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By: Angela Kuhns, LPC  The holiday season is upon us and the new year is approaching fast. Our traditions, at their best, are how we mark time and connect to meaning in life. This can be a time to gather, celebrate, reflect, and set intentions. I hope we’re able to do all that AND it is cold- it is dark- many of us are running on fumes. Times like these highlight the complexity of being human and intensify our emotions. We might experience a longing for connection and challenging family dynamics that lead to isolation, fatigue and the pressure to do it all, being surrounded by people and feeling alone, ideas about how things “should” be and the reality of how they really are, ideals of “the most wonderful time of year” and unrelenting grief. It can all be overwhelming and disorienting.
What I most often see and experience in moments of overwhelm is either a shutdown (think feeling numb/disconnected) or a panicked what’s wrong with me and how to do I fix it so I can do more. These are natural responses, sometimes getting us by short-term, and long-term end up wreaking havoc. It is important to be mindful that we ourselves and others are likely experiencing many intense feelings this time of year. If we feel ourselves slipping into overwhelm, or suddenly just wake up there, it is time to take a break. I mean full on stop. Yes, problem solving and processing are important, and in a state of overwhelm none of us come up with solutions or helpful interpretations. Step out of the chaos for a moment- This might look like taking a quiet moment in the bathroom, a walk around the block, or acknowledging a worried part and asking it to slow down so we can effectively address what’s coming up. Reorient- We are physical bodies, this means we first reorient ourselves by grounding in our senses, establishing physical safety, and breathing deep into our bellies. Acceptance- I know this word can be tricky. Think of a map. Acceptance is just saying these are my current coordinates. You are not saying that what happened to you that led to these coordinates was okay, that this is where you want/planned to be, that you like where you are, or that you will be staying in this place. Simply, this is where I am right now. The next right action- Engage with compassion. It may help to think of what you would want for a loved one. Be clear on what is and isn’t within your control, establish realistic expectations and boundaries, and connect back to your values. Take your next action from this place. Our wellbeing is so much more about embracing the fullness and complexity of our experiences, who we are, and what we need in any given moment than about trying harder or pretending everything is ok.
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By: Angela Kuhns, LPC
It is the time of year where Gratitude is scrolled across every inspirational post and barn board in sight. There is a significant amount of research that supports the numerable benefits of a gratitude practice such as improved mental and physical health, increased resiliency, improved relationships, increased self- esteem, and increased empathy. Yet the word snags on the jagged edges of my judgment and I am instantly suspicious. When I hear someone say “I should be grateful” or “just be thankful” I cringe. Cue the inner critic and concern for what others will think. I am not supposed to think that way yet alone share it. Maybe I am a bad therapist- a bad human. I am going to go ahead and pause right there. I have never investigated a part that didn’t have a deep caring, something it was fiercely attempting to protect. So, like I encourage the people I work with to do, I try to get curious and explore with compassion rather than judging the part or over identify with it. The part brings forward how hard this time of year is for so many people. Grief, loneliness, stress of unrealistic expectations, the sense of not enough... it is agonizing. There is so much minimizing, shaming, and dismissal of pain that masquerades as gratitude. The meaning gets misconstrued and weaponized. We hear how our pain is unacceptable and a personal failure. In the depths of our pain, we need to know someone sees us, our suffering, and will follow through with compassionate action. Pain is profound and it asks to be acknowledged along side the profoundness of gratitude. For gratitude is not a way to circumvent pain, it is a salve that eases suffering not denies it. It is protective. It increases our wellbeing. Now more than ever we need gratitude in its truest form, not some watered-down performative version or the false stand-ins that cause further harm. Brené Brown in Atlas of the Heart writes “Gratitude is an emotion that reflects our deep appreciation for what we value, what brings meaning to our lives, and what makes us feel connected to ourselves and others.” This points to ways we can check in with ourselves and our practice. Do I feel thankful or guilty? Open or hardened? Relaxed or tense? Connected or isolated? Expansive or diminished? Intentional or forced? Warm or numb? Compassionate or judgmental? I hope this season we can connect to the heart of gratitude. May we receive the gifts of both gratitude and the acknowledgement of pain May we practice gratitude in ways that expand compassion to ourselves and others May we make space for all parts and connect to the deep caring within By: Angela Kuhns, LPC
Laughter, joy, excitement, and the like are often not the first things that come to mind when we think about therapy. It is true, most of us seek out therapy when the pain in our lives has become unbearable. What’s good and how we take the good in are not at the forefront. However, the practice of taking in the good is vital to our wellbeing. It is sustaining, adds to our sense of wellbeing, and puts us in a more resourced place as we confront the many challenges of being alive.
