neck

UM. I YELLED and immediately posted about it and freaked out because by googling “hard crunchy back of neck floating” I discovered atlas subluxation. http://newvagabond.tumblr.com/post/155495266822/atlas-orthogonal-changed-my-life-migraines

1.6.17: Appointment with primary care physician to update her on my rapidly worsening condition and talk to her about atlas subluxation. She got flustered and was saying, “this isn’t something the healthcare system considers as treatment” and I was like WHY and at this point I was done being pushed around and I said many times, “Sorry, I just need you to hear everything that I’m saying” as I went over this whole page of notes I made for her about how this procedure could give me my life back. I lamb’d her into submission in order to get her to write several referrals to try to find someone. All she could do was refer me to the bone doctor and the neurologist.

GUYS IT’S LITERALLY LIKE, oh, your brain and body are breaking down because this one bone might be out of place? It’s that simple and obvious and we can find it in x-rays easily if we know what we’re looking for and there are already specialists who do this specific adjustment around the world?

Hmm... nahhh... nah... don’t even check there. Just treat this girl’s depression and pain with drugs FIRST, before we determine that it’s the organs themselves with the deficiency. We’ll just try that and see what happens, $50 please. I have been on 3 different depression/anxiety meds, zofran, xanax, ativan, tramadol, various colon steroids?? Just a ton of crap.

Even knowing I will need to pay an atlas doc out of pocket, I get so depressed that I can’t even bring myself to make a phone call for an appointment. 

1.11.17: Crying and screaming level of pain, very weak, depression so intense all I could think while obviously very, very ill was “I’m the worst/I should die/I’m just a problem/I’m ruining my dad’s life/I’m an unreliable loser and all my coworkers and employers think I’m lazy and dumb/no one likes me because I’m too weird and always sick” etc etc. My dad almost took me to the hospital because the pain was just way too intense and making me lose my shit. 

1.12.17, day of procedure: In the morning my dad called me and suggested we just do it, just call one of those specialists. I was in no state to make phone calls so he did it for me. He picked the closest one and called her. He said, “my daughter has fibromyalgia and she’s in bad shape” and the doctor said we could come in that day.

My post after the adjustment describing the experience with photos Even walking is different Other details about the visit Brain activity is high at bedtime but I can feel my body 1.13.17, day after procedure: Wake up sharp at 8am, do yoga. Got some pretty intense back and neck pains and fatigue but it’s different. I feel sore and aching like my body is letting go after holding onto something for a long time. I have an appetite.  Talking about how this is the first doctor I’ve ever met who was just so confident in her ability to help me instead of shrugging and giving me drugs Reeling because everything is making so much sense and how our medical system is awful Prophetic dream? 1.14.17, day 2: Went to school, had fun because I could think properly. My dad took me to do errands after. I got really tired and had pain but it was still very different. We picked up some suggestions the doc gave me to help my body during the healing process. Thinking about how crazy it is that my body is going to be slowly adjusting and healing over the next year or so More thoughts as I feel my body change and think about what lead up to all this Hope and healing Already seeing a drastic change in sleep

1.15.17, day 3: Back to work at my retail job. Kind of difficult because I’m under strict orders from the doctor not to lift more than 5lbs as not to make my atlas go back out of whack. Lots of pain and fatigue by noon from having to use my body so much. But brain is still sharp, having fun with customers.  On my break I start looking up atlas subluxation and how it affects a child’s brain development since I realize that this means that I grew up with a compressed brain stem. Unfamiliar feeling of peace and calm Sad thoughts remembering my childhood Suspicious of the medical system not recognizing this A thank you to friends and followers during this hugely important time

1.16.17, day 4: Day off. Pain levels got pretty high so I did my best to rest a lot. I was too tired to play more than a little video games.  Noticing I look different in pictures Anon asks if the bump on my spine is gone More research, ebook with alarming symptoms that match mine Exposing a secret Text post talking about the pain and family members looking into this now/ Meant to be Stepping stones Having another look at my MRI More info 1.17.17, day 5: Very tired. Slept in until 9am, managed to do 5 pushups, yoga, and some light hula hooping. Had a good breakfast and got about an hour of editing done by 11:30 before I was just way too tired, so I napped until a little after 1 and had a small lunch. The pain wasn’t so bad, it was mostly fatigue. I ended up needing another 30 minute nap before I went to work. I felt kind of depressed but I’m not sure if it’s because of my worry about work. I worked today and I have to work tomorrow, I’m just worried 2 days in a row will be rough like it usually is. I still really wish I could just take time off completely and not force myself through these shifts. But I don’t want to lose my jobs. :( We’ll see. Epic upper body spasm while trying to make a snack 1.18.17, day 6: I slept really well despite waking up randomly at 3. I felt calm and warm without my heated blanket on for awhile, and fell back asleep easily. I ate a really good breakfast and lunch and work wasn’t too bad. I’m still very sore and aching, and having to move around so much definitely doesn’t help that. My mood was back up again, but I do feel a bit emotionally overwhelmed by all this information. I’m feeling anger and the urge to call my primary care doctor and ask her how she can even call herself a doctor.  Wondering what differences my acupuncturist will notice Crooked glasses no crooked atlas yes Sharper brain at work Frustration and wondering how much worse I would’ve gotten Positivity is important but it doesn’t fix a spine by itself Happy to have answers but feeling a lot of sadness 1.19.17, day 7 and my follow up with the atlas orthogonal doctor: Follow up post here with “after” x-ray pics Thoughts on Snapchat Ashwagandha Lots of fatigue and also depressive mood swings keeping me in bed.  1.20.17, day 8: Fun day out with a friend, very much needed. She got me a gemstone for spinal alignment! Pain wasn’t too bad all day and by 5pm I was getting tired. VERY squirmy feelings. 

Atlas noise is grossing me out Dear my body Reflection on my experience in the crystal store and how life has been the past 4 years being so sick Thinking about a classmate saying something kind of inappropriate 1.21.17, day 9: Bad depression and fatigue. Missed school and had a really rough time at work. 1.22.17, day 10: Mood improved a lot, felt okay at work and had a good massage. Super hungry.  Sat at my desk for so long! But also so much wiggliness that I hate 

1.23.17, day 11: I felt good so I vlogged a lot! I pushed it a little and had to rest a lot after though, oops. 

Pain is high at bedtime, I need some kind of memory foam pillow 1.24.17, day 12: Acupuncture appointment went well, she was pretty amazed. Worked, pain came and went. Felt energetic. Even played OW when I got home. Depression is coming in smaller waves now but they’re still strong and can knock me over. Answering an ask about x-rays Another ask about fixing the atlas yourself Depression coping tips

1.25.17, day 13: A lot of depression first half of the day. It got better once I got to work. Pain got up there at night but I managed to get some OW in. Forgot to buy spicy patches but I have a new magnesium oil spray.

Brain reprogramming

1.26.17, day 14: Went to the market by myself and regretted it because I ended up in bad pain by 11am. Didn’t get much done the whole day, slept on and off like a toddler. 

Thoughts on growing up Spoonie snaps: food and owies Night sweats pretty much gone 1.27.17, day 15: Another day of lots of pain and fatigue, but I managed to do a little bit and play some games. The impact of choosing not to suffer in silence Fatigue depression

2.6.17, day... omg idfk! I’ve been so wiped out I haven’t had the energy to sit at my desk and keep this updated. 

Basically, things have still been a wild ride. I had a little over a week of high pain levels and fatigue but thankfully no vomiting, but looots of depression and badbrain. I’ve been doing my best to manage everything and stay on top of my self-care routine as usual. Each day is different and things are changing little by little. 

Since so many of my updates/thoughts are in text posts I’ll just link them like I was already doing. 

