Consejeria de Parejas: Cuándo, Dónde y Cómo

Las relaciones son difíciles, pero a menudo esperamos que sean el tipo de historias de amor que vemos en las novelas, películas o que escuchamos en canciones de amor. Cuando nuestra relación no está a la altura, nos decepcionamos y, a menudo, nos damos por vencidos sin realmente intentar formar una buena relacion con expectativas mas realistas. Muchos llegan a pensar que cometieron un error al elegir a su pareja y sienten que si la relación realmente fuera a funcionar, no sería tan difícil. Algunos se obligan a hacer que la relación "funcione" debido a los valores culturales, religiosos o familiares y las presiones sociales y permanecen en una relación infeliz, sobreviviendo y sintiéndose atrapados, para evitar el ser juzgados por los demas o sentirse como un fracaso.

La realidad es que la mayoría de nosotros no crecimos aprendiendo a formar relaciones saludables y tenemos un concepto limitado de que las relaciones son buenas o malas. Sin embargo, hay algunas cosas que podemos hacer para mejorar nuestras habilidades de relación y hacer nuestra parte para convertirnos en la mejor pareja posible.

Primero, debemos reconocer nuestra responsabilidad y no quedarnos estancados culpando de todo a nuestra pareja, incluso aun cuando parezca que nuestra pareja tiene el problema. Lo más probable es que la pareja esté protestando con sus palabras o acciones sobre algo que podemos o no estar haciendo de manera inconsciente que los hace sentir inseguros o desconectados en la relación.

Segundo, debemos entender el problema. Si se trata de algo que está fuera de nuestro control solucionar, como si es algo que hizo otra persona, nuestra pareja puede estar simplemente buscando que reconozcamos y validemos su experiencia. Si se trata de un comportamiento que hacemos o no, o de establecer un límite con alguien que no parece respetar la relación o a nuestra pareja, entonces nuestra pareja puede necesitar tomemos acción para remediar la situacion, y requiere que trabajemos para crear un cambio.

Tercero, debemos sentir curiosidad y descubrir cuál piensa nuestra pareja que es la mejor solución. Si la pareja tiene una solución que requiere que ambos hagamos algo para encontrarnos a mitad del camino y parece justo, entonces puede que tengamos suerte y el problema puede no haber sido tan grande después de todo. O tal vez, puede implicar que solamente tu hagas algo que te parezca razonable, porque si fuera al revés, querrías eso de tu pareja... en este caso, también tienes suerte. Debes asegurarte de identificar tus propias opciones de solución antes de acercarte a tu pareja para que tu pareja no sienta que le estás pidiendo que haga todo el trabajo en la relación.

Cuando la comunicación en la relación se vuelve demasiado complicada o nos sentimos desconectados y parece que nada funciona, esto es cuando se necesita ayuda profesional si deseas salvar la relación. Las parejas que experimentan una falla importante en la comunicación o alcanzan un estado de desconexión constante probablemente crearon una crisis por haber evitado enfrentar una serie de problemas que se fueron acumulando. A veces esto sucede cuando una pareja sufre de ansiedad, depresión o no se siente emocionalmente estable debido a haber experimentado un evento traumático o la pérdida de alguien o algo significativo; en estos casos, la consejeria de pareja puede ser realmente útil para la pareja que necesita aprender cómo pedir ayuda y separar su lucha interna de la realidad de la relación y para que la otra pareja tenga apoyo para saber como apoyar a su pareja.

NOTA IMPORTANTE: Las parejas que han experimentado violencia o amenazas de violencia en la relación no se consideran apropiadas para recibir consejeria de pareja. La consejeria de pareja requiere un cierto nivel de seguridad emocional para que ambos expresen abiertamente sus pensamientos y emociones sobre la relación sin correr el riesgo de sufrir daños físicos, psicológicos o emocionales. En estos casos, primero se recomienda consejeria individual para ambos. En algunos casos, el consejero aceptará trabajar con una pareja solo si cada persona tiene un consejero individual, la pareja violenta reconoce su problema y está motivado a cambiar y ambas personas acuerdan firmar un contrato de no violencia y un plan de seguridad.