It is very common for us to lose sight of the good or what brings joy into our lives. This might simply be getting lost in the busyness of life, an oversight remedied by being more mindful and intentional. It is also very common to actually be defending against allowing the good in. Harmful conditioning, fear of vulnerability, and incidents that interrupt our sense of self and safety often cause the good to be perceived as a liability. We become locked into avoiding pain. So much so that we are all avoidance with no sense of what to approach. Our world becomes smaller; we experience the emergence of depression and anxiety. Our protective strategies that helped us survive, while they deserve our respect and gratitude, are not conducive for fostering our greater sense of wellbeing. It is impossible to fully embrace goodness if it is being perceived as a threat. When we notice we are unable to take in the good, it is time to act. If depressive symptoms and/or anxiety are so debilitating that we can’t seem to engage, it is important to enlist the help of a therapist and establish care with a psychiatrist. Sometimes support is necessary to connect us to our resources and unpack the experiences and beliefs that are keeping us overwhelmed. When we are able to engage, we can start by investigating what we are defending against. The specifics are different for everyone, and common themes include guarding against: failure, loss, disappointment, judgement, being manipulated or taken advantage of, being perceived as less than, vulnerability, a sense of unworthiness, guilt, and shame. When we know what we are afraid of we can start working towards establishing safety. Again, this looks different for everyone, and common themes include: acceptance of the full range of human emotions, establishing realistic and compassionate self-talk, connecting to our worth, tolerance of inherit vulnerability, boundaries, and building healthy relationships. Once we are in a place where we are willing to allow the good in, we must identify what bring us joy. It is almost certain if we have been defending against allowing the good in, out of fear or a need to protect, our initial reaction will be “I don’t know what brings me joy.” Not knowing is okay; our fate is not sealed. Not knowing is our invitation to get curious. We may review what we do know. Where have I experienced joy, interest, or playfulness in the past? We may research. What would people I trust say about when I am most joyful? What do experts say about human joy? We may experiment. What are some of my best guesses and how can I try them out? From here we can make a list of the good we would like to take in. We can work to foster it in our lives through setting our intention, direction action, and mindful awareness. To anchor those positive experiences and practice taking in the good
If you’d like to dive deeper, check out the practice of Taking in the Good with Dr. Rick Hanson. By: Sarah Sanburn, LPC  School has just started, first day jitters are over and students are beginning to learn
the classroom expectations.... now what? Whether your child has anxiety that pops up periodically or they have an anxiety disorder; it is important to understand the best ways to support your child with their worries. Transitioning back to the start of school can feel overwhelming for parents and children alike. As parents, we are often loaded with back-to-school activities, the start of after school programs, managing the changing schedule and of course, if you’re anything like me, the never-ending laundry and dishes that children seem to forever be creating. With pumpkin spice latte’s still not on the menu and the chilly mornings not something we can look forward to, it is normal that this time of year would be stressful for anyone. It’s important to be mindful about children’s schedules having a healthy balance with school, activities and rest. Here are some guidelines to support your child as they begin the school year... Checking In The start of school can bring nerves to even the calmest of children. It’s normal to have the back-to-school butterflies in the stomach feeling, as I’m sure we’ve all experienced when starting a new job. To check in with your child on their feelings, ask open ended questions instead of leading questions. Instead of, “Are you feeling anxious?”. Try asking in an open-ended way, “How are you feeling today?” or “What do you think about your new class?”