Gabrielle Ferrara, MSW, LSW

@gabrielleferrara | contributor
Super Contributor
Hi! I am passionate about mental health on both a professional level and a personal level. I am proud to be a therapist who sees a therapist :) I graduated with my MSW degree (Master of Social Work) in May 2020 and am now a Licensed Social Worker (LSW). I enjoy writing about and sharing my own experiences as well as hearing the personal stories of others.

Jess Sims Stopping Her Peloton Class Early Is a Mental Health Lesson

“Listen to your body.” It’s a phrase that is commonplace in self-help literature, therapy circles and eating disorder recovery discourse. But how often do we really put it into practice? How often do we give ourselves “permission” to truly listen to what our bodies are telling us? If you are at all familiar with the Peloton universe, you have probably heard of Jess Sims. Jess Sims is known for coaching some of the most difficult classes Peloton has to offer — on the bike, treadmill and mat. And despite how hard her classes are, she makes it look effortless. She is strong, powerful and motivating. She is also human. On Monday night, Jess was teaching a live bike bootcamp class. For those who aren’t familiar, Peloton’s bootcamp classes are a 50/50 split between cardio training (on the bike or tread) and strength training (on the floor). During one of the bike segments, Jess was seen struggling to catch her breath before the class suddenly cut out and ended early. This was uncharacteristic of Jess, and people immediately flooded to social media to express concern and send messages of care and well-wishes to the instructor. Jess followed up with her fans on Instagram later in the evening, posting a video to her story where she explains: “If you were on my bike bootcamp tonight, you saw me say that I needed to listen to my body and I stopped class a little bit early. Obviously that’s not easy, but it’s something that was necessary for me in the moment, and it’s something that I’ve had practice doing as an athlete my whole life, of just knowing when it’s not best for me to continue doing whatever I’m doing.” Jess is no stranger to listening to her body. Jess recently took a break from instructing Peloton classes. In an Instagram post shared on March 5, Jess announced to her followers that she wouldn’t be doing any live classes for a few weeks so she could “rest [her] mind and body.”   View this post on Instagram  A post shared by JESS SIMS (@jsimsfit) In a follow-up post on April 7, after Jess returned to the Peloton schedule, she shared nine things she learned during her time off:   View this post on Instagram  A post shared by JESS SIMS (@jsimsfit) 7. “Listen to your body. Your body is not just an ear to listen to you and what you want it to do. It has a mouth, too. Listen. You’re in a relationship. Learn its love language.” Let’s just pause here for a second. Jess Sims, a lifelong athlete, and arguably one of the toughest Peloton instructors, stopped a live class, because her body was telling her she needed to stop. And she wasn’t embarrassed about it. She didn’t see it as a weakness. In fact — she saw it as a strength. She owned this experience. And we could all benefit from the lesson Jess taught us last night. How often do we push ourselves past the point of exhaustion? How often do we keep going even though our bodies are screaming at us to stop? And more importantly — why? Why do we treat our bodies this way? Exercise shouldn’t hurt. It shouldn’t feel like a chore, or something we dread doing. It is meant to be a celebration of all the amazing things our bodies can do. So, Jess — thank you. Thank you for teaching us how to push ourselves toward growth and strength, but also showing us how to listen to our bodies. Thank you for modeling self-love and self-care. And thank you for always reminding us that “you can be a work in progress and a masterpiece at the same time.”

