Monthly Archives: November 2016

What counselors can do to help clients stop smoking

By Bethany Bray November 29, 2016

Nearly half of the cigarettes consumed in the United States are smoked by people dealing with a mental illness, according to the Substance Abuse and Mental Health Services Administration. The federal agency says that rates of smoking are disproportionately higher — a little more than double — among those diagnosed with mental illness than among the general population.

It is widely accepted that the nicotine in cigarettes is highly addictive, but people struggling with mental health issues often turn to cigarettes for reasons that go beyond their addictive qualities. For instance, many people smoke as a coping mechanism to deal with difficult feelings. In addition, despite their negative health effects, cigarettes are still largely viewed by society as an “acceptable” addiction in comparison with other substances.

The reality? “[Smoking] is a devastating addiction and a difficult one to quit,” says Gary Tedeschi, clinical director of the California Smokers’ Helpline and a member of the American Counseling Association. “This clientele [those with mental illness], in particular, need the encouragement and support to go forward [with quitting], and many of them want to, despite what people might think. … To let people continue to smoke because ‘it’s not as bad’ [as other addictions] is missing a really important chance to help someone get healthier.”

To drive home his point, Tedeschi points to a statistic from the 2014 release of The Health Consequences of Smoking — 50 Years of Progress: A Report of the Surgeon General, which says that more than 480,000 people die annually in the United States from causes related to cigarette smoking. Close to half of the Americans who die from tobacco-related causes are people with mental illness or substance abuse disorders, Tedeschi says.

In Tedeschi’s view, the statistics connecting smoking to mental illness are “so obvious that it’s almost an ethical and moral responsibility to help this population quit.”

Part of a package

Ford Brooks, a licensed professional counselor (LPC) and professor at Shippensburg University of Pennsylvania, says he has never had a client walk in to therapy with a primary presentation of wanting to stop smoking.

Tobacco use “is always part of a package” that clients will bring to counseling, Brooks says. In his experience as an addictions counselor, smoking is often piled on top of a laundry list of other challenges that may include alcohol or drug addiction, depression, a marriage that is on the rocks, the loss of a job or financial trouble.

“They’re on the train to destruction, and their nicotine use, in their minds, is on the back end [in terms of importance]. … Is the smoking related to what their presenting issue is? Chances are it probably connects somehow. Don’t be afraid to bring it up,” advises Brooks, co-author of the book A Contemporary Approach to Substance Use Disorders and Addiction Counseling, which is published by ACA.

Tedeschi, a national certified counselor and licensed psychologist, notes that many people who call the California Smokers’ Helpline are struggling with comorbid conditions or mental illness in addition to tobacco use. The phone line is one in a system of “quitlines” operating in each of the 50 U.S. states, the District of Columbia, Puerto Rico and Guam.

For clients struggling with mental health issues, smoking may serve as a coping mechanism to deal with uncomfortable feelings or anxiety, Brooks says. Years ago, when smoking was still allowed in many indoor spaces, Brooks led group counseling in detox, outpatient and inpatient addictions facilities. “When powerful emotions would come up in group, [clients] would fire up cigarette after cigarette to deal with those feelings and quell anxiety,” he recalls.

With this in mind, counselors should help prepare clients for the irritability, anxiety and other uncomfortable feelings they are likely to experience when they attempt to stop smoking cigarettes. “Talk about what it will feel like to be really anxious and not smoke” and how they plan to handle those feelings, Brooks says. “… If a person has anxiety or depression and stops smoking, what initially happens is they could get more depressed or more anxious without nicotine to quell the emotion.”

The counselors interviewed for this article urge practitioners to ask every single client about their tobacco use during the intake process, no matter what the person’s presenting problem is. “If you’re helping them to get mentally and physically healthier, this [quitting smoking] is a very critical part of the overall wellness picture,” Tedeschi says.

Counselors shouldn’t be afraid to ask their clients whether they smoke, says Greg Harms, a licensed clinical professional counselor (LCPC), certified addictions specialist, and alcohol and drug counselor with a private practice in Chicago. “It can feel weird the first couple of times, especially if this is not your area of expertise,” says Harms, who does postdoctoral work at Diamond Headache Clinic in Chicago, an inpatient unit for people with chronic headaches. “A lot of times, clients have heard all the bad stuff about smoking. A lot of them, deep down, they know they’d be better off if they were to quit smoking. They may have failed so many times in the past that they’re discouraged. They might be hesitant to bring it up because this is a counselor and not the [medical] doctor. If you bring it up, more often than not, the client is going to engage with that. Even if they don’t, if it’s not the right time for them, you’ve planted that seed. … It might come to fruition down the road. I’d much rather plant that seed than not say anything at all.”

When Harms was a counseling graduate student, he completed an internship at the Anixter Center, a Chicago agency that serves clients with disabilities. While there, he worked as part of a grant-funded program for smoking cessation for people with disabilities that was spearheaded by the American Lung Association. He also presented a session titled “Integrating Smoking Cessation Treatment with Mental Health Services” at ACA’s 2013 Conference & Expo in Cincinnati.smoking

If a client doesn’t feel ready to begin the quitting process right away, the counselor can put the topic on the back burner to address again once the client has made progress on other presenting problems or has forged a stronger relationship with the practitioner. However, that shouldn’t mean that the topic is off the table completely, Harms says. A counselor should talk regularly with the client about quitting smoking, even if it’s only for a few minutes each session.

“Give them a little nugget of information [about quitting], and then you can focus on what they’re there for,” Harms says. “Help them find ways to deal with their presenting problem, then they’ll trust you. Once they’re in a better place, revisit [the idea of quitting]. We don’t have to address it and get their buy-in during the first session. It would be fantastic if that was the case, but it’s OK if it’s not. In most cases, time is on our side to develop the relationship, plant the seed and revisit it. If the client is not ready, we can harp on [quitting] all we want, [but] it won’t do anything.”

“You really have to take the client’s lead and go at the pace they’re willing,” Harms continues. “Don’t push. Respect their decision. Even if they’re not ready for [quitting], let them know that [you’re] there for them and respect their autonomy to make that decision.”

Positioned to help

Counselors are particularly suited to help clients quit smoking because the profession has an array of tools focused on behavior modification, Tedeschi asserts. Motivational interviewing, cognitive behavior therapy, acceptance and commitment therapy, and other models can be useful in helping clients stop smoking. But techniques from any therapy model that counselors are comfortable using can be adapted to help clients navigate the challenge of quitting, Tedeschi says, especially when combined appropriately with pharmacologic aids approved by the Food and Drug Administration.

“We’re in the business of helping people change. The principles that a counselor uses to help someone understand an issue and begin to make steps toward change apply to smoking cessation as well,” Tedeschi says. “Counselors help people understand their motivation to change and help them come up with a plan to change.”

