Tag Archives: Resilience

Helping clients grow from loss

By Sherry Cormier February 4, 2020

Loss is a universal experience and an underpinning of many therapeutic issues. The client who has just lost a job, the parents whose son is addicted to opioids, the client whose long-term relationship unraveled, and the client who received a devastating health diagnosis all have loss in common.

As a professional counselor and bereavement trauma specialist, I am sensitized to the ways that loss informs clients’ worldviews and emotional struggles. And as a grief survivor, I am aware of the unique ways in which loss can serve as a catalyst for growth. An African proverb captures this sentiment when it says, “Smooth seas do not make for skillful sailors.” But this raises questions: Is growth possible for everyone, and how do counselors help clients grow after a traumatic loss?

Posttraumatic growth: What is it?

Posttraumatic growth (PTG) is an approach that informs our practice as professional counselors. Richard Tedeschi and Lawrence Calhoun, who pioneered much of the research and theory on PTG, define it as positive change that follows the struggle after some kind of traumatic event. PTG represents change that occurs after a life crisis rather than during it. It usually involves longer-term change that occurs over an extended period of months to years as individuals cope with crisis by developing ways of thinking, feeling and behaving that are different from what they relied on prior to the life-changing event.

PTG is not the same as personal development or maturity. It may be thought of as something that occurs somewhat spontaneously as the result of trying to cope with a challenging life experience of seismic impact. Evidence of PTG does not imply that the loss or traumatic event was somehow desired.

Approximately 10% of loss survivors stay mired in grief, guilt and despair for an extended period of time following their loss. Clients who experience these emotions, coupled with an intense yearning for who or what was lost, might be suffering from complicated grief, which requires a particular kind of professional treatment (see complicatedgrief.columbia.edu). The majority of loss survivors do not get stuck in acute grief, however, and report some measure of growth during recovery from loss. For many of these survivors, growth may coexist with distress.

Research summary: What do we know?

In 1996, Tedeschi and Calhoun’s research resulted in the Posttraumatic Growth Inventory, a 21-item self-report measure that yielded five empirically derived markers of PTG:

1) Improved relationships with others

2) Greater appreciation for life

3) New possibilities for one’s life

4) Greater awareness of personal strengths

5) Changes in spirituality

These five markers of growth have been reported by a variety of survivors, including prisoners of war, veterans with posttraumatic stress disorder, people diagnosed with cancer or other life-threatening illnesses, people who became paralyzed from accidents, and those who have lost spouses or life partners. Although much of the research has been conducted with people living in the United States, other studies have explored PTG with individuals in other countries.

Among current findings on PTG, Tedeschi and his co-authors cited the following in their 2018 book Posttraumatic Growth: Theory, Research, and Applications:

  • About 30% to 60% of survivors report some experience of PTG following a difficult life event.
  • PTG is both a process and an outcome.
  • PTG is generally a stable phenomenon over time.
  • PTG is more evident in those individuals who score higher on measures of extraversion and openness to experience and is also related to optimism.
  • There are both universal aspects and culturally specific characteristics of PTG.

Critics of PTG point out that self-reported or perceived growth is not necessarily the same as actual growth. Some of the conflicting findings on PTG seem to be the result of differences in how growth is defined and measured across studies.

Growth-promoting practices with loss survivors

There has been less research about specific interventions and techniques that might facilitate PTG in survivors, although a predominant feature of a growth-oriented therapeutic approach involves working with client stories or narratives. The following practical strategies can be used to help facilitate growth with loss survivors.

Create a safe therapeutic environment. Traumatic loss erodes a sense of security and thrusts survivors into the middle of unfamiliar circumstances. Social support is crucial, yet many people in survivors’ social networks may be uncomfortable with grief or may offer well-intentioned comments that feel offensive to the survivor. Counselors’ first task is to provide a safe container that is comforting and companionable for loss survivors. Creating a therapeutic environment in which we listen closely and hold up a mirror to reflect these clients’ experiences will help loss survivors feel known.

Use self-care practices. Traumatic loss may disrupt the rhythm of survivors’ connections. One way to help loss survivors reestablish bonds with others is to encourage them to grow a new relationship with themselves. We can help clients do this by recommending effective self-care practices such as movement and exercise, adequate sleep, and the intake of nourishing food. In the 2012 book The Emotional Life of Your Brain, Richard Davidson points out that a lack of consistent self-care practices sabotages our ability to regulate our bodies and emotions. Mindfulness and self-compassion are additional self-care practices that can be used by loss survivors who feel emotionally flooded with anger, guilt or anxiety. Teaching self-compassion and mindful meditation to these clients can help them reestablish a connection with themselves and, ultimately, with others. These tools also enhance clients’ equilibrium, making further work toward growth possible.

Explore client narratives. An important part of therapy with loss survivors involves exploring their narratives or stories. PTG occurs most often with clients who create an adaptive narrative in which they are able to see themselves as survivors rather than victims. The following items play integral roles in exploring client narratives.

Timelines: Initially, clients can construct a timeline of their lives with significant events marked at various ages. Timelines provide critical clues about pre- and post-loss stressors as well as the loss event itself. Clients who have been subjected to many pre-loss stressors often have more difficulty discovering growth. Using strength-oriented queries when asking clients to review their timelines is useful. For example, “Juanita, I noticed you had a miscarriage when you were 20. How did you cope with that? What tools did you find that helped you through that loss?”

Clues of growth: Many clients are so affixed to the trauma of the event that it’s hard for them to detect anything positive about their story. Counselors can be most helpful by noting clues of growth and healing in clients.

For example, James, an African American in his mid-20s, is discouraged because he has been through multiple losses. The house he once lived in with his grandmother was recently obliterated by a tornado, and now she is in the hospital with multiple injuries. In addition, the business he started just folded. In recounting his narrative, James mentions that a local church has offered to help rebuild the home, and a nearby car dealership just offered him a job. He says having others reach out to him with offers of assistance feels so unfamiliar that it’s starting to change his opinions about the world and other people. Although he doesn’t identify this as an indicator of growth, his counselor does by pointing out ways in which James’ views of himself, other people and the world are shifting in a new direction.

Cultural context: Exploring client narratives within a cultural context is also crucial. Some clients may present narratives of cultural losses rather than individual losses in instances in which they have faced significant discrimination based on their race, ethnicity, gender, age, ability status or sexual orientation. It is important for counselors to be aware of the ways that clients’ cultural affiliations affect their lives and their views of traumatic loss and healing.

For example, James reveals that he has been working odd jobs since he was 14 to support himself and his grandmother, whose only source of income is a small Social Security check. James confides that this elevated level of financial stress and the recent losses he has experienced make him feel more vulnerable as a black man living in a predominantly white rural community.

Journaling: Counselors can also facilitate client narratives by encouraging the use of journaling as an adjunctive therapeutic intervention. Therapeutic journaling is a tool developed by James Pennebaker, who says that writing about traumatic events reduces stress and strengthens immune cells. Consistent journaling is most effective, but 15 to 30 minutes of journaling several days a week can be more productive than daily journaling, which may produce more rumination than growth, according to Pennebaker. When working with survivors of loss, counselors typically instruct these clients to write about their deepest thoughts and feelings regarding their loss.

