Podcast focuses on Mindfulness and Grief

I came across this podcast on Mindfulness and Grief that you may find helpful for yourself, someone you love, or a client.

Mindfulness & Grief: 

From Self-Care to Posttraumatic Growth with Heather Stang

 

Meditation for grief can help you cope with the pain and overwhelming emotions of loss, provide much needed self-care, as well as find new footing in your very changed world. It may even lead to posttraumatic growth. Author Heather Stang discusses the second edition of her book, Mindfulness & Grief, with guest host Karla Helbert.

The act of being mindful in your grieving process is about finding the places where you can create more space to allievate some suffering and to find the places where you can become the person that you want to be now that this has happened.

- Heather Stang

In this episode the tables were turned—Karla Helbert, author of Yoga for Grief & Loss, interviewed me on my own podcast! This gave me an opportunity to share some "behind the scenes" tidbits from the second edition of Mindfulness & Grief, and explain how I developed the eight week program in the first place. Both Karla and I find the concept of Posttraumatic Growth interesting and powerful.  While neither of us see grief as a gift— in fact when I hear that I cringe in pain—but we agree that grief changes you.  The mindful approach to grief includes both acknowledging what you can not change, and taking charge where you can. This may included applying self-care techniques to your grieving body, mind, and spirit. Not being so hard on yourself by decreasing negative self-talk. Saying no to others when you just don't feel up to socializing. Getting that massage, doing yoga, and finding meditation and relaxation tools that help you get back to sleep. Spending times doing things that sooth your soul, or help you remember and honor your special person. Once you begin to take care of yourself,  you may start to find that you are benefiting from this self care and introspection. THIS IS NOT TO SAY YOU ARE BENEFITING FROM GRIEF! Right? You would rather have your special person. You are benefiting from how you are treating yourself, and now seeing the world. In fact, there are five domains of posttruamtic growth (Calhoun & Tedeschi, 2006):

• Increased Appreciation of Personal Strength
• Sense of New Opportunities & Possibilities
• Deepened Sense of Connection & Compassion
• Appreciation of Life in General
• Spiritual or Religious Change

Please consider adding the second edition of Mindfulness & Grief to your collection, and leave a review on Amazon if you already have a copy. I tried to write the book I wanted to read, and I feel the updates in the new edition are helpful. Thank you for listening!

Are Colors Really Emotions?

This is an interesting article that looks at our perceptions of color and how they are connected with emotion rather than being simply refractions of light. Perhaps this is another reason why art therapy works so well with emotional components!

https://www.psychologytoday.com/us/blog/biocentrism/202109/evidence-colors-are-emotions-not-the-properties-light

Evidence That Colors Are Emotions, Not the Properties of Light 

Understanding colors is the first step to understanding the nature of things. 

Posted September 13, 2021 | Reviewed by Kaja Perina 

 KEY POINTS 

• Colors are deep patterns of emotions and neural connections, not the intrinsic physical properties of light. 
• We cannot discern the components that make up color any more than we can discern the ingredients in a breakfast cereal. 
• Understanding the subjective nature of rainbows is the first required leap to the true nature of things. 

What is red? Green? Blue? This may seem like a question too dumb to merit a moment’s contemplation.

The answer is not what you were taught in school. As explained in the new book The Grand Biocentric Design, the answer lies deeper than anyone thought. It involves our very selves.

To understand, let’s start by coming to a stop at a traffic light. We all agree the stoplight is “red,” even though we can never prove that the exact visual experience I call “red” is the same as yours. It doesn’t matter because, whatever it is, it stays consistent, and it has since someone thought to name the colors in the first place.

One of the big puzzles of consciousness is why we experience something called “red” to begin with. To understand the problem, consider the fact that visible light is part of the electromagnetic spectrum, which is a gradient of electromagnetic radiation running from shorter to longer wavelengths, and includes gamma rays, radar, radio, and micro-waves (none of which we perceive as “color”).

Such fields are not “responsible” for the perception of color; indeed, they themselves are wholly invisible. At best, we should experience the visual spectrum as a grayscale continuum ranging from dark to light―a simple quantitative experience. But, for humans and some other animals, it isn’t. Instead, we have a unique qualitative experience.

