Made

It’s the end of my first year of becoming a counselor, and in a class reflection the other night I commented that I felt like we had all been “Made.”

There’s an MTV show by the same name, in which teenagers want to be “made” into something they currently are not; a cheerleader, an artist, a BMX biker, a soap actor. With the help of a coach and inevitable adolescent whining, the show generally ends in tears and a sense of accomplishment on behalf of the teenager.

Well, we didn’t necessarily have tears in the last class, and we really didn’t whine all that much on the way… but with our professors, supervisors and peers as coaches, we have been made into beginning counselors. A couple of my classmates agreed that if we were to go back in time and shake hands with ourselves on the first day of classes, we might not recognize our new professional selves. We are now armed with both theory and practice as we head towards our summer classes and internship year.

One Louder Entertainment. Producer. (2003). Made (Television series). New York: Music Television (MTV).

Exploring Rochester

For students and professionals moving to Rochester, returning to the city and those who already live here but might want to know more, here is a quick guide that might be helpful.

Quick Facts:
-population in the greater Rochester area: 1 million
-culture of a big city, atmosphere of a small town
-known as the “flour city” or the “flower city” for its industry and natural beauty
-home of Kodak, Xerox, and Wegmans

Festivals:
-Park Avenue Summer Art Fest
-Corn Hill Art Fest
-East End festival (music)
-International Jazz Festival
-Lilac Festival
-High Falls Film Festival
-Clothesline Festival (art)

Things to do:
-Music – Rochester Philharmonic Orchestra, Eastman School of Music, Hochstein School of Music
-Art – Memorial Art Gallery, George Eastman House (International Museum of Photography and Film), Village Gate Square
-Sports – Rochester Red Wings (baseball), Rochester Amerks (hockey), Knighthawks (lacrosse), Rochester Rhinos (soccer)
-Theatre – Geva Theater
-Film – The Little Theater, Dryden Theater
-Shopping – Eastview Mall, Marketplace Mall, Greece Ridge Mall, Waterloo Premium Outlets
-For kids and the young at heart – Planetarium at the Rochester Musuem and Science Center, Strong Museum of Play, Seneca Park Zoo, Seabreeze Amusement and Waterpark
-Nearby: Finger Lakes Region (wineries, lakes, B&Bs), Letchworth State Park, Niagara Falls, Six Flags Darien Lake, Buffalo Bills (NFL)

Favorite Foods:
-Nick Tahou’s “Garbage Plate” – a favorite Rochester dining experience, consisting of a plate piled with macaroni, homefries, burgers or hotdogs, covered in meat sauce
-Dinosaur BBQ
-Abbott’s Custard Cream – perfect refreshment on a hot summer day
-Highland Park Diner
-Wegmans – More than just a grocery store. Complete with Tea Bar, Sushi Bar, Asian Bar, Indian Bar, Burrito Bar, Pizza Bar, Submarine Shop
-Rochester Public Market – a year-round outdoor market with fresh produce
-Pontillo’s Pizza

Parks:
-Genesee Valley Park (along the river near the University)
-Highland Park (home of the Lilac Festival)
-Mt. Hope Cemetery
-Erie Canal
-Cobb’s Hill Reservoir
-Ontario Beach Park
-Durand-Eastman Park
-Mendon Ponds Park
-Maplewood Rose Garden

There’s a lot going on in Rochester, and this is just a brief overview. If I’ve left out your favorite thing to do or place to eat, please feel free to leave a comment!

“The Hunger Games” and Psychological Trauma

There is a scene at the end of the movie “The Hunger Games” in which Peeta and Katniss are staring out the window of a high-speed train. The two characters have just won a deadly competition in which twenty-four children fought to the death in a man-made, televised arena. The two both look to be in shock as they ask themselves the question, “what do we do now?”, and debate whether they start the process of trying to forget, or forcing themselves to always remember the horror they endured as members (and survivors/champions) of the Hunger Games.

The scene sticks with me because it seems to be a central question to the process of recovering from trauma. Should a person try to forget atrocities, in order to return to a “normal” life? Or is it necessary to always remember, in order to honor the experience and the way it has changed the individual? Where is the line drawn between actively forgetting and actively remembering? Especially when there are severe changes in context that call for intense emotional adjustment, it may be difficult to find an appropriate and healthy balance of forgetting and remembering. In the movie, Katniss and Peeta must endure the difficulty of emotionally processing the Games while simultaneously returning to their hometown, families and friends. In the second book of the Hunger Games series, Katniss struggles with symptoms of Post-Traumatic Stress Disorder, such as debilitating nightmares. In our own society, combat military veterans returning to civilian life must adjust to civilian life while processing experiences of war. They too must adjust to a return to a once-familiar life with an identity scarred by trauma, and potentially deal with aspects of PTSD themselves.

