Are You One of Them?

Are you? You know, the kind that just sits and watches things happen to people? Bad things, without saying a word? Without getting involved? Without coming to their aid or rescue? The ABC show What Would You Do has drawn attention to what social scientists have long known: that people are largely bystanders even when really bad things happen. Apathetic, uninvolved bystanders who tend to stay on the sidelines and watch even when there is something we can do. Even when there is no guarantee that any help we can offer can make a difference. We just don’t even try. There is a reason God gave us voices, and frontal lobes, and the ability to make judgments and decisions. You can speak out against injustice. It’s nothing more than a decision. A choice. 

I want to rally all of my people no matter the color of your skin. I am appealing to the content of your hearts, your character. Are you going to sit idly by and watch citizens be attacked, marginalized, dehumanized, disenfranchised, and cast aside by a system of racism that continues to trickle down? Or are you going to use your voice, the power of your pen, and the impact of your vote to make a difference? Too many of you who are my personal or business connections have been silent about all of the injustice, inhumanity, and prejudice being espoused by those minorities who happen to occupy the White House. Too many of you sit by and watch people of color be bullied at work, passed over for promotions year after year, be locked out of opportunities and chances that others get just because. You’ve seen it. Watched it. Heard your friends of color complain and scream and cry about it. It maybe they just suffered in silence. But you’ve watched. And maybe you didn’t quite know what to day, and so you’ve said nothing. And when the race word is brought up, the quick and convenient thought was, ‘I’m not so sure it’s that.’ Here’s a newsflash darlings: it ain’t always that, but there are an awful lot of times it is.

When you CHOOSE to remain an observer, you choose to be an unwitting participant. When you remain silent about what you see, you become complicit. I have seen and felt and experienced this complicity firsthand. And when you do this, you become one of them.
Now is not the time to remain silent. Silence equals death. We’ve already lost one brave soul. But at least she made a choice, and yes, she is now magnified. And glorified. I hope you choose as wisely as she.

Be well.

Dr. Nik
#BlackLivesMatter #mentalhealth #endracism #speakout #silenceequalsdeath

The ‘N’ Word: A Psychological Perspective on Bill Maher in the Outhouse & the Reappropriation of the ‘N’ Word

I’ve given much thought to the most recent ‘N’ word controversy over late night, cable talk show host Bill Maher’s use of the term — referring to himself as a “house Nigger.” He had the extreme misfortune of having quite possibly been baited by Nebraska Senator Ben Sasse, whom he was hosting at the time. Nevertheless, his response was solely his and as such, his responsibility alone.  That said, y’all know I’ve always maintained my own unapologetic way of thinking. So let me explain why for me, not only is Bill’s apology absolutely accepted, but also why I am not so sure he even needed to give one.  

  1. Context matters:  As a social scientist, I’ve been trained to never look at a behavior in isolation; behavior is best understood within the context in which it occurs. Context always matters when trying to understand or explain a behavior. By looking at behavior in context, behaviors that would initially appear grossly malicious could be mitigated. To wit, society has traditionally given passes for even the most egregious acts. Even the heinous act of murder, when understood within a context, can be absolved. In this particular case, the context was within a comedic forum. It was meant to solicit laughs, albeit at a group’s expense. Notwithstanding that fact, the context, and the intent absolutely matters.
  2. Can we really own a word? Our very own, very beloved, and ofttimes ‘spokesman for the cause’ Ice Cube made a statement in the midst of his public castigation of Maher. He argued regarding the ‘N’ word “It’s our word now. And you can’t have it back.” Is this the basis of our argument? Are we as Blacks saying that only we have license to use this word? And more importantly, is this a word we really want to own? Even more importantly, why would we want to? The ‘N’ word has historically been used to denigrate, to humiliate, dehumanize, and to separate Blacks from our white cohort. The word has been used to remind us that as Blacks we are ‘other;’ that we share nothing in common —  not even humanity, with our oppressors. And some still use the word maliciously against us to date. And so my point is simply, why would we want to “own” such a terribly offensive and historically hateful word?  This sort of undoing of the negativity associated with this word is mere wishful thinking. 
  3. And what about artistic license? Comics and other actors have long since been excused and given a pass for doing and saying things out of mainstream expectation. We have even given them a pass to use the ‘N’ word. As a wanna be artist myself, I agree with Maher’s point that as a comic, the comedic mind sometimes reacts and responds very quickly; almost reflexively when it recognizes an opportune moment. And at times the mind reacts and the mouth instinctively opens; at times inappropriately so. Not at all saying that there should not be a line that should be drawn. Boundaries are always a good thing. Comics must realize that some things simply aren’t to be joked about. But if we draw the line, then it’s a hard-line. And ANYONE who crosses the line must pay the piper. This brings me to my next point:
  4. And what about Richard?: My clearest memories of the late, great comedian Richard Pryor include his very liberal use of the ‘N’ word — in every other sentence it seemed; both as a term of endearment and to demean other Blacks. And so my point is simply, because one is Black, does one have automatic license to very freely use the word? Because Biggie or Tupac or Ice Cube use it as a point of reference or a term of endearment towards others who look like them, should that somehow make it ok for them to use it? I disagree vehemently with this type of cherry picking (at best), and terribly faulty logic. Folks, we cannot pick and choose. There is no shade of gray here — not on this issue. If the word is bad —  historically and continuously, then it is what it is. And NO ONE GETS A PASS. 
  5. Reclamation…REALLY?: When did Black America adopt this word?  When did this word begin to have a much less negative connotation and meaning? For as much as we say we use it to denote a certain fondness and belongingness for those individuals in our group (affectionately referred to as “My Niggers”), we African Americans also use it to disrespect and demean each other. We Blacks also use the word to refer to other Blacks who are seemingly less refined, more hoodish, thuggish, and quite frankly less ‘civilized’ than we might think we are.  This type of behavior and use of the word is an interesting psychological conversion; indeed, a form of the psychological defense reaction formation. Psychologically, this behavior from more seeming ‘refine’ Blacks also represents an identification with the aggressor — whereby the word as a tool of hatred and in its most pejorative sense against each other — just as whites have always used it against us.  In sum, we must take responsibility for this. Let us stop pretending that the word somehow has magically lost its negative power. We must own the truth of the ‘N’ word. It is a hateful word. Period. There is no reclamation or reappropriation that can happen here. There is nothing positive that can come from such a reprehensible word. There is no undoing here. No matter how hard we wish for it to be so.

