All In The Family

I am happy to announce the newest addition to the Abound & Flourish family (who happens to be related to me), Stephanie Dang, APRN, MSN, ACNS-BC, PMHNP-BC (she owns half the alphabet)!

Stephanie is a a Psychiatric Mental Health Nurse Practitioner and I have had the pleasure of being able to consult and collaborate with her on many cases. I’m thankful for her expertise, compassion for clients who are suffering from mood disorders and PTSD (the population I specialize working with), and the continuity of care she and I are able to provide to those in need. It’s a bonus that she is my sister and friend. I highly respect her profession and medication management often benefits the therapeutic work I am doing with clients.

I wanted to take some time to introduce her to you with a short interview.

Q: What drew you to the mental health field?

A: What drew me to the mental health field was observing the significant need in almost, if not every encounter I had with patients. I previously treated the medical needs of patients, but quickly learned their mental health and psychological needs impacted their medical health and often times were neglected.

Q: What do you most enjoy about your job?

A: What I enjoy most is providing hope for patients who are in the midst of their most difficult days. I also enjoy meeting patients where they are in their treatment and addressing their questions and concerns in order to empower them, this allows patients to participate fully in their care.

Q: What do you find most challenging your job?

A: What I find most challenging is the process itself. Addressing mental health needs does not occur quickly and is not always straight forward. It can be discouraging especially when the patient is eager to improve. I have to remind myself to set reasonable expectations, but also confidence in the process.

Q: What would you say to someone uncertain whether or not medication management is needed in their case?

A: If a patient is uncertain about the recommendation to initiate medication I would want to understand their hesitation and address their concern. I would also educate the patient on how medications addresses the neurobiological component of mental health. As important it is for patients to also address their behaviors and environment, it is also important to address the neurobiological factor.

Q: What would you say to someone who thinks therapy/exercise/diet is enough to treat their symptoms? Or vice versa, that medication is enough to treat their symptoms?

A: If a patient believes therapy/exercise/diet and other behavioral modifications are sufficient to treat their symptom and find themselves in remission, then I would support their plan of care. And vice versa. However, often times addressing behavioral modifications or medications alone is not sufficient and patients still remain with unmanaged symptoms. As a provider I am here to educate and recommend safe and evidence based practices to help reach patients' goal of remission. Studies and data have shown both behavioral modifications and medication management has better outcomes.

“As a provider I am here to educate and recommend safe and evidence based practices to help reach patients’ goal of remission. Studies and data have shown both behavioral modifications and medication management has better outcomes. ”

Q: What do people often misunderstand or have concerns about mental health and medication management?

A: Some of the common misunderstanding or concerns about mental health and medication management is taking prescribed medications leads to apathy or feeling "Zombie like", dependency, too many side effects, "putting a bandaid and not fixing the problem," and the chronic treatment. With all medications there are side effects and the recommendation for medication management in treatment mental health disorders is not to numb your personality or who you are, but rather allows you to become more of who you are. It is about finding the right medication that minimizes the negative side effects. It is also important to participate in psychotherapy to address the underlying issues as to not put a "bandaid." Some patients over time are successful to discontinue medication management under the care of their provider while others maintain on medications indefinitely.

Q: How can someone go about seeing if you might be a good fit for them?

A: It is important for patients to feel comfortable and safe with their provider. It is also important for the patient to feel heard and participate in their treatment. I suggest having a few appointments to become familiar with my approach and if it meets their needs. It would be my pleasure to join patients in their process to healing and well being.

“What I enjoy most is providing hope for patients who are in the midst of their most difficult days. I also enjoy meeting patients where they are in their treatment and addressing their questions and concerns in order to empower them, this allows patients to participate fully in their care. ”

— Stephanie Dang

Abound & Flourish, What's in a Name?

Our website got a little pick me up with an updated logo. When I was naming the practice, I didn’t want it to be my name (website domain is different for simplicity’s sake) because counseling isn’t about me. It’s about the client and their personal growth. As verbs the difference between abound and flourish is that abound is to be full to overflowing while flourish is to thrive or grow well. This is what I want your experience to be as you dive into the therapeutic work that awaits you. I hope that you would find yourself overflowing with gratitude, joy, understanding, acceptance and compassion for self and others. I hope that taking these gifts with you, you would continue to grow well even after you leave my office.