Case example: Sharon

Sharon is a 62-year-old woman whose live-in partner of 40 years died of a sudden heart attack. Sharon resides in rural Appalachia, where she had lived with her now-deceased partner for many years. She has no children, and her one brother lives hundreds of miles away. Sharon stopped working in a dental office seven years ago to help take of her partner, who had uncontrolled diabetes. She has no real friends and reports that she has rarely been out of the house in the past seven years. She says that she has no neighborhood acquaintances or memberships in any social groups.

In the first several counseling sessions, Sharon sobs and indicates that she has no idea how she will go on after losing her partner. She has limited income but no real expenses other than rent and utilities. She insists that she does not want to return to work and has sufficient income to meet her monthly obligations. She presents herself as something of a loner and describes herself as isolated.

Sharon came to the community counseling center at the urging of her brother, but she is unsure that grief counseling can be helpful to her. Short of bringing her partner back to life, she doesn’t know how talking and crying about her loss will accomplish anything. She is not having trouble sleeping but feels compelled to get out of the house during the day. She drives around randomly and visits local discount stores just to have someplace to go.

Sharon becomes more interested in counseling when a grief support group is offered, and she attends several sessions. She returns to individual counseling in a much more animated state and is even able to laugh. Having made several friends in the grief support group, Sharon reports that the group has helped her feel less alone. She is able to construct a grief timeline in counseling and is amenable to doing occasional journaling when she has bursts of grief. Over time, she pursues recommendations for joining a local gym and a book club at the public library.

Four months into individual counseling, Sharon becomes interested in volunteering at a local animal shelter and starts doing so on a weekly basis. Several months later, she feels like a different person. She says she is ready to stop coming to individual counseling sessions but will continue attending the grief support group.

Not all grief survivors experience the kind of growth that Sharon experienced — or so quickly. Even though she continued to miss her partner terribly, her life as a caregiver for the past seven years had precluded her from developing much life satisfaction for herself. Her ability to make friends and develop social connections and her volunteering activities with the animal shelter gave her a great deal of self-efficacy and provided positive ways to deal with the absence of her partner.

Some people will not cope with loss as effectively as Sharon did. Those who experience losses associated with violence or who have coexisting diagnoses such as depression, anxiety or substance disorders are more likely to go through an extended recovery period for healing. In addition, many grief survivors feel guilty for experiencing any kind of satisfaction, as if it amounts to some kind of betrayal of the person who is no longer here.

At the same time, it is not uncommon for grief survivors to reevaluate and shift their priorities in life, in part because their life circumstances have changed. For example, Emilee lost her spouse Roberto, who was a retired military officer and active in veterans’ affairs. Roberto had spent his retirement years traveling internationally in support of this cause. Emilee had rarely accompanied him because of her fears of terrorism and plane crashes. After Roberto’s death, however, Emilee decided to engage with the same veterans’ foundation that Roberto had been active in and found herself traveling all over the globe. Emilee wanted to preserve her spouse’s legacy and share her own gifts with a larger number of people. Loss survivors such as Emilee and Sharon who find ways to give back or volunteer are more likely to report narratives of growth.

Being attuned to growth

Potential for growth exists when clients uncover meaning from their loss and construct narratives that fit into their worldview and sense of self. Skilled counselors can serve as guides to help survivors make sense of what has happened. No survivor should ever be pushed to grow, but having a counselor attuned to growth may be the missing piece that helps clients become more resilient in the face of traumatic loss.

In my own experience as a grief survivor following a series of personally devastating losses, awareness of my growth sneaked up on me. It was as if a dimmer switch got turned up again as my outlook and mood shifted in a positive direction. I include this because being attuned to indices of growth may be one of the best ways that we can help clients recognize growth possibilities and emerge from the darkness of a traumatic loss to find light again. As Jon Kabat-Zinn, founder of mindfulness-based stress reduction, has said, “You can’t stop the waves, but you can learn to surf.”

 

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Sherry Cormier is a licensed therapist, certified bereavement trauma specialist, and former faculty member at the University of Tennessee and West Virginia University, as well as being a public speaker, trainer and consultant. She is the author of Counseling Strategies and Interventions for Professional Helpers (ninth edition), senior author of Interviewing and Change Strategies for Helpers (eighth edition), and co-producer (with Cynthia J. Osborn) of more than 100 training videos for Cengage. Her newest book is Sweet Sorrow: Finding Enduring Wholeness After Loss and Grief. Contact her through her website, sherrycormierauthor.com.

 

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Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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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.

Fostering resiliency in families and caregivers of individuals with disabilities

By Mariagrazia Buttitta September 26, 2019

It was like the world had collapsed on me, or worse. The words pronounced by my eye specialist felt like a sudden punch to my stomach, leaving me bruised and gasping for air. My life seemed over, or so I thought when I received an eye diagnosis of cone dystrophy at age 14. To this very day, it is emotional to recall the impact that diagnosis had on me and the confused look on my parents’ faces as they heard, for the first time, phrases such as “legally blind” and “disability.”

We all stood there in complete shock. Our faces must have looked ghostly white, perhaps hoping this was a nightmare from which we would soon awake. Instead, we left the office feeling defeated and frightened of what my future would look like, literally. The following day, I gathered all the energy I had left and Googled “cone dystrophy,” learning that it affects roughly 1 out of every 30,000 individuals (according to the National Organization for Rare Disorders). That number did nothing to lift our spirits or morale. My family still feared for my future and, the truth is, so did I.

According to the World Health Organization, nearly 1.3 billion people have a form of vision impairment. Furthermore, the Centers for Disease Control and Prevention reports that 1 in 4 people in the United States lives with a form of disability. So, why did my parents and I feel alone at the time of my diagnosis?

 

Media portrayals of disabilities

Today, it is clear to me that both my cultural background and the way that the media portrays individuals with disabilities might have influenced how my family and I coped with this news.

Growing up in Sicily, I experienced firsthand how my culture viewed disabilities as a weakness. Generally, individuals with physical or mental disabilities were looked down on and were not provided with the same opportunities as other people were. For example, it was assumed that I — someone affected by an eye condition — had less to offer; therefore, I was discouraged from pursuing education. Being the first person in my family with a visible disability did not help us know how to move forward either.

In addition, the media seems to send mixed messages regarding individuals with disabilities. Most of us have compared ourselves with models on magazine covers or wished to be the next Jennifer Lopez or George Clooney. But rarely does our society associate beauty with a physical disability. How many times have you watched TV and noticed someone with a visible disability? GLAAD’s annual report on inclusion notes that less than 2% of the main characters on American TV shows have a disability. A 2015 “Sandy’s View” column for The Chicago Lighthouse website discussed both the positive and negative stereotypes used when representing disabilities in the media. Both stereotypes seem to be extreme — one representing these individuals as victims, and the other representing them as “exceptional” individuals with unrealistic powers.

It is no wonder that my family and I were uncertain about my future. We lacked the proper resources and role models that could have helped us combat some of the negative stereotypes. Despite this, we overcame tremendous obstacles. Having a physical disability did not limit my life, and the realities of my disability only made my parents stronger and more resilient. In addition, it made them more educated about disabilities and cognizant of what other families and caregivers might experience.