No, I don’t give Bill Maher a pass. But Ice Cube, Jay-Z, Issa Raye, or myriad other Black don’t get one either — nor should they just because they are Black.  If using the word is wrong for Bill, then it’s wrong for anyone irrespective of their color. We must stop perpetuating double standards; they always somehow boomerang back at the user anyway. We must recognize the moment we have here. In fact, why don’t we use this teachable moment to change the American vernacular, and to erase this hateful word from the lexicon. 

Be well. 

The Good Dr. Nik

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The Good Dr. Nik, aka Dr. Nicole Alford, is a DMV-based Clinical Psychologist, writer and blogger, media commentator, and compassionate activist. For more information about her services, follow her @theGoodDrNik on all social media platforms, and visit her website at http://www.TheGoodDrNik.com

 

The Wages of War: The Unpaid Debt Owed to Our Veterans

This Memorial Day in particular has me feeling some kind of way; not just because I am keenly aware of those lives lost to ensure my freedom, but also because I am acutely aware of those lives indelibly changed as a result of their service to this great country.  My own service in Afghanistan as a civilian has given me an entirely different perspective on the combat experience. On what it means to be prepared for war; and what it means to go to war unprepared (like so many of our young men during Vietnam). I understand just a bit more about their sacrifice. I know what it is to go to bed with one eye open, with your weapons and ammo and boots near you. To be ever vigilant, never at ease, and always on the ready.  To have your heart pound almost out of your chest and fight to keep your wits about you the very first time you feel the impact of an IED blast. To be separated from your loved ones for a really long time.  But I don’t know what it’s like to have to fight for your life. Or to kill to protect your life.  Or to see the gory horrors of war.

And so because of my experience, I have a newfound respect for all combat veterans; but especially those who continue to fight the silent war.  The silent war is the war inside their minds. It is a war waged largely against their own thoughts, memories, feelings.  It is a war against habits and behaviors that many implement to numb the pain. It is the isolation that they enact because they feel that no one understands, or that they cannot be totally open and honest and trusting of anyone, and because they just don’t want anyone to know the depths of their pain. They don’t want to deal with the stigma. The stigma is real. For a soldier even more so.

As much as we say we honor them, we dishonor them and their sacrifices. We turn our heads when we see a homeless guy with a nappy hat, and a tattered jacket, and a dirty sign saying, “Hungry veteran. Please help me eat.”  We cross to the other side of the street when we see the woman mumbling to herself.  We forget that it was war that contributed to this social problem. And we forget that our brothers and sisters who were prepared to lay down their lives, they are our problem.

No veteran should struggle with mental illness, addiction, unemployment, homelessness, or hunger following his or her service. So many of them have been adversely impacted by their combat experiences. We still don’t really know how many Vietnam-era vets struggle with PTSD, but certainly our best guess pales in comparison to the true numbers. Four decades later, we now know that a large majority (THE vast majority) of Vietnam vets struggle(d) with chronic PTSD symptoms. Four out of five Vietnam veterans reported active PTSD symptoms when interviewed 20 to 25 years after that war. Indeed, I recently interviewed a Vietnam-era vet who sobbed as he recounted story after story of his war experience in vivid detail just like it was yesterday. He had never spoken of his experiences in theatre. They rarely if ever do.

Why do I do what I do? Why is it so important to shed light on the issues facing our veterans? Because the rates of suicide amongst veterans are astounding; in one year it was 2 times the number of suicides in the US population writ large.  In 2014, 20 veterans per day committed suicide. I do what I do because:

  • 50% of those with PTSD do not seek treatment.
  • Rates of post-traumatic stress are greater for the Iraq and Afghanistan wars than for prior conflicts
  • 19% of veterans may have a traumatic brain injury (TBI); and 7% may have PTSD and TBI
  • More active duty personnel die by their own hand than from combat.
  • It is estimated that 20% of Iraq and Afghanistan combat veterans have PTSD and/or depression.

There is a consequence to waging war, and it is a costly one. You cannot place a price on mental health, or psychological wholeness. Nevertheless, we owe this debt and it must be paid in full. How can we ensure that we do right by the men and women who have valiantly served?  We must demand that Congress allocate the funds to providing state of the art services, to hiring the best and brightest clinicians and researchers, and to creating the infrastructure to properly and adequately care for our wounded warriors.

To do your part — to truly thank them for their sacrifice, and to honor those lives lost for your freedom and mine, contact your state representatives to Congress via letter or phone, and demand that this be a priority.

We owe it to those who laid their lives down for us — to take care of their brothers and sisters-in-arms who are still fighting a war alone.

Be well,

The Good Dr. Nik

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Dr. Nicole Alford is a DMV-based clinical psychologist, writer and prolific blogger, teacher, media commentator and compassionate activist working to raise mental health awareness and end stigma. For more information on her professional services, view her website at http://www.TheGoodDrNik.com, and follow her @TheGoodDrNik on all social media platforms.