. Then, and this is the most important part, listen. I have often been asked what I say to my child to get her to talk to me, and the thing that has made the biggest impact is not exactly what I said but that I listened. Kids can sense when you’re really invested and hearing them or if you’re running through the to do list in your head. Before bed is a great time to have these conversations, and leads to great bonding time. Set Healthy Boundaries Limit after-school activities and provide unstructured play time. It’s easy to feel like your child is missing out when you are surrounded by social media posts with parents showing off their child’s new activities. Here is a hard truth-there will always be something your child is missing out on. However, by saying “No” to another extra-curricular activity you are also saying “YES!” to unstructured play time. This type of play, play that is not organized by adults and typically does not have an intended outcome, is essential for children to thrive emotionally and socially. Model Behaviors You Are Looking For What we say is important, however what our children see us do on a daily basis is more important. If your go to stress technique is to acknowledge the feeling and take a deep breath before responding then they will follow in your footsteps. When you model this anxiety reducing technique, they internalize the understanding that anxious feelings are ok to come up and to let go. Normalizing expressing emotions in this way is going to set your kiddo up for success as they grow and develop in communicating their needs. Be Proactive If your child’s anxiety seems to linger longer than expected, checking into resources could be helpful. It’s important to know and understand your resources at your children’s school and in the community. Missouri state law encourages schools to have an established resource for mental health. Most schools in the area have at least one school counselor, crisis counselor or have established a resource from an outside organization to provide mental health support for students. You can call your child’s school and inquire about the resources available. Most school counselors also have a list of recommended therapists in the area. I wish you luck in the school year ahead, hopefully you can also make time to prioritize yourself. Here’s to a great school year! by Sarah Sanburn, LPC
We live in a culture that praises the active and invested parent, in my over 10 years of working with children and families I have seen an increase in the parent’s participation. It’s been wonderful to see parents become more interested in their children’s lives and more attuned to how they are feeling. However, when involvement becomes parental interference, it can be at the expense of the child and parent's mental health. The extreme cases of this were seen in the news when wealthy parents were caught buying and bribing their children’s way into top schools. In daily interactions, teachers, administrators and school counselors often see parents calling to solve problems for their children. I know from my own parenting the pressure we feel to help our children live pain-free lives. Here is the case for allowing children to fail.
As parents, we want to see our children live full, happy lives and it can easily feel like removing obstacles is a way to support our children. However, when we remove the learning experiences that failure brings for children, we are not allowing them to fully grow and develop into their authentic selves. I see these tendencies to bulldoze problems increasing the perfectionistic tendencies of our children as well. When they easily overcome everything that they set out to do, they don’t develop a growth mindset and instead begin to expect perfection from themselves. By allowing our children to fail, within an environment of empathy and unconditional love, we set them up to increase flexibility and grit. As I raise my two-year-old son and seven-year-old daughter I have plenty of practice in this any time we go to the park, or really anywhere for that matter! When my two-year-old goes to climb up the same play structure his older sister does I do not go behind him and help him up the whole way to the top. I will allow him to try independently first, encouraging his attempts and validating moments he struggles. If I were to automatically help him to the top, he would not have gained the confidence that comes from overcoming a challenge or trying something new. This also shows up as my seven-year-old enters the world of competitive sports. I have often heard parents screaming from the sidelines, walking over to talk to their kids on the bench mid game and at times even asking the coach for more field time. These well intended parents are giving their children the message that they don’t think they can handle it on their own and that perfection is a top priority. While the parent’s intention is to do what is best for the child, the impact can be an increase in anxiety. Instead of inserting ourselves into each issue our children face, we can choose to support our children as they learn to face life's challenges. When little league feels overwhelming and it’s going to be a tough game we can give children the support, love and encouragement they need without solving the problems for them. Kids love to hear how adults make mistakes also, it gives them a template to learn from and normalizes failing. I often like to use car rides to talk with my kids, as we always have