Many years ago the diagnosis of ADD and ADHD was not well known or treated. Then it seemed like everyone was diagnosed with it and started on medication. I, myself, was put on Ritalin at the age of 7. For me, at least, it was helpful. My teacher told my mom I grew up 3 years over night and my grades went from Ds and Fs in 2nd grade to As and Bs in 3rd. I stopped taking Ritalin when I was 18 and headed off to college. My mom was very upset at this. She thought the medication was working well for me; why stop now that I’m going into college?! I told her at this point I need to figure out how to concentrate and focus on my own.
The question I pose is how much of our inability to focus as adults is based on a medical illness versus what’s going on in our world? What’s going on in our world affects us and affects our abilities to be present. We are either expected to – or expect ourselves to – work at 200% capacity, including on our time off. Be honest, how many of you check your work emails outside of work hours? We know what’s happening on the other side of the globe 5 minutes after it happens. We are constantly inundated with information, and are in a culture that expects us to “multitask” at work; getting 15 hours of work done in 8 hours. We are also told how useful being present is; that we can actually do better work by not multitasking and being present in everything we do. Seriously?! That seems like an impossibility. Stay present and don’t multitask, but get 15 hours of work done in 8 hours.
Mindfulness, or staying present, seems like a pipe dream. Not to mention, I’m sure you’ve all tried it once or twice. How well did it work for you? Have you heard of neuroplasticity? It is a pivotal point in trauma recovery. Neuroplasticity is the brain’s ability to form new neural pathways throughout life. When there’s a boulder in our path, we will go around it. When information gets stuck somewhere in the brain, the brain will find a new pathway allowing you to continue what you need to do, despite the block. This means we are able to learn new things and react differently to changes in our environment. However, we will do what works until something else becomes “better.” The brain works the same. We will continue the same behavioral and emotional patterns until something becomes “better. It will take a VERY long time to make being mindful “better” than chaos if you only practice it a few minutes a week in your therapist’s office. Can you practice baseball for 15 minutes a week when you’ve been doing soccer for years and expect to get good at it overnight? What if you practice baseball an hour every day? You’ll become better much quicker, right? The brain will reorganize to changes in its environment. If you introduce mindfulness to your routine and practice it 200 times per day, you will notice a difference. This I promise. And yes, I said 200 times per day.
How do you practice something 200 times per day? Mindfulness is nothing more than staying present non-judgmentally. When you’re washing dishes, for example, focus on all aspects of the dishes – what the soap feels like, what it smells like, how hot or cold the water is, the food you see on the plate, the color of the plate, the sound of the water as it is coming out of the faucet, etc. When your mind wanders, as it absolutely will, bring it back by saying to yourself: “I’m not thinking about that right now. The soap is an orange color and has a citrus-y scent.” Don’t beat yourself up: “Geez, I can’t stay focused. I’m not good at this; my mind keeps wandering.” You are learning something new. Learning something new takes time and patience. It is a large effort at first which will give a huge return on investment with time. Do whatever you need in order to make sure you practice it 200 times per day. It does not take a lot of time to tell your mind “hey, we’re not focused on what’s for dinner right now, we’re focused on xxxx.”
I believe I spoke in a previous blog about our culture wanting things now. We don’t want to wait to feel better. However, nothing in life is that simple. It takes practice, time, and patience to learn anything in life. Are you ready to make this change? Do you have other options? (Not changing IS an option, so is it one of YOUR options)? As long as you have other options, it will make this difficult. Once change and success become your only option, you will put 100% effort into it giving it the time, effort, and patience it needs to become your new reality. What will it take to make this your only option? Do you need to hear other people’s stories of how well it works? Do you need to spiral out of control? Do you need someone to do this with (buddy system?) Everyone is at a different place in their readiness to make their lives better. This is not a race, but if it were, remember the story of the tortoise and the hare…slow and steady wins the race. How can I help you? Do you need help figuring out how to make this your only option? Or identifying how to remember to do it 200 times per day? Leave me a note or send me an email (megberrylcsw@fastmail.com). Let’s start this process!