 

 

May Aint Just About Flowers: Why Mental Health Awareness Month Is So Important

May is Mental Health Awareness Month. This is the month that we mental health professionals, survivors, families, and those otherwise dedicated to the cause take to raising awareness and dollars to advance our agenda. For us, May aint just about the flowers! The Good Dr. is here to tell you that for some, April showers are a 12-month occurrence. For others, the flowers are but an illusion. So here is why I do what I do, and why this month is so incredibly important:

To Educate: Knowledge truly is power. You can’t address what you don’t admit, and you won’t heal what you don’t acknowledge. Not only must we become a more educated society with respect to mental illness, but we must seek truth.  A wise Bishop once stated, “It is not the truth that will set you free, it’s the knowledge of the truth.” So here is a small sampling of the truth about mental illness and its impact:

  • Approx. 63M Americans (26.2%) suffer from a diagnosable mental illness each year — whether or not they are ever diagnosed (NIMH)
  • Anxiety Disorders comprise the most frequently occurring diagnosis; with 18.1% of Americans and women more likely to suffer this type of disorder than men (NAMI)
  • 16M adults live with major depression
  • African-Americans and Hispanics utilize mental health services at half the rate of Caucasian Americans (NAMI)
  • Each day an estimated 18-22 veterans die by suicide
  • Suicide is the 10th leading cause of death in the US; the 3rd leading cause in people aged 10-24 and the 2nd leading cause in people aged 15-24
  • Among the 20.2M Americans in the US living with a substance use disorder, 50.5% of them have another co-occurring mental illness
  • Gay, lesbian, transgendered or Q youth are twice as likely to attempt suicide than their heterosexual counterparts

The truth of the matter is that minority communities are predisposed and significantly more vulnerable to mental health issues due to the stress of living in a society that discriminates, marginalizes and moves against them aggressively on the regular, the stress of a life of poverty, urban violence, and lack of access to affordable quality healthcare. The truth of the matter is that even when we do have the means to afford mental health care or the access to it, we don’t use it. The sad truth is that there are historical and cultural myths, traditions, and beliefs that keep us stuck in dysfunction and suffering in silence. The truth of the matter is that we are a prideful people who are trained not to ask for help, to take it on the chin, to be the superwoman and Mandingo warrior labels that have been ascribed to us.

To Advocate:  Those of we regular people who have voices and concerns that often go unheard need to not only learn to advocate for ourselves, but we must also empower those in the position to advocate for our interests. Grassroots organizations and activists like the National Alliance for the Mentally Ill (NAMI) regularly lobby Congress and state legislatures to enact laws that ensure the ease of accessibility, quality, and affordability of mental health care in addition to taking stances, (even unpopular ones), on issues that have a mental health nexus. For example, it was lobbyists that were instrumental in getting the gun laws strengthened following the Virginia Tech massacre in 2007, and lobbyists that led to the tightening of the mental health data reporting laws from states to federal databases for background checks. Related to empowering advocates, one way is to donate money and/or volunteer your time in assistance to these organizations.

To Eradicate:  In the early 1960’s, psychiatrist Thomas Szasz wrote a well publicized (and criticized) book entitled The Myth of Mental Illness; eschewing mental illness as nothing more than a stigmatizing label placed on people with problems in living. While I understand his argument, and agree that mental illness has historically been a destructive label used to isolate and separate those with real problems, it has also been a way that behavioral scientists and researchers have come to understand, study, categorize and treat classes of symptoms. There is still great stigma attached to having, admitting to, or seeking treatment for any type of mental illness — no matter the context. Even when, by right, symptoms should be expected (i.e. veterans returning from the horrors of battle, or someone going through a difficult divorce), we tout only the strength and seeming resilience shown as if it is a badge of honor to not break down during such tragedies. If history teaches us anything, it is that silence kills. We must work together to end stigma. We must admit and acknowledge when we are struggling. We must make it OK to say, “I am not OK.”

One thing the Millennial generation understands and gets my total admiration for is their openness and proud ownership of their issues and ‘isms.’ They wear their issues like a crown for all to see, and true to their generational nature highlight their battles and make a platform of them to help others. From Prince Harry’s admission of his early struggles with depression, to Chance the Rapper’s acknowledging his PTSD from urban violence, to Kid Cudi very openly admitting his battles with depression and suicidality — these youngins are launching a very public campaign to destigmatize help seeking. As the Good Book says, ‘…A little child shall lead them’ and the Bible aint never lie! Say what you want to about Generation Z but right now, they lead the fight to end stigma. And I stand boldly and courageously with them.

Do your part in May. Educate someone. Admit that there have been times when you were not OK. Check on your people. Donate some dollars to the cause, or join the annual NAMI walk that every major city has on May 20th. For more information on how you can advance this cause, especially during this seminal month, go to http://www.NAMI.org.

Be well,

The Good Dr. Nik

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Dr. Nicole Alford is a DMV-based clinical psychologist, writer and prolific blogger, teacher, media commentator and compassionate activist working to raise mental health awareness and end stigma. For more information on her professional services, view her website at http://www.TheGoodDrNik.com, and follow her @TheGoodDrNik on all social media platforms.

 Lessons From the Couch, About the Couch: So you can coach me too, right Doc?

This is the third entry in my series on psychotherapy entitled Lessons From the Couch, About the Couch. This series seeks to educate the potential consumer of counseling/psychotherapy about important aspects of therapy, and how to go about smartly engaging in the process in order to maximize benefit.

I have a confession: I watch Iyanla’s Fix My Life series. And I have to admit, it became a bit addictive and I found myself  hardly able to WAIT until the next week’s episode! And then I started to think about why.  And it dawned on me — it has all the makings of good entertainment; melodrama, a hook, something the viewer can identify with, and a twist to keep you from channel surfing and never coming back. But those attributes of the show, yes The Show —  the drama, the hook, and the entertaining — that was exactly the problem with it. People’s pain, and issues, and desire to be whole should not in any way be held out for public consumption (in my opinion). It shouldn’t be for entertainment purposes. It shouldn’t be for the voyeurs to gawk at. How people experience pain is personal. The work they do to alleviate it adaptively is personal. That brings me to my question: What exactly is the difference between psychotherapy and coaching?

