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

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

The loneliness behind our success…

How do you define success? Who or what shaped your ideas of what success is? Has this definition served you not only financially, but so too spiritually, and emotionally?

Our vision of success has likely been dictated by past experiences, relationships, education, opportunity, culture, and the society in which we live. In our society success is often defined by external accomplishments- our bank accounts, our home, our cars, our clothing, how many letters we have after our name, and how many followers we have on our social media accounts. Many of us know there are shortcomings to this model of success, yet we nevertheless embrace the facade day after day.

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Putting on a bit of a masquerade is human nature. We all like to flaunt our stuff once in a while or feel impressive from time to time. Our quest for belonging and acceptance is part of the human experience that has roots in survival, emotional, and physical well-being.

What worries me is that we have set the bar too high and this has had significant ramifications on our well-being. We are bombarded by expectations that are both unrealistic and often impossible all the time every day. We have bought into the idea that our value is connected to fleeting affirmations of worth and we compare ourselves to filtered, edited, and false portrayals. Have you ever followed somebody on social media and then met up with them in person only to realize their life is nowhere near as effortless as their virtual portrayal may seem? And have you been guilty of trying to portray your own “effortless” existence? My answer is yes and YES.

Former Facebook executive, Chamath Palihapitiya, in an interview with the Washington Post (2017) emphasized this dynamic:

“…We curate our lives around the perceived sense of perfection, because we get rewarded in these short-term signals—hearts, likes, thumbs up—and we conflate that with value and we conflate it with truth. And instead, what it is is a fake, brittle popularity that’s short-term and leaves you even more, admit it, vacant and empty…”

Some of us are afraid to portray anything but an edited version of who we are. Aside from social media we may rely on our fancy labels, titles, career, makeup, or substances to distract from vulnerability and authenticity. Ultimately, this can be pretty lonely. We realize our connections to others are built on a facade that can be exhausting to maintain and that few if any persons have been allowed access to what’s behind the mask. Maintaining prestige, fame, and status can ultimately be emotionally depleting as well as isolating.

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Genuine social connection and space to be simply “real” is central to our health and I might argue, success. Loneliness and isolation have been associated with cardiovascular disease, inflammation, diabetes, depression, anxiety, and suicide. Our largely individualistic society loves to give pats on the back to those who have apparently forged life by their own willpower. We become afraid to ask for help fearing it is a sign of weakness. We convince ourselves that virtual followers and connections can replace face to face encounters.

In my opinion the loss of genuine human connection is central to the rising depression and suicide rates plaguing our country. It is why wealth does not always buy health and why those who appear to “have it all together” may be experiencing deep personal struggle. So in addition to your yoga class, green smoothie, eco-friendly home, and meditation make sure that you also call a friend, meet a neighbor, plan a coffee date, and just maybe let your guard down a bit.

Thanks for listening everyone.

With gratitude,

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLCheadshot4

www.shesoarspsych.com

Sisters & Silverton, Oregon

541-595-8337

A Woman’s Desire for Control: Origins and Ramifications

One of my goals in my practice is to heighten insight and self-awareness among my clients. Many of my female clients come to me with complaints of feeling overwhelmed, exhausted, and underappreciated. These symptoms are often married to perfectionistic tendencies and attempts to control the external to compensate for internal chaos.

Now for some controversy. When it comes to control and gender, it does seem that a double standard exists. Men are often chastised for seeking control in a relationship as it seems akin to emotional abuse and patriarchy. In my opinion this sense of disapproval is warranted; however, I question whether women are judged by the same standard. It also seems more acceptable for a woman to voice emotional distress over a controlling man, yet if a man were to voice his emotional distress it seems he would need to overcome a societally reinforced barrier of embarrassment and defeat. A man may feel pressure to acquiesce in order to not “rock the boat” and consequently, similar to a woman in the same position, resentment can flourish.

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When I ask women- many of whom laud equality as a core value- to put themselves in the shoes of their partner or children or inquire whether they would tolerate the same level of control from their partner, a good healthy pause and then reflection ensues. Ironically, these same women often voice that their partner is too passive, yet simultaneously insist on “doing it all” and have difficulty delegating even simple tasks.

A woman’s desire for control certainly in not born in a vacuum. Often the origins of her controlling tendencies are rooted in trauma. Trauma is an insidious and almost universal experience among women. Taking control and maintaining order may have been critical to emotional and physical survival at times, which can be a hard pattern to shake even when emotional and physical safety are secured. This can leave well-meaning spouses, children, coworkers, and others in the path of the “control storm”, so to speak. Putting aside individual experiences, our society alone perpetuates the persistent unease among women that “we are not yet good enough until…”. This by itself can cause a strong fear of disapproval and ongoing attempts to control partners, children, coworkers, food, appearances, and money, among other things.

A woman may have experienced times of chaos or abuse or dysfunction that left her feeling desperate for a sense of control. Micromanaging, demands, and persistent critique are often secondary to a sense of emptiness or internal turmoil that fuels uncertainly, self-doubt, and the need for external validation, praise, or a sense of order. In some cases, a woman experiencing abuse from a spouse or partner may seek to regain a sense of power or control by displacing her anger and resentment onto her children. It comes as no surprise that the children who have absorbed emotional impacts from their mother and father then also start displaying concerning behaviors. Children may then be chastised given that they are not fulfilling desired outcomes and yet in trying to correct the be

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havior, it is only further reinforced.