Harms agrees, noting that in most cases, a counselor will have significantly more time with a client than a medical professional will. Instead of “hitting [the client] over the head” with the dangers of smoking, Harms says, a counselor can afford to focus on the positive, use a strengths-based approach and build on what the client wants to work toward rather than what he or she wants to avoid.

“We [counselors] are so strengths-based. It’s our natural inclination to tell the client, ‘Yes, you’re strong enough to do this,’ rather than [taking] a scare approach,” Harms says. “We can find their strength and have that unconditional positive regard for them, regardless of how long it’s taking. We have the patience to sit with a client as they’re going through [quitting]. We can build that relationship and be a resource.”

Start small

Tedeschi recommends that counselors use the “five A’s” to discuss smoking with clients. In this approach, a practitioner should:

  • Ask each client about his or her tobacco use
  • Advise all tobacco users to quit
  • Assess whether the client is ready to quit
  • Assist the client with a quit plan
  • Arrange follow-up contact to mitigate relapse

Each of these steps is important, but providing support and follow-up as the client begins to quit is particularly critical, Tedeschi says.

“The first week of quitting is the hardest. If [a counselor] waits for a week to talk to the client, you could lose about 60 percent of people back to relapse,” he says. “If someone is able to quit for two weeks, their risk of relapse drops dramatically.”

If clients resist the idea of quitting or do not feel ready to quit entirely, Tedeschi suggests that counselors work with them to stop smoking for one day or even just an afternoon. During this time, have clients monitor how they felt: How was their anxiety level? What were their cravings like? This technique can introduce the idea of stopping and prepare clients for the quitting process, he says.

Brooks recommends using motivational interviewing to help clients make the life change to quit smoking. “Nicotine is a drug, and it’s no different than if [clients] were to say they want to stop drinking. Work with their motivation to identify what they can possibly do for that,” he says.

Part of the quitting process involves clients going through an identity shift, Tedeschi notes. Clients can be behaving as nonsmokers — abstaining from cigarettes — long before they make the mental leap that they are no longer smokers, he says. It is important for clients to make that mental shift from “a smoker who is not smoking” to a “nonsmoker,” Tedeschi says. Counselors need to work with these clients to identify as and accept the nonsmoker label. “As long as someone calls [himself or herself] a smoker, they will be open to turning back to cigarettes,” he explains.

Kicking the habit

Counselors can use the following tips and techniques to better equip clients to meet the challenge to stop smoking.

Set a quit date. This is an important step, but one that clients must take the lead on and choose for themselves, Tedeschi says. Research shows that simply cutting back without setting a quit date isn’t very effective, he adds. The behavioral patterns that often accompany smoking (for example, smoking after eating or taking smoke breaks at work) make it very hard to keep tobacco use at a low level. Setting a quit date creates accountability and is a “sign of seriousness,” he says. At the same time, be flexible. “For some people, it’s just too hard to think about [sticking to a quit date],” Tedeschi says. “For some — especially those who are struggling with other substances — they need to take one day at a time.”

Be aware of psychotropic medications. Counselors should be aware that if clients are taking prescription medicines for anxiety, depression, bipolar disorder or other mental illnesses, their dosages might need to be adjusted as they quit smoking. Nicotine is a stimulant, so it speeds up a person’s metabolism. This means a person who smokes will burn through psychotropic medications faster than someone who doesn’t smoke, Harms explains. Counselors should be certain to talk this through with clients and work with their doctors to modify their dosages, he says. “This is especially noticeable with mood stabilizers. It’s acute with bipolar disorder,” Harms says.

The same holds true with caffeine, Tedeschi notes. After they quit smoking, clients may notice that they get jittery from caffeine and may need to cut back on their coffee intake.

Use cognitive strategies. Counselors can help clients create a list of personal reasons why they want to stop smoking — beyond the health implications, Tedeschi says. The list doesn’t need to be long, but the reasons need to be compelling and motivating enough to carry clients through a nicotine craving. For example, one of Tedeschi’s clients wanted to quit because his young grandson asked him to. As a reminder, the client kept a toy car that belonged to his grandson in his pocket. “When he had a craving [for a cigarette], he would pull [the toy car] out of his pocket, look at it, hold it and squeeze it,” Tedeschi says. “It helped.”

Turn over a new leaf. As they quit smoking, encourage clients to organize, clean and purge their homes and cars of smoking-related materials such as ashtrays, advises ACA member Pari Sharif, an LPC with a practice in Franklin Lakes, New Jersey. That action will help clients turn a new page mentally and start fresh, she says. Sharif also encourages clients to air out their homes and clean their closets so their clothes and furniture no longer smell like smoke.

On a similar note, if clients have a certain mug that they always use to drink coffee while smoking, Harms suggests that they get a new mug. Or if they always stopped at a certain gas station to buy cigarettes, he suggests that they now change where they buy gas.

When cravings strike, breathe. Sharif, a certified tobacco treatment specialist, introduces breathing techniques to all of her smoking cessation clients. She asks these clients to take measured breaths for roughly two minutes, inhaling while slowly counting to four, then exhaling for four counts.

“Instead of the reflex habit to grab a cigarette, take a moment to stop and ask why. Be more in control of yourself and your mind,” she tells clients. “Pause to do breathing and body scanning from head to toe. Ask yourself, ‘What am I doing? Why do I need this [cigarette] to calm down?’ … [Through breathing exercises,] your breath becomes deeper and deeper. Close your eyes. Your body starts relaxing and your anxiety level goes down.”

Sharif also recommends that clients download a meditation app for their smartphones and use a journal to record how they’re feeling when cigarette cravings strike. This helps them log and identify which situations and emotions are triggering their need for nicotine,
she explains.

Get to the root of it. Asking clients about the circumstances that first caused them to start smoking can help in identifying what triggers their nicotine use and the bigger issues that may need to be addressed through counseling, Sharif says. In some cases, a specific traumatic event or stressor caused the person to start smoking. In other instances, it was a learned behavior because everyone in the household smoked as the client was growing up. “Find out when they started smoking and why,” Sharif says. “Gradually, when they become more aware of themselves, they quit.”

Change social patterns. Cigarettes are often used as a coping mechanism when people experience anxiety in social situations, Harms says, so clients may need to focus on social skills as they start the process of quitting smoking.

“[Cigarettes] are their way to socialize and get out and meet people. If you have social anxiety, you can still go up to someone and ask for a cigarette or ask for a light. It’s programmed socialization,” Harms explains. “It gives you an excuse to be close to people, feel more sociable. If you take away their cigarettes, you’ve got to replace that.”