some place to go and I know there are much fewer distractions, it gives a good set up for healthy conversations. I will bring up to my daughter what the most challenging part of my day was, how it felt to fail at something new, and what I learned from the experience. This has become a favorite past time and my daughter now lights up any time I tell her about a mistake I’ve made. I will also check in about what she felt when she faced something challenging, how good it felt to overcome the obstacle or her feelings about the difficulty in having to walk away from something and what she learned. There are many ways to allow your children the space to develop a growth mindset through mistakes. Offering genuinely challenging tasks to children based on their age and skill is a great way to grow a growth mindset. For instance, you can empower them to seek out a difficult class, a new sport or hobby, or meeting new friends. Allowing children to face failure with a supportive and loving safety net, allows them to develop courage, confidence to overcome a challenge, and bravery- all things we want for our children as they grow into wonderful adults. by Michael P. Raymond
Happy Pride Month! I am a gay man. I want June to feel extra special for me. But the depressive episode I am experiencing makes it hard. According to the National Alliance on Mental Illness, the lesbian, gay and bisexual community are twice as likely to experience a mental health condition. Transgender individuals are nearly four times as likely. This is the same for adults and youth. As a young gay kid in the mid-90s, I dreaded being the object of a bully’s ire, for crossing my legs like a woman or playing Little House on the Prairie with the girls at recess instead of kick ball. In second grade I was a called a “gay wad.” My sexuality was used to hurt me before I even had any idea what sexuality was; an all too common experience for many queer people. I was taught to be ashamed of who I was. I grew up the son of a preacher, in a church that believed being gay is a sin. My shame was reinforced in all areas of my life. I wasn’t able to come out until I was twenty-two, when I was financially independent and could insure my safety. But the shame didn’t stop there. I love my family very much. But like the military from 1994 to 2011, we have a strict “Don’t Ask, Don’t Tell” policy. And it takes its toll. I was twenty-one the first time I had trouble getting out of bed for days on end. I have been taken anti-depressants since then. I didn’t start seeing a therapist until summer of 2019. I am in the midst of the complicated and grueling task of shuffling off the mortal coil of my shame. A phrase taken from Hamlet’s famous “to be or not to be” soliloquy. A speech about choosing to live or die. I am out an out and proud gay man, but sometimes my shame makes me ask that same question. Pride Month is supposed to be about throwing off my oppressors and taking to the streets in protest and celebrating my innate queerness! But how can I do that when I can barely get out of bed? All of the “Happy Pride Months”, pride parades, and corporations changing their social media profiles to a rainbow logo can’t heal my shame. That is up to me (with the support of my therapist, and my chosen family of queer friends and allies). Pride month shouldn’t be just for queer people to be proud of ourselves, but for the people in our lives to affirm our existence. So please, tell your brother, your cousin, your aunt, your non-binary child, your trans co-worker that you are proud to know them. That you see them for who they are. And if that doesn’t work, we gladly accept cash.  National Children’s Mental Health Awareness Day
By: Sarah Sanburn, LPC Children's Mental Health Awareness Day, May 7th this year, was established to bring attention to to the importance of children’s emotional, behavioral and mental health. Children are resilient, we hear this often. While true, it is not the whole story. Building resilience requires supportive and understanding adults. Both children and their caregivers are struggling recently. As research shows us, there has been a consistent decrease in children’s mental health. The American Academy of Pediatrics declared a national emergency in child and adolescent mental health in 2021 due to the increase in mental illness in children nationwide. Rates of childhood mental health concerns and suicide have been on the rise since 2010 with the pandemic increasing these rates due to the surge in stress and instability. As the bias around mental health services decreases and awareness is more widely understood parents are seeking therapy at a growing rate. However, there is a lack of resources for children’s mental, emotional and behavioral health. As a child therapist I see daily the impact that a lack of mental health resources has on children and their families. When I first talk to parents it is common to hear about how many calls they made or how many times