COSAS A TENER EN CUENTA

EN LA BUSQUEDA DE CONSEJERIA DE PAREJAS

• CONFIDENCIALIDAD: Los consejeros que tienen licencia o trabajan bajo la licencia de un supervisor clínico están regulados por la junta de gobierno de su estado y entre las reglas legales y éticas que deben seguir, la confidencialidad es una de ellas. Las excepciones a la confidencialidad (situaciones en las que un consejero tiene que romper la confidencialidad y notificar a las autoridades) incluyen situaciones en las que el cliente es peligroso para sí mismo u otra persona o casos de sospecha de abuso o negligencia infantil, o abuso de un adulto dependiente con una discapacidad o mayor de 65 años de edad.

• COMPETENCIA CULTURAL: Siempre es mejor trabajar con un consejero que entienda nuestro trasfondo cultural. Esto no significa que trabajar con alguien que no es parte de tu cultura esté mal. Solo quieres asegurarte de que entiendan tu cultura, porque esto sí importa. Para asegurarte de que un consejero entienda tu cultura, si no son de tu mismo origen étnico o cultural, puedes pedirle que compartan lo que saben sobre tu cultura y lo que han hecho para educarse.

• CAPACITACIÓN Y CALIFICACIONES: Trabajar con parejas y relaciones es una especialización y la mayoría de los consejeros son requeridos solamente completar un curso en su programa de posgrado en este tema, lo cual no es suficiente. Aunque es cierto que hay algunos consejeros altamente calificados sin capacitación especializada, siempre que sea posible, debes asegurarte de que tu consejero tenga capacitación especializada para trabajar con parejas. No te detengas en hacer preguntas sobre la capacitación de un consejero.

• CENTROS COMUNITARIOS DE CONSEJERÍA: La mayoría de las comunidades tienen al menos un centro local de consejeria comunitaria que generalmente no rechaza a las personas por no poder pagar. Por lo general, son centros de capacitación para asesorar a estudiantes que trabajan bajo la licencia de un supervisor clínico. Los estudiantes están ansiosos por aprender y ayudar a sus clientes, no te apresures a pensar que no recibirás servicios de calidad en un centro de consejeria comunitario. La mayoría de estos centros son financiados por subvenciones gubernamentales y donaciones privadas, por lo que sus servicios suelen ser más accesibles financieramente y algunos proporcionarán servicios gratuitos si calificas. Para encontrar el centro de consejeria comunitario más cercano, puedes llamar al 211 o visitar el sitio web AQUÍ.

• CONSEJEROS DE PRÁCTICA PRIVADA: Estos consejeros a menudo trabajan de manera independiente o como empleados de otro practicantes independientes. A menudo, aquí es donde encontrarás los consejeros con más experiencia y capacitación especializada. Puedes encontrar estos consejeros en diferentes directorios haciendo una simple búsqueda en Google. Algunos trabajan con las companias de seguro medico, otros solo proporcionarán un recibo para que puedas solicitar el reembolso con tu compañía de seguros y otros solo trabajarán con clientes paga privados; algunos también tendrán espacios de tarifas bajas disponibles, por lo que se te recomienda te asegúres de preguntar sobre esto.

• SEGURO MÉDICO: La mayoría de las compañías de seguros no cubren las sesiones de consejeria de la pareja a menos que se consideren "una necesidad médica" para alguno de los individuos dentro de la pareja. Lo que significa que esta persona debe cumplir con los criterios para recibir un diagnóstico clínico de una condicion de salud mental. Si tu o tu pareja padecen de ansiedad o depresión o cualquier otro problema de salud mental, pueden ser elegible para esto.

