With no engagement, a full time job and a full caseload of patients who bring me their day to day as well as their trauma I’ve decided to help prevent burn out, stress and all the other good things that lead to a need to protect one’s health, I’m wrapping this up. So heres to good mental health, the death of the he fucking orange cheeto, the fucking downfall of the whole mutherfucking regime, the osterization of every fucking piece of shit who cheered it on, equal Fucking rights for EVERYONE and a free Palestinian
IT HAS BEGUN
The boxes have been checked, meeting with IT, meeting with HR, meeting with colleagues, training for the systems, trainings for the notations, trainings for the appointment making, introduction to my supervisor, and setting up state required supervision to attain my LCSW.
I have set up my email, my signatures, my accounts needed for every fucking possible consideration, my extension, my away messages and out of office responses. Even my fucking Linked In has been updated.
All that is left is the patients, and this week saw the slow trickle of building a caseload. I’ve had a handful of assessments, treatment planning, and established patients being transferred to me. Unfortunately, there’s been more paperwork and getting through the technicalites than rapport building. It has still been there, and I’ve had 5 patients respond to me in a positive way, I’ve had 4 react with ambivilance, and only 1 gave me a hard pass. The rest have been no shows for assessments that haven’t happened, and I may get rescheduled for them , and they may go to someone else when or if they reschedule.
The bulk of my patients have been women and have been members of the alphabet mafia with a history of abuse or trauma with high levels of anxiety and depression…which is very much in my wheelhouse and in most cases where I shine. It’s been a very mixed bag of demographics, including age, race, and socioeconomic backgrounds, as well as their readiness for change. I have a handful of patients who are very ready for change, as well as prepared for the work. I also have just as many who aren’t ready or unwilling to do work. Lord, help me , I have one patient who just believes if they show up, I’m just going to wave a wand and make their life better through suggestions.
All in all it’s better than I expected, and I do love the agency’s method of slowly opening time up on my calander…which has really helped me get used to the paperwork while creating my own flow and comfort in the process.
…until next week
MUTHERFUKING ONBOARDING
The day has come, the day has finaly fucking come. I filed all the papers, submitted the documents, and signed all of the papers. Effectively proving that I am who the fuck I say I am, and I will pay all the taxes. Once that proof was accepted, I got my start date and waited for the first day and hoped that I made a good impression.
There are very few esthetics for a therapist these days, and my current esthetic of aging, former rock fan, cool mom, and never minivan driver mostly consist of messy buns, tanktops and yoga pants. Clearly not who you want to secure life advice from, but what the fuck am I to do? Power suits, dress suits, high fashion and office caual don’t suite me in any way. So, I decided on a Stevie Nicks vibe, miunus a few flowing scarves.
This was a good choice as I settled in for day one and met some coworkers, supervisors , trainers, and other department employees. It not only fit my overall vibe, but definetly was a fucking ice breaker when meeting everyone.
The long and short of it is very simple. I learned the systems, I learned charting, I learned assessments, I learned documentation, scheduling, interofice communication, policies, insurances, and HIPA. I created my email, my work accounts, and signed up for my insurances and benefits. I met supervisors and department heads and will struggle to remember everything day after day for a week to come . Next week, I officially ge to start seeing patients, and I feel confident and excited.
The only thing left for me to do is to decide how to run this blog and for how much longer. Nobody really seems to be out there, and honetsly, that’s fine by me. I started this as an outlet just for me. A way to navagate, manage an handle the stress, information and any other fucking emotion or situations that came up with grad school. I didn’t need readers, I needed release. I’ll likely stop when it stops serving me, and not a second before or fucking after.
I also wonder if I will simply keep writing basic info about mental health disorders, diseases, and diagnosis or if I will wright about the experiences I have, a little bit of both or evenyuallly none of it ? Only time will tell fuckers.
…….until next week
THE FUCKING OFFER
So, it has begun. The transition from student to professional, unsure to need to know, intern to paid employee. I was prepared for this to feel unreal, overwhelming, and to even experience inposter syndrome. The only problem was that it never came.
I’m not sure why this is, because trust me my anxiety and confidence levels can betray me at any time and in a multiple of fucking ways. My instincts tell me this is because I’ve already danced this fucking tango before, well before I even began the job search. It felt unreal and overwhelming the second I walked into my first angency to learn how to provide services and the system of health care, mental health services and the intellectually and developmentally disabled population. I couldn’t believe I was being trusted to do shit with a single soul in the agency. I felt 1,000% convinced that I would leave a trail of damage and havoc behind me on my way out the door. I left the agency after my rotation grateful for the experience , comfortable in some of my abilities, some of my skills and a better understanding of creating and establishing a theraputic relationship. I also left with a better sense of what I didn’t want to do , and what population I enjoyed.