they were turned away before getting their child into therapy. I am lucky enough to have two wonderful healthy children, ages 7 and 2. Being a mother is the most amazing and the most challenging thing I have ever done, I am sure most parents feel similarly that showing up for their kiddos emotionally is incredibly rewarding and also difficult. I find that when I make time to care for myself I am able to be more present for my children. Making time to recharge is a huge piece of the challenge to parenting amidst all of the laundry, soccer practices and activities. Reading, especially listening to audiobooks, has given me comfort in the knowledge that I am supporting my kiddos to grow into resilient humans. Here are a few of my favorite parenting books:
 Lessons on Self Harm
By: Angela Kuhns, MA, LPC I would like to explore something that is both heavy and important to talk about. AND nothing is more important than your safety. If you find discussions of self-harm or references to suicidal ideation activating or overwhelming, do what you need to do to keep yourself safe, including choosing not to read this post. Self-harm refers to deliberately hurting your own body. This commonly takes the form of, but is not limited to, cutting, bruising, or burning. March is Self-Harm Awareness Month, and I would like to create an opportunity to connect by sharing my own story and what I have learned. By the middle of high school my depression was in full force with all its attendant sadness, confusion, anger, and feelings of worthlessness. Totally overwhelmed and without access to better tools, I began self-harming. There were times I self-harmed because it all felt like too much to bear. I have learned we all need to be taught to identify and label our emotions. We need emotion regulation/tolerance skills that work for us. There were times it was because I felt nothing, trapped in periods of numbness, suppression, and anhedonia. Self-harm was an attempt to feel something. I have learned we all need ways to safely feel our feelings, strategies to ride out waves of difficult emotions, and to know that it is okay to get treatment for any underlying issues. There were times it was out of anger that I didn’t know how to safely hold or communicate. I have learned we all need to understand that there are no “bad” emotions. Yes, there are painful and difficult emotions, and we need to realize they provide us with valuable information. We need to learn how sit with, listen to, and communicate our feelings. There were times it was because the results of physical self-harm were tangible. I could see it, I knew why it hurt, and I could control how much and when it hurt. I have learned we all need ways to express ourselves. We need insight into our pain and suffering. We need to connect to the agency that we do have in our lives. There were times it was the reflection of the toxic shame that can accompany shoulds, rejection, loss, and disappointment. I have learned we all need to challenge our avoidance, judgements, and harmful ways of thinking. We need to learn good boundaries, to take responsibility for our own feelings and not the feelings of others. There was even one time that self-harm seemed like the only thing between me and suicide. I have learned we all need our self-harm, underlying issues, and any co-occurring suicidal ideation treated. We need love, support, belonging, and as many protective factors as possible. During all this, I would have smiled and told you everything was okay. People around me didn’t know or if they did, they surely didn’t know what to do or say. There are many reasons someone might self-harm and what leads to harm reduction depends on each individual’s needs. Whatever the reasons, know that THERE ARE THINGS WE CAN DO. If you have lived experience of self-harm or have thought about self-harming know that you are not alone, you are not inherently flawed, there is help, and it is okay access that help. If none of that seems believable right now---I hear you, there are reasons those blocks are there, and there are people who can help you work through the blocks, self-harm, and whatever is going on in your life. If you think someone you care about might be self-harming, please don’t ignore it. It is equally important to not overreact, which may require you to address your own needs. A person struggling to manage their emotions doesn’t need high reactivity to also try and manage. If you’re dysregulated, you cannot help coregulate or model emotion regulation. Let the person know you care, work with them towards safety, and help them get connected to as many resources as possible including internal strengths, skills building, and professional support. When a part of self or a loved one self-harms:
Self-harm is not a suicide attempt. It is often non-lethal AND behaviors can escalate. Suicidal ideation can also co-occur. This should be assessed by a professional who will work on a safety plan and harm reduction.
