Ladies, we are all traumatized…

Here’s to my first blog post ever! After pondering what I wanted to say, I felt compelled to write about something we all share…trauma. Uplifting? Not so much, but trauma and stress is often the launching pad from which so many chronic conditions arise and it seems fitting that we start with foundations.

That’s right ladies (and yes, men too)- I have a theory that we are all traumatized. If you you have somehow escaped trauma, congratulations, and please share your secrets. Before you call me Debbie Downer and switch to your favorite cooking blog, keep reading- it’s important.

Within conventional psychiatry and psychology, when the burden of trauma elicits a certain set of criteria from a person, they may be diagnosed with post-traumatic stress disorder (PTSD). I personally have a bit of a beef with labels we use in mental health and do not like the word “disorder”. I find it limiting and disempowering.

As I will explain a bit in this post and more extensively in the future, the symptoms that define PTSD may be counterproductive in certain situations, but are rooted in our evolution and survival instincts.

What is trauma? In my assessment, trauma can be characterized as anytime we have a perceived sense of helplessness or loss of control. It is something that has caused harm or has the perceived potential to cause harm. It can be a physical form- a person, a place, an object, or it can be a collection of thoughts, memories, nightmares. Trauma is not necessarily what happened to us, but the effect it has upon us.

Let’s consider some examples. Have you ever been in a car accident? Did you know motor vehicle accidents are the number one cause of “PTSD”? I bet you can remember certain details…perhaps it happened at a particular intersection or stretch of road, perhaps you had a certain song on the radio at the time, or you can remember the time of day, or the weather.

Have you ever felt belittled, harassed, talked down to, discriminated against? Most of us- especially women and girls have had this experience at one time or another. Maybe it was a coworker, a significant other, a stranger on the street, or a family member. Or maybe you are a survivor of sexual assault or abuse…or maybe you witnessed somebody else’s trauma… or maybe you heard about something scary on the news…you see, given all the possibilities, it is hard to imagine anyone would not be traumatized.

Do you notice the discomfort and vulnerability when walking alone? Maybe you carry pepper spray, a knife, or even a gun. Perhaps you have become really good at assessing the scene, looking over your shoulder, looking for signs of danger. Do you find yourself feeling inferior or intimidated around others (particularly men) even when you stand for equality and you know this should not be? Is it hard to look people in the eye, speak up for yourself, be assertive? You may not have actually experienced an attack or harassment, but by simply being privy to stories in the media or from someone you know, you may adopt certain behaviors in response to a potentially traumatic situation.

And then there’s the trauma of not feeling good enough and the negative self-talk that comes with it. For so many of us, we have a constant buzz within ourselves to look a certain way, meet societal expectations, lose the weight, perform in our jobs, buy the right clothes, appease our families, religious organizations, significant others, children… and all the while do it with a smile, because you know, we have to have those Facebook posts just right.

Our society breeds dissatisfaction and it seems that  us women & girls are particularly susceptible to this near-constant, hypervigilant mindset of what must I do to be better? What must I do to be on par with everyone else? Well, maybe I should get some pointers from Facebook, Instagram, etc…see how I measure up…but wait, that did not make me feel any better! This hypervigilance can be traumatic in itself as it creates the ongoing need to feel more and more in control of our appearance, reputation, and what we portray to the world. Unfortunately, this race has no finish line and we often exhaust ourselves trying to find it.

Trust me, I am entirely guilty of this- hard not to be, right? Type A personality, perfectionist, ambitious, afraid to settle…yup, all worthy descriptions of who I am. I do not have a pedestal and even if I did, I would still have my self-doubts…

Trauma is like throwing a stone into the water. There is the initial impact, but then there are the ripples…

Let’s go back to a time when you felt belittled or talked down to. If this has happened a lot in your life, you might find yourself often defensive and feel as though you have something to prove. Can you remember the person that did this to you? I imagine you remember them well. Can you remember where you were when it took place?

Can you remember the feelings of fear, anger, shame…? Have you met others that reminded you of that person, that place, or maybe you have gone further to generalize your experience to being associated with an entire group of people. Ripples…trauma builds on itself. The original trigger multiplies into more triggers and then more triggers from secondary triggers and so on.

Trauma is not something that hides out in the brain. It elicits reactions throughout every system in your body from your head to your toes. Every thought and emotion positive or negative has an associated chemical reaction that is communicated throughout our body. We will go more into this later.

Ever feel achy, sick, fatigued, nauseated in the midst of stress? Yup, a few of the not so uncommon reactions.

Going back to evolution- when we are faced with something potentially harmful or life-threatening, our natural reaction is to fight or flight. Basic survival instincts.

While this can be really helpful when you are being chased by a bear, some of us (actually a lot of us) find ourselves in a perpetual state of fight or flight driven by actual or imagined fears, threats, or circumstances. It is important to remember that events or situations that may not be perceived as “traumatic” can cause this same reaction. Having a baby, starting a new job, moving, starting a relationship are a few examples. We might feel buzzed at first- energized, enthused, but then the surge of adrenaline and other stress hormones may not sustain themselves and we feel the burden of fatigue, burn out, apathy, sadness, and even despair.

Some of us in the midst of feeling the lull, may seek out even more exciting or risky ventures that may spike our interests and adrenaline levels for a while longer before we again fall back and the cycle continues. Addictions work this way too.

You see, some of us can become so familiarized with trauma and chaos that it becomes part of our identity…our modus operandi, our comfort zone, our ego. Some of us may be conscious of this while some of us have not yet recognized it. Do you take pride in being able to juggle so many balls at once? Do you have a silent pride in being there for somebody who may be abusive, but you feel you are the only one that can help? Do you find yourself attracted to gossip and drama? Perhaps you like the thrill of a challenge and have difficulty with stillness, quiet, and slowness? Do you like danger, risk-taking, pushing the envelope? Is it harder to receive love and care then to extend it to others? If you are like a lot of us, the answer is yes, yes, and yes.