You’ve had a stressful day. Most of your days are stressful, but for some reason (maybe a known reason, maybe not), today just seemed more stressful. You get home and pour yourself an adult drink. As you sit down to unwind, you take the first sip and immediately start to feel better. You’re home now. The day is over. You can just be at home. Even if there’s chaos with the family, it is manageable…or maybe it isn’t manageable yet and all you want is to be left alone. Alcohol works as a stress reliever…to a certain point.

Alcohol is a depressant. It calms and slows the central nervous system thus making you feel more relaxed and calm. The problem is, it does not help you make sense of your day. It does not help you work through what you went through today. All it does is pushes it aside. The day and all its stressors are still there; unprocessed; unfinished. In and of itself this isn’t a big deal as long as you come back to the stress of the day to process it through. Be honest, how often do you go back to the stress and process it? Talk about it, your feelings, and your reactions? Probably very rarely, right? That is where the problem lies. As the memories of the day just sit there, unprocessed, the stress of the next day will add to the stress of the previous day. Your daily experiences are cumulative. If you don’t take care of the stress, it will take control of you.

What happens when one stressful day follows another? What happens when one drink isn’t enough? Then two isn’t enough? What started out as a normal experience of coming home and having a drink to unwind can quickly become out of control. It creeps up also. You don’t start drinking too much all of a sudden. Often your significant other will start to see a pattern of increased drinking (whether more days per week or more drinks per day). They may not know if they should bring it up to you. Afterall, you have such a stressful job and deserve to have something to help you relax, right? You’re not breaking any laws either. So it’s ok…no it’s not.

When you don’t take care of the stress, the stress takes over. The body wants to be relaxed. The body doesn’t like being in a stressed state. When you drink, it calms the central nervous system and it feels good. You are now relaxed which is what the body wants. As stated above, the problem is it just pushes the stress aside. It is still there. You didn’t actually relax yourself from the day. You numbed yourself from the day. A dentist putting novacaine in your mouth will not fix the problem. It will temporarily numb the pain, but the problem is still there. Alcohol does the same to the central nervous system. It calms by numbing, but does not help you solve the problem.

How do you know if you have a problem with drinking? Answering yes to at least two of these questions could mean talking to a professional is a good step for you: Have you ever wanted to or thought you should cut down on your drinking? Do you get annoyed with people complaining about your drinking? Do you feel guilty about your drinking? Do you ever need a drink in the morning to relieve the shakiness or get the day started? These questions are questions a therapist may ask. They are standard questions to determine someone MIGHT have a problem with drinking. It does not mean you DO have a problem. If you answered yes to at least two of those questions, talking to a professional may be a good next step.
Another thing to think about is other people are able to see things in us before we are. We very easily can ignore or explain away anything. If other people are saying things to you about your drinking (or about your stress level, or about the impact of your job on the family, or ANYTHING that has to do with you, your job, or your relationships – any of them – it may behoove you to listen to what they are saying before pushing what they have to say aside. What if they are onto something? You can reclaim yourself, your life, before it is so far gone.

You are strong. You are resilient. Alcohol will decrease your beliefs in yourself. It can make you start to doubt yourself. It is powerful. But it is not a fix for the stress. There are many places to go for help. Start with your doctor. Ask for a referral. Talk to your friends, colleagues, and family. Ask for support. 211 is a great resource (dial 211 on the phone or www.211.org). There are sometimes free resources as well. You want to talk with someone who is knowledgeable with first responders AND with addiction. It takes a great deal of courage to make that first call. If you don’t find the right person the first time, keep trying. Don’t give up on it. This is your life. It is worth it. You are worth it. Thank you for all you do for your community and beyond. Choose strength! Call or email me if you need help locating someone in your area. I will be more than happy to do what I can for you. 860-501-9767 or 941-462-4807 or meg@megberrylcsw.com.

In a recent blog, I explained how PTSD is a family illness. But what is it really like as a family member living with someone with PTSD? When a loved one is fighting an internal war, often they think it is only affecting them…until they see the effects on their family. The effects on the family didn’t happen over night. The symptoms have been building up for quite some time, just as your PTSD symptoms have been building up over quite some time.

