Thera-pets: Reminders that you matter

We’re surrounded by messages telling us that we need to be hustling all the time to get stuff done—excelling at school, advancing our careers, earning more money, buying bigger and better stuff. You’ve heard all these and many more, I’m sure. This “advice” doesn’t work for many people (and even when it does, it probably shouldn’t). But when you’re living with a chronic illness—or three or five or nine chronic illnesses—it really doesn’t work. And when you fail to live up to these expectations, of course you feel bad about yourself, because everywhere you look you get the message that you are the problem.

What if there was another way?

What if you aren’t the problem—what if the expectations are unrealistic and the standard is impossible for most people to achieve? What if you don’t have to keep hustling? What if what you really need to do is rest? What if you are enough exactly as you are? I certainly believe that you are enough right now. I think it makes sense if you feel like you aren’t enough—and I believe that you aren’t doomed to feel that way forever.

There are many things that can help you start thinking about yourself differently, and I want to share one of them with you today: Thera-pets emotional support cards from Kate Allan (The Latest Kate). A client introduced me to Kate’s work a few years ago, and I’ve been thankful for that ever since. She has such great messages (example: “Just because you feel like trash doesn’t mean you are trash”), and each one is presented with adorable animal illustrations (that particular one comes with a pink unicorn).

[Image description: A thera-pet card with an illustrated pink unicorn. Text reads: “Just because you feel like trash doesn’t mean you are trash.”]

Research shows that it takes somewhere between five and seven positive messages or experiences to offset one negative. This isn’t necessarily a problem, because you want to be able to remember that the spoiled food made you sick or that the hot pan burned your hand. It’s not helpful when the message isn’t true, though, like if you believe that the world would be better off without you—that’s why it’s so important to have reminders that you DO matter, that you are enough, and that it’s good that you’re in the world.

Find what works for you

I’m not affiliated with The Latest Kate—I just like her work. If it’s not your style, that’s OK! But I hope you find something you can use as a frequent reminder that you don’t need to keep working harder. You are doing enough—maybe too much—and you are worthy of good things.

Christy Reichert, MSW, LICSW/LCSW, is a feminist, disability-justice oriented therapist specializing in helping professional women who live with chronic illness and/or chronic pain in Oregon and Washington state. Learn how to become a client by clicking here.

Sexism in the medical system: It’s NOT all in your head!

“You get dizzy and nauseated because you have an anxiety disorder. You need to go to therapy.”

“You get migraines because you’re depressed. You need to go to therapy.”

“Your pelvic pain is caused by unresolved sexual trauma. You need to go to therapy.”

“You’re turning your stress into physical pain and sickness—it’s called conversion disorder. You need to go to therapy.”

“You absolutely, positively don’t have [insert literally any medical condition here]. You need to go therapy.”

You’re not alone

Sound familiar? Maybe you’ve been told that you’re too young to have all these problems. Or that your symptoms match those of a particular disease, “but that’s really rare so it can’t be the answer.” Or the classic: “It’s all in your head!” Maybe you’ve heard all of these and more—for months or for years.

These are all examples of how women are consistently overlooked, misunderstood, misdiagnosed, gaslighted, neglected, and abused within our medical system. (It happens to others too: trans people, queer people, BIPOC, and more—pretty much everyone who isn’t a cishet white man. And even some of them get treated this way too, especially if they’re fat.) Women and people who hold other intentionally marginalized identities are frequently told that their symptoms are caused by stress, depression, and anxiety (and often also their weight), which leads to their actual—and often serious—medical problems going undiagnosed and untreated. If it’s happened to you, know that you aren’t alone and you aren’t imagining it or “being too sensitive.” This is a systemic issue, and it is very much by design.

The truth you’ve been waiting for

If you’re still here, you’re enthusiastically agreeing with me and want to know more—or you’re skeptical and want to read all the way to the end so that you’ll be fully prepared to argue with me (it’s OK—I do it too). Either way, you’ll definitely want to read Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick by Maya Dusenbery.

Reading that book changed my life. It offered, to quote the blurb on the back cover, “studies and statistics, interviews with doctors and researchers, and moving personal stories” that validated everything I’d already known in my heart to be true but for which I had no “official” proof. Look for it at your local library (I first listened through the Libby app before buying a hard copy to keep), or purchase it from almost any bookstore.