While Ms. Iyanla does not market herself as a psychotherapist, what she does comes across as therapy.  And it starts out very similarly to how a real, therapeutic relationship with a psychologist or counselor begins.  For example, initially Ms. Iyanla tries to establish a rapport before easing into the sensitive issue(s). In many respects, it would appear to the therapy unsavvy layperson that there is very little distinction between coaching and counseling. But then it starts, and I am reminded that no, this aint therapy.  The change in tone. The loud voice. The perhaps overly assertive (code word for what some might call aggressive) confrontation. The touching and hugging and rubbing of backs. The up in yo’ face. The very things that I love about the show because it’s just great entertainment and keeps pulling me back, — is the very problem that I have with it. No, this aint therapy!

See, it would be unethical for psychologists to get in your face, yell, or raise our voices in anger or frustration. I get it though. That’s what sports coaches do. And maybe that’s just Ms. Iyanla’s tactic. It is not customary to have so much (if any) physical contact with the patient at all. We are trained and cautioned to have very strict boundaries. Emotionally, physically, and ethically.  For the five or six or seven years of clinical training we do, we are indoctrinated to knowing about boundaries and understanding lest that WE ourselves are a tool in therapy. And everything we do, say, feel, react — EVERYTHING is interpreted by the client. Can impact the relationship.  That is a key difference between coaching and psychotherapy.

Mental health professionals understand that it is the relationship that fuels the change.  And we know how fragile the therapeutic relationship is. Perceived insults or slights can indelibly impact it. And when that occurs, there is no sustainable change that can occur.

So boundaries, the ethics and strict professional standards, and the regulation of our professional practice by law are key differences between mental health professions and coaching. Anyone can become a coach. And while there might be a couple hundred hours of training needed, there is no process of vetting. No process of intense supervision, feedback or opportunity for correction.

The focus on the past (because we understand that to move forward, you oftentimes first have to go backwards), the type of client (we work with pathology, mental disease, and people who at times are very entrenched in their illnesses), and the many years of academic study, rigorous clinical training, supervision, and practice to hone our craft are important differences that separate us from coaching. Last, but certainly not least, counseling and psychotherapy are based upon the sciences of psychology, human behavior, neurobiology, and physiology among others. We have over a hundred and twenty years of research and scientific study to back us. And we use the research to form the basis of our interventions.

What we (psychologists) do is treatment. While we fuel change, motivate, and seek to shape human behavior just like coaches do, we treat. Period. We treat the wound. We dig deep and look for the wound because nine times out of ten, there is a wound. It isn’t always in the form of abuse, or assault. Sometimes it is much less salient, but just as profoundly impacting on a life. We know that there is always a wound. And that wound, and that lack of healing is what keeps people in a perpetual state of stuck.

So naw, I can’t coach you. I cannot put on my metaphorical happy face and cheer you along to the job, salary, business or life you dream of.  While mental health professionals aspire to move people forward, that’s simply not all we do. I can figuratively hold  your hand, take you on a long journey, guide you to the deep places, find the hurt, partner with you to heal the hurt, and allow you to own your story. I can empower you to be the best you by empowering you to do the hard work. And being perhaps the only constant you have ever had in your life while you do it. Once you’ve done that, the job, the salary, the life…will follow.

Don’t get it twisted; there are some uber talented, TALENTED coaches of all sorts. And there is a place for coaches. And yes, I still do love so many things about Ms. Iyanla! But the place for the coach is not with the couch, or with those who would be best served on the proverbial couch. And the techniques should not in any way mirror psychotherapeutic techniques.  Because simply, coaches do not do therapy. They encourage, they motivate, they empower, they move people towards their life goals and towards positive change. But that is not therapy. And that is not treatment. And the very best coaches understand that. And they don’t blur the very definite lines. And with that, they are ok.

There is room for both of us. There are more than enough people in need of some type of assistance. We’ll take the people in need treatment. And we’ll leave the coaching to the coaches.

Be well,

The Good Dr. Nik

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Dr. Nicole M. Alford is a DMV-area Clinical Psychologist in private practice. She is a prolific blogger, teacher, mentor, compassionate activist and media commentator. To learn more about Dr. Nik’s services, please visit http://www.TheGoodDrNik.com, and please follow her @theGoodDrNik on all social media platforms.

Lessons From The Couch, About The Couch: How to find a really good, effective therapist. (Or better yet, where’s that darn needle in this haystack)?

This is the second entry in my series entitled, “Lessons From The Couch, About the Couch.”  As we are on the cusp of Mental Health Awareness Month (May, annually), and with the advent of spring, what better way to set yourself up for a new beginning than to set yourself on a path to a New You?  The road to this novelty, for many, begins with psychotherapy. But finding a good therapist can itself be a barrier to seeking services; particularly for people of color.

