Ending Victimhood: How to Own Your Life

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Want to improve your life immediately? Stop being a victim. Stop blaming others for the injustices that are going on for you in your life, work, relationships, friendships, diet, exercise….blah blah blah…. You don’t need to see a therapist, coach, or lifestyle consultant to do this. This is a very simple thing to do, and I suggest that it is in your own best interest (along with the interest of those who care about you) to do it immediately. My experience shows that being a victim is the quickest way to lose all personal power, to be pathetic and to give yourself permission to be unable – or unwilling – to change.

Don’t get me wrong, tragically, there are true victims in our society everywhere including children of abuse, domestic violence partners, and families trapped in poverty; however, I highly doubt that these are the victims you and I know. You know who I am referring to. Individuals that refuse to take ownership of their actions, choices, or the consequences of their behaviors. Victimhood kills personal empowerment. It creates weakness and apathy. For any change to occur the first step must be to take charge of yourself and to stop blaming others for the things in your life that are not going as you wish.

not-a-victim

I mentioned that this is simple; however, that does not mean it’s easy. Simple means you can truly change your thinking this exact minute. As you read this blog you can choose to begin to think in an empowered manner. Use words in your head like choice, my responsibility, my part. Be prepared though, that it can be incredibly hard to face yourself, stand in front of the mirror, and see who you really are. When you begin to empower yourself by realizing you are creating your reality, your choices are dictating your answers, and you are exactly as you imagine yourself to be, it is SCARY. You become vulnerable. It is this place of fear; however, that leads to power, strength, and most importantly true change.

Does your partner treat you poorly? Are you feeling sorry for yourself because you are not being appreciated at work? Do you feel like you ended up in someone else’s life, marriage or home? All of these things are on you. We teach others how to treat us, what we are willing to put up with, how open we are to relaxing our boundaries. US. No one else is able to do that “for us”, or do that “to us”. We are entirely responsible for how we are walking around in this earth, treating others, and letting others treat us. We are the only ones who can use powerful words like “yes”, “no”, or “I feel” when faced with a decision.

I do not want to sound unsympathetic and yet we are a society full of victimization. I just believe that we are perfectly capable of changing our lives in any way we choose and in order to do this we need to begin to take ownership of all of our actions. If we constantly blame others, we are never going to change. How can you change something that you are not “doing” but instead is being “done to you”? Yes, you can remove yourself from the situation, but you also need to own your part in all of the dynamics that make up your life.

I challenge you to become empowered today. Shift your perspective by asking yourself what you can do to change the areas in your life that make you feel like they are being done to you against your wishes. Decide you are done playing a role in any unhealthy dynamics and get help from a therapist, coach, or friend if you cannot find your way out of harmful patterns or behaviors. You can choose to have the life you have always imagined by taking charge of yourself and being authentically you.

Yours in Health,
Stacey Neil

Believe In Yourself

Choose to be happy today. This is within your power only.

Refused Consent: How HIPPA Can Hurt the Families of Adult Children with Mental Illness

A first year graduate student interviewed me last week for a paper she was writing for her law and ethics class. She asked me what was the most challenging legal or ethical issue I have yet to face in my work as a therapist. I thought for a moment about so many of the challenging issues I face in my work with clients. These are not simple answers. When you are sitting alone in an office one on one with a variety of different clients, presenting with their own unique struggles, a myriad of things come up all the time. As a therapist, I must be mindful of my legal and ethical obligations as almost a second nature. I have found that this gets easier hour after hour sitting with another human being but is never uncomplicated.

I thought about her question to me and reflected back on some of the hardest legal/ethical issues that have come up. Some hurdles I’ve had to navigate have to do with the mandatory reporting of child abuse cases, the sometimes strange laws surrounding minors engaged in mutually initiated sexual acts, and the moral dilemma about taking clients rights away to place them on a 5150 hold (due to their threats of harm to self or others). As intense as these issues are, however, these legal and ethical challenges are not the toughest to deal with for me because I can feel an internalized sense of “right or wrong” in handling them.