PASOS PARA CONECTARSE CON UN CONSEJERO DE PAREJA

1. EXPLORA TUS OPCIONES: ¿Usar tu seguro médico es una opción? Si es así, puedes pedirles que te den referencias. Si presentar una solicitud de reembolso es una opción, tendrás más flexibilidad para elegir un consejero, averigüa si tu plan de seguro reembolsa a proveedores fuera de la red, el porcentaje que de reembolso que cubre tu plan y los pasos que debes seguir para presentar una solicitud. De lo contrario, considera identificar un par de centros de consejeria comunitarios y un par de consejeros de práctica privada para ver qué se adapta mejor a tu situación.

2. PREPÁRETE PARA CONECTARTE: Identifica una lista de preguntas que puedas considerar importantes cuando hables con posibles consejeros (Ejemplo: Pregunta sobre la disponibilidad, frecuencia, duración esperada del tratamiento, tarifas, duración de la sesión, política de cancelación, etc.)

3. CONECTATE: Los Centros de Consejería Comunitaria pueden o no ofrecer la opción de que te conectes con un consejero directamente por telefono antes de tu primer cita, si esto es importante para ti, solicita hablar con el consejero. La mayoría de los consejeros de práctica privada ofrecen consultas telefónicas gratuitas donde puedes hacerles preguntas y tener una mejor idea si pueden ayudarte o no. Asegúrate de llamar y hablar con al menos un par de consejeros.

4. HAZ TU ELECCIÓN: No tiene nada de malo decidir que el consejero no es el adecuado para ti despues de tu primer cita. Es importante que tanto tu pareja como tu se sientan lo suficientemente cómodos con el consejero para poder hacer el trabajo importante. Los consejeros sabemos que no siempre funciona y siempre estamos listos para ofrecer referencias de otros colegas de confianza que creemos podrian resultar una mejor opcion.

5. AJUSTA TUS EXPECTATIVAS: Si esperaS que el consejero “arregle” a tu pareja, ya te haz encargado de que la experiencia resulte una decepción. Los consejeros de pareja están ahí para cuidar tu relación, no para tomar partes. Están allí para mostrarles cómo comunicarse de manera más efectiva, para ayudarlos a identificar qué cosas se interponen en el camino y apoyarlos a ti y a tu pareja para que aprendan a trabajar juntos una vez más. Esto requerirá trabajo tanto de tu parte como de tu pareja.

Couple's Counseling: When, Where, How

Relationships are hard, yet we often expect them to be the kind of love stories we see on television, movies or hear about in love songs. When our relationship doesn’t measure up we are disappointed and often give up without really trying. We find ourselves thinking we made a mistake in choosing our partner and feel if the relationship was truly meant to be it wouldn’t be so hard. Some force themselves to make the relationship “work” because of cultural, religious or family values and social pressures and stay in an unhappy relationship, surviving and feeling trapped, to avoid judgment or feeling like a failure for it.

The reality is most of us didn’t grow up being taught how to form healthy relationships and we have a limited concept that relationships are either good or bad. However, there are a few things we can do to improve our relationship skills and do our part in becoming the best partner we can possibly be.

First, we must recognize our responsibility and not get caught up blaming it all on our partner, even when it appears our partner is the one with the problem. Chances are that our partner is protesting with their words or actions about something we may or may not be doing that is making them feel insecure or disconnected in the relationship.

Second, we must understand the problem. If it involves something that is out of our control to fix, like something someone else did, our partner may just be looking for us to acknowledge and validate their experience. If it involves a behavior we do or don’t do or setting a boundary with someone who doesn’t seem to respect the relationship or our partner, then our partner may be needing active reassurance, which may require us to work on making a change or taking some sort of action.

Third, we must get curious and find out what our partner thinks the best solution is. If our partner has a solution that requires both of us to do something to meet each other half-way and it seems fair, then you may be in luck and the issue may not have been that bad after all. Or perhaps, it may involve you doing something that seems reasonable to you, because if it were the other way around you’d want that from your partner… in this case you’re also in luck. You also want to make sure to come up with your own solution options before approaching your partner so your partner won’t feel like you’re asking them to do all the work in the relationship.