I was struck by how realistic this moment on the train, between two fictional characters in a post-apocalyptic world, could be. Not only do horrors like those portrayed in “The Hunger Games” exist in our own world today, but this central question of remembering or forgetting exists for many people who have encountered those horrors. Indeed, any person who is forced to change after experiencing trauma must face the question.

Self-Care for Counselors

The other night in my practicum class, I had an informal discussion with some classmates about self-care. I said, “if I do one self-care activity, that should be it, right? I should be emotionally ready to move on with my life, even if it was a really intense day of counseling.” Unfortunately, self-care is not always something you can check off of a list – it may be more of a mindset, of being aware that you are more emotionally fragile while you are processing your counseling sessions. My friend Michael DeJesus said in response to my statement that we need we remember we are new at this and have not developed an understanding of our own emotional reactions yet. He said to think of it like a sore muscle; if you go for a long, hard run for the first time ever, you will be sore afterwards. You may not notice it until you go to walk up stairs, or go out for the second run, but you will be sore nonetheless. With more training, you will build up the strength and endurance. Similarly, with beginning counseling we may be emotionally sore to start.

Self-care may take a little time and a little patience, as well as a few good tools. For some counselors, this may mean singing loudly on the drive home, chatting with a friend on the phone, making a nice dinner, taking a walk or going for a run, or watching a mindless tv show. For counseling graduate students, it might mean taking some of that pressure off of yourself, even if it’s just for an evening.

One word of advice: if you are struggling to adjust emotionally to working in the baggage department of other people’s lives, let at least one of your social supports know. That way, at least if you end up crying in your kitchen because the coffee grounds spilled all over the floor while you were making dinner, your boyfriend (or girlfriend, spouse, parent, cat or roommate) will have some idea why!

The Community of Mental Health Counseling

When a person plans to become ordained in the Episcopal Church, he or she must first obtain the support of a parish. They then enter what is called the “discernment process” with the full backing of a community. I sometimes wish graduate school for counseling had a similar system, so that in the overwhelmed moments of doubt, I could step forward with the knowledge that there is a group of people who think I am not only qualified for pursuing the education, but that I am suited for the job and am on the right path.

I had my first clients at my practicum site a few weeks ago. It was a wonderful and overwhelming experience, and when I returned home I found I did not know how to process it and my usual confidants were not available to me fully (due to confidentiality) and also did not understand the context of my emotions. So I called my classmate, who was able to relate to my experience of nerves, excitement and accomplishment, and who made me feel less alone in my first experience as a “real” counselor. When I hung up I realized that I do, in fact, have a community backing me up in this process… my classmates, my professors, my supervisors, my fellow counselors. We are supporting each other and receiving support as we realize our lack of competence in some areas, our unexpected preparedness in others, and the ways we are developing as professionals.

Alternative Therapies

There’s an anecdotal story about two Red Cross mental health volunteers who approached a man walking in a big rectangle. They introduced themselves and asked if they could walk with the man; he agreed and continued to walk. He would walk one straight line then turn, one straight line then turn. The volunteers walked with the man, step by step, until the man eventually sat down on three steps leading nowhere halfway through one straight line. The volunteers, sitting down with the man, asked if he wanted to talk. The man explained that this rectangle was where his house had been, before the tornado took it away. They had been walking the perimeter of the house.

Counseling takes place in many forms, in many settings, with various ideas behind what works and how counselors can best act to help their clients. In this case, the volunteers were providing psychological first aid following a crisis and assisting this man as best they could; by simply walking with him, before they even know why they were walking. There are several types of counseling that I had not heard of (or did not really understand) before entering the counseling field, including crisis counseling, play therapy, narrative therapy, animal therapy, and art therapy. These are just a few of many new or alternative types of therapy.

Crisis Counseling

A crisis intervention generally takes place over the course of no more than six weeks, with the goal of returning an individual to a pre-crisis level of functioning (Gladding & Newsome, 2010). To the best of their abilities, counselors provide an introduction, safety and comfort, validation of the emotional experience and may also help the individual to figure out what steps to take following the crisis. By assessing the immediate needs of the individual, counselors are able to provide psychological first aid. This type of counseling is helpful in cases of widespread crisis, as in natural disasters, as well as in cases of more individual crisis, as in house fire. Some counselors volunteer with the Red Cross as part of a Disaster Mental Health Team. Crisis Counseling is now a required aspect of the master’s degree in community mental health counseling.

