A Therapist Facing Challenges Which Test Emotional Endurance

I have joined the clan of chronic illness. Don’t worry. I am not going to go on complaining about my miserable symptoms. Instead, I think it is very interesting how a therapist who has taught about cognitive distortions for over 20 years responded to some significant medical occurrences.


First, six years ago, I suddenly had a foot fracture. I had run a 10k two months before! As I was winding down from that, I took up Pilates. One day, I got into a plank position which caused pain in my toes. Then my foot swelled and it hurt to walk. It didn’t go away. The doctor said it was just the final straw on an overstressed fragile bone. The flawed structure of my foot shifted the pressure to a smaller bone when my foot landed during running. Well, that meant I really shouldn’t keep running. I was unhappy. Becoming a runner in my 40s had improved my self-image. Now, this just placed me back into the physically weak, uncoordinated, rejected role I had lived most of my life.

I healed from the foot fracture and stayed active with walking, hiking, swimming, and paddle boarding. While growing up, I was not athletic nor was I comfortable in or around water. These activities I took up independently out of my own interest and curiosity. This again contributed to improving my self-image. 

Then, I developed a chronic cough. I had learned to wait things out and they usually went away. Plus, whenever I was out on the water, I could exert myself and not start coughing. Seemed like asthma to me. But the cough got worse, louder and more forceful. I was certain I was scaring everyone around me. Over more than a year passed as my doctor tried to eliminate possible causes. Then a CT scan of my lungs produced a very alarming picture. I was rushed in to see a lung specialist the next day. Soon I met with a lung surgeon and I was admitted to the hospital for a surgical lung biopsy. 


The two nights in the hospital following the surgery were quite painful. This is where my own thinking became interesting. The pain was severe. I thought, “I can’t stand this! I can’t go all night hurting like this!” But it got worse. The pain medication caused me to vomit. “Do I take it for the pain? What if it makes me sick again? But this pain is too much!” I was hurting and could not get comfortable. The night was very long. I had the sense of despair. But I caught my own thinking and reminded myself that I was the one who taught others that your way of thinking can make the experience of pain worse. Time to take the medicine I handed out to others. I told myself I wasn’t going to die from the pain. It wouldn’t be forever. Others got through this sort of thing. I can handle it. Luckily, the pain was less the second night.


I was diagnosed with an autoimmune disorder and began treatment. I was positive and had faith in the recommended treatment. The process to get cleared up and into remission took almost a year. But I was triumphant! I engaged in healthy activity and decided I would walk a 5k at the end of May. But as I increased my distance and pace, my foot began hurting down the side. I backed off a little and hoped the pain would go away. One day, I went for a little trail hike and knew I had to keep to a flat path and take it slow and careful. I knew this wasn’t good.

I ended up in a walking boot again with a stress fracture in a different spot. I was so upset that simply walking would cause a fracture! I was upset that I wasn’t capable of doing a 3.1-mile fun walk. This was going to be my marker of recovery from my lung issue. Nope.

I was still in the boot when it was time for a camping trip I had planned. I went camping and made the best of it. In years past, I wouldn’t have gone. Still, I was highly frustrated at my bad luck. I wasn’t experiencing the full joy of camping. Plus, a bone scan showed that I had osteoporosis years before I should. After about a decade of running which I was sure was building my bones up and protecting me, it turned out the treatment for my lung disorder may have contributed to bone weakening and loss! How could this be after all of my hard work and persistence? Why me?! I felt very discouraged and vulnerable. Then my cough returned! A CT scan again produced an awful picture. I went back on medication. Now I was knowingly taking something that harms bones in order to save my lungs. I felt trapped.


I am currently tapering down off of that. My foot has healed. Spring is around the corner. Shall I try it again? How much walking can I do? At what pace? Should I try to increase? What about hiking? Is it safe for me to go on mild natural trails? What if I mis-step? I am at risk for a hip fracture not just a foot fracture. But it seems I have some natural optimism (or the ability to distance myself from reality). I have plans to be active and to get as much enjoyment out of spring and summer as I can. My kayak and my paddle board are waiting!