When the communication in the relationship becomes too complicated or we feel disconnected and nothing seems to work, this is when professional help is necessary if you want to save the relationship. Couples who experience a major break down in communication or reach a state of constant disconnection in the relationship may have allowed too many issues in the relationship to go unaddressed and this created a crisis. Sometimes this happens when one partner suffers with anxiety, depression or doesn’t feel emotionally stable due to having experienced a traumatic event or the loss of someone or something significant; in these cases couple’s counseling can be really helpful for the partner in need to know how to ask for support and separate their struggle from the reality of the relationship and for the other partner to have support in supporting their struggling partner.

IMPORTANT NOTE: Couples who have experienced violence or threats of violence in the relationship are not considered appropriate to receive couple’s counseling. Couple’s counseling requires a certain level of emotional safety in order for partners to openly express their thoughts and emotions about their partner and the relationship without running the risk of being hurt physically, psychologically or emotionally. In these cases, individual counseling for both partners is recommended first. In some cases, a couple’s counselor will agree to work with a couple only if they each have an individual counselor, the violent partner recognizes their problem and is motivated to change it and both partners agree to sign a no-violence contract and safety plan.

THINGS TO CONSIDER IN FINDING COUPLE’S COUNSELING

• CONFIDENTIALITY: Counselors who are licensed or working under the license of a clinical supervisor are regulated by their state’s governing board and among the legal and ethical rules they must follow, confidentiality is one of them. The exceptions to confidentiality (situations where a counselor has to break confidentiality and notify authorities) include situations where the client is danger to themselves or another or cases where child abuse or neglect, or abuse of a dependent adult with a disability or over the age of 65 is suspected.

• CULTURAL COMPETENCE: It is always best to work with a counselor who understands our cultural background. This doesn’t mean that working with someone who is not part of your culture is wrong. You just want to make sure they understand your culture, because this does matter. In order to make sure a counselor understands your culture, if they are not of your same ethnic or cultural background, you may ask them to share with you what they know about your culture and what they’ve done to educate themselves.

• TRAINING & QUALIFICATIONS: Working with couples and relationships is a specialization and most counselors are only required to complete one course in their graduate program on this subject, which is not enough. While it is true there are some highly skilled counselors without specialized training, whenever possible, you want to make sure your counselor has specialized training in working with couples. It’s okay to ask questions about a counselor’s training.

• COMMUNITY COUNSELING CENTERS: Most communities have at least one local community counseling center that typically doesn’t turn people away for inability to pay. These are usually training centers for counseling students working under the license of a clinical supervisor. Students are eager to learn and help their clients, don’t be quick to think you will not get quality services at a community counseling center. Most of these are funded by government grants and private donations so their services are typically more affordable and some will provide services for free if you qualify. To find your closest community counseling center you may call 211 or visit their website HERE.

• PRIVATE PRACTICE CLINICIANS: These clinicians are often working independently or as an employee for another clinician. Often, this is where you will find the most experienced counselors with specialized training. You can find these counselors listed on different directories by doing a simple google search. Some may work with insurance, others will only provide you a receipt so that you may file for reimbursement with your insurance company and others will only work with private pay clients—some will also have a few low fee slots available, so you want to make sure to ask about this.

• MEDICAL INSURANCE: Most insurance companies do not cover couple’s counseling sessions unless these are considered “a medical necessity” for one of the partners. Which means one partner needs to meet criteria to receive a clinical diagnosis for a mental health condition. If you or your partner are experiencing anxiety or depression or any other mental health concern you may be eligible for this.

STEPS TO CONNECT WITH A COUPLE’S COUNSELOR

1. EXPLORE YOUR OPTIONS: Is using your medical insurance an option? If so, you can ask them to give you referrals. If filing a claim for reimbursement is an option, you will have more flexibility in choosing a counselor, find out if your insurance plan reimburses for out-of-network providers, the reimbursement rate and the steps you’d have to take to file a claim. Otherwise, consider identifying a couple community counseling centers and a couple private practice counselors to see what’s a better fit for your situation.

