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How to be a Therapist When Your Life is Falling Apart

You are a human being in the real world and sometimes your life, like a taco, is going to fall apart. You still have a job to do. Some jobs are easier than others when heavy things are going on. Therapy isn’t one of them. You can take a sabbatical, maybe, cancel your clients for a day or two, or a week, but probably not much longer than that. Or you can keep working and get by. What to do is a very personal choice and depends on many factors that you will have to weigh. You might seek supervision about transferring your caseload while things settle down or how to proceed.

Doing the minimum Get up, take a shower, and get dressed. You can do the minimum if you have to for now. That may mean not shaving, not dressing well, or not styling your hair. It’s alright to do what you can. Even the minimum can be a lot sometimes. Go easy with yourself.

Being there for your clients when you don’t have anything to give Therapy is part conversation, part technique, part education, and part entertainment. When you’re depleted in your personal life, you may not feel able to do those things. Just show up. When the part of conversation that is yours drags, use silence; you didn’t choose to be a clown and don’t have to entertain all the time.

What do I say? But what if my clients notice I’m not myself, not cheerful, not energetic? Own it. Use it as a teaching moment to say “we’re all going through stuff and we all get by sometimes, even me, even you.” Let it be okay to not be okay all the time. Demonstrate the principles you teach. I also like the analogy “Sometimes I’m at 100% and I can give 100%, but sometimes I’m at 30% and that’s what I can give.”

How much to share Keep it to yourself to be ethical and process your stuff in your time. Use a blanket statement like “I’m just going through some things right now” or “things are just rough right now.” You don’t have to reassure your clients that you’re fine if you’re not, promise them you’ll be alright if you’re not sure you will be, or worry them unnecessarily. You also don’t want them guessing about your personal life, prying, or following up on your issues – that’s your job for them, after all.

Get therapy Don’t hesitate to get yourself therapy. Find one who is a good fit for your needs. Process your stuff. Do your homework. Be a good patient. It’s okay if you just cry the whole time. Sometimes just thinking about my therapy appointment coming up makes me cry because I’m holding it together the rest of the time until then. If you can’t cry in therapy, I don’t know where you can. Express any countertransference as it comes up.

Self care Oh boy is this a hard one! Sleep, eat decently, journal, get some gentle movement in like a walk, and drink water. Oh, and socialize and do your hobbies. You know, all that stuff you tell your clients about. I know you don’t want to and feel like you can’t; do what you can, then do a little more. Oh, I know how hard it is but you have to in order to have a chance at getting out of The Pit, and you need out. Even spending one minute on a self care activity can be progress, so mark that progress and go forward.

Referring out and consultation If there are certain topics that are too close to home right now (relationship issues, parenting issues, whatever the thing may be) or certain populations you cannot deal with right now, stop taking those new cases and refer out your existing similar cases. It’s the ethical thing to do, to let them continue their treatment with someone who has the capacity for them if you currently do not. Unsure how to do this or to whom to send them? Seek consultation. Ask your peers for recommendations on how to handle things that are sensitive for now. Consider taking a sabbatical if it’s possible for you to take a leave for awhile while you get things sorted out. Tell your clients only the brief statement you prepare in advance that does not inure them, like “I’m stepping away from my practice for now and am uncertain when I will return, but am providing you with 3 capable therapists to choose from that work with your needs and insurance. I’m emailing your their contact information and a link to their websites so you can decide who to work with.” Consultation can help you set up referrals and a statement like this. It probably won’t feel good to do, but having done it will feel like relief and will minimize countertransference.

Know that this, too, will pass. What is happening is hard, but you will persevere. You have survived every bad day so far. Keep going. Be gentle with yourself.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Why me? and It’s not fair.

person walking in rain with red umbrella at night

When a traumatic event happens, most people are left with the question “Why me?” and the feeling of “It’s not fair.” What do you do with those and how do you move beyond the stuck feeling they leave you?

