How Cold Is It Really?

We are under a cold advisory right now, which I thought made a great metaphor for how we process and talk about trauma.

If you’ve spent any amount of time in the American Midwest between November and March, you’ve heard our sacred motto: “The cold wouldn’t be so bad if it wasn’t for the wind.” Sometimes this is just a lie to make ourselves feel better about our long, frigid winters – as I am typing this, the air temperature outside is -3 (Fahrenheit) with a wind chill of -15. Personally, I feel like that is still pretty cold even without the wind!

Other times, though, it rings true. The wind chill might drop the temperature from a not-fantastic-but-tolerable mid-30s day into the single-digits. It really wouldn’t be so bad if it wasn’t for the wind! But the fact is, the wind is there, making the weather intolerable.

dog wearing crochet scarf with fringe while sitting on snow selective focus photography
Photo by Benjamin Lehman on

You have probably downplayed other things in your life like we Midwesterners downplay our weather. “It wasn’t so bad,” “Someone else had it worse,” “At least I didn’t _____,” however you say it to yourself, downplaying your experience to seem better than it was does not change the fact of what happened and how it impacted you.

Sometimes, it’s okay to just admit that the weather kind of sucks right now, and I wish it would change. Sometimes, it’s okay to sit with the knowledge that something was awful and had a big effect on you.

Wind chill also brings to mind how the way we perceive things can be so subjective, especially surrounding trauma. Many victims share that, when they reach out for support, they are met with people telling them that their experience is not as bad as they perceive it to be. How is that helpful? What does it change to tell me that the temperature isn’t actually as cold as it feels on my skin, it’s just the wind making me perceive it as worse than it is?

It’s valid to say the cold bothers you, even if there is a wind chill, even if it could be worse, even if it’s colder in Minnesota. Your perspective is valid, and you do not have to meet some threshold of discomfort or suffering to earn support.

I hope you are somewhere warm and safe right now.

5 Ways To Embrace Opportunity in a Midlife Crisis

As we approach the new year, Julie Morris has shared another great guest post! This time, she has some tips for managing a midlife crisis, including how to make some positive changes to your life during an emotionally challenging time.

Image of a white woman on a computer, her fingers on the keys. She is looking up and away with a distressed expression on her face.
Image via Pexels

If you’re struggling to overcome a midlife crisis, you might be wondering how to create a life that you truly love. In midlife, it’s easy to find yourself questioning everything you thought you wanted. But the insights that come with experience can inspire you to reach for more. Here’s how to turn your midlife crisis into a brand new chapter, from opening a business to moving to finding a new job.

Open Your Own Business

Maybe you’re frustrated because you haven’t been able to reach your full potential in your professional life. If you’ve been unhappy working for someone else, why not try working for yourself instead? To increase your chances of succeeding as an entrepreneur, make a business plan before committing to a particular idea. Take some time to describe your company, figure out where and how you’ll sell your products or services, and break down your financial projections, funding needs, and business structure.

Move to a New Area

You might find it hard to move forward if you’re stuck in the same environment. If you no longer feel connected to the city you live in, it’s time to think about moving somewhere else that you love. But before you make concrete moving plans, you’ll need to research the local housing market to ensure that home prices are within your budget.

Find a New Career

What if you’re not interested in pursuing entrepreneurship – but you are getting burnt out at your current job? It never hurts to browse job openings to see if you come across any positions that you might be a good fit for. Prior to job hunting, you’ll want to create a new curriculum vitae in order to illustrate your academic credentials, work experience, and professional skills. If you don’t want to start from scratch, you can choose a template for a CV and then add your work history, images, and photos.

Work With a Therapist

Sometimes, you need a little extra support in order to untangle the emotions that come with a mid-life crisis. If you’re interested in working with a therapist, don’t hesitate to reach out for help – there’s no shame in speaking with a professional when you’re struggling. It can take time to find a therapist you click with, so it’s a good idea to start looking early. But how can you go about finding the right therapist for you? To begin your search, UMPC Health Beat recommends asking your primary care doctor if they have any recommendations and checking in with your insurance provider to find out which therapists in your area accept your coverage.