2. PREPARE TO REACH OUT: Identify a list of questions you may consider important when speaking to potential counselors (i.e. availability, frequency, expected duration of treatment, fees, length of session, cancellation policy, etc.)

3. REACH OUT: Community Counseling Centers may or may not offer the option of you connecting with a counselor before you get to meet with them for the first time, if this is important for you, make the request to speak with the counselor you’d be working with. Most private practice counselors offer free phone consultations where you can ask question and find out if they are a good fit for you and where they can get a sense of whether or not they can help you. Make sure you call around and speak to at least a couple counselors.

4. MAKE YOUR PICK: It’s okay to schedule an appointment and decide the counselor is not a good fit. It is important both your partner and you feel comfortable enough with the counselor in order to get to do the important work. Counselors know it doesn’t always work out and we’re always ready to offer referrals of other trusted colleagues that we think you may find a better fit.

5. CHECK YOUR EXPECTATIONS: If you are expecting the counselor will “fix” your partner, already you have set yourself up for disappointment. Couple’s counselors are there to look out for your relationship, not to take sides or fix partners. They are there to show you how to communicate more effectively, to help you identify what things get in the way and support you and your partner at learning to work together once again. This will require work from both you and your partner.

"My Partner was Abused" A Guide On How To Support A Partner

By: Maritza Plascencia, M.A., Licensed Marriage & Family Therapist

Was your partner physically, psychologically, emotionally, or sexually abused?  Did your partner grow up in a dysfunctional home where s/he was neglected or witnessed domestic violence?  No matter at what point in their life you partner may have been hurt, the reality is that if they have not been able to experience healing from their traumatic experiences, these are more likely than not coloring their experience in the relationship they have with you.  The best thing we can do to support a partner is to be patient and educate ourselves in order to team up with them on their healing journey.

In my work with couples where one or both partners has experienced some form of abuse in their lifetime, I have witnessed that most healing happens when both partners are able to be open and vulnerable on a deep emotional level, as this creates a sense of deep connection between them.  Once this is achieved, the very thing that used to get in the way of that intimate connection, becomes the force that drives the connection.  One of the crucial things we must all understand when dealing with a partner's trauma is that a traumatic experience always changes and impacts the nervous system.  This means that until that person is able to have enough corrective experiences where the sense of emotional safety is reestablished, then and only then will their brain change again, for the better.  An intimate relationship with a partner is the kind of relationship that perhaps has the most potential to help any individual heal and simultaneously the kind of relationship with the highest potential for triggers.  In this partnership, both individuals possess the same opportunity to create emotional safety for the other.  Below are a few tips you may find helpful in doing so.

BE OPEN: We all know it takes time to feel comfortable in being open and deeply honest with a partner.  Also, depending on our background and the environment we were brought up in our definition of "openness" may vary.  For example, I may have been brought up in a home where it was okay to admit to really uncomfortable feelings or thoughts and this may be what I am working towards in recreating with my partner.  My partner may have had the opposite experience, where being open in the same way was perhaps perceived as being disrespectful, inconsiderate and/or selfish.  In this type of situation, we must lead by example and be patient as ultimately we must aim for creating a relationship where we are able to tolerate exposing our partner to the depth (darkness and light alike) that we carry within; if what we want is to convey emotional safety to our partner. If the opposite is true, if we are the ones who grew up with a negative connotation of “openness,” then we must know it is never too late to begin making changes that can make the relationship with our partner a safer and more deeply connected one.

