Sun Sailor introduces Birch Counseling Walk-In

Birch Counseling in Hopkins offers same-day, walk-in mental health counseling

By Kristen Miller kristen.miller@ecm-inc.com

To address the lack of immediate mental health counseling options in the Twin Cities, Birch Counseling has opened a dedicated same-day, walk-in clinic at 904 Mainstreet in downtown Hopkins.

“What we are offering is akin to urgent care for mental health,” explains Christa Surerus, licensed professional clinical counselor.

She and her husband, James Mallon, also a licensed mental health counselor, operate three other Birch Counseling locations with an office in Golden Valley and two offices in Minneapolis.

However, they wanted to provide greater flexibility and accessibility for those in crisis.

“Currently, it takes about three weeks to get into Golden Valley, and that’s very common with just about any counseling service,” Surerus said

“Up until now, if someone was experiencing a mental health crisis, that person would have to choose between scheduling an appointment for a later date, which could be days or weeks away, or going to an emergency room, which is really meant for life-threatening situations,” she said. “We are filling in that gap for when those unexpected issues in life become too much.”

They have seen that the demand for care, having witnessed people walking through closed-door sessions in order to be seen, and decided they needed to do something about it by making mental health care more readily available.

With 12 offices, people can walk in and expect to be seen that same day.

“There are so many people who are dealing with these sorts of traumatic situations that can come up very suddenly,” Mallon said. “We are here for them today. Not tomorrow. Not next week. Today.”

The most important reason they opened the walk-in clinic is to help combat the rising number of suicides in Minnesota.

“As you may know, suicide rates around the country have been going up, and Minnesota is one of the top gainers,” Surerus said.

According to the Minnesota Department of Health, the suicide rate has increased 53 percent from 1999-2017.

Surerus also noted that 85% of males who die by suicide have no known mental health condition, “which means they never sought professional help,” she said. Completed suicides by females are also on the rise, she said.

“It is our goal to offer a safe place for individuals, families and couples to get the support they need by helping them calm and stabilize sufficiently to problem solve life challenges,” she said.

Birch Counseling also has the capacity to grow and expand its hours.

Currently, they are open 10 a.m. to 6 p.m. Monday through Friday, with hopes of offering evening and weekends hours in the fall.

They accept all major insurance, medical assistance and out-of-pocket payments.

To make an appointment, call 952-562-4116 or visit birchcounselingwalk-in.com.

Follow the Sun Sailor on Facebook at facebook.com/mnsunsailor.

Twinc Cities Business Magazine features Birch Counseling Walk-In Clinic

HEALTH CARE

Birch Counseling Launches Walk-in Mental Health Clinic

Owner Christa Surerus sees it as ‘urgent care’ for mental health crises.

MAY 23, 2019

DAN NIEPOW

Birch Counseling last week opened a walk-in mental health clinic in Hopkins. 

The clinic is intended to address mental health issues on a quicker time frame than traditional therapy. 

Before the clinic’s opening, Birch Counseling providers had been struggling to meet increasing demands for services, says owner Christa Surerus.

At the company’s Golden Valley clinic, for instance, every provider has a three-week waitlist.

“It is quite frankly difficult to keep up with demand,” Surerus says. “We noticed there’s a huge gap in our community between what people need and what’s actually offered as far as mental health services.”

The clinic is aimed at serving folks “whose worlds have fallen apart,” she says. That could include people who have just lost a job or received a dire health diagnosis.

Surerus sees her clinic as a sort of “urgent care” for mental health crises. She believes it's the only clinic of its kind in Minnesota.

The clinic accepts all forms of major insurance, though it doesn’t yet have a contract with Medicare, according to Surerus.

For those who want to pay for services out of pocket, the cost is $120 to see a licensed provider. For $95, clients also can opt to see providers working toward licensure.

Mental health issues and suicidal behavior often go hand-in-hand, according to Surerus. What’s more, the uptick in demand for more services locally is emblematic of larger issues brewing across the nation. According to data from the Centers for Disease Control and Prevention, about 45,000 Americans died by suicide in 2016, marking a 25 percent increase since 1999.

Minneapolis and St. Paul Business Journal features Birch Counseling Walk-In

By Alex Wittenberg  – Staff writer, Minneapolis / St. Paul Business Journal 

May 29, 2019, 2:58pm EDT

People in the Twin Cities suffering from a mental health-related condition have a new option for treatment. 

Birch Counseling on May 15 opened a walk-in mental health clinic in Hopkins that provides same-day counseling services to patients. The service, the first of its kind in the Twin Cities, according to Birch, hopes to make mental health treatment more accessible. 