How do you identify or label yourself? Might it be that how we define ourselves and the labels we assign to who we are can also cause pain and perhaps perpetuate trauma? If we are too rigid with our expectations for ourselves and keep ourselves in a box, we are likely to be disappointed.

If we are all traumatized, we are also all on a spectrum. Some of us are in the midst of trauma right now. Some of us are struggling to overcome memories of trauma. Some of us are being overwhelmed with the news of our world today.

Ask yourself how you perceive yourself in the midst of the trauma past or present? What is your role? Victim, survivor, witness, standing on the sidelines? How do you also label the person, place, event, or thought process that perpetuated the trauma?

Language is powerful. Remember that feelings are real, but they are not always true.

Medication, supplements, fitness, and lab testing all certainly have their merits in supporting wellness, but true vitality and contentment often lies in how we perceive ourselves and others around us. It is the process of learning to trust ourselves and in doing so, be able to extend trust to others.

Be careful how you perceive yourself, how you label yourself. Be careful not to let yourself be defined with too much rigidity. Embrace fluidity. Be kind to yourself and give yourself grace. Recognize that you are not alone.

I am fascinated with the concept of resilience in the midst of trauma…I would love to hear from you how you main resilient? What keeps you grounded? Please share!

In future posts we will be discussing the physiological impacts trauma has throughout our bodies and steps we can take to restore vitality and stay grounded in the midst of our complex world! So stay tuned!

As always find out more about us at http://www.shesoarspsych.com

Be well,

Audry Van Houweling, PMHNP-BC

Honoring Our History & Leading with Accountability

March is Women’s History Month. It is a time to reflect on the many women and men who have carved pathways toward the sought after hopes of equity, respect, and opportunity. It is a time to reflect on privilege and intersectionality where systems in our society continue to favor some while sizeable gaps remain for others. It is a time to remember the women in our own lives and take inventory of sacrifice, resilience, and compassion, but also acknowledge the dark spots. It is a time for inspiration and mobilization as we seek togetherness and connection. It is a time for honesty. It is a time for accountability.

Accountability can be a controversial word. Accountability insinuates responsibility and responsibility insinuates blame, which can often lead to defensiveness. The reasons behind continued inequities for some women are complex and layered. However, amid the effects of patriarchy and discrimination also lies the subtle and more obvious ways in which we as women sabotage each other.

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Women and girls have been historically socialized to lead with softness, hospitality, modesty, beauty, and maternalism. While these traits have value, the roles of assertiveness and boldness have had historically masculine connotations. As women, we may become caregivers, people-pleasers, and super-moms, but too often carry silent resentments and loneliness as speaking up, setting boundaries, and being direct can seem challenging. We may act like who we think we should be rather than who we may truly be, which can ultimately be exhausting and isolating.

Historically, women have also been too frequently in a place of dependence- often on a man. This is evident in our story books, fairy tales, media, and cultural values. This dependence has been and remains socially reinforced as a woman’s worth, financial standing, property, and welfare may be socially dictated by her marital or relationship status. Yes, this has changed in the United States (for some) although in other parts of the world it continues to be reality. Meeting social norms for some women is not simply about fitting in, but about survival. This dynamic creates competition, desperation, and disempowers a woman as her society may dismiss the value of her character, work ethic, or intellect. Women have made great strides, but for many women and girls there remains a hypervigilance of being accepted and attractive even at the expense of their welfare and aspirations.

While opportunity continues to remain staggered for women across the United States and inequities continue to be problematic, a good number of women in this country are privileged to have autonomy, free agency, access to education, financial independence, and professional opportunity. It seems these ‘privileges’ should be rights; however, they can be a luxury when compared to women on a global scale. In this place of privilege, there can still be struggle. Simply being aware of the grossly unsettling rates of abuse, assault, and mistreatment women endure creates widespread resentment, sadness, and anger.

Ultimately, many of us have been hurt, wounded, and traumatized. We have ample reason to be defensive, on-guard, and mistrusting. Many of us have faced situations where we have felt powerless and out of control. Too often this leads to self-blame, insecurity, and shame, which if not acknowledged, can be projected frequently on our female counterparts in ways that can be very ugly.

Arising from our own insecurities, we tear each other down for how we look, judge each other’s successes, shame each other’s sexuality, insult each other’s intelligence, and maintain rigid viewpoints of what constitutes a worthy woman. We gossip, backstab, serve the silent treatment, and spread rumors. We must learn to lead with accountability rather than blame and self-reflection rather than projection.

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Women need to support women. There is a special resilience that binds us all. It is a strength that transcends labels, political affiliations, beliefs, occupation, relationship status, and financial standing. We must own our voice, our prejudices, our privilege, our decisions, our feelings, our actions, and our story. Jealousy, competition, and judgement only regresses our progress. So, let’s honor our history and lead with courage, togetherness, humility, openness, and yes, accountability. We still have work to do.

Thank you for listening everyone.

With gratitude,

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Audry Van Houweling, Owner & Founder,

She Soars Psychiatry, LLC

www.shesoarspsych.com 

Sisters & Silverton, Oregon

 

Grateful, blessed, & struggling… How all can exist at once

Struggle does not discriminate. Grief and loss are part of the human experience. Many of us will face heartbreak, regret, and despair. It is also possible that amid all of these realities, we can simultaneously feel grateful, ‘blessed’, and perhaps just lucky.