Finding a good therapist is hard. While therapists abound, (and to be perfectly honest, at times it feels like there’s one every corner), we differ in style, therapeutic   and level of training, treatment paradigms, skill sets, and of course fees.  Here are my tips, from the couch; both as a therapist and having served at times as a client. Here are some things to look for and to be aware of when trying to find a therapist:

  1. Know who you are going to, and what they can offer:  There are various types of mental health professionals, and they each vary in terms of education and training, expertise, and types of professional services they can provide.  Understanding these differences is key.  For example, psychiatrists are licensed medical doctors (MDs) who specialize in the diagnosis and pharmacological treatment of mental disorders. In others words, they can write prescriptions and administer certain types of medical treatments that must be performed by a physician (like ECT). Most psychiatrists only do diagnosis and medication treatment and management; NOT psychotherapy.  Psychologists have either a Ph.D. (doctorate of philosophy) in psychology; this is an academic degree with an emphasis on both clinical skills and research on mental disorders and  psychotherapy, OR a Psy.D. (a doctorate of psychology). The latter is a relatively new professional degree with an emphasis on clinical training; research — not so much.  Many clinical and counseling psychologists directly practice psychotherapy, but we are all trained to do psychotherapy.  Social workers are master’s level practitioners whose training is really more so on the welfare and community services available to families, groups and individuals. Clinical social workers are trained specifically in psychotherapy and the diagnosis and treatment of mental disorders, as are licensed professional counselors (LPCs), another type of master’s level clinician. However, the latter 2 categories have half, if not less than half of the years of clinical training and education than psychologists or psychiatrists; that said, there are many kick-ass, clinically astute social workers. So decide which clinician might be best based upon your issue(s) and potential treatment needs.
  2. Search for a therapist like you search for a babysitter (the parents know what I mean!):  This is a serious matter. You wouldn’t let just anyone care for your kid; do you really wanna just let anyone care for your mind? So here I  appeal to the consumer in each of you, and I encourage the consumer of psychotherapy to take this bull by the horns! Research finding a potential therapist just like you would a babysitter. Be meticulous and detail-oriented in your search. Your therapist should be vetted. This could mean getting recommendations from trusted friends or family members (yes, many of them might currently be in therapy or have been in the past, and may be willing to share resources and experiences).  You can read the online profiles on the therapist’s website, their profile on your health insurer’s website, or on any of the major psychotherapy referral services. This will give you a feel for his or her educational and professional background, areas of specialization, style, etc.  And last, call and engage the therapist you are considering in a brief discussion. Interview the therapist and ask important questions such as how long he or she has been practicing, how many cases of (depression, anxiety or whatever your issue is) has the therapist seen, etc. Get a vibe, and then think about the conversation you just had. Did you feel rushed? Did you feel heard? Were you given an opportunity to ask questions and were your questions answered? This will give you some indicator of therapist professionalism, demeanor, and style.  And this might likely give you some understanding of whether or not this is the person for you.
  3. Use your available resources to find a therapist:  Your medical doctor likely has a vast network of both medical and mental health professionals, and could therefore be a good resource to tap into (especially if you like your doctor, respect his or her professional recommendations, and have developed a good relationship with your physician).  Second, many churches also have direct links to community-based providers or Christian counseling practices. Another untapped resource is the state! Our tax dollars paid to the state go towards vetting, licensing, and regulating the practice of mental health practitioners. Every state has a board of psychologists, social workers, and/or counselors that has a public website whereby you can search for a specific provider, search the status of his/her license, and learn whether there are any active ethical complaints or malpractice suits against that person. I strongly encourage this type of search be done on any potential therapist you are considering employing.
  4. Assess your needs and choose accordingly:  Do you need someone to see your child? Are you looking for a couple’s counselor? Are you a Christian and only wish to see a Christian counselor? Do you think you would feel more comfortable with someone who is of the same cultural background? Did you have previous therapeutic success with a certain type of therapy or intervention? These are all important questions that should absolutely drive your selection of a therapist.  Find someone who has the expertise, years of experience, and training in the area that you are presenting with. For example, if I am a veteran with a diagnosis of PTSD, but I want to see someone outside of the VA system, then I would look for people who are certified in trauma treatment, and who have experience treating veterans and/or those with PTSD. If I need someone to see my child, then I want someone who has vast educational training and experience and perhaps special credentials in working with children (i.e. board certified in child/adolescent psychiatry).
  5. Trust your gut: All too often, we Monday morning quarterback the situation that ensued when we didn’t listen to our initial gut feeling about a situation. The minute a therapist says or does something that makes you feel uncomfortable or fearful, or makes you question his or her ethics, or does not answer your basic questions, it’s time to switch. Now keep in mind, you should feel uncomfortable in therapy — if it is all roses, if you are only hearing what you want to hear, then nine times out of ten you are not being totally open and forthright in the sessions. However, what you should not feel is whether or not this is ‘right,’ sexually hit on, disrespected, or any of those emotions. The therapists office, and demeanor, should communicate safety and compassion. If that doesn’t exist, trust your gut.

Where to look:  Last, there are a number of free referral services that exist solely to help consumers to find local mental health providers in their area, that take their insurance, and which list specific areas of expertise. http://www.PsychologyToday.com and http://www.GoodTherapy.org are the two largest ones that millions of people turn to.  Second, each state’s psychological association has a referral list on their website. Google your state’s psychological association and start there. And lastly, your health insurer’s website will also list in-network providers, by specialty.  However, also keep in mind that you can also pay for you mental health treatment out of pocket, which allows you to be the driver and to be open to see whomever you choose. Flexible healthcare spending accounts can reimburse you; just make sure the therapist provides you with the appropriate documentation. You can also seek reimbursement through your insurer, however, check first to ensure that out-of-network mental health benefits are reimbursed — and at what percentage.

I really hope this helps to demystify the ofttimes gargantuan task of finding a good therapist. And I wish each of you the very best in your quest to change. The more of us that really do the work on ourselves, the better off the world will be.

Be well,

The Good Dr. Nik

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Dr. Nik is a DMV-based Clinical Psychologist, prolific blogger, speaker, media commentator and compassionate activist. For more information about her services, go to http://www.TheGoodDrNik.Com, and follow her @theGoodDrNik on FB, Twitter, and Instagram.

 

Lessons from the couch, about the couch: What is therapy really and how does it work?