"Our clinic in Golden Valley has a three-week waitlist, and that's just not good enough," said Christa Surerus, founder and owner of Birch Counseling. "People are calling in with very urgent needs, and they can't wait even a week to be seen. We're trying to close that gap."

The clinic, located at 904 Main St. in Hopkins, has four dedicated counselors on staff. As demand for the service increases, Birch plans to have as many as 40 staff members working extended hours at the clinic, Surerus said. 

Surerus expects the clinic to treat people who feel overwhelmed by grief, sadness or worry. One recent patient was a woman who was struggling going about daily life after the death of her partner. Other patients, for example, may feel unsettled over job and housing precarity or a serious health diagnosis they have to share with their family, Surerus said. 

"We wanted to make it accessible in the terminology we use," she said. "Very rarely do people wake up at 3 a.m. and say, 'Oh my god, I need to see someone, I have anxiety.' Most of they time they don't know they have anxiety. They just know they're worried." 

Birch works with most major insurance plans. The out-of-pocket cost for an appointment with a licensed counselor at the new clinic is $120.

Being Present

One of the keys to overcoming depression and anxiety in our lives is the ability to be in the present moment. You might be thinking, “That won’t change my past” or “That won’t solve my problems.” Yes that is correct because we cannot relive our past and most of our worrying does nothing to solve the problem. Ruminating about mistakes in the past only brings us down, and worrying takes away the peace of the present moment. 

Maybe you tried a mindfulness exercise which helps for 15 minutes be in the present moment, but your problem is waiting to greet you when you arrive home. How do we escape the inner critic or fears that seem to follow us around daily? Here are some practical strategies to stay in the present moment. 

1. Take a worry break: Take a set period and think about all your worries. Next, write down all the actions you can do to reduce or manage the worries. Put these actions into a calendar. Now write down the the worries you have no control over. Address the worries one day or moment at a time. You now have an action plan to address your worries. When you are not in a worry break or there is nothing else you can do to manage your worry at the time do not continue ruminating about the future! 

2. Resolve any troubles from the past: What is lingering from the past thats bothering you today? Whether it is a trauma, financial mistake, or opportunity you missed out on, ask yourself “what is a step I can take today to resolve this?” Rather then ruminate on the past, it’s time to take that action step forward. This might mean involve reaching out to a therapist or counselor for the support. Like the worry break, when you are not taking action towards resolving the past it’s time to stay focused on the life in front of you.

3. Take one task at a time: When you have 20 things that need to get done, life can get overwhelming. The problem is we cannot do 20 things at a time and we don’t perform at one task when thinking of the other 19. Instead put the priority of the things that must be done today and concentrate at the task at hand. The other tasks will be taken care of when the time comes.

4. Stop the procrastination and avoidance: Some things in life will always be unpleasant and the quicker we take care of them, the quicker we can get back to the things we enjoy. Rather that dwell upon errands all day, take of them sooner and reward yourself. This also applies to specific fears. It may be time to confront the fear rather then avoid. Avoiding the uncomfortable conversation you need to have only keeps the problem lingering around or make it worse. 

5. Have meaningful or enjoyable activities daily: Speaking of rewarding yourself, the whole purpose of this article is to get back to enjoying life. In order for that to happen you need to be living the life you were born to live! Spend daily time present in those activities that bring value or meaning to your life. This is also a challenge to try new activities or meet new people that will bring joy to your life. 

Again, working with a trained therapist or counselor is a great way to practice these strategies and take in individual circumstances. The past is behind us and the future is never guaranteed so lets focus our time and energy on the present moment. 

Social Media and Teen Mental Health

A study recently published in JAMA suggests social media use among teenagers is significantly correlated with increasing suicide rates. The U.S. Department of Health & Human Services suggests 71% of pre-teens, teenagers and young adults use more than one social media site. The most popular social media platforms are Snapchat, Instagram, Twitter, Facebook, and YouTube. Day-to-day usage can include messaging, video chatting, picture posting, blogging, article sharing, among many others. Essentially, young people today are connecting with each other online far more than face-to-face.

Teens spend dozens of hours a week scrolling, posting, and reading, and increasingly data confirm this comes at a high cost. Social media makes it easy to airbrush experiences and life events, leaving out details about the mundane, the struggles and difficulties. Young people are particularly vulnerable to these distortions as their sense of self is still in the process of developing, and peers are highly influential. “Who am I compared to others” is one of their top concerns, and when you compare yourself to airbrushed profiles, you tend to come up short. Increasing numbers of young people report feeling inadequate, jealous, anxious and depressed.