One of the most dynamic aspects of my job is that because of universal struggle, I have the privilege to sit with clients across the cultural, socioeconomic, psychosocial, and spiritual spectrum. Each story is unique and avenues toward healing demand creativity and personalization.

While there are certainly exceptions, the small towns in which I work, Sisters and Silverton, are known as quaint, desirable, safe, and each attracts its fair share of affluence and privilege. Both communities are also largely populated by decent, hard-working, and well-meaning residents sensitive to their footprint in the community and larger world.

“I feel bad being here”, some say in reference to stepping in my office. “I feel like I am just complaining”, others say. “I am probably wasting your time…I am so grateful for my life…but I feel like I am drowning.” I do my best to gently inform each client that it is entirely possible to be both grateful and dismal at the same time. My more affluent clients, worried their trials will be perceived as petty, sometimes sheepishly tell their story as if there is a level of shame to their concerns. In truth, emotional struggle is a great equalizer. While there may be pockets of advanced treatment options available to the wealthy and money may allow for more privileged treatments for cancer, chronic disease, weight management, and aesthetic pursuits, cash cannot provide a lavish cure for depression, worry, loss, loneliness, abandonment, and heartbreak. The pain can be just as relevant and intense regardless of socioeconomic status.

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Certainly, money can provide a lifestyle that may be protective against certain emotional trials and can allow for opportunities that may buffer emotional burdens, but the human experience that inevitably includes suffering cannot be avoided. Furthermore, wealth and popularity can also reinforce the need to maintain an image and reputation that limits a person’s ability to be authentic or to live their truth. This can be burdensome and quite frankly, exhausting.

We have seen celebrities, athletes, and prominent leaders and community members who appear to ‘have it all’ disclose their emotional battles or mental illness and have also felt the shock of when emotional struggle overcomes a person’s will to continue on living. We might scratch our heads in search of how or why someone so ‘successful’ could have been suffering so deeply.

Those devout to certain faith-based beliefs may also struggle within the paradox of emotional pain and simultaneous devotion to hope and redemption.  It can feel at times that the promises and comforts of  faith can fall short amid loss and despair. Seeking respite outside a congregation can even feel like a betrayal of sorts. In my humble opinion, one should be able to be ‘blessed’, devout, and seek outside help without fear of judgement.

In writing this, it is my continued hope that we would all learn to lead with compassion and kindness. We like to create labels and divisions that create a perception of how people should live and behave. When we try to have such rigidity and expectation, the world often proves us wrong. If you are experiencing struggle and pain, breathe easy, you are human. Support is priceless- we are made to lean on each other and not go through this thing called life alone.

Thank you for listening everyone.

With gratitude, kiger gorge

Audry Van Houweling, Owner & Founder,

She Soars Psychiatry, LLC

www.shesoarspsych.com Sisters & Silverton, Oregon

The Shadow of Desperation in Healthcare and a Call for Advocacy

In my home state of Oregon suicide rates have increased nearly 30 percent from 1999-2016 and suicide is now the second leading cause of death among children and young adults ages 10-24. Per Mental Health America, Oregon has the highest prevalence of mental illness in the nation.

Oregon can also claim the third worst high school graduation rate and the nation’s second highest number of unsheltered homeless persons. In many of Oregon’s rural counties, opioid prescriptions are also among the highest in the nation. There is a lot of hurt, a lot of desperation, and widespread feelings of being “stuck” in a system that allows little upward mobility.

Nearly 18 months ago I decided to make the shift to embracing functional medicine in my mental health practice. I have become convinced that functional medicine is not the latest trend, but simply common-sense medicine, I am a firm believer that functional medicine is the future of medicine.

That said, the reality is that functional medicine and frankly a lot worthwhile therapies are still a bit idealistic and inaccessible for many. Specialized labs are often not covered by insurance, supplements can be expensive, personalized nutrition approaches are not in the budget, and “stress management” may be a stretch for the many individuals existing in survival mode where relaxation, deep breathing, and self-reflection are luxuries.

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And so, myself and many other healthcare providers are tasked with navigating the complexities of attempting to promote holistic, personalized care amid social realities that create immense barriers. Too many of our patients are stuck in the “fight or flight or freeze” mode where true healing becomes elusive. If we (as providers) are not careful and especially if we are being rushed into providing care for big problems, burn out can come quick.

Economic stability, physical environment, education, food, community and social supports, and access to healthcare are identified as the primary social determinants of health by the Centers for Disease Control. Many patients come my way seeking respite from understandable distress when one or more of these determinants are minimal or absent. And while counseling has often been suggested, so too has medication in many cases. The patient may be panicked, overwhelmed, depressed, hopeless, and isolated. Yes, they may meet “criteria” for a myriad of diagnoses; however, how often are we really medicating or even numbing symptoms that are not indicative of pathology, but of societal shortcomings?  I ponder the “what if’s” all the time…what if they had stable housing…enough food…a safe home? If only I had a magic wand.

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Let’s go back to Psych 101 and revisit Maslow’s hierarchy of needs. Food, water, warmth, rest, security, and safety. It is in fact rare that I come across a patient that has all these basic needs met. Even in circles of affluence and privilege, there can certainly cases of unrest, insecurity, abuse, and a perception of feeling unsafe. Ultimately, when the body cannot be in a state of rest, healing is difficulty if not impossible. To expect favorable health outcomes in the context of desperation is simply irrational.

My opinions do not negate the potential value of pharmaceuticals and other mainstream therapies as tools to help regulate a person’s symptoms, but if we pretend that “the treatment” of mental illness and emotional distress is relegated to pharmaceuticals and counseling, we are being shortsighted and ignorant.

