Addiction Change Counseling Psychology

Beyond Trend

Two glass tumbers with ice and dark brown whiskey next to bottle of Ballantine's scotch whiskey laying on its side atop a wood table.

Assessing Your Readiness to Change (Even When It’s Not Fashionable)

The following post is the expressed opinion of the author and is not be used as a substitute for medical advice. If you are struggling with a substance use disorder, eating disorder, or self-harm behavior, please seek medical advice from a licensed and/or certified provider.

The other day, I found myself chatting about a subject that rubbed me all sorts of wrong: Food Ennui.

Just a few days ago, the U.S. entered its third year in the global pandemic, and all the cracks in the system are apparent. With supply chains affected, workers shifting jobs or resigning outright, and a surge of the Omicron variant triggering localized calls for the National Guard to assist in everything from teaching in classrooms to helping in the hospitals, being bored with food seems disconnected from a reality that looks more like a war zone.

And yet I am not surprised how many people casually responded in a text chat that food ennui is real, as real as the fatigue many of us are experiencing in other parts of our lives. Some of us are really feeling tired of eating the same things, yet we’re aware that there bigger fish to fry and larger fires to put out.

Like many decisions we can make about how we function, order our days, care for our family members, and meet our own needs, not all of our decisions are going to be the latest trend. Not all of our choices are filled with fun or ease. Yet avoiding change just because it goes against the current trend has its personal consequences.

You do not need New Year’s resolutions to learn to make sound decisions and create a plan for change. So what DO you need?

Readiness for Change

The first thing you need to know before you make a change, big or small, is your answer to this question, “Are you ready?”

It’s OK if you answer that you’re not sure if you are ready, or that you want to be ready but you have some hesitation. Yet I think it’s important to give yourself a chance to hear your thoughts and feelings about how ready you are to make a change in your life, and go from there.

There is no one magic pathway to determining your readiness, yet here are a few questions to ponder that will help you think about readiness and what it would take to see some real change:

  1. WHAT do I think needs to change? What will I gain or lose by this change?
  2. WHY is that change important to me?
  3. HOW have I tried to change this before, and what stopped me the last time?
  4. WHO is in my corner, even if the only support I have is myself? Is it enough, or can I find a way to get more support?

Make a Plan with Small Steps

Whenever people find out I like to run long distances, they can’t get over how far I run. “How do you even get to a place where you can run those kinds of miles?” they ask.

“Well, you start by running from your house and around the block and back.” In essence, you start with where you are: start with small steps, and then add on more over time. Small and incremental changes that can be sustained have an accumulative effect.

My answer remains fundamentally the same whether you want to start a meditation practice, learn a language, play an instrument, or get rid of processed sugar from your diet. Once you have assessed your readiness for whatever change you have chosen (and accepting it as your choice, even if you don’t like the thing you chose in the moment), you can start with small changes.

As a therapist, I get asked for help with many of the same kinds of behavioral trends that come in and out of vogue. Here are just a few:

  • stop smoking
  • lose weight >20 pounds
  • begin and progress into a fitness program
  • learn how to cook at home to eat less processed food
  • decrease or eliminate drinking alcohol* (see comment below)
  • minimize negativity and maximize action
  • increase mental resilience
  • improve sleep
  • communicate with empathy
  • stick to a hobby
  • watch less television
  • learn to meditate and relax
  • decrease mindless activities on computer or devices

If you want to try a short exercise in how to look at a change with small steps, pick something on this list of which you experience success, and imagine sharing with a close friend how you came about experiencing that success. Take each factor, and make the steps even smaller, so that each step does not have much distance between them.

Beyond Trend

On a personal note, I noticed that Social Media is flooded with memes surrounding the pandemic, fatigue, and humorous reasons to indulge in drinking alcohol, overeating, and spending money regardless of budget or means.

This is not to say that these memes didn’t exist before the pandemic, or that people should be shamed for their personal choices. I simply noticed that the amount of content around these themes appears to have risen significantly. I’ll leave that to data scientists to tell us if my observations are statistically significant!