Colors Are Associated with Deep Built-In Patterns of Emotions 

In 1965, researchers discovered three types of cone-shaped cells in the eye that, when stimulated, are associated with the unique visual sensations of red, green, and blue. Stimulation of each type of cone is associated with a unique experience. But how and why? A clue comes from the fact that fully two-thirds of these cone-shaped cells are the “L type” responsible for the sensation of red. This lopsided majority suggests that perceiving light in that range of the visual spectrum is of higher priority than perceiving other wavelengths of light.

Red likely gets extra attention from the brain because it’s associated with alarming, important events like injury and blood. In life, the sudden presence of that color in your consciousness usually meant either that your bicycle had gone off the road into a field of begonias, or, more worrisome, that blood was pouring down your arm, requiring immediate attention.

This possibility of a life-threatening situation made red the traditional signal of bad news that shouldn’t be ignored. We know this instinctively, which is why no one except a contrarian teenager would dream of painting their bedroom a bright red, at least not if they valued a tranquil environment. This explains why red was universally agreed on as the color for things like warning notices and railroad and, later, automobile stop signals. And why even culturally distinct nations and those antagonistic enough toward the West to want to thumb their noses at new modern conventions didn’t buck this rule. Obviously, the qualitatively attention-getting experience we call “red” is associated with a deep built-in pattern of emotions and neural connections.

A similarly distinct circuitry comprising labyrinthine clusters of cells is connected with the other colors and cones—each associated with separate areas of the brain. When these cell architectures are stimulated via their respective cones in the retina, we have distinctive experiences: blue evokes the vastness of the sky and yields a much calmer feeling than red, and green conveys countless bygone centuries of plants and vegetation and is a comforting invocation of life.

We Cannot Discern the Mix of Components That Make Up Colors 

We believe that these three most basic colors and their various combinations must have had unique survival value during early evolution, and thus they are associated with their own functional pathways in the brain. When the complex relational logic associated with these distinct clusters of cells is brought into the actively entangled region of the brain associated with consciousness, we have discrete sensations even if we rarely give a second thought to the components that make up each of these colors, any more than we can discern the ingredients in mayonnaise or a piece of Cap’n Crunch.

The unquestionable reality is that colors could not be present without our consciousness. Indeed, on a more fundamental level, photons of light themselves only arise upon observation and wave function collapse; experiments clearly show that particles of light themselves do not exist with real properties until they are actually observed.

Understanding Rainbows―The First Required Leap to the True Nature of Things 

When contemplating colors, it’s hard not to consider the colors of the rainbow. The sudden appearance of those prismatic colors juxtaposed between mountains can take our breath away. Like colors, rainbows occur entirely within our skull. But unlike other objects, they have no shared tangibility with other observers.

Indeed, three components are necessary for a rainbow. There must be sun, there must be raindrops, and there must be a conscious eye (or its surrogate film) at the correct geometric location. If your eyes look directly opposite the sun, the sunlit water droplets will produce a rainbow that surrounds that precise spot at a distance of 42 degrees. But your eyes must be located at that spot where the refracted light from the sunlit droplet converges, to complete the required geometry. A person next to you will complete their own geometry and will be at the apex of a cone for an entirely different set of droplets and will therefore see a separate rainbow. Their rainbow is very likely to look like yours, but it needn’t be so. Then, too, if the sunlit droplets are very nearby, as from a lawn sprinkler, the person nearby may not see a rainbow at all. Your rainbow is yours alone.

But now we get to the point: what if no one’s there? Answer: No rainbow. An eye-brain system (or its surrogate, a camera, whose results will only be viewed later by a conscious observer) must be present to complete the geometry. As real as the rainbow looks, it requires your presence as much as it requires sun and rain.

Few would dispute the subjective nature of rainbows, which figure so prominently in fairytales that they seem only marginally to belong to our world in the first place. But it is when we fully grasp that the sight of a skyscraper is just as dependent on the observer, that we have made the first required leap to the true nature of things.

Adapted from The Grand Biocentric Design, by Robert Lanza and Matej Pavsic, with Bob Berman (BenBella Books 2020).

Flow State from Creating Art Facilitates Healing

One of the main elements of art therapy and creating art is entering the flow state.  That is something that was more recently discovered by my friend Lauren Zalewski / Gratitude Addict and she found this artist who has used her own art as a way of processing her grief from multiple losses. She posted this video of this artist's TED talk on using art to find flow, and how flow helps healing.