Brooks agrees, noting that clients who smoke likely have friends who are also smokers. For example, he says, it is not uncommon to see people smoking and talking together outside of Alcoholics Anonymous meetings. Counselors can help clients prepare to avoid situations where smoking is expected and practice asking people not to smoke around them, Brooks says. Counselors can also support clients in creating social networks of people who don’t smoke, including support groups for ex-smokers, he adds.

Break behavioral habits. Similarly, Brooks says, counselors can help clients change the behavioral habits they connect to smoking, such as starting the morning by reading the paper, drinking coffee and smoking a cigarette. Counselors can suggest activities and new rituals to replace the old ones, such as taking a daily walk, he says.

Harms encourages clients to replace their former smoke breaks with “clean air breaks.” They can still take their normal time outside, but instead of smoking, he suggests that they walk around the block, sit and read a book, eat an apple or use their smartphones outdoors. If they had a favorite smoking spot outside, he urges them to find a new place to go instead.

Find comforting substitutes. “The whole ritual of lighting up a cigarette — tapping the pack to pull out a cigarette and flicking the lighter — the behaviors that go with [smoking] can be very comforting,” Harms says. “Sometimes that’s what’s so hard to break — the behaviors that go with it.”

Tedeschi recommends that counselors work with clients to have comforting alternatives ready to go even before the clients attempt to quit smoking. It is hard for people to figure out alternatives in the heat of the moment when a craving strikes, he explains. Tedeschi offers several possible substitutes for consideration: sugar-free gum, beef jerky, cinnamon sticks and even drinking straws cut into cigarette-sized lengths through which clients can inhale and exhale.

If clients are comforted by having something in their hands, Brooks suggests keeping a pen, stress ball or prayer beads nearby. Staying hydrated and carrying a water bottle can also help these clients, Tedeschi adds. Most of all, counselors should work toward the idea of replenishment and filling in where clients feel they are losing something, he says.

Don’t dismiss pharmacotherapy. A wide variety of quitting aids are available, from nicotine patches, lozenges and gum, to prescription pills such as Chantix. The counselors interviewed for this article agree that these stop-smoking aids can be helpful when used alongside counseling. However, Tedeschi says, counselors should work with their clients’ physicians when such medications are being used, or make sure that clients are talking with their physicians. Counselors should also be aware of the potential side affects that these medications can have, such as aggressive behavior.

Brooks notes that none of these options is a magic solution to quit smoking. For example, nicotine gum and other medications can be prohibitively expensive, and some clients can continue to smoke even while using nicotine patches or gum. As for electronic cigarettes, Sharif and Harms agree that they are not a recommended alternative. Electronic cigarettes are carcinogenic, addictive and mimic the “puffing” behavior of regular smoking, Harms notes.

Connect clients with other supports. Counselors should equip clients with resources they can turn to outside of counseling sessions, such as local support groups for ex-smokers or the phone number for their state’s tobacco quitline, Brooks suggests. Nicotine Anonymous (nicotine-anonymous.org) is an ideal resource for clients who are trying to stop smoking, Brooks says. The 12-step method at Alcoholics Anonymous (AA) can also be applied to tobacco use for clients who attend AA meetings already or who don’t have a Nicotine Anonymous support group in their local area, he adds.

Sharif suggests that counselors keep brochures and other information about quitting smoking alongside the materials they might have about depression or suicide prevention in their offices or waiting rooms. It is better for counselors to distribute information that they have vetted themselves rather than having clients search the internet for information on their own, she notes.

 

Try and try again

On average, it takes a smoker 10-12 attempts to fully quit cigarettes, according to Tedeschi. For that reason, it is imperative that practitioners not give up on clients after their first, second or even 10th try, he stresses.

Quitting smoking is hard, Tedeschi acknowledges, but possible with perseverance. “Don’t be discouraged as a clinician if your client relapses. [Quitting] is definitely not a one-time event; it’s a process. … Relapse prevention is important, but it’s equally important to be ready for the relapse,” he says. “One of the best things a counselor can give a client is that reassurance. Any attempt to quit for any length of time is a success rather than a failure. That’s just the reality of this addiction. As long as they keep trying, they’ll get there. The only failure is to stop trying. The most important message a counselor can give a client is to never give up.”

 

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Statistics: Smoking and mental health

  • Roughly 50 percent of people with behavioral health disorders smoke, compared with 23 percent of the general population.
  • People with mental illnesses and addictions smoke half of all cigarettes consumed in the U.S. and are only half as likely as other smokers to quit.
  • Smoking-related illnesses cause half of all deaths among people with behavioral health disorders.
  • Approximately 30-35 percent of the behavioral health care workforce smokes (versus 1.7 percent of primary care physicians).

— Source: U.S. Substance Abuse and Mental Health Administration (see bit.ly/1sEx97a)

 

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Resources

 

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Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org

Letters to the editorct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Nonprofit News: Surviving the loss of key members

By “Doc Warren” Corson III November 28, 2016

When counselors look to build a board of directors and fill key positions in their nonprofit programs, it is imperative to remember that there are many different types of leaders.

Some leaders are great thinkers and developers of new ideas and programs but lack the desire to maintain or reconfigure a program once it has taken root. Others are great maintainers but may lack the skills to start a program from scratch or reconfigure an existing program. Still others are best suited to take an existing but lagging program and make it stronger than they found it originally. All of these leaders can serve a program well so long as the timing is right.

When an existing program finds itself in transition naturally, it may discover that certain invaluable board members are less than fully equipped to handle the transition. As a result, the program, or the board member, may seek to open that board position to new blood. This often leads to angst at some level. It is important to note that we are all replaceable; change in and of itself need not be seen as a negative.

Transitions can bring great change. The loss of key board members may indeed bring about changes that are less than ideal. Perhaps the board member had a particular passion or key connections that made a program stand out. The loss of a particular board member may mean the loss of that program, or at least a great reduction to it. This in and of itself can have an impact, but it can also allow the program to find a new niche or direction that may bring about growth that was previously unforeseen. It may also allow the main program to redirect funds to a new program or at the very least allow for some experimentation.

Years ago, we faced the need to expand our offerings because we had outgrown our space. We looked at locations for a second office that would have allowed us to do many of the same things we had already been doing for years, but we ended up finding an 1860s farm for sale about 4 miles from our original location. This purchase allowed us to greatly increase the services we were already offering and also add new types of services.

While we lost the “homey” feel that was characteristic of our first (now secondary) office, we gained a “homey community” feel as part of our therapeutic farm-based program. Now folks feel cozy even though they are in a building that is nearly 8,000 square feet. This was made possible through the many innovations introduced by new board members and key staff changes. At the time there was a great deal of change and transition, but we viewed these as a natural extension of what we always had.