So let me choose one of the three to talk about here as a “beyond trend” choice. What if those who decided to try a “Dry January” — that is, a month abstaining from drinking alcohol in order to increase their awareness around their relationship to alcohol and its use — wanted to extend that practice beyond the month of January and beyond the supportive trend that has become an annual event, even a badge of honor to boast about?

Well, if you went 31 days without alcohol, you already walked yourself through an analysis of your own readiness to change, taken the initiative to implement small steps of change (i.e. removing alcohol from home, or going out with friends but telling them you are not drinking alcohol for a month, having an alternative beverage choice, choosing activities that are not centered around food and beverage, etc).

Lasting changes that go beyond the trend and support of short-term changes take more planning. It may involve talking to people in your support system and your household about what you need from them to be successful, as well as what you will provide on your own (such as boundaries, limits, and choices).

If you find yourself struggling, you may want to get more support, such as joining a group of likeminded people, hiring professional help, or broadcasting your choice and your needs to a larger group beyond your immediate support system in order to hear about more similar stories. You may discover that you aren’t among the majority making that decision, but you don’t need a majority to stick to it.

You may wish to keep track of your thoughts and feelings about your choice to abstain from alcohol in a journal, reminding yourself why you are doing what you do. In the world of sobriety, the phrase, “One day at a time” helps those who have chosen a sober life to focus on getting through each day without drugs or alcohol.

You might need to turn down the volume of the Social Media memes and messages that promote lifestyle choices* that are not in line with what you are trying to accomplish. Again, it may not be on trend with what “everyone” else is doing. Turning down that volume so you can hear your own thoughts and choices can help you maintain clarity.
Ensuring your lifestyle choice does not encourage dangerous or damaging thoughts and actions is also a part of the process of change

Living a sober life has much more complexity to it than eliminating drugs and alcohol. The underlying causes of drug and alcohol addiction or use, and even its identification in the user, have been the study of philosophers, healers, and addiction specialists for centuries.

If you have chosen to reduce and/or eliminate drugs and alcohol for any reason, there is help available for ALL of the complexity.


* Lifestyle choices – let me clarify, a lifestyle choice can have an intersection with appropriate medical advice. I am not advocating for dropping sound medical advice in lieu of a lifestyle choice. An example of this would be using one’s insulin pump for diabetes as a means to drop weight fast, or taking on a restrictive diet at the expense of syncope, hormonal damage, and severe anxiety or depression.

Change Counseling Love and Romance Psychology Social Media

On Love v. Admiration

In the movie, My Life As a House, George Monroe is an architect who is let go from his job and discovers he has terminal cancer, of which he withholds his diagnosis from others. After deciding he wants to tear down an old house on a piece of property he has been dreaming about for a rebuild, he tells his ex-wife that he wants to take his son Sam for the summer and build the house with him.

In a powerful scene between father and son, Sam’s repulsed expression of disbelief flies out at his father, “You trying to get me to like you?” George’s response is equally telling, “I was trying to get you to love me.”

The things we do for love. Or, is it love that we’re truly pursuing?

With the rare exception of individuals with personality disorders that manifest in social aloofness, we crave love and connection. Children can create imaginary friends to fill in loneliness, boredom, or fearful emotions. And in the age of the Internet, many of us flock to Social Media to not only see what others are doing, but to curate a world where others might connect with us.

All of this sounds pretty innocuous, maybe even adaptive. Until it isn’t.

I’ve been intrigued by conversation around a fast-growing group of people who are being called out as repeat marathon cheaters. These are people, usually everyday non-elite runners, who engaged in ways to cheat the system in order to gain awards, access to other races, and followers because of their astonishing fast-paced finishes. The numbers of cheaters caught at marathons, half marathons, and triathlons are enough that there are forums and a website dedicated to investigating marathon cheaters and turning them in to the race directors and organizations to determine what, if any, consequences should be rendered. The cheating is so common place enough that Wired magazine recently published a story about the founder of Marathon Investigations and the most perplexing responses and consequences of cheating exposures. 