If you think social media may be affecting your mental health or the health of someone you know, consider these tips:

• Turn off your notifications for at least a few hours each day (which you can gradually increase); put your phone in “Airplane” mode or “Do Not Disturb”.

• Delete apps that contribute to unhealthy body image or other feelings of inadequacy. Add apps that help you feel better about yourself or inspire you to engage in healthy behaviors. Meditation apps can be a better use of your time, for example: Calm, Insight Timer, and Headspace. 

• Use an alarm clock instead of relying on your phone as an alarm to prevent you from using your phone the minute you wake up.

• Take a day off from social media to focus on other things. Sunday is a good suggestion since it is a day when you probably aren’t in school or at work.

• Consider putting your phone in grayscale. This makes your phone less enticing to look at. With the colorful apps and notifications changed to gray, they may be easier to ignore.

• Set boundaries or only certain times when you can check your notifications.

• Start a habit of placing your phone near the door when you come home — doing it with a friend, partner, or family member can help you stay motivated and accountable! Make a plan with a group of friends to spend more time hanging out in person and less time interacting via social media.

• If you are a parent wanting to learn more about how to limit your child or teenager’s social media use, check out these additional tips from the American Academy of Pediatrics.

Expectations and Emotions: The Wedding Stressors

For better or worse, a wedding brings people from all parts of your life together. You’ll have different personalities, different relationships and histories, and societal, familial, or cultural expectations of what and how the whole event is supposed to happen all swirling together for one day.

Sometimes, people get caught up in themselves and their feelings that have or sometimes have nothing to do with the couple. Emotions can rise to the surface that are brought on by memories — something you probably had no idea existed until they surfaced. This was just supposed to be a celebration, right?

So with all of these potential problems, it’s amazing to think that most weddings go off without a hitch.

So what’s the secret to sanity during the planning and day of celebration? Managing expectations, yours and — to the best of your ability — everyone else.

Know that you will encounter problem/s you cannot control — not logistical problems, but someone will have a difficult time emotionally and it will come out directly or sideways, like caring too much about one tiny aspect of the wedding.

Know that everyone has different expectations — This is the cause of most problems in weddings. Managing expectations requires knowing what you want as a couple and how to work with your family-to-be, too.

Communication, communication, communication —  The more you talk, the more you know.  The more you know, the more you can help avoid any foreseeable problems.

Laugh it off and just have fun — At the end of the day, it’s about the couple getting married. You chose to have a cultural event with a celebration instead of a simple and short legal ceremony. We have parties to celebrate. So have fun.  Something will go wrong or someone will not be happy about something, so practice a good sense of humor and do the best you can.

Technology: enhancing or hurting relationships?

The growth in our use of technology has been exponential.  It is easy to see how our increased use of devices has eliminated the separation, or at least blurred the lines, between our work, home and social lives.  The interconnection of these different components of our existence make it more and more difficult to be present in the moment.  Our ability to send a work email while cooking dinner at home, checking social media while at work, and texting our significant other during lunch with a friend, contribute to the state of absent presence.  These common daily behaviors reflect the pervasiveness of technology, particularly the use of smartphones.  

Since technology offers instant gratification, it can be difficult to resist the urge to be online at all times.  Thus, the practice of phone-checking has become as natural and involuntary as yawning.  In 2016, Apple found that its device users unlocked their phones 80 times every day.  If we consider what we do at any given hour throughout the day, does phone-checking enhance or detract from what, or whom, is in front of us?

Technology has proven to expand our social lives, yet could it be constricting our private one? When was the last time you shared a meal with someone without your phone being within reach?  Brandon McDaniel, a researcher in human development coined the term “technoference” as “everyday intrusions or interruption in couple interactions..that occur due to technology”.  Since it has become so common for people to engage in phone-checking while out to dinner, the opportunity to connect face-to-face is limited and authentic engagement is fragmented.  Thus the art of breaking bread together lacks fulfillment when a device is present.

Dr. John Gottman, famous marriage researcher states, “While communication issues have many causes, a common culprit in today’s world is the seemingly endless number of notifications from our digital devices. They have become a distraction from the real connection right in front of us”.  Furthermore, it is in unstructured moments that partners, in particular, hold the potential for spontaneous conversation and laughter that help to build closeness and a sense of connection.

The benefits of authentic connection are endless, including the release of hormones which contribute to a boost in mood and can increase overall happiness.  Does knowing that our constant phone checking compromise our relationships, and keep us from experiencing a natural mood boost enough to change our behavior?  If not, consider setting limits for yourself and your significant other through a tech agreement that includes:

-expectations for use; an agreement that both partners will not text, check email, or update their social profiles during specific times of the day or particular events, such as date night, mealtime, or when either of you needs to talk.

