Biopsychosocial Factors

I know I’ve talked about this before, but this one needs ALOT of repetition.

Living with a (or multiple) mental health condition(s) means keeping track of Biopsychosocial Factors. I think this is also true for any health condition…that’s my personal opinion…everything I write here is my personal opinion and like all good research you should check with multiple sources in order to find your answers.

Bio=Biological

Biological factors are: Did I eat nutritious food today? Did I sleep? Did I exercise/move in some way? Did I drink water (Do you have a headache?…drink water)? Am I aware of genetics…basically what are my blood relatives dealing with? Is my body hurting and it what ways? Am I breathing shallow or deep?

Psycho…no it doesn’t mean horror movie…it means Psychological…or

How we think of situations and ourselves

Factors are: Being aware of your thoughts. Example: You go to make your bed. Thought: What’s the point? This is getting messed up soon. Or I can’t keep make my bed/do laundry/sweep the floor, because I’m [lazy, worthless, an idiot…other mean names, ect.]. Or Things will never get better. This is how it will always be.

These are called: Automatic Negative Thoughts. We all have them, but some have more than others and/or don’t realize they are actually thoughts and not facts.

This is where therapy comes in and the best way to get into therapy is to look at the back of your insurance card, ask for a list of in-network providers, and call one. Know what your own budget looks like and ask the therapist if every other week or once a month can work due to financial concerns. They will usually say that’s fine, unless your mental health is at a point where your life is in danger.

The best types of therapy depends on more than I can explain today. Ones I like are: Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, EMDR-Eye movement desensitization and reprocessing (this is for trauma memories). I’ve been recently learning about Solution Focused Therapy…which may be pulling into the lead for favorite.

Always know that you have choices in therapists, the same as you have choices in dentists, doctors, teachers, etc. There are human beings and its okay to leave and never come back if someone isn’t helping you.

If you want to do therapy at home, just start with tracking your thoughts with journaling. Include events/situations, thoughts, and emotions. Example: Situation: I was at the store. Thoughts: I was thinking how everything get shipped from so far away. That it’s bad on the environment. Am I even worth it? Emotions: Sadness and anxiety. Then, go back and challenge the thoughts. Yes, everything gets shipped from so far away and I can choose to eat some locally grown food from the farmer’s market. I do what I can for the environment. I don’t know if I’m worth it or not…but if I’m not around to help with the worlds problems I won’t be doing my part to solve them.

I’m not going to lie…challenging thoughts is a lot of work. For some of us, this goes on all day. And that’s just the way it is. It is possible though…to notice thoughts…to challenge thoughts…and to have more freedom and peace in our days.

Social=relationships

Family, friends, and neighbors are social factors and possibly the most important part of being healthy. You can talk to your friends over the phone, text, and in-person. You can connect with people you’ve never met through books, YouTube, and podcasts. An important piece here is noticing the flow/balance of each relationship. For me, it was a great deal of monologuing early in my life. I didn’t really listen to others, and it was lonely. Now, the opposite can happen to me on some days. If I spend the whole day listening, and not saying anything…well, that is lonely as well. Try to look back at your day and ask yourself if…on the whole…there is balance in the amount you give and receive within your relationships. Some of the relationships are more giving and some will be more receiving. Just notice if through the whole day or week…is there balance?

With Love,

Terra Rose

Helping

I used to not be able to tell someone else’s feelings from my own. Just whatever someone else was feeling, I was feeling that too.

It is good to have empathy for others and to be able to see their perspective. Taking on other people’s pain though…well, that doesn’t really help anyone.

A little kid was telling me the story of watching one parent saying they would kill the other and proceeding to drag that person into another room. The kid looked up at me and asked, “Are you going to cry?” I said, “No, I hear a lot of sad things.” The kid was visibly relieved.

It is sad, but making that story my own to cry about wouldn’t help. I do cry about all the terrible things that happen and that’s usually in my car or on a walk or run, but right in front of the person telling would be profoundly unhelpful.

I used to block people out. When its all or nothing, for feeling what others are feeling…nothing was an okay option. I used to run a monologue and keep the focus on me so I wouldn’t have to take on what other people were feeling.