Exercise Addiction Recovery and 'Breaking Up' With My Apple Watch

This is a breakup story. No, not that kind of breakup. My fiancé and I are still happily engaged, hoping for brighter and better days in 2022. No, this is a different kind of breakup story. One year ago, I broke up with my Apple Watch. After a very committed two and a half years together, I ended things. I had to do this for reasons similar to why we make the hard decision to end any relationship ; it had become unhealthy, toxic and unfulfilling. That said, anyone who knows me knows I loved my Apple Watch. I was the girl who wore it to parties with a nice dress even though it definitely didn’t match. I brought it everywhere. From the outside, it probably just seemed like I was very invested in health and fitness. And I was — but it quickly became much more intense than that. You see, wearing the watch wasn’t just wearing an accessory to me. It was more like wearing handcuffs. And someone had thrown away the key. With the watch, I was trapped in an obsessive, compulsive cycle of counting calories and exercise minutes. I had to close my rings. My worth was based on numbers on a little screen attached to my wrist. The handcuffs were getting tighter and tighter. And I couldn’t find the key; but here’s the thing — for a very long time, I also didn’t want to find the key. One year ago, I broke free from the chains. And if I’m being honest, it wasn’t an easy breakup. I still have urges to count calories and exercise minutes and base my worth off these arbitrary things. And some days, I give into these urges. Accompanying these urges are memories of a painful relationship that I am working every single day to permanently put in my rearview mirror. But I haven’t put the watch back on. I haven’t even turned it on. It ran out of battery shortly after I took it off, and I haven’t plugged it in since. This is a breakup story, but it is also the beginning of an addiction recovery story. Again, not in the traditional sense. I am not celebrating one year sober from drugs or alcohol. Many of my clients are valiantly fighting that battle, and it’s no easy feat. But in the addiction field, we have people identify their “drug(s) of choice.” I realize this may sound like a bit of a stretch, but consider it this way: my “drug of choice” was my watch. My “drug of choice” was closing my rings. It was feeling the haptic vibration on my wrist, providing me with the positive reinforcement and the surge of happy chemicals that I craved. It was finally feeling worthy each time I engaged in my “ addiction. ” But, much like an addiction to drugs or alcohol, the relief was temporary. It would fade, and I’d have to do the behaviors again. And again. And again. This addictive cycle continued day after day, mile after mile, minute after minute, calorie after calorie… until I was ready to change. In the past year, I’ve learned how to fall in love with exercise again (or maybe for the first time). I move my body in ways that feel good. I know that calories are just a number (though some days I have to remind myself of that fact more than others) and that my worth is based on so much more than that. I feel so grateful for the way my body can move. I run faster than ever before, I lift heavier, and I carry myself more confidently. I learned exercise doesn’t have to be a punishment. So, this is a breakup story. It’s also a recovery story. But most importantly, it’s my story. Today, as I’m writing this, I feel stronger than I did one year ago in so many different ways. I finally feel free.

Ready, Willing and Able: The Ingredients for Change

There are countless clichés in the English language about “change.” “Change is never easy, but always worth it.” “The only thing constant in life is change.” And let’s not forget the Serenity Prayer, commonly quoted and used as inspiration in 12-Step programs such as Alcoholics Anonymous: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Change is all around us. More importantly, the desire for change seems to be omnipresent. We are always aspiring for that “next step” — in self-improvement, in our relationships, in our careers; the list goes on. So, what needs to happen for us to truly be prepared to embrace change? To sum it up using three key words: we need to be ready, willing and able. My therapist first used this phrase with me in one of our sessions during a conversation about my own change process with regard to my mental illness recovery. He explained to me how all three of these simple, two-syllable words need to be present in my mind and my heart if I wanted to make lasting change and progress. According to English Lessons Brighton, these three terms are very similar, yet slightly different in very important ways: • Ready — “prepared to do something in either a physical or mental state, demonstrating either physical or mental capacity or eagerness” • Willing — “prepared to do something as a choice, demonstrating eagerness” • Able — “prepared to do something as a possibility, demonstrating capacity to do it, not eagerness” As you can see, these three words are nearly indiscernible from one another by means of definition. However, to make a lasting change, we must manifest all three. It is not enough to simply embody one or two; we might see some change with one or two, but it will not be lasting or true change. Let’s consider an example. Say that your goal/idea for change is to start taking better care of your mental health . You decide that you want to start seeing a therapist and attending weekly counseling sessions to work on this goal and make this change. Remember, true and lasting change will only occur if you are willing, ready and able. Let’s look at each component in isolation, keeping this example, and the definitions above, in mind. Able : Are you physically capable of attending therapy sessions, either in-person or online? Will your insurance cover the sessions? Are you able to cover any co-pay or deductible? Can you arrange for childcare or time off of work to attend your sessions, if necessary? “Able” includes all the logistical considerations. This is where you take into account the time, money and any other “administrative” variables involved in making this change. Willing : Are you going to actually call and schedule the first appointment? After you schedule it, are you going to get in your car, drive there and walk in the door? Are you willing to be open and honest with the therapist about what you’re feeling and experiencing? “Willing” involves the element of choice. If you are willing to make a change, you are choosing to voluntarily engage in the change process and all of the steps that this process may include. Ready : Here’s the tough one. Are you ready? Are you ready to internalize the words exchanged between you and your therapist? Are you ready to experience difficult emotions in a way that will serve you in the long run? Are you ready to translate what you learn and discover in therapy into your other relationships? Are you ready to let go of some aspects of your past, in order to move forward and experience real change? Being “ready” is easier said than done. We might think we’re “ready” for a lot of things, even when we’re really not. But “ready” is where the true change occurs. It is where the lasting progress is made. Without being ready, we are not able to truly embody and manifest the change we are making. If we are not ready, we are not able to be vulnerable, humble, and malleable. Some change may occur, but it will eventually dissipate or begin to feel unsatisfying, simply because we weren’t ready. Ready, willing and able. Three two-syllable words that can make all the difference. The trifecta of change. Next time you or someone you know is thinking of making a change, consider these three elements. Are you able? Possibly. Are you willing? Maybe. Are you ready? Maybe not (or maybe not yet). A version of this story appeared on Psychology Today.