A few simple steps to begin practicing this openness:

1. Share something personal with your partner (you can start with something easy)

2. Describe how you feel about it

3. Explore the ways in which this thing or situation impacts the way you see yourself and the messages it creates about who you are (share this with your partner as well, it’ll deepen the conversation)

4. Practice in-the-moment awareness and talk about what sharing this feels like

5. Be curious about how your partner feels or what s/he thinks about what you’ve just shared

6. Repeat (as you continue practicing, you may want to begin sharing things that are slightly more difficult for you and progressively work up to something you never thought would be possible to share)

Most people who have been hurt in severe and traumatic ways are able to recognize when another person is being painfully vulnerable with them, as they tend to be very familiar with their own pain and vulnerability.  Which is why having a partner that is able to meet them at that level can be such a relief as they may finally and for the first time (in some cases) feel like there is someone who truly sees them. Feeling seen and understood by a partner can bring so much healing to any trauma survivor.

COMMUNICATE FROM WITHIN:  In the United States, a country where culturally we place great value on the individual and "being yourself" or "being the best" we have been set up to think of ourselves and our needs first, sometimes without much regard for those we are in a relationship with.  We become conditioned to communicate in reaction to what is outside of us, in order to guard what we carry within; therefore, making us be more connected and aware of all that is in our outer world and numb or disconnected to that which we carry within--a reason most relationships that fail, do so.

To communicate from within means:

1. To take time to analyze what we are feeling and thinking in any given situation, before reacting

2. To recognize the ways the situation at hand may be triggering us based on past experiences

3. To have the ability to separate what belongs to us from that which does not

4. To respond to the situation at hand rather than impulsively react

5. To communicate in an authentic and honest way, putting the intention forward of contributing in a productive manner rather than looking to compete in order to win

6. To approach with compassion and really strive to do so from a non-judgmental position

7. To focus on listening as much, if not more, than on being heard

RESPECT BOUNDARIES: When someone has experienced abuse or in other words been violated in any way by another human being, the sense of boundaries may be thrown off. Think about it this way, every time that anyone experiences someone making them feel disrespected or act in a way that has no regard for their needs or boundaries (emotional, physical or otherwise) the experience often gets internalized as a sense of helplessness and disempowerment. As time goes on, following the traumatic event, there may be other experiences that even if on their own are not acts of abuse or traumatic, they nonetheless reinforce the sense of helplessness and disempowerment, which for many trauma survivors may translate into ambivalence about setting boundaries. Any trauma survivor in a healthy and safe relationship is more likely to progress in their healing and regain a sense of control over themselves. A supportive partner makes a good ally for emotional and psychological healing.

Respecting your partner’s boundaries can be more simple than you think:

1. Validate your partner’s boundaries when you notice your partner setting them, even if you don’t agree with or understand those boundaries; it’s important to support your partner’s efforts in setting boundaries

2. Model good boundaries to your partner, speaking up for yourself and setting boundaries with your partner or with others for your partner to see can be a good way to help your partner have some sense of what good boundaries are

3. Encourage your partner to speak-up when they feel uncomfortable in a situation with you as this creates safe opportunities for your partner to practice and gain confidence in setting boundaries

4. Remind your partner about their boundaries if you notice they are forgetting they have the right to set them, especially when you notice they seem uncomfortable around any given situation; sometimes it can be as simple as reminding a partner to speak-up if they don’t agree in going to a specific restaurant for dinner

5. Celebrate your partner’s ability to use boundaries whenever you notice them doing so, this can further validate and help your partner in gaining confidence in trusting themselves to know when to set boundaries