But I’ve learned that we have choices about how much comes in and that takes practice…to set emotional boundaries…to say to ourselves…that’s them and this is me. Some people think that boundaries mean they’ll have less friendships. Actually, its the opposite!

The more skilled you become at setting boundaries, you’ll find you can be around many people and have friends and relationships and acquaintances with people who have their own struggles and own emotions and actions. You trust them to handle their own selves, and they surprise you by doing just that. And if they can’t right away, you can return responsibility by asking, “What are your options?”

Even a child has options. Some of those options aren’t amazing, but children grow and gain more freedom. We can help children look toward the future and see one where they don’t allow violence in their homes. We can help children learn to identify and manage their own thoughts, emotions, and actions.

Anyone can be present for someone else. I promise you that the work I do could be done by anyone and someday my job won’t be needed anymore. We will all just show up for each other and no one will turn away from sad stories or reality, because God helps us to be strong enough for those moments.

And some people don’t believe in God. Or maybe they just don’t like that word? It brings up for them stereotypes and negativity that is, at least partially, grounded in the reality of historical trauma. Sometimes, I’ll turn the radio to a station where an angry guy is half yelling about what he knows that God wants. Then, I can get why church has less people attending…if that’s what people expect to find there.

God is with us.

I can’t fully explain how I know and it’s okay if you don’t believe.

With Love,

Terra Rose

Meaning

Here’s another quote (there are many of these on my desktop….and I need to let some go…I can find them later if needed).

“Behind the patchwork quilt of school sequences and the school obsession with facts and theories, the age-old human search for meaning lies well concealed.” —Author?

I think this one was from a book about improving the school system. It might come back to me. This quote could apply to other settings though. Many of us find ourselves in sequences: get up, brush teeth, go to work, etc. It’s easy (and honestly rather nice) to be so busy that we never think of meaning.

If there’s one complaint that I hear the most from people who come to therapy, but haven’t had a recent trauma (child’s death, house fire, serious health diagnosis)…it’s: I’m so busy. Or it’s just so busy. I’ve got so much to do.

And I say that one too.

I can feel this big empty space since I finished the EMT program. That was on my wish list since 2017.

There are other things I could want to do. I just don’t want to jump into the same hole…of being so busy…this constant activity leaves little room for loved ones and their hopes and dreams. Or just playing UNO together.

It’s a real Me Show when we’re always busy.

Love,

Terra Rose

Cleaning my desktop

“We must let go of the life we have planned, so as to accept the one that is waiting for us.”  

-Joseph Campbell

Found that quote when I was cleaning off my desktop. Sometimes, I save things like that and I don’t know what folder to put them in. Or I’ll name folders things that I later forget. Like, “quotes” or “resources.” Then, I’ll never think to look for it again.

I’m not sure what my plans are for life anymore. Maybe I’m actually out of plans. Maybe I’m in a kind of a free fall and it’s time to accept the life that is waiting for me.

It think I had more to share, but needed here 🙂

Hugs!

Terra

What to say

For a few years, after I went back to school, and got a job as a therapist my conversational skills improved. Now, I’ve gotten much worse. I have no idea what to say to anyone. There’s just acres of long awkward silences. I’m not sure what’s causing this and I’d like it to change.

Sometimes, I think I’ll move on from talking altogether. Like start running more or go way back to childhood when I would read most of the day. Or paint a picture. Dance.

When I was young, I would think it was so weird if someone was quiet or didn’t talk much. I remember a boyfriend who barely had anything to say, and I just couldn’t get him. I regret that I wasn’t kinder to that person.

A woman came in for an appointment and her husband is dying. She asked me what she could do to help her child through this time. All I could say was, “People will bring you food and you’ll eat it together.”

I hope that people always bring food.

Confirmation Bias

After we were on vacation for a week, there was a letter in the mailbox.

The letter was from our town, letting us know that our compost was attracting raccoons to the neighborhood. My husband and I were mad, sad, and perplexed. We have been here 5 years, doing the same stuff…if anything our yard is slightly better than it was when we moved here. The family that lived here before us had a long row of rabbits in cages outside (which I hate…rabbits in cages…why??!!! But that’s another rant for another morning).