-what kind of technological contact does each person consider appropriate?

-when is it OK to be anonymous online?

-rules for technology use in the car

-how much of your relationship are you OK with being shared on line?

Making such adjustments to behavior require effort and self-control, so remember to slow down, take time to reflect and support yourself and others in making these important decisions to be more connected …without the use of technology.

Breaking the Silence on Sexual Assault

Birch Counseling would like to thank Governor Mark Dayton and the State of Minnesota for proclaiming “Break the Silence” Day on August 16. 

In the line of our work, we have witnessed too many stories of sexual violence, and are struck by the deep hurt that haunts those who have experienced it.  Survivors of sexual violence too often remain silent.  It takes tremendous courage for those who experienced this form of violence to share their pain with others. Speaking up, sharing with others, connecting with support paves the way for healing.

Common responses from others who’ve heard stories of survivors include “what were you wearing,” “why didn’t you...”, “you should have known…” This compounds the self-blame, which already tortures those who have experienced this form of violence. Confronted with judgment, survivors remain silent. 

Breaking the Silence helps fight the stigma. The event allows survivors to speak out and feel acceptance from a community that offers nothing but hope and support. 

We’re so pleased that Sarah Super found the courage to speak out.  She has formed Break the Silence, and has consistently advocated on behalf of survivors so they may find their voice. 

We are grateful to live in Minnesota.  Our State continues to offer strong support for those who struggle with mental health problems that too often stem from experiencing violence. 

Brian Borre on KARE-TV on Hostile Workplaces

STUDY: ONE-FIFTH OF AMERICANS FIND WORKPLACE HOSTILE

Nearly one in five workers say they face a hostile or threatening environment at work, according to a recent study.

Author: Zach Lashway Published:08/14/17

GOLDEN VALLEY, Minn. - Nearly one in five workers say they face a hostile or threatening environment at work, according to a recent study.

Rand Corp., Harvard Medical School and UCLA surveyed 3,066 U.S. workers. The study found:

A "disturbingly high" number of workers say they face a hostile or threatening environment at work, which can include sexual harassment and bullying. Workers who have to face customers endure a disproportionate share of abuse.

• Nearly 55% say they face "unpleasant and potentially hazardous" conditions.
• Nearly three quarters say they spend at least a fourth of their time on the job in "intense or repetitive physical" labor.
• Only 38% say their jobs offer good prospects for advancement. And the older they get, the less optimistic they become.

About half say they work on their own time to meet the demands of their job. In many cases, less-educated workers endure tougher working conditions.

Brian Borre, a licensed counselor at Birch Counseling in Golden Valley, said he is not surprised by these numbers.

“Work-related stress and work hostility is a huge factor in why a lot of people come into counseling,” Borre said.

Borre recommends assertive communication.

“The onus is very much on both parties, however, I think the employee – the individually will benefit greatly by utilizing assertive communication and having these strong and clear boundaries," he said.

Borre said assertive communication is one of the main tools an employee has at their disposal.

"(When) they’re experiencing hostility, sexual harassment and any other adverse environments, utilizing assertive communication allows the individual to not only establish clear and healthy boundaries, but hopefully maintain them and at least have a perimeter in which individuals understand when someone else is violating that boundary," he said.

Which reminds us, we may have more control over stress than what we realize.

Be wary of self help blogs (even this one!)

Encouraging critical thought and autonomous decision making (should be) part of any mental health provider’s core objective for clients. My assertion is that this applies to not only health care providers, but also the information that flows across your screen. People sharing their experience, and more specifically their personal successes in overcoming life obstacles is a wonderful aspect of mass media, and should be celebrated. Most of us would like to assume that we are resilient and insightful enough to distinguish plausible and useful self-help articles from ill-conceived and amateurish messages parading as fact.

And this very well may be the case for you.

The concern is that even the on-line messages that we do recognize as somehow ‘off’ or skewed can nonetheless impact us. If you find yourself engaged in some form of social media or online presence; you may have noticed the ubiquity of self improvement posts/blogs/editorials/websites/ted-talks, etc. There tends to be a full spectrum of professionalism around these blogs ranging from disguised advertisements and charlatans to journal entries to actual new information based on scientific data to support a hypothesis. In this era of so-called ‘fake news’, I have often wondered about the notion of ‘fake expertise’ in terms of espousing opinions lacking research based credibility and/or information emanating from an individual lacking any kind of training or professional accountability.

So the question becomes: why would someone want to critically assess a self help article that ‘rings true’ or aligns with one’s values and/or goals?