I have no affiliation with the author or publisher, except that I will be forever grateful to them. Reading Doing Harm early in 2019 inspired me to open Dazzling Spoons Counseling later that year so that I could support the people who have been hurt in this way: People who live with complex medical conditions, who, yes, do feel sad and anxious sometimes—but who wouldn’t when you’ve been through what they’ve been through? I started Dazzling Spoons Counseling (after working as a therapist in community mental health for several years), because therapy really can help—but not as a miracle cure for your pain or sickness. It makes a difference having someone listen to you and believe you (and maybe even help you figure out where to learn more about your physical health symptoms and what doctors might be a good fit for your needs). It makes a difference having someone on your side. If you live in Oregon or Washington state and are interested in trying therapy with me, you can learn more about me—and how to get started working with me—in the links above.

Christy Reichert, MSW, LICSW/LCSW, is a feminist, disability-justice oriented therapist specializing in helping professional women who live with chronic illness and/or chronic pain in Oregon and Washington state. Learn how to become a client by clicking here.

Troubling sleep issue: Therapy questions and answers

As a therapist to people with chronic illness and chronic pain, I hear a lot of questions about sleep. While I hope to write more about sleep in future posts, I’ve answered one of these questions here today. And if you’re looking for a therapist for support with your medical conditions, sleep problems, or both, click here to get started working with me.

Question: Sometimes when I’m in bed, I see shadows out of the corner of my eye. Sometimes I see other weird stuff too, like sea creatures or giant spiders on the ceiling above my bed. While this is happening, sometimes I hear weird stuff too, like humming and buzzing. And a couple of times, it's felt like an earthquake or tornado hit while I was lying in bed, but then there was nothing about it on the news afterward. Do I have schizophrenia?

Answer: That sounds really intense, and you were probably pretty scared when it happened. I'm glad you're asking about it! And chances are good that you don't have schizophrenia. It does sound like you may be having sleep hallucinations (referred to as either hypnagogic or hypnopompic, depending on whether you're going to sleep or waking up), which are common and not necessarily problematic, even though they can be very alarming at the time. (You can learn more about them here.) Even though they aren’t dangerous, they’re usually not a lot of fun. One thing that usually helps is to make sure you’re only going to bed when you’re really, truly sleepy (meaning that you can’t keep your eyes open and you’re having trouble staying awake). If you feel fatigued (slowed down, heavy, and perhaps sore or achy), it’s often better to rest in a chair or on the couch until you feel better rather than going to bed to try to sleep. Sometimes eating or drinking can help to reduce fatigue too (although this is not true for everyone), but food and drink usually won’t energize you if you are actually sleepy.

Christy Reichert, MSW, LICSW/LCSW, is a feminist, disability-justice oriented therapist specializing in helping professional women who live with chronic illness and/or chronic pain in Oregon and Washington state. Learn how to become a client by clicking here.

Top 3: Therapy questions and answers

Hi, there! You clicked this link because you have questions about therapy, but you’re nervous about asking them. But chances are if you’re wondering, then someone else is too. In this post, I’ll address some of the most common questions I’ve heard over the years as a therapist. (Besides, of course, “where’s the bathroom?”—that one is pretty important too!) And if you have a question about therapy that I haven’t answered here, please feel free to ask here.)

OK, on to the questions!

Question 1: What am I supposed to talk about?

Answer: Anything you want! With the right therapist for you, there is no topic that’s off-limits. You will generally get the most out of your time in therapy if you address topics that affect you personally. And a skilled therapist can help you discover new insights about yourself while discussing just about any topic.

Question 2: Should I even be in therapy? Other people have it worse than me; I don’t want to waste your time.

Answer: You are absolutely not wasting my time! While, for various reasons, not everyone who needs therapy can access it, I believe that everyone who wants therapy should get therapy. For some people, that means sessions twice a week to get help for suicidal thoughts. For others, it means once a month to check in and keep yourself on track. Therapy can help people cope with serious problems, like psychosis or mania; with more “ordinary” things, like going through a breakup or starting a new career; and with everything in between. Going to therapy can be great self-care. Beyond problems related to access (financial, location, etc.), the only reason to NOT try therapy is because you don’t want to try therapy.

Question 3: What’s the point in coming every week and complaining? Talking about it won’t make my [chronic illness/disability] go away.

Answer: That’s true—no amount of talking can cure most diseases, and many conditions have no cure. Another truth: NOT talking about your pain won’t make it go away either. And sometimes, with the right therapist, talking about it can help a lot, even though it’s not a cure. Also, while you might think of it as complaining, what you’re actually doing is expressing your emotions. If you try keep them bottled up inside, they’ll find a way out anyway. By sharing them in a safe place with someone you trust (and that takes time to build, so don’t beat yourself up if you don’t immediately trust your therapist), you can often use them to make something beautiful.