This is a piece for the uninformed yet potential therapy user that I hope will be equally esteemed by therapists themselves. In an effort to demystify the process of healing and change that we call psychotherapy, I decided to put pen to paper with the hope that the more one knows about a thing, the less anxious one will be about trying that thing. So I’m going to offer my thoughts on what I have learned from being a practicing psychotherapist and working with people from all walks of life dealing all types of issues, using all types of psychotherapies. This is what I have learned, so far:

  1. Therapy is a journey:  From the very first session, you start out on a quest together — doctor and patient. As the pilot, the therapist is keenly aware of where you the patient needs to go (at least most of the time).  And much of the the therapist knows where you have to travel to get there. But oh, the places we’ll go! It’s the twists and turns that you can never predict and that you don’t quite expect that make the journey. It’s the loopdey loops and the slow ascensions followed by the steep drops that leave you, the therapist, sometimes breathless. Thoughtless. Speechless. And truth be told, sometimes very frustrated. And many times scratching your head in sheer confusion. The therapeutic journey is real. And sometimes it’s a real trip! Sometimes it feels like a trip on the highest, fastest rollercoaster ever built. But I’ve learned that there is magic in the journey. And that is what makes the journey worth it.
  2. Therapy, like life, is about relationships: The therapeutic relationship — that between patient and doctor, is indeed, a rare one.  In fact, I am going to go so far as to say that I don’t know of any other relationship quite like it. It’s a special bond forged by mutual trust, honesty, compassion and vulnerability.  But unlike other relationships with a similar foundation, rarely is there ever the type of implicit trust that this relationship packs. As the patient you’ve given your therapist carte blanche to give you his or her honest interpretations and clinical opinions of you and your thoughts. And your behavior. And your decisions. No matter how HARD it is to hear. And you have made the explicit decision that since this therapist is an expert in human behavior; he or she must know what the heck she is talking about. So you trust what they say. Most times. And you keep coming back. Most times. Because you feel that this doctor cares in a way that no one else has or can. And you trust that if you keep coming back, and listen to the recommendations, and do the work then change will come at some point.
  3. The therapist is a tool (it’s not what you think)! I’ve been practicing professional psychology for exactly two decades. I was 24 when I saw my very first therapy client in graduate school. Not only was I green to therapy, but for real, I was green to life! And while I had a few tools in my toolbox and a bit of skills, I had no wisdom. Like Zorro with the proverbial sword, I didn’t know how to use the sword. I had no context to marry the skills with. While many of my colleagues may disagree, here is what I know for certain: I know that I have become a thousand times more comfortable in this role over time and with  experience: life experience. I’ve become more genuine with those on the couch the more I came into my own being and my own acceptance of me. Of what I know, and more importantly, of what I don’t know. The more life I had lived, and the more experiences that I had (both good and bad), the more I understood life. These are the experiences that I rely upon in my sessions. They have given me street creds. They are my bona fides. They are the passport that gets me into a foreign land (the minds of my patients). And so because I have lived some life, I have some wisdom about some things. There are just some things you know because you have lived enough life to have seen them over and over again. I know that trouble doesn’t last always. I know that emotional pain isn’t permanent. I understand that there are hills and valleys in life. So with that said, I am a tool in therapy. And my near 50 years of life are the scrapes and scratches and marks that have well seasoned me to be of good use: to drill down to the issues and get to the depths of the pain. And to facilitate the journey.
  4. Therapy is part art & all science lightly sprinkled with a pinch of miracle dust: Though it may seem so, therapy is not hocus-pocus conjury. On the contrary, psychotherapy is based on hard science. Its foundation is built on the integration of various schools of psychological thought and a century of research in human behavior, with a smattering of miracle dust and a sprinkling of Wonka juice. I jest, of course, but sometimes that’s what it feels like. Though there is no proverbial waving of a wand by the therapist, something magical happens in therapy. At the end of the journey, if the therapist is truthful with herself, she acknowledges that it was very little of her own skills or talent. And maybe it wasn’t even much of the science implemented or the techniques recommended. Rather it was a great deal of trust, courage, consistency, and difficult individual reflection done in the comfort of the patient’s home. Outside of the therapist’s office.
  5. Therapist As Superhero: In the end, we are not superheroes. We are mere mortals with the same emotions, issues, and insecurities as our patients. We aspire to be just a bit more authentic, self-aware, real, and emotionally healthy as our clients do. But the truth is, we are not superheroes, or even super human. Truth is, this is hard, emotionally taxing, and really heavy work. It weighs on us. And we hurt sometimes because of it. There is no cape we wear; no red cape to hide the wounds. No suit that gives us special strength, no wand we wave. There is no magic in us, yet I am clear that very magical things sometimes happens through us.

The therapist is simply a mirror. We simply show you…YOU in a realistic way. The way the world sees you. Like the queen in the fairy tale, you must have the courage to ask the mirror (metaphorically speaking), what it sees and even more courage to accept the response. That right there; that’s the magic. And when therapy is done right, you get to see the you that you are and begin moving towards becoming the you that you were destined to be. It will be a journey. I don’t guarantee much, but I can guarantee that. But in the end you’ll say it was the greatest ride ever.

So, consider therapy. Find a good therapist. It can and will change your life!

Be well,

The good Dr. Nik

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Dr. Nik is a DMV-based Clinical Psychologist, prolific blogger, speaker, media commentator and compassionate activist. For more information about her services, go to http://www.TheGoodDrNik.Com, and follow her @theGoodDrNik on FB, Twitter, and Instagram.

GIMME BACK MY HOUR: Why Daylight Saving Time Affects You More Than You Think!