1.28.17 Chronic pain problem of trying to time medicating

1.29.17 I feel like I’m not allowed to rest One day I’ll be big and strong Recent snaps of pain management and finding comfort in cats and facemasks

1.30.17 PMS messing me up and such

1.31.17 Before and after x-rays and thoughts about my MRIs Got an adjustment at my regular chiro and it went great

2.1.17 Recent snaps of special spine pillow and such Missing gaming because too much pain ;(

2.2.17 Vlog teaser: working on medical marijuana vlogs! Advice for an anon Relating to a follower about overstimulation caused by a new pain

2.3.17 Spoonie actor visibility Snapchat story Heard back from the MyStrength people Intense flare with bad spine and rib pain and fever

2.4.17 Vlog about getting my handicap parking placard

2.5.17 Tonsil stones ; ; Morning depression Spoonies, Stay (about spoonie suicide) Intrusive thoughts, healing is painful, and on being a late bloomer

3.14.17

Time has gotten away from me. It’s hard to keep track of things. I’m having good days but more bad days. Lots of swelling in my upper neck now. Video here to show how big it gets http://newvagabond.tumblr.com/post/158336271242/this-is-what-i-mean-when-i-say-ow-my-upper-spine possibly because I didn’t rest and stuff, chiro had to do a lot

Depression was pretty bad too. And there’s been a huge weather change. It’s possibly that’s related to my flare up. Feeling hopeless.

Frustration at being told I’m lucky to be so skinny when I am skinny because of health problems Going to school in pain and realizing other people don’t have any idea what this is like  Spine pain feels like spine is moving slowly, like braces on teeth Feeling pressured to work when my body is not well I wish I’d known it’s not normal Bad pain, acupuncture, experimenting with oils Threw up for the first time since January  Being happy isn’t only for the neurotypical ER doctors hate us Malingering, teachers thinking I was faking Low spoons from having to keep up with people who have near infinite spoons

March got better towards the end with more frequent massage and me getting very serious about my Ayurveda self-care routine. Yoga deep stretch 2x a day, strict rest breaks, lots of ashwagandha, etc. Sleep became difficult again, both at night and during the day. 

Neurological tics and SP Spine spoonie end of March Appreciate the time a spoonie gives you Emotional detox the past 4 years Low pain day despite stress and activity ?? didn’t have to medicate until 9pm Ashwagandha powder feeling changes Two days in a row of low pain and good brain function Survival is anything but typical More ashwa goodness Glass half full Suddenly back to being in bed most of the day Medical records showing just how incompetent my old docs were What does it mean to be strong? Spine swelling stealing my days I want a spinal implant Spoonies are always performing Losing friends when you get sick

Sesame oil and hot/cold pack life New vape cartridge for spine pain relief! Golden milk with ashwagandha every night!

Had a very busy week even with low pain days and got worn out after 6 days, high pain, but still great mood. I felt very positive and optimistic. Reality felt very strange with low pain. But I was back to my usual struggle the next week. 

I still feel very much like the only way people will take my health seriously is if I push myself into collapsing. Also spine is so noisy when I do my yoga. I got my tax return and I’m so thankful because I was able to stock up on pain relief products! But I’m still kinda worried about the neurological symptoms I’m having.

 I saw my new doctor and was really surprised.

4.12.17 3 month update and thoughts.

[stephenmccull]

For Seniors, COVID-19 Sets Off A Pandemic Of Despair

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

We Want To Hear From You

Are you a senior who is affected by COVID-19? Tell us what you’re seeing, and help us report on important, untold stories. Contact us at covidtips@kff.org.

Email Us

As states relax coronavirus restrictions, older adults are advised, in most cases, to keep sheltering in place. But for some, the burden of isolation and uncertainty is becoming hard to bear.

This “stay at home awhile longer” advice recognizes that older adults are more likely to become critically ill and die if infected with the virus. At highest risk are seniors with underlying medical conditions such as heart, lung or autoimmune diseases.

Yet after two months at home, many want to go out into the world again. It is discouraging for them to see people of other ages resume activities. They feel excluded. Still, they want to be safe.

“It’s been really lonely,” said Kathleen Koenen, 77, who moved to Atlanta in July after selling her house in South Carolina. She’s living in a 16th-floor apartment while waiting to move into a senior housing community, which has had cases of COVID-19.

“I had thought that would be a new community for me, but everyone there is isolated,” Koenen said. “Wherever we go, we’re isolated in this situation. And the longer it goes on, the harder it becomes.”

(Georgia residents age 65 and older are required to shelter in place through June 12, along with other vulnerable populations.)

Her daughter, Karestan Koenen, is a professor of psychiatric epidemiology at Harvard University’s T.H. Chan School of Public Health. During a Facebook Live event this month, she said her mother had felt in March and April that “everyone was in [this crisis] together.” But now, that sense of communality has disappeared.

Making it worse, some seniors fear that their lives may be seen as expendable in the rush to reopen the country.

“[Older adults] are wondering if their lives are going to end shortly for reasons out of their control,” said Dr. Linda Fried, dean of the Mailman School of Public Health at Columbia University, in a university publication. “They’re wondering if they’ll be able to get the care they need. And most profoundly, they’re wondering if they are going to be cast out of society. If their lives have value.”

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On the positive side, resilience is common in this age group. Virtually all older adults have known adversity and loss; many have a “this too shall pass” attitude. And research confirms that they tend to be adept at regulating their reactions to stressful life events — a useful skill in this pandemic.

“If anything, I’ve seen a very strong will to live and acceptance of whatever one’s fate might be,” said Dr. Marc Agronin, a geriatric psychiatrist and vice president of behavioral health at Miami Jewish Health, a 20-acre campus with independent living, assisted living, nursing home care and other services.

Several times a week, psychologists, nurses and social workers are calling residents on the campus, doing brief mental health checks and referring anyone who needs help for follow-up attention. There’s “a lot of loneliness,” Agronin said, but many seniors are “already habituated to being alone or are doing OK with contact [only] from staff.”

Still, “if this goes on much longer,” he said, “I think we’ll start to see less engagement, more withdrawal, more isolation — a greater toll of disconnection.”

Erin Cassidy-Eagle, a clinical associate professor of psychiatry at Stanford University, shares that concern.

From mid-March to mid-April, all her conversations with older patients revolved around several questions: “How do we keep from getting COVID-19? How am I going to get my needs met? What’s going to happen to me?”

But more recently, Cassidy-Eagle said, “older adults have realized the course of being isolated is going to be much longer for them than for everyone else. And sadness, loneliness and some hopelessness have set in.”

She tells of a woman in her 70s who moved into independent living in a continuing care community because she wanted to build a strong social network. Since March, activities and group dining have been canceled. The community’s director recently announced that restrictions would remain until 2021.

“This woman had a tendency to be depressed, but she was doing OK,” Cassidy-Eagle said. “Now she’s incredibly depressed and she feels trapped.”

Especially vulnerable during this pandemic are older adults who have suffered previous trauma. Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in New York City, has seen this happen to several patients, including a Holocaust survivor in her 90s.

This woman lives with her son, who got COVID-19. Then she did as well. “It’s like going back to the terror of the [concentration] camp,” Kennedy said, “an agonizing emotional flashback.”

Jennifer Olszewski, an expert in gerontology at Drexel University, works in three nursing homes in the Philadelphia area. As is true across most of the country, no visitors are allowed and residents are mostly confined to their rooms.

“I’m seeing a lot of patients with pronounced situational depression,” she said — “decreased appetite, decreased energy, a lack of motivation and overall feelings of sadness.”

“If this goes on for months longer, I think we’ll see more people with functional decline, mental health decline and failure to thrive,” Olszewski said.

Some are simply giving up. Anne Sansevero, a geriatric care manager in New York City, has a 93-year-old client who plunged into despair after her assisted living facility went on lockdown in mid-March. Antidepressant and anti-anxiety medications have not helped.

“She’s telling her family and her health aides ‘life’s not worth living. Please help me end it,’” Sansevero said. “And she’s stopped eating and getting out of bed.”

The woman’s attentive adult children are doing all they can to comfort their mother at a distance and are feeling acute anguish.

What can be done to ease this sort of psychic pain? Kennedy of Montefiore has several suggestions.

“Don’t try to counter the person’s perception and offer false reassurance. Instead, say, yes, this is bad, no doubt about it. It’s understandable to be angry, to be sad. Then provide a sense of companionship. Tell the person, ‘I can’t change this situation but I can be with you. I’ll call tomorrow or in a few days and check in with you again.’”