[As I consulted with Erica Dang on the logo she created, here is her process that I wanted to share:

- When I think of the word "abound", I think of being plentiful, full. I can't help but think of a thicker font for this word.

- The bolder font also alludes to stability, which you mentioned you want your clients to feel when they visit you.

- "Flourish" is a whimsical word, that most people can't help but think of growing. It takes good (thick strokes) and difficult (thin strokes) experiences to truly grow. The calligraphic approach you'll see in one of the options shows that those thick and thin strokes creates a beautiful picture when we look back on our lives.

I so value collaborating with professionals in different spheres because their gifts and talents help communicate and contribute more than I can on my own.]

#nofilter

I was thinking about various messages we lives our lives by. We are meaning makers by nature. That’s how our brain works. It creates schemas to help us process things fast and make an assessment about whether we are safe or not. Did you know that is your brain’s #1 priority? To determine whether you are safe and determine the degree of threat….0 to get the hell out. And sometimes because of passed painful experiences and trauma, our brain can be rewired to see threat where there isn’t one. Now we have this threat filter (“people are dangerous…stay safe…isolate…numb” or “attack…defend at all costs”). Those filters shape how we see others and how we see ourselves and how others see us. And a narrative is formed…this schema. It’s our brain’s shortcut and shortcuts can be efficient but they can also miss out on very important data.

Do you know what your natural filters are? If we are unconscious and unaware of them, we will live our lives looking through a lens that may not reflect reality and can have us miss out on true connection to others and within.

So let’s begin by looking at events that shaped us and see how those filters were meant to protect but when it’s used on everything, life becomes very limited. Identifying the filter is the first step. Next, learning to slow down to name the filter and its purpose. As I slow down, I can see more of the present moment and take it all in and can use that data to make meaning of that moment.

New Year. Same You.

When the clock struck midnight, wherever you were, whomever you were with, whether your were in a conscious state or not, you were still the same you that you were at 11:59.I think there can be a misperception that we are re-invented magically at the start of a new year. Like, the opposite of Cinderella. I don’t know how you woke up, but I woke up with the same forehead wrinkles, same blemishes, same body (height and weight), same scar on my knee.

Yes, January 1st meets criteria as “new” simply based on the resetting of our modern day calendars. Most importantly, It mark passage of time. And within that passage of time, situations and circumstances unfolded. Some of them were expected, some were unexpected, some were welcome, some were unwelcome. Some were refreshing and restorative. Some were gut-wrenching and soul-sucking. Just because the calendar re-set, doesn’t mean our lives do. Some of those situations and circumstances have long-lasting impact and consequences that will shape our future. If you had a baby this year, that will shape your years to come. If you lost a loved one this year, it changes your relationship to the past that held them and the future that carries their absence.

Please hear that there isn’t anything wrong with anticipation or excitement about the calendar changing. By all means, do make goals, do set intentions. create plans! But know the hidden danger that hype can create. As you look towards what will be and hope, do not erase or dismiss what came before. We must leave room to let the years teach us and inform us on how to move forward, how to make healthy, realistic, positive goals.

And know that you also don’t need to make January 1st anything more or less than what it needs to be for you.

The Art of Being Human

Volunteers working on hundreds of Amazon donations received at Austin Pets Alive.

“We think too much and feel too little. More than machinery, we need humanity. More than cleverness, we need kindness and gentleness.”

— Charlie Chaplan

This month has been a particularly difficult one. I've spent a good portion of it feeling outraged, sorrowful, hurt, disappointed, and confused. The events of the last few weeks beginning in Charlottesville and what played out on the national stage to the recent devastation from Hurricane Harvey have weighed heavily. The emotional, physical, mental and spiritual trauma of injustice and displacement leave its mark. To belittle and strip humans of their inherent dignity and worth is wrong. It's beyond wrong, it's evil. To lose one's home and sense of safety is distressing and overwhelming. It's traumatizing. 

“To belittle and strip humans of their inherent dignity and worth is wrong. It’s beyond wrong, it’s evil.

To lose one’s home and sense of safety is distressing and overwhelming. It’s traumatizing.”

