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Somatic Experiencing (SE) Therapy is a holistic approach to healing trauma, emphasizing the mind-body connection and utilizing techniques such as somatic exercises, polyvagal theory, and a focus on nervous system regulation. While SE has shown some promise in treating trauma and stress-related disorders such as anxiety, it's important to approach it with awareness and caution, particularly for individuals with certain psychological conditions. Who Can Benefit from Somatic Experiencing? SE is particularly beneficial for those who have experienced traumatic events resulting in emotional or physical symptoms. This therapy is designed to help process traumatic experiences and alleviate symptoms associated with multiple mental health challenges. The theory is grounded in the belief that trauma gets trapped in the body, and with an expert SE therapist, one can develop an increased awareness and conscious control of internal bodily sensations, aiding in healing trauma and chronic stress​​​​ (Ramirez-Duran, 2023). The Benefits of Somatic Experiencing SE offers several advantages, including: Reduction of tension and stress. Assistance in processing trauma and alleviating depression, addiction, and sexual issues. "Resetting the nervous system" to prevent triggering of trauma memories. Improvement in the mind-body connection and increased emotional resilience. Increased well-being and inner peace​​​​. (Levenson, 2023) The Risks and When to Avoid SE SE is not suitable for everyone. Those experiencing extreme dissociation, intense flashbacks, psychosis or acute psychiatric crises should avoid this form of therapy. It's crucial to consult a mental health provider before starting SE, especially for those with severe histories of trauma. Unfortunately, there are also some poorly trained providers who can contribute to the formation of false memories in vulnerable populations (Levenson, 2023). The Science Behind SE It can be argued that the effectiveness of SE is backed by neuroscience, showing that traumatic experiences leave imprints on the brain and nervous system, affecting both mental and physical health. SE engages the somatic nervous system to promote healing and regulation of emotions. Neuroimaging studies have demonstrated changes in brain activity and connectivity following SE interventions​​ (Inspire Malibu, 2023). Methodological Limitations and Criticisms Despite its benefits, SE faces methodological limitations. The scarcity of published studies and small sample sizes make it challenging to generalize its effectiveness. Furthermore, much of the evidence supporting SE comes from anecdotal experiences and clinical observations rather than rigorous scientific studies​​  (Ramirez-Duran, 2023). Key Techniques in SE SE employs techniques such as titration and pendulation. Titration involves gently and slowly approaching physical sensations related to trauma, while pendulation oscillates between a state of arousal and calm, aiding in the transition to a state of homeostasis without overwhelming the nervous system​​ (Ramirez-Duran, 2023). Conclusion: A Balanced Approach to SE In conclusion, while Somatic Experiencing offers significant benefits in treating trauma and stress disorders, it's essential to approach it carefully. It is not suitable for everyone, and the methodological limitations in research warrant a careful and informed approach. Those interested in SE should consult licensed mental health professionals and consider their individual needs and conditions before trying this therapy approach. Sources: Inspire Malibu. (2023, December 5). Exploring the evidence behind somatic therapy: Is it truly effective? https://www.inspiremalibu.com/blog/mental-health/evidence-behind-somatic-therapy-is-it-truly-effective/ Levenson, J. (2023, June 1). Somatic experiencing: Pros and cons. Online Mental Health Reviews. https://onlinementalhealthreviews.com/somatic-experiencing-pros-and-cons/ Ramirez-Duran, D. (2023, December 26). Somatic experiencing therapy: 10 best exercises & examples. PositivePsychology.com. https://positivepsychology.com/somatic-experiencing/

In a world where success is top priority, the intense pressure to be perfect can become overwhelming. Perfectionism has indeed become a significant aspect of today's society, driven by various cultural, social, and technological factors. It continues to thrive in our ever-changing and constantly progressing society which validates over-working and overachievement. The expectation to perpetually better ourselves coupled with the weight of sustaining a perfectly maintained exterior can quickly become all-consuming. While striving for excellence and setting high standards can be motivating and lead to personal growth, the relentless pursuit of perfectionism can have detrimental effects on one’s well-being. What can perfectionism look like in today’s society? What are the impacts? Let's address some of what influences perfectionism and how it can be a detriment to your well-being. Social Media and Comparison Culture: Social media platforms often present curated and idealized versions of people's lives, fostering an environment where individuals compare themselves to seemingly flawless images and achievements. “Hustle culture” (an intense focus on productivity, ambition, and success, with little regard for rest, self-care, or any sense of work-life balance) comes to mind as a popular phenomenon that may promote harmful patterns of behavior. This constant comparison