Play Therapy

Play therapy allows the counselor to reach out to a child at his or her level and is an excellent option when working with children. Adults communicate by talking; children communicate by playing. Counselors may talk with children or reflect upon their playing habits, but most of therapy is spent playing with the child in a non-directive manner (meaning, the child takes the lead in the session rather than the counselor). Generally therapy focuses on allowing the child to express him or herself by playing without restrictive limits or regulations. Natalie Rogers (daughter of person-centered therapist Carl Rogers) worked extensively with a person-centered approach in a play context.

Narrative Therapy

In narrative therapy, clients create a narrative about their life or experiences and then discuss how their experiences, thoughts and emotions fit within that narrative. This allows for the counselor to gain a unique insight into the client’s perspective, while giving the client the opportunity to take ownership over his or her story and create meaning around the story.

Animal Therapy

Some individuals connect better with animals. Playing with a dog may be the best way for some people to relieve stress. For autistic children, interacting with horses (called “equine therapy”) has been shown to be effective. One severely autistic boy had tried several other therapies, and his parents were incredibly frustrated when they discovered the boy’s love of horses and ability to relate to them. In their book “The Horse Boy,” they document how their son first learned to connect with the world with horses in Mongolia (Isaacson, 2009).

Expressive Arts Therapy

Art therapy provides the opportunity for self-expression in counseling. Some clients may be better able to express their current mental state through art than through their words. As in play therapy, some clients may also be more comfortable actively creating something as a part of their therapy.
Counseling student Naomi Smith is currently taking a class at Warner on Art Therapy. She describes the therapy, saying that “Many times people will use the expressive arts in a session, but the entire therapy may not revolve around art/music/etc… I think that the expressive arts are used most often with children – but that may be because it’s hard to talk to children for an hour and incorporating art can help them. It can also be used with traumatized clients or clients who have difficulty putting their emotions into words… It might be difficult to use in an agency setting when the sessions are limited in number… We are being taught, in the class, not to offer our interpretations of each other’s work, but to explore along with the client.”

There are many ways to reach out to a client in counseling; these techniques and approaches to counseling offer unique perspectives on innovative methods for connecting with clients in a counseling setting.

Gladding, S., & Newsome, J. (2010). Clinical Mental Health Counseling in Community and Agency Settings (3rd ed.). Upper Saddle River, NJ: Prentice Hall.

Isaacson, R. (2009). The Horse Boy. New York, NY: Little, Brown & Co.

DSM-IV-TR

The Diagnostic and Statistical Manual of Mental Disorders. Fourth version. Text revision.

The title doesn’t even begin to grasp the enormity of this book (Book? Monster? Free weight? Friend?). Physically, it makes for a great dumbbell replacement. Emotionally, it makes you wince in fear a little the first time you open it. Mentally, it holds your attention with some of the most interesting, complex, scientific and political mental health issues and disorders you can possibly come across in our culture.

I say scientific because many of the disorders listed have been supported with empirical evidence and numerous studies. There are some disorders that we know to represent different ways of functioning than the “norm,” but we don’t always know how or why they are different and how they might impair an individual’s functioning.

I say political because this book is tied to current psychological trends and their political influences; its disorders may in some cases be defined by psychologists sitting around a table arguing whether grieving should last for 2 months, or 4 months, or 6 months… And the book, in doing this, reflects society and the politics that govern it. Case in point: homosexuality was not long ago considered a mental disorder.

The book, to be honest, can be kind of fun to read. Overwhelming, but incredibly comprehensive and insightful both into the human mind and into the way we treat mental health. Once you’ve gotten through the DSM, you supposedly know a lot. Or at least can say you’ve read a really big book.

The book is also more than a little scary. It’s scary to read because it is huge and because, as a mental health professional, it is hugely important to understand what’s in it. It’s scary in its existence because of its power to inform insurance policies, agency practices and individual clinician-client interactions.

When I get through it, I will be giving myself a big pat on the back. Except by that point, I may not remember to, as I will be more focused on the fact that I am held responsible for what’s in it in my practice as a counselor. As a professional-in-training I will be counseling and will be expected not only to have read the darn book, but to be able to use it to actually help people.

And, once that’s conquered… DSM-V will come out. Graduation: Summer 2013. New DSM: 2013. Here we go…