Only Two Years Since I Last Wrote

It has been 2 years since I last wrote. Wow! What have I been doing? I have been starting a small outpatient counseling practice in the after hours of my job at the hospital youth acute unit. In addition, I have been developing a craft business in which I sell handmade jewelry and handmade boxes with wood-burned designs on the lids. I have also taken a trip to Jacksonville, FL and very recently to Las Vegas, NV. Last March, I had a surgical lung biopsy and was diagnosed with an immune system disorder which I now have under control. Over the summer, I made it out onto the lake with my standup paddleboard and once in the fall with my kayak. Mid-summer, there was a sudden change at my place of employment which threw myself and my co-therapist into having larger caseloads than we typically could manage. This situation continues at this time.

After all of that, I think I am ready to start writing again. Stay tuned. I am becoming more active on my Facebook business page: www.facebook.com/ldonreed and will be improving my web page: www.ldonreed.com. The physical location of my outpatient practice will be moving soon. Updated information to come.

This was just 10 days after my surgery. Kinda dumb of me. I was hurting on the drive home.

                                                                         Women's Wellness Fair

I Need a Therapist, But Who?

How do you find and choose a therapist? You do not have to go to any random person that somehow is assigned to you. You have the right to seek out a therapist that interacts well with you and has an approach which fits your needs.

Trusty referral sources who can give you a good lead include:
your general practice physician who may suggest that therapy could be beneficial to you, or
friends or family who may have worked with a therapist they liked and recommend that person to you.

You might also see advertising, blogs, social media, or web sites of a therapist which give you an opportunity to learn about the person.

If you have not been referred to someone in particular, a good place to start is with your insurance company. 

1.  Make sure you have a mental health counseling benefit and find out how much insurance will cover and what your co-pay will be. This might be most easily done by calling the customer service number on the insurance card. 

2.  Look through the counselors that are contracted to be in network with your insurance. You should be able to use the insurance web site’s search feature for a professional. Or, if you are on the phone with customer service, they might run the search and e-mail it to you. 

3.  Look at the convenience of each counselor’s business location to your home and work routes. This may seem superficial, but people are more likely to continue with counseling on a regular basis when payment is assisted by insurance and it is easy and convenient to get to the counselor in your busy life.

Choose a few therapists to call. By the way, the terms therapist and counselor are interchangeable, meaning the same thing, usually a licensed professional with a masters level degree. Other designations you will find include psychologist with a PhD or psychiatrist which is a medical doctor in psychology who specializes in prescribing medication.

Think of your search for the right therapist as an interview process. Essentially, therapy should be a team effort with you and the therapist working together. You want to find a therapist whose experience, approach, and presentation fit with you. 

There are many types of therapy methods. An effective type is cognitive-behavioral therapy (CBT) which focuses on the present issues and helps you improve by addressing thinking patterns and practicing actions to change habits. This therapy and a more recently developed version, Dialectical Behavioral Therapy (DBT), are proven treatments for many issues.

Other therapies may include art or music therapy, experiential or Gestalt therapy, trauma focused therapy, systems approach, interpersonal or therapies which access the unconscious. It is important that the type of therapy is an approach which appeals to you. Also, actually enjoying talking with the therapist is immensely helpful.

Call each of the therapists you have selected and ask a few questions such as if they work with issues like you are experiencing and what type of treatment approach they use. You might be speaking first to a receptionist. See if you can speak either by phone or in person with the therapist to see if this is someone with whom you want to work. Some will be willing to have a brief conversation free of charge to establish if you want to enter into therapy with each other.

Here are some questions you could ask:

What license do you hold with this state and what is your education? How long have you been practicing?

I have these difficult issues occurring in my life and I have these symptoms. Do you work with clients with issues like mine? What types of clients do you work with: children, adults, families, couples? What type of therapy do you use and is it helpful for my issues?

How soon could you get me in for an intake session? Do you have availability for a weekly session, more or less frequent?

What insurance do you take? Are you contracted with my insurance company? Do you bill the insurance? Do you ask that the co-pay be paid by me at each session, or do you bill me for my co-pay after insurance has paid? (If you don’t have insurance which covers that therapist, ask if they have a sliding scale fee and how fees are determined.) Are you willing to establish a payment plan?

After speaking to a few therapists and asking the above questions, determine the one with whom you would like to officially begin therapy. Call back and schedule an intake appointment. This will include a diagnostic interview. The first session is longer than the subsequent regular sessions.

Therapists will typically discuss such topics as confidentiality, nature of the therapeutic relationship, treatment goals, and how you may take a break from or end treatment.

Find a therapist that you will experience as supportive and trustworthy. They should be able to give you honest feedback, recommend skills for you to learn and practice, challenge your thinking, and guide you in growth towards your goals.

