Writing about mental health from a feminist counselling perspective
Medication is a topic that's come up a lot in the last few months, and I wanted to put my thoughts to paper. A lot of people have been wondering if it's time for them to try anti-depressants, and my thought is this: it's okay to try. You're allowed to ask for help. Doing so doesn't mean you're "giving up" and it definitely doesn't mean you failed.
A little bit of history: As a feminist therapist I've often tried to help look for the broader contextual reasons that people are feeling depressed (traumatic experiences from the past, current job situations, difficult relationships, state of the world, etc). In traditional therapies, this has sometimes been overlooked. Instead, psychologists of the past have honed in too much on the individual and forgotten the broader social context we live in. Way too many people (women and marginalized individuals particularly) were left feeling as though how they were responding to unjust situations was somehow wrong, or pathological.
At the same time, addressing the social context is just one way of working with depression. Since it's typically been an overlooked area, it's one that I as a feminist therapist tend to focus on. But there are also other, totally important management strategies that we can still use for depression. Medication can be one of those strategies some people use part of managing their depression. I also think it's important to say that trying medication is totally valid EVEN IF depression can be traced back to contextual factors. It might be that thing to help someone get out of bed in the morning and be able to do all the other things they know help them.
It's not the right fit for everyone, and I know it's important that it's part of a bigger depression management plan, but let's start here: it's okay to try.
P.S. Let's be super clear: I'm not a doctor! I can't give medical advice and I get no benefit at all from pharmaceutical companies, which is why I didn't name any. If you're curious about medication, please talk to an actual doctor. One that you trust. And make sure they know about any other substances you're taking including over the counter, naturopathic stuff, and any other drugs you might use.
Someone read all of the above thinking I wrote “meditation”, and hey, it still fits! So, there ya go. Meditation and mindfulness practices don’t have to be done in a particular way, in a particular place, or in a particular style. It’s mostly about bringing our attention to the present moment, without judgment. There’s a ton of research these days on the psychological benefits of meditation and mindfulness practices, giving us reason to think that this might benefit a lot of people. It doesn’t have to be your “go to”, but it’s okay to give it a try. It’s okay to give it a try at different times in your life, in different ways, with different people. If you want to.
Take a Break From Work
You're also allowed to take a break from work. Around these parts we call this "stress leave", and my thought? We have stress leave set up for a reason. That reason is so that we can use it when needed. I watch waaaayyyy too many people wait too long to step back from work and by the time they do, they're completely burnt out that even getting out of bed is difficult. At that point, it takes months and months and months to recover, let alone feel rejuvenated and do the healing work that's needed and think about new boundaries going back into work. If you're overwhelmed enough that you're thinking about taking stress leave, chances are you need it. I encourage you talk more to your doctor or mental health professional about your options!
ps. Not sure if I need to say this but what I'm sharing here is not intended to replace the medical advice of your doctor or healthcare provider. Seriously. Go talk to them!
This one may just seem like a plug for my own services, but that’s not my intention. The reason I wanted to include it is that it’s not uncommon in my office for clients to show up and feel bad for “using up my time”. So, I’ll make it clear. You’re not taking a spot from anyone else. I fully consented to being here. I’m 100% okay with doing it. And, I actually appreciate the opportunity to walk through life with you.
People sometimes worry that their problems aren’t bad enough for them to go to therapy. So I’ll be honest: I’m not a fan of waiting until it gets bad enough, if we can help it. Another way to think about it is there’s always going to be someone with “bigger problems”, and it doesn’t serve us to get into the comparison trap. We can recognize our privilege and acknowledge the gifts we’ve been given without dismissing our own pain and hurt.
So here’s my big message here, one more time: you’re allowed. You’re allowed to do the things. You can give yourself the nourishment you need and know that’s not selfish or indulgent. That’s doing the work.
Most of us here can’t help but notice the abrupt change in seasons we experienced at the end of summer. Many people walked into my office feeling “off” – for some, this was a subtle feeling of strangeness, while for others, it was a more profoundly felt environmental grief. We’re a part of nature and so of course, it makes sense that we’re deeply impacted by it, emotionally and physically.
I was sent a beautiful article that touched on environmental grief that you can check out here. For this post, I’m going to focus on how we can cope with change of seasons more generally.