can fuel perfectionistic tendencies, as people strive to project an image of perfection to gain validation and acceptance. High Expectations and Pressure: Modern society places a strong emphasis on achievement, success, and constant improvement. As a result, individuals may feel compelled to meet impossibly high standards in various areas of life, such as academics, careers, appearance, relationships, and more. The pressure to excel in all these areas can lead to chronic stress, anxiety, and burnout. Fear of Failure and Risk Aversion: Perfectionism often involves an intense fear of failure and a need to avoid making mistakes at all costs. This fear can paralyze individuals, preventing them from taking calculated risks, trying new things, or pursuing creative endeavors. This risk aversion can hinder personal growth, innovation, and the development of new skills. Negative Impact on Mental Health: The constant pursuit of perfectionism can contribute to the development or exacerbation of mental health issues such as anxiety, depression, and eating disorders. The unrelenting pressure to be flawless and the fear of falling short can lead to chronic feelings of inadequacy and self-criticism. Impaired Relationships: Perfectionism can extend to interpersonal relationships, where individuals may set unrealistic expectations for themselves and others. This can strain relationships, as the pursuit of perfection may lead to dissatisfaction, criticism, and an inability to appreciate the strengths and imperfections of oneself and others. Diminished Creativity and Innovation: Perfectionism can stifle creativity and innovation, as individuals may be hesitant to experiment or take risks that might lead to imperfect outcomes. The fear of not meeting high standards can prevent the exploration of new ideas and limit the potential for breakthroughs. Time and Energy Drain: The pursuit of perfection often demands significant time and energy, leading to a preoccupation with details and an overemphasis on minor aspects of tasks or projects. This can detract from the bigger picture and prevent individuals from allocating resources effectively to achieve meaningful goals. Unrealistic Goals and Discontentment: Perfectionism can perpetuate a cycle of setting unattainable goals and experiencing chronic dissatisfaction, as the goalposts of perfection are constantly shifting. This can undermine feelings of accomplishment and contentment, as individuals may never feel they have truly achieved success. How can you identify this in your own life? There are some things you can look for to identify some possibly harmful patterns. Signs That Perfectionism Is Holding You Back: Fear of Failure: Perfectionists often avoid taking risks due to an intense fear of failure. This fear can feel paralyzing—ultimately preventing you from pursuing new opportunities. Procrastination: Striving for perfection can lead to procrastination as the fear of not meeting high standards can make starting a task seem daunting. Harsh Self-Criticism: Perfectionists are often their own harshest critics. Constant self-criticism can erode self-esteem and hinder progress. All-or-Nothing Thinking: Viewing situations in black and white terms can limit your options and prevent you from seeing the nuances and possibilities in between. Burnout and Stress: The relentless pursuit of perfection can lead to burnout, stress, and even physical health issues. If this seems applicable to your own life, it may be worth considering that perfectionism could be keeping you from reaching your goals. Luckily, there are skills you can implement to help manage the negative impacts of perfectionism. Overcoming Perfectionism Challenge Your Inner Critic: Start by becoming aware of your self-critical thoughts. Challenge them by asking yourself if they are based on reality or if they are exaggerated. Set Realistic Goals: Instead of striving for perfection, set achievable and realistic goals. Celebrate small victories along the way. Practice Self-Compassion: Treat yourself with the same kindness and understanding you would offer to a friend. Remember that nobody is perfect. Embrace Mistakes: Mistakes are opportunities for growth. Embrace them as chances to learn and improve. Focus on the Process: Shift your focus from the end result to the process. Enjoy the process and the learning that comes along with it. Seek Support: Consider gaining support from a mental health professional or therapist. Bringing up your concerns in therapy could help to explore the roots of your perfectionism and develop healthy coping strategies. How Therapy Can Help One option to address and manage perfectionism is through therapy. Whether it be individual therapy, group therapy, or even family therapy, individuals can gain insights into the underlying causes of their perfectionistic tendencies and learn strategies to shift their mindset and behaviors. Therapists can provide valuable guidance and support when discussing your concerns and can assist in navigating the challenges of perfectionism. Therapists can also help you develop healthier ways of coping with stress, managing expectations, and setting realistic goals. Taking The Next Step If you're considering therapy for perfectionism, it can be helpful to find a therapist who specializes in this area. From Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), or Radically Open DBT (RO-DBT), determining the right therapy for your personal needs can seem daunting. For this reason, it may be helpful to discuss your