Generally speaking, others will see things in us before we do. I always encourage my clients to listen to others when they say “you’ve changed” or “why are you [doing, behaving, acting, saying, etc] that”? We can very easily make excuses for our behavior – “I’m tired, work is stressful, etc.” However, when a loved one tells you you’ve changed, it isn’t because this is the first incident they’ve seen. Others seeing changes in you before you do is a key component to getting help before it knocks the boat over completely.

You cannot throw a stone in the water and have no ripples. The ripples will be smaller therefore more compact and stronger, right around where the stone hit the water, and will get bigger and less intense the farther out from the stone they go. The same goes for relationships. The closer the people are to you, the stronger the impact will be. The more removed people are to you, the less the impact, although there will still be some impact.

As your loved one starts to notice changes in you, they might ask more questions. Are you ok? What’s wrong? You seem (insert emotion). If you answer honestly, telling your loved one that you are having trouble sleeping due to racing thoughts about work, (or whatever is going on for you), they will worry about you. That is normal; they care about you and don’t want you hurting. If you lie and say you’re fine, they’ll worry even more because they know something’s not right and fear of the unknown (what’s going on for you), is very strong. So you always want to be honest.

Children are very perceptive. They rely on their perceptions as a baby for survival. As they grow up, they lose some of the reliance on their perception, but as children, it is still strong and accurate. Children know something changed in you. They see it. They don’t know what it is, don’t know how to react to it. Often their behavior will change because they don’t know what to do; they don’t understand what is going on. They just “know” something is wrong. You may see regressive behaviors or rebellious behaviors.

As your outward composure starts to break down, leaking internal truth into the outside world, if you are not being honest with yourself and loved ones, relationships start to deteriorate. Your loved one knows you’re not ok. They want to help. They don’t want you hurting. If you’re not being honest with them, the fear of the unknown starts to take hold of them and they may become more irritable, clingy, or withdrawn. In other words, their behavior changes in turn. As you see their behavior changing, you feel bad but you don’t know what to do. After all, it is not because of changes in you, right? Your problems are held tightly inside. So you ask them. Your significant other has already been lied to by you, so they may minimize what is going on, or put it back on you, telling you that you’ve changed. If they minimize it, it will perpetuate your worry about them. (And perpetuate a cycle of lying to each other). If they put it back on you, are you ready to hear it? What may happen if you’re not ready to hear it? You might get into an argument, right?

Your kids start to notice the change in your significant other and they get very confused. Again, their keen perception is telling them something is very wrong. But they don’t know how to respond because they don’t know what is wrong. So their behavior changes even more.

Your significant other sees changes in the children and starts to worry about them. Because your significant other is already worried, they may not have been able to provide the kids with exactly what they need to get through this. (He or she may not have picked up on the smaller changes in the kids. Sometimes it takes larger changes for parents to notice something is wrong with them too). Worry is part of the fight/flight response. Your significant other doesn’t want anyone hurting, and is now worried about the kids and you. So they come to you to talk about the changes. But because you are struggling so much inside, you may have a hard time giving your significant other what they need at that moment. They react to that out of their own fight/flight and things may not go well.

As you fight this internal war and your significant other and children notice changes and have changed themselves, you may find yourself withdrawing from them or getting more irritated with them because “they aren’t the same; they’ve changed.” As you withdraw or are more irritated with them, this affects them more as well and it becomes a vicious downward spiral for the family unit.

It is important to realize that PTSD does not affect only you. It will have ripple effects into the family unit and beyond. Many times loved ones just don’t know what to do. Keeping them in the dark makes it significantly scarier for them. Honesty will get the family through PTSD with much less damage than trying to pretend everything is ok. Your loved ones will feel the effects which will impact how they act and respond. They are responding to the PTSD in the house. Their emotional and behavior changes are a direct result of the PTSD. If you notice they’ve changed, maybe it’s time to take a look at yourself.

If you need help, reach out. If you don’t know who to reach out to, call me (860-501-9767; 941-462-4807) or email me (meg@megberrylcsw.com) and I will help you locate someone who can help you.