My next placement had such a wide range of services and clientele that my experience swung like a fucking pendulum. I worked with families, and anybody who sat through any form of fucking entertainment knows, this includes everything. My youngest patient was 4, and my oldest was 65. I saw individuals, families, foster families, couples, and groups. I was involved in the mental health , criminal, family courts, and educational systems. I saw run of the mill depression , and anxiety up to eating disorders, bipolar and schizophrenia. I had patients who were high risk due to suicidality, self harm or homicidality. There was a high volume of trauma, abuse, and survivors of sexual violence. I did in person or telahealth. I worked with multiple demographics of people who need social support, middle and upper class, as well as every race, religion, and, of course, clients in the alphabet mafia.
I walked into this placement more overwhelmed and definitely experiencing imposter syndrome, thinking that I was in over my head, lacking too much experience, and simply didn’t know enough to be of any help. Then my instincts kicked in and I learned time after fucking time that my instincts had evolved with my knowledge. I learned overwhelmingly that I choose an appropriate and effective intervention and that my reaction to patients almost always made the session or situation better.
Getting these experiences out of the way left me feeling prepared and ready to work in the field the second that diploma was in my fucking hands. They also taught me that while I do enjoy the day to day long term work of managing mental health disorders such as anxiety and depression I really thrive with trauma. My work with survivors of sexual violence and long term abuse was perhaps the most rewarding. I also found working with the LGBTQ+ community especially satisfying. Not only did I enjoy this work I found I was really fucking good at it.
Obviously, these experiences guided me as I began the job search and finding the agency that I felt would be the most rewarding. And, I’m not going to lie. The process of job hunting is so stressful that there should be therapy offered directly on LinkedIn and Indeed. Despite this I as pretty lucky ,as the search lasted about 3 months and I managed to find a job I really fucking wanted raher than jus taking the first one I could. Ironicaly I ended up taking the very first job that I interviewed for. I was the second runner up , and moths later, when they were ready to hire more clinicians, they reached out to me. I didn’t hesitate, as I had wanted the job and had already navigated 3 rejected offers and 3 rejections.
At the risk of sounding smug , it seemed perfect for me. The clientle I preferred, a killer commute, benefits I wanted, benefits I didn’t expect, and hours that worked for me. It did pay a bit less than I wanted, but that was something I was willing to sacrifice for benefits and the clintel/work I knew I wanted.
………until next wek
Transitions
The next 2 weeks are going to be dedicated to settling into my new role as a therapist within a private practice. I will be focused on learning a new system, policy and other aspects of starting a new job. This job will be the catalyst to my transition from student to professional, but Ibwill continue to document the process of growing a practice, developing a professional reputation and building hours to take the lcsw and dbt exams.
I will return when all the “housekeeping ” aspects have been completed and I begin to treat clients. Patient privacy will always be respected.
Schizophrenia
This is a complex and severe neuropsychiatric disorder with multiple clinical features. It usually presents in late adolescence or early 30s , but the average age is in one’s early 20s. While it can present in children under 13, this is extremely rare , as it can be mistaken for bipolar disorder and other delusional disorders.
Due to the significant disruptions in thinking, perception, emotional responsivness, and social interactions because of hallucinations and delusions. It is difficult to maintain relationships, employment, and management of daily living skills. This is also a lifelong illness, and it has a strong genetic component. If there is a family history of it is important to divulge this to a mental health clinician when seeking help.
This illness is often confused with schizoaffective disorder, and the main difference between the two is the inclusion of symptoms of mood disorders. especially depression or mania, as well as hallucinations and delusions.
Early signs can include withdrawal, social isolation, academic or work difficulties ,insomnia or excessive sleep, irritability, depression,anxiety, changes in usual thoughts or beliefs, and memory issues or problems concentrating. Symptoms include visual or audio hallucinations ,delusions,disorganized speech and thoughts, impaired social functioning, flat affect, difficulties with memory, concentration, and decision making
This is an illness that requires lifelong medication and professional mental health services. Hospitilization is common, and people managing this illness need all the support they can get. It’s also important to know that the idea that people with schizphrenia are almost always violent is a purposeful depiction based on fucking ignorance, shame and intent to glorify , expand or exploit people. While it can happen, it is not the norm. Remember that shit.
…until next week
Mutherfucking OCD
OCD, or obessessive compulsive disorder, is a relatively common type of anxiety disorder where people develop compulsive behaviors or actions to help manage obsessive thoughts. This usually begins gradually with a person taking part in some behavior that helps slow down or momentary stop an obsessive thought. This, in turn, becomes a ritual where the behavior may be repeated multiple times with the goal of stopping the obsessive thoughts.
The most common behaviors include activities such as hand washing, showering, cleaning, and checking locks or appliances. In fact, the obsessive thoughts most commonly revolve around health, illness, and safety.
Some common symptoms of this include samples of three main aspects of behaviors, mood, and psychology. Behaviors include compulsion, agitation, hording, hypervigilance, impulsivity, ritualistic behaviors, social isolation, and meaningless repitition of words and movement. Mood symptoms include anxiety, apprehension, guilt, and panic attacks. Psychological symptoms include depression, fears, and replaying thoughts. Most common of these include food aversions, nightmares, and fears connected to germs or safety.
Now I wish I could tell you why or what causes this type of anxiety disorder, but I fucking can’t. Every person is different and every contributing factor can be unique to each person and their diagnosis. What we do know is that it is suspected to be a combination fucking genetics, biology and the environment.