What I have struggled with the most has to do with the limitations that HIPPA (the Health Insurance Portability and Accountability Act) places on the families I work with who cannot participate in the care of their loved ones if they have not been given consent by their adult child .  Historically this act was put into place in 1996 with the best of intentions around protecting health information and allowing individuals to have privacy around the medical care they seek.  To use an extreme example, if you are suffering with HIV, HIPPA allows you to have confidential treatment that your workplace, who handles your medical insurance, has no access to.  This has freed up many individuals to safely seek medical attention and care for issues that they may otherwise want to keep hidden.  It has been a really powerful ally in client’s rights; however, like many of the mandates that are put into place, there have been consequences to the righteous  limits of HIPPA that may or may not have been anticipated, but nonetheless, have been heartbreaking for some of the families I work with.

At the age of 18 we are deemed “adults” in the eyes of the law.  This adult status allows us to choose who we do or do not share medical information with.   The challenge this brings up for the families I work with is that they may have an “adult” child (over 18) who is suffering greatly with a severe and persistent mental illness,  who may even still lives in their home, and is in need of more intensive services or care.  If that adult child does not sign a consent form giving their loved ones the ability to share in the treatment of their illness, the parents cannot have access to any information regarding their child nor can they seek out treatment for them even if it is in their child’s best interest.  In extreme cases, I have worked with families who have an adult child living in their home in the midst of a psychotic episode in which they are extremely paranoid.  This paranoia extends to believing that their parent is “out to get them” and they are unwilling  to have their family member speak to their Psychiatrist or Psychotherapist to coordinate the best possible care.  Or even more detrimentally, they may not be receiving treatment at all and the parent is unable to initiate services for them without their permission.

This can be an issue for a variety of clients, for example, consider an adult child suffering from Major Depressive Disorder who chooses to leave their family out of the loop deliberately and refuses consent as a way to isolate from their parents or punitively keep them unable to get involved with trying to support treatment.  Keep in mind that this is an adult child still living in the home causing distress to the entire family as they are refusing treatment for their illness.  This family is trying to stand by their adult child and keep them safe in the home. Families are left frustrated, hurt, and helpless.  Mothers and fathers sit back and watch their cherished son or daughter spiral downward and feel unable to do anything to intervene. Of course, there is always calling the police if their child gets out of control, or forcing the adult child to move out of the home,  but the fear of their child living on the street, or in a homeless shelter, keeps them shackled in a vicious cycle of trying to manage a volatile situation with very few tools on hand.  This situation forces them to tirelessly try to stand by their son or daughter as their symptoms continue to worsen in a tragic manner. Often families will bring in their adult children to therapy in hopes of getting them help.  Sometimes they have to threaten to kick them out of the house unless they come.  As a therapist, this is not always the easiest client to engage with as you are their “punishment” in order to stay in the home.  

As someone who used to work in a county contracted mental health organization, I am familiar with the resources available in the community and the many ways to work with these individual clients and also their family members.   As a provider, without a client’s consent, I am able to receive information from these families so they call me to vent or let me know how their child is doing.  However, I can share no information in return regarding the progress, interventions, or work we do together in session.  I have had parents cry in frustration, lose sleep out of fear, and yell at me from worry for their child, and I still cannot offer any comfort.  I can not share with them that things are getting better, their child is learning new tools, they are finding hope in their illness, that they love you more than anything.  I can say nothing.  It is the hardest part of my job, this inability to provide comfort.

I often wonder if it is because I too am a mother.  I know that mental illness strikes at any time to anyone.  I know that I could just as easily be sitting on the large couch vs. on the therapist chair begging for more information because my child is hurting and I can’t help them.  My child is in pain and he/she won’t talk to me, won’t let me in, won’t sign a simple piece of paper that will allow me to find out how they are doing.  I must speak in generalities, not specific  to their child.  I can teach them about different diagnosis’ and provide education while making no personalized statements that may be meaningful to them.   I am grateful I have learned of something to offer these families.  I  refer them to the best program I know for families of children who are suffering from a mental illness:  NAMI’s Family to Family Program.    It is a program from the National Association of Mental Illness that is taught by families for families  in a small support group format.  It teaches them all about how to be as empowered as possible about caring for their family member as well as how to have self-care and compassion towards themselves.  The families I have referred say it has saved their sanity and given them some strength in what can feel like a vast vacuum.