specific concerns with a mental health professional who can help guide you in the right direction in determining the type of therapy skills and techniques that may work best for you. A qualified therapist can tailor their approach to your specific needs and help you work towards overcoming perfectionism. Conclusion Recognizing the signs of perfectionism is an important step towards reclaiming your well-being and happiness. Figuring out the balance between success and well-being is key to living a fulfilling life. The journey to overcoming perfectionism involves embracing your imperfections and creating a life filled with authenticity, growth, and joy. By learning to embrace imperfections and cultivate self-compassion, you can unlock your full potential and thrive in both personal and professional spheres. Interested in exploring therapy for managing perfectionistic tendencies? At PSYCHē, we have expert therapists who can assess your individual needs and provide personalized recommendations. Reach out for more information or book a consultation online today. We also offer multiple DBT Skills Groups as well as an RO-DBT Skills Group. Groups are like a class, not therapy. Click the link to enroll in a group today.

Lesson #1: Don’t take anyone’s word for anything as 100% truth…not even mine. Always check in with your Wise Mind. Lesson #2: You know you. You (and only you) know what is best for you and what you can handle. F^*k em if they don’t get it. Some people end up in “difficult” relationships whereas others choose them. Many professionals in the mental health industry would suggest that if you are the latter type, you are probably disturbed. I vividly recall a liability insurance conference I attended years ago in which the speaker chuckled about therapists who would actually CHOOSE to treat Borderline Personality Disorder and how there must be “something wrong with them.” Don’t worry—I made sure to raise my hand in the middle of the room to passive-aggressively #represent, but I was disgusted. This same attitude permeates our industry in other ways. Being in a relationship with a partner who is using drugs or alcohol, for example, is often automatically considered to be “codependent” and evidence of boundary issues, lack of ego strength, or poor “self-esteem” by those in the mental health field. And unless you are doing “self-care” the way that Brene Brown does it, you are just in denial and “self-medicating” by taking care of others (as if that was the worst thing that could happen). My unpopular opinion? There is a subset of people who have a higher threshold for emotional pain— and thankfully they exist to help people with a lower threshold. I am one of those people…as I SHOULD be because I’m a therapist who helps people with THEIR emotional pain. And not only do I CHOOSE this profession of working with highly suicidal and severely depressed/anxious/angry people, but I have been known to choose to stay in personal relationships that some might call “toxic” (I call it “difficult”) because I think there’s something I can learn from it and I care about the person. *GASP * So what’s the difference between a “difficult” vs a “toxic” relationship? A toxic relationship causes damage that is greater than the benefit received from it. A difficult one is just uncomfortable, but not harmful. I think of it like the difference between 2 people sitting in the sun for the same amount of time…one is soaking up the Vitamin D with no ill effects while the other gets burned. Different genetics, different experiences, the same amount of exposure. That’s how it works with relationships—some can take more heat than others. But you’ve gotta be real with yourself about what you can take. If you numb out, you won’t know you’re getting burned. The trick is to check in with how you’re feeling and whether or not you can truly keep going without causing yourself damage. We take our hand away from a stove because it’s hot…we FEEL it. The key is to FEEEEEL the emotions in full. I know when I’ve had enough…for now, at least, and I’ll stop then. But if you find that you are getting depressed, self-harming, anxious, or otherwise symptomatic, you may be kidding yourself about what you can handle. THAT’S when it becomes toxic…both for you and the other person. Because you end up blaming them, you, or both. At the end of the day, you are the only one who knows how long you can and should “swim with the sharks.” Happy diving. ;) —Stephanie Vaughn, Psy.D., Clinical Psychologist-HSP, owner of PSYCHē

Let's talk therapy in Tennessee. Whether it's navigating life changes or tackling anxiety, there are several therapists in Tennessee with specialized expertise in various areas. You can directly connect with specialists offering therapy tailored to your unique situation as well as experts who will pair you with the best therapists in Tennessee. Your options are no longer limited to in-person therapy. In today's digital age, online therapy has become a beneficial option for many Tennesseans. It offers the convenience of engaging with an expert therapist from the comfort of your home – or anywhere you like. Tennessee online therapists who serve the entire state are just a few clicks away. Online therapists can provide high-quality care with a flexible schedule to fit your busy lifestyle. Regardless of where you live in Tennessee, finding an expert therapist in Tennessee perfect for you is possible– especially an online therapist. Whether you are looking for DBT, an anxiety therapist, RO-DBT, or