October 1 looms large for us mental health and medical professionals in the US. From that date on we’re required to switch from using the DSM V or ICD-9 codes for illness to the International Codes for Disease tenth edition (ICD-10 for short).
This is already feeling like too much for a blog post so I’ll try to make my point fast.
If you are a consumer of mental health services the switch doesn’t change much of anything. Your treatment, therapy, medication and general care doesn’t change one bit. The ICD-10, like the DSM V, is a code that is primarily used for third party payment claims, like for insurance or medicare. That’s it really, but if you have questions ask your behavioral healthcare professional.
If you’re a mental health professional I suggest you start by referring to your specific local, state or national professional organization for guidance, the American Psychological Association, American Psychiatric Association, National Association of Social Workers, the American Mental Health Counselors Association to name a few. The good news is that the DSM V did most of the heavy lifting for us so that conversion from DSM V to ICD-10 for mental illness diagnoses is fairly seamless.
The good health care professional makes sure everyone from the direct care provider to the billing manager is up to date on stuff like this. Even if it is a pain in the patootie.
A while ago I was having a wee meltdown, a “what the hell was I thinking?!” moment. This was at the tail end of working my butt off getting my new office location ready for operation, bringing in two new associates to the practice, playing Whack A Mole with all the little headaches that are part of any expansion.
Reaching out to my daughter, I told her I was freaking out. In response she said sweetly, “That’s OK, Mom. That’s your process.”
“I have a process?”
“Sure you do. You work, nose to the grindstone, doing what has to be done to fulfill your dream. Your dream comes true and you get overwhelmed. Then you sleep on it, give it time, let it sink in, and you’re good.”
“I have a process!”
Yesterday I was at the Albright Knox Art Gallery at a presentation with artists and curators of the current exhibition, Screen Play. One of the curators asked a young artist what his process was for conceiving and implementing a huge animation installation the AK just acquired. He smiled and said, “I sit with my thoughts. My mind is pretty fascinating if I just take the time to observe it. An idea comes into view but it needs time to develop. Then I play video games. I love video games.” The audience, sophisticated people, most of whom grew up in a pre-digital world, appeared a bit perplexed by this. Video games as part of an artistic creative process?
But I was thinking, “He has a process! Just like me! Ha!” Which led me to think that doing anything creative has a process and that is so cool. We are all creators, not just artists. In big ways and small, the entrepreneur, teacher, medical professional, attorney, student, mother, father, we all evolve, develop and grow. It’s when our process stops that we stagnate and risk burn out.
We may not call it A Process. We may call it our weird obsessive compulsive need to light a candle and pray to the muse every time we sit down to write. Whatever our process is, it’s our unique way of loosening up the pathways that allow us to be creative, to grow. That wondrous thing within us wants to come out to meet the world. To do that we need a way to get around anxiety, doubt, comparing ourselves to others, those huge boulders in the path of creativity. Our process is what we do to get out of Creativity’s way.
Ever since my daughter, (let’s call her Sofia, since that’s, you know, her name) ever since Sofia pointed out my process I’ve caught myself getting anxious in other new situations. Before the nasty feeling over-takes me I remember this is a stage of my creative process.
Then I can let myself observe the overwhelmed feeling instead of being completely carried away by it. I can ride it like a surfer over a mighty wave until I get to the solid ground of the beach. That gives me space to be patient, breathe, to get to the realization that it’s all OK. It’s all good.
What is your process? Are you aware of what it is? Is it simple? Complicated? Do you use little rituals? Talk with a particular person who gets it? Play video games? Play with your dog? Please share your thoughts. Click the button under and to the right of the title to leave a comment!
Looking for a good therapist? You do not need to look beyond the therapists at Explore What’s Next!
Nicole is a veteran New Yorker who, lucky for us, came to our area about a year ago, moving here with her husband and kids. Nicole’s goal is to create a safe, warm, and respectful space where you can work together to uncover what’s troubling you and relieve your distress. She works with people from young adulthood to the elderly, with depression or anxiety. She also enjoys working with people from the LGBT community and anyone going through a tough life transition.
917.674.6742 / email@example.com.
Michelle comes to us from Virginia, through Boston. She is working toward her Psy.D. in clinical psychology. Fortunately for us, while Michelle takes the final steps in becoming a licensed psychologist, she is able to practice as a mental health counselor with permit (MHC-P). Michelle is a dedicated clinician who has deep experience in helping people struggling with serious mental illness, bi-polar disorder and schizophrenia, as well as anxiety and depression. Michelle works with couples and adult individuals.
