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May You Live in Interesting Times

Gloriosa by Jitney58 is licensed through CC-BY-2.0

There is conflicting information about the origins of this expression, but it is generally agreed to be a curse. We are watching history be made as each day goes by, and frankly, I wish I lived during a more boring chapter of future history books. At the same time, though, it is through the difficult times that we grow.

As a psychologist, I’m used to walking with people through the difficult times. I usually can’t offer a quick or simple fix, but I can be there with tools, hope, and connection.

My goal in creating this site is to offer resources to a wide audience during these trying times. I want to reach those who share my drive to help children and provide them with the tools to do this effectively: teachers, social workers, counselors, and fellow psychologists. If there are specific resources that you would like to see, please let me know, and if I have the appropriate skills and knowledge, I will do my best to make it happen.

Thank you for joining me during these interesting times. Follow my site to stay up-to-date with resources.

Interview with Elizabeth Earnshaw, LMFT, CGT

Last month, I had the pleasure of sitting down (via Zoom) with Elizabeth Earnshaw, LMFT, CGT. Elizabeth is a couples’ therapist and author of I Want This To Work: An Inclusive Guide to Navigating the Most Difficult Relationship Issues We Face in the Modern Age.

We bonded over the challenges of practicing psychology in a pandemic and finding our niche. I told Elizabeth that I have the utmost respect for couples’ therapists because my skill set definitely does not include couple work, and she shared that she previously worked with kids and found her fit in couples’ therapy.

Elizabeth Earnshaw, LMFT, CGT

Elizabeth has worked with couples for more than 10 years and wanted to help educate couples before they come into the therapy office. Her book helps couples navigate their relationships and the challenges faced by couples in the twenty-first century.

When recommending resources to clients, Elizabeth found that the available books tended to have a niche focus, and she had to recommend several books to each couple. She also found that the existing literature tended to be heteronormative and cisnormative. Although the themes and conflicts addressed in these books can apply to other couples, representation matters! Elizabeth set out to create a book where all couples could see themselves represented. She created “a comprehensive guide that is inclusive to people.”

The book is currently available in English but is in the process of being translated into other languages for worldwide accessibility. Elizabeth shared with me that she will be working with an editorial team to ensure that I Want This To Work remains culturally sensitive and competent when it is translated.

I Want This To Work was just released in November 2021, but Elizabeth is already thinking about creating a series of various relationship needs, including postpartum, following a mental health diagnosis, or other issues. She has noticed that there are books about these issues that do not specifically encompass the unique challenges that a couple might face.

I Want This To Work

In addition to her book and her therapy practice, Elizabeth offers online courses in learning how to get the most out of your relationships and developing healthy boundaries with your partner. In her practice, Elizabeth offers couples’ therapy and premarital counseling. You can follow her on Instagram.

App Review: White Noise

If you are like me, you have a hard time working in a “quiet” environment because it is never really quiet. I am writing this in my office today, and I can hear the clock ticking, the heating system, and someone walking by outside the door. Usually, I put on a television show or a movie, but for a lot of people, this will distract them further.

White Noise is a free app that, as the name suggests, makes white noise.

White Noise loading screen

The app has dozens of background sounds to choose from, including nature and industrial sounds as well as a series of “White Noise,” “Brown Noise,” “Pink Noise,” “Blue Noise,” “Violet Noise,” and “Gray Noise.” I am not sure how they decide what color different sounds are, but they are all very nice.

If none of the sounds that come pre-loaded work for you, you can record your own. You can also create mixes – multiple white noise sounds played simultaneously. For example, I took Beach Waves Crashing and Camp Fire to create the sound of a camp fire on the beach.

Amazon Jungle background noise

You can set timers so that the noise plays as you fall asleep but does not go all night, or the timer can cue you to stop working on a project when the noise ends.

This is a handy app that you can use for meditation, background noise as you work, or help with sleep. Basically, it has something for everyone!