 

Accepting and moving forward

Admittedly, my diagnosis of cone dystrophy was life-changing, both for me and my parents. The families of individuals with disabilities may have a difficult time adjusting and can develop their own mental health problems as a result. A study by Juan J. Sola-Carmona and colleagues that looked at 61 parents of blind children found that anxiety is higher and well-being is lower among these parents compared with the general population (published in Frontiers in Psychology, 2016). In general, families with individuals who have a disability are at greater risk of developing psychological problems. However, if these families learn how to cope well, it can increase the strength of the family. Here are the top five things that helped my family and me at the time of my diagnosis:

1) Reaching acceptance: Learning to accept the diagnosis was one of the hardest things for all of us, and I can assure you that it didn’t happen overnight. Acceptance developed with time. Once we traveled to various specialists and knew there was nothing that could be done to cure my vision, we needed to figure out how to live with the diagnosis effectively. After reaching that point of acceptance, we were able to figure out how we would cope and move forward as a family.

2) Seeking professional help: I was a teenager at the time of my diagnosis. The diagnosis was devastating, and it took a negative toll on me. As I got older, I had no faith in my ability to be successful, and that led me to feel helpless and useless.

Counseling proved extremely beneficial to me, but that came later in my life, when I was in my 20s. Talking to someone was therapeutic. My parents were extremely supportive of me, but they were also emotionally impacted by witnessing my struggles. Therefore, it was nice to find a therapist with whom I could talk and share all my emotions without feeling the guilt of hurting anyone else.

Once I gained confidence in myself, it automatically made the process much easier on my parents. I was a happier person to be around. Seeking professional help can be equally effective for family members and caregivers, providing them the time and space to focus on themselves and their own experience.

3) Educating ourselves: We spent hours educating ourselves as a family about my eye condition. We looked at hundreds of websites, articles, journals and magazines. After gaining that understanding and knowledge, we could start educating others about my level of blindness, why I walk with a white cane, and why I have to wear sunglasses all the time.

4) Learning about resources: Neither my family nor I had any idea about the resources available to me. Through research, however, we came across various resources, including the Commission for the Blind. After joining, we learned about still other resources, such as the various tools and technologies that would help me navigate the world with confidence. The resources reassured my parents that I, too, could go to college, get a job, and live a life like people without disabilities.

5) Having role models: Despite the number of individuals with a disability, we can often feel alone or misunderstood. Over time, my family and I met other individuals who, despite being blind or having other forms of disability, managed to live a successful life. As a result, my family and I started to view disabilities differently. No longer did we view my disability as a barrier. More importantly, we learned that we were not alone. My dream of going to college would become a reality.

 

A counselor’s perspective on disabilities

Throughout my graduate studies in a clinical mental health counseling program, I took note of a significant gap in how professionals are trained to work with those impacted by a visible disability. So, from there, I was on a mission: I rolled up my sleeves and got to work.

First, I interviewed Judy Schwartzhoff, a licensed clinical social worker with more than 30 years of experience in the mental health field, to ask her point of view on this subject. I posed several questions to her, including “How competent do you feel working with individuals, families, and caregivers of those affected by a visible disability?” and “Do you feel there are enough trainings provided to help deal with these clients?”

Her response didn’t surprise me one bit: “As mental health practitioners, we are often trained to treat the  emotional side of things, but I agree that we could use more knowledge and training in this area. However, if we do come across the issue, we tend to overlook the disability and stick with the emotional problem because that’s what we are trained in. We continue to separate mental health issues from physical disabilities, but sometimes, the two go hand-in-hand. As professionals, we need to expose ourselves to a diverse population and become more inclusive and know how to deal with different abilities as well as be able to assist their families and caregivers.”

I walked out of the office feeling determined and ready to put my thoughts on paper. Having witnessed, firsthand, the impact this issue had on my parents, I had to bring light to this issue. I immediately asked myself, a soon-to-be mental health professional, a question: What can I do to ease some of the worries and anxieties surrounding individuals affected by a different ability and their families and caregivers?

 

What mental health practitioners need to know

The chances of working with clients who have a visible disability, or their families or caregivers, are high. The truth is, we all will experience a form of loss in physical functioning at one point or another. This could be as simple as experiencing hearing or vision loss as we age. Even so, mental health professionals may feel incompetent if they’re lacking the proper resources and knowledge regarding these clients’ needs.

The day of my diagnosis, I recall a sense of fear and worry hovering over me. My parents had similar feelings, but they also experienced other emotions such as disbelief, sadness and confusion. An article by Josephine Defini in VisionAware described how blindness really affects the entire family as a whole — and I believe this truth can easily be applied to any form of disability.

As mental health professionals, we must be cognizant that each member of the family (or caregiver) might be experiencing a different state of mind and level of acceptance. Therefore, each person may require additional time to process and cope with the diagnosis. As practitioners, we want to be cautious not to assume that all family members are dealing with the news in the same manner or that they are even ready to deal with it at all. As a recent graduate counseling intern, I’ll acknowledge that I catch myself wanting to fix clients’ problems right away. I need to remind myself that everyone has his or her own timeline for healing and processing.

What follows are my top five recommendations for mental health professionals:

1) Use a psychosocial assessment: A psychosocial assessment can be helpful to gather information about the level of acceptance, skills needed to cope, resources, and any other observations noted for the individuals and their families or caregivers (Defini). By gaining this insight, mental health professionals will have a better understanding of what services are needed. For example, when working with an individual who uses alcohol as a way of coping with their issues, co-occurring treatment can be offered. Understanding the client’s individual experience of a disability can reduce bias or assumptions.

2) Use person-first language: In a 2014 article for the American Counseling Association’s VISTAS, Susan Stuntzner and Michael T. Hartley suggested that counselors use person-first language and avoid using negative phrases that could make clients feel less empowered. This would include saying “person with a disability” rather than “disabled person,” for example. In addition, don’t jump to conclusions about how clients feel about their disability. For example, don’t assume that they feel any weaker or have lower quality of life because of the disability. Speaking from my own experience, I think that being open and asking your client to educate you is also important. Everyone deals with a disability in a different way. Ask your clients what they prefer, and do not assume anything.

3) Know your resources: As mental health professionals, it is fundamental to know the resources that can be most helpful to clients. For example, as Defini suggests, if someone is experiencing vision loss, be sure to know the proper state services or local community programs that are available, such as rehabilitation, vocational rehabilitation, or low vision services. As mental health professionals, it might be impossible to know all of the resources out there, but we can be knowledgeable about who might have that information. Listed at the bottom of this article are some resources that may be helpful to you and your clients. Don’t be afraid to seek out information about resources that are more specific to each client’s needs and location.

4) Understand the adjustment process: It is important for mental health professionals to understand their clients’ adjustment process, including awareness of when they found out about their disability and how they coped. If individuals or their families or caregivers are not yet ready to process anything, they might not be able to utilize available resources to the best of their ability. Depending on how well adjusted they feel, the treatment will vary. Specifically, if they just found out about the disability, counseling might need to focus on the grieving process rather than on finding services and moving forward. Additionally, understand the individual’s barriers and that of their caregivers or family members (Stuntzner and Hartley).