Take the Time to Reflect
For me, fall equinox was a time to slow down and set some new intentions: rest, support, and self-regulate. Not because I’ve met all my goals for the year (that would be nice) or have somehow otherwise “earned” it. I don’t believe that we need to earn rest. I’m listening to my body now because I’m tired. Now is a time for me to keep slowing down, to let extra work fall away (just as the leaves fall...) and focus on these 3 intentions so that I can continue offering the presence of self with my clients that’s so important to my work.
Many of my colleagues who live South of here speak about letting ourselves move with the rhythm of the seasons. For example, there may be a naturally “turning in” or cozying that we do in the winter months. At the same time, this is my perspective: as residents of Edmonton we’re in kind of a unique situation. Yes, it makes sense to move with the seasons to some degree. At the same time, I think we can really start to suffer when we’re alone or in our beds for too long, and the winter IS long here. We miss out on social connection, we miss out on being with nature, and if a lot of that time in our homes is in front of the tv, we can really miss out on being with ourselves.
It seems like a real balance – allowing ourselves to cozy in at times, while also stretching our comfort edges and ensuring we get outside at times too. The change of seasons gives us a clear chance to reflect on what we need and how we want to move into the next few months.
Get Your Routines in Place
Okay, so now you know that winter is coming. Time to get your routines in place. Bring your SAD lamp out of its hiding place. Sign up for the dance class that’s going to get you out of the house over the winter and keep your body warm. Organize that book club that helps you keep connected. Okay serious note. If your depression symptoms are worse over the winter, I’d seriously consider investing in a SAD lamp. If seasonal depression is truly at play, it’s one of the most supported treatments in the research.
And did you catch the three other things I put in there? Movement, being in nature, and social connection. These are often missing in winter and worth thinking about how you might integrate them. Of course, it’s up to you to consider the routines you need in place to feel whole.
I think it’s also super important to actually carve out time for this daunting task. Personally, I spent an entire day getting the routines in place and on the calendar. From my perspective, it’s worth the investment, and best to do early, before it’s hard to find the energy for.
Give Yourself Something to Look Forward to
Okay, while you’re planning all those necessary daily and weekly routines, are there parts of fall and winter you can actually look forward to? Maybe you love making your way through the corn maze and listening to the sound of the leaves crunching under your feet. Perhaps the quiet of the snow is really peaceful for you, and you’re looking forward to some cross-country skiing this year.
If finding something about fall and winter specifically seems to daunting at the moment, you can still find things over the next 6 months to look forward to. It might be a trip to the mountains, a vacation somewhere warm, tickets to the ballet, or some good local craft shows and holiday festivals. And of course there’s Halloween – a lot of my clients love dressing up, carving pumpkins, and having an excuse to get together with friends. If there’s even one thing a month you can look forward to, that’s wonderful. Again, I really encourage people to take the time to sit down and plan this out. Often, we can fall into a trap where we don’t end up organizing the things we need until we’re already in need of them, and then we’re more likely to run into barriers.
None of the things I’ve suggested are mind-blowing, I realize that. But I wanted to be the Psychologist in your ear saying, “you’re allowed to have things to look forward to. You’re allowed to take this time for yourself.” I hope it helps.
Over the years I’ve worked with a number of people trying to make hard decisions, and these hard decisions usually boil down to this: “should I stay or should I go?” What people struggle with most is knowing whether the situation they’re in (a workplace, a relationship, etc) is one that will get better by working on or not. I watch people struggle for months and sometimes years, caught up in the distress of trying to make a decision that’s best for them.
Hope you're all having a lovely Thursday - just a quick announcement on my end. After much consideration, I wanted to let you all know that I will soon be increasing my rates. As of September 1, 2018, standard fees will be as follows:
The other day I was explaining to my 3 year old why I’m not spending quite as much time outside as I’d like to. I explained to her that there’s a lot of pollen this year and that the pollen can make my nose itchy, and my eyes watery, and it’s not very much fun. “I have allergies,” I told her, “you know, just like how Grandpa gets.” I further explained that’s why I wasn’t using my lawnmower as much this year, and why her dad was doing the lawn instead. Without missing a beat, she asked, “so who mows grandpa’s lawn?”
It’s not uncommon in my therapy office to talk about social media. Specifically, I’ve been having a lot of conversations about wanting to not be on social media but having a hard time stopping.