As a final note, I think it is important to mention that not all families have the best interest of their adult children at heart and can actually be pretty harmful at times in provoking their adult child who is suffering from a serious mental illness.  There are families that have mental illness throughout the genetic lines and a parent who is suffering from a mental illness cannot always be a strong advocate for their child without first doing their own work.  In my experience this is the exception and not the rule in the families that I work with, but it does exist.  Some families have the potential to be toxic and enabling of each other in their illness or addictions.  However, 99.9% of the time, the families I work with are loving, concerned, desperate and short of hope.  This is the toughest legal issue I work with as a therapist.  I wish there could be built- in exceptions to consent forms that took into consideration that just because an individual turns 18 does not always mean they know what is in their best interest or how to best care for themselves.

Yours in Health,

Stacey Neil

Growing Up The Fat Girl

 

My parents always used to describe me as a “big boned” girl, but I didn’t start needing to shop in the “Pretty & Plump” size clothes until I hit second grade at which point I started really packing on the inches eating my way up to 155 pounds by 4th grade. As a therapist, I can spend time telling you all of the reasons I decided to eat my way into a protective fat cocoon, but that isn’t really the point I want to share in this blog. I feel compelled to write this blog in the hopes to reach those of you who may still feel it is helpful to make overt and painful comments to others in hopes of shaming them into losing weight. I work with clients in my private practice who suffer daily under the hurtful “jokes” other kids make; or even the comments their parents make on having “such a pretty face if only you could lose a little weight sweetie”. If only. There is no tough love approach to a young adolescent or teenager that will help them make smarter food choices, get their bodies moving, or not want to eat what their friends eat at parties. I know because I was one of them.

I proudly put a lock on my door when I was 8. I told my mom it was to protect my “stuff” from my two older brothers, but the truth was much simpler than that. I wanted to eat without anyone watching. I became really good at this. I hid like a shame filled drug addict and ate food obsessively and without joy. I would sloppily lick hot chocolate packets I hid under the socks in my drawer eating the powder straight out of the foil when I was sad. Or hurt. Or lonely. One of the highlights of my early years was when it was time to do the candy bar fund raiser because I knew I had a supply of at least 15 candy bars that came in their own cardboard carrying case for my closed door pleasure. I would eat guiltily and quickly forcing myself to lie to the school fund raiser committee about already turning in my money, or explaining that it was stolen…again.

I was constantly self conscious about my developing body. The more body fat I put on my body as an adolescent the more quickly I hit puberty and grew larger parts that just attracted the unwanted embarrassed attraction of the boys I went to school with. The taunts came at me tinged with equal parts jeering fat comments and fascination with my blooming chest. This combination of negative and positive attention was very confusing for me as it is for my current clients in private practice. I found myself caught between excitement that someone (anyone!) is noticing my body and horror because they’re criticizing what they’re attracted to and it left me feeling dirty.

I want to tell you as siblings of overweight family members, parents of young children, and friends of overweight kids in classes; be kind. It is unbelievably hard to want to fit in so bad and yet feel so different. This internalized “difference” can set someone up for a lifetime of longer term problems like low self esteem, substance abuse, addictive food patterns, and negative attention seeking behaviors. It makes you feel lonely surrounded by others.

When someone uses food to soothe, cope, or hide, it is a form of self harming behavior. No one is forcing an overweight person to eat. No one who is overweight is not fully aware that they are. When they find themselves eating a second portion, hiding in their rooms or cars while shamefully eating, or constantly thinking about food, there is typically something larger going on in their life.

I believe that we are a fat shaming society that attaches all kinds of unhealthy, not supportive, labels on fat people. Some of these labels are: lazy, smelly, disgusting, gross, unworthy, less than, ugly. I suggest an alternative approach to considering another person who has a weight challenge. Ask yourself what may be going on with them. Challenge yourself to stop judging…be a better friend. We are not kind to one another most of the time regarding this issue. We are competitive, judgmental and cruel. I believe that women are some of the harshest critics of all. We are constantly criticizing ourselves along with slapping our labels on others.

I see the suffering this brings on each day in my private practice when I work with the shell of some of my clients who are suffering so greatly they have lost self respect. When this happens there is only one place that brings comfort: food. This cycle is destructive in ways that you cannot imagine if you have not been judged for your weight or for any other perceived characteristic that makes you “different”.