So where does this all leave us and how do we move forward? First and foremost, we cannot pretend that illness is happening in a vacuum. As a healthcare system, we know this intellectually, but in practice, as we silo care to different specialties, rush patients through appointments, and take away time for important communication, we can fail to address psycho-social, socioeconomic, and spiritual impacts. We cannot expect a pharmaceutical to solve homelessness, hunger, abuse, or poverty and we must prioritize trauma-centered care. This takes courage, radical responsibility, teamwork, and innovation. We must provide opportunities and space for discussion and emotional vulnerability in our families, schools, places of worship, and workplaces. The idea that mental health is a “personal problem” and therefore an individual burden, only increases secrecy, shame, and stigma. We must all be advocates. Your health and my health depend on it.

Thanks for listening everyone.

With gratitude,

kiger gorge

Audry Van Houweling, Owner, She Soars Psychiatry, LLC

Sisters & Silverton, Oregon. www.shesoarspsych.com

This Year… Give Yourself Permission to Change Your Mind

Its about two weeks into the New Year and rather than inspire you with a weight loss solution or exercise regimen, I want to challenge you to change your own dang mind.

In our society there is praise and admiration to be had for those who are steadfast, stay the course, and remain committed. We can get respect, kudos from our family and friends, and we may avoid the risk of nonconformity. These character attributes certainly have their merits; however, there are times when the path we choose is depleting and even destructive.

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Have you ever given yourself permission to question your own path? This path has often been dictated by family, societal, and cultural expectations. This can be a path that has been ingrained for generations and in some cases, it can become difficult to differentiate between tradition versus truth. Perhaps you have identified with beliefs that may limit your personal fulfillment or your ability to express your personal gifts. Your definition of success may be rigid and formulaic leaving little room for diversion, risk, expression, or innovation. May you believe you must not ruffle feathers or rock the boat. You may feel that the repercussions of speaking up or being different outweigh the benefits. And so, you begrudgingly stay on the path.

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Personally, I have long been a “box-checker” borne from the fallacy of perfectionism. I like to call myself a perfectionist in recovery and as I envision my 2019, I want to continue to question my own boundaries, labels, and “boxes” I have identified with. The boxes represent what I think I “should” do and it has been a personal challenge (and gift) to change these “shoulds” into “coulds”. Adopting this mindset, suddenly the narrow, singular trail has become a network of possibilities.

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Many of us have felt it. The itch to go against the grain, try something new, and embrace a healthy dose of rebellion. Perhaps its pursuing your dream job, going back to school, moving away from your hometown, finding your own spiritual path, asserting your own political beliefs, or simply breaking from family tradition. We can tell ourselves we are too old, we don’t have the skills, we don’t have the motivation, people will be mad at us, or that whatever the itch may be, it is just a bit too crazy, ambitious, or unorthodox, and therefore, out of reach.

Most of us know what is burdening us and yet giving ourselves permission to do something about it is the challenge. Yes, some of our burdens cannot be changed and there is beauty to be found in struggle. There are times when diverting from our path could result in more harm than good. The point is that we question our allegiance to the path we have chosen. Are we simply going through the motions that we have been taught or told? Do our beliefs and values hold us back? Quoting one of my clients, in some cases, “you are not living, you are just not dying”.

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This stuff gets a bit spiritual and philosophical, right? It begs the questions of what is purpose and what is meaning? Is there a right or wrong path? I am on level ground with everyone else and by no means on a pedestal, but per my assessment it seems appropriate that the path we choose inspires us to be the best human beings for ourselves and for others. Remember, these paths do not have to equate to action. You may have to keep your boring job or postpone a dream, but are you doing so on a path of pessimism or hope? Practicing gratitude, making a point to smile at others, seeing the glass half full, and simply being kind to yourself can be wholly transformative.

Ultimately, do not be afraid to question and invite curiosity to the path you have chosen. Embrace the idea of changing your mind, open up possibility, and be your own trailblazer.

Happy 2019 everyone!

With gratitude,blog-me1

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLC

Sisters & Silverton, Oregon www.shesoarspsych.com

Your followers won’t make you happy…The power of real connection.

The holiday season can be a mixed bag of emotions. In the best case, it is filled with joy and merriment; however, feelings of grief, stress, and loneliness are also common. In either case, what makes the season most meaningful for most of us is celebrating the connections we share with those we love.

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In these digitalized times, establishing and maintaining social connections that allow for face-face contact has become more challenging. It is has become the norm- especially in our younger generations that social “connection” is most commonly mediated through a device or screen and “everyone is doing it” so it creates its own unique social pressure to follow suit. While our digitalized social connections and tribes may have merit, they cannot substitute for genuine face-face human contact. Furthermore, the profiles of individuals we are “connected” to are most generally filtered and edited facades that often do not allow for authentic relationships. We too create facades for ourselves of which we may feel a pressure to live up to, which can limit our opportunities to let our guard down and display emotional vulnerability. Altogether, the loss of face-face contact can create a void of social isolation, which I believe is one of the great public health concerns of our time.

At our core we are social beings. Having a tribe or community has evolutionary roots in being central to our survival, defense, and welfare; however, amid individualism and modernism, close connections have withered for many of us.

Social integration or the frequency of which we have face-face social contact with others- from the grocery clerk to our spouse, has in fact been found to be a major social determinant of health and longevity. In reviewing over 148 studies and 308, 849 middle-age participants, researchers from Brigham Young University and University of North Carolina at Chapel Hill (2010) found that close interpersonal relationships in addition to social integration were the primary factors predicting longevity even superseding substance use, exercise, and diet.