Gender, Sexuality, and Relationship Diversity and Kids: Guest Post

CW: This post talks about sex and kink.

Dr. Stefani Goerlich is a sex therapist and author of The Leather Couch and the upcoming book Kink-Affirming Practice: Culturally Competent Therapy from the Leather Chair. She asked me to share the thread below that she posted on Twitter last week regarding competent practice with children. With her permission, I have made small edits for better flow in this blog.

Dr. Stefani Goerlich

Over the weekend, a small group tried to make an issue out of me posting that many kink-identified adults recognized that their initial interest in what they would later come to understand as kink before the age of 10. This fact made them SUPER uncomfortable, and they responded to this discomfort by trying to say I was advocating for teaching young children about BDSM and kink. Which…no. Of course not.

At the same time, the viscerally negative reactions to information such as this highlights exactly what makes it so incredibly hard for parents and therapists to offer actual support to kids who might potentially grow up to identify as kinky. The argument seemed to be that children are sexual blank slates who are naturally immune to any awareness of pleasant sensory experiences or close emotional ties before reaching the age of 18, at which point they emerge into adulthood – fully formed and ready for the monogamous, heterosexual relationship of their parent or therapist’s dreams. Because the alternative? Feels too icky to the adults around them.

The notion that children might have physical or social experiences that they later as adults contextualize as kinky is unthinkable to many parents and providers. And yet, kinky adults tell us this happens.

So, what do we do? How do we balance not exposing children to inappropriate content while also validating their experiences and curiosities? As a former Pediatric Sexual Assault Response Advocate and current Certified Sex Therapist, I have some thoughts.

First and foremost: children should not have or receive developmentally inappropriate information about sex and sexual behaviors. No child should know or use the terms BDSM, kink, et cetera. If they do? That’s a serious red flag for abuse.

If you have or are working with a child who acts out sexually, uses sexual language or terminology, or engages in sexualized play? Please connect them with a qualified children’s therapist with training in assessing potential abuse immediately. RAINN can help you find local resources. Their 24-hour hotline is 1-800-656-4673.

If, on the other hand, you have or are working with a child who expresses curiosity about or enjoyment of the way their body responds to developmentally appropriate activities, play, or interactions?  (Ex: “that makes my tummy feel funny. I like it.”) Then we respond to those statements in a neutral, non-shaming way that lets the child know that they are normal, healthy, and safe. We don’t scold or punish. We don’t tease or minimize. And we don’t label or introduce terms. In other words: if your son tells you he liked how it felt to be tied up with jump ropes while playing cops and robbers with their friends in the neighborhood? You don’t call that bondage or introduce the term to him. You can ask him open-ended questions about why.

It Is 100% possible to balance protection from abuse with encouragement of healthy sexual development. Likewise, it is 100% possible to provide sex-positive, GSRD-affirming, support for young people without introducing inappropriate subject matter. How?

In my book, Kink-Affirming Practice: Culturally Competent Therapy from the Leather Chair, I offer some suggested messages for parents and providers working with young people who may identify as GSRD as adults. These include:

  1. Everyone has a body with different kinds of parts. Some people have bodies that look different than yours. It’s okay to be curious about those differences. You can ask your Important Adults any questions you have.
  2. All kinds of touch feel good. When you’re alone, you can touch your body in ways that feel good to you. And when you grow up? You can touch other grownups bodies in ways that feel good for them too. That is for grownups ONLY.
  3. Our bodies like all different kinds of touch. Different touches will make us feel different things. Sometimes you might like a kind of touch and then later decide you don’t. You can always say STOP. Whatever you feel is okay!
  4. You can ASK for what feels good to you. And you can say NO when something doesn’t feel good. Your body is beautiful and healthy and good. Most importantly? Your body is yours.

“But Stefani,” I can hear you saying, “I thought you said this was your explanation of kink-affirming care for children? none of this seems all that unique. It’s just basic sexual health stuff.”

Because it is!