“Try to explore what made life worth living before the person started feeling this way,” she said. “Remind them of ways they’ve coped with adversity in the past.”

If someone is religiously-inclined, encourage them to reach out to a pastor or a rabbi. “Tell them, I’d like to pray together or read this Bible passage and discuss it,” Kennedy said. “Comforting person-to-person interaction is a very effective form of support.”

Do not count on older adults to own up to feeling depressed. “Some people will acknowledge that, yes, they’ve been feeling sad, but others may describe physical symptoms — fatigue, difficulty sleeping, difficulty concentrating,” said Julie Lutz, a geropsychologist and postdoctoral fellow at the University of Rochester.

If someone has expressed frequent concerns about being a burden to other people or has become notably withdrawn, that’s a worrisome sign, Lutz said.

In nursing homes, ask for a referral to a psychologist or social worker, especially for a loved one who’s recovering from a COVID hospitalization.

“Almost everybody that I’m seeing has some kind of adjustment disorder because their whole worlds have been turned upside down,” said Eleanor Feldman Barbera, an elder care psychologist in New York City. “Talking to a psychologist when they first come in can help put people on a good trajectory.”

The National Alliance on Mental Illness has compiled a COVID-19 information and resource guide, available at https://www.nami.org/covid-19-guide. The American Psychological Association has created a webpage devoted to this topic and recently wrote about finding local mental health resources. The Substance Abuse and Mental Health Services Administration has a 24-hour hotline, 1-800-662-4357. And the national suicide prevention hotline for those in acute distress is 1-800-273-8255.

For Seniors, COVID-19 Sets Off A Pandemic Of Despair published first on https://smartdrinkingweb.weebly.com/

[gordonwilliamsweb]

For Seniors, COVID-19 Sets Off A Pandemic Of Despair

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

We Want To Hear From You

Are you a senior who is affected by COVID-19? Tell us what you’re seeing, and help us report on important, untold stories. Contact us at covidtips@kff.org.

Email Us

As states relax coronavirus restrictions, older adults are advised, in most cases, to keep sheltering in place. But for some, the burden of isolation and uncertainty is becoming hard to bear.

This “stay at home awhile longer” advice recognizes that older adults are more likely to become critically ill and die if infected with the virus. At highest risk are seniors with underlying medical conditions such as heart, lung or autoimmune diseases.

Yet after two months at home, many want to go out into the world again. It is discouraging for them to see people of other ages resume activities. They feel excluded. Still, they want to be safe.

“It’s been really lonely,” said Kathleen Koenen, 77, who moved to Atlanta in July after selling her house in South Carolina. She’s living in a 16th-floor apartment while waiting to move into a senior housing community, which has had cases of COVID-19.

“I had thought that would be a new community for me, but everyone there is isolated,” Koenen said. “Wherever we go, we’re isolated in this situation. And the longer it goes on, the harder it becomes.”

(Georgia residents age 65 and older are required to shelter in place through June 12, along with other vulnerable populations.)

Her daughter, Karestan Koenen, is a professor of psychiatric epidemiology at Harvard University’s T.H. Chan School of Public Health. During a Facebook Live event this month, she said her mother had felt in March and April that “everyone was in [this crisis] together.” But now, that sense of communality has disappeared.

Making it worse, some seniors fear that their lives may be seen as expendable in the rush to reopen the country.

“[Older adults] are wondering if their lives are going to end shortly for reasons out of their control,” said Dr. Linda Fried, dean of the Mailman School of Public Health at Columbia University, in a university publication. “They’re wondering if they’ll be able to get the care they need. And most profoundly, they’re wondering if they are going to be cast out of society. If their lives have value.”

Don't Miss A Story

Subscribe to KHN’s free Weekly Edition newsletter.

Sign Up

Please confirm your email address below:

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On the positive side, resilience is common in this age group. Virtually all older adults have known adversity and loss; many have a “this too shall pass” attitude. And research confirms that they tend to be adept at regulating their reactions to stressful life events — a useful skill in this pandemic.

“If anything, I’ve seen a very strong will to live and acceptance of whatever one’s fate might be,” said Dr. Marc Agronin, a geriatric psychiatrist and vice president of behavioral health at Miami Jewish Health, a 20-acre campus with independent living, assisted living, nursing home care and other services.

Several times a week, psychologists, nurses and social workers are calling residents on the campus, doing brief mental health checks and referring anyone who needs help for follow-up attention. There’s “a lot of loneliness,” Agronin said, but many seniors are “already habituated to being alone or are doing OK with contact [only] from staff.”

Still, “if this goes on much longer,” he said, “I think we’ll start to see less engagement, more withdrawal, more isolation — a greater toll of disconnection.”

Erin Cassidy-Eagle, a clinical associate professor of psychiatry at Stanford University, shares that concern.

From mid-March to mid-April, all her conversations with older patients revolved around several questions: “How do we keep from getting COVID-19? How am I going to get my needs met? What’s going to happen to me?”

But more recently, Cassidy-Eagle said, “older adults have realized the course of being isolated is going to be much longer for them than for everyone else. And sadness, loneliness and some hopelessness have set in.”

She tells of a woman in her 70s who moved into independent living in a continuing care community because she wanted to build a strong social network. Since March, activities and group dining have been canceled. The community’s director recently announced that restrictions would remain until 2021.

“This woman had a tendency to be depressed, but she was doing OK,” Cassidy-Eagle said. “Now she’s incredibly depressed and she feels trapped.”

Especially vulnerable during this pandemic are older adults who have suffered previous trauma. Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in New York City, has seen this happen to several patients, including a Holocaust survivor in her 90s.

This woman lives with her son, who got COVID-19. Then she did as well. “It’s like going back to the terror of the [concentration] camp,” Kennedy said, “an agonizing emotional flashback.”

Jennifer Olszewski, an expert in gerontology at Drexel University, works in three nursing homes in the Philadelphia area. As is true across most of the country, no visitors are allowed and residents are mostly confined to their rooms.

“I’m seeing a lot of patients with pronounced situational depression,” she said — “decreased appetite, decreased energy, a lack of motivation and overall feelings of sadness.”

“If this goes on for months longer, I think we’ll see more people with functional decline, mental health decline and failure to thrive,” Olszewski said.

Some are simply giving up. Anne Sansevero, a geriatric care manager in New York City, has a 93-year-old client who plunged into despair after her assisted living facility went on lockdown in mid-March. Antidepressant and anti-anxiety medications have not helped.

“She’s telling her family and her health aides ‘life’s not worth living. Please help me end it,’” Sansevero said. “And she’s stopped eating and getting out of bed.”

The woman’s attentive adult children are doing all they can to comfort their mother at a distance and are feeling acute anguish.

What can be done to ease this sort of psychic pain? Kennedy of Montefiore has several suggestions.

“Don’t try to counter the person’s perception and offer false reassurance. Instead, say, yes, this is bad, no doubt about it. It’s understandable to be angry, to be sad. Then provide a sense of companionship. Tell the person, ‘I can’t change this situation but I can be with you. I’ll call tomorrow or in a few days and check in with you again.’”

“Try to explore what made life worth living before the person started feeling this way,” she said. “Remind them of ways they’ve coped with adversity in the past.”

If someone is religiously-inclined, encourage them to reach out to a pastor or a rabbi. “Tell them, I’d like to pray together or read this Bible passage and discuss it,” Kennedy said. “Comforting person-to-person interaction is a very effective form of support.”

Do not count on older adults to own up to feeling depressed. “Some people will acknowledge that, yes, they’ve been feeling sad, but others may describe physical symptoms — fatigue, difficulty sleeping, difficulty concentrating,” said Julie Lutz, a geropsychologist and postdoctoral fellow at the University of Rochester.

If someone has expressed frequent concerns about being a burden to other people or has become notably withdrawn, that’s a worrisome sign, Lutz said.

In nursing homes, ask for a referral to a psychologist or social worker, especially for a loved one who’s recovering from a COVID hospitalization.