 

Face to face contact has genuine neurochemical and physiological benefits that cannot be mimicked via social media, text messaging, or other forms of digitalized forms of communication. Eye contact, a good handshake, and high fives all release oxytocin otherwise known as the “bonding hormone”. Oxytocin furthermore can reduce cortisol- our primary stress hormone. Dopamine is also released, which promotes feelings of reward and pleasure. Additionally, face to face contact provides opportunities for empathy far more than via social media or texting, where you are removed from the emotional consequences of your communication. In other words, you have more reign to be a schmuck without having to bear witness to the sadness, tears, fear, or anger you may inspire.

Our digital devices have also become great distractions, and might I say, time-suckers that allow us to procrastinate and postpone confronting emotional struggle. They have also in many ways become the modern-day pacifier for children (and adults), and the preferred solution for awkwardness and conversational pauses. Basically, they have thwarted emotional resilience and the art of conversing. Our followers don’t make us happy and study after study demonstrates that the more time we spend on social media, the more susceptible we are to feelings of anxiety, loneliness, and depression. So yeah, it’s a masterful lie.

Given that social media and device addiction is in my opinion, very legitimate, we all must be a bit more intentional about giving ourselves opportunities for face-face interactions. Schedule routine coffee visits with a friend, join a club, take a class, go on date nights with your spouse, or simply surround yourself with human energy at the gym, mall, or local park. And remember, your smartphone is not your best friend.

Wishing everyone a safe and healthy holiday season. Give yourself the gift of connection, allow yourself a digital detox, and soak in the beauty of the human spirit. Happy holidays!

With gratitude,

Audry Van Houweling, PMHNP-BC

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Owner & Founder She Soars Psychiatry, LLC,

Sisters & Silverton, Oregon

Conversations worth having…Suicide.

Have you ever felt so overwhelmed, sad, or hopeless that you considered ending your life?

This is a question I ask to almost every new client that comes in my doors.

You might be surprised who says, “yes”.

Prominent community members, business owners, CEOs, healthcare providers, educators, honor roll students, dedicated parents, spiritual leaders, elementary aged children, elite athletes, yoga masters, and politicians are all among the many individuals who were brave enough to tell me that yes, they have contemplated suicide.

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The reasons are varied. Wanting to escape, not seeing a way out, exhaustion, burnout, unbearable physical or emotional pain, hopelessness, perceived failure, powerlessness, releasing others from a perceived burden, feeling worthless, or to escape ridicule or bullying are just some possibilities.

We live in a society where we often see one aspect of a person. You might call it a mask, a façade, or social expectations, but behind closed doors that person may be facing an entirely different reality than what might be perceived.

We also live in a society that would come running if I were to break my arm and sign my cast, but if I were to disclose depression or suicidal thoughts, people might judge or run the other way. For many of us, talking about our emotions and feelings may feel uncomfortable or even foreign. Some of us may have been taught to suppress emotions, keep our heads down, work hard, and don’t be a problem. Sound familiar? Strangely and perhaps sadly, this mindset is reminiscent to our society’s version of success. But, as I like to ask my stoic, hard-working clients, how’s that working for you? Furthermore, with suicide rates and depression rates on the rise, how’s that working for us- as a society, community, family?

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We have all experienced our share of emotional pain and struggle. Many of us have a personal story about suicide whether it is regarding ourselves or somebody else. Suicide can have profound impacts on communities. In the small towns of Silverton and Sisters where I practice, the impact of tragedy can feel more intense, palpable, and immediate. The shroud of grief can be heavy. Most of the time, attempting to sweep such things under the rug only perpetuates a sense of isolation and shame.

The misguided notion that suicide is somehow selfish or the easy way out does us no favors and compounds shame and silence. Most often it is rather the point that in desperation, people are overcome by the long, hard struggle of staying alive- many have fought hard time after time and may ultimately feel defeated. They did not simply give up.

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Not everyone who contemplates or completes suicide has a mental illness per se. While mental illness can contribute, rejection, financial woes, impending crises, loss, and/or relationship problems can all be driving factors as well.

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Like many small towns, Sisters and Silverton are charming and somewhat idyllic communities, but certainly both have their emotional layers and undercurrents. People are struggling and too often they are among those you least suspect. We all compartmentalize at times- especially in our go-go-go society, which often gives us little time to grieve, process, and feel, but a community’s social decorum, culture, and pressures can sometimes leave little room for authenticity and acceptance.

Suicide rates are up 30 percent across the nation since 1999. Suicide is the leading cause of death among Oregonians age 10-24. So, we must start asking tough questions, having tough conversations, and allowing space for personal stories to be shared. Talking about suicide and our emotional well-being needs to take place beyond the walls of a counseling office. It is a topic that ought to be talked about in our places of worship, clubs, schools, workplaces, and within the walls of our home. Let’s come together, support one another, strategize, and work towards prevention. We cannot afford to be silent.

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“The power of community to create health is far greater than any physician, clinic, or hospital.”

-Mark Hyman

 

 

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With gratitude,

Audry Van Houweling, PMHNP-BC, Owner, She Soars Psychiatry, LLC

Sisters & Silverton, Oregon, www.shesoarspsych.com

 

 

Binging, Booze, Boys, Bags, & Beachbody… Our attempts to escape the inescapable.

Do you struggle with sitting still? Is watching a movie, reading a book, or even having a conversation a test of your patience? Many of us have become accustomed to a routine of constant stimulation and distraction. Embracing the present can seem counterproductive, like a waste of time, or perhaps even painful. As women we can be pros at creating distractions for ourselves or about reaching an outcome. We give ourselves kudos for being master jugglers. We are praised for our maternalism and caring capabilities, and yet self-care can be met with skepticism.