The second and third generation of a board can make or break a program. When change is massive, such as the case of multiple key members leaving at once, this can lead to full-scale dilution of the organization’s main goals or mission. It can even lead to the possible dissolution of the program as a whole. More often than not, however, the loss of board members comes in small doses, and careful replacements can help secure the future of the program with little interruption. Be sure to do a thorough assessment of the program’s needs before selecting potential candidates. The “ideal” candidate may become less than effective if his or her abilities are not in line with the program’s current and emerging needs.

Everyone can be replaced. Panic can set in for some companies upon announcing the impending loss of a founder. Founding board members choose to leave for many reasons, though perhaps the most common reason is their wish to retire. Good leadership on the part of other key players can reduce any major transitional issues, however. Case in point: Albert Ellis,Depositphotos_43929729_m-2015 who developed rational emotive behavior therapy, was removed from the board of directors of the Albert Ellis Institute despite the fact that he founded the institute and it was named after him. In fact, he lived in the building that housed it! Sure, there was some backlash from fans and supporters after he was removed (a New York state Supreme Court judge later reinstated Ellis to the board, saying he had been removed without proper notice). Regardless, since passing away, both Ellis’ institute and his legacy remain intact.

Not all losses are real losses. Every nonprofit program will eventually see the loss of key members. Some of these losses will come as an initial shock, but in many instances, these losses can actually lead to new possibilities, especially if the person had been suffering from burnout or otherwise grown lethargic. New blood can lead to new energy, ideas and improved services.

Stay true to your core mission. It is very important to make sure that new members not only are aware of the history, mission, beliefs and ideals of your nonprofit program, but also appreciate and respect them so that the “original recipe” remains intact (even if some changes are needed to grow with the times). The culture of your nonprofit is key, and it is important that potential new board members are aligned with that culture.

Pay attention to demographic shifts and adjust accordingly. New members or not, it is important to look at demographic shifts and adjust your nonprofit programming as needed. Replacing some key members may actually help you to do this because there may come a time when your leadership team lacks some key knowledge or ability to meet an emergent trend. No one wants to be the company that is caught figuratively stockpiling DVD players in an increasingly wireless world.

Periodic mission adjustments are healthy. Staying true to your mission is healthy, but remember to update that mission on occasion. Transition times may be the perfect opportunity to review and tweak as needed. Examples may include adding different types of programs and increasing the scope (or possibly narrowing the scope) of your operation to reflect current needs and successes.

Replacing key members of your nonprofit need not be a time for strife. Do your homework, remember some key points and move forward. After all, worrying about the loss will do nothing to prevent it, so wouldn’t it be better to simply act proactively?

I’m rooting for you.

 

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Dr. Warren Corson III

Dr. Warren Corson III

“Doc Warren” Corson III is a counselor, educator, writer and the founder, developer, and clinical and executive director of Community Counseling Centers of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). Contact him at docwarren@docwarren.org.

 

 

 

 

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The path forward: A counselor’s coming out in counselor education

By Jack D. Simons November 22, 2016

businessman with a rainbow necktie, with a slight vignette addedTo be who you are, you don’t have to wait a lifetime.

I knew at age 5 that I was attracted to the same gender. This realization occurred during a time when, in my mind, it was not OK to be gay. I just couldn’t see it. It wouldn’t get better.

I grew up in the Midwest during the AIDS generation. People were dying, and the media portrayed the so-called “plague” as horrific. This definitely impacted me, including how I thought of myself and who I was. The advent of AIDS changed the lives of millions. Sexuality, for many, was no longer the same.

It was also during this time that I witnessed my uncle die of AIDS, shortly after the death of my great-grandfather. My uncle was gay, and he was just beginning life with his partner. He had moved to Portland to work as a musician and a nurse, but shortly thereafter he died. His life had been cut short by a condition that could not be cured.

How challenging it was for me as a teenager to see this while also questioning my own sexuality. Unfortunately, I never got to talk to my uncle about his life, but I wish that I had. Instead, I just asked myself, “Why would I live a life like his if I could die?” Being gay wasn’t an option that I wanted, so I did not accept myself for many years. I became one of those men who married a woman and started a family, thinking that my same-sex attractions would go away.

Well, it didn’t. I had just done what I thought I was supposed to do. I didn’t tell anyone in my family that I was gay until my early 30s.

Remaining in the closet comes at a cost. It depleted me of energy and compromised my health, which is not uncommon for those who come out later in life. I was unable to live a life congruent with my values, and others were hurt. This upset me.

While in my Ph.D. program, I decided to take active steps toward authenticity, whatever the cost. I asked myself how I could be a role model in counselor education if I wasn’t true to myself. How could I be vital and thrive in the world if I was inauthentic? How could I look my daughter in the eye in good faith?

I knew the answers, and they were all the same. I could not bear to continue to live an inauthentic life. I told my family members and close loved ones about what I was going through. It wasn’t easy, but I began to meet others like me and build a support system. Ultimately, I disclosed at work, which is a key milestone. Those who stood by me during this time are now some of my closet friends and colleagues.

I am grateful that I have been able to come out and live an authentic life. My education played a part in this. I am fortunate to teach and inspire others. Over the past two years, I completed my dissertation, taught, and worked on research and community events that I felt were important. As a former school counselor, it has also been exciting for me to see how the field of school counseling has become more inclusive of LGBTQ+ people, or those perceived to be (note: LGBTQ+ is an umbrella term that aims to capture all sexual and gender minority groups).

I thank everyone who has challenged me to be myself. Without this support, I may not have fully come out. I also know that if I had had more visible role models (like I am trying to be now) when I was younger, I would have accepted myself sooner.

 

Final thoughts

For those who haven’t yet come out, for whatever reason(s), don’t lose hope. There is time to work toward authenticity. It just takes longer for some. The experience has been hard for me, but it has gotten better.

If you wish to come out but you don’t think you can do it on your own, seek support. Some people might find this difficult, but I have always said that nothing of value is easy. This might be the time for you. If, however, you just want to learn more about LGBTQ+ communities, I recommend that you reach out to these communities and ask questions to make new friends or professional contacts.

In addition, I encourage counselors and counselors-in-training who have limited experience in working with LGBTQ+ communities to attend workshops and to reflect on their own sexual identity development. LGBTQ+ communities are very diverse, so there are many people to learn about, to learn from, to draw strength from and to stand tall with. If you see me, say hi!