5) Know the proper techniques: Be competent and knowledgable about what techniques can assist your clients. Many techniques used center around self-compassion, forgiveness and resiliency (Stuntzner and Hartley). Family counseling may also be helpful to clients and their family members because it gives each individual the opportunity to be open about their needs with each other and the counselor. One intervention may be to have families engage in activities together (e.g., take a meditation class, go to dinner, see a movie, visit a museum) to keep the disability from overtaking their lives.

Mental health professionals shouldn’t be afraid to use their own judgment to see what their clients and clients’ family members or caregivers may need. Every person copes with a disability differently, and everyone is going to need different strategies, so get to know the needs of your clients and their families or caregivers.

 

Conclusion

I wish that I could go back in time and wipe clean the past — especially the day I received my diagnosis — to remove the fear and anxiety my parents felt. Sadly, I can’t. But as a recent graduate counseling student, career counselor intern, author, motivational speaker, and mental health and disability advocate, I aim to help decrease the pain and fear that others may experience. I plan to do this by educating individuals who have disabilities, as well as their families and caregivers, and by setting as example, because a disability does not have to define or determine our future or the future of our loved ones. As figure skater Scott Hamilton once said, “The only disability in life is a bad attitude.”

 

Resources

https://www.familyresourcenetwork.org/

https://nfb.org/

https://sites.ed.gov/idea/parents-families/

https://www.psychologytoday.com/us/groups

https://www.cdc.gov/ncbddd/developmentaldisabilities/links.html

rarediseases.org page on cone dystrophy

 

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Mariagrazia Buttitta is an author, motivational speaker, and mental health and disability advocate. She holds a master’s degree in counseling education from the College of New Jersey and is national certified counselor candidate. Contact her at buttitm1@tcnj.edu and through her website at embracingyourdifferences.com.

 

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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.

Building client and counselor resilience

By Laurie Meyers December 26, 2018

Merriam-Webster offers two definitions for resilience. One is literal and drawn from physics: the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress. The second definition is a symbolic mirror of the first: an ability to recover from or adjust easily to misfortune or change.

In the past, many experts ascribed this ability to an innate quality that certain people possessed but others did not. More recently, however, researchers and mental health experts have concluded that resilience is multifaceted — something that is influenced by genetics, yes, but also something that can be built and enhanced over a lifetime (see sidebar, below).

“I believe we all have the capacity for [resilience],” says licensed professional counselor (LPC) Cara McCarty, “but it’s not something that’s earned or received without work. It’s not something that we just get for free. It’s something that you fight for, you have to work for, you have to earn.”

McCarty says that in the counseling profession, the idea of developing resilience — at its essence, the ability to rebound, bounce back and overcome — has most often been linked to trauma work. However, she believes it is something that counselors should be trying to nurture in all of their clients. Indeed, resilience is so central to McCarty’s counseling philosophy that she named her Oklahoma City practice Resilience Counseling.

McCarty says it was her initial work as a counseling intern with transgender clients that opened the door for her to see what she calls the “incredible power” of resilience. As she points out, transgender people are a minority even within the LGBTQ community, are marginalized by society and live every day in bodies that they don’t feel are their own. They often have co-occurring depression and anxiety and are pursuing a goal that often feels out of reach to them — to live fully as the gender with which they identify. Despite all of these challenges, they choose to keep going and pursue being themselves. This ability to endure in the face of existential obstacles led McCarty, who continues to work with transgender clients, to believe that resilience is the key to navigating all of life’s challenges.

LPC Karl Memmer has also based his practice on resilience. “I believe the concept of resilience captures the balance between the acceptance of the negative in our lives and the acknowledgment that we can all develop the skills necessary to overcome the adversities we all face,” he says. “Building resilience empowers individuals to take more control of their own lives, take responsibility for what they can and cannot control, and develop a greater sense of confidence in overcoming challenges. … I feel it is central to the practice of counseling as, ultimately, our jobs are not to take away the burdens of others but to help them organize the chaos in their own lives by listening objectively and helping them develop or enhance skills to more effectively take action and responsibility.”

Assessing and building resilience

What does resilience look like? McCarty says that in her experience, people with high levels of resilience are more “flexible,” meaning they are more easily able to adapt and adjust to life’s happenings as needed. This applies to everything from being inconvenienced by a simple mix-up in plans to being diagnosed with a serious medical condition or experiencing the sudden death of a loved one. People with high levels of resilience take in what has happened to them and ask, “What next?” she explains. Other people, such as those who struggle with anxiety, are less flexible, so they have to work harder at building their resilience.

McCarty isn’t aware of a scale or assessment tool to measure a person’s resilience. Rather, she says that she begins introducing the concept at intake. In her paperwork, she asks clients to describe past difficulties that they have overcome. “It gives me a window on how they view themselves,” McCarty says.

Clients sometimes leave this question blank because they don’t view their own challenges as serious or particularly difficult. In other instances, clients may perceive that they have failed to address the challenges in their lives. In either case, the responses give McCarty an opportunity to explain resilience to her clients, point out the ways in which they have already been resilient and discuss ways to continue building on that resilience.

“I think everything counts as a chance to be resilient, [such as] changing jobs or moving neighborhoods. It’s not just for major life events but for things that happen all the time,” she says.

McCarty’s aim is to help clients recognize that they are already using their personal strengths and attributes — such as grit, toughness and persistence — every day to do hard things on a smaller scale.

“For example, let’s say my client has been working on social anxiety and we’ve made a goal of attempting low-pressure conversation three times this week. My client reports they spoke to someone in the break room at work, they made small talk with their cashier and they interacted with someone while pumping gas,” McCarty says. “I might ask them how successful each of these were. Let’s say two out of three were positive. I might ask my client if they noticed a change in their anxiety with each interaction and if they felt the interactions got easier or harder. Assuming their anxiety was lower with each interaction and they felt more comfortable as a result, I would point out how their grit and persistence kept them moving forward.”

“In this example,” she continues, “even if the interactions were negative, the fact that the client kept trying shows grit and persistence and helps the client understand that it’s not about the result of the interaction, it’s about the attempt. The more attempts we make, the easier it is to keep going regardless of the result or outcome. Resilience is the culmination of this practice and work.”

Andrea Cooper, an LPC and licensed clinical professional counselor who works with Memmer at Resilience Counseling and Social Skills Center in the Richmond, Virginia, area, says that building resilience often begins with shoring up clients’ self-esteem. She asks clients to keep a thought record, which helps them monitor what they are feeling and how they are reacting to situations that they find difficult or unsettling. The goal is to uncover automatic thoughts tied to negative
self-perceptions.

“Someone who has ideas about contributing to a business meeting but doesn’t speak up may be listening to their own automatic thoughts,” Cooper says, “such as ‘No one will care. They will not think this is a very good idea. Who am I to speak up?’”

She explains that these negative self-messages are often an indication of false core beliefs, such as “I have nothing of value to contribute” or “I’m not smart enough.”