HAVE REALISTIC EXPECTATIONS: Awareness, time, patience, effort and a good support system are what it takes for any of us to heal from past traumas. Over time you’ll begin to notice subtle changes in your partner; this can be weeks, months or years, everyone heals differently. For example, you may notice your partner no longer cries every time they talk about what happened. Perhaps they no longer get triggered like they used to or maybe they are able to work through their triggers in a shorter period of time. Some people may find it very helpful to seek professional support in dealing with this process of healing; if your partner is receiving individual counseling you may want to ask if they’d be comfortable in requesting to have you join one or two sessions in order for their therapist to help you understand how to better support your partner’s healing process (a lot of people don’t know this is something they can request). Be patient if your partner is not ready for taking this step, it may be that they are still not feeling fully emotionally safe with their therapist or feeling protective of their healing space; this is absolutely normal. If you feel that your partner’s trauma is causing conflict in your relationship couple’s counseling may be a great way to seek additional support for your relationship. If you do seek out couple’s counseling you want to make sure you seek out a professional who has training in trauma and specialized training in working with couples. It’s okay to straight up ask a therapist about their training, you want to make sure you are getting what you are looking for. If you find yourself feeling triggered and/or in need of additional support for yourself then pursuing your own individual counseling is definitely appropriate and normal.

Consider the following to form more realistic expectations in supporting your partner’s healing:

1. Understand healing is a process and not a task, therefore the length of the process varies from person to person. Don’t put a deadline on your partner’s healing!

2. Expect to be triggered; we all have triggers and even if you’ve never experienced abuse you may find yourself feeling triggered over other things you haven’t taken the time to address within yourself or maybe didn’t even know you needed to address.

3. Embrace the frustration…yes, I mean it! It can be frustrating to support a partner in their healing process and if we don’t allow ourselves to own our own frustration within this process we may end up building up resentment towards our partner. This is why you need your own support system.

4. Communicate with your partner (see above on communicating from within)! Don’t expect yourself to be okay by putting your partner’s needs ahead of yours, this will burn you out. While your partner does need you to be supportive, understand that healthy support is to be able to set boundaries and care for yourself as well. This way, not only are you making sure you won’t burn out on your partner, but you’ll also be normalizing and modeling the idea of taking a break from dealing with the difficult stuff in order to recharge.

5. PRACTICE SELF-CARE!!! I know, I know I’ve mentioned self-care in the last two tips, but it is so important you understand how much this will play a role in supporting your partner if you want the relationship to be healthy and more importantly to survive.

"A Nation United In Trauma: Using Self-Care to Heal"

By: Maritza Plascencia, M.A., Licensed Marriage and Family Therapist

When tragedy happens and lives are lost, it can either make us feel intensely and take inventory on a personal level and in relation to others or simply leave us feeling numb with a sense of confusion and thoughts of uncertainty.  Monday, October 2, 2017, exactly a week ago as I write this, was the morning most people woke up to the tragic news of the mass shooting in Las Vegas, Nevada at the Route 91 Harvest festival, where 58 lives were lost and 500 plus were injured.  By now, most people have had some time to process the initial emotions that come up with something so devastating and as time goes on their feelings may be evolving from shock to sadness to anger and despair or maybe...nothing.  I have encountered many who have shared their inability to feel much as they are experiencing what some call "compassion fatigue" and others "emotional burnout."  Given how in recent times we have been bombarded through every social media outlet with images, stories and calls for support for victims and their families of the multiple hurricanes, earthquakes and now this massacre, on top of the warnings from experts of more natural disasters headed our way and rumors of nuclear war, based on impulsive threats from certain government leaders, most of us have probably asked ourselves if and when this will all be over.  Ironically, as I sit here in my office in Orange County California, just a few miles down the currently closed freeway, thousands are being evacuated from their homes, some for the second time in the last 30 days, due to the rapidly spreading wildfires.  It is therefore clear to see, from the point of view of anyone who knows and works with trauma, how the new "normal" is beginning to settle in and how so many are now operating primarily from a place of fear.  

It is especially important, during times like these, to remind ourselves that self-care is not an option, but a necessity.  We must keep in mind that repeated exposure to events that evoke feelings of fear and/or sadness can lead us to develop anxiety and depression, but in some cases can also lead us to block any and every emotion due to the overload on our nervous system and the threat to our psychological integrity.  We already live a fast-paced life with a high demand for our time, energy and attention and when events that are out of the ordinary take place we are being pushed to our limits.  If we are not mindful of how the external world is interacting with our internal world, we can be caught off guard when anxiety, depression or numbness hits us, like a ton of bricks falling on our chest (the general area most of us report feeling everything or nothing at all). 