 

Select resources

  • The AIDS Generation: Stories of Survival and Resilience by Perry N. Halkitis (2014)
  • Transgender Explained for Those Who Are Not by Joanne Herman (2009)
  • The Five Secrets You Must Discover Before You Die by John B. Izzo (2008)
  • “Coming out in mid-adulthood: Building a new identity” by Lon B. Johnston and David Jenkins, in the Journal of Gay & Lesbian Social Services, Volume 16, Issue 2, 2004
  • Outing Yourself: How to Come Out as Lesbian or Gay to Your Family, Friends and Coworkers by Michelangelo Signorile
  • Wood, A. M., Linley, P. A., Maltby, J., Baliousis, M., & Joseph, S. (2008). “The authentic personality: A theoretical and empirical conceptualization and the development of the Authenticity Scale” by Alex M. Wood, P. Alex Linley, John Maltby, Michael Baliousis and Stephen Joseph, in the Journal of Counseling Psychology, Volume 55, No. 3, 2008

 

 

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Jack D. Simons is a core faculty member in the counseling program at Mercy College in Dobbs Ferry, New York. Contact him at jsimons1@mercy.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

Investigating identity

By Laurie Meyers November 21, 2016

“W hat are you?”

That is a question commonly asked of individuals who are multiracial. As a society, we have gotten used to checking off a metaphorical — and often literal — “box” when it comes to questions of race. We seem to expect everyone to “just pick one.”

But the population of the United States is becoming increasingly diverse, not just in terms of our nation’s racial makeup, but also in the growing number of people who identify themselves as belonging to two, three or more racial groups.

The U.S. Census Bureau first started letting respondents choose more than one racial category to describe themselves in its 2000 survey. Since then, the multiracial population (defined as individuals who have at least two different races in their backgrounds) has grown rapidly. Between 2000 and 2010, the number of white and black Americans who identified as biracial more than doubled, and the population of Americans who identified as being of both Asian and Caucasian descent grew by 87 percent. In addition, according to information compiled from the family2010 census and the Census Bureau’s 2013 American Community Survey, the percentage of infants born to parents of two or more different races increased from 1 percent in 1970 to 10 percent in 2013. And, of course, in 2008, in a historic event that in part reflects the nation’s growing multiracial population, Americans elected a biracial president, Barack Obama, the son of a black Kenyan farther and a white mother.

The Census Bureau estimates that 2.1 percent of the U.S. population is multiracial. However, in 2015, the Pew Research Center conducted a survey and issued a report, “Multiracial in America,” estimating that 6.9 percent of the U.S. population is multiracial. The Pew study arrived at this figure by taking into account not only how individuals describe their own racial backgrounds, but also the backgrounds of their parents and grandparents, which the U.S census does not do.

The Pew survey also found that many people with mixed racial backgrounds do not identify themselves as “multiracial.” In fact, 61 percent of such respondents identify themselves as belonging to only one race. However, the survey also discovered that individuals’ racial self-identification can change over the years. Some choose to identify with a different part of their racial background later in life or decide to begin identifying as multiracial rather than monoracial (and vice versa).

Counselors who study multiracial issues and in some cases are multiracial themselves say that this finding of shifting racial identity is indicative of one of the core issues of being from multiple races — identity and belonging.

On the outside looking in

“When I was young, I didn’t know I was different,” says licensed professional clinical counselor Leah Brew, who is half white and half Japanese. “Then we moved, and I was made fun of [at her new school] because they said I was Chinese.”

Brew didn’t know what being Chinese meant, but based on the teasing she was subjected to, she assumed it was something horrible. “So I asked my mom if I was Chinese, and she said, ‘No, you’re Japanese,’” Brew recounts. She was relieved but soon found that when she corrected her tormentors, it made no difference. Although Brew was also white, it was her Japanese appearance that mattered to her classmates.

As she grew older, Brew, a professor and chair of the Department of Counseling at California State University, Fullerton, became interested in exploring the Japanese side of her heritage and even traveled to Japan. Although she loved experiencing the culture and the people, she didn’t feel quite at home there either. For one thing, she says, she inherited her white father’s height and towered over everyone on the street. “I thought, ‘No, that’s not it’” — where she “belonged,” Brew says.

“When I moved to California, I thought this was it” because the state has many residents from various racial backgrounds, Brew says. “But the other biracial people I encountered were very dissimilar to me and got their identities from other things, like religion.”

Today, Brew, a member of the American Counseling Association, sees a significant number of multiracial and multicultural clients in her practice. She also helped write the Competencies for Counseling the Multiracial Population, a set of professional counseling practices developed by ACA’s Multiracial/Multiethnic Counseling Concerns Interest Network to competently and effectively attend to the diverse needs of the multiple heritage population. When it comes to her own identity and culture, Brew says she at times sees herself as mostly white and at other times mostly Japanese. She acknowledges that she is always moving back and forth between the two.

C. Peeper MacDonald, a practitioner and counselor educator whose research focuses on multiracial issues, is both white and Native American. Most people assume she’s white, however, which makes MacDonald feel that they are missing or ignoring a large part of who she is.

“I often use the opportunity [the assumption of her monoracial whiteness] to correct people and educate them about my identity,” MacDonald says. “I do, however, often get the sense that people feel that I am reaching. For example, I often hear, ‘Oh, well, everyone in the United States has Native American in them.’”

MacDonald, who teaches undergraduate psychology classes part time at Georgia Gwinnett College and is also counseling and supervising part time at the Atlanta campus of the Savannah College of Art and Design, often feels compelled to “prove” her ethnicity, she says. For instance, she will share her Cherokee name with people, which seems to satisfy them.

It was actually MacDonald’s interest in her family’s Native American heritage that led to her maternal grandfather reclaiming his history. For most of his life, MacDonald explains, her grandfather experienced severe racism because he was a Native American, so he often identified himself as Hispanic instead. MacDonald’s mother was raised by her white mother and a white stepfather and, as a result, has never really considered herself Native American, even though MacDonald says her mother does not look white. It wasn’t until MacDonald started asking as a child about the Native American side of the family that her grandfather, then in his 70s, started to embrace his heritage again.

ACA member Derrick Paladino, who is part Puerto Rican and part Italian American, grew up in a predominantly white neighborhood in Connecticut. When kids at school would question him about “what” he was, Paladino would simply say Italian because that seemed easier and perhaps safer.

Paladino, who also helped to develop the Competencies for Counseling the Multiracial Population, says he didn’t have a lot of contact with the Puerto Rican side of his extended family when he grew up, so he didn’t have much opportunity to explore the Latino part of his identity. When he ultimately decided to go to college at the University of Florida, Paladino says he was thrilled at the prospect of meeting other Latino students.

“I got my Latino Students Association card, and I was so excited,” Paladino recalls. “But I discovered that because I was not fluent or hadn’t had [what was considered] the full Latino experience, I didn’t fit in well.”