Why Asking If People Want Support of Solutions Helps

On January 23, 2021, the following tweet was shared by Alexander James (@DrunkScribe) on Twitter: Some years back my wife and I got into the habit of asking each other ‘do you want comfort or solutions’ when the other was having a bad time. That one sentence can save us from an argument 9/10 times.— Alexander James (@DrunkScribe) January 23, 2021 “Some years back my wife and I got into the habit of asking each other ‘do you want comfort or solutions’ when the other was having a bad time. That one sentence can save us from an argument 9/10 times.” As of the writing of this article, it has been retweeted over 21.5K times. The support for, and agreement with, this simple phrase is seemingly universal: “Do you want comfort or solutions?” When was the last time somebody asked you that question? Unfortunately, you may have never been asked that question. As humans, we tend to jump to problem-solving when someone close to us is struggling. It’s natural; of course we want to make them feel better. And if we have a solution in mind that we believe will solve the problem, why wouldn’t we offer it? However, this tweet opens the door to a different type of conversation — one where we simply listen and sit with the person and their pain. In the therapy world, we call this “holding the space”; it is an approach that allows the person to speak what is on their mind and openly express any painful or difficult emotions in a safe space, free from judgment. You can probably relate; let’s walk through it. How many times have you come home from a tough day and started venting to your partner, friend, coworker or parent, just to have them respond with, “Have you tried…?” or “What if you just…?” or the seemingly innocent, “If I were you, I would…” If you aren’t in a place where you want solutions, this question probably infuriated you. “Can’t you just let me vent?! ” Suddenly, you are arguing with someone who was just trying to help you; you’re more upset than you were before, the person trying to help is confused and unsure where they went wrong, and the potential for effective communication just went out the window. So, what did go wrong? Like I mentioned before, human beings are awesome. We love to help solve the problems of those closest to us when they are struggling. But sometimes we get it wrong. We read the situation wrong, or we assume we know what someone needs in that moment (and you know what they say about assuming…), and we end up making the situation worse when our only intention was to help make things better. This is where those six words can come into play. Next time someone comes to you with a problem, a bad day or a mental health struggle, practice holding the space. “Do you want comfort or solutions?” And it’s not enough to just ask the question. Make sure you listen to the response. If the person says they want comfort, and you start offering solutions anyway, that defeats the point. What does offering comfort look like? It may seem simple, but like I said before — we’re conditioned to give advice and solutions. Instead, practice the art of just being there. Offer active, reflective listening — nodding, words of agreement, gestures of understanding (“mhmm,” “I hear you,” etc.). Give the person your undivided attention. Put your phone away and focus on being present. Ask the person if they would like physical comfort, such as a hug or holding their hand (if appropriate). Do not judge or ask too many questions. Meet the person where they are. (There’s another therapist slogan for you!) Sometimes we feel better just knowing that someone else is listening to us in our deepest and darkest moments. It’s helpful, in and of itself, just to know we are not alone in our suffering or our frustration. Effective communication in relationships doesn’t necessarily have to involve words all the time. It’s enough to just be there.