“Almost everybody that I’m seeing has some kind of adjustment disorder because their whole worlds have been turned upside down,” said Eleanor Feldman Barbera, an elder care psychologist in New York City. “Talking to a psychologist when they first come in can help put people on a good trajectory.”

The National Alliance on Mental Illness has compiled a COVID-19 information and resource guide, available at https://www.nami.org/covid-19-guide. The American Psychological Association has created a webpage devoted to this topic and recently wrote about finding local mental health resources. The Substance Abuse and Mental Health Services Administration has a 24-hour hotline, 1-800-662-4357. And the national suicide prevention hotline for those in acute distress is 1-800-273-8255.

For Seniors, COVID-19 Sets Off A Pandemic Of Despair published first on https://nootropicspowdersupplier.tumblr.com/

[dinafbrownil]

For Seniors, COVID-19 Sets Off A Pandemic Of Despair

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

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We Want To Hear From You

Are you a senior who is affected by COVID-19? Tell us what you’re seeing, and help us report on important, untold stories. Contact us at covidtips@kff.org.

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As states relax coronavirus restrictions, older adults are advised, in most cases, to keep sheltering in place. But for some, the burden of isolation and uncertainty is becoming hard to bear.

This “stay at home awhile longer” advice recognizes that older adults are more likely to become critically ill and die if infected with the virus. At highest risk are seniors with underlying medical conditions such as heart, lung or autoimmune diseases.

Yet after two months at home, many want to go out into the world again. It is discouraging for them to see people of other ages resume activities. They feel excluded. Still, they want to be safe.

“It’s been really lonely,” said Kathleen Koenen, 77, who moved to Atlanta in July after selling her house in South Carolina. She’s living in a 16th-floor apartment while waiting to move into a senior housing community, which has had cases of COVID-19.

“I had thought that would be a new community for me, but everyone there is isolated,” Koenen said. “Wherever we go, we’re isolated in this situation. And the longer it goes on, the harder it becomes.”

(Georgia residents age 65 and older are required to shelter in place through June 12, along with other vulnerable populations.)

Her daughter, Karestan Koenen, is a professor of psychiatric epidemiology at Harvard University’s T.H. Chan School of Public Health. During a Facebook Live event this month, she said her mother had felt in March and April that “everyone was in [this crisis] together.” But now, that sense of communality has disappeared.

Making it worse, some seniors fear that their lives may be seen as expendable in the rush to reopen the country.

“[Older adults] are wondering if their lives are going to end shortly for reasons out of their control,” said Dr. Linda Fried, dean of the Mailman School of Public Health at Columbia University, in a university publication. “They’re wondering if they’ll be able to get the care they need. And most profoundly, they’re wondering if they are going to be cast out of society. If their lives have value.”

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On the positive side, resilience is common in this age group. Virtually all older adults have known adversity and loss; many have a “this too shall pass” attitude. And research confirms that they tend to be adept at regulating their reactions to stressful life events — a useful skill in this pandemic.

“If anything, I’ve seen a very strong will to live and acceptance of whatever one’s fate might be,” said Dr. Marc Agronin, a geriatric psychiatrist and vice president of behavioral health at Miami Jewish Health, a 20-acre campus with independent living, assisted living, nursing home care and other services.

Several times a week, psychologists, nurses and social workers are calling residents on the campus, doing brief mental health checks and referring anyone who needs help for follow-up attention. There’s “a lot of loneliness,” Agronin said, but many seniors are “already habituated to being alone or are doing OK with contact [only] from staff.”

Still, “if this goes on much longer,” he said, “I think we’ll start to see less engagement, more withdrawal, more isolation — a greater toll of disconnection.”

Erin Cassidy-Eagle, a clinical associate professor of psychiatry at Stanford University, shares that concern.

From mid-March to mid-April, all her conversations with older patients revolved around several questions: “How do we keep from getting COVID-19? How am I going to get my needs met? What’s going to happen to me?”

But more recently, Cassidy-Eagle said, “older adults have realized the course of being isolated is going to be much longer for them than for everyone else. And sadness, loneliness and some hopelessness have set in.”

She tells of a woman in her 70s who moved into independent living in a continuing care community because she wanted to build a strong social network. Since March, activities and group dining have been canceled. The community’s director recently announced that restrictions would remain until 2021.

“This woman had a tendency to be depressed, but she was doing OK,” Cassidy-Eagle said. “Now she’s incredibly depressed and she feels trapped.”

Especially vulnerable during this pandemic are older adults who have suffered previous trauma. Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in New York City, has seen this happen to several patients, including a Holocaust survivor in her 90s.

This woman lives with her son, who got COVID-19. Then she did as well. “It’s like going back to the terror of the [concentration] camp,” Kennedy said, “an agonizing emotional flashback.”

Jennifer Olszewski, an expert in gerontology at Drexel University, works in three nursing homes in the Philadelphia area. As is true across most of the country, no visitors are allowed and residents are mostly confined to their rooms.

“I’m seeing a lot of patients with pronounced situational depression,” she said — “decreased appetite, decreased energy, a lack of motivation and overall feelings of sadness.”

“If this goes on for months longer, I think we’ll see more people with functional decline, mental health decline and failure to thrive,” Olszewski said.

Some are simply giving up. Anne Sansevero, a geriatric care manager in New York City, has a 93-year-old client who plunged into despair after her assisted living facility went on lockdown in mid-March. Antidepressant and anti-anxiety medications have not helped.

“She’s telling her family and her health aides ‘life’s not worth living. Please help me end it,’” Sansevero said. “And she’s stopped eating and getting out of bed.”

The woman’s attentive adult children are doing all they can to comfort their mother at a distance and are feeling acute anguish.

What can be done to ease this sort of psychic pain? Kennedy of Montefiore has several suggestions.

“Don’t try to counter the person’s perception and offer false reassurance. Instead, say, yes, this is bad, no doubt about it. It’s understandable to be angry, to be sad. Then provide a sense of companionship. Tell the person, ‘I can’t change this situation but I can be with you. I’ll call tomorrow or in a few days and check in with you again.’”

“Try to explore what made life worth living before the person started feeling this way,” she said. “Remind them of ways they’ve coped with adversity in the past.”

If someone is religiously-inclined, encourage them to reach out to a pastor or a rabbi. “Tell them, I’d like to pray together or read this Bible passage and discuss it,” Kennedy said. “Comforting person-to-person interaction is a very effective form of support.”

Do not count on older adults to own up to feeling depressed. “Some people will acknowledge that, yes, they’ve been feeling sad, but others may describe physical symptoms — fatigue, difficulty sleeping, difficulty concentrating,” said Julie Lutz, a geropsychologist and postdoctoral fellow at the University of Rochester.

If someone has expressed frequent concerns about being a burden to other people or has become notably withdrawn, that’s a worrisome sign, Lutz said.

In nursing homes, ask for a referral to a psychologist or social worker, especially for a loved one who’s recovering from a COVID hospitalization.

“Almost everybody that I’m seeing has some kind of adjustment disorder because their whole worlds have been turned upside down,” said Eleanor Feldman Barbera, an elder care psychologist in New York City. “Talking to a psychologist when they first come in can help put people on a good trajectory.”

The National Alliance on Mental Illness has compiled a COVID-19 information and resource guide, available at https://www.nami.org/covid-19-guide. The American Psychological Association has created a webpage devoted to this topic and recently wrote about finding local mental health resources. The Substance Abuse and Mental Health Services Administration has a 24-hour hotline, 1-800-662-4357. And the national suicide prevention hotline for those in acute distress is 1-800-273-8255.

from Updates By Dina https://khn.org/news/for-seniors-covid-19-sets-off-a-pandemic-of-despair/

[torturedwarrior]

Healthy ways to deal with mental illness:

What is mental illness? Mental illnesses are conditions of health involving (or a combination of) changes in emotion, thinking, or behavior. In social, work or family activities, mental illnesses are associated with distress and/or problems. Nearly one in five (19%) adults in the U.S. experience some form of mental illness, one in 24 (4.1%) has a serious mental illness * one in 12 (8.5%) has a diagnosed substance use disorder. “There’s only us. There’s only this. Forget regret, or life is yours to miss. No other road. No other way, no day but today.” — “No Day but Today,” Rent (submitted by Colleen McDaniel). It takes time and patience to find the right coping mechanism, but it can have a huge impact on how you feel. If you haven't had success with the strategies you've used, or you're looking to add a few more to your toolkit, here are seven coping mechanisms that are worth trying out suggested by mental health professionals. They are Radical Acceptance, Deep Breathing, Opposite to emotion thinking, the five senses, Mental Reframing, and Emotion awareness.