Control is about being attached to an outcome that will somehow, per our perception, dissipate fear of the unknown. Yet despite our best efforts to plan, manage, and control, the unknown will always exist a minute from now, an hour from now, tomorrow, and so on. Letting go of outcomes is not giving up, but rather trusting yourself enough to navigate the unknown…whatever may come your way.

With gratitude,

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

www.shesoarspsych.co2017-09-09 Audry VanHouweling Headshots (2 of 2)m

Sisters & Silverton Oregon***541-595-8337

 

Thyroid Function & Your Mood

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In my office I practice functional medicine. Functional medicine aims to identify root causes of health concerns and in doing so, supports treatment solutions that are long-lasting and sustainable. Given my specialty in mental health, the intersection between your hormones and emotional is a “root” that cannot be dismissed. Your hormones are intimately connected with your mood in a bidirectional, dynamic relationship and one of the major players in this relationship is your thyroid.

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Your thyroid is a butterfly shaped gland that sits in the lower part of your neck. It has many important roles including growth & development, metabolism, temperature regulation, and neurotransmitter production among others.

Thyroid dysfunction is on the rise these days. This may be due to the thyroid being particularly susceptible to potentially damaging effects of synthetic, hormone disrupting chemicals that have increased exponentially the past 40-50 years finding their way into the air, water, and food supply. It is estimated that worldwide up to 25 percent of the population have some degree of thyroid dysfunction. Therefore, when I evaluate someone for depression, anxiety, poor motivation, and poor focus among other symptoms, it is imperative that thyroid function be assessed.

Thyroid imbalances can trend in two directions. Most commonly, thyroid function and hormones associated with the thyroid create a state of hypothyroidism. Symptoms associated with hypothyroidism may include fatigue, depression, brain fog, memory loss, cold intolerance, weight gain, muscle pain, and dry skin. Alternatively, hyperthyroidism can be associated with restlessness, anxiety, weight loss, insomnia, rapid heart rate, irritability, and heat intolerance.

Thyroid dysfunction may be the consequence of an autoimmune disorder. Hashimoto’s disease is the autoimmune state more commonly associated with hypothyroidism while Grave’s disease is more commonly associated with hyperthyroidism.

Women have seen the highest increases in thyroid dysfunction especially during pregnancy, postpartum, and postmenopausal states. In fact, it is estimated that up to 80 percent of postpartum depression may be associated with thyroid dysfunction.

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It is important to recognize that somebody with undiagnosed thyroid dysfunction may present to a mental health clinician and meet criteria for a number of psychiatric diagnoses such as major depression, generalized anxiety, panic, or attention deficit disorder. Therefore, while your symptoms may qualify you for a psychiatric diagnosis, the foundation of these symptoms may be hormonal, which often demands treatment approaches beyond psychotropic medications.

In my opinion, truly assessing thyroid function necessitates looking at multiple pieces of the puzzle. Too often many of these pieces are neglected leaving an incomplete picture of what your thyroid is doing or not doing. At a minimum I recommend the following lab tests to assess thyroid function:

  1. TSH (Thyroid Stimulating Hormone, regulates secretion of T3 & T4)
  2. Free T3 (active form of thyroid hormone)
  3. Free T4 (inactive thyroid hormone, requires conversion to T3)
  4. Thyroid Antibody Test (this is important to rule out an autoimmune disease)
  5. Liver Function Test (your liver is very important for activating thyroid hormone)
  6. Ferritin (required for T3, your active thyroid hormone to work at the cellular level)

 Stress, diet, nutrient deficiency, lack of physical activity, oral contraceptives, heavy metals, pesticide exposure, chronic illness, and compromised liver or kidney function can all be contributors to thyroid dysfunction. Thus, treating thyroid dysfunction demands a personalized approach that considers these multiple factors. There is not a one-size fits all solution. The good news that with a combination of hormonal support, lifestyle changes, and close monitoring, significant improvement is possible.

Ultimately, it is important that mental health symptoms are not seen in a box and that we take a broad approach in investigating what their origins may be. Acknowledging the power of your thyroid and other possible root causes is paramount to finding sustainable solutions.

Stay healthy everyone.

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

With gratitude,

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

www.shesoarspsych.com

Confronting Body Shame

I always ask my clients to rate their self-esteem 0-10. The vast majority of my clients rate themselves below 5. If my client happens to be female, complaints about her body almost always dominate the list of why. Intellect, character, performance, and achievement are often never mentioned.

It is altogether disheartening how many of us associate value and worth with size, the number on the scale, and measurements that are idealized by a social concept that is both unrealistic and, in many cases, impossible.