“Developing an awareness of that automatic thought trail gives the person an opportunity to interrupt their habitual response — not contributing — by choosing alternative statements to tell themselves, such as ‘I feel uncomfortable speaking up, and that’s an old habit. I have an idea worth sharing,’” Cooper continues.

The process may sound simple on paper, but disrupting negative automatic thoughts takes practice. “We generally start practicing with low-risk situations — such as contributing to a social encounter in the break room — so the client gains a sense of success with their new behavior,” Cooper says.

Memmer chips away at self-esteem issues that can hamper resilience by teaching clients to distinguish between thoughts, feelings and actions. One tool he uses to do this is a “thought pyramid.” He and the client start by drawing a pyramid on a piece of paper. The pyramid is divided into three sections: Thoughts are at the top, feelings are in the bottom left-hand side, and actions are assigned to the bottom right.

Memmer then asks clients for examples of thoughts — typically negative — that frequently pop up in their daily lives. Those thoughts — for example, “I’m a loser” — are recorded at the top of the pyramid. Next, emotions such as anxiety, sadness and hopelessness that accompany those thoughts are recorded in the bottom left space. Finally, Memmer and the client move to the bottom right-hand corner: actions.

Memmer asks clients what they typically do when they feel these negative emotions. They might respond by saying that they isolate themselves from their friends. Memmer then demonstrates how those actions are contributing to a negative feedback loop by asking clients how they feel when they isolate themselves. The answer (for example, “Like an undesirable loser”) lands them back at the top of the pyramid: their thoughts.

By using this exercise, Memmer is also highlighting that clients cannot change negative thought patterns just by “deciding” to feel or act differently. Rather, they must disrupt the cycle through identifying and reframing the negative thoughts.

As clients begin changing their negative beliefs, they often come to the realization that they cannot always control their daily stress and strife, but they can control how they react. This awareness allows them to feel more capable and empowered — more resilient, Memmer says.

Because Cooper believes that cultivating emotional and physical wellness enhances resilience, she encourages clients to take time between sessions to focus on mindfulness techniques such as guided meditation. Rather than asking clients to sit down and aim for 30 minutes of meditation on their own, she recommends that they use an app such as Headspace, which offers numerous guided meditations that focus on stress, anger, anxiety and other issues. Other meditations are geared toward helping listeners sleep better or develop stronger focus.

The important things in life

Cooper also believes that helping clients identify their values — what is most important to them — and evaluating how closely their lives conform to those core principles enhances resilience. She does this by listening to clients’ stories.

For example, a client might talk about being unhappy at work because he or she is supervised very closely by a manager and expected to provide continual incremental updates. This tells Cooper that the client is feeling smothered and values autonomy at work. The client can then work to change or improve the situation by setting boundaries in the current job or perhaps looking for a different position that offers more autonomy.

Cooper has also worked with numerous teachers who feel they are never really off the clock. Responding to parent phone calls and email inquiries extends their workdays well into the evening, leaving them little time to spend with their spouse, partner or children. When these clients identify family time as one of their primary values, Cooper helps them explore whether they can engage in more family activities on the weekends or whether they might benefit from improving their time-management skills.

“Once we can name [our] values, we’re more apt to seek them out and improve our quality of life,” she says.

Cooper asserts that being connected to others is also essential to building and maintaining resilience. “Connectedness is important [because] we are social beings and need some meaningful relationship to others,” she says. She adds that depression, isolation and loneliness often accompany each other.

Cooper points out that life phase changes are one common cause for social disconnectedness. Relocating for a new job or graduating from college or high school may be exciting life events, but they often result in the dissolution of previously established social circles. “We have to learn how to connect with new people,” she says.

One way that counselors can assist clients in building resilience is to help them find ways of establishing new connections. This might involve encouraging clients to explore their interests and engage in activities. “Do what you love and you are likely to encounter others who are like-minded,” Cooper advises. She adds that religious or spiritual connections and volunteer work can also lead to rewarding social contact.

In fact, resilience is not limited to the personal level. It is also manifested at the relationship level and the community level, says American Counseling Association member Matthew Fullen, an assistant professor at Virginia Tech who studies resilience in aging adults.

He explains that the counseling relationship itself can be a source of resilience for clients because of its supportive nature. It also helps demonstrate that resilience is developed with the help of relationships that lift people up and support them. Likewise, communities such as cultural or faith-based groups not only surround people with support but derive resilience
from their shared histories, traditions and experiences.

Fullen, a licensed professional clinical counselor in Ohio, believes that group therapy is particularly effective for building resilience precisely because of this community effect. As part of a study, Fullen ran a program at a day facility that offered support and rehabilitation for people 55 and older with disabilities that severely curtailed their functioning. The group spent a substantial amount of its time discussing resilience. Members not only shared times when they had been personally resilient but also pointed out examples of resiliency demonstrated by other group members.

“I remember someone saying, ‘Every day I have this physical therapy. It’s excruciating and it’s really hard, and there are times when I feel like I can’t take one more step. When that happens, I think about this group,’” Fullen recounts. He points out that the group member was able to call on the collective resilience of the group as a source of support and inspiration that increased the group member’s personal level of resilience.

Another incident had a particularly profound effect on the group, according to Fullen. One day, he asked group members to name someone who exemplified resilience to them. Fullen was expecting people to name family members or celebrities. Instead, a soft-spoken group member shyly raised her hand and said, “Judy. Judy is who I think of,” pointing to one of the people in the room. The woman explained that Judy came in daily for difficult physical therapy and never complained.

“I know she has a lot going on at home,” the woman continued. “Her kids are having problems, and it weighs on her, but she is still able to come in and be nice and helpful.”

It was a moment of revelation for everyone in the room, Fullen says, because it drove home the point that resilience isn’t something possessed only by people who are outwardly “successful.” It can also be embodied by those who are marginalized. In fact, participants in the group showed significantly increased levels of resilience at the end of Fullen’s study.

Counselor, heal thyself

As counselors attend to clients’ resilience, they must also make sure to build and maintain their own. “What we do as clinicians impacts others,” says ACA member Robert J. Wicks, an expert on secondary stress in clinicians and the author of books such as The Resilient Clinician, Bounce: Living the Resilient Life and Night Call: Embracing Compassion and Hope in a Troubled World.

“There is a Chinese proverb that says, ‘When the tide rises, the boats in the water do as well,’” he continues. “I think this is true, but as clinicians, that doesn’t mean that raising the psychological tide is easy.”

The primary risk to counselors’ resilience is bound up in an essential paradox: The seeds of therapeutic compassion and the seeds of secondary stress are the same. Therapy is performed through reaching out to others, but the pressure caused by the therapeutic connection puts practitioners at risk for compassion fatigue, Wicks explains.

Those in the helping professions need to recognize that no matter how prepared they are, the pain of those they serve is so omnipresent that it can catch practitioners off guard and drain them, he continues.

When working with physicians and nurses, Wicks gives them a reminder of their epidemiology studies: For every case of poisoning, there are at least a dozen cases of subclinical toxicity. The parallel to counseling? He believes that for every impaired clinician, there are a least a dozen cases of practitioners who are on the edge of compassion fatigue.