This is your brain today. I was surfing FB this morning, and many of you couldn’t sleep last night, or are loath to peel yourself off the bed this morning. You feel the loss of the hour. It’s ONLY an hour right? WRONG! Research says it’s best thought of as one hour each day for an entire week. So make that 7 hours. This is tantamount to the worst kind of jet lag: the kind where you are chasing the sun. How can you make it through the next week? Here’s my tips:
1. Proper planning prevents piss poor performance: It helps to go to bed an hour earlier the night we reset the clocks. I know I am a bit Monday morning quarterbacking this. Didn’t do it? Not to worry. I’ve got more where that came from.
2. The body’s clock is regulated by light: Our circadian rhythms run on a 24-hour cycle regulated by the sun. And when we go doing stupid things like messing with time like we can really control such a thing, we are actually interrupting the natural balance the body has. I say all that to say this: light is your friend.  And dark is too. Practice good sleep hygiene tips by sleeping in a totally dark room. And when you can’t sleep in the middle of the night: please God puhleeeeze, don’t reach for the smartfone. The blue light emissions from it mimic the UV rays from the sun. Only sends the brain the message: It’s time to get up!
3. You will be a bit off for the next few days (perhaps): Your body will naturally begin to wind down and lose energy at the usual time until it regulates. This means you will feel sluggish at work late afternoon; early morning when you rise you are rising an hour earlier.  Keep this in mind.  Auto insurance companies have found a drastic, indeed statistically significant increase in auto accidents the couple of days following DST. DON’T drive while groggy. If you need to pull over, please do. Keep yourself, and everyone else safe.
4. Reset your body’s rhythms naturally: Melatonin is my go to for patients with sleep difficulties or diagnosable insomnia. It is a natural hormone that the brain secretes which regulates sleep-wake cycles. It is safe to take, and can help to speed up the equilibrium-seeking process that your body will go through for the next week.
5. Caffeine is NOT your friend:  Not in this instance.  While drinking your normal cup or 2 of java will help increase alertness and energy levels shortly thereafter, limit caffeine after about 2PM, particularly this week.  This includes dark sodas and chocolates (no one every thinks of these)!
Good sleep hygiene practice is essential. If you feel tired earlier this week (which you will), pop a melatonin, sleep earlier, limit caffeine after mid-day, and most importantly start winding down an hour before bedtime.  A little mindfulness meditation 30 minutes before bed will likely help you sleep better.
I hope these tips help. Until Chronos, or the US Government decides to give us our hour back!
Be well.
The Good Dr. Nik
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Nicole M. Alford, Ph.D. (aka The Good Dr. Nik) is a DC-area Clinical Psychologist, prolific blogger, speaker and media commentator. Follow her on Facebook, Twitter and Instagram @theGoodDrNik and learn about her services at http://www.TheGoodDrNik.com

Surviving the Trump Card: When you Hate The Playa AND The Game, What Do You Do?

The Presidential election results of 2016 left millions of Americans reeling; spiraling uncontrollably in an emotional vortex. They caught us by surprise and left us stunned and dazed and confused. The results left us wondering. Wondering what will become of us financially, medically, and socially. Wondering if families and whole communities will be deported. Wondering if the spate of violence enacted against Black men, women, and children will increase exponentially. Wondering if the anti-Muslim sentiments, swastikas and defaming of our places of worship will intensify. Wondering if our good government jobs that our mamas told us to get and retire from will remain in place so that we can continue to work and retire. For we women, wondering if our bodies would become controlled by the proverbial body snatchers. And for most, wondering if there will be a world at the end of all of this.

What to do with all this uncertainty?  What do you do when you see decisions being made that to even the most politically unsavvy of us makes utterly no sense? When billionaire cabinet picks are so far removed from the reality of the struggles of regular folk that they can’t possibly have the average American’s best interests at heart? When you believed, to borrow from the Material Girl’s very memorable Women’s March on Washington Speech, “that good would win over evil,” but evil seemed to triumph over good? When you hate the playa for so deftly playing the trump card and then winning the game?  What do you do? My clinical thoughts to help you maintain peace and presence of mind, include taking a backward glance to fuel you forward. Here we go!

  1. Exhale: (also known as Woosah or simply…Breathe):  I get it. It takes a minute to get your breath back when you get the wind knocked out of you. And that is exactly what happened on election night. But like a football player that is dazed from a hit, we’ve got to shake it off.  We’ve got to get up, dust the dirt and soot of disappointment off of us, and we’ve got to breathe. Breathing steadies us. It grounds us. It calms us. And anxiety and calm cannot exist in the same body at the same time. Breathing allows oxygen and freshness of life and new energy to fill our bodies and invigorate our minds.  And it prepares us to GO!
  2. Quit Belly-aching! I borrow this phrase from the late, great Elliott Cates; my granddaddy. There is a time and place for everything under the sun. But kvetching, complaining, and whining will not change the reality of the situation. Rather, it keeps the whiner in a perpetual state of negativity. It keeps one stagnant, and wastes energy that could be better used on problem solving and progress. To make it plain, with respect to the presidential situation; it is what it is. And when we know what things are, we can deal with them as they are.
  3. See the end from the beginning (Stephen Covey): What is the end game in all of this? How do we want things to look in 4 years? When we know these answers, we can plot out a course of action and work towards the end goal. Change is not only hard, but it is even harder when attempted alone. There is strength in numbers. And fortunately for us, we are a collective people who have big numbers. We must look at our strengths and capitalize upon them. We must take our collective anger and channel it into collective action. For example, the Black community has a buying power upwards of 1.2 trillion dollars per annum. How can we leverage this? Do we just spend as usual? Or do we prepare ourselves financially for an unknown situation. Do we prepare to fund a movement? Further to my point, we have a significant collective voting power — ask Former President Barack Obama. For too long we’ve felt that the Republicans just ignore our interests and discount our votes, and the Dems take our vote for granted. This means holding BOTH parties accountable for action.
  4. Take responsibility: I’m not into the blame game. It’s counterproductive.  But I am into taking lessons learned from a thing. Simply, in order to ensure success moving forward, you’ve got to know where you went wrong. We’ve got to do a debrief of what the heck happened on November 8th so we can make sure history NEVER repeats itself in that manner again. We sat out. We thought that just one less vote wouldn’t matter. We thought for sure the best candidate would win. There are precious lessons here for all of us if we simply look. Here’s the deal: this happened on our watch. On the watch of all of us. So I ask…what could you have done differently? And better yet, what will you do differently next election?
  5. Educate Yo’self: The history of the Black vote must change. No longer must we be uninformed voters, and no longer must we leave the politics and governing — even at the community level — to others and then complain when decisions are made that don’t reflect our reality or wishes. Like Sheryl Sandberg advises in her book Lean In, we must have a seat at the table. When you have a seat at the table, you get to speak and be heard by the others seated at the table. At The table is where the power brokers are. That’s where the decisions are made.  At the table. We must be more than marchers. We must be more than yellers and screamers and protesters only when some event occurs that leaves us feeling violated. We MUST understand the game. And we must know how to play it. And when we’ve got that down, then and only then must we engage.