Simply put: because often times our ‘default thought process’ (i.e.how we emotionally respond to something in the moment) may actually NOT have our best interest in mind. An example is a self help blog that taps into a person’s internalized shame via covert messages that ultimately translate to ‘you are not good enough’, ‘you are responsible for others people’s feelings/behaviors’, you are an inadequate spouse/parent/lover/etc’.

Every time a blog, ted talk, or pod cast lists out the ways you SHOULD be doing or thinking about something; please keep in mind there is a not-so-obvious implication that you yourself are not good enough.

This actually is a rather successful marketing strategy that has been used for decades. I remember in the early days of social media; I would take the time to consider if a particular article/message was in some way a commercial in disguise. More recently I have noticed that I stopped really caring one way or the other. . . that can’t be a good thing. The problem arises when marketing, shaming, and self-help become blurred into easily digestible messages leaving us satisfied in the moment; but unsatisfied over time (rather sounds akin to fast food, no?).

Another way in which one can critically examine a self help message is to look for the ‘grey’. That is, does the author address the plurality of ways to achieve a desired goal as opposed to doing something the ‘healthy way’ (i.e. the author's way) or the wrong way (essentially anything else). No matter how much you may agree with a blog’s message, ask yourself if the author is stumbling into a black or white thinking error. If only real and healthy change was as easy as finding the right way to raise your children, or cure addiction, or vanquish depression, or nullify anxiety. It is definitely NOT my intention to vilify the attempts of people to share motivational messages and strategies to navigate through life.

Again, our lives are a shared experience and are deserving of a shared narrative that other can benefit from. The only way to sift out the helpful messages from the rest is via critical thinking and avoiding the trap of seeking out messages that act to simply confirm what we already believe. Because, more often that we might hope or think, that which we ‘already know’ may be emanating from unhealthy parts of ourselves (i.e. addiction, shame, fear, anger, jealousy, etc.). So don’t turn off your screens (or do, but that is for a different blog), simply remember to use you critical thinking skills on even the self help messages that resinate the most. . . yes, yes - this one too.

Understanding and Protecting Your Family from Dark Web Opioid Purchases

The number of people who have died from heroin and opioids in the United States has more than quadrupled since 1999, according to numbers from the CDC. Drug overdose is now a greater cause of death than car accidents.

Although many people unfortunately develop an opioid addiction through the use of prescription pain relievers, prescription abuse is no longer the easiest way to gain access to these drugs. The Internet has become a major player in the opioid industry, with purchases made on the so-called “dark web”—the part of the Internet that exists on encrypted networks and requires special software to access. Since traffic on the dark web is difficult to trace, it is a prime venue for illicit commerce.

Exacerbating this problem is a particular synthetic opioid—fentanyl—which is extremely potent. Because only a tiny amount is enough to get an adult high and only a few flakes of it are enough to cause an overdose, large quantities of it can be transported in a standard first-class envelope. Dealers in China have been known to deliver the drug through the US Mail by routing it through Hong Kong. The dark web is making it easier than ever for dangerous opioids to reach the streets in the United States.

The opioid epidemic is a major public health problem that will require the best efforts of law enforcement, legislators, and local communities to solve. Parents and families may not be able to immediately stop illegal drugs from reaching the streets, but they can teach common sense practices to their children to help protect them. Although the dangers are different, the solutions are largely the same—the chief of which is clear communication between parents and children.

Communicate with your children about the dangers of drug use. And remember that communication is a two-way street: be willing to listen to your children’s experiences of peer pressure, and provide a safe space for them to share their experiences with you—without fear of punishment. Having a strong relationship with your child and encouraging strong and healthy relationships with responsible peers is one of the best ways to prevent high-risk behaviors like experimenting with illicit drugs.

Communicate, too, about the risks of the Internet. In our digital age, it is not unheard of for a curious teenager to explore the dark web and the “deep web”—the part of the Internet not indexed by standard search engines, which houses the dark web. Help your child understand the legal and ethical implications of Internet use, and instill in them a healthy fear of products and services that they may find on the web. Be sure you know what your child is doing on the Internet, and find a positive outlet for their interests—like a coding class.

What Anxiety Feels Like

Q: What is Anxiety?
A: The American Psychological Association defines anxiety as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.” Anxiety is a normal emotion that most people experience at some point in their life. It is common before significant events—like an important exam or a job interview. But some people experience anxiety with enough intensity and frequency that it interferes with their normal life. In that case, they are experiencing what is called an anxiety disorder.