“The reality is that — and this is important — clinician impairment is most often a developmental process … not a cataclysmic event,” he asserts. He adds that clinicians must learn to recognize, and lean back, when their stress is high.

Wicks says that counselors can build and maintain their resiliency by:

  • Gaining skills in regulation of emotions
  • Decreasing maladaptive behavior patterns that result from poor self-awareness
  • Improving their ability to balance their personal and professional lives
  • Developing a willingness to honestly assess their own coping patterns
  • Taking responsibility for managing personality-based coping tendencies and attitudes that drive them
  • Uncovering disruptive maladaptive coping habits, including workaholism and other compulsions
  • Treating their body/mind/spirit with respect
  • Counteracting toxic emotions
  • Learning to self-nurture with healthy pleasures
  • Using positive interpersonal skills such as assertiveness, anger management and principled conflict negotiation
  • Employing realistic work and family balancing strategies

Wicks also stresses the importance of counselors regularly setting aside time to be alone and reflect. Practitioners may be able to give themselves this necessary breathing room by modifying their habits and practice style. For instance, Wicks suggests that practitioners make it a habit of arriving early to their offices so they have time to center themselves rather than rushing in with only minutes to spare. He also advises against counselors putting client sessions back-to-back, which can cause client issues and details to run together.

Setting aside this time can assist counselors in recognizing their own foibles, protecting their “inner fire” and accepting change and loss. “We all need time to adjust and grieve,” Wicks says.

Rodney Dieser, a professor of health, recreation and community services and affiliated faculty member in the Department of Clinical Mental Health Counseling at the University of Northern Iowa, has centered his research, practice and teaching on the importance of leisure to overall well-being. He is a proponent of sociologist Robert Stebbins’ “serious leisure perspective.” Dieser, a licensed mental health counselor, believes that leisure is an essential component of maintaining counselor resilience by helping to prevent burnout.

Summarizing Stebbins’ research, Dieser explains that leisure has three categories:

1) Serious leisure involves spending a large amount of time mastering certain skills as a hobby. An example would be learning to play an instrument over time and participating in the community orchestra.

2) Casual leisure is what most people think of as leisure. It requires little in the way of special training to enjoy. Examples include relaxing, going to a restaurant, reading, engaging in social conversations, resting on a hammock or going to the beach.

3) Project-based leisure involves taking on a project that is somewhat complicated but that doesn’t involve more “serious skills.” Examples include planning a family vacation, engaging in fundraising for a local community project or participating in other kinds of volunteer efforts.

Research has shown that leisure can relieve stress, provide healthy coping methods and offer protection from the negative health effects of extreme and prolonged stress, says Dieser, a member of ACA. With that in mind, Dieser has students in his introductory counseling classes design self-care plans that include one serious leisure, one casual leisure and one project-based leisure activity. 

“Leisure programs can minimize the impact of stress through enjoyable distractions that create psychological breathers or regrouping,” he explains. “Leisure pursuits serve as a source of protection against stress because they enable coping through social support and the application of self-determination. During a stressful event, groups of similar people or acquaintances, including [those based on leisure activities], can provide a source of relief, instill hope, serve as a catharsis in expressing feelings and help a person not to feel alone. Application of self-determination through leisure allows a person to feel they have some control in their lives when other parts of their lives are out of control. … [Finally], leisure experiences can create or restore a sense of optimism through pleasant experiences in the face of intense stress.”

Cooper reminds counselors that they are their own best instrument of practice when it comes to resilience. “Practice some of the things you try to teach clients,” she urges. “Take care of your physical health, take time for yourself [and] get enough sleep.”

 

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The science of resilience

The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat.” According to the October 2012 Science article “The science of resilience: Implications for the prevention and treatment of depression,” genetics play an important part in people’s responses to stress and trauma, but there are also important psychosocial factors that contribute to resilience. These factors include:

  • Positive emotion and optimism
  • Loving caretakers and solid role models
  • A history of mastering challenges
  • Cognitive flexibility, including the ability to reframe adversity in a more positive light
  • The ability to regulate emotions
  • High coping self-efficacy
  • Strong social support
  • Disciplined focus on skill development
  • Altruism
  • Commitment to a valued cause or purpose
  • The capacity to extract meaning from adverse situations
  • Support from religion and spirituality
  • Attention to health and good cardiovascular fitness
  • The capacity to rapidly recover from stress

 

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Additional resources

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

Counseling Today (ct.counseling.org)

Books (counseling.org/publications/bookstore)

  • Neurocounseling: Brain-Based Clinical Approaches, edited by Thomas A. Field, Laura K. Jones and Lori A. Russell-Chapin
  • Counselor Self-Care by Gerald Corey, Michelle Muratori, Jude T. Austin II and Julius A. Austin

ACA Mental Health Resources (counseling.org/knowledge-center/mental-health-resources/self-care-resources)

  • Self-care Resources for Professional Counselors

 

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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.

Thriving in times of crisis

By Lennis G. Echterling December 10, 2018

I am now reaching the age when people assume that I have achieved a certain amount of wisdom. I admit that I usually enjoy playing the role of the sage as a professor, but at times it definitely has its downside. For example, a new faculty member once said to me, “Hey, Lennie, you’re the silverback gorilla in our department. What’s your advice about this proposed new policy?” I was so irritated that I wanted to hit him with a banana.

For me personally, a more serious downside of aging is that I am now facing a threat to my health, well-being and life. Two years ago, I was notified that I have cancer. A biopsy that I had fully expected to be benign instead turned out to be malignant. I received the call in my office, just before leaving to teach my crisis counseling class. Ironically, after decades of responding to the crises of others, I suddenly became my own case study.

When I entered the classroom late and out of breath, still reeling from the shock of the cancer diagnosis, I realized that I had taught my students well — they immediately sensed that I was troubled and kindly invited me to talk about it. Touched by their sensitivity and concern, I decided to take a risk and openly share with them my bad news.

As I told my story, I began to feel a mixture of profound emotional relief as a person and immense pride as a teacher because my students intervened in my personal crisis with empathy, skill and compassion. It turned out to be a powerful lesson, both for my students and for me. I believe that my students learned to trust the process of counseling, no matter when, where and with whom an intervention suddenly is required. The lesson I learned was to accept the gifts that others generously offer me in my own times of turmoil. That is the essence of counselor education — to practice our craft with one another to promote professional growth and personal healing.

Four principles of thriving

As counseling students, supervisors, teachers and practitioners, we all will have our share of personal, professional and family crises. So, I offer here four principles of thriving that emerged from my own life lessons in dealing with times of turmoil, threat and adversity.

The first principle of thriving is to be resilient. Resilience comes from the Latin word resilire. To resile means to bounce back. In physics, resilience refers to the elasticity of material that can endure strain. For each and every one of us, personal resilience involves not only surviving those inevitable crises ahead, but also truly thriving in our lives.