a trauma therapist, there are skilled professionals ready to work with you. Speaking of DBT...If you're searching for a DBT therapist in Tennessee, you're in luck. Dialectical Behavioral Therapy (DBT) is a game-changer for many, especially for those dealing with emotion regulation and distress tolerance issues. At PSYCHē, we have multiple extensively trained online DBT therapists skilled in helping people navigate their own personal concerns and life's struggles. At PSYCHē, finding the right therapist in Tennessee is pretty straightforward, as our online therapists are readily available. Expert therapists licensed in Tennessee are just a click away, offering flexible, high-quality care that fits into your busy schedule. Let PSYCHē pair you with your best Tennessee therapist today! Interested in exploring therapy? Reach out to PSYCHē for more information, learn more about our expert therapists, or book a consultation online today. We also offer multiple DBT Skills Groups as well as an RO-DBT Skills Group. Groups are like a class, not therapy. Click the link to enroll in a group today.

Just in case you needed one more reason to feel like you aren’t keeping up, let us consider whether your “self-care” is up to standard. No???? Wow. Shocking. KNOW WHY? Because getting the “recommended” amount of sleep, water, exercise, “me time,” journaling, vitamins, etc., etc. is abso-freakin-lutely impossible. Wait—sorry, actually, you know who IS able to do self-care 100% on a daily basis? Liars. That’s who. Anyone with a job, kid, friend, patient, dog, significant other, or a family member has, at one time or another, gone without food, sleep, or bathroom breaks because to do otherwise would compromise something or someone that was more important than “self-care.” Sometimes, it is a dream that would die, for others it could be a person. Regardless, the loss or the threat of loss was unacceptable, so “me time” fell to the wayside. For my next #unpopularopinion, let me recommend that mental health professionals stop subtly shaming people for burning the midnight oil. Too many times I’ve worked to clean up the fallout after a well-meaning “holistic workshop” that a surgeon, CEO, or single mother of 4 attended because after returning, they can’t find the time to journal like they “committed to do.” Not only that, but they aren’t able to “access feelings” like they were taught during psychodrama classes so now they think there is something wrong with them. They now have one more thing to feel bad about and more for their to-do list. Therapists need to stop treating everyone the same when it comes to how much traditional “self-care” is recommended. Some people are Warriors and Caregivers, not Sages, Innocents, and Artists. Warriors need a therapist’s help taking off their armor, airing it out, and putting it back on when it’s time for battle, not destroying it entirely. Caregivers need a therapist’s help to avoid martyrdom while finding people to care for; they don’t need them to pathologize their sacrifices. Want 3 “take-homes?” Here they are: 1. Failure to take care of yourself from time to time is completely human and completely normal. It is what differentiates you from a narcissistic psychopath (no offense to either diagnosis, of course). 2. Stop beating yourself up for not taking “self-care time,” it’s not an “all or nothing” thing. A soda at 4pm can be considered “self-care.” 3. And finally, “you do you” because the Sages, Innocents, and Artists will call for the Warriors and Caregivers to fight the battle and heal the wounds. As the saying goes, “it takes all kinds.” Take care ;) —Stephanie Vaughn, Psy.D., Clinical Psychologist-HSP, owner of PSYCHē

Are you struggling with emotional shut-down? Do you find yourself purposefully (and sometimes accidentally!) disconnecting from your emotions? You may be lonely but you are not alone. Many people struggle with recurring patterns of detachment and disconnection that can be difficult to overcome. Radically Open Dialectical Behavior Therapy (RO-DBT) classes teach skills to help you understand what is happening so you can break free from toxic patterns and connect with others. Emotional shut-down, also known as emotional avoidance, is a common defense mechanism many over-controlled individuals use to protect themselves from uncomfortable emotions. The benefit is that it works—but only temporarily. The downside is that this coping strategy can lead to a sense of disconnection (and actual disconnection) from others. RO-DBT Skills Group is an essential part of full RO-DBT and is specifically developed to help those with over-controlled personality styles. It focuses on increasing emotional expressiveness and openness, which can be particularly helpful in preventing emotional shut-down. According to RO-DBT, an over-controlled coping style can result in difficulty trusting others and may lead to a tendency to withdraw from social interactions. Over-controlled individuals may also have difficulty coping with stress and may be prone to depression, anxiety and eating disorders. If you're looking for an RO-DBT Skills Group online, that's where we come in. At PSYCHē, we offer an RO-DBT Skills Group as well as multiple DBT Skills Groups. Groups are like a class, not therapy. Click the link to enroll in a group today. Interested in exploring therapy? At PSYCHē, we have expert therapists who can assess your individual needs and provide personalized recommendations. Reach out for more information or book a consultation online today.