When people bring up the topic of their social media use, it’s usually said with a bit of a guilty look, and can come across as a shrug off comment. “I really shouldn’t be using my phone so much,” they might say in an off-hand way. But, since people are paying me money to notice things, I don’t just shrug it off. Instead, I invite them to talk about it. So many of my clients are finding that they’re on social media more than they actually want to be, and that it’s causing upset in their lives. These are some of the things we’ve been talking about in those conversations.
It’s hard saying no. For a lot of new therapists, we really struggle with the idea of disappointing someone in our care.
It can be easy to feel that because our clients need something, we need to be the one to give it to them. I hear new therapists say things like “but they need evening hours – they can’t make it during the normal workday“ or “they need a sliding scale – they can’t afford the full fee”.
My good friend Lily recently did an episode on "mom pressures" for her podcast (the fantastic Lady Sh!t with Lily and Britt). She asked me to write a few things about the pressures moms face, and I accidentally wrote her a novel about it. Here's what I came up with one evening.
"It's Actually a Good Thing": A Little Reassurance When Your Loved One is Working on Their Boundaries
As a partner/friend/lover/ally of someone who is working on boundaries, you may be noticing some changes. Like most changes, this can feel pretty scary and you might be unsure or hesitant about what’s happening. That’s why I wanted to write you this letter. I think it’s normal to feel afraid in times of change, especially when the change involves something unfamiliar.
Annina Schmid (M.A.) is a feminist counsellor who helps women recover from binge drinking and disordered eating, as well as families with young adults who "failed to launch". Annina employs Solution Focused Dialogue to support and empower her clients in making lasting life changes. She works from a strengths-based harm reduction approach. Annina works with all genders and people on the LGBTTIQQ+ spectrum.
As a counsellor who works mostly with women who struggle with disordered eating and binge drinking, I have started running monthly online support groups at the beginning of the year. Here are the four most important things I have learned from my participants:
Alright y'all, big announcement time! I'M MOVING... UPSTAIRS! I'm excited to share with all of you that as of May 31, I will be relocating upstairs, to the 5th floor of College Plaza. The new space I’ll be practicing out of is located within Transcend Psychological Services and Blossom Counselling, though of course I'll still always be Feminist Counsellor Edmonton. It’s a dedicated therapy office which means I get to work alongside some amazing therapists. It's got some big beautiful windows, a little more space... and I'm so looking forward to sharing it with all of you.
As health professionals in positions of power, we have certain standards of practice we need to adhere to it in order to protect the public. The Standards of Practice of the College of Alberta Psychologists are “the minimum standards of professional behaviour and ethical conduct expected of all regulated members”. These include informed consent, avoiding dual relationships, and acting within our scope, to name a few. These are incredibly important to know and adhere to, and yet it’s not enough to ensure that we’re working in a way that’s ethical and sustainable.
This is soon going to become quite obvious, but I still want to begin this post by saying that I wrote out these ideas based on my own experience of pain. They've helping me immensely in coping with what's probably been the most despairing experiences of straight up suffering I have lived through (and continue to live through). I continue to be humbled by it. So, from someone who's in it with you:
I want to offer some assurance for anyone struggling with setting boundaries. Ready for it? Deep breath.
It’s not your fault.
Yep, I said it, and I’m going to say it again. It’s not your fault.
Tiny Beautiful Things: Advice on Love and Life from Dear Sugar by Cheryl Strayed
My rating: 5 of 5 stars
After having this book on my shelf for several months, I read it over the December break, knowing that I needed the time and space to fully immerse myself in it. And I did. I sat on my office couch, and in my bed at home, and I had a good long cry or two (or more). I let myself take in the sorrow of the letter writers' grief and be moved by it. I let my guard down and allowed myself to be different. I even took off my psychologist hat (a thing I almost never do) and let myself read it as a person first.
This book will transform you, if you let it in. I definitely recommend reading it over several sittings (all at once could be overwhelming) but within a short enough time frame that you can stay down in the depths with it. I thought it might be too much but the order of the letters has been designed wonderfully, so it intersperses shorter more humorous letters with the more difficult ones. I was particularly moved by the letters that had to do with family and mothering, but really this is a book about life.