Q: What does anxiety feel like?
A: Someone who is anxious is nervous and restless. Anxiety focuses the mind on a subject—an exam, or a job interview, for example—and causes a person to think about the potential dangers. They will likely also experience physical symptoms, such as increased heart rate, more rapid breathing, sweating, and trembling. Sometimes physical manifestations can be more serious—insomnia, gastro-intestinal irritation, or fatigue.

People experience extreme anxiety in different ways. General anxiety disorder is often characterized by excessive and persistent worrying about normal activities. Panic disorders involve episodic, rapidly onsetting anxiety that peaks in a state of mental and emotional overload and cause physical symptoms like chest pain and shortness of breath. People with Obsessive Compulsive Disorder have intrusive thoughts that disturb them and motivate them to engage in repetitive acts. Phobias will cause a person to be anxious about a very specific thing or situation. These are just a few examples of serious anxiety disorders.

Q: How do I know whether my anxiety is normal or serious?
A: When a person finds it difficult or impossible to control anxiety and calm themselves, when anxiety begins to interfere with their everyday activities, or when anxiety causes them to avoid places and activities that they might not otherwise, then their experience of anxiety is problematic. Some critical warning signs are depression, self-medication through alcohol or drug use, and the serious physical manifestations mentioned above—insomnia, gastrointestinal irritation, and fatigue. If any of these warning signs are present, it is important to see a doctor about potential treatment, which may or may not include medication.

Q: What if I’m thinking of harming myself.
A: Call the National Suicide Prevention Lifeline right away: 1-800-273-8255; or use the online crisis chat: http://chat.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx. You’ll be connected to a grief counselor and your conversation will be confidential. Anxiety is not a permanent problem, and there are real and effective solutions.

Q: What can I do to reduce my anxiety?
A: It is most important to know yourself and your symptoms, recognize when you need help, and be willing to seek help when you need it. A mental health professional can provide you with the tools to learn about and keep track of your disorder and can direct you to relevant resources and support groups.

There are also a number ways to self-manage anxiety symptoms that are safe and effective in conjunction with medical advice. Staying physically active is a proven way to reduce stress and overall health and well-being. Developing good sleeping and eating habits can also improve mental acuity. On the other hand, it is best to avoid substances that can increase anxiety, including caffeine and nicotine as well as drugs and alcohol.

Relaxation techniques such as mindfulness meditation are often helpful for reducing anxiety. If you are unfamiliar with mindfulness meditation or other relaxation techniques, a mental health professional can recommend local resources to help you learn about them.

How to Suggest Therapy for a Friend

Therapy can be a difficult subject to broach. For all its benefits, many still consider the need for therapy and other forms of mental health care to be shameful. For someone who is already feeling the burden of anxiety, depression, or another mental illness, careless advice—even if it's good advice—can be harmful.

Nevertheless, there may be a time when it is important to offer such advice to someone. As a friend and loved one, you often have insight into the lives a people around you that they don’t have themselves. Reflecting on Aristotle’s views of friendship, philosophy professor Massimo Pigliucci writes, “Friends hold a mirror up to each other; through that mirror they can see each other in ways that would not otherwise be accessible to them, and it is this (reciprocal)  mirroring that helps them improve themselves as persons.”

The first step is to know what you are talking about. Be aware of the symptoms of depression and mental illness, and be aware of the real benefits of psychotherapy. Depending on pop psychology and attempting to diagnose a friend or loved one can lead to offense, and misconceptions about therapy can create false promises. If you are concerned about someone, make yourself aware of the symptoms and treatments before you say anything. Be careful not to call simple differences in personality mental illness. Rather, be on the lookout for unusual changes in behavior and erratic moods. Be aware of factors in someone’s life that might be contributing to those changes.

Next, consider carefully how you communicate your concerns. Treatment for mental health problems often involves serious and potentially embarrassing topics. Approach the conversation seriously and privately. Both of these factors avoid shaming your friend by demonstrating that you take them and their well-being seriously. By not going behind their back to other friends and family members, you show them that you respect them and trust them to make sound and independent decisions about their life. A group intervention is never the first step.

It’s also important to be aware of your friend or loved one’s mood and receptivity. In their moment of frustration, anger, or stress, their need for therapy might be the first thing on your mind, but it’s likely not an opportune time to communicate it. Avoid raising the topic in the heat of the moment. Let your friend know that you have something serious and important that you would like to talk about, and set aside a specific time to talk about it.

How you frame the conversation is important. Emotional health is a personal matter, and someone who is experiencing a hard time may take any conversation about it as a personal attack. Be careful to use “I” statements rather than “you” statements: “I’m concerned about you”; not “There’s something going on with you.” Focus on the specific words or behaviors that have raised your concern rather than a general sense about your friend: “I’m concerned about the fact that you’ve been doing this thing that’s out of character. Is there anything going on? I think you might benefit from some talk therapy.”