Ever wonder why they would do it?

I suspect the numbers of marathon cheaters is actually not growing as much as you’d think. Rather, the technology used to catch marathon cheaters has improved in such a way as to punish the cheater in a public way by way of disclosure and the removal of awards, a ban from races, and potentially retroactive removal of finish times if there is a proven history of cheating across multiple races.

In other words, marathon cheaters risk being shamed and despised for their behaviour, if they are caught. And if they aren’t caught, they receive the love and admiration of fans.

Actually, I think these people stumble on another truth. They don’t receive love from their fans. They receive admiration based on achievement. Another way of putting it is that they cull conditional love based on a transaction: I perform, and you compliment me. 

Is It Worth It?

As you might have guessed, this post isn’t about running and marathon cheaters as much as it is about answering a question: is it worth it? And what “it” did you receive?

What “it” are we talking about? 

The subject is Love. Most of us learn about the importance of love when we are children. We see it in the sacrifices our parents and caregivers made in order to provide for our needs, listen to us, take us ball games and movies, and make sure we have opportunities to learn and grow. Love is can be hidden within a voice wishing us goodnight, folded into a homemade cake for a birthday party, and embedded in a hug and a kiss. 

Admiration is a similar feeling as Love, yet with a subtle difference. Admiration involves respect and approval, usually because of something we did to earn that feeling from another. An example of being admired is when a stranger put his/her personal safety in jeopardy in order to save the life of another.  We admire that person for bravery; we don’t love that person (the person is a stranger), as much as we hold in high esteem that person’s choice of action at the risk of personal injury. 

So back to the question, is it worth it. It is my belief that one of the reasons why marathon cheaters continue a pattern of cheating is because they trade Love for Admiration.  Finding and experiencing unconditional, non-transactional Love is rare. What they want is to be loved, but what they seek through cheating is the next best thing: Respect and Admiration for being a high performer. 

If Respect and Admiration means that much to a person, I believe they can  – sometimes do — pursue Admiration at all costs; therefore, it is worth it to them. The ‘likes’ on their Social Media posts, the adoring comments filled with heart emojis and ‘way to go’s, gives the person a lot of validation. It becomes its own kind of pellet food bar, of which a hungry mouse will keep pushing despite the fear of being shocked as long as the memory of getting a pellet of food remains. Rewards light up our brains, even if the reward as an emotional one.

And it works on the negative side of the equation too. Some people will do act outrageously to get attention, even orchestrating daring examples of socially unjust or violent actions. Earning a nickname that inspires fear has become its own kind of admiration in the half light of glowing screens across the globe. 

Can’t Buy Me Love

If Love can’t be bought, can its next best feeling, Admiration, be had by lesser means? In the Age of the Internet and the viral nature of Social Media, the answer could very well be Yes

Let me propose an example. You are a woman, a mom, a wife, and you’ve worked all your life to help your family. You do good things in community, volunteer for charities, do your share of duties in your local PTSA, and help the kids with school. At the end of a long day, you take a glance at your Social Media feeds. What do you see?  The accounts with thousands and millions of followers for women are often in the world of beauty, celebrities in film and music, wellness, politics, and sports figures. Oh, and cat ownership.

While you have changed diapers,  helped the kids get launched to college, supported a spouse through think and thin, perhaps you have not been celebrated and noticed. One of the ways we feel Loved is when we have been seen. And one of the ways many of us have sought to be seen by more people is through Social Media. 

One of the ways we feel Loved is when we have been Seen.

The strange thing is this: even accomplished people, celebrities, and sports figures can fall prey to the this online search for recognition. In those cases, there may be money involved in the form of exclusive sponsorships, and a poor performance could translate into loss of income. There would be incredible pressure to cheat, lie, or embellish a story. I’m not excusing cheating, just providing a possible explanation of why someone who was already accomplished might feel pressured to cheat or lie in his or her industry.

What about the Age Group athlete (a non-elite, non-professional athlete), in running or triathlon? Why would they cheat if there was no other financial reward for an Age Group win?