The key to affirming young people (even children) who might come to identify as kinky in adulthood is not to teach them how to be kinky. We just have to teach them the key concepts we want every sexually healthy adult (kinky or vanilla) to have:

Consent.

Autonomy.

Agency.

Choice.

Goodness (perhaps even sacredness, depending upon your belief system).

And pleasure.

That is what kink-affirming care looks like, for people of all ages.

The Weekly Mews with Armani

Hello friends! I apologize for not keeping you as updated with the mews as I could be.

Armani won’t let me type

Armani is so happy that I’ve been home more lately! But he is confused about why it’s so cold on his balcony when it is warm inside. That doesn’t stop him from exploring, and he wants to remind you to get outside every day even if it’s just for a minute.

Sleepy kitty

Then come back inside and snuggle.

Interview with Molly Fennig, Author and PhD Student

CW: This post talks about eating disorders in general terms.

Back in November, Molly Fennig reached out to me via my website to discuss a possible collaboration. (If you’re an author and in mental health, feel free to reach out here!)

Molly is a first-year PhD student at Washington University in St. Louis and originally from Minnesota. Of course, as a fellow native Minnesotan, we were immediately the best of friends. I also got to virtually meet Peach, Molly’s dog, who is training to be a therapy dog.

Molly and Peaches

Molly is the author of Starvation, a story of a high school wrestling student who develops an eating disorder. I read Starvation and found that Molly handled the difficult issues in this book very well. She portrayed the trauma behind her character’s mental illness with nuance and accuracy, which is difficult to find in fiction.

She wanted to specifically explore eating disorders in boys, an often-overlooked population, and the aspects of diet culture that influence unhealthy eating. Talking to Molly, I could tell she takes a careful approach to physical health and emphasizes Health at Any Size.

Many of the books I talk about on this blog are non-fiction, but I think it is important to also look at fictional depictions of mental health. There is a need for accurate representations in media, and Molly’s book provides that for eating disorders.

Starvation Cover

For her next book, Molly is working on a story of a girl coping with panic disorder. It will be another example of mental health being accurately and sensitively portrayed in media. Her progress has had to slow down a bit with graduate school, but I am excited to check it out!

As a student, Molly is still in the process of figuring out her career goals. Her current clinical interests are eating disorders, trauma, and anxiety disorders. She is also interested in EMDR and outpatient therapy.

Molly is also in the process of developing an app to help clients step down from inpatient or intensive treatment as a supplement to ongoing therapy services. I look forward to sharing more information on this when it becomes available!

Molly’s website has an extensive list of resources for anyone needing support.

App Review: Mind Doc

I am going to preface this review by letting you all know that this app partners with a certain therapy website with which I have significant ethical concerns. I am not naming said website here because they have sent Cease and Desist letters to fellow therapists who have questioned their business practices.

I tried this app, like I do with all apps that I review, and I found the free version helpful. That is why I still chose to include it in my blog. But I am not endorsing the therapy referral indicated in the app. This review only speaks to the free version of Mind Doc.

If you are looking for affordable therapy services with a provider who meets your unique needs, I recommend Open Path Collective or Therapy Den as resources to finding a therapist.

Mind Doc: Over the last two weeks, have you felt less interest and pleasure in doing things you normally would have enjoyed?

Mind Doc cues you to track your mood three times per day and has a journal option. When you sign in, it asks questions about how you have been feeling in the last few weeks as well as how you are feeling now, in this moment. It cues you both to look generally at your positive versus negative feelings as well as giving specific names for your current emotions.

How do you feel in this moment?

It also offers self-guided courses relating to things like mindfulness and mental health. There is even one about working through pandemic stress. The courses are pretty basic, but the information seems good, and they are free!

Navigating through the pandemic

If you are looking for a mood tracker that also has some great psychoeducation, I recommend checking out the free version of Mind Doc!