Be honest and empathetic. Trust your friend to make the best choice, and offer your advice as simply that: advice. Not everyone will take it, but it is important to respect their decisions nonetheless.

Summer Self-Care Strategies

“Self-care” is the word of the moment in pop-psychology. Although it gets a bit of pushback in some circles (is avocado toast part of your self-care plan?), self-care can be beneficial if it really is self-care and not simply self-indulgence. Genuine self-care is all about establishing healthy habits that improve your overall well-being, whether at work or at home. Summer, with the many changes it brings to people’s schedules, is a great time to consider starting new habits to improve your life.

1. Develop a Routine
If you don’t have a regular routine yet—or if you have one that you’re unhappy with—establish a good one now! There is no better way provide structure to your day, increase your efficiency, and build your momentum. If you find it hard to motivate yourself to do important work, a regular time every day to do it can help you avoid a daily battle with procrastination. And getting important work done early and regularly will keep it from hanging over your head and allow you to enjoy the rest of your day.

Start simple and begin doing a few things daily and strictly to develop the habit. Don’t expect to become perfectly disciplined overnight. A simple daily planner is a great resource when you are first developing a new routine. Write down reasonable daily goals and check them off as you complete them to avoid the constant feeling that something needs to be done. A routine also allows you to schedule some of the mainstays of self-care—mindfulness exercises, self-reflection, and creative outlets.

2. Sleep Well
One of the best places to start a new habit is in how you sleep. In an era of abundant coffee and Internet access, it’s tempting to trade sleep for a little extra work or the easy stimulation of a Netflix binge. But regular and adequate sleep is a key component to physical and mental well-being. Besides the proven benefits to physical health and performance, sleep improves memory, attention, and mood. Setting a strict and consistent bedtime and giving yourself time to decompress and brush your teeth beforehand are important first steps in developing a healthy routine.

3. Take a Break from Technology
Set limits for yourself when it comes to technology. This is one of the places where the difference between self-care and self-indulgence is most clear. Cell phone use and checking email are quick and easy sources of dopamine. You can get a small rush from them that motivates habitual behavior. But unscheduled screentime has a number of drawbacks. It hurts sleep, lowering melatonin levels and shortening REM cycles. It also interferes with your productivity, interrupting important activities and taking your mind off track. An outright fast can have enormous benefits and provide you with some perspective, but, whether you can go cold turkey or not, it’s important to set reasonable limits. Scheduling regular times for email and social media and avoiding screens before bedtime are great places to start.

4. Go outside.
Being indoors and subject to electric lighting constantly disrupts the body’s internal clock and makes it difficult to keep a healthy sleep schedule. Natural light is important to both physical and mental well-being, and walking outdoors for at least twenty minutes a day—preferably in green spaces, whether a local park or a nearby hiking trail—is a great source of exercise that has been shown to improve mood and a sense of vitality. If the summer heat is a concern, schedule time to be outdoors in the cool of the morning or evening. And don’t underestimate the value of a vacation.

5. Make Time for Friends
Real, face-to-face social connection is the key. Being physically and mentally present with other people has been shown to reduce the risk of depression and promote empathy. That’s not to mention that most people find time with friends to be a worthy end in itself. Combine this with other self-care goals by enjoying outdoor recreation with like-minded peers. Ask everyone to leave their cell phone at home and enjoy the sunlight.

When Empathy Hurts You – Part 2: Minnesota Nice

Having been born and raised in Minnesota, I am very familiar with “Minnesota nice” and the expectations that go along with it.  I have heard that he or she is “so nice” and knew from a young age that being “nice” was something important and valued in our culture.

We all likely know someone who presents as nice all the time – they are pleasing, agreeable, delightful. These individuals often have many friends and their kindness and selflessness is praised. Giving of oneself – often to the point of having nothing left to give – is seen as a virtue.
 
But what if we have this all wrong?

What if anger, dissatisfaction or other forms of unpleasant feelings are just part of the normal range of emotions and not giving them a voice or allowing them to be expressed can cause you harm?
 
Gabor Mate in this youtube video, speaking about his book “When the Body Says No: The Cost of Hidden Stress” highlights the importance learning how to express our anger in a healthy way arguing that unhealthy emotional expression (particularly anger) can have disastrous effects on not only our emotional health but our physical health as well.