Peggy Spear

An Alcoholic's Perspective on Drinking During the Pandemic

I quit drinking nearly six years ago. I’d known I was an alcoholic for many years, but it took a long time for me to reach the incomparable demoralization that gave me the courage — no, the need — to put down my favorite chardonnay bottle. It was an April day in 2015 when I quit. I had been “day drinking” at home for several months. I worked from home and when I had no deadlines looming that day, my only real responsibility was keeping the dogs fed and picking my son up from high school. I fed the dogs each day. I had even picked my son up from school, drunk, when hundreds of kids left through a gate. I could have hit one or many of them, but some higher power kept them safe. On that April day, I had drunk tequila since 9 a.m. It had become a habit. As I had been going to Alcoholics Anonymous meetings and trying to stop. I failed miserably in the latter, but was becoming a pro at the former. But on that day, I texted my son and told him he had to walk home or get a ride. He came into my home office, where I had a guest bed and I was “napping,” and asked what was wrong. “Your mom’s a drunk,” I told him. He was 16. That afternoon, when I had sobered up enough to make a phone call, I called the Kaiser Chemical Dependency Program and told them I wanted to start an Intensive Outpatient Program. I started the following Monday, having not taken a drink since that one afternoon. I can happily and proudly say I did not have a craving for alcohol for over five years. Until COVID-19. One day, when I was quarantining at home during the pandemic, I wished I could drink. I didn’t, of course. I attended one of the hundreds of AA meetings on Zoom that have helped save so many lives. I haven’t had a desire to drink since that day. But I’m in the minority. Many people have turned to alcohol to help handle the stress of the pandemic, of working from home without the socialization they’re used to, the loneliness and the extreme stress of working and managing children, either too young for school or trying to help them manage distance learning. Then there’s the stress of trying to work from home with a spouse working there too, without any outside stress-relieving activities. It can be overwhelming. And I am warning you to watch out. According to the American Heart Association, “There are data to indicate people are drinking more than usual,” says Dr. Mariann Piano, a substance abuse researcher. “And there’s no question that drinking too much every day leads to an increase in health risks.” Nielsen reports alcohol sales in stores were up 54% in late March compared to that time last year, while online sales were up nearly 500% in late April. According to a Morning Consult poll of 2,200 U.S. adults conducted in early April, 16% of all adults said they were drinking more during the pandemic, with higher rates among younger adults: One in 4 Millennials and nearly 1 in 5 Gen Xers said they had upped their alcohol intake.“Some people are saying, ‘Whoa! That’s binge drinking? That’s what I drink every night,'” says Piano, a professor of nursing and senior associate dean for research at Vanderbilt University in Nashville.Excessive drinking can increase the risk for liver disease, obesity, breast cancer, depression, suicide, accidents and a wide range of cardiovascular problems, including high blood pressure, atrial fibrillation, stroke and heart attack. Piano says alcohol also can lead to harmful interactions with prescription drugs, dehydration and poor sleep. It also affects brain functions such as memory, balance and rational thinking – a key factor when it comes to stopping the spread of the coronavirus, she says. “It can completely impair your judgment.” Perhaps more scarily, she says “I’ve seen bars where there’s no physical distancing happening, with people in clusters or lined up against each other.” Piano says people who are alcohol-dependent have compromised immune systems, reducing the body’s ability to fight off infectious diseases such as COVID-19. And the more you drink, the higher your risk. Humans have long turned to alcohol to try to relieve everyday stress, and the pandemic has pushed anxiety levels up for many people, says Dr. Adriane dela Cruz, a psychiatrist who specializes in drug and alcohol addiction. “There are all these uncertainties: ‘Will I still have a job? When will my kids go back to school? When can I see my family again and hug them?'” she says. “A lot of my patients talk about this idea that there’s a hamster wheel constantly going in their head and that alcohol quiets down the hamster wheel.” Anxiety isn’t the only thing fueling pandemic drinking. As people work from home and self-isolate, they experience loneliness and boredom — two more potential triggers for excessive alcohol use, she says. Theses stats are backed up by the popular website Healthline: Researchers say binge drinking, especially among women, has increased significantly during the COVID-19 pandemic; They say that stress, anxiety, and isolation are contributing to the issue; They also note that COVID-19 restrictions are preventing people from attending counseling and 12-step program meetings; (This is not entirely true — Zoom meetings have made attending AA and other 12-step meetings easier than ever.) Experts recommend people eat healthy, exercise, and get sufficient sleep during these stressful times. I’m sure if I were still a drinker, I would have turned to alcohol a long time ago. I have no judgment when it comes to those who choose to drink to relieve the stress of this awful pandemic. But I can warn you, it can become a habit. If you have a propensity to open a bottle of something over any anxiety-producing emotion, you may want to take a look at your drinking. If you need to drink to celebrate, you may want to look at your drinking habit. Especially if you’re bored and you drink, you may want to take a look at yourself. This is not preaching. I know, because that’s how I lived my life for more than 35 years. For many people, it’s not an issue. They can stop. They can leave half a glass of wine without guzzling it. Weirdos. We in the program call those of you who can do that “normies.” But if you wake up in the mornings — or the middle of the night — and swear you’re not going to drink that whole bottle of wine again, or have that third or fourth drink, yet you do, you may want to look at yourself. I lost one of my best friends to alcoholism two years ago. Many people I know in the program have lost family members or loved ones, whether to alcohol-related illnesses or suicide. Many people I know in the program have killed people when they were drunk. Many people, like me, could have easily killed people when they were drunk. I know there was a higher power than me that has allowed me to be sober for 2,055 days. The nice thing about AA is it’s like a buffet: we get to create our own higher power. Whoever or whatever mine is has watched over me and my family during this pandemic, and your higher power, if you feel like you have one, will look over yours. As my old friend Hugh, a retired high school teacher, used to say, “My problems make me want to go home and drink. But maybe I’ll do that tomorrow.” So one day at a time we face this annoying, deadly, dangerous pandemic. There is light at the end of the tunnel, and we will get there. In small, bite-sized pieces, we will get back to normal. Just be careful you don’t come out of this dark tunnel with an even deadlier problem. Follow this journey on Peggy Spear’s site.