Pharmacy Looking to Provide Therapy at Stores

I came across this article reporting that pharmacy chains are looking to incorporate therapy sessions at their store locations. Given the ongoing difficulty of accessing mental health care (which telehealth has also helped), this could provide more availability needed by people. There are pros and cons to everything, but I'm wondering what you all think about this idea personally. Please leave your ideas in the comments below. 

https://www.wsj.com/articles/cvs-wants-to-be-your-therapist-too-11630238400 

CVS Wants to be Your Therapist, too 

August 31, 2021 

CVS Health Corp. is betting Americans will get therapy at the same place they buy their snacks, soda and prescription drugs. The pharmacy company is among several retailers including Walmart Inc. and Walgreens Boots Alliance Inc., that are experimenting with offering counseling services in or near stores. 

They see potential as the Covid-19 pandemic has prompted more people to seek help for addiction, depression and other issues, according to federal data. “It’s creative and we certainly need the help,” said Ken Duckworth, medical director of the National Alliance on Mental Illness. “It’s an interesting idea to post a mental-health resource at a place where people already are at.” 

https://mashable.com/article/cvs-therapy

The therapist at CVS will see you now

What it's like to get mental healthcare at the retail pharmacy chain.

By Rebecca Ruiz

May 2, 2021

When a client walks into Eve Townsend's office for therapy, they're often carrying a snack, drink, or new prescription.

That's because Townsend, a licensed clinical social worker, provides mental healthcare in a CVS store. Stationed in a nondescript consultation room very much unlike the therapist offices you might recognize from cable television dramas, Townsend's job is to help anyone who asks for support.

The CVS pharmacist might recommend a customer to Townsend after screening them for depression and asking if they want assistance. A client might discover Townsend through CVS brochures and mailers, or by word-of-mouth. Sometimes customers walk into the store to get milk or bread, see signs asking if they'd like to talk to someone about how they're feeling, and decide to take CVS up on the unexpected offer.

What they tell Townsend these days goes something like this: They're stressed, anxious, and often feeling depressed.

"I think a lot of that, I'm quite sure, is related to the COVID-19 pandemic, political discourse, civil unrest, and just individuals actually realizing that what they're going through is a little more beyond what they're capable of handling," says Townsend, who works in a CVS in suburban Philadelphia.

Townsend started her job in late January as part of a pilot to test placing licensed clinical social workers in select CVS stores in Philadelphia, Houston, and Tampa. The company has also posted listings for social workers in places like Phoenix, Brooklyn, Seattle, and Omaha. Therapists are part of the chain's MinuteClinics within their HealthHUBs, which provide a range of health and wellness products and services, including access to a nurse practitioner or physician assistant for treatment of urgent and chronic conditions. The mental health concept is an attempt to solve two major problems.

As a major retailer in the space and owner of the insurance company Aetna, CVS knows that healthcare costs in the U.S. are high. Its own internal data, along with research, suggest that when people receive treatment and care for both their physical and mental health needs, it leads to less spending over time. It makes sense when considering, for example, the patient with diabetes who takes medication to control their blood sugar but whose depression goes untreated. If that depression means they don't exercise or eat well, a prescription can only do so much.

Yet CVS also sees alarming gaps in the country's mental healthcare services. There's a shortage of providers. Many don't take insurance. Wait lists are long. These and other realities make it difficult or impossible for someone to get care when they want it. The aim is to simplify access to mental health treatment, removing from the equation the confusion and complexity of locating a qualified mental health provider. CVS is trying to meet people where they are: in the cereal aisle, picking out nail polish, getting a flu shot, or grabbing a medication refill.

What you won't find, at least on Townsend's watch, is a "cookie cutter" approach to therapy. Townsend, a longtime social worker, practices what she calls "social work 101."

"We are advocates for change," she says, referring to her professional training. This means hearing what a client needs to be holistically well and trouble-shooting how to get those resources. That can include providing social services referrals for someone who is food or housing insecure. Townsend directs people who need psychiatric care or substance misuse treatment to outside providers and support groups. In partnership with the nurse practitioner and pharmacist, she might triage suggestions for someone with multiple health conditions.