Christy Reichert, MSW, LICSW/LCSW, is a feminist, disability-justice oriented therapist specializing in helping professional women who live with chronic illness and/or chronic pain in Oregon and Washington state. Learn how to become a client by clicking here.

Mother's Day: When you had to parent yourself

I’ve been trying to write a new blog post for a few weeks. I have a couple started, but I can’t seem to get them to a level that is coherent enough to publish. Like many of you, I am frequently out of spoons. But I wrote this on my personal Facebook page this morning, and based on the responses I got, I thought it was worth sharing here too. Here goes:

I’m drowning in the Mother’s Day posts. I haven’t spoken to my mother at all in about six months; I don’t know if I will again. We’re supposed to take today to honor the women who raised us (slight tangent: If your mom really is great, why is it limited to one day a year?), so I’m going to do just that. I’d like you to meet her—not the person who brought me into this world, but the one who kept me alive this long. The one who taught me to cook for myself, to care for my clothes so they weren’t ruined after a couple washes. Who taught me that I deserve better, that my words and ideas matter, and that giving myself credit is not a sin. I’d like you to meet her—and you already have. She’s me.

Part of therapy is learning to parent ourselves—this is beneficial to everyone but especially for those whose primary caregivers were inadequate. This is not an attack on anyone (there are always reasons why parents did what they did)—this is allowing myself to take up space and take credit for getting to this point. I hope that doing so gives someone else permission to do the same. And having said this, I didn’t do it alone. To every woman who has helped to parent me (not in the ways you’d expect but in the ways that really mattered), thank you. I’m going to try to tag all of you in the comments.

I wasn’t sure what to expect. Lectures about being an ungrateful daughter? Mass unfriendings? Just silence? My digestive system, which has been raising hell since COVID-19 became a thing in our lives, kicked the chaos up a notch. I waited.

And then people started to see the post, and the likes and loves flooded in. Most of the women tagged said such kind things to me, as did other friends who wanted to support me. It was a beautiful reminder that vulnerability is one of the greatest strengths a person can have. When you are open about who you are and what you’re experiencing, you take away the power from those who try to shame and silence you. You shine in speaking your truth. As zebras and spoonies, we’ve experienced so much of this, including dismissal and gaslighting, so often we silence ourselves. Sometimes we have supportive parents who help us in this struggle; sometimes (as in my case) our parents are some of the biggest gaslighters.

Wherever you fit in the examples above, know that you are not alone and your voice matters. Whatever your relationship to motherhood and your mother, I hope you had at least a moment of peace and love today. And if you didn’t, please believe that you are good and loving enough to give that to yourself exactly as you are.

There’s also no shame in needing help to figure it all out. If you’d like to talk to a therapist, you can reach me here.

Christy Olson, MSW, LICSW, is a therapist who specializes in supporting clients who live with chronic illness and chronic pain. She enjoys making to-do lists and then ignoring her own instructions, and she really hopes the tales of the murder hornets are greatly exaggerated. Learn how to become a client by clicking here.

Coping with the COVID-19 pandemic: Did you know you can just not?

“I feel so alone. No one understands exactly what it’s like to be me right now. When I try to talk to people for support, I just end up getting mad. I cry at least twice a day—usually more.”

These are all things I said to my therapist today. That’s right. I go to therapy. I think almost everyone should. Living with complex medical conditions while trying to keep up with the demands of our capitalist society by continuing to work full-time is HARD. (Honestly, doing either one of those things on its own is hard.) I don’t know what I’d do without her validation. That was true before I’d ever heard of COVID-19. It’s especially true lately. In the past month, almost all of my doctors’ appointments have been canceled. A couple of months ago, my excellent physical therapist went to work somewhere else (where I’m unable to follow her), and I hadn’t met the PT she’d recommended before the shelter-in-place order (so I don’t have the option to email either of them for advice or anything). My day job is allowing me to work from home, as of last week, and I’m grateful to be doing it, but it comes with its own problems. I had to choose: continuing to work at my office (and risk infecting myself and others) but having most of the physical supports I need or working from home in a comfortable chair but without any of the other things I need (like a proper keyboard and mouse on a large desk). I could go into a lot more detail, but the point is that a lot of things really suck right now.

Even the experts don’t know

For the past several weeks, every time I think I finally have a good idea for a new blog post, I read the news—and there goes what I was going to say. New information becomes obsolete faster than cellphones in 2020, it seems. At this moment, I can’t remember what I wanted to say with those unwritten words. I’m not even completely clear on it right now, but I want you to know that it’s OK not to be clear, not to know. And it’s OK to be certain of something one minute and be in absolute despair and doubt the next. Although people have lived through pandemics and other national emergencies before, no one has ever experienced exactly what we are dealing with now. Anyone who tells you they have all the answers and they know exactly what to do…well, they’re full of it. There are a lot people doing great things to help right now, but not one of them has all of the answers.