Why 'Pandemic Fatigue' Is Making People Less Anxious About COVID-19

Pandemic fatigue. By this point, you’re probably reading about it, hearing about it and even experiencing it yourself. It’s the phrase used to describe being utterly fatigued and exhausted by the coronavirus ( COVID-19 ) pandemic and all the havoc and heartbreak it has caused, as well as all the rules and regulations that have been put in place to slow the spread. Simply – it’s the justification being used to explain why people are going out more and social distancing less, even as the pandemic rages on and cases reach record numbers. Pandemic fatigue is a fair way to describe this feeling; we are fatigued. It’s been a long nine months. But, psychologically speaking, it’s more nuanced than “just fatigue.” Psychologically speaking and evolutionarily speaking, we are responding to a prolonged period of stress and anxiety the only way our brains and bodies know how — by habituating to the threat and returning to mental homeostasis because our brains are not equipped or prepared to handle this level of activation forever. Let me explain. I was hesitant to even write this piece because it is a controversial topic, and I encourage you to please read beyond the headline. I am all-in for continued social distancing and other rules and restrictions to keep everyone safe from this virus. I know that now is not the time to let our guard down or get complacent, nor am I suggesting that it is OK to do so. But it might be helpful to understand why, from an anxiety -treatment perspective, some people may be beginning to find it easier to engage in “normal” activities without as much fear or worry as we all had earlier this year. This perspective is especially true for people who have not contracted the virus or had a mild case and have since recovered. For people with intense fears such as those associated with obsessive-compulsive disorder (OCD) or other anxiety disorders (such as phobias ), a method of therapy known as exposure and response prevention (ERP) is the gold-standard approach. Explaining ERP is an article of its own, but the core idea is that with continued, prolonged exposure to a feared stimulus, without the threatening situation coming to fruition as expected, the brain and the body will eventually habituate, and anxiety will subside. For example, if a person with OCD has a fear of germs or getting sick, they might practice overcoming this fear by touching doorknobs and then not washing their hands before eating. I realize this is a simple example and explanation of OCD /ERP, but it is helpful to understand the overall concept. With time, the person engaging in this type of mental exercise retrains their brain and realizes that the feared threat (i.e., getting sick or contaminating others) has not come to fruition (or was not as bad as anticipated) and the situation is no longer as scary or anxiety -inducing. Additionally, the person’s level of distress (often called “subjective units of distress,” or SUDs) subsides, their parasympathetic nervous system is activated, and the fight-or-flight response that is associated with anxiety begins to dissipate. This habituation and the gradual decrease in anxiety is evolutionary – our bodies are not able to sustain high levels of activation and arousal for too long without becoming exhausted. ERP works well for so many people with OCD and phobias because it teaches our brains how to sit with the anxiety, fear and uncertainty, and learn that the fears will most likely not come true (or, if they do, we can handle it). It’s a protective, beneficial and natural way for our bodies and our brains to respond to stimuli and survive. So, let’s consider this in the context of the current COVID-19 pandemic. When the pandemic first began impacting us, there was an intense response of anxiety, fear and compulsive behaviors. People started hoarding toilet paper and soap, sanitizing anything and everything, and living in a near-constant state of panic and arousal. Many of those around us fell ill with the virus. Thousands of people were dying each day. The fear was real, and the threat was coming to fruition before our eyes. We lived in this state of hyperarousal for months. We had to, for our own safety, and for the safety of everyone else. Our fight-or-flight systems were activated. We were scared, overwhelmed, uncertain and shaken to the core. And now we’re tired. Our brains and our bodies are tired. We are habituating to the anxiety in the only way that human beings know how. We are getting used to it and becoming less anxious. This, again, might be especially true for those who have not yet had the virus or who had a mild case. We can know that people are dying and this virus is devastating and still be becoming desensitized to the anxiety because, from an evolutionary and biological perspective, that’s how we survive. Even the most caring, intelligent and selfless people might appear to be acting in risky or more reckless ways. “Pandemic fatigue” is an accurate description for what we are experiencing right now, but it’s more than just being “tired”. It’s even more than just being exhausted. We are coping and trying to survive, and we simply cannot function as human beings in a highly activated and aroused state; we are not wired for it. Again, I am not implying that we give in to this complacency and stop working to actively keep ourselves and others safe during this pandemic. But it’s interesting to consider why some people around you might be loosening their diligence and are seemingly less anxious about contracting the virus, despite knowing that cases are rising and the pandemic is still very much active. In order to continue to follow the rules and regulations and stay safe during this time, we have to fight back against what our brains and bodies naturally want to do right now, nine-plus months into a state of hyperarousal. People are fatigued, but for the vast majority, it is not because they are lazy, selfish or careless. Our brains and bodies are just trying to keep us alive in the best way we know how. So, this is unprecedented territory. Our primitive survival mechanisms are being called into question. We have seen more loss, pain and grief this year than anyone should ever have to experience. Intense uncertainty surrounds us every moment. Continue to be gentle with yourself, and gentle with others as well. Thank the essential workers in your life. Do good deeds when and where you can. And please, wear a mask. I’ll let you in on a little secret — our brains and our bodies are also pretty good at resilience, too. A version of this article was published on Psychology Today.