I tell my clients who come to see me for weight challenges, “Sure I can help you learn about healthier eating habits and self control”. “I can help you understand how to work out”….but then I need to tell them the truth. I tell them that their weight problem is typically the frosting on the forbidden cupcake. The tip of the iceberg. The larger issue is always the cake underneath that really needs to be addressed. I believe we walk around in bodies that represent how we feel on the inside. The work lies in finding out what my client is trying not to feel. Typically when a client learns how to feel their feelings, accept their truths, and learn to become empowered in their life; they then can have a body that represents their authentic nature. This process is not a journey for the weak of heart and can be some of the hardest work to do in therapy; however, I stand beside the belief that uncovering your best self is always worth the fight.

Yours in Health,
Stacey Neil

In Order to Authentically Live; You May First Need to Imagine Your Death

Typically at some point in the beginning of your work with a therapist you will get some form of the question, “What brings you in to therapy?”, or maybe “What would you like to work on together?”. It doesn’t matter if I am working with a client who comes in for therapy, personal training, or wellness coaching (which combines them both), the question needs to come up in order to provide good ethical service on behalf of my paying client. In theory, a client should know what it is they are having trouble with, or what is causing them distress; however, I have found this is not always the case. Some clients come to see me because they aren’t feeling well, living authentically, or without knowing what’s wrong at all. They just know something is off. That life promised more than what they felt was being delivered to them and they couldn’t begin to figure out what to do about it or how to fix it. These are some of my favorite clients to work with because I get the double pleasure of helping them to articulate and discover what it is they are looking for and THEN support them to figure out what they need to change in order to attract the possibility of a different path for themselves.

In my work I have found that sometimes the best way to figure out how to live is to imagine your death. I draw out a tombstone on a piece of binder paper and send my clients home with a homework assignment to write out their headstone. I ask them to imagine that they are at their funeral and their family and friends are surrounding their grave. “How would you want to be remembered?”, I ask. “What are the characteristics that matter to you most: kind father, loving partner, foundation president responsible for funding the cure for cancer?”. I ask them to imagine the possibilities are limitless. This is an exercise that you can do at home on your own. The answers point you in the direction of what matters most to you and uncovers for you your core values and goals in life. It helps to start you off on a direction towards authenticity if you feel stuck and it can take as little as 10-15 minutes.

I have done this exercise with gang impacted teenage boys aged 15-19 who were in an anger management class I taught at a local High School in East San Jose. They came in with their creased tombstone hand outs from the previous week folded up and pulled out of their back pockets. I hadn’t really been sure what to expect as these were not typical homework “doers” and I hadn’t tried this exercise with this population before. Imagine how incredible it was when all 10 of them came in and one by one read out loud how they wanted to be remembered when they died. These young men are surrounded by death at every turn in their gang families and were no stranger to dying young. Most of them wrote that they “had lived a long life” which quickly became evident as a common goal they shared. They talked about raising children outside of the gang culture, providing a home for their families and working an honest job. Many of them for the first time were given the opportunity to experience hope as they imagined a life with different goals and values then they were currently promoting. It was one of the most powerful sessions I have ever had the honor of facilitating. It was inspiring.

Once you are able to see the final curtain for yourself, you can ask yourself the next fundamental question: “What does my life look like today?”. If what you are living today and what you want to be remembered for in your life are not in alignment, you have an answer to the question of what to work on in your life. You can begin to change the choices you are making each and everyday by asking yourself when faced with a choice, “Is this in alignment with my vision of who I want to be remembered as, or not?”. If the answer is NO, you know it is time to make a different choice.

When I first went to graduate school, I was given this task as an assignment. Part of what I learned about myself that day is that I am afraid to die. Another thing that I learned was that I am passionate about helping others change their life because with the realization that death is scary is the knowledge that life is delicate and short. This blog is a part of my larger plan to do everything I can to help anyone who is interested, seeking, or curious to become empowered to start living the life they want now. Right Now.

I welcome your comments or suggestions. I would also love to hear about how this exercise goes for you if you give it a try.

Yours in Health,
Stacey Neil