It’s not fair. No, it’s not. Much of real life isn’t fair and this thing is also not fair. There’s no making it fair. There’s no making it right. It was a terrible thing and it doesn’t have to be better or make sense or fit in with an idealized version of reality. Some things just suck and this is one of them. It’s okay that this is how it went down. Fighting the unfairness of it is futile. Allow it to be unfair and you’ll stop coming up against this obstacle.

Why me? No reason, or maybe some reason that isn’t useful to speculate. People do terrible things. Sometimes they’re terrible people, and sometimes not, but done is done. It sucks that it happened to you. Crappy things happen to people all the time and you’re one of the people that had a crappy thing (or series of crappy things) happen to them. Spending your energy trying to solve this is a wasted time.

I get that that this doesn’t sound positive or hopeful. I’m not trying to be a ray of sunshine as I think that’s too far from the truth and wouldn’t be useful anyhow. If you are throwing yourself against these walls and stuck on them, the way past them is through understanding that they don’t have to be fixed to be understood. This is only one piece of the healing, but it’s a crucial piece if its a place where you’re repeatedly finding yourself.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Be Here Now

Have you been feeling unmoored from your body, your sense of self, or your life? Do you feel adrift, unhinged, untethered, or in need of grounding? Have you been spinning out of control in your thoughts and unable to gain traction?

Try this mantra: “Be here now.” But say it like each word is a sentence: Be. Here. Now.

With each word, do it.

Be. Be in your body. Notice your body, the weight of it, the position it is in, the feeling of any fabric or material on your skin, and any movement of the air.

Here. In this place. Where you are, with anything you can notice around you, eyes open or closed. Engage your senses: see, hear, smell, taste, feel – to notice absolutely anything.

Now. In this moment, the only moment that exists, present as best you can, eliminating thoughts of past and future as best you can right now. It might be difficult and that’s okay; just do your best and reset and reset again if you need to.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

What is a Trauma-Informed Therapist?

What’s this buzzword “trauma-informed” mean? Trauma-informed means that the therapist has been trained to see client behaviors as symptoms of trauma, instead of as dysfunction.

Why is being trauma-informed useful? Understanding things from a trauma perspective allows a therapist to view the client as a whole person from the angle of trauma, with the behaviors as a function of trauma, as a means to an end, a repeating of negative patterns, a way they adapted to their environment. It allows the therapist to see the client outside of negative labels such as: willful, inappropriate, manipulative, or staff-splitting. This is especially useful for people who have developed personality disorders like borderline personality disorder. Seeing clients differently allows us to act differently and treat the behaviors with more care and usefulness.

Trauma-Informed vs. Trauma Specialist Is a trauma-informed therapist the same as a trauma specialist? No. There has been a big push to get therapists trained in trauma-informed care over the past 5 years or so, which is wonderful. This often consists of a single introductory-level training which may be only a couple of hours. A trauma specialist, by contrast, has been training in trauma-related treatments for at least dozens of hours, generally over many years. Personally, I have trained hundreds of hours over a decade in various trauma-related treatments over a decade.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Overwhelmed? Obsessing? A technique for you.

several plants in pots along a sunny windowsill

Zooming in/out

When I am overwhelmed, like thinking about war and climate change and politics, global issues that I have little to no control over, I am zoomed too far out. I’m looking at life through a telescope. I’m needing to change the focus to what is now, here in front of me, that I can change or have control over.

When I’m obsessing, like thinking about day-to-day stressors and my to-do list and all the little pieces that seem to need my attention, I am zoomed too far in. I’m looking at life through a microscope. I’m needing to change the focus to what is now, that I can accomplish and check off, that I can move in the priority if necessary.

I challenge you to change your focus. Notice if you are zoomed too far in or out, and move to a more comfortable middle ground. This is a skill and takes practice, so assume that the lens is going to get out of focus sometimes, and that’s okay, but it is also adjustable and you have the ability to adjust it to be comfortable for you.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

What Does the “Don’t Say Gay” Bill Mean for School Counselors

boy sitting cross-legged, wearing goggles and a hat, making airplane arms, with wooden toy of plane next to him

On March 8, 2022, new legislation was enacted by the Florida Senate by means of House Bill 1557: Parental Rights in Education that will go into effect July 1, 2022. According to the bill, parents and guardians are the ones who shall remain in control of what dialogue their child has in regard to sexual orientation and gender identity, and no school personnel should engage in these discussions as it may interfere with what the family chooses for the child to know/think.