Afraid of confronting destructive beliefs and patterns, we externalize our problems and blame our bodies, relationships, work environment, and finances among other “causes” rather than looking within. And so, we rely on such things as binging, booze, boys, bags, and never-ending body projects to keep us occupied and detached from our truth. We lose patience as patience is nothing more than simply accepting the present moment.

A note on binging…

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It is often a cycle of guilt, shame, and secrecy. Perhaps when the kids are in bed and the husband is not watching, or a hush-hush trip through the drive-thru, or a secret “snack” drawer at work. Everyone is allowed a sugar-spree every so often, but when binging and food becomes a false sense of control or the mechanism by which we quell our emotions, it can become dangerous and destructive. Rather than feel the discomfort, fear, sadness, or grief, we drown it out with the fleeting pleasure of sugar and salt on our taste buds. We might gain weight, or we might purge to try to cover up the “evidence”. The guilt takes over and then the feelings, which must again be quieted.

A note on booze…

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While there has been a recent spotlight on opioid and prescription drug use, alcohol use has quietly been climbing and deaths attributed to alcohol continue to rival any other substance. High risk drinking, which was defined in the study as women consuming more than 4 drinks per day or men consuming more than 5 drinks per day increased by 30% between 2001-2002 to 2012-2013. Among women specifically, high risk drinking increased by nearly 60%. In the Northwest, alcohol consumption and being privy to the latest and greatest brew pub is associated with social prowess and prestige.

A note on boys…

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Lust, codependency, and compromising our own comfort to satisfy. It is human nature to fantasize and want to please to an extent, but boys or whomever you place affection can be a powerful distraction and our means to validation and self-worth. We might be plagued by self-doubt if we assume we are not meeting expectations. Sometimes we may subconsciously (or consciously) seek out or relive situations reminiscent of past traumas or heartache to try to make the traumatic pleasurable or find power when we previously may have felt powerless.

 A note on bags…

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I was in Las Vegas recently and took some strolls through the opulent designer rows filled with top trends to satiate high rollers. It is all a bit exciting for a moment and then I found myself rather quickly disillusioned. I suddenly felt pride for my $15.00 Target purse and my sleek black jumpsuit I got from Ross Dress for Less. Really, who gives a damn and if they do, do I give a damn? I must admit I enjoy shopping, fashion, and I understand the power of a first impression. That said, character is not defined by designer labels and if you think external possessions are going to make you happy, you will be quickly disappointed. When it comes to judging one another based on materialism, quite frankly, my give a damn is busted. I think your’s should be too.

A note on Beachbody’s…

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Your body is your vessel and if you can walk, talk, move without pain, digest your food, and have a healthy heart, there is so much to be grateful for. Many cannot say the same. We take the power of our body for granted as women and we fight the inevitable process of change. We believe that we must punish our body’s until we reach a socially predetermined goal. Through deprivation and often exhaustion we may lose the 10 pounds, but weblog-beachbody reach it having done so with a mentality of shame and self-degradation. We tell ourselves we will finally be happy when we have a 6-pack, lose 10 pounds, run the race, or get rid of the jiggle. Problem is we are acting out of fear rather than love and when fear is the driver, we almost always crash.

Okay so now what?

Okay so you have some vices, guilty pleasures, or admittedly, self-destructive behaviors. Now what?

  • You must take time to practice being OK with the present, which means learning to acknowledge your feelings and fears. This takes practice and intentionality and it might take professional help. Deep breathing, meditation, keeping a gratitude journal, taking a sensory inventory are all small ways to invite the present. This takes practice and intentionality and it might take professional help.
  • Acknowledge your inner child- it is likely desperate to be heard. Picture a hurt child coming to you for help- would you deprive, degrade, and punish that child? That seems cringeworthy as most of us would seek to help that child with gentle curiosity. “What’s wrong? How can I help? Tell me what hurt you? I am here for you. You are going to be OK.” Perhaps then we should be kinder to the wounded child within ourselves. inner child
  • Question everything. Question your core beliefs. Are they born out of fear of love? What behaviors and patterns are energy restorative versus energy depleting? Are you acting and behaving out of compliance or tradition? Has this caused you to sacrifice your personal truth?
  • Treat self-care as a responsibility. This means you honor yourself- your mind, your body, and your spirit. You honor yourself because the energy that you bring into this world has consequences- positive and negative from interacting with the grocery store clerk to your spouse. Take ownership of your energy.

Remember, the present is all you have. Right now, right here, there is power.

Thanks for listening everyone.

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With gratitude,

Audry Van Houweling, Owner, She Soars Psychiatry, LLC

www.shesoarspsych.com

Sisters & Silverton, Oregon

 

Scarlet letters & shame in a small town

Nathaniel Hawthorne’s classic, The Scarlet Letter, tells the story of a woman, Hester Prynne, chastised by a Puritan community after she is found guilty of infidelity. She is forced to wear a scarlet letter, “A” on her chest for ‘adultery’ and endures public judgement and shaming. While small-town America has generally moved beyond such extremes, we certainly can wear our own metaphorical scarlet letters and brand them on each other. Given the intimacy and interconnections of small towns, emotions can spread like contagions transforming a community’s energy. Joy, excitement, peace, strife, sadness, fear, and certainly shame.

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Many of us have felt burdened by the perceived mark of shame- our own scarlet letter. Be it financial woes, family drama, infidelity, illness, or simply choosing to live outside the bounds of what has been deemed acceptable. Many of us try to hide our scarlet letter through work, isolation, distraction, external appearances, and forced smiles among other efforts that altogether can make life downright exhausting. Afraid we will be found out, we rob ourselves of authenticity.

I work in two beautiful small towns. Sisters, Oregon on the eastside of the Cascade mountains and Silverton, Oregon on the westside of the mountains. Each is similar, but different and each with its own ideas of social idealism.