As I reflect on my two years of cancer treatment, I find that my personal experience has mirrored the typical reactions to a life-threatening situation. I appreciate now more than ever how adaptive negative emotions such as fear and anxiety can be because they focus our attention on the threat and press us to take appropriate action rapidly. But during this time, I also have been discovering deep and abiding positive emotions such as hope, compassion and heartfelt gratitude. Those emotions have broadened and enriched my ways of being. The truth is that both negative and positive feelings are essential for surviving and thriving in times of crisis.

My second principle for thriving is a reminder that you are not alone (and neither am I). Every culture has its folk tales and myths that portray a hero on a quest. No matter how talented and strong this protagonist may be, the person neither travels nor triumphs alone. Jason, the ancient Greek mythological hero, counted on his Argonauts in his search for the Golden Fleece. Somewhere over the rainbow, Dorothy was gifted with the Cowardly Lion, the Tin Man and the Scarecrow to help her find the Wizard of Oz. And in his Star Wars adventures, Luke Skywalker relied on Obi-Wan Kenobi, Princess Leia and Han Solo.

Like the protagonists in those archetypal stories, we also will encounter others who will have a profound impact on our life’s journey. To thrive in our future endeavors, we must accept the gifts that others offer us. To flourish in our personal lives and professional careers, we need to join with others to engage in the collaborative work of supporting, inspiring, challenging and encouraging one another. We are not islands unto ourselves in achieving our potential. We cannot succeed as completely, or as joyfully, on our own.

Third, thriving in our future involves remaining committed to learning throughout our lives. Our graduate training is not a mere dress rehearsal. It is an integral part of our lifelong dedication to continued professional development. A mind is like a parachute — it works best when it’s open. And actions do speak louder than words, so we must seek out mentors who exemplify what we aspire to become, because the most important lessons in life are not taught but caught. Passion, commitment and curiosity are highly contagious. For that reason, I regularly take a close look at my colleagues and my students. What do I want to catch from them?

The counseling profession is like a fidgety kid who is never still — it is constantly on the move as students and practitioners contribute to its vitality. The Mbuti of Africa have a ritualized song that offers a wonderful example of what every professional community should aspire to achieve. In the song, individual singers are responsible for specific notes, but no one carries the entire melody. As a result, only the community can sing the song.

My fourth and final principle for thriving is to make the journey your destination. In Travels With Charley, John Steinbeck wrote, “We do not take a trip; a trip takes us.” I am neither the person who originally entered my own training program nor the beginning counselor who launched my counseling career. Along the way, I have gained a sense of confidence and trust in my own abilities. I have questioned my old assumptions and, as a result, made new discoveries that guide my work. I aspire to continue going with the flow of my career and to be open to the enormous possibilities of future transformations.

Decades ago, as I was immersed in my own graduate education, I was fortunate to develop lifelong friendships with members of my cohort. We brought to our training a similar mixture of rough edges and fine potential, nagging doubts and yearning dreams, neurotic hang-ups and transformational hopes. We told our life stories to one another and threw ourselves into heartfelt discussions that lasted late into the night. Along the way, we would party together. My fellow students taught me how essential it is not only to work hard with your colleagues but also to celebrate with them.

More lessons to learn

Six months ago, lab results revealed a recurrence of my cancer. After completing 15 more radiation sessions, my skin was a raw and painful reminder of my vulnerability and mortality. I continue to Google for any innovative breakthroughs for my cancer, to remain committed to practicing a healthier lifestyle and to explore complementary approaches. I now face a regimen of medications, phototherapy sessions, appointments and lab tests.

I have become accustomed to the role of the patient, but I endeavor to thrive throughout the process. I cherish my loved ones. I give extra hugs to my family and dear friends. And I take every opportunity to show my gratitude for the countless acts of kindness that others bestow on me every single day. My hopes and dreams for the future, which serve as the personal beacons that light my way, are to savor and cherish all the meaningful, loving and joyful moments that remain in my life. I have many more lessons to learn from my students.

 

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Lennis G. Echterling is a professor of counseling at James Madison University. Contact him at echterlg@jmu.edu.

 

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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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.

Moving through trauma

By Jessica Smith November 7, 2018

I am a wounded healer. I remember a professor in graduate school telling our class that most counselors are wounded healers. As human beings, we gravitate toward what we know. As counselors, many of us are attracted to this work because of our difficult life experiences. These events in our lives often include trauma.

Trauma is woven into the tapestry of my life. My hope in sharing my story is to continue the discussion around personal and vicarious trauma for counselors to remind others that they are not alone. I also wish to provide tools and strategies to assist counselors and their clients in moving through and releasing the trauma that is stored in their bodies and hearts.

My story

At age 17, I was sexually assaulted at a New Year’s Eve party. My life and my perception of the world instantly altered in that moment. Before the assault, I was the captain of my varsity field hockey team and was taking Advanced Placement courses to pursue my dream of going to an Ivy League school. My primary focus at the time was finding a date to the senior prom, but after that night, I lost all direction and shut down.

From that point on, I went to school and then went straight home each afternoon. I started avoiding my family and friends because I feared the questions they would ask and the suffering my responses would reveal. I slept a lot and found myself drifting off in the majority of my classes. Sleep was one of the few activities that allowed me to escape my thoughts and emotions, so I found refuge in the silence as often as possible. I isolated myself by spending most of my time alone in my bedroom, which was one of the only places where I felt physically and emotionally safe.

When sleep wasn’t enough, I turned to alcohol to numb the pain. Substance use issues run in my family, so drinking was modeled for me at a young age as a way to release and relax. When I was crumbling on the inside, drinking allowed me to appear stronger on the outside. In social situations, drinking helped replace my anxiety and insecurity with confidence and courage. I was aware that drinking offered only a short-term fix, but at the time, it was the only way I knew to cope with my discomfort and pain.

I managed to finish my senior year of high school and go off to college. I thought I would reinvent myself in college and leave behind my past experiences, but the drinking and my desire to numb myself followed me to this next stage of life. I would stay up late drinking with friends and subsequently miss most of my morning classes, even though attendance counted for a large portion of the grade.

I thought I was doing well, but in reality I was barely keeping my head above water. My grades suffered, and I ended my first semester of college with a C average. School had always been a grounding force in my life when everything else felt like it was floating away, so I knew that something had to change.

As a high school athlete, I had used sports and exercise to move through and release difficult emotions, so I once again began exercising and taking longer walks on an almost daily basis. Still, I felt that something was missing. My college was located in a rural town in southwest Virginia, but I managed to find a yoga studio to try out the practice, telling myself that it would serve as a beneficial cross-training exercise to my running. The prospect of cross-training was what brought me to my mat, but it was not what kept me there.

I still remember my first class. It was a hot yoga series with a set sequence of 26 standing and seated poses in a room heated to 92 degrees. I recall the teacher saying that if we needed to take breaks during the class, we could sit on our mats in Hero pose. Hero pose (see photos in Counseling Today‘s print magazine) is a kneeling pose, which also makes it a vulnerable posture. Although it is a grounding and surrendering pose, it is also a strengthening and activating pose.