According to the law school counselors follow, counselors do not have to report things to a parent or guardian if the child may be in danger by their reporting. For example, if a child reported abuse by a parent, the counselor is required by law to report that information to the Child Abuse Hotline, but do not have to tell the parent they are making a report. The bill itself states “This subparagraph does not prohibit a school district from adopting procedures that permit school personnel to withhold such information from a parent if a reasonably prudent person would believe that disclosure would result in abuse, abandonment, or neglect…” (section 8c2).

In many homes, a gay or transgender child would be in danger if the parent or guardian was aware of their true nature, so students often hide who they are at home to keep the peace, and express themselves more freely at school. Many schools have become safe havens, allowing children to use their preferred names and pronouns.

What does this law mean for these children, now?

It is useful to delineate that this bill applies only to children in grades K-3 (section 8c3). At those ages, most children do not know their sexual orientation or gender identity, but some will. The bill wants the family to be the primary source of information at these young years and to steer the child in the direct they feel is most appropriate. Of course, there are those families that will use fundamental religion as a weapon against children who are not both heterosexual and cisgender, and this bill does give them the express right to do so.

There was fear around this bill before it was in its final form (as linked in the first paragraph above) that a homosexual teacher could be fired for answering the question “What did you do this weekend?” with “I went to the movies with my wife,” when a heterosexual teacher would have no consequences for saying the exact same thing. However, the bill states that students shall not have “classroom instruction…on sexual orientation or gender identity…that is not developmentally appropriate.” I read this as: it is absolutely developmentally appropriate to say “families look lots of different ways – some people have 1 parent or 2, or grandparents or aunts and uncles who live in the home, some have siblings or none, some have 2 moms or a mom and dad…” even at the Kindergarten level. In fact, I’m certain Sesame Street must have taught me this (and it did: Here and Here and Here and Here). Will a child get in trouble, or be hushed if she says she has 2 dads? No. This is developmentally appropriate.

Will a school counselor have to call the parent when a child says they think they have the wrong body and want to talk about it? Not necessarily, but maybe. Since this bill states that parents are to be kept in the know about what is going with their child, to be “notified about a change in his or her student’s [healthcare] services” (section 8c5), it would be prudent for the counselor to notify the family that the counselor met with the student at the child’s request and the child brought up certain issues or concerns. In this meeting, the counselor would be advised, according to this bill, to remain neutral, teach the child to remain calm, and suggest the child speak to their family about the matter. However, if the child expressed that they would be “abused, abandoned, or neglected” as a result of telling the family, the counselor would be wise to make a note of how the child expressed this, what they presented as the issue, how the counselor responded, and what the session consisted of; this protects the counselor in case the issue ever goes to court.

If the child is in the 4th grade or above, no change needs to take place. Children in progressive schools that have created the kind of safety that allows for use of their preferred name and pronouns can still employ those practice. Schools with a Safe Club that allows kids to express themselves and their feelings and thoughts around sexuality and gender can still hold those meetings. However, it would be best if those meetings were run by the students, for the students, and not led by a staff member, but overseen by a staff member; this ensures that it is not seen as the children being indoctrinated by anyone with an ulterior motive.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Disordered Eating in Modern Times

Ad for 1950s dress patterns

I was watching a show on Netflix, Explained – every episode covers a different topic – about food (I think it might be Why Diets Fail from season 1). They stated that diet culture has followed disordered thoughts around eating closely. Check out this timeline:

  • 1950s – women were housewives who cooked, cleaned, and raised the children while the husbands worked. How did they get it all done, look perfect, have tiny waists, and have differ on the table when their men came home from work? Amphetamines! It was common to have doctors prescribing amphetamines to get women up and going all day, then barbiturates at night to go to sleep. Was this healthy? No way! But it was common.
  • 1960s-19070s – women were starting to work outside of the home and doctors had figured out that amphetamines were probably not a good idea on a daily basis. Women were still doing the majority of the housework and child-rearing. They were tired. Men continued to work outside of the home. Women’s waistlines started expanding. That’ll happen when you eat throughout the day because you’re not on speed. The diet industry started poking up saying “buy these control-top pantyhose” and “girdles help you look like like you used to” and the food industry said “fat is bad, fat makes you fat” and made a bunch of fat-free foods. When you take the fat from food, it tastes bad, so they added sugar to make it taste better. Now fat-free meant added sugar it was unhealthy.
  • 1980s – The food industry said “sugar-free is the way to go” and started producing artificial sugars. Our bodies don’t know how to process this and it was not more healthy. Diet culture pushed artificial sugars and stopped spotlighting fat-free foods, which still existed, and still exist, and started heavily discussing diets. The media focused on Africa being a continent of starving children with We Are the World and children being told to clean their plates because “there are starving children in Africa.”
  • Fast forward to now. Germany is credited with making videos about how the US is dealing with food insecurity. (In fact, the video was made by a US non-profit.) Diet culture is as strong as ever, and eating disorders are going strong as well.

So what do we do? Lean in – whatever you’re rocking, someone loves it and desires you just as you are. Whether you are fat or thin or somewhere in between, you are a perfectly good person living in a body that was assigned to you, just like everyone else. Yes, there’s such a thing as “too big causes problems with your health” such as extra weight putting pressure on your knees, hips, spine, and heart. But there is also such a thing as “too small causes problems with your health” and 80 pounds for an adult is not enough, causing problems with your heart, lungs, and circulatory system. There’s a lot of good grey area to be in. If you’d like to work on your thoughts around disordered thinking, I’m happy to see you for that. If you are actively engaging in an eating disorder, please seek local treatment at a center that specializes in teaching you to eat appropriately.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Winter Blues

Winter landscape branches form a heart-shaped pattern

Clients at my practice have shown an increase in depressive symptoms in the past month. This is typical for this time of year. The decrease in sunlight causes the Winter Blues, or technically, Seasonal Affective Disorder (SAD).

Our brains are dependent on chemicals from sunlight to create the happy chemicals. You may have noticed you are feeling more: sad, irritable, grumpy, touchy, or frustrated this month. If this is you, make an effort to get more sunlight. Sit outside during lunch. Go for a short walk before work. Anywhere you can get an extra 20-40 minutes of sunlight will be an improvement.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Is My Child Suicidal?

Child sitting alone, curled up

If you are worried about your child, whatever their age, it is good that you are paying attention. Let’s talk about warning signs and give you the tools to act appropriately.

Warning signs of depression in children:

  • Irritability
  • Aggression
  • Crying spells
  • Isolation – not wanting to talk, not wanting to be around their friends
  • Lack of pleasure in things – do not want to play with their toys, their pets, their friends

Talking about suicide is okay. Talking about or asking about suicidal thoughts does not increase them, so ask. “Are you thinking of suicide at all?” An open-ended question like this invites the child to talk about what they have been thinking, so you know what is on their mind, if they choose to share.

If your child says they have been thinking about suicide, or thinking “it would be better if I were not alive” or “sometimes I think about being dead” or “it would be easier if I were just gone”, this does not mean they are suicidal. These are normal thoughts that many people have, no matter their age. Therapy would be a good intervention at this point. Your child is saying they are in pain and need relief.

Probe to the next level “Do you have a plan to kill yourself? Do you want to kill yourself?” Use plain language like this and be direct. You need to know the information and asking like this will get you what you need. If your child has a plan and a desire to attempt suicide, intervene immediately. Google “mobile crisis team [your county]” to find the number for who to call. A mobile crisis team will come to your home, interview you and your child, and make a determination as to the severity of the suicidality. If warranted, they will take your child (or refer you) to the nearest psychiatric admitting hospital. If not warranted, meaning there is not immediate danger, they will encourage you to seek therapy for your child, which you should start as soon as possible. To find a therapist, you can search Psychology Today for your city and insurance, but be aware that many therapists (like myself) use telebehavioral health and you can see them from anywhere in the state, so you have additional options if you open your search to include telehealth.