As a counselor, I face stories of evil and trauma often. It's not easy for me but why I do what I do, how I can do what I do, is because of what my clients bring. Their resilience, their courage, their willingness to fight the lies and fight for restoration to find their voice, their freedom, their meaning is something to behold. I often don't feel worthy of this work but am greatly aware of its privilege. My clients show me what it is to be human in all its beauty, glory, sacrifice and triumph. 

“My clients show me what it is to be human in all its beauty, glory, sacrifice, and triumph.”

Earlier this week, I witnessed on a larger scale what it means to be human. My city and fellow Texans fulfilling the command to love one's neighbor. I feel inspired, encouraged, and amazed by seeing others seek to restore and speak into sorrow through whatever means possible. Yesterday, my sister and I arrived at Austin Pets Alive to see scores of volunteers organizing the hundreds of donated boxes that carried much-needed supplies to care for the 300+ animals that needed shelter. 

We went to Costco and you could feel it in the air: this powerful sense of taking up the cause because our fellow humans, though strangers to us, need us. So there I am in Costco inspired by the carts filled with bulk items waiting to be driven across cities along the coast just because that's what it means to participate in this being human. It means caring about others' misfortune and their plight. It means taking up the banner on their behalf. And while there are many who would seek to destroy, there are many more who make it their mission to build up. 

“What it means to be human: caring about others’ misfortune and their plight, taking up the banner on their behalf.

And while there are many who would seek to destroy, there are many more who make it their mission to build up.”

I am well aware that often times we rise to the challenge when we see humanity threatened and then easily return to states of selfish preoccupation. I'm well aware that across this country and countries over, there is horror occurring with little being done. I'm well aware that this post doesn't change the hate that was spoken (still spoken) and experienced or that highlighting local acts of kindness doesn't change that there is real suffering. This post isn't meant to minimize the pain.

In moments like this, when we're in crisis, I think it necessary to see what human agency is capable of (both for harm and for blessing). It's necessary that when we feel helpless and powerless to consider what is within our personal, social and cultural jurisdiction and ask what one's contribution is. How can your voice reflect what it means to be human and what action will it lead you towards?

I am confident goodness has the final say. So let us be a people and community that uses our words for this important conversation. 

{if you have not yet been able to contribute for Hurricane Harvey relief, please take some time to consider how you might be able to donate. Even looking around your pantry and giving your non-perishable food items will go a long way! I've included links above for ways you can help.}

Our Shadow Side

“It intrigues me that great success is this brilliant light, but also every brilliant light creates a dark shadow. I think wisdom only comes when you can navigate both.”

— Sting

If you've spent much time with me via this blog, you're well familiar with my philosophy that we learn to hide/cast away parts of us (personality traits, emotions, desires) that have been directly or indirectly deemed unacceptable. Those unacceptable parts are shamed deeply affecting our mental and emotional health. This collection of cast offs results in the formation of the shadow. What Carl Jung describes as the "dark" side of being human.

We decide that we only present the respectable part of our personality and hide the socially unacceptable parts of us which ultimately gets buried in our unconscious.

No one is without their own shadow. But the difference is one's awareness of their shadow. 

If we're not aware of what is happening within, it contributes to "self destructive behaviors so many individuals struggle with and are unable to control despite consciously knowing they would be better off not engaging in such actions...The task in life which thus confronts everyone is to become conscious of and integrate one’s shadow into one’s conscious personality: accepting it with open arms not as an abhorrent aspect of one’s self, but as a necessary and vital part of one’s being." (Academy of Ideas)

Way easier said than done. I am aware. I've said it before and I'll continue to say it: this process is not for the faint of heart. You must truly long for wholeness because only then will you work towards it. Many are unwilling. And they settle for an unexamined life becoming shells. 

“We must be willing to see ourselves as we really are, not someone we assume or fantasize of being.”

However, for those who dare venture to look they'll discover the shadow isn't all bad as we would like to believe (it would be easier if it was because it would justify keeping it in the basement). Recall that we hide any part of us that isn't acceptable to others. These can be positive traits: sensitivity, compassion, creativity, intellect, the list goes on. These aspects that would "lead to greater wholeness and harmony" are met with condemnation from others (family, peers, society) and in order to belong, away they went. 