It's OK to Give in to Anxiety and OCD Compulsions Sometimes

Last night, I gave in to anxiety and did a compulsion. Well, sort of. I went over to my partner’s for dinner and was planning on spending the night, something I have done countless times before. At the same time, I couldn’t stop thinking about my cat, Jade, who gets very upset when I leave for more than a few hours. She weaves in and around my legs meowing any time she thinks I might be leaving, and when I get back she wants me to pet her constantly. Logically, she’s a cat. She has food, water and a litter box. She’s fine. But on the other hand, she is a very emotionally bonded, nervous cat, and I start to feel really bad when I leave her alone. Also, you can’t out-logic obsessive-compulsive disorder ( OCD ).   Rather than continuing to read and work on my homework at his place, I became wrapped up in the anxiety. I began feeling terrible for leaving her, and I had an urge to go back home immediately. I knew going home would be giving in to the anxiety and OCD. I also knew if I went home, it would make leaving her all the harder the next time. I have to be able to leave my house and have a life. I tried to question what would be working toward my values, but both my partner and my cat are part of my values. Plus, when in a thought spiral, it’s hard to think too straight about values. I’m all for doing exposure and response prevention (ERP), but at the same time, we sometimes don’t have the emotional capacity to resist. And that’s OK. In the end, I decided to go home — well, sort of. I decided to go home but delay the compulsion by half an hour. I looked at my phone and scheduled that I could leave at 10:30 p.m. I had to sit with the anxiety until then. This is a common technique in ERP. If you can’t resist doing the compulsion altogether, delay it. This is how I did my first exposure ever in treatment. I used to have a fear of anything touching my nose. OCD told me I would breathe in that smell instead of oxygen, and die. My first exposure was to touch something with a mild smell to my nose: a piece of chocolate. Then, the goal wasn’t to completely resist washing off my nose forever. The goal was to wait five minutes before doing the compulsion. The next day, the goal was 10 minutes. Then 30. Then an hour, until I could go without washing my nose. Exposures are not black or white, resist or compulse. In dialectical behavior therapy (DBT), we call this type of compromise “walking the middle path.” So, I laid down on his couch while he worked, and I rode the anxiety wave. Every once in a while, he came over to give me an encouraging squeeze. I mostly kept my eyes closed as I felt the fear, though I checked the time every few minutes. By the time it hit 10:30 p.m., I was noticeably calmer. I had let myself feel the anxiety, and a lot of it had come down. I would say my subjective units of distress (SUDS), a tool for measuring anxiety, went from a 7 out of 10 to a 3. I almost considered staying again. I decided though I had done enough work facing anxiety for that evening, and I went home. Sometimes, anxiety wins. Sometimes, I win. Sometimes we both win, like in this case where I did the compulsion and was able to delay it. It’s OK to have compassion for yourself if you do the compulsion. It doesn’t mean a relapse; sometimes it’s just a lapse, or a blip, even. I’m always doing my best. And I’ll try again next time. Morgan