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Every woman has her own story about body shame. Like most women, memories of my own body shame are all too vivid. I remember the early days of elementary school playing follow the leader on the playground and not being able to fit through small spaces that seemed so effortless for my peers. I remember my portions and food choices being scrutinized by family members. I remember seeing the school counselor and being told I eat too much. I remember starting at my young body in the mirror- loathing what I saw and wishing I could switch bodies with the Disney princesses or Barbies I idolized. In dismay I would compare the size of my legs, my arms, my stomach compared to my peers…and this was all before middle school.

Rather quickly my body seemed to lengthen rather than widen. I stretched to nearly 5’10” by the seventh grade and the dynamic of attention and commentary shifted. Yet seemingly too tall for pre-pubescent boys my own age, suddenly there were comments from men- sometimes much older men. Cat calls, innuendos, and crass remarks on my physical form that still seemed so new and foreign to my budding mind. Soaking in what seemed to be validation, I aimed to maintain the streak of physical affirmation sometimes by means of extremes. Food restriction and excessive exercise became a pattern. Negative self-talk was the driver. I could not let myself be satisfied. I was terrified of regressing.body image2

 

Our society promotes a sustained hypervigilance around body image and while I have made progress, I am not out of the woods. Most of us are actually still pretty deep in the woods so to speak. Women & girls are often ridden with trauma regarding their bodies. Whether it be a collection of accumulated comments and encounters or events of blatant harassment or abuse, we are taught from a very young age that the form of our bodies defines our worth and, in some cases, even our survival. Other elements of our being and soul are minimized, disregarded, and suppressed. As the inevitable shifting and ultimate decline of our physical bodies occurs, we are confronted by shame and guilt as the form of our body may drift farther away from the social ideal. Social media further reinforces our shame as edited and filtered comparisons are only one click away.

So make a point to praise your daughter, partner, spouse, or family member on attributes other than her physicality. Support her in creating a legacy of inner beauty and confidence. Ladies- we can be our own worst enemies. Let’s try to refrain from objectifying one another. Let’s honor each other’s accomplishments outside of what happens in the gym or on a scale. Modest or immodest, let’s realize we are all marvelously complex despite our exterior. Let’s celebrate our diversity and be unafraid to call out unrealistic and harmful stereotypes and ideals.

Character, compassion, intellectualism, humor, empathy, and mindfulness resonate far more than the number on a scale. After all, I have yet to see anything about weight loss or dress size on somebody’s tombstone. On that note, give your body grace. It will fail standards again and again, but your value is far more unconditional.

Be kind to yourself.

With gratitude,

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

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

www.shesoarspsych.com

Embracing Grey in a Black & White World

We all like to feel safe. When chaos and uncertainty surround us, it is common to fall back on rigid thinking in order to create the sense of control, predictability, and make sense out of the inexplicable. Reducing a complex world into right and wrong, good and bad, successful and unsuccessful, and so on might seem to give us security until we have to confront the endless variables that suddenly make our black and white thinking so grey.

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A lot of us are experiencing fear and heightened stress these days. Many of us live in a state of adrenaline, fight or flight, and hypervigilance. When we are afraid we often resort to primitive ways of thinking that include language such as “always”, “never”, and “must”. We tell ourselves to “never” associate with certain people, to “always” present a certain way, and that we “must” adhere to societally driven formulas to succeed. These rules for ourselves and others leave little room for flexibility and a lot of room for disappointment. An all or nothing experience emerges…
We either succeed or we fail, someone is a good guy or a bad guy, something is either right or it is wrong.

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Black and white thinking limits both our grace for ourselves and others in addition to robbing potential connection, self-discovery, and empathy. Because the world is not static and ultimately nuanced with a whole lot of grey, holding tight to such rigidity can perpetuate pessimism, perfectionistic thinking, depression, and anxiety. We may feel like we are running a race and the finish line keeps on moving.

Seeing the world as grey can be uncomfortable especially when we may feel threatened or when we have been hurt. We categorize, we stereotype, and we generalize. We let labels and assumptions take over. We hesitate to let go of our way of sorting the world due to fear we may get hurt. To defend our black and white thinking we find ways to validate our worldview perhaps through the media we choose to consume, the people we surround ourselves with, or the spiritual beliefs we adhere to. Essentially, we often find what we are looking for.

Because black and white thinking is often kept alive by fear, we must defend the fear to defend our thought processes and thus, in many ways, it creates a fear-based existence. It turns out spending so much time and energy defending ourselves and seeking validation can also be quite exhausting.

When we let go of the black and white in exchange for the grey, we open doors for kindness and understanding for ourselves and others. We can more readily “step into someone else’s shoes”. The pressures that we put on ourselves are not as burdensome, and compassion comes easier.

It is important to question how we categorize ourselves- what labels, roles, and rules have we tried to adhere to? Are these restorative or draining to our being and those around us? Do they allow for growth and self-exploration or do they keep us confined?

As we consider the world of yes and no, good and bad, right and wrong, successful and unsuccessful, we must recognize that these are all on a spectrum nuanced by numerous variables unique to each of us. Putting aside black and white thinking and embracing the grey takes courage but can also be pretty darn liberating. In the words of Deepak Chopra, “Instead of thinking outside the box, get rid of the box”.

Thanks for listening everyone.

With Gratitude,

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

www.shesoarspsych.com

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

Sisters & Silverton, Oregon