716.249.4432, or e-mail me, firstname.lastname@example.org,
Nicole and Michelle are both intelligent, dedicated professionals who take their work seriously without taking themselves too seriously. They are well-grounded in high quality education, experience and training in psychodynamic psychotherapy as well as CBT and DBT. Their love for their work and the empathy they feel for their clients is absolutely authentic.
Like all the therapists at Explore What’s Next, Michelle and Nicole offer an initial consultation free of charge. So if you are looking for a good therapist call today!
Just got the keys!
This is a dream come true! The new offices at 1231 Delaware Avenue in Buffalo look gorgeous and our always beautiful offices at 1416 Sweet Home Road in Amherst, New York are also getting a little love. It is a mission of mine to provide an environment where all, client and professional, feel safe, comfortable and nurtured. It makes me proud to say we do that now in Amherst and we are well on our way in Buffalo. Still waiting for furniture to arrive, then we can say “Mission accomplished!”
Editor’s Note: Here’s Nicole with some ideas about how to selfie in a way that grows your self-esteem!
Selfie: Noun: an image of oneself taken by oneself using a digital camera especially for posting on social networks (Merriam-Webster)
Imagine that you just spent an hour trying to take a selfie in your awesome new outfit. You did your make up just right, your hair fell just like you wanted and after 30 different poses you got the perfect selfie for your new online profile pic. Trying different poses, lighting and facial expressions to make everything look just right took time and energy. You are so excited to post it and see what compliments you get. After posting and waiting a while the comments start to flood in. There are some compliments about how great you look but in the mix of comments a friend posts that you don’t look as good as you used to. Instantly, your flame of excitement burns out and turns into a self-critical mind warp. You are left being self-conscious all day.
It seems most profile pictures these days are selfies and the word has even made it to the dictionary. For a while I was nervous about this new trend where the intent was to portray yourself (seemingly in promiscuous ways) to appeal to others. As the trend caught on and selfies became more about making memories, I began to be more open-minded. I even started taking a few of my own! However, I could not stop my brain from analyzing the pros and cons. I began wondering if this trend was something that would benefit or hurt me.
Like anything you do too much of, or do irresponsibly, selfies can have negative consequences. They can open the door to:
- Attract attention. Not all attention you get on social media is positive. It is important to be prepared to handle criticism or unwanted attention. Knowing how to handle these situations before hand can help create a more positive online experience.
- New preoccupation with looks. If you were not already concerned about the way you look, you might all of a sudden find yourself worrying about it. Don’t forget, life is not about your looks but rather the way you interact with the world!
- Worry more about what others think. If you are posting a picture of yourself and choosing how others see you, it is normal to think, “What will my friends think about my new tattoo.” However, it is more important what you think. Be proud of what you are promoting in your selfie!
- Over sharing. As stated earlier, it is important to be responsible with what you decide to share on social media. Letting people know where you are and who you are with at every second leaves you vulnerable. Not every one needs to know you are “out with your whole family and the poor dog is home alone.”
Making a presence on social media has many risks. It has a very well know link to cyberbullying. But what about the positives? Let’s face it, social media is not going anywhere. Used responsibly, I can see where it can have benefits such as:
- Build your own identity. You get the chance to decide how you want people to see you. We are not talking photo shop here! You can portray your artistic, fun loving or adventurous side. Your selfie has the capacity to communicate a lot more than your looks.
- Gain confidence. It’s ok to show off your strengths! Let people see that you can do a headstand or that you won an excellence award. Why strive for growth if we cannot share it?
- Spend more time with yourself. I cannot sit here and say that you won’t think about how your physical appearance looks in your selfie. So, turn it into time for self-care: primp, wear outfits that make you feel good or practice your smile! These self-care tips promote higher self-esteem and make for a good selfie!
- Make more memories. By taking selfies, you are not always the one behind the camera.
So how do I choose whether or not to selfie? Ask yourself, “Does posting these pictures making me feel better or worse about myself? Is it safe?” If it makes you feel truly better and you do it responsibly, selfie it up! If you feel worse or are being risky with your behavior then it might be beneficial to hold off and talk to a therapist about your experiences.
Give Nicole a call at 585.737.4564, find her on Facebook, or email her at email@example.com to schedule your fee-free initial consultation!
Explore What’s Next has new offices at 1231 Delaware Avenue in Buffalo! The ‘before’ photo here is of the front entrance to our new suite. The building is a two story converted apartment building so it will have a homey feel just like our Sweet Home, Amherst offices. The Delaware office officially open for business in May 2015!