Call for Interviews: Adults Diagnosed with ADHD and/or Autism

Last week, I briefly mentioned getting diagnosed with ADHD at the old, old age of 33. Naturally, this led to some introspection and wondering how someone could get through a doctoral program in clinical psychology (including and internship AND post-doc that included specializing in identifying and diagnosing neurodivergence) with no one realizing they were also part of that population. (I literally wrote a piece on ADHD treatment for adults a few months ago, with no idea that it applied to me!) How are we so bad at identifying these things?

Photo by Tara Winstead on Pexels.com

Cynthia Hammer, MSW, sent me an article she wrote recently about ADHD including information about how people who go undiagnosed have a 12 year shorter life expectancy than the general population. People are dying younger because we assume everyone is neurotypical unless proved otherwise, and our existing diagnostic criteria focus on white boys. Yes, this has improved in recent years, but we are nowhere near where we need to be.

Because of who I am as a person, my solution is to write a book. My first thought was to create something memoir-style that documented my journey to getting diagnosed as an adult, but I’m a sample size of 1, and my story only goes so far.

I want to interview others about their experience being diagnosed as neurodivergent. This can be ADHD, autism, or both. Your personal information will be kept anonymous. Complete the form below if one of the following applies to you:

  1. You were diagnosed with ADHD or autism as an adult
  2. You were diagnosed as a child but no one told you until you were an adult

I hope that this can help us re-think how we identify neurodivergence. I am very excited for this project.

App Review: DayCount

CW: This post talks about addiction, specifically alcoholism, in general and vague terms.

This app suggestion comes courtesy of my friend and excellent pharmacist, Ashley. Ashley runs a non-profit that works to fight stigma and empower people with mental health diagnoses to share their stories without fear of judgment called We Matter Too. Ashley has also been sober from alcohol for more than 1,000 days, which is amazing!

DayCount is an app that helps you keep track of how long you have gone since you reset the tracker. So, for Ashley, she started the timer when she decided not to drink alcohol anymore. It then tells you, down to the second, how long it has been.

DayCount Logo

When you set up your goals, you decide what you want your timer to look like and how you want to label it. You can choose from different themes depending on your aesthetic preferences. If you purchase the upgraded version of the app, you can choose from your own photographs as a theme, which I think is particularly cool because you can choose an image that motivates you with this particular goal.

My test count, indicating it has been 19 days, 56 minutes, and 32 seconds

When I downloaded this app to try it out, I was a little apprehensive. Not everyone benefits from full abstinence – some might want to cut back on a habit without quitting all together. This is a valid goal, and each person considering using this app gets to decide what their needs are.

It seems like the app developers thought of this also! When you set up the timer, you can choose to exclude certain days. For example, you could say that you want to stop drinking alcohol on weekdays, and you would not have to re-set your timer if you had a cocktail on a Friday night.

Of course, you can always specify your goal; instead of “Days since my last drink,” you could label your goal, “Days since I had more than one drink,” or whatever fits your needs.

You can also have multiple goals, so if you are trying to stop or cut down on using more than one substance, you can track each one separately. This could help you notice specific triggers, withdrawal, et cetera, for each one.

If you are trying to increase a habit, DayCount can help with that, too! Maybe you live alone, and you want to make sure you interact with another human at least once per day. Maybe you want to leave your house daily, or do stretches, or eat breakfast every day. Instead of re-setting the timer when you do something, you re-set it on days you have not done that thing.

This is a great resource for building or breaking habits. The free version seems to be great on its own, with some helpful upgrade options based on your needs.

Telehealth Activity: Bad Ice Cream

Great news, everyone! The wonderful people at PESI asked me to write a Volume II to my Telehealth with Kids book! That does mean that the telehealth posts in this blog will probably be fewer and farther in between, as I will be focusing on putting together content for the book. Don’t worry, though – I will still have lots of app reviews, explanations of psychological terms, and posts about whatever other topic comes into my mind.