 The Right Therapist Is Out There
By: Michael P. Raymond A new year means New Year’s Resolutions! We decide to exercise more, declutter our home, read one hundred books, etc. A common resolution – and the point of this blog post – is to get a handle on our mental health. Resolutions can be daunting without a plan. Don’t worry because I am here to help! I am Sandhill’s Practice Manager. I don’t have a degree in psychology, but I am passionate and knowledgeable about mental health. Finding a therapist, especially when amid a mental health crisis, can be overwhelming. Any time I am daunted by a task, I break it down to manageable steps. I find comfort in knowledge. When I do research and am well-informed, I feel prepared for the unknown. Start by thinking critically. What do you want to get a handle on? Have you experienced trauma? Are you feeling depressed? Maybe you have strained relationships in your life, or experienced a significant loss? Also start to think about what kind of therapist you’d like to see. Someone of the same gender? The same sexuality? Someone who is close to your age? I was a queer, twenty-seven-year-old when I started seeing a therapist. And the most important thing to me was finding someone who could relate. Armed with my thought exercise, I started the practical part of finding a therapist. Cost was a major factor for me. Therapy can be expensive, but my mental health was a priority, even if it meant curbing my Starbucks habit. I was lucky to have health insurance. So, I figured out what my plan covered, and how I could find an in-network provider. The provider search engine on my insurance website was a lifesaver. It showed me providers who were in-network, where they were located, and their contact information. And then, I Googled, a lot. Searching online for medical providers is a mixed bag. I’m a Millennial, so if someone doesn’t have an internet presence, I’m going to be hesitant. Psychology Today’s Find a Therapist function was my best discovery. Many therapists have a profile on Psychology Today that includes a bio, as well as, a list of areas and demographics they work with. And if you’re lucky, a picture as well. If you’re really lucky, it will have a link to their personal website. I selected four potential therapists from my research. I contacted them to confirm they took my insurance and if they were taking new clients. Based on timeliness of response and availability of appointments, I setup an appointment! The first time I saw a therapist, I did not connect with them. I hadn’t thought critically about what I was looking for. I saw them for three months, and then stopped. Two years went by, and I needed to talk to someone. I was wary of going through the process again, but I learned from my previous experience, so I felt more confident. I followed the steps again. I read many bios to get a sense of their energy. I reached out to a therapist for an appointment in August of 2019. It is now January 2022 and I have been seeing him since. He is helping me change my life. Finding a therapist can be a daunting task, and I hope I’ve provided some useful tips to help you find the right therapist for you!  Veterans Mental Health
By Andrea Schramm, MA, LPC I’ve been thinking about this month’s topic for our November blog as this month, the month of November, is when we honor and celebrate our Veterans who have given so much to all of us through their service to our country, many have given their lives both in and out of conflict. It’s a huge topic. I am not a Veteran so my experience is uniquely civilian in scope. I am the wife of a prior Senior Master Sergeant and 25-year Veteran of the United States Navy and Air National Guard and the mom of a prior Sergeant in the United States Marine Corps. It is from these roles I have come to understand the significant and unique differences between our experience as civilians and those who have served in our military. I remember when my son returned from serving in the Marine Corps and despite having been in constant contact with him, visiting him at Camp Pendleton may times and meeting his close buddies in the Corps, I realized I struggled to understand the unique experience he had while in the Marine Corps. Each of us is unique in our experience and although may be common with those close to us, they are our own and this can feel isolating even amongst those we shared our experiences with. One thing I learned which I found helpful is the core purpose of those serving across our military branches is the goal of “Mission Ready.” Our service members train constantly and this is the single experience they have with each other outside of what is uniquely their own. Their training is constant in support of their ability to be ready to engage at any moment with their mission in our defense. It is also a mind set each and every service member internalizes. In order for our service members to do their unique job, they must be mission ready at all times. The United Nations offers this guide for Mission Readiness and Stress Management. I encourage you to take a look at the process of deployment for our service members whether in training missions or in combat missions. https://www.un.org/Depts/OHRM/stress.htm How can we support and understand the mental health needs of our service members and Veterans? I can offer a few experiences of my own having had to adapt to something I had no knowledge of myself. We can be active participants in helping our Veterans stay in touch with those they have served with. Watching how incredibly important it has been to maintain contact with those they have served with within my own home, this is a significant investment in our Veterans mental health and well-being. If you know a Veteran, take the time to ask them about their buddies they have served with and encourage them to remain in touch. This is an incredibly significant support for our Veterans. Consider involvement with an organization such as Make the Connection that connects Veterans and families through their experiences. https://www.maketheconnection.net/family-friends/ We can ask to hear and listen to our Veterans stories. Not all Veterans want to share their experiences, however, we can still ask and tell them we want to know about their experience serving in our military. Tell them how important they are to you and how much you want to share in their experience. Talking about something can be very helpful for a person’s mental well-being and fosters the very important connection between those who have served and their families and the greater community in which they live. |
JENNIFER EULBERG, MA, LPCWelcome Jennifer, our new blogger!
Jennifer is a counselor at Sandhill who specializes in depression, self-esteem, and grief & loss. Get to know Jennifer as she shares her perspectives on life, contemplates value themes, and offers gentle encouragement. THANK YOU to Stefanie Pisarkiewicz, LPC for her blog contributions from November 2014 - February 2019! 
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