“When positive traits are relegated to the shadow, one is by necessity less than one could be...growth of the individual becomes blocked, and life becomes sterile. ”

— Academy of Ideas

In order to grow, we must accept those parts we've been afraid to recognize. Growth requires more than mere acknowledgement or awareness. We must be willing to see ourselves as we really are, not someone we assume or fantasize of being. Take an honest assessment. And that's where the real growth can begin take root. As you become aware, you can then internally negotiate which parts lead to wholeness and which parts detract. Because they are no longer hidden, you are able to determine what and who you want to be. You are not bound by the fear of what might be hidden in the shadows because you've taken your flashlight and revealed the truth. 

This is why you will hear therapist after therapist describe their clients as some of the most courageous people they know. They risk for the sake of growth and truly living an engaged and present life. 

Will you join their ranks?

Gratitude & Growth

"Painful as it may be, a significant emotional event can be the catalyst for choosing a direction that serves us- and those around us- more effectively. Look for the learning." Louisa May Alcott

Fifi made the list! My good friend, Ashley, texted me and told me her 2-year-old son, who affectionately calls me "Fifi" mentioned me in his prayers. Not only did I get a mention but I was first (a spot reserved solely for his dad). Ashley and her husband are teaching Jack to be thankful. Each night, he lists off the people/things (inanimate objects) for whom/which he is thankful. They are cultivating character development in this little person. That is the most significant thing happening.  In addition, Jack's brain is forming neuronal networks that are building a sturdy foundation that will serve him well when he begins to face difficult and disappointing things in life.

Last week, I came across this article on gratitude protecting against PTSD with the tagline, "In the aftermath of trauma, gratitude helps us grow". As someone who specializes in working with trauma, my curiosity piqued. (I define trauma the way Dr. Tina Bryson does, "anything immediately and overwhelmingly difficult" which will be different for different people. What is traumatic for me, may not be for you, but it does not make it any less traumatic.)

Trauma rocks us to the core and shatters our sense of safety (hence, the definition: immediately and overwhelmingly difficult). It causes us to seek a new belief system as we try to understand why this terrible thing happened and what it means for our worldview.

Post-traumatic growth (PTG), developed by psychologists Richard Tedeschi, PhD, and Lawrence Calhoun, PhD, is the psychological concept that the transformation following trauma leads to "develop[ing] new understandings of themselves, the world they live in, how to relate to other people, the kind of future they might have and a better understanding of how to live life" (Tedeschi).

“Post-Traumatic Growth can provide a framework that trauma is not defining and a newfound hope can arise from the ashes of pain.”

"Post-Traumatic Growth happens in the season after the trauma, when some people start to feel thankful to be alive, thankful that the trauma wasn’t even worse, and grateful for the chance to learn more about themselves," reporter Athena Dickau writes. Post-Traumatic Growth does NOT minimize or negate the trauma. This does NOT mean you must be thankful for the actual trauma.  It also is not to be misunderstood as the goal to achieve and bypassing necessary processing of the trauma. Rather PTG can provide a framework that trauma is not defining and a newfound hope can arise from the ashes of pain. 

In her article, Dickau highlighted a study conducted by researchers Julie Vieselmeyer and colleagues. The team sought to "discover whether gratitude can actually protect someone from the detrimental effects of witnessing trauma". They interviewed 359 students and faculty that were present or nearby during the campus shooting at Seattle Pacific University.

The results of the study showed that the individuals who already had higher levels of gratitude before the shooting were better able to turn their post-traumatic stress into growth. Dickau points out, "This is actually quite profound. It suggests that if we can help ourselves and others feel more grateful on a daily basis, we can actually prime ourselves to handle the trauma that life will inevitably bring."

“If we can help ourselves and others feel more grateful on a daily basis, we can actually prime ourselves to handle the trauma that life will inevitably bring.”

— Athena Dickau

Just like Ashley is teaching Jack to cultivate thankfulness we, too, must do the same.

Professor Robert E. Emmons defines gratitude as such: “Feelings of gratitude are anchored in two essential pieces of information processed by an individual: (a) an affirming of goodness or ‘good things’ in one’s life and (b) the recognition that the sources of this goodness lie at least partially outside ourselves.”