Sisters has this sort of cowboy-bohemian-earthy vibe. The town’s Old West theme is contrasted by vegan fare, yoga studios, and chic boutiques lining streets. Tourists are a mixed bunch donning their cowboy hats, outdoor gear, paisley prints, and California couture. On multiple occasions I have passed a local cowboy riding his horse downtown as I walk to the vegan smoothie bar across the street- so yeah, it is a special place.

Silverton, the garden-city of Oregon, has a quaint-Norman Rockwell-ag town-meets modernism sort of vibe. It is a place where families tracing back to the Oregon Trail hold strong to tradition while also attracting newcomers enchanted by its charm. While it does not yet have a vegan smoothie bar (at least as of last week), Silverton is a good mix of traditionalism sprinkled with just enough hipster to make it officially “cool”.

Shame is a funny thing. Each town seems to have their own rules about shame dictated by the uniqueness of its culture and social norms. Sisters & Silverton for example have certain criteria you may have to meet to be considered acceptable or ‘a local’. Your scarlet letter may be particularly painful in one town while it may be celebrated in another. Sometimes when so many people have the same scarlet letter, it becomes shameful to not have a scarlet letter. This can happen in cases of learned helplessness when forward mobility can seem unorthodox and even condescending.

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If there is one thing I have learned in my work, it is that no one person is immune to shame and insecurity. Not the most successful, not the wealthiest, not the most popular- everybody has their burdens. Everybody has their struggles.

Sharing the Scarlet Letter: 5 Ways to Lessen the Burden

So assuming we all have our own scarlet letter how then can we lessen each other’s burden of shame and move towards acceptance and authenticity?

  1. Be wary of gossip– Small towns are notorious hot-beds for gossip. Gossip gives the illusion of pseudo-closeness and by being a participant, it can increase our own sense of hypervigilance and shame. It can leave a person feeling on edge, judged, and even shunned. Talking about somebody’s successes can promote positivity but gabbing about somebody’s trials is a disservice to everyone- you included.
  2. Give each other (and yourself) space to make mistakes– Or maybe I should just say let’s give each space to be human. We all f**k up once in a while and while there are certainly limits to our slip-ups, holding ourselves or each other to unrealistic standards of perfection or control is probably the biggest mistake we make. Try not to make assumptions and realize a person’s actions are part of a complex story.
  3. Be genuine– Formalities have their place, but how often do you really ask with true curiosity, “how are you?” By the same token, don’t be afraid to respond to such questions with genuine honesty. You may be surprised how this provides safety for others to open up with you as well.
  4. Shame vs guilt– This is an important distinction. Guilt means I did something bad. Shame means I am bad. Learn to acknowledge this in yourself and others. One action does not have to define your worth or value.
  5. Pieces of you– Remember that Jewel song, Pieces of You? Recognize that which you dislike in others is often secondary to what you dislike in yourself. Therefore, if you are feeling shameful you are probably more likely to “shame” others. Own your shame story, acknowledge the pain, and be weary of projecting it onto others.

Do you live in a small town? What have your experiences been with ‘Scarlet Letters’ & shame? Let’s challenge ourselves to stop the judgment and chastising. After all, we will all likely need help overcoming our own scarlet letter at some point.

Thank you as always for listening.

With gratitude,

2017-09-09 Audry VanHouweling Headshots (2 of 2)

Audry Van Houweling, PMHNP-BC, Owner of She Soars Psychiatry, Sisters & Silverton, Oregon

Work, Life, and Bathtime…

About 2 years ago I had an epiphany while soaking in my bathtub—seemingly my favorite place for epiphanies. I was 30, had a high paying job, a beautiful house, a supportive husband, good friends, an idyllic place to live, contemplating children, and yet, alas…I was fizzling, tired, and burnt out. A classic case of perfectionism hitting the wall. My body, my mind, and soul had been aching for change, but guilt sprinkled with denial and social expectations kept me stuck. Yet that evening in the bathtub, I finally gave myself permission to feel the dichotomy, to sit with the discomfort, and to plot a plan of action.

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Our cottage now…

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The house that was with the great bathtub…

 

 

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Presenting She Soars Psychiatry, LLC

 

 

 

Fast-forward to the present day. I got rid of my 4-bedroom house, moved into a cottage of sorts,  got rid of my job, started a business aligned with my passions, decided my parental energy was best spent on dogs, did hold on to my husband, but ultimately began a process of sorting and shedding the layers of ‘shoulds’ and put a question mark after the social expectations that seemed so important. I even parted with my bathtub for a standup shower…this was a BIG DEAL.

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My husband also enjoyed the tub…permission was not obtained to post this photo…

I realize my shift is a privilege. I was able to leave my bureaucratic workplace and carve out my own niche. I had a supportive family, I was able to ‘follow my heart’, I had resources, and I recognize my ability do so is an impossibility for many. How can we then maintain a level of sanity, contentment, and balance in the midst of work, deadlines, pressure, interpersonal stress, preserving our reputation, relationships, and oh yes, going to the gym, meditating, and drinking our green smoothie?