Radical Acceptance- According to Marsha Linehan (creator of dialectal behavior therapy), progressive tolerance means "fully and absolutely embracing something from the core of your soul, with your heart and mind." The idea that no matter what, you can't change a situation is included in this definition. Imagine, for instance, that a tornado is coming. Obviously, to stop the tornado you can't do anything; it's not possible. But if you agree that it's coming, you can respond, plan and stay safe. If you're lying there hoping to get the storm to stop or pretend there's no tornado, when it arrives, you'll be in real trouble. The same applies to the illness of the mind. They can't change the fact you're having a mental disorder, so any time you're wasting trying to "get rid of it" or pretending it doesn't exist just drains precious energy from them. Grant. Accept. Consider the state you are in. Then take the steps you need to take care of yourself.

Deep Breathing-At this level, relaxing is an irritating cliché, but that's because breathing deeply is really the best way to relax fear. I switched to the idea of "5 3 7" breathing while combating my own anxiety: breathe in for 5 seconds Keep the air for 3 seconds Breathe out for 7 seconds This subtle repetition sends a message to the brain that all is well (or soon). Your heart will slow its pace soon, and you'll start relaxing — sometimes without even realizing it. Opposite to emotion thinking-That's how it sounds: the instincts command you to behave in the opposite way. Say you're angry and you need to separate yourself. Reverse-to-emotion urges you to go out and be with men, isolation's reverse behavior. Fight that with something calming like meditation when you feel anxious. Switch to something that stabilizes you while you feel manic. Perhaps this strategy is one of the toughest to put into play, but the outcomes are amazing if you can do it.

The use of a technique called "the five senses" is another effective method of using the physical space to help you perceive the crisis. Instead of concentrating on a particular object, "the 5 senses" shows you what each of the senses feels in that moment. As an example, think of a PTSD flashback in the classroom. Save it! Stop it! Look around you. Look around you. See the clock's hand movement. Feel under you the chair. Listen to the voice of your professor. Smell the chalkboard's faint scent. Chew a rubber slice. It takes only a few seconds to pass through your senses and helps you keep up with what is real, what is happening right now. Mental reframing involves taking and thinking differently about an emotion or stressor. Take traffic, for instance, to get stuck. Yeah, you might say, "Oh, my life is terrible. It's awful. Due to this rain, I'll be late. Why is this happening to me always? “Or you can reframe the thought that might seem like it," The traffic is bad, but I'm still going to get where I go. I can do nothing, so I'm just going to listen to music or an audiobook to spend time. "Perfecting this technology literally can change your point of view in difficult situations. But this ability takes time and practice, as you might imagine.

Emotion Awareness- If you live in denial, it will take much longer to care for your emotions, because once we realize what we feel, we can deal with it or what it causes. So, if you're afraid, take a few minutes to meditate, let's you be anxious. If you're angry, just get angry— then listen to some soothing music. Taking your feelings into account. Allow yourself to feel like you are, and then take action to reduce unhealthy feelings. You can't control your psychological condition, but you can monitor how you react to your symptoms. This isn't easy or easy (like everything else with mental illness), but it can make you feel better emotionally, spiritually and physically by learning, practicing and perfecting treatments. I have tried all of the above approaches and changed the way I deal with the challenges of mental health. To heal from mental disease, it takes strength and determination–in the expectation of feeling better, to try to battle symptoms. You are incredibly strong to survive them, even if you feel weak or helpless about your daily battles. Simple and practical methods can help you fight. Consider these techniques, and the way you feel and live your life will change clearly.

9 Questions Someone with Mental Illness Wishes You Would Ask: Can you help me understand what it’s like living with your condition? Is there anything you need from me or something I can do to help you? Can we do something together – get coffee, go for a walk or see a movie? (Just because the person has mental illness doesn’t mean he/she won’t want to do regular activities), What is your diagnosis and how do you feel about it?, Do you need to talk?, Sometimes talking can help make things feel a little better, What can I do to be there for you, and help you feel supported?, How can I support you – can I listen to you, leave you alone, give you a hug?,  How has living with this condition shaped who you are today?, How are you? You don’t seem like yourself, and I want to know how you’re really feeling because I care about you. “Happiness can be found even in the darkest of times, if one only remembers to turn on the light.” — Albus Dumbledore from “Harry Potter and the Prisoner of Azkaban” (submitted by Eva Gigis). “Sometimes you climb out of bed in the morning and you think, I’m not going to make it, but you laugh inside — remembering all the times you’ve felt that way.”— Charles Bukowski from “Gamblers All” (submitted by Ashley Mobley).

Mental Health...involves effective functioning in daily activities resulting in Productive activities (work, school, caregiving), Healthy relationships, Ability to adapt to change and cope with adversity. Mental Illness...refers collectively to all diagnosable mental disorders — health conditions involving, Significant changes in thinking, emotion and/or behavior, Distress and/or problems functioning in social, work or family activities.

1.     Talk about your feelings:

         Talking about your feelings can help you stay in good mental health and deal with times when you feel troubled.

2.     Keep active:

Regular exercise can boost your self-esteem and can help you concentrate, sleep, and feel better. Exercise keeps the brain and your other vital organs healthy and is also a significant benefit towards improving your mental health. 3. Eat well: Your brain needs a mix of nutrients in order to stay healthy and function well, just like the other organs in your body. A diet that’s good for your physical health is also good for your mental health.

4. Drink sensibly:

We often drink alcohol to change our mood. Some people drink to deal with fear or loneliness, but the effect is only temporary. When the drink wears off, you feel worse because of the way the alcohol has affected your brain and the rest of your body. Drinking is not a good way to manage difficult feelings.

5. Keep in touch:

There’s nothing better than catching up with someone face to face, but that’s not always possible. You can also give them a call, drop them a note, or chat to them online instead. Keep the lines of communication open: it’s good for you!

 6. Ask for help:

None of us are superhuman. We all sometimes get tired or overwhelmed by how we feel or when things don’t go to plan. If things are getting too much for you and you feel you can’t cope, ask for help. Your family or friends may be able to offer practical help or a listening ear. Local services are there to help you.

7. Take a break

A change of scene or a change of pace is good for your mental health. It could be a five-minute pause from cleaning your kitchen, a half-hour lunch break at work, or a weekend exploring somewhere new. A few minutes can be enough to de-stress you. Give yourself some ‘me time’.

8. Do something you’re good at

What do you love doing? What activities can you lose yourself in? What did you love doing in the past? Enjoying yourself can help beat stress. Doing an activity, you enjoy probably means you’re good at it, and achieving something boosts your self-esteem.

9. Accept who you are:

We’re all different. It’s much healthier to accept that you’re unique than to wish you were more like someone else. Feeling good about yourself boosts your confidence to learn new skills, visit new places and make new friends. Good self-esteem helps you cope when life takes a difficult turn.

10. Care for others:

‘Friends are really important… We help each other whenever we can, so it’s a two-way street, and supporting them uplifts me.’ Caring for others is often an important part of keeping up relationships with people close to you. It can even bring you closer together.

“Promise me you’ll always remember — you’re braver than you believe, and stronger than you seem, and smarter than you think.” — Christopher Robin from “Winnie the Pooh” (submitted by Monica Jean Cozadd).  “Start by doing what’s necessary, then do what’s possible; and suddenly you are doing the impossible.” — Saint Francis of Assisi (submitted by Sherri Paricio Bornhoft). Most people who do not want to address mental illness. But there's nothing to be afraid of mental illness! It is just like heart disease or diabetes a medical condition. Yet symptoms of mental health can be controlled. They constantly broaden our knowledge of the workings of the human brain and therapies that assist people in the effective control of mental health conditions.