Coping is optional

I imagine you’ve seen a lot of things lately about how to cope with anxiety and how to develop resilience in the face of trauma. There is good stuff in most of those articles, videos, memes, etc. But how many have you seen that tell you it’s OK to not be OK? Because the world is not OK right now. When I work with clients, we often do an exercise to determine if the client is safe in the present moment. We identify evidence to prove it. Usually the answer is yes, because they can say they are with someone they trust, they’re in a room with the door closed, the room is not on fire, etc. While those things might still be true, we don’t truly know if we’re safe right now. We could be infected with the coronavirus and not know it. Under these circumstances, it is appropriate to feel afraid. All of the things that help with “regular anxiety,” like calling a friend, listening to your favorite music, and spending time outside in the fresh air, are still good things to do—but they probably won’t work as well as we’d like them to. They’ll be there if you want to try them; it’s OK if you don’t.

Happily never after

Today I found myself thinking about the musical Into the Woods. (It’s probably free to watch somewhere right now. I recommend the original Broadway version over the newer movie version.) I love it for many reasons—but especially because they don’t all live happily ever after. It depicts trauma and grief that rings absolutely true, even though it’s a fairytale. I’m not saying that it will give you any more answers than I have here, but when I listened to some of it this afternoon I did believe, at least for a minute, that no one is alone. While it’s through a screen, for now, we’re still here to take care of each other. (If you prefer it over the video, here’s a link to the song lyrics.)

Final thought: You are even better than tacos, so you go ahead and fall apart as much as you need to.

Christy Olson, MSW, LICSW, is a therapist who specializes in supporting clients who live with chronic illness and chronic pain. She likes working from home because she can wear sweatpants, but she worries that her cat is starting to resent her constant presence and may be plotting revenge. Learn how to become a client by clicking here.

A recipe for self-compassion

I have an activity hangover today. Earlier this week, my gastroparesis flared more intensely than it has in a long time (the improvement was a good thing, but it also lulled me into a false sense of security), so I was already down a few spoons for the week. Then yesterday evening I went to a book signing, one that I’d been eagerly anticipating for several weeks. Fortunately, my partner was willing to drive. He picked me up at work, and then it took us about 45 minutes to get to the event, which we’d anticipated. What came as a surprise was how long we had to sit and wait after that. It started at 7 p.m., so I thought we’d be done by 8:30 or 9. By 9, I had started to think about leaving. My chair had no arms to lean on for support and very little padding. It felt like my nerves were being crushed between metal and bone. By 10, I really wanted to leave. Even though I was exhausted, I had to get up and walk around to relieve the pain. But I kept telling myself that leaving without getting what we came for would be worse than toughing it out. When it was finally our turn with the author, even though we got her autograph and a photo op, I could think of nothing clever or meaningful to say. (I hope I thanked her!) After that, we left—at 11.

Measuring spoons

On the way home, my physical pain improved somewhat, thanks to the padded seats in the car, but I couldn’t shake an uneasy sadness. As my partner, who is usually in bed by 10, sped silently up I-5 (I assume he was trying to beat the laws of physics through sheer force of will), I searched for the source. Then it hit me.

“Uh, I don’t know how to say this to make it seem any better…” I trailed off.

“Just say it,” he said, not unkindly but with a sigh.

“I think it wasn’t worth it. And I think it was only worth it to you because you knew how much I wanted it. So now I feel doubly bad. I really want to measure my spoons better before I suggest another event for us.”

I don’t remember exactly what he said—something about how it’s true but it’s OK—that I couldn’t have known how things would go. He’s always understanding and reassuring, and I appreciate it. I still feel guilty sometimes.

I know that I shouldn’t, though. Because how do you measure accurately when the recipe is different every time and no one tells you how many spoons you’ll need until you’ve run out? Mise en place is damn near impossible when you live with a chronic illness (or two or three or…). So pretty much all I’ve done today is shower, eat, and watch TV (my partner is a therapist too, and he’d never seen Frasier, so we have a lot of bingeing ahead of us!). While I’m always saying things like “your worth is not determined by your productivity” and “when your body tells you to rest, listen” to my clients, we all know it’s a lot harder to believe those things about yourself. If you’re struggling with that right now, I hope it helps to know that therapists do too. And though it’s still easier said than done, the best thing for all of us is self-compassion.