The skill set that someone like Townsend possesses is why CVS chose to hire licensed social workers who have a masters degree in the field. Cara McNulty, president of Aetna Behavioral Health and EAP (Employee Assistance Program), says the goal is to bring on therapists from the local community, who know it well and can connect with clients.

"Their interpersonal skills really, really matter, because you get one chance to have that first impression with that person who has reached for help, to make them feel welcome, normalize the situation, reassure them that it's OK, especially reassuring them that it's OK to not be OK," says McNulty.

She's also aware that an empathetic approach will likely appeal to CVS customers wary of seeking mental healthcare because of stigma or past negative experiences. CVS' strategy may be particularly attractive to millennials and Gen Z customers, many of whom may be less worried about stigma and more concerned that a CVS therapist will be more interested in diagnosing them than empathetically listening to them.

SEE ALSO: Police killings are a mental health crisis for Black people. They deserve real solutions. 

Theresa Nguyen, chief program officer and vice president of research and innovation of the advocacy organization Mental Health America, said putting social workers in a non-clinical setting like a CVS store, compared to a doctor's office or hospital, could be transformational. In effect, CVS is reminding people they can get help, that services are available, or catching them at a time when they might "otherwise fall through the cracks," said Nguyen. (CVS has partnered with MHA to discuss improving mental healthcare access at pharmacies, but was not involved in the development of the pilot.)

Nguyen, a licensed social worker who has frequently worked with people experiencing mental health conditions and poverty, said that she often worried about her clients whose symptoms might flair up when they went to fill their prescriptions or get food. If she knew which corner store or pharmacy they frequented, she might feel more confident in their safety.

"If I know people there are friendly and kind, I know this is a safe space for my client to get support," she said. When that wasn't the case, "I would always get worried it's going to get elevated to a 911 call."

 "If I know people there are friendly and kind, I know this is a safe space for my client to get support."

Now that Nguyen works on policy issues, she hears from pharmacy staff that they see customers in distress but don't have the skills or time to help. To Nguyen, making highly-skilled social workers available in a pharmacy can prevent crises for both the customers and employees. She also hopes that it reduces the barriers that keep many people from seeking help and normalizes having a conversation about mental health. If seeing treatment happen in an ordinary place demystifies what it means to talk to a therapist, perhaps more CVS customers will consider pursuing it.

Customers typically come to Townsend after seeing in-store messaging or receiving a referral from the pharmacy. Like other social workers in the same job, she'll perform an initial assessment and listen to what a customer needs, including food, shelter, or assistance with an abusive relationship. Next she'll try to problem-solve the urgent issues, then schedule a future appointment or refer the customer to another mental health provider, if necessary. CVS accepts insurance and Medicaid for Townsend's services, which may cover all or part of the appointment fee. If someone is uninsured, Townsend will see if the customer qualifies for local mental healthcare coverage through county or state resources. Customers can also pay out-of-pocket. The cost varies depending on insurance coverage.

Townsend says there's no predetermined end date to therapy with her. Clients can come and go as they need. Recently she treated an anxious 15-year-old who came in with his parent. They discussed the "cognitive distortions," or negative thought patterns, that kept surfacing in his mind and ways to reframe those thoughts. He returned two weeks later saying he felt better, but he can keep seeing Townsend if he chooses.

"It has given me the opportunity to see diverse populations of people — young ones, older ones — who are seeking support," says Townsend of her new job. "And [for customers] to be able to access the help that they need in a facility or in a forum like this, where you can receive all of these other additional services, is great. It works."

If you need to talk to someone about your mental health, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 8:00 p.m. ET, or email info@nami.org.

Psychological Fallout from the Pandemic and Its Impact on Behavioral Health

I found an interesting article on the psychological fallout from the pandemic.  It has affected people in many different ways, and they discuss what we know vs. what we don't yet know and the implications for behavioral health.  

https://behavioralhealthnews.org/psychological-fallout-of-the-pandemic-what-we-know-what-we-dont/

Psychological Fallout of the Pandemic: What We Know, What We Don’t

By: Michael B. Friedman, LMSW Calliope Holinque, MPH, PhD

January 1st, 2021

More and more studies confirm widespread psychological fallout from the pandemic. The studies also confirm intuitive expectations about which populations are most psychologically vulnerable—those directly experiencing illness and death, those with economic hardship, frontline health care and other essential workers, and more.