Paladino, a professor and coordinator in the graduate studies in counseling program at Rollins College in Florida, may no longer stand out like he did in the white Connecticut enclave in which he grew up, but like most people of color, he is still subject to many assumptions and microaggressions. For instance, Paladino, who co-wrote and co-edited the book Counseling Multiple Heritage Individuals, Couples and Families (published by ACA), has been asked by a cashier at a department store whether he was his son’s nanny. Recently, as he stood in line at an amusement park, he was asked to settle a bet between two people he didn’t know. The wager? Whether Paladino was Puerto Rican.

These counselors’ stories provide a glimpse of the myriad forces — societal, familial and personal — that shape and challenge the lives of multiracial individuals. Counselors can play an integral role in helping their clients navigate these forces.

Identity intervention

That sense of not quite belonging — or even being told that they don’t belong — often starts early for multiracial individuals.

As Brew notes, as early as elementary school, multiracial children can begin experiencing microaggressions such as that question: “What are you?” Or, as in Brew’s case, these children might become the targets of racist taunts based on their actual or perceived ethnic backgrounds. For that reason, it is important for the parents of multiracial children to talk to them about race and racism from an early age, she says.

“Parents, in general, are reluctant to do that, but when parents do engage in it, the children are more prepared to handle comments,” Brew says. “There was an interesting study out of [the University of Texas at Austin] where they asked participants to talk with their kids about racism. When it came down to the wire, most parents dropped out of the study. It was simply too hard.”

Because the topic is so difficult and sensitive, counselors can be a tremendous asset to these parents by helping them to have conversations about racism with their children and with each other, Brew says. “This conversation needs to be explicit and purposeful,” she says. “The parents may need to work on thinking in inclusive ways rather than judgmental ways — the way we teach our students to respect differences. It’s the seed that helps teach children about their own culture as well.”

“I think it’s important for parents to start with very small children talking about skin color and how it’s different, but to give no meaning to color,” Brew continues. “We all see differences, and that’s fine. It’s when meaning is applied that differences become a problem. For biracial children, talking about how mommy and daddy — or mommy and mommy, or daddy and daddy — are different is also important to note, although, again, not giving meaning to those differences.”

“If the child is likely to experience racism or any other type of prejudice based upon differences, then [it’s] letting kids know that some people don’t understand differences and believe that people are bad based on how they look or how they dress, etc.,” she says. “Then when it actually happens, kids can feel safe to talk with parents, who should validate the child’s experience and help them make sense of it.”

It isn’t unusual for multiracial children to grow up, like Paladino did, in predominantly white neighborhoods. Even if these children don’t encounter bullying or overt racism, being one of the few (or perhaps only) children of color in an overwhelmingly white environment can exacerbate their feelings of not belonging. Counselors can help these children cope, Paladino says.

“I would want to continually validate what they are feeling and experiencing, which may be ‘otherness’ or not fitting in,” he explains. “At a young age, it may be difficult for [children] to fully grasp why they are experiencing these feelings, so I really want to be there for them in this part of the journey and allow them to ventilate feelings, thoughts and experiences.”

“For the parents, if they are a part of counseling or a parent consult, I would talk to them about what their child is feeling,” Paladino continues. “[I would] help them to experience empathy toward their child, talk to them about how to create a safe space for their child to talk and ventilate about how they are feeling and what they are experiencing, and help them look up children’s books as a way to talk about feeling different.”

School counselors — indeed all school faculty members — also play a critical role in helping multiracial children cope with racism and the struggle to feel included, says Taryne Michelle Mingo, an ACA member and former school counselor whose research focuses on marginalized populations. “I would [as a school counselor] develop a trusting relationship with the children and let them know that I can be a support system,” she says. For instance, she explains, if a child is being taunted or verbally abused, it is important for the child to view the school counselor as a safe person whom he or she can trust and feel comfortable going to for help.

One of the primary tasks for school counselors, Mingo says, is to get to know their students and make sure that everyone feels included. During her time as a school counselor, Mingo, who is African American, worked at a majority white school where only a small number of students were African American. Children of color aren’t typically used to seeing themselves reflected or represented in school materials, Mingo says, so she was careful about making sure there were dolls and books in her office that included children of multiple races. “Make sure that [these children] know they are visible,” she urges. “[That as counselors you are saying], ‘We know you are here.’”

When children who were feeling excluded showed up in her office, Mingo, who is now an assistant professor in the Counseling, Leadership and Special Education Department at Missouri State University, would engage them by asking them what they thought about themselves aside from what anyone else thought about them. She would have them describe themselves and ask them to draw a self-portrait. She would then go on to ask them what they liked to do and who their friends were.

If during the course of the conversation Mingo discovered that the child was feeling harassed or hearing negative comments, she would inquire where the child was and what was happening when he or she heard such comments. Mingo then asked what the child said or would have liked to say in response to those comments. Finally, she and the child would practice responding.

Mingo would also bring in the child’s teachers to make them aware of what was happening. When possible, she also liked to bring in the child’s parents or parent so that she and the parents could work together to more effectively support the child as a team.

Family tensions

In some cases, a child’s feelings of exclusion might be emanating from within the family itself. Not necessarily within the immediate family, but more often from the extended family, which might not have approved of the multiracial relationship in the first place, Paladino says. He notes that it was only in 1967 that it became legal to marry outside of one’s own race throughout the United States. That’s when the Supreme Court handed down a landmark decision in the Loving v. Virginia case that invalidated state laws prohibiting interracial marriage.

Brew has worked with multiracial couples and families facing the disapproval of extended family. “In terms of working with extended family racism, I first provide empathy to both partners,” she says. “Then I provide psychoeducation about the damage to self-esteem on children who listen to that type of talk. The biggest challenge is that so many minority families are hierarchical, so the adult child may not feel comfortable initiating these kinds of conversations. When it’s a Caucasian family member, then the relationship can often be less hierarchical, so the biggest challenge is just getting that partner to buy in and set limits with family members.”

“I haven’t had experiences with needing to cut off family members,” Brew continues. “[I] try to avoid that unless abuse is part of the picture. So, I help the clients manage their feelings about their own family members’ disapproval and try to offer support so that they eventually have the courage to confront their families. If they choose to confront, of course we practice that many times and prepare them for the worst possible outcome so they feel more confident.”

But even when there is no racial tension in the family, a multiracial person’s parents and other monoracial family members can never truly understand what it is like to be multiracial or multiethnic, Paladino says. “Validation is huge for this population,” he says. “They need support to figure out what they are, to allow them to be angry at family, angry at friends.”

MacDonald agrees. “My father, who is white, never understood why it was important for me to identify as biracial,” she says. “He views me as white and thinks I should identify as white. In a way, my white dad has always been a symbol for me of white culture because he also holds beliefs that don’t acknowledge institutionalized oppression and a belief that because we live in America, everyone has an equal opportunity to succeed — beliefs in which I do not share. Even as adults to this day, we do not speak of race, politics or privilege.”

