Are You One of Them?

Posted on by TheGoodDrNik

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

Posted on by TheGoodDrNik

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

Posted on by TheGoodDrNik

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.

 

 

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)?

Posted on by TheGoodDrNik
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?

Posted on by TheGoodDrNik

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.