Progress, not perfection

Self-compassion says “I didn’t accomplish what I’d hoped for, but that’s OK because I’m human.” It says “I wish I’d planned better and avoided the pain and inconvenience, but there’s no way I could have known exactly what was going to happen.” Self-compassion allows us to treat ourselves the way we would treat the person we love most in the whole world. Who knows? With enough practice, the person you love most might just be yourself. For me, some days it’s true and some days it isn’t—and that’s OK, because I’m allowed to be a work in progress. You are allowed too.

In closing, I think it’s important to note that I did accomplish something else today: I wrote this blog post. I hope reading it made you feel less alone. But even if no one ever reads it or finds it helpful, I’m still going to be kind to myself about it. And I’m going to have some ice cream. How will you practice self-compassion and self-care today?

Christy Olson, MSW, LICSW, is a therapist who specializes in supporting clients who live with chronic illness and chronic pain. Learn how to become a client by clicking here.

Do you have to, do you have to say ‘malinger’?

“The child asks to stay home from school frequently; I suspect malingering.”

When I read that sentence in an online group for therapists, my blood boiled. Malinger means to “exaggerate or feign illness in order to escape duty or work,” according to the first hit from the Google search on my smartphone. As a therapist, my reaction stems from my belief that it’s my job to stay curious and not rush to judgment about clients. It also bothered me because people have said similar things about me.

You are allowed to fire your doctor

I have Ehlers-Danlos syndrome (EDS), a genetic connective tissue disorder that I’ve had since birth. But I was undiagnosed for the first half of my life and then misdiagnosed for most of the second half of it, because no one believed me about my own experience. When I brought this to my father’s attention recently, he just said, “we thought you were making it up.” We could debate the appropriateness of this attitude in a parent, but there is no question that it was unethical on the part of the doctors who clearly thought that same thing about me. The first doctor I asked for help with applying for disability, the one who misdiagnosed me with fibromyalgia, told me, “I am not going to help you try to get out of working.” After that I never tried again. I didn’t know I had the right to change doctors; I kept seeing him for almost six years. I wish someone had told me I could fire him. I never got to read what he wrote in my medical record, and now I am not sure that I should. I probably don’t want to.

A troubling trend

Lucy*, a medical coding auditor who lives with chronic pain, agrees with me. “This very thing gets to me on a daily basis,” she said. “Sometimes I feel that [providers] document their inner opinions and forget their audience and permanence of the medical record. I do get that there are difficult situations that are necessary to note, but some are just troubling.” Lucy also believes that many therapists need to do better when it comes to listening to their clients and understanding what they go through medically. “There is a huge need for mental health professionals that understand the complexity of these conditions.” Lucy told me she’d gone to a therapist who “claimed to have experience with chronic pain patients…but she clearly did not understand.” While I wish she’d had a better experience, I’m glad Lucy knew that she deserved someone who would listen to her and that she could fire her therapist.

A collection of judgment and prejudice

In The “M” Word: Accusations of Malingering are Harmful to Patient Care, Joshua Ellis said, “the seed of doubt grows into a small tree of criticism which blooms into a collection of judgment and prejudice that prevent the patient from receiving the care that he or she deserves. All of this can happen after a patient is accused of malingering.” This can look like Gina being told by her doctor to “just take some Tylenol,” when she has undiagnosed endometriosis. It can look like Brian, who has hypermobility in his knees, which causes him to frequently collapse when going up and down stairs, receiving instructions from his physical therapist to “run more on the treadmill to build up those muscles, and be sure to stretch after”—when he should be reducing impact on his knees and learning to control his range rather than increasing it—because “he must be making it up.” It can look like Heather, a single mother who holds it together in public for her children being denied mental health care because “patient seems fine—likely a drug-seeker,” even though she spends her nights anxious and crying, terrified that she won’t be able to cope much longer.

These people, and too many others like them, have a hard-enough time already without so-called “helping professionals” making things worse. You always hear stories about somebody who knows somebody who’s taking advantage of the system, who’s committing fraud, who’s just looking for drugs or a handout. As a therapist, I have never met one of those somebodies. I only see people who are far too hard on themselves, who usually won’t accept the help they need because their greatest fear is being “a burden,” so they rarely mention their pain. It’s time for health-care professionals to start paying attention and believing their patients. It’s time for malinger to get the hell out.

*Names have been changed for privacy.

Christy Olson, MSW, LICSW, is a therapist who specializes in supporting clients who live with chronic illness and chronic pain. She likes musicals, thunderstorms, and cheesecake, and she really hates the word malinger. She also hopes you’ll enjoy having The Cranberries stuck in your head for the foreseeable future as a result of reading this blog post. Learn how to become a client by clicking here.