Trigger warning: Cheryl Strayed talks pretty openly about her childhood sexual abuse, and a number of the letters have to do with sexual violence. I absolutely found it readable - and I don't always - but it wouldn't be the best book for someone in the early stages of healing from trauma or dealing with active flashbacks/nightmares.
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Most people who have seen me in the last few years know how much I rely on self-compassion - in my own life and in my life as a clinician. I've seen so many amazing people struggle with never feeling good enough and self-compassion is the foundation I return to again and again.
Come as You Are: The Surprising New Science that Will Transform Your Sex Life by Emily Nagoski
My rating: 5 of 5 stars
This is absolutely my favorite book for women related to sex and sexual desire. I first heard Emily Nagoski speak as a guest on Sex Nerd Sandra's podcast, and loved what she had to say in that episode. I feel like I learned a ton and it also left me wanting to know more. She spoke so clearly and knowledgeably that I was pretty excited to learn she'd also written a book, complete with worksheets to fill out.
Emily brings a really fresh perspective on desire styles and offers insights about female sexual desire specifically (unlike old models that were based on the average male desire style). I've found myself teaching others what I've learned from her about spontaneous vs responsive desire. She also teaches readers (in a really accessible and fun way) about the dual control model of sex, suggesting that if we want to feel like having sex more often, we need to focus on "turning on the ons and turning off the offs". At the same time, it never comes across as prescriptive or judgmental. She reminds readers every chapter or so that there's nothing wrong with your desire, and helps us understand what a huge role context plays in desire for women.
"Come as You Are" is great for folks who might like to have a more active sex life, but don't necessarily feel like having sex. It's great for women in relationships where their desire style is much different than their partners (higher or lower). It's great for women who've worried that there's something wrong with their desire. It's great for partners of these women. It's great for women in heterosexual relationships and queer relationships. And the list goes on.
I love love love this book! As a bonus, Emily Nagoski is a generally awesome person and speaker who really does come across as wanting to share what she's learned and help remind readers just how fantastic and normal they are. The audiobook is read by her and it's lovely to listen to.
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Adulting: How to Become a Grown-up in 468 Easy(ish) Steps by Kelly Williams Brown
My rating: 5 of 5 stars
As anyone who knows me might guess, I was initially drawn to this book because of the cover (woman alone in her apartment with her cat! So obviously me!). I also was at a point in my life where learning to do more adulting just felt right. I was 28 at the time and ready to feel more like a professional woman. I'd already started to feel more settled in my career and less like a student just struggling to get by. So if you're a woman in your 20s thinking "adulting! I need more of that!" then you'll very likely enjoy this book.
One big thing I appreciated about the book was the very user-friendly breakdown. The chapters are by topic (eg., Domesticity, Fake it Till You Make it, Get a Job, and Love) and within each chapter, there are a number of bitesize "steps". It was nice to pick and choose the things that felt most relevant and go from there.
Looking back now, it's interesting how much I loved a book that's basically about taking responsibility for your life. The tone absolutely helps (it's fun, light, and authentic) and so does the author's voice. She's a young, modern woman who is compassionate and a bit awkward and completely relatable. I never felt judged or like I wasn't doing a good enough job as I read through the steps. Instead I felt pride (there was a lot I was already doing right) and a lot of validation for where I was in my life and the specific day to day struggles I was having.
Now that I'm flipping through it to write this review, I kind of want to read it again. While it's probably not a good book to buy for someone else , it's definitely relevant and fun to read. Worth the purchase.
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I know some people aren't going to like this post. At the same time, as a Psychologist I think it's important to tackle difficult issues and share what I know from the research and from making a career out of helping people heal and move forward in their lives. Especially for those of us who are mental health professionals or are trusted experts in our communities, we need to make sure that what we tell others about healing and growth is safe, compassionate, and ultimately does no harm. I've been seeing more and more professionals suggesting books like The Secret, and it's extremely worrisome to me.
Nicole Perry is a Registered Psychologist and writer with a private practice in Edmonton. Her approach is collaborative and feminist at its heart. She specializes in healing trauma, building shame resilience, and setting boundaries.
About the Blog
This space will provide information, stories, and answers to big questions about some of my favorite topics - boundaries, burnout, trauma, self compassion, and shame resilience - all from a feminist counselling perspective. It's also a space I'm exploring and refining new ideas.
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