"So gratitude is recognizing that our life is a gift, no matter our circumstances and realizing that this goodness does not come from our efforts alone," writes Dickau.

As one study instructed participants, we also must "focus for a moment on benefits or gifts that you have received in your life. These gifts could be simple everyday pleasures, people in your life, personal strengths or talents, moments of natural beauty, or gestures of kindness from others. We might not normally think about these things as gifts, but that is how we want you to think about them. Take a moment to really savor or relish these gifts, think about their value, and then write them down every night before going to sleep.”

I would imagine that as gratitude deepens, you'll find positive responses in the areas that define Post-Traumatic Growth:

• Appreciation of life
• Relationships with others
• New possibilities in life
• Personal strength
• Spiritual change

May we be people defined, not by our tragedies, but by our response to them.

{If you have yet to process your pain, my invitation awaits to sit and journey with you towards a healing transformation where meaning can be made of what has occurred. Please do not hesitate to contact me.} 

Manipulate Like a Boss

“We are all travelers in the wilderness of this world, and the best we can find in our travels is an honest friend.”

— Robert Louis Stevenson

All humans are manipulative. And if you're like me, you're already wincing and recoiling at this statement. Hang in there with me for a moment though. After clarifying and discussing with Dr. Steve Harris (my mentor's mentor), I want to offer what he so graciously took the time to share with me. So let's get our foundation set:

• Fact #1: All humans are manipulative.
• Fact #2: How the manipulation comes out determines the health of the person.

Still uneasy? Ok...maybe a clarification on the definition. Dr. Harris recognizes, "Manipulation as a word definitely gets a bad rap. But manipulation extends itself into many spheres as this definition shows:

Manipulation is the skillful handling, controlling or using of something or someone. Whether it's the sculpture you made in art class or how you convinced your friend to do your homework — both are considered manipulation."

Based on this, we can see that manipulation can have either an incredible result displayed throughout museums the world over or a painful, hurtful consequence laced with heartache and tears.

What does it look like in relationships? There are four forms of manipulation:

• Seductive
• Deceptive
• Intimidating
• Negotiating

“Negotiation is the highest and most desirable form since it is more relational and mutually respectful.”

— Dr. Steve Harris

The first three are focused only on my needs. Negotiation is the only healthy form of manipulation as it invites the needs of others (note: "invites" is radically different from "take responsibility for").  Dr. Harris expounds on this idea, "Negotiation is the highest and most desirable form since it is more relational and mutually respectful. The others, tend to be either less direct, one-sided, or misrepresentational."

He continues, "Although when manipulations are exposed, they more often than not, reveal something less than desirable. But with negotiation, it stops being one person's act upon another, but both people trying to benefit." (Think: Separate/Equal/Open)

We seduce, deceive and/or intimidate to protect ourselves, preventing another from seeing us. It's incredibly vulnerable to recognize our own neediness and it's another thing to share that with someone. We would rather get our needs met without taking ownership of them because it's less threatening to our sense of self. Yet we become bitter and resentful when the other does not meet our needs because we refused to offer them. We are so focused on what is and is not being met that we have little to no capacity to see or give to the other person. 

Dr. Harris points out no relationship is satisfying when both parties are "doing things to each other that may not be direct. We don't like hidden agendas. I think another thing that [we] don't like about manipulation is that something is less exposed, less direct, perhaps even less honest."

“Another thing we don’t like about manipulation is that something is less exposed, less direct, perhaps even less honest.”

— Dr. Steve Harris

We long for what is true and authentic; it provides safety, stability, and security. Trust is inherent and required for any thriving relationship. It's why betrayal and deception can shatter what seemed like a sturdy foundation. In order to create and establish trustworthy relationships, we will need to be open and honest about who we are, who we are not, our longings, hopes, fears, dreams, failures, triumphs, sorrows, joys. "Perhaps the healthier manipulation becomes, the less it is manipulation and more mutual respect or mutual cooperation--the manipulation is transformed," Dr. Harris.

Will we choose to be people of clarity and truth, honoring our needs by sharing them with another and inviting their needs to be known? 

“We need to be open and honest about who we are, who we are not, our longings, hopes, fears, dreams, failures, triumphs, sorrows, joys.”