As it says in the good book, one day is as a thousand years, and a thousand years as one day. While I agree that four years is quite some time, I also know that it is enough time. It is enough time to roll up our sleeves, get involved, and get a winning plan. And these next four years will pass as slowly or as quickly as we want. It’s all up to us.

Be well,

The Good Dr. Nik

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Dr. Nik is a Washington, DC-area based clinical psychologist, writer and prolific blogger, speaker, healer, and compassionate activist. Follow her blog by clicking the link above, and follow her @TheGoodDrNik on Twitter, Instagram, and Facebook. Learn more at http://www.TheGoodDrNik.com

 

ELECTION RESULTS 2016: HOW TO EFFECTIVELY COPE WITH THE WOUNDING WILL OF THE PEOPLE

For so many minorities and those who have always perceived themselves to be on the fringes of American society, the results of the 2016 Presidential election is a big and bitter pill to swallow.  For the vast majority of people of varying colors, those living proudly under the rainbowed flag, and we women who were all ‘with Her,’ it feels like a mortal wound akin to a stake in the heart. For what we have always known about America, what we have sensed and felt and experienced at work, in school and in the shopping malls has now in our minds been confirmed and made public. The schism is real.  The ‘ism’ is real.  Racism and racial hatred is no longer a covert operation.  It’s pretty much out there for all to see and hear.

Given this, how do we deal with the myriad emotions we are struggling to come to grips with?  The fear, the loathing, the disappointment, shock, the hopelessness?  How do we survive in Trumpland?  We go back to basics, and we remember some simple things that have sustained us in tougher times:

  1. Identity: During a time when we are feeling devalued as a people, like we do not fit in and don’t belong and aren’t wanted, Black people living in America must know and celebrate who we are and from whence we come.  We must celebrate all that is us and is unique to us, and help our children to accept and embrace all of what is our cultural contributions to this nation. A trip to the Smithsonian Museum of African American History and Culture, or rather a series of trips, is a wonderful place to begin. It is so important that we set the foundation for our children’s healthy sense of self and self-esteem despite the overt and covert messages to the contrary.
  2. Community: We are a communal people, and we have survived and thrived by sticking together and by having each other’s backs. It’s funny though; seems the more progress we’ve made, the less unity we seem to have. Nevertheless, we need to reflect on our history and get back to basics. Together we enacted great change in this nation. Together we elected the first African American President. Together we have overcome so much, and together we will do it again.  During this difficult time, let’s not isolate or separate but let us remember there is both strength and power in numbers and in unity.  Let’s not simply come together for protests or boycotts (though these can be adaptive ways of dealing with the upset and inequality in our country).  But let’s come together and be proactive. This could be the catalyst to healing some of the internal strife and schisms that exist within.
  3. Conversation: The election results should and hopefully will pave the way for honest conversation; both in this country and in our community. Thoughtful, ope and real conversation about our community, about problems that are seemingly endemic, about the solutions, and about how we will break the cycles of poverty, lack of education, lack of opportunity, and others that continue to plague us.  We gotta be willing to look at the man in the mirror.  Everything aint about the enemy.  Sometimes the enemy is within.
  4. Spirituality: No matter what your spiritual bent, where there is faith in and reliance on God or whatever higher power you subscribe to, there is hope.  This hope is what has gotten us over many a mountain, and it is what we need to cling to now.  As a people, we have clung to this hope when the only thing that could be seen was pure darkness. Out of our faith came an optimism and an unshakeable belief that better would come.  Because of our faith, we knew we would overcome.  And so we did.  And so we will. During these difficult times, lean on your faith. If you don’t have a religious practice or attend a religious service, try attending one as soon as possible. Or try praying, or having a conversation with God or your higher power. Even meditation can be a way of connecting with Spirit. The point is, getting back to the roots of your belief system can be a grounding force and a powerful accelerant for change.
  5. Keep it rolling: We as a people have taken a licking, and kept on ticking.  Its what we do, and a part of who we are archetypically.  While today was a difficult prelude to what might be a new reality, tomorrow will be just another day, and the world will go on. And we will wake up, and we will put on our big girl underwear or panties, and we will keep it moving.  It’s what we do.

I’m learning to appreciate this one thing: in life and business, one should always seek to achieve the win-win situation.  Losing doesn’t have to be an all or none. There is great progress that can be made despite such disappointment, and much good that can come from what is seemingly so bad. Let’s strive for that.  And let’s maintain hope, for hope is ALWAYS here.

Be well,

The Good Dr. Nik

 

Dr. Nicole M. Alford, aka ‘The Good Dr. Nik,’ is a Washington, DC-area based Clinical Psychologist, Life-ologist, blogger, speaker and compassionate activist.  Follow her on Twitter and Facebook @theGoodDrNik and view her website at http://www.TheGoodDrNik.com.