While treatment usually includes the use of SSRIs and antidepressants in combination of therapies such as CBT, EMDR, aversion, exposure, psychoeducation, and support groups, there have been the introduction of new techniques.
The most popular of these growing interventions is known as the 15-minute rule. This is when an individual waits a minimum of 15 minutes after the start of ugres to begin a compulsive behavior. The idea is that the delay or resistance of the behavior is enough to help interrupt the cycle of obsession to compulsion and allow anxiety to naturally play out and decline.
…until next week
How To Create Fucking Mental Health Goals
The talk about good mental health, mental balance and how to achieve or maintain that is fucking incessant. It’s also somewhat shallow and never really develes into how to do that. Actually, I take that back, there is constant chatter about fucking journaling ,meditation and being outside. Don’t get me wrong, I actually adore journaling, meditation, and some outdoor activities, but those don’t work for everyone, and they certainly aren’t the end all fucking be all of mental health.
All that being said, the very first step in achieving and maintaining good mental health is creating mental health goals and then pursuing the shit out of them. To do this, one must start with the simple step of identifying what is a problem for you and what you believe needs to change. Perhaps you do this by envisioning your ideal outlook, the behaviors you wish you both did and didn’t have, the habits you have, and the perspective you have. You may consider how you handle conflict, emotions, stressors, and problem solving. Maybe you consider how you are in relationships, friendships, and peer interactions. Any and all of these aspects are considerations you should be taking as you prioritize what you want to work on ,start doing, or stop doing.
Now, I will say this, this can be really hard to do. It is difficult, uncomfortable, and sometimes downright, painful to exam and confront every shitty thing you’ve done, the things that cause you shame and embarrassment. To look at your weaknesses, strengths, and fuckups is not for the faint of heart. But to look at yourself with that sort of wide-eyed honesty and decide to take control is a badass move that nobody can deny you.
Now that you’ve decided to prioritize yourself and your health, and you’ve identified the areas you want to work on and prioritize their scale of importance, you can create your goals.
The only thing you need to know when creating as many or as little goals that you want is they need to be SMART. Specific, measurable, achievable, realistic, and Time Bound.
The best way to explain this is by example. Let’s pretend your goal is to manage your stress. A specific goal would be to start mindful meditation, a measurable goal would be to meditate for 10 minutes every day, an achievable goal would be to recognize you have the time in your evening routine, a relevant goal is meditation will address managing your stress and a time bound goal would be to address how effective your stress is being managed during scheduled intervals.
Now, you can break down any goal to help you manage your mental health.
…..until next week
How To Improve Your Mental Fucking Health
This is a brief list of ways to improve your mental health. Consider this a jumping off point, and feel free to add your own.
Prioritize sleep…aim to get 7-9 hours a night.
Regular physical activity…try to get at least 30 minutes of some sort of physical activity a day.
A balanced diet…by balanced I don’t mean just healthy. I mean enjoying all food. Yes,eat the protein ,veggies, and fruits, but also indulge in the sweet treats or salty snack. There is no such thing as bad food, and a healthy relationship with food helps you have a balanced diet. This also includes staying hydrated.
Build meaningful connections…create a support system and community.
Practice stress reducing activities…find things that you enjoy or that relax you and make time for it.
Explore creative outlets… Maybe it’s writing, painting, music, or photography.
Professional Support….checking in with a therapist when you need it.
Set boundaries….learn to know yourself, and remember no is a complete fucking sentence.
Practice gratitude….finding small things to be grateful for each day can increase your mood and reduce stress.
Stay connected… keep in touch with peers, family, and supporters.
Take breaks… sometimes you need to unplug from social media and 24-hour news cycles and enjoy silence or your own company.
Turn your phone off… a minimum of 30 mins before bed or after getting up can do wonders for your mood.
Practice self compassion….we tend to be harder on ourselves than we are everyone else. Practice being your own cheerleader and talk to yourself whenever you mess up like you would talk to your loved ones.
Celebrate small wins….Celebrate and take a bow when something goes your way or you do something positive.
Get outside….cliche , but true, fresh air, and the sun can improve moods and reduce stress, even if it’s just sipping a drink in the sun.
…until next week
5 Fucking Facts about PTSD
PTSD affects 7% of the population. Women are twice as likely to experience PTSD. PTSD only became a diagnosis 42 years ago. Caregivers can develop PTSD. Not all trauma is traumatic, and various factors of people’s personalities, such as hardiness, play a role i the risk of developing PTSD
5 signs of PTSD are found in the domains of symptoms. These include reexperiencing the trauma, avoidance of reminders, numbing or detachment, negative changes in thinking, and hyperarousal on a regular basis.
These are the most common causes of PTSD, which includes exposure to one or multiple traumatic events such as combat, sexual violence, accidents, natural disasters and repeated instances of abuse and violence.
5 common treatments include the use of SSRIs, cognitive behavioral therapy, eye movement desensitization and reprocessing therapy, support groups, and self care based on mindfulness.
…until next week
herewesayf&@#k!!! 