It takes people years to make that first call for therapy. Picking up the phone can be very, very hard, especially for you, a first responder who prides yourself on your strength. Asking for help in this way is very different than asking for help on the job and is still stigmatized despite our efforts to destigmatize it.

Until going to therapy is fully destigmatized, I want to talk to you today about some of the barriers to going to therapy and some ways to overcome those barriers. Please comment if I missed any barriers or solutions. I’ll be happy to respond and add if I can. I am always interested in feedback.
I spoke above about the stigma of therapy. Knowing that exists, if you look for a therapist who has as much confidentiality as possible, it may make going to therapy easier. All therapists should adhere to HIPAA guidelines for confidentiality but there might be other factors to consider. For example, do they have separate entrance and exit doors so you don’t run into someone else in the waiting room walking out? What other types of businesses are in the building, or are they a standalone office? Does the therapist have flexibility in their schedule so they can see you as you likely don’t work Monday-Friday 9-5? An important thing for you to know also is you do not need to tell anyone you are going to therapy if you don’t want to. None of these factors are vital, but things that may help you find a therapist if you’re concerned about them.

Another barrier is what will going to mental health treatment cost to your work life? Some people may lose their position if they are in counseling. Also, some first responders fear that if their boss finds out, they won’t be able to go on calls because they aren’t “stable enough.” I never condone lying, but maybe looking outside the box can solve some of those barriers. Does the therapist do coaching? Coaching is VERY different from counseling and the therapist really needs to have specific training in coaching and know the boundary between counseling and coaching, but if you find a therapist that does coaching, they can help with specific skill building.

We have health insurance to minimize our cost to access to healthcare, but there are downfalls to using insurance. Insurance companies need to justify the services they are paying for. Because of this, you need to have a diagnosis to be treated. Many first responders don’t meet the full criteria for any specific “disorder.” Once you have a diagnosis on file, it can follow you for a long time as part of your permanent record. To minimize this risk, going to someone out of pocket may be the answer. Deductibles are so high these days that often what you pay out of pocket won’t be too different from what your deductible will be. Some therapists accept flexible spending accounts or health savings accounts as well.

If you’re considering going out of pocket for services, a question to ask yourself is: would you see a general practitioner or primary care doctor for a specialized problem or would you go to a specialist? Maybe going to a therapist who specializes in PTSD of first responders is an out of pocket expense, but if they can get you functioning and back to yourself sooner than the therapist you see through insurance, is that worth it? You may end up paying approximately the same over time anyway.
Timing may be another barrier. Many first responders don’t work a traditional Monday-Friday work schedule. Volunteer firefighters often have a full time job on top of their passion. There are many therapists that work early morning, late evening and weekend hours who can accommodate your schedule. “Making” time for therapy is a better way to think about it than “finding” time due to all of your home responsibilities as well.

Will the therapist understand you? Many first responders don’t want to share details and don’t want the therapist to ask. You don’t want to be seen as weak. This solution may go back to seeing a specialist. First responders have a different culture than the rest of the population. Even when you find a specialist, there is no guarantee that you and the therapist will be right for each other. If you feel uncomfortable, let the therapist know. Most therapists will have no problem providing referrals elsewhere as they are there for you. Additionally, if you found a therapist who specializes in first responders, they’re likely to know others who do as well.

You already use coping skills. What can a therapist do for you? Coping skills are only half the battle. What you see and do everyday will have an impact on you and going to the gym, gun range, or using less healthy options such as gambling or drinking will let out some of the energy, but will not put your experiences to rest inside of you. A therapist will help you get your mind back. They will help you lessen the impact in your head which in turn will help you sleep better, eat better, improve your relationships and mood, and maintain your career. I know you are doing everything in your power and using your skills. You are not weak. Even so, these coping skills aren’t always enough.

I’m sure I haven’t captured all of the barriers of going to therapy. However, I hope I hit on several that will give you whatever you need to pick up the phone and make that call. There is no shame in going to therapy. There is a hope that you will reclaim your life, relationships, and maintain your career. You are worth every cent you pay to the therapist. If you aren’t sure where to locate a therapist for you, feel free to email (meg@megberrylcsw.com) or call (860-501-9767; 941-462-4807) me. I’d be happy to help you locate someone.