I mean—what even IS a “personality?” That’s my typical comeback when some Psychologist (like myself) gets all triggered when I dare to insinuate that our (Psychologist) career is based on “soft science..." at best. I used to teach a graduate-level class on Personality Theory and that was the first question proposed in the textbook that accompanied the course…something to the effect of: Is there even such a thing as a personality? The answer: We don’t know, but it’s fine. Ignore that. Let’s just operate like there IS such a thing and move on with our lives. [Great.] In the realm of psychological science, of course, there are assumptions we all have to make (such as that there IS such a thing as a “personality”) in order to share a common language. That way, we can identify symptoms, know when something has gone wrong, and then, treat if necessary. But what if a core assumption is incorrect, and let’s say, there is NOT an actual thing called a “personality." Well, then that leaves us with major limitations in our ability to generalize. After all, the conclusions we make are only as valid as the assumptions that underlie them. In other words, the risk of being super wrong about what to do about the problem is super high if we are wrong about the cause. We used to think, for example, that psychological distress was caused by an imbalance of body fluids or that the womb was floating around in the body. That leads to far different treatments (yikes) than the belief that there is an imbalance of neurotransmitters! One of the problems I recognized early in my training was that several of the assumptions we rely on as Clinical Psychologists may be better understood by the arts than the sciences. We cannot see a “personality” through a microscope or other imaging technique, for example, but we do know when someone “has changed” in a person-- even when there is no concrete data to prove it. There is also value in what Neurology brings to the table: A closer relationship to tangible, observable, PROVABLE phenomena such as blood flow and structural differences in the brain. When you combine the art of Psychology with the science of Neurology, you end up with what is, in my opinion, a perfect mix: A Clinical Neuropsychologist 😍. —Stephanie Vaughn, Psy.D., Clinical Psychologist-HSP, owner of PSYCHē

Let’s start with this if you’re not anywhere close to a point where you can consider reconciliation, read no further. The last thing I would want is for my attempt to help to actually be invalidating. So if you have JUST experienced a traumatic incident, it’s probably not the time to listen to this or to read the accompanying blog. However, if you have ANY shred of interest in repairing a relationship, here’s some food for thought: Cutoffs are easy, reconciliation is hard: Sometimes cutting people off is the only thing that makes sense. But in the family therapy world, cutoffs are considered a last resort, to be reserved for cases of abuse. To be frank, you only get a couple of relationship cutoffs before a therapist starts questioning the common denominator—which is you. 😕 Grieve the death of the relationship you wanted so you can participate in the relationship you actually have: Shift the depth of the relationship to reflect the relationship you can stand. At this point, you know who you are and who they are. If you can’t have the relationship you wanted, then consider changing the depth of the relationship to match the relationship you can have. It’s not an “all-or-nothing.” Don’t look at a “shallow” relationship as being inferior. Chances are, you already have some deeper relationships. Be grateful for those but don’t get stuck on the idea that just because someone is “family” you should have a deeper relationship. As I like to say…your mother IS this way. It’s NOT groveling and apologies: In fact, you don’t necessarily need to apologize for anything, particularly if you don’t believe you did anything against your values. I’m don’t believe in forcing “sorry—”even for kids. Sometimes, reconciliation involves setting your boundaries, expressing what you want the other person to change, and even sharing the pissed off feelings you have. If you just can’t imagine reconciling, it may be because you are thinking that you just have to act like something didn’t happen. Not so. In some circumstances, it’s absolutely vital that you confront a person in order to reconcile with them. Keep it diplomatic, remember your validation skills, and assertively say what you need to say without blaming or labeling them and you may find it’s enough for you to let it go. Fear of “Starting Something”: This could be just your own avoidance tendencies and wanting to look more laid back than you actually are, but in the case that seeking reconciliation might