Today’s activity is similar to Duo Survival, which I reviewed a while ago. That post has more information about the therapeutic benefits of cooperative games, so I will not reiterate why I find these kinds of games beneficial here.

Bad Ice Cream is another cooperative flash game that you can play via telehealth. Share your screen, grant your client remote control, and bring up the game. You each choose an ice cream cone character, with the options of vanilla, chocolate or strawberry. You cannot both be the same flavor, which is good because this makes it easier to know who is who on the screen.

Choose Your Flavor

Player 1 uses arrow keys to move. Player 2 uses W, A, S, D keys to move. In some levels, you create ice blocks to protect yourselves from enemies – on these levels, Player 1 controls ice with the space key, and Player 2 uses the F key.

Each level has different fruits to collect, in different amounts and with different goals to pass. There are different “bad guys” in each level that follow you and try to squish you. If one player gets squished, the other player can still beat the level.

When you clear the level, the game tells you which player collected more fruit, so you can add a competitive component to this activity if you would like.

It’s pretty simple: another fun, cooperative game you can play with clients in your sessions!

Dr. Amy’s Life Updates

We made it to 2022! Can you believe it?

Photo by cottonbro on Pexels.com

Usually this blog is my way of giving you useful information, like tips for how to be a better therapist, information about how to get support for your mental health, or things I wish people knew about my line of work. Today, I thought I would share a bit about things I have been working on, what I accomplished in 2021, and what I hope to see in 2022.

Sharing accomplishments is healthy, and telling people what you are working on can help with follow through, so this post is me modeling those skills. If you truly do not care, please feel free to skip this post, and I will be back later this week with more telehealth activities, app reviews, and whatever other topic I feel like exploring.

2021: The Good

Where to begin? Just before the new year, I launched my Telehealth with Kids training with the help of the awesome people at PESI. It was well-received, and they ended up giving me a book deal to create Telemental Health with Kids Toolbox, which was basically me listing my 102 favorite things to do in telehealth sessions. (By the way, you can find information on how to buy all of my books here!)

Well, you all seemed to really like that, even though Amazon crashed the day of the launch (coincidence?). My editor told me to let her know when I’m ready to do “volume 2,” and because I’m me, I said, “Literally as soon as you will let me.” So we will see what next year brings!

My first publication of the year was my guided journal, which (self-plug) is a great gift to yourself for the new year! I also self-published Armani Doesn’t Feel Well to help kids with health issues, and my good friend Dr. Katelyn and I co-authored It’s About to Get Real Unprofessional.

Armani has shown some great progress in his diabetes treatment. I’m so glad he continues to get stronger!

2021: The Bad

As many other mental and medical health professionals can relate, I have been dancing with burnout over the last almost two years. It seems to cycle from feeling burned out -> taking a break -> feeling better -> back to work -> feeling burned out again, with the spiral a little tighter each time.

This, unfortunately, means that I have to make some changes. Fortunately, PESI asked me to create a new training (more on that later), VeryWell asked to up my contract writing for them (more on THAT later), and I have another book in the works (more on that later too), and leaning into that has meant adjusting my clinical schedule. I’m hoping this shift helps me with my own self-care.

2021: The Personal

I am unendingly grateful to my friends. We continue to pull each other through the nightmare that is the 25th month of 2020.

Also, I was diagnosed with ADHD earlier this year. Shocking, right? That definitely cleared some things up for me.

My hair is teal now, too!

2022: Looking Forward

As I learned in 2020, when every single one of my resolutions was destroyed by the pandemic, we make plans and then life happens. That being said, here’s what I am hoping for this year:

  • More blog posts! Lately, three posts per week has been a good pace because I have lots to say, but I might cut it down if I ever need a break.
  • A book about clinical documentation for those of us who work with kids, which does not sound super exciting but I promise you is needed.
  • I’d love to do more creative writing, which I may or may not share depending on how cringe-y I feel anything comes out.
  • More rest, whatever that ends up looking like.

I hope you have the 2022 that you deserve.