There are many levels in the practice of self-care and most of us don't necessarily think of meeting our basic needs as one, though it is so.  In my experience, most people talk about that vacation they took, the last massage they got or about how the salon where they get their hair done serves mimosas or champagne, in reference to their self-care.  While those with less financial stability, often express a sense of defeat as they believe self-care is out of their reach.  Reality is that we are all surrounded by opportunities for self-care, but we are unable to recognize these because of how caught up we are in our busy lives and the fear of when the next tragedy will hit.  Below is a list of ideas of basic, inexpensive or free ways we can all practice self-care to ensure our healing from our exposure to or experience of these recent traumatic events.

1. GET SOME REST!  Even when you feel you cannot fall asleep because your thoughts are keeping you awake, it is important to have some down time.  Which means, create an environment with minimal stimulus or none at all if possible.  Sometimes we must coax the mind and body into relaxation by setting up the mood through appealing to our senses.  If being in total darkness is not helping you fall asleep, be intentional with the lighting (dim lights, night light or battery operated candles).  Sometimes laying in bed listening to silence is not helpful and in fact can produce more restlessness than we can handle; YouTube is a great resource for us to introduce the kind of noise that we need when trying to rest (playing videos of white noise, nature sounds, or Tibetan singing bowls).  Some people report the smell of incense or using an essential oil diffuser (inexpensive ones can be found on Amazon or at places like Marshall's or TJ Maxx) or perhaps applying a lotion that contains the smell of lavender on the back of their neck are ways they find effective to become relaxed.  Personally, I find that drinking chamomile, cinnamon or any other decaffeinated tea helps put my body into a resting mode.  Finally, it is important to also consider the sense of touch; if possible switch to that softer blanket or if you are like me, the one that feels cool to the touch, but in fact is very warm.
2. EAT!  Yes, even when you have no appetite despite it being over 6 hours since your last meal.  Have a fruit or some vegetables, maybe some trail mix or plain raisins/almonds, something simple.  If you are experiencing anxiety or depression, this will ensure you don't give yourself a physical reason to reinforce these.  
3. STAY HYDRATED!  Drinking plenty of water (you can add some lemon wedges or pieces of fruit to make it more appealing) is one of the best ways we can safeguard the balance in our body because we release bacteria and toxins every time we have to empty our bladder.
4. STAY ACTIVE!  We don't need a gym or to go hiking in order to get a good work out session (although both of these are pretty great).  Simply by doing things around our home (dusting, reorganizing, cleaning out, rearranging furniture) is a good way to break a sweat and get some of those "feel good" chemicals going in the brain.
5. ENGAGE!  Doing things that give us a break from thinking about the tragedies surrounding us can be very helpful.  Meeting up with friends or visiting family can also reinforce the sense of community and support.  Engaging for empowerment and to combat the fear can be done by volunteering, donating money or simply doing a random act of kindness for another.
6. DISENGAGE!  Getting away from doing and from others and taking time for just being can be a great way to check-in with ourselves.  Meditation, guided body-scan meditations (also found on YouTube) or prayer can great ways to disengage from the chaos that surrounds us. 
7. TALK ABOUT IT!  If you have someone you trust that you feel comfortable talking to about your feelings or lack thereof, great!  Talking is what helps us process and integrate our experiences in a more adaptive way, it prevents us from stuffing ourselves with unfinished business that may show up later in the form of triggers, anger, anxiety, depression, hopelessness.  Think of it as mental and emotional health maintenance.  If you feel that you are in need of seeking professional help, know that affordable counseling may be available in your area.  If you don't know how to find it, begin by calling a therapist in your area and telling them what you are looking for, most therapists are happy to provide local referrals.  If you are one of the many people that were in the Route 91 Harvest festival in Las Vegas or lost a family member during the shooting you may qualify to have your counseling expenses covered by applying here.