lead to confrontation, remember this: One of the greatest things about being an adult is that you can always get up and leave. You don’t have to listen to ANYTHING or be subjected to ANYTHING that you don’t choose to. That is, unless you are arrested or otherwise detained involuntarily :) It’s ok to set limits and to remove yourself from the conversation if need be. Be sure you drove separately. Getting “rejected” isn’t the end of the world: If your biggest concern is that the other person will blame you or will otherwise reject your attempt to reconcile, it boils down to your fragile ego. Sorry—it’s my job to tell it. The best way to strengthen it? Do it BECAUSE it will be uncomfortable. There’s a big difference between something that’s just uncomfortable and something that is harmful. Know the difference. Remember who you are before you go into the conversation so you don’t get inflamed if and when they say something ludicrous. Other people have the right to be wrong. The person you are attempting to reconcile with is going through their own process and battling their own fears. Don’t take it personally and don’t let them tell you who you are. Breathe and let it go right through you. Finally, reconciliation may not be a one time thing. In romantic relationships, it can happen repeatedly. Just remember, the one who attempts to reconcile first is the winner ;) Good luck. —Stephanie Vaughn, Psy.D., Clinical Psychologist-HSP, owner of PSYCHē

When it comes to therapy and counseling, it can be challenging to know where to start. With so many different options available, it can be difficult to determine which type of therapy is right for you and how to find the right therapist. Whether you're seeking therapy for yourself, your child, or your family, it's important to understand the different types of therapy services available and how they can help you. Online therapy and virtual therapy have become increasingly popular in recent years, particularly with the advent of the COVID-19 pandemic. These types of therapy allow you to receive counseling from the comfort of your own home, using video conferencing technology. Online therapy can be a great option for those who live in remote areas or for those who have difficulty leaving their homes. If you're experiencing relationship issues, couples therapy, parent coaching, or family therapy may be the right choice for you. These types of therapy and coaching focus on improving communication, changing behavior, and resolving conflicts within relationships. They can also help families navigate difficult situations, such as the loss of a loved one or a child's behavioral problems. Anxiety therapy and depression therapy are designed to help individuals who are struggling with mental health issues. These types of therapy can help you understand and manage emotions, reduce symptoms of anxiety and depression, and improve overall mental well-being. Adolescent therapy and teen therapy are specialized forms of therapy designed to help young people navigate the unique challenges of growing up. These types of therapy can help teens develop healthy coping mechanisms, improve their social skills, and build self-esteem. When searching for a therapist or counselor, it's important to find someone who is licensed and qualified to provide therapy services. Look for a therapist or counselor who has a Master's degree or higher in psychology or a related field, and who is licensed by your state's professional licensing board. They should be able to answer specific questions about the model of psychotherapy you are seeking. If you're looking for therapy services in your area, you can use the keyword "therapy near me" to find local providers. You can also search for therapy services in your city or state to find providers who specialize in the type of therapy you're interested in. In conclusion, when it comes to therapy and counseling, it can be overwhelming to navigate through the plethora of options. But why waste your time searching through countless therapists when you can trust the experts at PSYCHē to pair you with YOUR perfect therapist? Whether you're looking for couples therapy, family therapy, teen therapy, anxiety therapy, depression therapy, online therapy or virtual therapy, PSYCHē's team of experts understand the importance of finding the right therapy match to achieve your goals. Don't waste any more time searching, let us take the burden off your shoulders and expertly pair you with the perfect therapist for you. Reach out to PSYCHē for more information, learn more about our expert therapists, or book a consultation online today. We also offer multiple DBT Skills Groups as well as an RO-DBT Skills Group. Groups are like a class, not therapy. Click the link to enroll in a group today.