Trump's Perpetuation of Addiction Stigma in the 2020 Debates

I’m a therapist who works with people struggling with  addiction / substance use disorders . I watch my clients fight against their own minds and bodies, day in and day out, to overcome a disease that is relentless. They are warriors. On Tuesday night during the first Presidential Debate, our President delivered arguably one of the lowest blows of his presidency, as he ruthlessly went after Hunter Biden — a man who fought for our country and fought for himself, battling drug addiction and all the pain that comes with that fight. In case you missed it, Joe Biden was in the process of defending his late son, Beau Biden, against previous allegations that Trump called those who died fighting in war “losers” and suckers.”  Beau Biden served in Iraq from 2008-2009 and died of a brain tumor in 2015. Trump retaliated quickly, stating “I don’t know Beau, I know Hunter,” before continuing on to attack Hunter Biden for his substance use problem and alleging that Hunter was “dishonorably discharged” from the military for cocaine use. A fact check after the debate confirms that this statement was false; Hunter was not dishonorably discharged. He was administratively discharged from the U.S. Navy in 2014 after failing a drug test . At this point, in what can only be described as a very emotionally charged moment, Biden turns to the camera and states: “My son, like a lot of people, like a lot of people we know at home, had a drug problem. He’s overtaken it. He’s fixed it, he’s worked on it, and I’m proud of him. I’m proud of my son.” You can see the full exchange here. Social media erupted in anger and disbelief following this moment in the debate. There was an outpouring of support for Hunter Biden, Joe Biden and the millions of other families that are affected by addiction and substance use in America. According to SAMHSA (Substance Abuse and Mental Health Services Administration), 20.4 million people aged 12 or older had a substance use disorder in the past year . Many took to Twitter to express their shock, support and positive messages: I know it happened a couple minutes ago which feels like a lifetime ago in this debate, but: Biden looking directly at the camera and saying his son had a drug problem like many do and he loves him anyway was a really powerful moment that will resonate and stick with people.— Laura Bassett (@LEBassett) September 30, 2020 Sending love to Hunter Biden tonight. No addict deserves to have their substance abuse problems politicized on national television for a talking point.— POST WOOK (@POSTWOOK) September 30, 2020 How can we possibly eliminate mental health stigma when we have a leader who uses someone’s child’s addiction and mental health history as a means to discredit them during an argument? #presidentialdebate #2020debate— Whitney Goodman, LMFT (@sitwithwhit) September 30, 2020 Trump’s attack on the Biden family is incredibly harmful to millions of people and their loved ones. It perpetuates a history of stigma and shame surrounding addiction . In a HuffPost Personal piece, guest writer Laura Cathcart Robbins speaks about her own reaction to the debate proceedings and her experience with addiction , recovery and stigma. “People in recovery have labored under this stigma long enough,” Cathcart Robbins says, “We’re not bad people trying to be good. We’re sick people trying to get better.” If you or a loved one is battling addiction , keep fighting the good fight. You are warriors. We see you. We see your strength, your power and your determination. We see your hope. Working professionally with individuals battling to overcome addiction has opened my eyes to some of the most beautiful and inspiring parts of humanity. For those in recovery, every day may not be easy, but every day is a gift. Little by little, with the help of one another, we will continue to overcome this disease. We will fight back against the harmful stigma. And we will do it all, simply, one day at a time. If Tuesday night was hard for you, please reach out for help. Talk to someone. Go to a meeting. You don’t ever have to do this alone. Resources: Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357) FindTreatment.gov National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

Dax Shepard's Battle With Relapse and Addiction

On Friday, September 25, 2020, actor Dax Shepard released a unique and uncharacteristic episode of his podcast “Armchair Expert” titled “Day 7.” In this honest and vulnerable episode, Shepard, who has been open about his experience with addiction , details his recent relapse with painkillers after 16 years of sobriety. On the day this episode was recorded (September 21), Shepard was newly sober for seven days. Shepard speaks candidly about the disease of addiction , lying to loved ones and denying anything was wrong at all. He also speaks about the importance of asking for help, moving forward and having hope. Regardless of whether or not you or a loved one struggles with addiction , Shepard’s depiction of his experience is full of lessons and takeaways for everyone. 1. Addiction is a disease; we need to treat it as such. Through his account of his experience, Dax Shepard and his co-host, actress Monica Padman, emphasize that addiction is a disease and an illness, just like any other mental health or physical health diagnosis. Treatment for addiction can involve therapy, lifestyle changes, social support and sometimes even medication — just like any other illness you can imagine. It is not the person’s fault or a character flaw. The stigma surrounding addiction unfortunately still exists, and this stigma can be a major barrier to people receiving the necessary help and treatment that they need. 2. Recovery is not linear; a relapse does not mean all progress is lost. As human beings, we naturally fall into a pattern of thinking that recovery or progress is a linear journey. In reality, recovery from a mental/physical health disorder or even just pure self-improvement more closely resembles a less-visually-appealing squiggly line. It’s easy to think that any small lapse or step backward means all progress is lost and our efforts were fruitless. Shepard makes sure to emphasize that he is still proud of himself for his 16 years, even if he had to start again at Day 1. He reflects on the progress he did make; he did not feel the urge to drink during this recent relapse like he had in the past and he also was able to recognize that he was gaslighting other people and acknowledge that he did not want to deceive the people around him who loved him. We can all take this message to heart in regard to our individual journeys; it might not be a perfect linear journey, but every up and down is there to teach us something and help us move forward. 3. We all need help sometimes. It’s OK to surrender, admit we don’t have control, and ask for help. Shepard speaks candidly throughout this episode about how his ego was his own worst enemy at times. During his relapse he felt like he could control things he could not control, and he was not able to admit his powerlessness at first. He explains that surrendering and admitting he was powerless over his addiction is an instrumental part of his recovery and a huge part of his overall story. Human beings don’t like to feel out of control; we aren’t comfortable feeling powerless and vulnerable. But life gets messy and we all need to ask for help sometimes. Asking for help isn’t a sign of weakness; it’s a sign of strength. 4. Every single person is going through something. Shepard and Padman touch upon this universal truth during this episode, and it is one that is worth discussing again and again. That “something” might not be addiction specifically; it might not even be something that is visible. But at the end of the day, we are all human and nobody is immune to the ups and downs of life. Especially in the midst of a global pandemic and a laundry list of other difficult current events, it is important to remind ourselves that we all have our demons and our battles. We must practice empathy and understanding toward our neighbors, strangers, and ourselves. Dax Shepard’s relapse is a story of honestly, vulnerability, support and hope. Even if your life has not been touched by addiction , this episode has a message for everyone. In our own individual journeys, we’ve all been at Day 1.