Breakdown of Reason

I have been becoming more and more distressed by positions presented in the news, on talk shows, supported by various public figures, and rights groups. I, of course, have my own opinions and would like others to agree with me. But what is truly bothering me is the profound lack of discourse based on careful gathering of information and examining the pros and cons of different courses of action. 

I see people everywhere taking up positions, often based on feelings and basic schema, and then shouting others down and rejecting those with different views while labeling them. From my education over the years, I have been encouraged to think to solve problems. I have learned effective and ineffective approaches to thinking. There is the scientific method, there are the rules of logic, and there is the gathering of supported facts, and the use and misuse of statistics. 

Speaking of statistics, everyone needs to know that correlation does not prove causation. The finding or observation that two things tend to appear together does not prove that one causes the other. There could be another factor exhibiting its influence on the first two. Often, we are not aware of or have trouble identifying the true influence. In addition, my education on the mind and human nature makes me well aware of the mistakes in thinking and the misperceptions on which we all develop our belief systems.

Though I am confident in my intellect, I am also humble enough to know that I don’t have all of the information. That is why we form research groups, create special committees on specific topics, and employ fact checkers. But even at that, we must take caution that the individuals or groups presenting their findings could be influenced by their own biases, their desire for a certain outcome.

I and other citizens of the enlightened civilization are becoming more and more disenchanted by the systems we believed in to perform the gathering of information and the developing of reasoned approaches. The American government, we were all taught, has a system of checks and balances which is very effective. The free press, unencumbered and protected by law, is there to expose the lies and ensure that the citizens have accurate information on which to form their own opinions. The citizens expect to have the right to true and accurate information, to not be kept in the dark, ignorant and subservient to those in power. The systems are not working correctly and the general public seems to be losing touch with the value of being educated and informed, of doing the hard work of thinking.

As I observe the breakdown of reason in our government, our press, and our citizens, I feel a sense of danger. I fear that others do not see it. Or those who are aware do not know what to do about it.

https://www.youtube.com/watch?v=87AEeLpodnE

Are You A Happiness Hater?

Being happy seems to be an obvious shared goal for most people. People with ongoing unhappiness or distress often enter treatment with the assumed goal of feeling better, of becoming happier. But an actual fear of happiness may undermine progress. Research is finding that people have beliefs which lead to anxiety when they try to be happy. For example, some people have a sense that enjoyment leads to an inevitable fall when something happens to disrupt it. They perceive the pain of that fall to be worse when they have allowed themselves higher levels of enjoyment. Others feel uneasy with times of pleasure because there is only value in productivity, having fun is wasting time; relaxing is being lazy. They may fear negative consequences if they take time away. In fact, though evidence shows that people who take breaks, attend to only one task at a time, or who take vacation time have higher levels of productivity, society in general and many employers do not recognize this. Instead, they disapprove of and have negative perceptions of the person who takes time to rejuvenate. Some people, especially depressed people, have dampened all emotions and need to practice feeling any emotion including happiness.

The prescription is choosing to take time for relaxation or enjoyment, even briefly, and allowing oneself to experience it without judgement. I struggle with experiencing anxiety related to taking time for pleasure, and I have had to make conscious steps to counter it. I am so terrible at prioritizing fun that I was paralyzed when it came to planning it. For several years, my coworkers would claim vacation times, especially in the summer, and I would be so slow in even contemplating it, that it would be difficult to find days I could take off around what my coworkers had already planned.

Because I am so terrible at planning what I even want to do, I have taken to choosing some days around a weekend and days around my birthday during the summer even without knowing how I will spend the time. At this point this summer, this has resulted in my being able to accept an invite to spend a day with a couple of friends including going for lunch together. I just scheduled an appointment for a massage the day before my birthday. The day of my birthday happens to be a discount day for an activity I want to do, and the next couple of days there is a live music event including several bands. 

I have spent so many summers resentful at spending the entire summer inside working and missing out on nice sunny days when I live next to a lake. I finally invested in a standup paddleboard which I can manage loading and transporting myself. Now, when a good sunny day is in the forecast (we have a lot of cool, rainy days) I at least take a half day off from work, a whole day if possible, to get the board and me out onto the lake. Taking the time isn’t the whole solution. While out a couple of weeks ago, I consciously made the choice to stop, lay back, notice the warm sun, the soft breeze, the water rocking me on the board. I chose to let myself feel pleasure, otherwise, I would have made it just another workout routine for exercise!