Improve Your Health

No matter what steps you take to put your midlife crisis behind you, it’s important to care for your physical health throughout the process. Make sure to commit to a consistent sleep schedule, and try to go to bed and wake up around the same time. Stick to a fitness routine, and consider finding a friend who will work out with you. Finally, focus on eating a healthy diet – Very Well Fit recommends adding a serving of vegetables to your lunch and dinner, eating fresh fruit every day, drinking more water, and swapping out refined carbohydrates for whole grains.

A midlife crisis can catch you off guard. It’s not easy to pick yourself up again and build something better out of your circumstances. But with these tips, you can polish up your resume to find a new job, move to an exciting city, or even launch a business!

Are you a therapist, counselor, teacher, or social worker? Visit Resiliency Mental Health for resources and support as you try to help others.

Mindfulness: 4 Alternatives to Breathing Activities

If we stop breathing, we die, so breathing is pretty important. We can breath intentionally or automatically, and deep, deliberate breaths can bring down big feelings and help us regulate our emotions. Many therapists have several breathing exercises to choose from that we share with our clients, like square breathing or wave breathing.

But breathing is just one skill, and there are many other ways to relax and bring down strong feelings. When we feel tense, it might be difficult to take full breaths, so it’s important to have alternatives. Plus, some clients might not feel that a breathing activity is a good fit for them. For some clients, being told to breathe or take a deep breath could be a trauma trigger.

woman doing yoga inside a room
Photo by Valeria Ushakova on

It’s always good to have other options, so here are four centering, de-escalating, calming activities that don’t involve telling your client to take deep breaths. The activities presented here are ones that I have used with kids in my practice, but they could be tailored to adult clients if needed.

Blow Up A Balloon

If someone has difficulty with being prompted to breathe but benefits from breath-based activities, blowing up a balloon can cue the act of taking a deep breath without putting the focus on the breath itself. This can be done with actual balloons in your office, or you can imagine blowing up a balloon at times when one isn’t available.

Five Senses Grounding Activity

This is a common mindfulness activity that emphasizes bringing one’s attention to the external environment rather than noticing what’s going on inside their body. This can be helpful for those for whom internal focus is unpleasant, painful, or uncomfortable but still want to bring their attention to the present moment.

For this activity, the client is prompted to name:

  1. 5 things they can see
  2. 4 things they can hear
  3. 3 things they can feel
  4. 2 things they can smell
  5. 1 thing they can taste

Feel Your Pulse

This activity can be done with a smart watch or by simply finding a pulse point on your body. While your client feels anxious, escalated, frustrated, or another Big Feeling, have them check their pulse, then notice if they can release tension from their body and lower it as they calm down.

This intervention can be a great way to teach people how to monitor their emotions as they occur. Set a schedule for the client to check their pulse on a regular schedule and keep track. This can help them notice when their body is starting to become tense or when a feeling might be getting bigger.

Note: people with certain medical conditions might not be a good fit for this specific method for monitoring feelings, since their heart rate may be affected by the health issue rather than emotional responses.

Emotional Freedom Technique (EFT) Tapping

EFT Tapping is a technique to reduce anxiety or trauma responses through a series of body taps. This is something I have learned about recently and am still exploring the research on it, but so far it seems like a great way to regulate.

There are many descriptions of EFT online – I found this one that breaks down the process and how it works in a user-friendly way. Here is a demo of the technique for practice. The demonstration includes cues to take deep breaths, so if you are avoiding breathing activities, you can simply cue your client another way, like with the Five Senses activity or checking pulse.

What coping skills activities have helped your clients?