Takeaways From NBA Player Kevin Love’s Recent Mental Health Article

On September 17, 2020, NBA player Kevin Love released an article on The Player’s Tribune titled “To Anybody Going Through It.” In this incredibly honest, vulnerable and boundary-breaking depiction of his struggle with mental illness (particularly depression and anxiety ), Love normalizes the human experience and the difficult emotions we all sometimes face. He speaks about what it was like to have a public panic attack and to experience suicidal ideation. He emphasizes the importance of talking to someone and asking for help. He talks about self-worth, stigma, shame and hope. Though he is certainly not the first male figure to go public about his mental health struggles (and this is not his first time doing so, either), this account of his experience is particularly heart-wrenching, yet immensely inspiring. A few themes stuck out to me while reading this piece: 1. “Being depressed is exhausting.” Love opens up this piece by talking about the pure exhaustion that comes along with having any mental illness . Love states: “But what people on the outside don’t always understand is that it takes all of your strength and willpower just to exist. Just to keep on going. Battling depression , battling anxiety , battling any mental health disorder … it’s all just so unbelievably exhausting.” The intense feeling of exhaustion that comes alone with battling your own mind every single day is something that goes undiscussed a lot of the time. People with mental illness are at a war with themselves each and every day, and the thoughts feel inescapable and permanent. Love describes that his “way out” was playing basketball (though not in the way we’d expect) and connects this experience to that of the late Robin Williams, who also battled his own mental health demons: “The best way I’ve ever heard it described was in the HBO documentary on Robin Williams after his death. He was talking about the only way he could combat his demons was to wake up in the morning and ride his bike until he had absolutely nothing left in the tank, and then at night he would go up on stage and do a two-hour stand-up set and just pour all of himself into it — every single ounce of himself, until he was just totally wrung out, mentally and physically. Anything to stop the thoughts. Because the thoughts can be disturbing.” People with mental illness can often feel an insatiable urge to do whatever is necessary to make the thoughts just stop. Love’s depiction of this element of mental illness is spot-on. 2. “My self-worth was all about performing.” Love candidly speaks about how he often felt like his worth as a human being was connected to his success and achievement on the basketball court. He talks about how he struggled to “just be unapologetically Kevin.” This drive for success and achievement is one that has been normalized in our society, even to the point of physical and mental breakdown. We fall into a trap, as human beings, of feeling like our accomplishments define us and believe that they carry much more weight than they actually do. Love describes this phenomenon perfectly, stating, “It was like I was trying to achieve my way out of depression.” Anyone who has experienced any mental illness knows that achieving, succeeding or having all the blessings in the world is not enough to overcome the demons in your mind. But, as Love says, we become consumed with the idea of “next,” falsely believing that some external form of validation will bring us peace within. In reality, it is much more nuanced and complicated than that. 3. “Nothing major has to happen to start a spiral.” Love acknowledges that he knows how fortunate and blessed he was during the darkest moments of his mental illness, and it is true that he has more financial security and material things than most people. But, what Love so eloquently normalizes here, is the fact that none of that matters when it comes to mental illness. Mental illness does not discriminate based on race, gender, wealth, status, success or anything else. Everyone can struggle with their mental health , and each person’s struggle is equally valid and real. This is something we have begun to normalize in society recently, but there is still a long way to go. 4. “Talk to somebody.” Love closes out this article by encouraging any and all readers to talk to somebody. He proudly admits that he needs therapy and medication to manage his symptoms, and he “probably always will.” Love speaks about the freeing feeling that he experienced after starting to talk to a therapist, and how it took him 29 years to figure out the answer to the question, “what do you need?” Therapy is not a cure-all, but it can definitely be the beginning of incredible change and growth. Asking for help is not something about which we should feel any shame, embarrassment, or guilt. We all need a little help sometimes; it’s one of the perks of being a human being. On a more personal note, as a “therapist who sees a therapist” myself, going to therapy changed my life. Being on medication to manage my symptoms changed my life. But what changed my life the most? Talking about it. Sharing what I was experiencing with other people. Learning to normalize everything I was feeling, and learning that I wasn’t alone. Love ends his article with a beautiful quote, and I have chosen to end my piece here the same way: “If you’re struggling right now, I can’t tell you that this is going to be easy. But I can tell you that it does get better. And I can tell you that you are definitely not alone.”