If your child is cutting, that is, you see marks on their arms, legs, or torso, ask about it. “Why do you cut yourself? How often do you do so? What is the benefit you get from that? When was the last time that you did it? Are you taking care of the wound so they heal properly and don’t get infected?” Cutting is not suicide. Please take cutting for what it is: a way to release emotion, or a way to feel something when numbness is all that they are feeling. Cutting behavior should always be accompanied by therapy because either cause is a sign of deep sadness.

If you have a child that is hurting, having your own therapy is a benefit to you and to the family. You can learn how to support your child, have an outlet to express your frustration or sadness, and get support as you go through this tough time for your family.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Multiple State Licenses

Autumn Hahn, Licensed Mental Health Counselor, Licensed Professional Counselor, Certified Clinical Hypnotherapist

There is a lot of confusion when it comes to getting licensed in multiple states. How do I begin? What is it called? What’s the benefit? I’ll demystify some of that here. I am licensed in Florida, my primary state, and state of residence, since 2010. I got licensed in Georgia in 2021, and have licenses pending in Washington DC and New York.

Why get licensed in multiple states?

The more states I am able to see clients in, the more business I stand to get. I accept insurance, and utilize a number of referral sources to get clients (if you are interested in information on those, please email me and I’ll refer you).

Having a wider base allows me to see the clients who are the most appropriate fit for my specialty. I specialize in trauma, and typically work with only those clients, so I don’t see everyone who needs therapy, only those who seek me out.

Working in multiple states allows me to serve a wider population. Being in telebehavioral health (seeing clients by video) allows me to serve clients in underserved areas, across the entire state.

The American Counseling Association is working on an Interstate Compact that will allow us to practice across state lines for those states participating in the compact, provided you are licensed in one of those states. The American Psychiatric Association has something similar for psychiatrists. You can learn more about the Compact here.

What are the types of license across states?

License by reciprocity – This is outdated. I have heard rumors that some states used to let you practice across state lines simply because you held a license in your state of origin. This is not true now, with the exception of some ability to do so during the pandemic. Do not pursue this. Even if you find it is true for some pandemic-related rules, it will go away at some point soon, if it hasn’t already. This is not a modern law or rule.

License by endorsement – This is your search criteria. If you want to become licensed in another state, search “License by endorsement counselor [state]” and follow the rules on their webpage. You may find that you need to have been licensed for a certain amount of years in your state of origin to qualify (in New York, for example, you have to be licensed for 5 years to qualify), or there may be other rules related to how many practicum hours you need to have completed, certain coursework your school needed to provide you, etc. You may also have to take an additional continuing education course to qualify; New York has a 2 hour child abuse awareness and reporting course everyone has to take. Complete the paperwork and send in your fee. Be aware that you will need access to: your unofficial transcript, your employment and education history, your existing license(s), professional references, and will likely have to send official transcripts, may have to get finger prints done, and more. The process varies by state. The verification and licensing process also varies by state. Georgia, for example, took less than 6 weeks to process all of my information and approve my license. DC, however, has had my paperwork for over 3 months and it is still “pending” with no reason given.

Your title may change as you apply across state lines. I am a Licensed Mental Health Counselor in Florida, but my title in Georgia is Licensed Professional Counselor. It is the same information, same degree, same everything, but certain states have different titles. It does not functionally mean or change anything.

Now what?

Once your secondary (or more) license has been approved, do a couple of things:

Update your referral sources to reflect the new status so you can begin advertising to those states. This includes your Psychology Today profile, website, email signature (mine says I am accepting clients in Florida and Georgia), and any paid referral sites that send you clients where you have a profile.

Go to your CE tracker and enter the new information so you can log all your appropriate CEUs and be certain you don’t miss any renewal dates. Make a note in your calendar to take a course that you need, as appropriate. I use CEBroker for Florida and CEWindow for Georgia.

I hope this information was helpful to you!

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.