Therapists: Tips For Charging for Consultations

Therapists, we possess unique expertise on mental health to provide care for the clients we see. Sometimes, we can use that expertise on a larger scale to reach more people and try to provide support on a broader scale. Unfortunately, the companies who want to partner with us to make this information available often expect us to work for free while they profit off of our knowledge.

Several months ago, a certain company who (according to Google) is currently valued at almost $200 billion asked me to help create an application featuring resources for parents. They balked at my suggestion that I be compensated for my time, even though they planned to sell the app to make even larger profits for their company. Excuse me?

woman psychologist taking notes on clipboard while talking with client
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Multiple times per week I get messages on LinkedIn asking to have “just a conversation” to “pick my brain” about mental health, almost always by large companies who plan to use my knowledge for their own profit. Many of my colleagues experience this too. But when we want to be paid for our labor, we’re greedy for not wanting to help people.

(Incidentally, when I started charging a consultation rate for my expertise, that added income has freed me up to increase my sliding scale and pro bono therapy hours! Multi billion dollar companies don’t need a break. People who are just trying to get mental health support do.)

I have started setting boundaries around my professional energy and set up consultation services for which I charge a rate that reflects the specialized expertise that goes into the role. Here are my tips for offering consultatoins.

  1. Your rate should be high. The companies who seek this service plan to use your knowledge to make them money, and they should pay you at a rate that reflects the value that you bring. Frankly, no matter what rate you choose, you’re going to be told that it’s too high (especially if you’re a woman, doubly so if you’re BIPOC). You need to factor in the unpaid time you spend listening to people argue with you about your rate, and don’t be afraid to cut off anyone who wants to negotiate with you about it.
  2. No, higher than that. Whatever number popped into your head when you read #1, add $50. Seriously, you are worth it. Graduate school trains us to not expect compensation for our labor, and it is a problem. You have specialized expertise that took years to cultivate, and you deserve to be compensated accordingly.
  3. Your rate should be set. This is not a negotiation. Your consultation rate is what it is, and they can pay it or they can stop wasting your time.
  4. Publish your rate. While it didn’t eliminate the problem of companies expecting unpaid expertise, I significantly reduced requests by putting my consultation rate in my LinkedIn profile. This also allows me to respond to the requests that I do get by confirming that they saw the information in my profile. They can’t claim it is a surprise – it’s the first thing on my page.
  5. They should pay you up front. I have heard multiple stories of companies stating that they agree to the consultation rate and later claiming that there was a “misunderstanding” – “That first meeting was just an interview!” “No, we never agreed to that.” “Oh no, our funding fell through!” – and again, the therapist was considered rude or cruel for still expecting to be paid the agreed-upon rate. It’s not ok for them to manipulate us like that, and one way to avoid that is to request pay in advance.
  6. You’re not being rude for expecting to be paid. They’re being rude for expecting you to work for free. I had to re-train myself to be assertive about consultation fees, and it took some work.

Companies trying to maximize their profits using therapist expertise are not the same as the clients we serve. Anyone who plans to turn your knowledge into their profits should compensate you accordingly. I hope that the more we push back on the assumption that our expertise is available for free, the more these companies learn to stop expecting it.

Discovering My Diagnosis

I’ve spoken with Lindsay Guentzel a couple of times about ADHD, both as a provider who helps people with this diagnosis and as a person who lives with the symptoms. Check out my episode of her podcast, Refocused Together, below. If you enjoy it, subscribe to hear even more people share their stories!

For more free resources, blogs, and webinars about ADHD, check out ADHD Online. They offer affordable telehealth evaluations in all 50 United States.

(While this is not a sponsored post, and I was not paid for my podcast interview, I do work with ADHD Online and complete psychological evaluations for their clients.)

Telehealth Activity: Magnet Poetry

I love creative therapy activities. Tapping into the client’s imagination is such an awesome tool. Kids, of course, have varying levels of comfort with different expressive therapies, and I never want them to feel pressured to engage in something that is not a good fit. That’s why I try to keep several options available.