Identity and acceptance

Ultimately, it is up to the multiracial individual to determine how he or she wants to self-identify. “A lot of clinical work is to help my clients articulate and identify what is from what culture so that they can make choices,” Brew says. “What feels right in different situations? Who am I, and what’s the right way to be?”

Counselors can play an important role by helping multiracial clients sift through all of their experiences and beliefs in the search for identity, says Mark Kenney, who helped write the multiracial counseling competencies and co-founded ACA’s Multiracial/Multiethnic Counseling Concerns Interest Network. He advises counselors to start by validating a client’s personal experiences and creating a safe environment for self-disclosure.

In some cases, counselors may need to help clients find resources, such as social groups or books, to explore their heritage because these clients didn’t have full access to part of their heritage growing up, Kenney says. He uses Barack Obama, who was raised by his white mother and grandparents, as an example. “His white family can’t tell him about being African American, and his father is Kenyan, so he can’t impart the African American experience,” Kenney notes.

Although identity is a pressing issue for many multiracial individuals, so is the question of feeling accepted or belonging. Kenney returns to the example of President Obama. Because of his phenotype, or physical appearance, most people automatically view Obama as African

President Barack Obama and First Lady Michelle Obama in September 2014. (Official White House photo by Pete Souza/via Flickr)

President Barack Obama and First Lady Michelle Obama in September 2014. (Official White House photo by Pete Souza/via Flickr)

American, and physical appearance is often an important factor that influences how multiracial individuals ultimately choose to identify themselves, Kenney explains. Given his lineage, Obama could have decided to identify himself as white, Kenney says, but because of the way he looks, society at large wouldn’t see or “accept” him that way, especially in our current racial climate. At the same time, Kenney continues, because Obama’s father was black but not African American (and because his mother was white), other people may not embrace Obama fully as being African American.

MacDonald says she sometimes struggles with feeling that she is a legitimate member of the multiracial community. “I am often viewed as white and, as a result, receive white privilege,” she explains. “So in many ways, I am an outsider to the multiracial community because I still receive privilege versus minority status.”

Again, counselors can help multiracial individuals reconcile these factors, but the process may not be smooth or easy. “Helping the person sort through their particular journey and come to their own decision about how they want to identify may put them in conflict with their family and their community,” Kenney notes.

With multiracial clients, Kenney likes to use solution-focused and narrative therapy. With narrative therapy in particular, clients can write a new story of their identity, he says. Kenney also stresses the importance of counselors familiarizing themselves with multiracial identity models so they are aware of all the factors involved in a person choosing an identity.

Because individuals who are multiracial might not be or feel fully accepted by any of their racial groups, counselors should help them seek out individuals who possess similar backgrounds, Kenney says. If organizations for multiracial individuals aren’t readily available in their communities, counselors might consider forming groups — perhaps using the group therapy model, but for social rather than therapeutic purposes, Kenney says.

Kenney and Paladino also recommend bibliotherapy as an effective intervention with multiracial clients who are struggling with their identity or sense of belonging. Paladino says he personally found Half and Half: Writers on Growing Up Biracial and Bicultural, edited by Claudine Chiawei O’Hearn, very helpful in his journey.

No assumptions

All of the counselors interviewed for this article caution against assuming that individuals who are multiracial have come to counseling because of their multiracial status. At the same time, Brew and MacDonald say it is important not to automatically assume that no connection exists between the person’s presenting problem and his or her multiracial status. After all, being multiracial does exert influence on clients’ lives, just as do other factors bound up in identity, such as being female, having a disability or identifying as lesbian, gay, bisexual or transgender.

Catherine Chang, an ACA member whose research specializes in multicultural issues, believes that society needs to change how it identifies people. Counselors can help, she says, starting with their intake forms and how they designate racial background.

“We force people to check a box,” Chang says. “I’m 100 percent Asian and married to a Caucasian man. My children have to check two separate boxes — white, Asian. They can’t check multiracial or biracial.”

Chang urges counselors to offer an option for multiracial individuals on intake forms and to also leave space for clients to fill in what they feel their background is. Paladino agrees, noting that check boxes don’t encompass multiple heritages such as being black and also being Jewish.

Finally, Chang says that it is important for counselors to examine their own heritage and how that background affects who they are and how they interact with individuals from other groups and races.

 

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Related reading: See Counseling Today‘s online article about transracial adoption, “Adopting across racial lines” wp.me/p2BxKN-4xn

 

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Additional resources

To learn more about the topics addressed in this article, take advantage of the following resources offered by the American Counseling Association:

Competencies (counseling.org/knowledge-center/competencies)

ACA Interest Networks and Divisions

Books (counseling.org/bookstore)

  • Counseling Multiple Heritage Individuals, Couples and Families, written and edited by Richard C. Henriksen Jr. and Derrick A. Paladino
  • Culturally Responsive Counseling With Latina/os by Patricia Arredondo, Maritza Gallardo-Cooper, Edward A. Delgado-Romero and Angela L. Zapata
  • Counseling for Multiculturalism and Social Justice: Integration, Theory and Application, fourth edition, by Manivong J. Ratts and Paul B. Pedersen
  • Multicultural Issues in Counseling: New Approaches to Diversity, fourth edition, edited by Courtland C. Lee
  • Understanding People in Context: The Ecological Perspective in Counseling, edited by Ellen P. Cook
  • Experiential Activities for Teaching Multicultural Competence in Counseling, edited by Mark Pope, Joseph S. Pangelinan and Angela D. Coker

Podcasts (counseling.org/continuing-education/podcasts)

  • “Queer People of Color” with Adrienne N. Erby and Christian D. Chan
  • “Microcounseling, Multiculturalism, Social Justice and the Brain” with Allen Ivey and Mary Bradford Ivey
  • “Multiculturalism and Diversity: What is the Difference? Is Not Counseling … Counseling? Why Does it Matter?” with Courtland C. Lee

Webinars (counseling.org/continuing-education/webinars)

  • “Why does culture matter? Isn’t counseling just counseling regardless?” with Courtland C. Lee

VISTAS Online articles (counseling.org/continuing-education/vistas

  • “The Invisible Client: Ramifications of Neglecting the Impact of Race and Culture in Professional Counseling” by Issac Burt, Valerie E.D. Russell and Michael Brooks
  • “Appreciating the Complexities of Race and Culture” by Ria Echteld Baker
  • “Counselors’ Multicultural Competencies: Race, Training, Ethnic Identity and Color-Blind Racial Attitudes” by Ruth Chao
  • “Enhancing Multicultural Empathy in the Classroom and Beyond: A Proposed Model for Training Beginner Counselors” by Jorge Garcia, Gerta Bardhoshi, Matthew Siblo, Sam Steen and Eileen Haase
  • “Ethnic Minority Clients’ Perceptions of Racism-Related Stress in Presenting Problems”
    by Ruth Chao
  • “Interracial Adoption and the Development of Cultural Identity” by Kimberly Kathryn Thompson