I am so excited about this next big step for EWN!!!
Ever since Explore What’s Next was a twinkle in my eye I have dreamt of having a second site, the better to serve the good people of Western New York. The choice of opening office space in downtown Buffalo is a reflection of the exciting growth that is happening here, culturally, in the arts, in business and in education though the expanding medical campus.
Anyone who has more than one kid knows that the impact on you and your family when your second child arrives is more than just 1+1=2. It’s more like 1+1=27! Of course that includes the terror, the joy, the good and the not-so-good stress. For months I’ve been going a little nuts. First looking for the right place, then negotiating with the landlord and contractors… Which finally leads to the more fun stuff like choosing paint colors, new furniture, lining up utilities and services! All while nurturing the first child, our lovely offices in Amherst.
In addition, new office space equals more room to bring in new therapists, psychologists and LCSW-Rs, psychiatrists and nurse practitioners! If you or someone you know believes in the highest standard of clinical care and is interested learning more about establishing their practice with Explore What’s Next, do not hesitate to contact me, Dr. Aletta, at 716.308.6683 or firstname.lastname@example.org. You can also learn more about joining the EWN team by clicking here.
You can follow the progress as the new offices shape up, before and after pics, color choices, etc, on Instagram, the EWN Facebook page and, just for fun, on Pinterest, too!
You would never know that the days are getting longer and my mare, Annie, is actually shedding. Anyone living in the deep North of the US is acutely aware of our sub-zero days, endless snow with drifts as high as an elephants eye! In other parts of the world it might be hard to imagine what we are dealing with. Over the weekend my sister who lives in Southern California sent me this picture of the view outside a beach house.
My reaction surprised me. Instead of being filled with envy and bitterness, I was relieved! Thank God! Somewhere in this world there is color and palm trees! It made me smile and shed a tear of gratitude.
Then I sent her this video of the view outside my window on the same day:
So the envy and bitterness wasn’t that far off after all. There it was lurking in the cold corners of my house, my neighborhood, my town, waiting to suffocate me any minute now.
These are tough times for the snow and cold bound. In my practice, just about everyone I see has something anxious, angry or depressing to say about the weather. No matter what the real theme they want to work on is, the coda plays: “…and then there’s the weather.”
Like labor pains, I don’t remember how bad past winters were. We tend to think that whatever we are experiencing now is the worst ever! But in this case, I really think this winter is the worse winter ever! A few years back I shared eight things that helped keep me warm, happy and sane despite the freezing temps after the holidays and without football to distract us. They still apply:
1) Alpaca fiber socks. These socks are the best socks in the world! They are called Survival Socks for a reason! Warm, soft and amazing at keeping dry. If you wear boots for any reason, for sport, for work, to dig out of the snow or walk your dog through the snowdrifts, these socks will not let you down. Even after coming in, I keep my alpaca socks on to pad around the house. A favorite sweater, wrap (#4), velvet-y soft pants and top, on some days can feel like a warm hug from Mom when we really need it.
2) Bonjour Primo Latte battery operated whisk. I am not big on kitchen gadgets but this is one I love! For under twenty bucks you can make your own skinny vanilla latte at home any time you want! Try this recipe: 3/4 cup 1% milk + 1/4 cup water heated in the microwave for 30 seconds, 1/2 tsp sugar, 1 tsp instant Espresso, a drop or two of real vanilla extract. Whisk with your new toy and Voila! A steamy, frothy, low cal treat!
3) Hot chocolate. Not just any hot chocolate. Ghirardelli Chocolate Mocha! I take my chocolate very, very seriously. This stuff is the Rolls Royce of hot chocolate. All other hot chocolate will turn to chalk in your mouth after you taste this rich goodness. That’s all I have to say.
4) A ruana, shawl, cosy blanket, throw or snuggie. OK, maybe not a snuggie but I love my favorite ruana, a soft wrap that traps my body heat just where I want it and it looks good, too! Which, let’s be honest, a snuggie can never do, even a leopard print one. Just thinking about my ruana makes me feel warm. I think I’ll go get it right now. (see #1)
5) Treadmill. If it weren’t for my treadmill I would be a squirrelly mess. Activity is a depression buster, and not being a skier, walking on my treadmill gives my cooped-up energy a place to go. Otherwise I’d be hurling large objects at my husband for no good reason. You don’t need a treadmill to move. Put on your favorite jam and dance wildly! Go through some yoga poses throughout the day. Stand and walk around while you’re on the phone calling the furnace guy.