Maintaining a work-life balance and emotional wellness is not an accomplishment that is one day reached and completed, but a daily, intentional endeavor. The following principles are what I both strive for and teach my many clients navigating this tricky proposition and trust me, I am in no way on a pedestal…

  • Prioritize non-negotiables:  What are those things that must take place of be present for you to feel grounded? Is it your morning run? Your 5-minute meditation? Scribing in your journal? Your favorite tunes? Prayer? Become familiar with your non-negotiables, share them with your family members, schedule them, make them habits. Horses, running, and nature happen to be personal faves.
  • Find a tribe: We are social beings and as much as you feel like you thrive as an introvert, the need for socialization is etched into your genetic code. Perhaps your tribe is small, perhaps large, but do not try to go at life’s peaks and valleys alone!friends
  • Goodbye perfectionism: Perfectionism is the fast track to burn out. The perfectionist in me still loves to try to resurface especially in the face of uncertainty or doubt. All or nothing, black and white, I must do X, Y, and Z to be successful…all classic perfectionistic mindsets. You run a race where the finish line keeps moving. You operate in hypervigilance and competition. Contentment is fleeting if ever perfectionismpresent. You are often exhausted. Your work may prosper, but your health, family, relationships, and contentment will almost surely suffer. Recognize that perfectionism is energy-depleting and not completing. Question your version of success.
  • Become mindful: We live in a world of noise, chaos, and distraction. Many of us are more comfortable in noise than we are in silence. Many of us fear solitude without distraction as it forces us to confront our own thoughts. We do not heal by avoidance, but by awareness. Take 5 minutes of your mindfulnessbusy day to focus on your breath, take a sensory inventory (what are you seeing, smelling, tasting, hearing?), practice gratitude, be present.
  • Be open and stay flexible: In my opinion the idea of ‘finding your true self’ as if that self were a stagnant being waiting for you over the horizon is overrated. You do not have to live to work…working to live is just fine, too. There may not be a perfect job or a perfect path. Life happens and inevitably, we will go through change, transformation, epiphanies, and growth. It is okay that a once upon a time passion becomes less exciting, or your beliefs evolve, or your relationships change. Be open to this change and recognize that decisions you make today may seem silly in retrospect. Such is life. Embrace the gray when the tendency may be compartmentalize life to black and white. Be gentle with yourself.black and white

Ultimately, emotional wellness and maintaining balance is a spectrum complicated by the unpredictability of life. Regardless of where you are on the spectrum, do not be afraid to feel, to love, and to give yourself permission to take action. I look forward to hearing about your bathtub epiphanies.

As always thanks for listening.

With gratitude, 2017-09-09-audry-vanhouweling-headshots-2-of-2.jpg

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLC located in Sisters & Silverton, Oregon www.shesoarspsych.com

Breaking the cycle of negative self-talk

How often do you seek out silence? Solitude? Are you afraid of it? Does it make you uncomfortable to be alone? Silence has become an anomaly in our high speed, digitalized world and we have become accustomed to distractibility that drowns out our own thoughts. Escapism via screen time, substances, spending money, pornography, food, and other means has become commonplace and has made embracing the present moment more and more elusive.

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My recent attempt at solitude in the middle of the Bighorn Mountains, Wyoming

Many of us struggle with negative self-talk. Many of us avoid silence, being alone, and continually seek out ways to distract and temporarily pacify our negativity. We become accustomed to “noise”, chaos, and obsession, which are all often a means to avoid confronting deeper roots of discontent. The noise, chaos, and obsessive thinking is named as the problem; however, addressing underlying core beliefs, trauma, and the “inner child” may feel even more problematic and thus the pattern of diversion continues. Many of us have also been told the cowboy lie to pull ourselves up from our bootstraps. Healing is not accomplished by running from our feelings. The medicine for pain is allowing ourselves to feel the pain.

Perfectionistic attitudes, the superman/woman complex, and the belief that the means somehow justify the end can go hand in hand with this unrest. We believe that if we just push ourselves enough, endure an amount of suffering, deprive ourselves for long enough, then perhaps we will meet an end that finally makes us feel “worthy”. This is not to say there is not value in hard work but being attached to an outcome that somehow dictates our self-worth is problematic. Many of us are convinced that we must somehow punish ourselves to feel a sense of accomplishment. Sounds absurd, right? Well yes, it is.

When we reach societal milestones of success, we reach them with the same self-deprecating, punitive mindset that led us there in the first place. Frustrated, we often find another obsession or distraction to latch onto. We find convenient scapegoats…our weight, our job, relationships, as the source of our discontent, yet we are many times afraid to recognize ourselves as the common denominator. And by the way, this takes a lot of insight and humility.

Negative self-talk is learned, rooted often in childhood, and perpetuated through various life experiences, relationships, and socioeconomic circumstances among other factors. Confronting what can be traumatic is difficult and may demand professional help. It necessitates time to process, which means, yes, quiet, stillness, and space to be mindful.

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Cloud Peak Wilderness, Wyoming

Negative self-talk does not simply go away. We are all bombarded with constant comparison, societal expectations, and judgments that can make even the most self-assured insecure. We can however strengthen our “inner observer”- that voice or conscience that questions the value or necessity of a thought or feeling. It is this observer that can acknowledge a feeling- not run from it, not distract it away- but see it for what it is and question the value of identifying with it or not. The inner observer invites curiosity about our feelings as we look to ask why the negativity is there in the first place.

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Kiger Gorge, Steens Mountains

Your inner observer may be akin to faith or the divine. It can become an internal compass allowing us to see toxicities with greater clarity and emboldens us to seek that which grounds us. This may lead to crossroads as you contemplate old patterns that kept you stuck versus new possibilities.

Ultimately, connecting to your inner observer means becoming comfortable with “you” again and questioning the stories we tell ourselves about our feelings. It means recognizing the present moment and embracing the belief that perhaps simply because you are alive, able to breathe the air, and have the capacity to love and be loved might just mean that for right now in this moment life is OK and perhaps even beautiful.

With gratitude,

2017-09-09 Audry VanHouweling Headshots (2 of 2)

Audry Van Houweling, PMHNP-BC, Owner

She Soars Psychiatry, LLC

Sisters & Silverton, Oregon