Mate describes that each individual has two vital tasks in life: to attach to others and to be authentic. Babies are able to pick up on the stress of their caregivers and if they determine that the caregiver is too stressed out to care for their needs they will shut down and suppress their feelings thus compromising authenticity for the sake of the attachment.

The problem is that as adults we continue this pattern. He argues that there are three ways to deal with anger:

1.      Repress – which can come out as being nice
2.     Giving in – which can be displayed by acting it out
3.     Healthy processing of our anger – setting boundaries, talking about it and funneling the energy into healthy expressions

Mate outlines that our emotional systems mirror our immune system and when we do not take care of ourselves by setting boundaries and being authentic to our feelings it will show up in physical illness – autoimmune diseases and if you tend to repress, and heart attacks and stroke if you tend to give in. The risk of the healthy processing of anger, particularly in setting boundaries and saying “no” is that others may choose to not stick around but the costs may be even more disastrous.

It can be a helpful mental switch to view setting boundaries as an act of kindness since you are showing others that you value, respect and care for yourself. It seems time that “Minnesota Nice” applies to ourselves as well!

You deserve better than to be cushioned.

Technology has changed the way in which a lot of us work, socialize, and date. While there are benefits to this technology, there’s are also plenty of challenges, like the prevalence of an well known behavior that now has a new term: “cushioning.”

What is cushioning?
At worst, cushioning can be outright cheating on an exclusive partner or it can be flirtatious texting back and forth with new eligible singles. The people you're flirting with, aka the “cushion”, soften a fall should you break up with your significant other.  

While the idea of “cushioning” a relationship has been around since dating began, the speed with which we make decisions and access new potential partners has seemed to compound this problem, making cushioning part of a “Netflix and Chill” lifestyle.

Protect yourself from cushioning.
You deserve better than to be cushioned. Here are some red flags:

1.    Secretive about who they’re talking to via text or social media.

2.   Hot and cold behavior - one moment you’re the center of the world, the next they’re too busy.

3.   Evasive about giving you their physical whereabouts.

4.   Tendency to cancel plans last minute, often with vague and sometimes dramatic excuses (“my grandma’s in the hospital”).

5.  Won’t call when they say they will.

6.  Won’t introduce you to friends or family.

Trust your gut. Your intuition is trying to help you. When you feel blown off and manipulated, you probably are.

Please remind yourself you can do better than this.  A person who is truly interested in you will invest in time and energy in you, and follow up on plans.

Everyone has a Love Triangle

A love triangle is something we all have, and, no,  it’s not the kind of triangle you might be envisioning. 

For couples in a relationship, love can be broken down into three concepts that represent corners of a triangle as described in Robert Sternberg’s “Triangle Theory of Love.”  

These corners are Passion, Intimacy, and Commitment. Through these three simplified concepts, we can comprehend, navigate, and even grow our loving relationships.

Passion
It can be thought of as emotional reactivity, physical arousal, excitement.  We experience the feelings associated with passion as visceral and deep-rooted.  Passion can be strong sexual or romantic feelings, strong feeling such as anger or fear, or an enthusiastic zeal.  

Intimacy
This can be understood as a general interconnectedness we feel with someone, the level of closeness/comfort we feel with another.  There are many types of intimacy including physical (both sexual and non-sexual), emotional (feeling of closeness), intellectual (shared ideas), professional (work related), spiritual (involves similar existential and/or religious view), recreational (involves doing pleasurable things together), artistic (shared sense of beauty), etc.  

Commitment
This component is more cognitive or “cold," but often the necessary foundation of a relationship without which passion and intimacy are lost.  A couple makes certain culturally and value based agreed upon promises to each other regarding exclusivity.  Exclusivity may manifest in may ways including sexual fidelity, engagement / marriage / commitment ceremonies, intimacy and emotional fidelity, etc.   Prioritizing and protecting the couple relationship on a daily basis is a manifestation of commitment.  

An Unequal Triangle
If these three corners are given equal attention and energy from each person in the couple, the relationship is healthy, but if one side or two sides are dismissed, it creates relationship problems. 

1. Only Passion = infatuated love (e.g. an affair)
2. Only Commitment = empty love (e.g. lost spark and business-like)
3. Only Intimacy = liking (‘friend-zone’)
4. Commitment + Intimacy = compassionate love (innate/visceral attraction gone)
5. Commitment + Passion = fatuous love (simple, shallow)
6. Intimacy + Passion = romantic love (‘don juan-ism’, often infidelity manifests)

Whether we are in a new relationship or celebrating our 25th anniversary, it’s important to take review the corners of your relationship triangle.  By identifying which component needs enhancement, a couple can actively make changes to significantly strengthen the relationship.