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Photo by Suzy Hazelwood on

Poetry is a fantastic creative outlet and can help clients explore their experiences and emotions using words. Sometimes, a client seems like they could benefit from this type of intervention, but they aren’t sure where to start. They may be unfamiliar with creative writing or struggle to come up with their own words.

This is where magnet poetry comes in. You craft a poem from a complied list of words available. You and the client can work together to make a poem (either by choosing each word jointly or by taking turns deciding which word will go next), or they can create something independently.

For telehealth, I have two methods that I use for this intervention, depending on the options available to the client. If you are able to share links and have the client join you on a website, PlayingCards.IO has a magnet poetry game that is very easy to use. Simply create a room, share the link with your client, and the two of you can simultaneously manipulate the space.

If your client is unable to access a website from their device, you can use Magnet Poetry’s website, share your screen, and grant your client remote control. One great thing about Magnet Poetry is that they have several different “packages” that you can select, so you can get words that are developmentally appropriate or specific to your client’s interests. If your client cannot access remote control on their device, or your telehealth platform does not have this option, you can still screen share and create a poem with your client instructing you.

Of course, there are benefits and limitations to both approaches. By sharing the room on PlayingCards, you can both interact with the space at the same time. This can get complicated if you are trying to move the same piece simultaneously, though. On the other hand, Magnet Poetry requires taking turns and more communication between the client and therapist, which is of course beneficial for building these skills, but it could potentially interfere with the client’s process as they craft their poem.

Whichever platform works best for you, this is another great expressive therapy you can do via telehealth.

Show Your Therapist Your Spotify Wrapped

Music is a powerful therapeutic tool. It can reflect feelings we are struggling to express or change our mood. Music is emotion, connection, healing.

turned on black samsung smartphone between headphones
Photo by Vlad Bagacian on

For those who use Spotify, it’s that time of year when you get your rundown of what songs and artists you spent the most time listening to. If you use YouTube for music, they give a similar list – I am not sure about other platforms.

Anyway, many people find themselves feeling contemplative during this time of year. We look back on what we accomplished, how we spent our time, and what has changed. I’ve seen many commenting on how their yearly playlist reflects this.

If you have a therapist, you might consider sharing your year-end wrap with them. Together, you can explore how the music represents how the year has been for you, the good, the bad, the terrifying, the wonderful. Notice any themes that came up for you in the soundtrack of your life. Notice anything that surprises you, or anything you regret.

If you’re just starting therapy, your playlist could provide background and context for any life events that contributed to your decision to reach out. If you don’t have a therapist, you can still reflect on your end-of-year playlist as you prepare for the new year.

What do you want to bring with you into 2023? What will you leave behind?

That’s all for now.

4 Tips for Seniors Who Wish To Improve Their Physical and Mental Health

Julie Morris, regular guest blogger, shared today’s post. I appreciate her willingness to share with you all, especially as admin tasks related to my private practice have had to take precedence over blogging lately. I hope you all find this helpful!

White woman wearing a red hoodie and black leggings, running outside on a sunny day. Image via Pexels.

As you age, you may feel as though your quality of life stagnates or even gets worse when you don’t actively look for ways to improve your physical and mental health. While people of all ages find benefit in hobby activities, exercise, and lifestyle improvements, retirees and other seniors can greatly improve their lives by investing in one or more of the following tips, courtesy of Resiliency Mental Health.

1. Find A New Hobby

If you’ve just retired or you’ve spent most of your life engaging in work, you may feel restless, bored, and even useless. The reality is that you’re transitioning to a new phase of life in which you have the time to pursue your dreams, hobbies, and plans you may have put off in your youth. Start by making a list of hobbies that you can pursue without breaking the bank and pick one off your list. If it doesn’t work for you or inspire passion, move on to the next one until you find something to fill your time.