Apparently, September is “Suicide Prevention” month and since it’s the end of the month and no one has said it, it looks like I will have to be the bad guy. As a DBT therapist for 12+ years, I have worked with multiple people with chronic suicidal urges, people who have attempted to cause their own death on several occasions, and those who have lost people to suicide. I teach licensed therapists all over the country how to use DBT to help clients who want to end their life and I supervise therapists-in-training in working with people who are suicidal. In short, I think my opinion might be worth sharing. It is the word “prevention” that I have a problem with. Here’s why: It suggests there is a way to 100% stop people from committing suicide. There is not. People kill themselves in inpatient units while on suicide watch. Here’s the truth: If someone has the intent to kill themselves and you stop them this morning, that does not guarantee anything about this afternoon. Free will is a bitch sometimes. It suggests that stopping people from killing themselves is good enough. It is not. People who are suicidal do not have a life they feel is currently worth living….to end life is their solution. It is necessary for them to believe there are other solutions to the problem(s) and to believe that “a life worth living” is even possible. Just because you chain someone up to keep them from hurting themselves doesn’t make you a hero. It is super authoritative and implies doing away with human autonomy … as they might just lock you up to keep you from offing yourself. Oh, wait, yeah, there’s that whole “involuntary commitment” thing. Wow—super helpful. No suicidal person is willing to open up to a provider whose only goal is to “prevent” suicide unless they are ok with ending up in the hospital. So people tend to avoid therapy… or lie. The belief that with the right interventions, suicide can be prevented is why soooo many mental health providers actually Will. Not. Treat. Suicidal. People. Did you know that??? Ohhh, yes. Many, many… Why? Because they are absolutely terrified of being held responsible if a patient kills themselves. Just attend one of my trainings and listen to the therapists ask questions about “liability.” It’s heartbreaking and semi-disgusting to me that professionals refuse to help those most in need because they are afraid of getting sued. It is the perpetuation of this myth that contributes to adolescents (and adults) staying up all hours of the night worrying about how to “save” ex-boyfriends, girlfriends, friends, acquaintances, and random people on the internet who post suicidal messages. You cannot “save” anyone. It is this belief that leads family members, friends, therapists, co-workers, neighbors, and anyone who might have crossed paths with a person who killed themselves to blame themselves, get depressed, and potentially even become suicidal. The thinking goes something like this, “If only I had…,” “I should have…,” “Maybe if I would have….,” If this is you, and no one has ever told you that you weren’t responsible, let me be the first: I am so sorry for your loss… you are not responsible for that person’s suicide. It suggests that suicide is BAD and “not suicide” is GOOD. Must be nice to be so certain of matters of life and death for people you don’t even know. Personally, I think global conclusions like this are insulting. Everyone has the right to decide what is GOOD and BAD for them. As a DBT clinician, it’s true that I will insist that clients “take suicide off the table as an option” for a specific period of time, but that’s not because of judgments about good and bad, it’s because, as the DBT founder, Marsha Linehan, Ph.D. says, “we can’t do treatment if you are dead.” To sum up, while it is a great thing to try to help suicidal folks, we need to remember that free will exists. We cannot fully control the actions of another person, nor in my opinion should we, because we are NOT the experts on anyone but ourselves. We can offer to help, but we cannot “save” anyone. We are just not that powerful. —Stephanie Vaughn, Psy.D., Clinical Psychologist-HSP, owner of PSYCHē

“Helping” someone involves doing (or not doing) something which improves the final outcome of a problem for another person. “Enabling” is any behavior that looks like help on the surface, but actually makes the problem worse in the long term. I really think so much of it ends up boiling down to this: Are you doing it for THEM or for YOU? On the surface, that may seem like a stupid question, “I’m doing it for them, of course!” But I challenge you to check again. Are you doing what you’re doing because you feel guilty? WHO feels guilty? You. Are you doing it because you don’t want to appear like you don’t care? WHO doesn’t want to be seen as not caring? You. Are you doing it because you just need some peace? Or because you are afraid of their response? Once again…you and YOU. Not that there’s anything wrong with doing things for yourself, it’s just important to recognize the difference between helping someone and doing something because it’s helping you feel better. Something that helps YOU feel better may or may not truly help the other person. In fact, it may even make the problem worse. Some mistakenly believe their enabling is “helping” because they misread the meaning of the other person’s reaction: Because the receiver expresses appreciation, seems happier (at least briefly), and/or appears to have a more positive view of them, the “helper” concludes that they MUST have helped. That is a mistake in logic. If therapists judged the effectiveness of their interventions in the same way, we would only tell patients things that they want to hear! Not exactly “therapy.” If you’re wondering whether you might be enabling, here are some important questions to ask yourself: Is the problem getting better, worse, or staying the same overall? How would the “help” I’m giving be perceived by others? Can I even tell them what I’m doing without feeling defensive? What is the likelihood that what I’m doing will make it harder in the long-run for the person to change? How much is what I’m doing actually for ME versus THEM? What am I getting out of it? Am I trading short-term relief for long-term problems? What underlying message(s) might this send? Am I communicating things I don’t believe or would never admit to? Am I getting resentful (or at risk of getting resentful) because of my efforts? Have other people (such as family, friends, or professionals) said that I’m making the problem worse? Am I doing this out of fear, guilt, anger, or other strong emotions? What is the WORST thing that could happen if I don’t do this? Am I believing that I would be responsible for that? The truth is, because actual help can be uncomfortable, you can’t always know immediately if what you’re doing is beneficial to the other person. If you stop enabling, don’t be surprised if the person you thought you were helping gets upset…and definitely don’t take that as a sign that what you’re doing is wrong. If you decide you want to provide “help” instead, start by taking a step back to “look at the forest” rather than just the trees. what makes sense, not just what alleviates discomfort for you, and get some advice from someone who can be objective and who isn’t afraid to challenge you. Good luck! —Stephanie Vaughn, Psy.D., Clinical Psychologist-HSP, owner of PSYCHē

I rolled my eyes as I scrolled past yet another one of those patronizing posts on Instagram from a therapy practice. You’ve seen something similar, I’m sure. There’s usually a mountain or some other form of nature background along with a silhouette of a person you are supposed to identify with who may or may not appear to be in some form of pain…or maybe they are leaping or climbing on something? This particular post indicated that it was “proud” of me and implied that, because of this, I had accomplished enough for the day. My first thought: “f^^^^^^*k youuuuuu.” Why so bitter, you ask? Don’t even get me started. Anyone who knows me knows that I am anti “ woo-woo” therapy marketing. [As an aside, I DARE you to try to find an online template for anything related to mental health that is not nature or Buddha related.] So here’s the thing…I’m not irritated because I don’t “believe in the woo-woo” therapy techniques. Believe it or not, I actually use (almost) alllll of the same stuff in therapy with my own clients (breath work, guided visualization, “inner child” work, positive thinking, nature, lovingkindness, meditation, etc.). We do what works. We don’t care what it is that works. We just do it. The problem is, there are a ton of people who think those sorts of things are weird and won’t help. They CERTAINLY don’t want or need anyone to say they are “proud” of them and thus, they conclude that therapy isn’t for them. That’s why I get angry. I can’t help people if I can’t get even them through the door because they think all therapy is “woo-woo.” Most of the men I treat, and many of the women, HATE being associated with that kind of thing, so they were pretty desperate to consider therapy in the first place. They ended up with us mainly because our message was different. It seemed to fit them better. More “practical.” Less “touchy feely.” It gets them in the door. Then, the drum circle is something we work up to. Just kidding on that last bit. The mental health industry has this whole schtick now about erasing the stigma (of having a mental illness, of seeking mental health treatment, etc.) but we clearly aren’t the brightest crayons in the box about how to actually go about doing so. This whole branding thing is pretty new to us all since historically, we were discouraged from even marketing at all. In my #notsopopularopinion therapy practices need to take a look at how their message accidentally perpetuates the very stigma they are trying to erase because they aren’t appealing to different personalities. The PSYCHē brand appeals to men, cynics, workaholics, people who are skeptical of therapy, and those who pride themselves on being hardcore-badass-tough types. 90% of other therapy brands appear to be aimed at boho women in their late 20’s-early 30s. Unless it involves substance abuse treatment which seems a little more diverse, although there is DEFINITELY a sunshine and/or a plant somewhere on that webpage. In short, some therapists could stand to diversify and re-brand so people can be more confident there could be a model of therapy and a style that fits them and that don’t have to be embarrassed to be a part of. The fact is, some people aren’t coming to the party because the party looks… CRINGY. —Stephanie Vaughn, Psy.D., Clinical Psychologist-HSP, owner of PSYCHē