But the published studies do not yet answer several critical questions. Do people having troubled emotional reactions to the pandemic have diagnosable mental disorders? Do increased rates of alcohol and drug use constitute a rise in the prevalence of diagnosable substance use disorders and addiction? How long lasting will emotional reactions to the pandemic be? Will they dissipate as the pandemic and the socio-economic conditions it has engendered come to an end? Will they last long beyond the pandemic itself, creating increased long-term need for behavioral health services?

What We Know

The studies confirm that some of the people experiencing emotional distress have pre-existing mental and/or substance use disorders that have recurred or been exacerbated during the pandemic. But they also make it clear that people, with and without diagnosable disorders, have experienced a broad range of emotional distress—including fears regarding illness and death, desperation regarding economic survival, isolation and loneliness, loss of a sense of control, hopelessness and profound sadness, moodiness, difficulties sleeping, family tensions, and grief.

The studies also indicate that reactions during the pandemic vary substantially. Some people are experiencing high levels of emotional distress; some very little. For some, emotional distress is relatively constant, for some it has declined and for some it has increased. For many people, emotional distress is “up and down.”

The Pulse survey done weekly by the Census Bureau initially showed a decline in emotional distress overall, suggesting some adaptation was taking place. Later, the survey indicated an increase in the number of people experiencing psychological distress, though this may also reflect political and racial tensions as well as the pandemic itself.

All of the studies show that some populations are experiencing more emotional distress than others, including:

• Those with direct experience of sickness or death due to COVID-19
• Those without adequate income, food, or housing
• Healthcare providers and other essential workers
• People of color
• People with pre-existing cognitive or behavioral disorders who are at risk for relapse or severe reactions
• Working parents with children at home
• Family caregivers.

The one finding that has been surprising to some people is that young adults are more at risk for emotional distress than older adults. But this should not be a surprise because, contrary to ageist perceptions, most older adults are not disabled and in need of help, and most have survived difficult times that have taught them to cope.

Nevertheless, many older adults experience significant emotional distress largely related to their vulnerability to illness and death and due to social isolation.

What We Do Not Know

The surveys unfortunately do not tell us whether reported emotional distress constitutes diagnosable mental or substance use disorders because diagnosing these conditions typically requires an interview or more in-depth questioning. The surveys are essentially screening tools rather than diagnostic instruments.

Whether or not they provide an adequate indication of diagnosable behavioral health conditions, they certainly do not answer the critical question of whether the psychological reactions to the pandemic will be long-lasting. After all, even some “serious” disorders, are transient, and some people will certainly experience adaptation and resilience over time.

In general, we do not know to what extent psychological reactions will diminish as the pandemic and its economic consequences diminish and to what extent there will be lingering emotional damage.

Implications for Behavioral Health Policy

Telehealth: Some behavioral health need is being met via tele-mental health. Unfortunately, many of the rule changes that support use of tele-health are temporary. They need to be made permanent. In addition, tele-health is not available to everyone due to lack of internet access, lack of needed hardware, and lack of technical skill. These issues need to be addressed.

Social Determinants: It is also essential to address the social determinants of emotional distress—economic hardship, persistent racial/ethnic inequities, the vitriolic political divide, and more. It is time for our society to face up to the social determinants of physical and behavioral health.

A Mental Health Tsunami? The claim made by some that there is a second pandemic coming—a tsunami of mental illness and substance abuse—is neither confirmed nor disconfirmed by existing studies. We do not know how long lasting and severe the lingering psychological effects of the pandemic will be.

Unmet Need: Whether or not there is a behavioral health tsunami, we know that our nation’s capacity to respond to behavioral health needs is woefully inadequate. We know that there are, and will continue to be, fault lines in American society that will continue to contribute to mental and substance use disorders if they are not addressed more effectively.

The pandemic has highlighted long-standing failures to meet America’s behavioral health challenges. It is long past time to act.

Michael B. Friedman taught at Columbia University School of Social Work before he retired. He is currently volunteer Chair, AARP Maryland Brain and Behavioral Health Advocacy Team. Calliope Holinque, MPH, PhD, is a postdoctoral research fellow at Kennedy Krieger Institute and the Johns Hopkins Bloomberg School of Public Health.