6) Oil popped popcorn. Microwave popcorn is good but real oil popped popcorn has that special almost like movie popcorn taste. Some people say popping your own is healthier than microwave. I don’t know but I do know it’s cheaper! Popcorn is not that hard to make once you have the knack. Try this recipe.
7) A dog or a cat or any cuddly pet. Their furry goodness warms the heart and makes the frozen days feel less isolating. If they let you get close, their body heat is a good as any heating pad. They are great entertainment value as well! My dog happily hopping in the deep snow makes me laugh every time. Winter depression busted!
8) Binge Watching. All the Mindy Project and The Good Wife episodes you can stand passes the time during a blizzard.
Try this. Work out first (#5), break a sweat doing any kind of movement, then settle down with #1-#7. Give yourself permission, to not be as productive as usual, to sleep a little more and eat carbs. You’ll be purring with contentment in no time.
What helps you survive the winter? Please share! I’ve added a few more ideas in the comments section. I’d love to hear from you, especially if your situation if different. Do you have kids? Are you an older person or have a disability? What do you do to cope with our crazy environment?
Many people complain that whatever they do it isn’t ever good enough. Then they get a rash of “I get so angry at myself” –itis. Who is their harshest critic? You guessed it. They beat themselves up with what amounts to verbal self-abuse.
Boy, do I know how that feels:
“Why did I get an 89 on that report? It should have been 100. I’m an idiot!”
“What was I thinking when I called in sick? I should have gone into work anyway. Now my boss will think I’m a bum. I am a bum!”
“Why did I eat that pie? Why did I eat two pieces of pie? I’m fat and out of control!”
A lot of us are guilty of being mean to ourselves in a way we would never tolerate form anyone else.
It has got to stop! Here’s how:
1) Tune in, like you would a radio dial, to the voices in your head. How are they sounding? Supportive or nasty? Sometimes we aren’t even aware of how cruel we can be to ourselves until we detach just enough to listen as an observer. Write some of it down. Let that help you realize the extent of the verbal self-abuse you’ve been sustaining. During an episode of depression I did this and was surprised to learn how unkind I was to myself.
2) Whose voice is it? It isn’t yours. Your genuine voice is thoughtful, even when you legitimately need a kick in the butt. Trust me on this. Often that harsh voice you hear is a parent or other adult who had an impression on us when we were kids. Back then our brains were sponges that soaked up and internalized everything, including repeated criticisms.
Isolate and defuse that negative voice. Identify where it came from and realize its origin was outside of yourself. Take another moment to filter through the ‘noise’ of the mean voice. Underneath all that muck is your genuine voice or your ‘gut’. That voice is reasonable and supportive. Listen to it.Read More...
Editor’s Note: Explore What’s Next therapist, Nicole Newcomb, LMHC, runs a great group for people who are recovering from an eating disorder. In today’s thin-obsessed society getting back to healthy self-care is no easy task! In this article Nicole describes why she created this program and how it works. ~Dr. Aletta, Director
Sometimes it feels like it is impossible to be happy with your body! Health magazines tell you “Lose 10 lbs in 5 Days!,” media broadcasts of unnatural photo-shopped models and even health insurance billboards show unrealistic expectations.
Every time we turn around someone or something is telling us that we do not look fit enough, thin enough, beautiful enough and therefore we are not good enough. Sadly, when told this repeatedly, we start to believe it! Internalizing all of the messages and expectations from our culture can be very detrimental to our self-esteem and drive us to “improve” ourselves.
However, with unattainable goals to increase our self-worth, we fall into the trap of unhealthy behaviors. It doesn’t take long for calorie counting, excessive exercising and food rules to take over our lives. Quickly, we realize our efforts are still not improving our self-esteem and we push ourselves harder, sometimes to the point of doing things we never thought we would!
Have you become rigid or anxious about your food, work- outs and weight? If you feel like you struggle with chronic body dissatisfaction, skipping meals, over-eating and have intense guilt… then it is time to Break the Rules! Explore how to get out of your head by learning how to break the eating disorder rules!
In this group you will gain an understanding of what it means to have an ED, support from peers who understand your struggle, education about symptoms from a qualified therapist and recovery skills for breaking bad habits and learning how to cope! You can be happy with your body AND be healthy!
Call, text (585.737.4564) or email me (email@example.com) anytime. I’d love to hear from you! ~Nicole Newcomb, LMHC, Group Leader.
Photo courtesy of Malingering via Flickr