 Work Cited:

"How to look after your mental health | Mental Health Foundation." Mental Health Foundation. Web. 10 Jan 2020. <http://www.mentalhealth.org.uk/publications/how-to-mental-health>.

Insights, Magellan Health. "9 Questions Someone with Mental Illness Wishes You Would Ask." Magellan Health Insights. 17 Jul 2018. Web. 10 Jan 2020. <http://magellanhealthinsights.com/2018/07/17/9-questions-someone-with-mental-illness-wishes-you-would-ask/>.

Pombo, Emmie. " Self-Help Techniques for Coping with Mental Illness | NAMI: National Alliance on Mental Illness." Home | NAMI: National Alliance on Mental Illness. 1 Feb 2019. Web. 10 Jan 2020. <http://www.nami.org/Blogs/NAMI-Blog/January-2019/Self-Help-Techniques-for-Coping-with-Mental-Illnes>.

Schuster, Sarah. "25 Quotes Everyone with a Mental Illness Should Hear | The Mighty." The Mighty. Making health about people... 11 Feb 2016. Web. 10 Jan 2020. <http://themighty.com/2016/02/25-quotes-everyone-with-a-mental-illness-should-hear/>.

"What Is Mental Illness?" Home │ psychiatry.org. Web. 10 Jan 2020. <http://www.psychiatry.org/patients-families/what-is-mental-illness>.

[prosebacon63]

How Do I Train My Dog To Be A Therapy Dog?

We love dogs because they make for a great shoulder to lean on. They make for great pals through the good times and bad. We do enjoy having personal companions, however, there are pups that have an opportunity to make a difference in the world. These dogs can help those in hospitals, retirement homes, schools, or areas that have recently undergone tragedy. 

Owners and pets volunteer their time to spread a little joy to those who need it. More places are opening up to the concept of therapy dogs and with more opportunities to go out and help, there is more need for dogs to put themselves to work! This begs the question if your dog is the right fit for the job. 

Therapy Dog vs. Service Dog

Despite a common misconception, service dogs and therapy dogs are not interchangeable titles. A service dog is specifically assigned and trained to assist a person or persons with special needs while a therapy dog is to aid people in a more emotionally supportive way.

Service dogs provide specific help with a disability which allows them special privileges such as being in restaurants and going on commercial flights. Dogs certified as therapy dogs do not have the same level of access. Service dogs are admitted into spaces to serve their owners who rely on them.  A big difference comes in how your approach these dutiful dogs. Therapy dogs are trained to interact with multiple people to provide comfort but you should not disturb a service dog on duty with outward distractions. Both dogs are working hard but they have different jobs! Those who are unsure can check in with their owners for permission to proceed or notification to stop. 

Trying to pass off a dog that is not a service dog as one is not only incredibly dishonest but is, in fact, illegal in certain states. Service dogs work hard to train for their job to assist their owner and it is a disservice to them and those who spent time working with them.

Where To Start

Ideally, if you have a puppy that you want to be trained as a therapy dog, you want to instill traits as early as possible. The American Kennel Club has a therapy dog program specific to puppies. Of course, if your dog doesn’t quite fit the category of a puppy anymore, these are things that can be worked on. There is no age limit on being a therapy dog! Socializing with other animals, humans, and environments is vital to ensure they can be well-behaved be around mixed company. Get your dog accommodated to other surroundings and people as early and as frequently as possible. This lays important groundwork for your dog to support strangers who may need the boost. You don’t want your dog to be uncomfortable when exploring these new areas as they will wear it on their faces. Having your pup be excited about venturing into these locations can be fun for both of you!

Keep In Control

Understanding commands that imbue a sense of self-control should be in every therapy dog’s toolbelt. Knowing how to sit, stay, come, leave it and how to not jump on people are qualities needed while volunteering as a therapy dog. Being responsive quickly when around new individuals is imperative.

Getting pet sounds like every dog’s dream but more skittish dogs won’t enjoy the attention and will react negatively. Therefore, a demeanor as if they were being groomed is a goal; sitting still and attentive.

Reinforcing training habits with treats help flesh out these behaviors. Being encouraging when these commands are done properly also help gain a grasp too! Fortifying that good actions receive good rewards prepare them for a therapy dog space.

Taming Temperament

Dogs are expressive creatures! This ranges from barking at every movement or having a tucked tail around people they aren’t familiar with. A therapy dog gives a sense of peace for those they assist, harder to do in circumstances where the dog is unsure of itself or having a passionate moment. We’re not saying that dogs are not welcome to communicate their feelings, it’s that dogs that volunteer milder in their manner to best offer relief. A resilience to sudden sounds and movements are important as well. You won’t have control of every single variable while out in these spaces volunteering. You have to ensure that your dog will remain calm, despite any noises or motion that may come abound.

A relaxed dog is the model therapy dog; taking in foreign smells, sights, and sounds in stride. Condition your dog by distracting them when loud noises happen, like having them focus on other activities help build fortitude. Using treats for positive reinforcement on a job well done. Circumstances with distractions are inevitable, you need a dog that can handle that without being frenzied.

Getting the Cred

After getting a handle on the training, the next step can be to take the Canine Good Citizen Test. This is a requirement for some therapy programs. From there, reach out to local facilities that have programs for therapy dogs where you would like to volunteer. Figure out their requirements and find an application through their volunteer coordinator as to set you and your dog up for success.

If you’re having trouble finding local places near you with these programs, reach out to your local American Kennel Club for more information! They can certainly point you in the right direction.

The American Kennel Club has places to register your dog as a therapy dog here. These organizations recognize AKC Therapy Dog Titles, earned through therapy dog visits. Next, get your dog ready for the big day as they will have to put those skills to test. The tester will examine your pup;  how they navigate crowds, react to startling noises, be open to polite pets, walking on loose leash and more.

Beyond having the correct obedience training and passing the tests, you have to ensure that your dog is up to date on all shots and preventative medication. While traversing spaces where being healthy is critical, your vet needs to sign off on your dog’s bill of health. Especially spaces with these types of programs, encountering other animals is a possibility. For this reason, being properly vaccinated is what is safe for everyone participating.

One final exam awaits after this. With that done, you and your pup are now a certified therapy team! At this point, you’ve both worked hard for this. Now it is time to go make a difference!

Where To Go

Programs that you are passionate about are perfect places to start when looking for places to help out. Therapy dogs help alleviate anxiety, lower blood pressure and help regulate heart rates.

Schools, where students are overwhelmed by their workload, can greatly benefit. Dogs stimulate problem-solving skills and socialization. Bringing therapy dogs into settings, like retirement homes, where people don’t get to mingle with others lift morale in residents.

In unfortunate situations, disasters take place and can have a damaging ripple effect on those left to cope. Therapy dogs (also known as Distaster Distress Relief Dogs in these situations) offer consolation and kindness. Having a dog to hold, to scratch or to just lean on can be a source of alleviation.

Therapy dogs can also dispell a sense a restlessness and lift spirits, comforting those in hospitals in need of some optimism. Having a positive outlook is essential in any recovery process, something that can be accomplished in a therapy team visit.

Knowing If It’s Right For Your Pup

Not all dogs have the attributes discussed and, above all, that is okay! This doesn’t make your dog any less special or important. There are dogs that are unable to calmly handle the strange new places. Or simply are uncomfortable with contact with too many strangers, even dogs that can’t help but greet you with their paws on your stomach! The fun in dogs is that they have such eclectic personalities. Not every personality is designed to help in that particular way.

Dogs that don’t make good therapy candidates can still affect change. There are other ways that your dog can help you and the community! For the more rambunctious furballs, look into doing canine charity runs. It’s an awesome way to put that extra energy to good use for the dog that can’t seem to sit still. For healthy pups, ask your vet how you can donate your dog’s blood to a blood bank. Having these banks assist in major surgeries that require blood transfusion and can save a fellow pooch’s life. The procedure is quick and painless and really pays it forward in the pet community.