Practice Briefs (counseling.org/knowledge-center/practice-briefs)

  • “Racial Microaggressions” by Cirleen DeBlaere, Terrence A. Jordan II and David G. Zelaya

 

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editorct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The Counseling Connoisseur: Mini-mindfulness moments

By Cheryl Fisher November 17, 2016

I wake up in the early morning to the sound of birds chirping delightfully outside my window. I quietly make my way to my yoga room, where the gentle flow of the tabletop waterfall cascades rhythmically, inviting me to my morning meditation. I inhale deeply, letting the stream of thoughts flowing in my mind pass gracefully in and out of consciousness. I then exhale any tension or tightness my body may be holding as I sit in my deep meditation for a delicious 40 minutes.

BEEP BEEP BEEP! The sound of my alarm wakes me from my dream. I roll out of bed, grab my robe and fumble to let the dogs out, stubbing my toe along the way. Following a few expletives, I scoop the dog food into the metal bowls, toss them to the floor and make my way to the steaming shower that must quickly wash away the lingering fog from my still-sleepy brain.

I jump into my clothes, paint on some semblance of a face and pull up my hair. I grab a glass of juice, a packet of instant oatmeal and a yogurt, which will serve as my breakfast and lunch when I make it to the office. I secure the dogs and (as I exit the house) take a deep breath (holding it for the required four seconds), offer a blessing for the day on the exhale and haul it to my Jeep because I am now five minutes late for work!

Research continues to remind us of the role of mindfulness in our experience of overall wellness. Yet, a culture of “busy” permeates, sabotaging earnest attempts at a peace-filled, mindful lifestyle. Jon Kabat-Zinn, in his groundbreaking book Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness, writes, “There is something about the cultivation of mindfulness that is healing, that is transformative and that can serve to give our lives back to us.”

A practice of mindfulness extends beyond the individual practitioner and benefits those who surround her or him. Thich Nhat Hanh, Buddhist monk and author of many books, including Planting Seeds: Practicing Mindfulness With Children, offers, “When you are solid, happy and full of photo-1478980236323-01c287f81aedcompassion, you will naturally know how to create a happy family or school environment, and how to water the positive qualities in your children, other family members, students and colleagues at work.”

Although most of us would agree that this sounds divine and long to attain a lifestyle that promotes full presence, many of us struggle with the basic logistics of beginning a mindfulness practice. To devote the suggested 40 minutes a day to meditation would require many of us to eliminate sleep. I am a huge advocate for daily meditation, but I find that a 20-minute practice following my hour at the gym is about all I can devote to it daily. However, there are numerous ways that we can create moments of mindfulness throughout our day.

1) Add intention to routine activities. Routine activities can take on contemplative practice when we set our intention on being fully present in the moment. Walking the dogs, making the bed, even emptying the dishwasher can become moments of mindfulness (if we put the distractions of our phones away). For example, a morning shower is filled with sensory experiences if we allow ourselves to be present to the sensations of the water cascading down the body. We can use that time to do a body scan and note where tension is being held, then allow the warm water to release the tightness and relax our muscles.

2) Breathe through the mundane. Traffic lights are notorious stressors. We can, however, repurpose those few minutes by taking deep breaths, setting aside our agenda for the day, turning off the radio and becoming fully present in our bodies.

3) Seek consciousness through coloring. Adult coloring books have become the latest craze because they allow the individual to focus on a single task. The activity incorporates creativity and color and allows for a few moments of relaxed consciousness. Grab a book and color during breaks at work.

4) Practice jigsaw meditation. Jigsaw puzzles are another way to promote a focused meditation. Dollar stores carry small puzzles that can be placed in break rooms at work, promoting collective consciousness with colleagues. Taking a few quiet moments to focus on this task may be just what the doctor ordered to relieve stress during the day.

5) Delve into devotion moments. Opening a book with inspirational quotes can offer moments of reflection and contemplation. My recent favorite such book, The Meaning of Life by Bradley Trevor Greive, provides brief reflections captured in combination with precious pictures of animals.

6) Make time for teatime. Taking a break for a cuppa tea has long been one of my favorite routines. Tea has been a staple in China for centuries, first being used for medicinal reasons and later for more social purposes. British afternoon tea was offered to break up the extremely long time between breakfast and the fashionably late dinner, which were the only two meals served. Still, a good cup of tea in the afternoon can provide a soothing, fragrant mini-escape from a stressful day.

7) Embrace the Zen of nature. Years ago, I purchased a mini-Zen garden, filled with sand and miniature rocks, for my office. I use a small rake and create swirls and twirls in the sand as I release the tension of the day. I know other colleagues who enjoy the art of bonsai and trim their tiny trees during breaks. Nature is a sacred space that connects with us in meaningful ways. Gardening, taking nature walks, watching a sunrise or sunset — just being present to the outdoors can significantly reduce our stress levels.

8) Blow bubbles. Bubble therapy is one of my personal favorites. It requires one to take a deep breath and skillfully exhale in a way that will not burst the bubble. After a particularly stressful day, I like to take my huge bubble bottle outside and blow to my heart’s content.

9) Make a gratitude list. Counting our blessings appears to offer not only moments of mindfulness but also a shift in brain chemistry. Taking time to reflect on that for which we are grateful can promote an immediate reduction in the experience of external stressors — and the effects can linger long after the moment has dissipated.

10) Connect with others. Animals can provide connection and comfort in the most primal way. For me, watching goldfish pop to the surface during feeding and then swim gracefully among the miniatures in the bowl is therapeutic. However, few things beat a cuddle (and a good tummy rub) with my two 65-pound dogs. We all huddle together and enjoy the connection between human and animal. Of course, although I love my canine cuddles, my ultimate is simply sitting quietly and hugging my spouse for a few moments.

Armed with a handful of ways to incorporate moments of mindfulness, take a deep breath, exhale and enjoy being present in your day.

 

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Cheryl Fisher

Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland, and a visiting full-time faculty member in the pastoral counseling program at Loyola University Maryland. Her current research is titled “Sex, Spirituality and Stage III Breast Cancer.” She is also writing a book, Homegrown Psychotherapy: Scientifically Based Organic Practices, that speaks to nature-informed wisdom. Contact her at cy.fisher@verizon.net.

 

 

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.