Taking brief moments for pleasure is still a struggle for me. I feel guilty when I take a walk break in the middle of my work day every once in a while. When I arrived home from work yesterday, it was warm and nice out. I couldn’t find the motivation to go outside even though I had been inside all day. I consciously talked myself into just stepping out into the backyard for a moment. Pretty soon, the cat wandered up to me and was clearly happy I was outside. I sat in a chair and enjoyed the warm day as I sat in some shade and petted the cat at my feet. After a couple of minutes, I needed to go inside for something, but I had now had a taste of the outdoors, and I was compelled to go back out. Success!

This past Saturday, I spent time with a friend, went to a barbeque, took the scenic route there, and spontaneously decided to go shopping for a tree. In the middle of it all, I realized I had no plans at all for the day. I didn’t have a list of things to do that I felt I was neglecting. I was truly relaxed and going along with what was right in front of me. Now that was unusual for me! And nothing bad came of it; no terrible consequence for “wasting” a day. It was a very nice day.

http://www.scientificamerican.com/article/fear-of-happiness-underlies-some-mental-illnesses/

Join A Group You Care About

A sense of loneliness tends to precede the development of depression.

And depression often includes the symptom of loneliness along with isolation.

Since my early days as a counselor, my mentors instructed me to encourage depressed clients to get out and around people. At the very least, a friendly interaction with someone might occur and lift their mood.

It turns out that being part of a group helps to ward off depression, but it must be a group to which the person identifies and feels connected.

Multiple studies have shown that higher levels of group identification were related to lower levels of depressive symptoms.

Group membership can be a treatment intervention for depression.

In a 2013 study of over 4000 adults over the age of 50, those who were depressed and joined one group reduced their risk of depression relapse from 41 percent to 31 percent. Joining two groups reduced the risk to 21 percent. And with three groups, the risk dropped to 15 percent.

For group membership to be effective at decreasing depression, people have to closely identify with the group and feel connected to it, not just physically be around a group of people.

Groups help by offering support and a sense of purpose.

Some groups, however, do not protect. Groups that revolve around a destructive focus such as self-harm, substance abuse or a sense of victimization are groups to break away from.

Currently in my life, I am part of a group of people who work together as a team with the purpose of helping people get through emotional crises. I also am a part of online groups of handmade artists which actively support and encourage each other.

Go ahead and find your favorite group(s) and know you are contributing to your own and others’ well-being.

http://www.scientificamerican.com/article/depressed-try-the-social-cure/

Becoming Enlightened By Hanging a Light

I hung up a shop light today. I had purchased it months ago. It was often on my mind that it needed to be put up. But my luck with simple little household projects has not been very good. Usually, it is the attaching to a wall that just doesn’t work out. So I wanted the shop light installed, but I dreaded the possibility of a botched job. I doubted my ability to do that basic work.

It could be a quick project of possibly half an hour, but not in my case. First, I had to move piles of stuff that had landed in front of and on the table that I wanted the light to be above. Then I pulled the table out from the wall so a ladder could be set up. While I had things pulled out, it was time to sweep up the dirt. Then, it turned out I did not have all of the hardware I needed. As I drove to two different stores to find ceiling hooks, I countered my negativity about wasting time with thoughts of this being part of the fun. I will frequently make a run to the craft store without thoughts of wasting time. Why not enjoy a trip to the hardware store?

I climbed up the ladder with the new drill I had obtained at Christmas and still had not tried out five months later. I felt awkward balancing on a ladder. I felt awkward using a drill. I felt uncertain I was anchoring the screw enough that it would hold. I had to get reading glasses to see well enough to attach a pull chain to the light. I wondered if pulling that chain over time would be enough to cause the hanging screws to come loose. It all went into place and, for the time being, seemed secure enough.

This little project took three hours to complete. I got some space organized in the garage. I enjoyed the fresh spring air with the garage door open while I worked. I browsed through hardware stores and had new ideas. I practiced my handyman skills once more and seemed to do a little better than the last time I tried. I felt satisfied with my work space which will allow me to try out some electric wood working tools and learn a new craft. It always amazes me how a simple little project provides so much personal growth. It seems odd that to most observers there would be little understanding of the negative self-assessments which were overcome in order to complete it. And once again, it is a marker of my independence and self-sufficiency I keep proving while being single and managing on my own. I am tentative and anxious, but little by little, I gain some confidence. Definitely time well spent!