I suspect that the search for Admiration and Respect are in play. It can feel so good to be called a, “Badass” because you are fast and strong. People are curious about seemingly unreachable feats that require commitment, sacrifice, dedication, and focus. We elevate athletic pursuit to be characteristics of the gods.

Still, you can be the head of a tribe of people – a leader! — if you promote a certain kind of lifestyle that others find challenging — such as being a Vegan* or being Sober**, but in the world of Social Media, being Vegan and being Sober aren’t necessarily enough to win the attention of others. If you’re aware that you hunger to be Admired, you’d better match that Vegan lifestyle with something else, something Hard, something Ideal, something Extraordinary.

Of course, I am pointing out the flaws in this formula for living. Why can’t each person be celebrated for these decisions, just as they are? Why don’t we see them?

On Reading

My point is, that rabbit hole has no end. If you search for a sense of worth by Doing instead of Being, you will be tired. You might get some followers, and you will be exhausted.

Valentine’s Day has come and gone. I personally don’t subscribe to the romantic overtures of expensive dinners and romance packages. You’re more likely to find me continuing to do the little things behind closed doors that lets my loved ones know how much I care. I still make the bed every morning, as much for myself as for my husband, so that the pillows are plumped and inviting, and a fresh pot of brown rice is ready for dinner at the end of the day. It’s mundane, yet it has it’s own Truth.

The love I feel is about having read people. It is not, “love at all costs” based on the accumulation of achievements. It is love based on our ability to see a person and choose to bestow warmth and affection for who they are.

Love is given because we can choose to love someone based on who they “be” in your life, not what they do. If you knew you were loved that way, you would never feel the need to cheat your way to being admired or respected. You would not worry so much what strangers thought about what clothes you wear when you’re on vacation, or what foods you do or don’t eat.

Yet, as I mentioned before, this kind of non-transactional Love is rare. It takes time to cultivated, because not everyone learns it early in life, and there are social forces around us that whisper other truths about what our essential worth is based on: appearance, agility, youth, genius, gender, economics, work performance, possessions.

The false form of love that people seek or fear on the Internet is costly. Yet, if you choose to See, it’s possible to learn how to cultivate Love versus Admiration based on accomplishment.

Note * and **: In case you were wondering, I have nothing personal against either lifestyle choices of Veganism nor Sobriety, and I have seen how some have healed aspects of their physical and mental health with both. I have simply chosen these two examples because of the abundance of writers on the subjects.

Counseling Online Therapy Psychology Telehealth

What Can and Cannot Be Seen During Online Therapy

When a person contacts me to initiate online therapy, they will receive a short consultation that helps both of us determine whether we’re a good “fit” to work together. I believe there are some good reasons to refer some people to see a counselor, psychologist, or psychiatrist who has a brick-and-mortar office, depending on their specific needs and the outcomes they seek.

For all others, online counseling can help bridge one of the most important gaps in healthcare: timely access. Getting people the help they need when they need it has been one of my lifetime goals for my mental health practice, now going entering its 19th year.

What I want every person to know, unequivocally, is what a licensed mental health professional can and cannot see in an online therapy session, based on the nature of the technology. While this appears plain, I’ve noticed that a brief discussion about the nature of online counseling — whether they will become my client or someone else’s — helps every person make better decisions regarding their health needs and the options they have to meet those needs.

What You Can See During An Online Therapy Session

Here’s is what I am able to see (and hear) during an online therapy session under the conditions of bright lighting, good audio, a video camera trained on head, shoulders, chest, and arm movements, robust Internet speed, and a quiet room where the session takes place:

  1. Facial expressions, which helps to reveal mood and changing emotions related to the content being discussed
  2. Body language, such as shoulder shrugs, hand wringing or rotating, posture, and body motions (i.e. rocking, shaking, trembling)
  3. Eyes: blinking, tears, darting, rolling, attentive, sleepy
  4. Breathing patterns, such as shallow, deep, rapid, slow, etc

Part of the reason online therapy can be helpful for people seeking mental health help is that the various measures of pain and progress can still be seen, heard, and felt through an online counseling session through your computer or smart device.