Your dog can still be an emotional support animal if they better support you as an individual. They do follow similar guidelines of a therapy dog. For instance, they cannot be taken into public spaces dogs aren’t allowed. With this said, they can still lend a supportive paw. Consult your therapist, psychiatrist or another certified mental health professional. Together, you can discuss your options regarding emotional support animals.   

Source: https://barkpost.com/answers/train-my-dog-to-be-therapy-dog/

[kiddiemom-blog]

PDA & Parenting-- Paula Sanchez

A critical-insider perspective on PDA and parenting

This post is based on a presentation I gave at the PARC event ‘Critical Perspectives on Pathological Demand Avoidance’ on Tuesday 15 May 2018. This is very much a walkthrough of the presentation, using a combination of material from the slides, in text and image form, and supplementary narrative where needed.

Please note that this is a long post, but there is a lot to say! A summary will shortly be available on the PARC website.

Both me and my son believe we would meet the criteria for PDA, yet we do not identify as PDAers. I recognise us both in accounts by and about PDAers, in programmes like ‘Born Naughty’, or as described on social media by parents and PDAers themselves, but we would both describe ourselves as ‘just’ autistic. I hope to write about my own ‘demand avoidance’ in a future post. I will not be describing in any detail how my son is PDAish because that is his story to tell, but there are times when I cannot tell my story without reference to him, and he has consented to this. I understand why parents need to talk about their children, because I know how isolating our situations can be, and how we need to learn from each other to be the best parents we can be. I would just urge caution, use anonymous accounts, delete your posting histories, use pseudonyms wherever possible.

Why am I talking about PDA parenting?

I have spent around 10 years hanging out and sharing ideas and support in online forums, with a particular interest in children and young people who exhibit demand avoidant, aggressive and violent behaviours, and I have around 10 years’ experience using PDA strategies and techniques as a parent.

I have over 20 years’ experience supporting often vulnerable adults, including 18 years’ probation work with adults in the criminal justice system, many of whom were almost certainly undiagnosed autistics, including those with a PDA-type profile. Very few had formal diagnoses. As a result, I have considerable experience supporting a wide variety of people who exhibit what is often called ‘challenging behaviour’.

I also have a personal and academic interest in the discourse of ‘mother-blame’ and I have noticed how mothers of PDA-type children often experience considerable judgement and intrusion due to poor understanding of autism by professionals.

I recognise PDA as a ‘profile of autism’ (I will come back to ‘profiles’ later) and I am concerned that critique of PDA could harm PDAers and parents of PDAers, by supporting discourses centred on behavioural problems, bad parenting and mother-blame.

My aim for the presentation was to explore and ponder the tensions between my experience and observations, including the usefulness of PDA for me as a parent, and the clinical and academic construct of PDA. In essence, I am seeking to balance my pragmatic use of PDA as a signpost and shorthand for me as a parent, with my ideological and theoretical concerns about PDA for me as a fledgling academic.

Aut-o-biography

We both have a similar ‘profile’:

My cognitive dissonance

PDA was not well known when my son was younger and Newson’s original PDA criteria included ‘passive early history’ and ’language delay’ which did not appear to ‘fit’ my son.

Despite my son exhibiting all other PDA characteristics, this stopped me describing him as having PDA, yet:

PDA is often confusingly described as both different to autism and as an ASD. As I consider autism and ASD to be synonymous, this does not make sense to me.

In 2016 Phil Christie (at the National Autistic Society’s Professionals Conference) said that the above 2 criteria (passive early history and language delay) were no longer considered essential criteria, and this got me thinking…

Can someone meet both a PDA and an AS profile of autism?

If I was to describe my son, or even myself using clinical, diagnostic terms, it might look something like this:

But, now look at the next 2 tables:

That is the same child (or the same adult) showing a perfect combination of 2 supposedly discrete autism profiles.

My experience and observations indicate that a more obviously- (stereotypically-) presenting Asperger-profile autistic child is likely to be diagnosed easier and quicker than a less obviously- (stereotypically-) presenting PDA-profile autistic child. My son was referred before his more PDA-profile type observable behaviours became more pronounced than his Asperger-profile type observable behaviours. This meant that identifying my son’s autism was fairly straightforward as he appeared to present with a textbook Asperger-profile of autism. We were lucky, and had we delayed, diagnosis might not have been so easy…

What is a typical path to a PDA diagnosis?

Sense of difference about the child:

Escalating ‘behaviour problems’:

Usual parenting strategies don’t work:

Ask for help:

Mother blame:

Autism assessment:

Stumble on PDA:

Find support in PDA community:

Find sympathetic clinician who can recognise ‘subtleties’:

What are ‘PDA strategies/interventions?

PDA adjustments are built around reducing demands and reducing the stress and anxiety which results in ‘demand avoidance’, and includes things like:

But PDA-style parenting and support is about more than ‘behaviour management’…

What does good PDA-style parenting and support look like?

Reducing anxiety:

Adjusting expectations and environment:

Teach and model problem-solving skills:

Focus on flexible and adaptable skills that will last a lifetime:

Support autonomy and self-advocacy:

It is my view that this set of aims should be the foundation for any autistic child, or indeed for all children.

How did PDA suddenly get so popular?

Online resources and forums:

Backlash against dominant interventions:

Increased autism ‘awareness’:

But was PDA really a new profile?

Back to the 1940s

I was somewhat surprised when I finally read Uta Frith’s 1991 translation of Hans Asperger’s 1944 paper, and that 3 out of 4 of the case studies he presents in some detail, described behaviours that now might be seen as evidence of PDA-type autism.

These are the extracts I used in the presentation, and there is more in a similar vein, but I urge you to read the case studies for yourself and see what you think:

“… the conduct disorders were particularly gross when demands were made on him … when one tried to give him something to do or to teach something … it required great skill to make him join some PE or work even for a short while … it was particularly in these situations that he would start jumping, hitting, climbing … or some stereotyped sing-song.” (Fritz V.)

“… he was repeating the second year because he had failed in all the subjects. The teachers believed that he ‘could if only he wanted to’ … he made surprisingly clever remarks of a maturity way beyond his age … he often refused to co-operate, sometimes using bad language … ‘this is far too stupid for me’ … little things drove him to senseless fury … extremely sensitive to teasing … an inveterate liar … told long fantastic stories* …” (Harro L.)

“… reported to have been a very difficult toddler … unable to cope with the ordinary demands of everyday life … he could be very naughty and would not do as he was told … it was impossible to go to a park with him, as he would instantly get embroiled in fighting … he liked to tell fantastic stories … he had a strong tendency to argue with everybody and to reprimand them … he made life hard for himself by his awkwardness and endless hesitations.” (Ernst K.)

Fast forward to the 1980s

In Lorna Wing’s 1981 paper she describes ‘Asperger’s Syndrome’ which was very much based on then contemporary understanding of autism and Asperger’s case studies, but she removed 2 interesting elements from Asperger’s analysis:

In Uta Frith’s 1991 footnotes to Asperger’s paper she too seemed to struggle with some of Asperger’s observations:

Elizabeth Newson, building on her 1970s/80s clinical work, and referred to in her 2003 paper, defined PDA as distinct from ‘classic autism’ and ‘Asperger Syndrome’ noting:

What PDA did

Do we need a PDA profile of autism?

Why PDA matters to PDAers/PDA parents

Representation:

Isolation:

Investment:

So, what’s my problem with PDA then?

The name is awful:

It cannot be simultaneously an autism and a not-autism:

Perpetuates stereotyped/outdated notion of non-PDA autism:

No empirical evidence that PDA ‘demand avoidance’ is different from autistic ‘demand avoidance’ or non-autistic ‘demand avoidance’:

PDA strategies/interventions are not only useful to PDAers:

Inadequate recognition of fluctuating ‘demand avoidance’:

The acceptance of ‘demand avoidance’ (and therefore high levels of anxiety) as a permanent state:

If PDA is a distinct profile because of the “extreme” nature of response to anxiety, what about other “extreme” anxiety responses?

Would we want:

What about compliance?

