All In The Family

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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.]

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To Each Their Own

Therapy is a unique relationship. Meaning it is about you and for you. I collaborate with you. I’m not the focus. I don’t direct. I walk alongside. I may guide for a bit. But you do the work. You’re in my office for 50 minutes each week. You are out in the world for the remaining (however many) minutes (I don’t care to do the math.).

Sometimes your work on the outside means:

-Clinging tight to the truth of who you are when it’s hard to believe.

-Holding on to hope and believing you will heal.

-Releasing yourself from old patterns.

-Surrender to the reality you cannot change others but you can change yourself.

-Developing and keeping healthy boundaries (knowing where you begin and end and where another begins and ends, separating yourself from unsafe and toxic people).

-Tearing down walls that prevent intimacy and being seen and known.

What is the work you’re doing? Might I be able to join you?

A Blessing, No Ordinary People

There are no ordinary people. You have never talked to a mere mortal. Nations, cultures, arts, civilizations-there are mortal, and their life is to ours as the life of a gnat. But it is immortals whom we joke with, work with, marry, snub and exploit-immortals horrors or everlasting splendors. This does not mean that we are to be perpetually solemn. WE must play. But our merriment must be of that kind (and it is, in fact, the merriest kind) which exists between people who have, from the outset, taken each other seriously-no flippancy, no superiority, no presumption.
— C.S. Lewis

Inner Circles

Most of our relational discomfort, conflict and unhealthy patterns stem from poor boundaries (see: You Do You) When I feel responsible for you or that you’re responsible for me, it is no longer a relationship. You are there to serve me, to emotionally care take and regulate my distress. It is transactional. This is often an area of focus for me with my clients: learning what is within your jurisdiction and what is not.

Another area that we discuss is determining your concentric circles of intimacy. I often find that people think others are due/owed information. Emotional, internal boundaries are misconstrued for “closed off”. (There are certainly people who are closed off and that is where the boundary is too rigid. Boundaries can be too loose or rigid. We’re going for “just right”.) Because they don’t want to be viewed or judged as closed off for not sharing parts of themselves, they may extend those parts to others who are not worthy, are not safe.

I share with clients they have their own concentric circles of intimacy and people they get to assign to a particular circle only have access to what that level of intimacy indicates. No more and no less. Others have to earn the right to be invited to a more intimate circle. It is a privilege to have access to our most vulnerable parts. And we need to protect ourselves by knowing who is allowed what.

Do you know who is in your circles?

Bittersweet Goodbyes

I’m in the business of goodbyes. My (and every counselor’s) job is to work myself out of a job. I know I’m meant to journey for a season, the length of that varies, but it will come to an end. And that means I say goodbye. And those are hard. They are hard because I have walked alongside someone through very intimate and significant moments. I’ve been invited into a very precious part of their life and given the honor to see them and hold their tears and join in their laughter. So when they’ve done the restorative work they set out to do and we know the season of working together has concluded, it also means our relationship ends. It’s a unique relationship for sure but a relationship nonetheless. And that makes the goodbye a hard one.

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“You know, we have pieces of the people that have cared about us all through our lives, and they’re all part of us now. And so each one of us represents so many investments from others. No one of us is a lone.”

No disrespect to the reigning Canadian pop queen. We’ve all sung her ballad “All By Myself” for karaoke or ironically. I do think a lot of the time we do think we are all by ourselves. Being by myself (without any emotional support or nurture) is very different than the feeling of being lonely. I want to address the feeling. It’s valid. Full stop. AND we can also self-soothe that ache by identifying our connection to parts of others that are comforting, protective, nurturing, loving, kind, compassionate, supportive.

When I work with clients, sometimes I will ask them to identify people (or animals/pets) that represent for them nurture, protection, and wisdom, so that they can draw from them when they need to feel loved, safe and protected and direction and guidance. The people or pets can be real or imagined. You may have met them or may only know them from afar. For example, I’ve had clients choose characters from Harry Potter. Other therapists have told me people have used Oprah or Michelle Obama as nurturing figures even though they never met them. I personally use Aslan. It’s so powerful what happens when we connect to parts of others (real or imagined) that can be so reassuring. The amazing thing is that we carry that representation within us. We are doing the reassurance by receiving from ourselves what we need and want and providing it through the connections we created.

We are your figures? Who are the people who you reach for in moments of pain and hurt?

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