Perhaps work was truly your passion. If so, start a new business to stay fulfilled after retirement. Research what you’ll need to get started and run your business in the digital age including a website, social media, and a relevant marketing campaign. Don’t forget to register your business, perhaps as a limited liability company, to separate it as an entity and to gain important tax advantages. You’ll save money by filing online, but you can ask an attorney for help looking over your paperwork, too. Be sure to do some research into how to start an LLC in your specific area.

2. Take Control of Your Health

You may be struggling with arthritis, Parkinson’s disease, or blood pressure issues. According to the Mayo Clinic, even the normal aches and pains and cognitive issues that accompany aging can interfere greatly with your life. Review your medical plan with your physician and make it a point to adhere to any medication changes or supplement regimens to stay as healthy as possible.  

Even if you’ve never exercised regularly before, a new routine can greatly benefit you at 60, 70, or 80 years of age. Begin with exercises that aren’t too difficult and build up from there. Yoga, tai chi, swimming, and walking are great starting points that are gentle and won’t put a lot of pressure on your joints. 

3. Adopt a Pet

There are countless benefits to adopting a pet, especially for seniors, ranging from reduced feelings of isolation to improved physical fitness. A pet can help you stay active and feel needed, and they aren’t necessarily that much work, either. One thing you might want to do, though, is invest in an escape-proof harness for your dog to take the stress out of walks.

4. Become Acquainted with Your Mental Health

A lot has changed in the mental health landscape over the past few decades, and it might be drastically different than what you grew up with. People speak more freely about mental health issues now, and it’s not as stigmatized. Perhaps you experienced postpartum depression as a new mother in the 1960s and you never got help for it, or maybe you just realized that you might be autistic after your grandchild was diagnosed with ASD.

Learning more about your mental health will only help you live a fuller life. Don’t be afraid to visit a mental health counselor or even speak with your regular doctor about these issues. They can point you in the right direction of resources and additional help.

Your “golden years” don’t have to be boring. Pursue what interests you, whether it’s starting a business, tackling a list of hobbies, or endeavoring to boost your health, and you’ll surely find fulfillment along the way.

Dr. Marschall created Resiliency Mental Health to provide resources for therapists and anyone who wants to learn more about mental health. Call 605-774-1754.

Black Friday/Small Business Saturday Sales

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It’s that time of year again…. The time when we all plug our small business products! For Black Friday and Small Business Saturday, everything in my Teachers Pay Teachers store is 10% off November 26-November 28. Get your therapy resources and telehealth games at a discount, and help me buy Christmas presents for my loved ones.

And for the entire month of November 2022, use code november25 to get 25% off your order in the A Change For Better store.

Play classic board games and therapy-specific games in your telehealth sessions, and access activities to improve impulse control, emotion regulation, coping skills, communication skills, and so much more!

Do you need continuing education? All my PESI courses are discounted for Black Friday too! (A ton of other fantastic and brilliant presenters have discounts on their trainings as well. It’s a great time of year to finish up your CEs!)

I hope that you have a very relaxing Thanksgiving holiday, that your stress levels are low, and if you travel that those travels are safe and uneventful. Thank you for making this blog successful enough that therapists from all over have found ways to improve their telehealth practice.

I Joined Mastodon!

As I continue to diversity my social media presence, I was advised to check out Mastodon, a platform with several different servers that is volunteer-run and has a similar user feel to Twitter.

Screen shot of my Mastodon profile,

I’m still feeling everything out, but I love that Mastodon reminds me to add alt text to photos to help those using screen readers engage with my content, and they make it really easy to add warnings or censor things that my followers might find triggering.

They also have an edit button and mods who actually respond if someone is engaging in harassment.

If you’re on Mastodon, you can follow me at this link!

Even if we aren’t on the same server, we can interact and share content. I’ve made some really fantastic connections with the neurodivergent community over there, and I look forward to learning more from the folks I’ve met.