I would argue that compliance is one of the greatest risks to autistic children and adults. The ability to say, express or indicate discomfort, displeasure or distress, or even just not wanting to do something for any or no reason at all, is a vital skill.

The dismissal of some of Asperger’s observations perpetuated a narrow view of autism:

Effect of egos and competition on diagnostic categorisation:

Impact of increased ‘awareness’, stereotypes and prescriptive interventions on non-compliant autistics:

Dimensional nature of demand avoidance is akin to other ‘extreme’ anxiety responses:

The PDA profile of autism, like other profiles and attempts to highlight under-represented groups (eg BAME/women and girls), has some use in the short-term to raise awareness and inform clinicians:

PDA techniques and interventions should be more widely used across the autism population to support autonomy and self-advocacy:

I finished my presentation by asking how do we build bridges across the spectrum?

[autism-actually]

10 tips on helping Autistic students transition to high school

The transition from primary school to high school is a big leap for many students - it is another journey in their life and school career. Some children may be excited to try something new, meet new friends, and explore different subjects. However, for many students on the spectrum, it is a very difficult time. For most Autistics, change is extremely hard to adjust to. There are a variety of subjects and structures that vary from class to class. Their friends may not be going to the same school, which can be scary.

As a community, there are things we can do to help Autistic students have a better experience at high school and make the transition a lot easier.

1.       Listen to the individual

First and foremost, the Autistic individual is an integral part of this process and accommodating them must be done with their input.

2.       Find out who the teachers for the year will be

When I was in year 7, it was highly stressful not knowing who my teachers would be. It may be good practice for the students to start writing to the relevant staff at the school, such as year 7 coordinators or administrative staff, and request that they have at least an idea of what teachers they might get. If the students are not confident in verbalising their concerns to staff (which is perfectly understandable), it may be necessary for parents to speak to relevant staff about the child's needs and why it is important for them to know in advance. Visuals of the teachers such as photographs may help the student.

3.       Having a buddy

Introducing us to another specific person takes some pressure off of the overwhelming social surroundings. For me, I had no friends from primary school, so having a specific buddy helped to provide structure to my socialising, especially as we shared similar issues. Particularly for girls on the autism spectrum, they may not relate very well to neurotypical (NT) girls which makes the whole process of socialising more confusing.

Buddies do not necessarily have to be assigned. If they are assigned, be aware that the Autistic student may not get along with their buddy. Make sure that you check in on the AS student as well as the buddy to ensure they are comfortable with each other. If the buddy is neurotypical, it may be worthwhile to explain that the student has trouble making friends or needs additional help. Notify the buddy and the Autistic student before placing them together and ask whether both are happy to do so. For some students on the spectrum, they may not make friends until much later on and will instead enjoy speaking to their teachers, especially if the teachers recognise their special interests. Remember that passions and special interests are a huge part of many Autistic individuals' lives and consider this before choosing a buddy.

4.       Quiet spaces and communication cards

I found it very challenging to ask for help. It was vital for me to have places to chill out and recharge when the environment in the classroom became overwhelming. I did so with a communication card that stated that I had permission to exit the classroom and spend time in a specific quiet area. It was signed by my principal. This took away the anxiety of having to explain the uncomfortable personal emotions I was feeling to my teachers. Trying to explain these emotions to teachers I did not have a rapport with made me feel very vulnerable. If possible, try and construct a quiet room for the student. Sometimes for us walking outside in Nature can help. Do not place us in a location that has other people in it, or is noisy such as another classroom, as this will create the same issues. Do not try and ask too many questions when the student is feeling distressed; wait until they have come back or the following lesson to ask them how they are feeling. Sending an email could be helpful as well.

5.       Multiple copies of colour coded visual timetables

My executive functioning, particularly under stress, is very poor, so I would constantly forget where I was supposed to be. I had four timetables: one in my locker, one electronic version on my phone, one in my computer bag, and one at home. Even with this system in place, I would still forget; I learnt to go and ask a teacher or student whom I had bonded with.

Students - Experiment to find out which way works best for you. Maybe you like using specific colours for particular subjects. Perhaps you require reminders on your phone for some lessons. If the system is not working, stop, reflect and re-evaluate. If you are struggling with finding a system that works for you, ask a teacher or your parent for help.

Staff - Understand that executive functioning is a big issue for many of us on the spectrum. It greatly helps if you respond to our forgetfulness with an encouraging comment, such as "It is ok to ask me for help. A lot of us struggle to remember sometimes. What do you think would help you to not forget where your class is in the future?". If you respond negatively, we are less likely to approach you for help in the future.

Parents - Encourage your child to think about how they can help themselves. Suggest ideas, and help them reach their own conclusions. By helping them develop their organisational skills themselves, this will help them with their independence and self-esteem.

 6.       Have specific teachers to ask for assistance

These teachers are often ones whom we have already had conversations with. They also may teach a subject we are passionate about. It is important to reassure the student that it is acceptable to speak to a staff member they trust. Key staff members can make a huge difference in an Autistic's school life. Remember - positive experiences create positive emotions that the student associates with you. The same goes for negative experiences. Autistics don't forget easily, so keep this in mind when forming a bond with them.

7.       Explain issues in writing

I am much better in articulating myself in writing even though I am verbal. Often when I was overloaded at school, words became too much. Students, if you are having difficulty expressing issues in the classroom, consider sending the teacher an email after class or writing down a note and handing it to them. If you have a trusted friend or buddy in the class, you could ask them to notify the teacher of how you are feeling. I was lucky to have very supportive NT friends at a camp, and when I could hardly speak and they worked out my issues they took initiative and told the teachers. The teachers then helped me debrief afterwards.

Parents - Help your child articulate by emboldening them to email their teachers. My parent helped encourage me to explain my Autism to my teachers in writing. This required a few prompts, such as specific questions, which at times I would only answer in a simple "yes" or "no". This helped me better understand how to convey my issues to my teachers. My parent did not write to the teachers for me - whilst I got help from her, I eventually got to the point where I felt comfortable emailing them myself if I had a concern.

Staff - For the classroom, sticky notes can be useful for the Autistic student to write down questions if they have too many, or struggle to verbally ask for help. Do not assume that just because a student looks calm that they are coping - a lot of us, particularly girls, become master maskers by the time we get to high school.

8.       Communication between school and home

What affects us at school can affect us in a different way at home, and vice versa. It is important for teachers and staff to communicate to one another as this can enlighten them on how a student is tracking at school.

9.       Permission to have breaks and days off

I was told that it was necessary for my mental health to have breaks. A trusted staff member gave me this advice. It provided a sense of relief that I was allowed to take time off to recharge. It also helped me take my mask off as I felt like those at my school were considering the real me.

Students - Do not feel bad or a failure for having to take breaks. Often us Autistics work so hard, as our brains are whirring so fast that we get exhausted. We are processing so much information all the time, and this means that we sometimes need space away from this barrage of information. For some of you, this may be an uncomfortable feeling, because you are so used to masking or running on very little energy. However, consider this - if you want to be the best version of yourself and be an effective learner, you need the energy to do so.

10.   One-on-one tours in action

Prior to attending school, I got a chance to see my school operating. This gave me a chance to ask questions of current students and staff and made the place more familiar and less daunting. It is not enough to visit the school when it is not operating. In orientation week, I was placed with specific students every day which meant that even when our classes changed the following year, it was comforting to see a few familiar faces.

Staff and parents - During the tour, direct the students to their subjects of interest and passion. Try and introduce them to the staff and students there, as we are more likely to develop a rapport with those who share our passions and interests. This could open up social opportunities for us.

Reflecting on my school years, my best moments have been spent by understanding and accepting staff and friends. This made my school life far more enjoyable. I will forever remember the teachers that were there for all my meltdowns, panic attacks, and achievements. Many were encouraging and supportive of my passions and I felt part of a community. Whilst there were some difficult times, I was not facing them alone. I wish for other Autistic individuals to have positive experiences at high school. I hope my insights based on personal experiences will help AS individuals be part of a more inclusive and accepting community.

Shadia Ibrahim, Autism Actually