In terms of insight-oriented counseling, the same elements that you would experience in a F2F session can be transmitted and experienced in an online session. But there are exceptions.

What You Can’t See in an Online Session

  1. Just like F2F sessions, I can’t see what someone is hiding. I can, however, see the indicators that would lead me to believe someone is hiding something. Another way to say this: if you are seeking therapy to end your ability to manipulate and lie to the people you love (and you’re good at it), a good therapist may detect the lie in both an online and a F2F session, and both may not be able to determine what exactly the lie is.
  2. I can’t see what you’re doing off-camera. I can only see the reaction of your body and mind to what is happening outside of your camera’s view. For example, if you broke your foot and you were on a pain medication that produces sedation, I would not see the foot cast, but I might see the effects of the sedation in your eyes and facial movement, or the slur or slowness of your speech and cognitive functions.
  3. I also can’t use my other senses, like my sense of smell. This is important for therapists treating someone for depression, as a depressed person might not have the energy or will to attend to their own personal hygiene or wear clean clothes.
  4. Energy levels take longer for me to feel through the lens of the camera, putting together such clues as body posture, vocal quality, alertness of the eyes, and extraneous movement cues, such as “happy feet” and nervous finger movement off camera.

Would Online Counseling Work for You?

So, would online counseling work for you? The answer, like so many other answers contingent on multiple points of concern: it depends.

The best way to determine if online counseling would work for you is have a brief consultation with a licensed therapist to discuss your needs. Next, host a brief time on a HIPAA compatible online counseling platform, such as the one I use, 

Take a moment to make direct eye contact during the video chat. Ask yourself if you sense your emotions and expressions can be easily read, even if you didn’t explicitly name them. You can also see how we bridge the physical gap by using the text box to write things down, send a resource link, or even give you a virtual high five.

If you feel you have your own bias against online counseling, I think it’s important to just say that upfront. I call this, “Putting your cards on the table.” When you do this, you’re acknowledging your bias. That acknowledgement can be helpful to know if you have some openness to experiencing something other than what you are “certain” you know; that is, that your experience might be different than your feelings.

For example, it might help to talk about your skepticism and negative feelings about talking about difficult things on a video chatting platform. At the same time, I might ask you if you like pets, such as a cat. If the answer is yes, and my cat obliges us, she may poke her head on the camera, and you can interact with her while you experience your real emotions about seeing my fluffy cat as she head butts the laptop and purrs into the microphone.

The reverse is true as well. You may be eager to try online counseling, only to be told that what you are wishing to address in your life needs more support and hands-on or sensory input than an online counseling experience can deliver.

You may have heard in the news that a man with a terminal illness received the bad news of his prognosis through a teleheath robot using a live video connection to his provider. The man died from his illness, and the family was so upset by the delivery method — a robot and a video chat instead of an in-person visit to the man’s bedside in hospital – that they complained to the hospital.

I personally don’t believe we as humans are ready for receiving bad news in this way, whether it is for the end of a relationship (an email), the end of a job (a group email or a recorded video message from the CEO), or an health prognosis. In the case of the latter, a patient may need their hand held, or to feel a presence in the room that speaks to the unspoken — “I’m still here, and my life has value because of the respect being paid to it by someone taking the time to be here.”

It is a subtle shift in thinking to understand that your online therapist has taken time to meet with you over an Internet connection, and the time has as much value as time that passes in the same room. It may help to ask an online counselor what they do to prepare, minimize distraction, and apply the steps of attending during a session.

In the end, a good first online counseling consult should leave you feeling like you made a good connection with the therapist, enough so that you would want to meet again to discuss more complex or difficult subjects.

During the time that the Greater Puget Sound area received a record number of snow days, school closures, and dangerous road conditions, I received an increase in calls inquiring about online counseling. You should know that I used the same elements in this post to help each person make their own decision about online counseling, and that not every call meant that online counseling was the best fit. Sometimes, it’s just not.

But when it is the right fit, we’re ready for you.