About halfway through that first class, I felt dizzy and nauseated from the heat and the movements. I had believed I was in good shape at the time, but yoga challenged both my mind and my body in ways that I wasn’t accustomed to. My pride told me to continue to stand and attempt the series of poses, but my heart told me to sit down and take a break. I decided to listen to my heart instead of my mind for one of the first times since my childhood. I knelt down in Hero pose, stared at myself in the mirror and began to cry. I had been avoiding the metaphorical mirrors in my life for so long after the assault that I did not recognize the person looking back at me.

In that moment, I allowed myself to feel the pain I had been avoiding for the past year. I felt safe and comforted on my mat in that space. The class continued to go on around me while I closed my eyes and breathed in the pose. “I’m here for you,” I said silently to myself. “I’m not going anywhere. You’re safe now.”

Initially, I attended yoga once a week, but that eventually turned into two and three times a week. Each time I stepped on my mat, I felt a little piece of myself coming back and healing where it had been broken apart. Gradually, my heart also began to open again. I was able to begin getting out of my head and into my heart, which had been a struggle for me much of my life. At first, I gravitated toward yoga for the physical practice, but what kept me coming back was the spiritual and heart connection that it continually fostered.

Breathing in

In college, I began learning and experimenting with pranayama, or breathwork, practices in yoga to try to manage my overwhelming emotions with something other than alcohol. My connection to my mind was powerful and familiar, but my connection to my body and breath felt feeble and foreign.

I knew it would take time to nurture this new relationship with my breath. I kept going to yoga even when I wanted to give up and choose the quick fix. I continued to show up to experience the sporadic moments of quiet I achieved each time in my practice. Even if that happened for only 10 seconds at a time, those 10 seconds were more of a reprieve from my thoughts than I had experienced at any other point in my life.

I soon discovered that feelings influence breath and breath influences feelings. I used breathwork to move through a variety of emotions in college, including stress, anxiety, frustration and exhaustion. Prana is translated as “life force,” and yama is translated as “control,” so pranayama means to control the life force within. When I felt like so many things were out of control in my life, it was empowering to have one area in which I could temporarily regain my sense of power and control. With each breath I took in yoga, I felt like I was coming back to life again.

My breathwork practice started with basic diaphragmatic breathing, in which you place one hand over your heart and one hand over your stomach while breathing deeply into the belly. Diaphragmatic breathing is still a touchstone in my practice when I am struggling to connect with my breath.

Early on, I also learned kapalabhati, or “breath of fire,” in which you place one or both hands on your stomach and use forced exhalations through your nose to move your stomach and increase fire or energy in your body. Through practice, I discovered I could use breath to activate or energize myself (kapalabhati), and I could also use breath to deactivate and calm myself (diaphragmatic breathing).

Sitting down

My interest in breathwork eventually evolved into a meditation practice. I attended a mindfulness-based stress reduction intensive in graduate school to strengthen my meditation practice. I remember learning about walking meditation and practicing this form of grounding for an hour outside in nature. I had moved from 10 seconds of stillness in my mind to minutes of stillness during this walking practice.

I began to use walking meditation while moving around campus during my internship. I noticed that I felt more present, relaxed and grounded in sessions with students. When I was in a rush and forgot about my meditation practice, I felt irritable, worried and distracted in meetings.

My meditation practice has changed over time, but I always come back to walking meditation and the basic breathing techniques I learned in college and graduate school. I typically meditate for at least 20 minutes each day during the evening. This allows me to quiet my mind before bed and to release anything I am holding on to from the day that is no longer serving me.

Recently, I started beginning my meditation practice with a mantra statement. Mantra is translated as a “mind tool.” A mantra I use often in my practice is “Ham-sah,” which is Sanskrit for “I am that.” I am divine. I am light. I am love. I breathe in “ham” and breathe out “sah.” I use a mala, a string of 108 beads, to recite the mantra. The mind is like a puppy; the mantra serves as a toy for the puppy to play with and explore while settling into your meditation practice.

I also use mudras, which I call yoga for the hands. We have thousands of nerve endings in our fingers that are linked to various organs and other parts of our bodies. When we place our hands in specific positions, this activates certain sensations in the mind and body.

One of my favorite mudras to teach to clients and students is Auspicious mudra, in which you place one hand over your heart and then the other hand, while intentionally sending your breath to the space around and through your heart. I use this mudra to nurture and show compassion to my heart and body.

Standing up

After the assault, I blamed my body for what had happened, and I wanted to punish it. Because of this, I disconnected from my body through alcohol and other means. Yoga helped me come back to my body and feel safe in my body again. It allowed me to reclaim my relationship with my body that I had severed a connection with out of fear and shame. The poses and postures reduced the negative thoughts I carried about my body and encouraged me to open up to the beauty and wonder it had to show me.

One definition of yoga is a practice to “calm the thought waves.” Yoga asks us to move out of our heads and gently into our bodies. Yoga encourages us to push ourselves to our edges and sit with the sensations but to back off when we experience pain. Yoga reminds us that we can be uncomfortable in a moment but that, eventually, the discomfort will pass. Yoga connects us to our physical, mental, emotional and spiritual bodies. Yoga invites us to play, explore and discover the magic of our minds, bodies and souls.

As with my breathwork and meditation practices, my yoga practice has evolved over time. My movement usually reflects what is going on with me internally. When I need calm and peace in my life, I turn to restorative or yin postures, which are cooling and relaxing. When I need strength and power in my life, I seek out vinyasa or hatha poses, which are heating and energizing. 

One pose that I return to each day in my practice, both personally and professionally, is Tree pose. Tree pose is a balancing pose. Balancing poses are particularly helpful in bringing ourselves into the present moment rather than focusing on the past or the future. It is difficult to stand tall and securely in a balancing posture when our minds are wandering or drifting out of the present moment. To not fall in a balance pose, we have to be fully in the here and now.

To begin, stand in Tadasana, or Mountain pose, with your shoulders stacked over your hips, knees and ankles. Inhale to lengthen up through the spine and the crown of the head, and exhale to ground and release into the feet. Feet are hips-width distance apart and parallel. Arms can gently rest by the sides with the palms facing up.

With an inhale, bring the right foot to rest on the left ankle or calf like a kickstand. Exhale to root into the left foot and then move the gaze to a wall or object 3 to 6 feet in front of the eyes. Inhale and bring the hands to heart center in Anjali mudra, or Prayer pose. Exhale to release the shoulders down the back. Inhale to lengthen in the pose, and exhale to settle in the pose. Remain in Tree pose for five additional breaths, then switch sides and repeat. 

Flowing through

I am a survivor. At one point in my life, I was only surviving, just trying to get through each minute and hour of the day. Now I can confidently say that I am truly thriving.

We deserve to thrive rather than just merely survive in our lives. Yoga, breathwork and meditation have helped me to survive and also thrive in my life. The yoga text, the Bhagavad Gita, reads, “Yoga is the journey of the self, through the self, to the self.” When I lost my way, breath and movement led me back home to my true self.

 

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Jessica Smith is a licensed professional counselor, licensed addiction counselor, yoga teacher and owner of Radiance Counseling in Denver. She believes self-care is an act of self-love, and she is passionate about spreading this message to her fellow healers and clients. She is currently writing a collaborative memoir with a former client in the justice system and a memoir on healing from burnout. Contact her at jsmith@radiancecounseling.com.

 

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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