Also, I took around the neighborhood and here’s what I saw: Rotting car on lawn, 20 foot skeleton statue holding a flag, broken down camper in backyard, somewhat working camper with family living in their friend’s yard since last fall, broken down trampoline and standing pool. Side story: I once stopped a little kid from shoveling the top off, of snow, in winter. Kid was looking at the pool, holding a shovel…looking at me as I was about to get in my car…and he kinda new it was a bad idea.

“[Name],” I said to him, “Please, don’t shovel off the top of your pool. It’s not safe. You could fall through the ice.” He wasn’t mad or anything. If anything, he looked relieved that an adult had talked…rather than yelled. I’m also aware of a neighbor that got arrested for selling meth. So, while I can’t see the meth, I know its here in our neighborhood where my family is inconveniencing everyone by turning banana peels, leaves, and egg shells back into dirt.

Not to mention the registered sex offender that lives up the hill and the unregistered sex offenders that live all around.

All this to say, one of neighbors called the town because they believed that our compost caused raccoons to come and destroy their sweet corn in their garden.

Confirmation Bias: “People’s tendency to process information by looking for, or interpreting, information that is consistent with their existing beliefs. This biased approach to decision making is largely unintentional, and it results in a person ignoring information that is inconsistent with their beliefs. These beliefs can include a person’s expectations in a given situation and their predictions about a particular outcome. People are especially likely to process information to support their own beliefs when an issue is highly important or self-relevant.” Source: https://www.britannica.com/science/confirmation-bias. I added the bold writing.

I’ve tried growing sweet corn, at our old house, and raccoons ate it. This is what attracts raccoons: delicious sweet corn!!!!!!! We didn’t even have a compost bin at that time. Raccoons have little paws that can grab and they are smart. But I get it. Our neighbors must of felt mad and looked across their yard, saw a couple egg shells and thought, “Aha!”

My husband used his natural ability to argue and wrote an evidenced-based letter back to the town. The compost remains, though we added a lid and $80 container that hopefully looks nice to people. We also moved it to the other side of the house, so the neighbors that were upset would not have to see it anymore at all.

For me, I’m sad for them, because they seemed to really enjoy gardening this year. I want to say, “Hey, don’t give up. Plant some things that raccoons don’t eat. Been there!” But now I have to just avoid them for awhile.

Hope your Saturday has moments of peace and joy!

Terra

Ps. Bonus rant: The dogs that live at the house that complained bark loudly at me EVERYDAY, EVERY TIME I leave my house to go to work and EVERY TIME I come home. “[Dogs names],” I say, “It’s okay. You know me. It’s okay buddies!” I don’t add: I’VE LIVED HERE FOR FIVE YEARS!!!!!

Themes

If you listen long enough, you’ll hear themes in the way people get stuck. “I’m not good enough” or “It’s never good enough” or “I’ll get started when I feel better” or “If people were nicer to me, I’d be nice to them” or “It’s unfair.”

I have thoughts like those also. For me, getting up early helps. Honestly, just get ahead of it. I want to tell people that….and maybe someday I will fully join the red hat club and just start saying exactly what I think about what people should do. That isn’t the way it works though. We, the people, are basically blind to direct suggestions of any kind. That’s why parables exist. I wish I were more talented in round about ways to explain healthy living as I understand it.

I’ve been trying, lately, not to let work affect me physically. When I pay close attention, I can feel my guts clench up or my neck start to ache. The things people think and say physically hurt me somehow. I don’t get that.

What does it mean?

I suppose that I lived in my own world, of my own thoughts and feelings, reading and running and writing that I didn’t have the pain I have now. I didn’t really listen to anyone and, while it was lonely at times, I didn’t hurt physically from it.

A gift is that I’ve learned to listen to an audiobook on the way home and leave this behind. You can only do what you can, in the moment, with what you have and mulling back over it for hours on end doesn’t help anyone….and it wastes your own time.

Today I saw a family of turkeys on the drive to work. The babies were oddly cute, and because there was no one else driving behind me, I stopped for awhile to look at them. It was funny the way they walked.

And that may sum up the most important lesson I’ve learned about mental health, it changes moment to moment…if you let it…if you let go and have faith that God is with us. Even when you don’t feel faith or hope…that you still believe that you will again feel those. It could be any moment! Unexpectedly, you might see a butterfly or taste fresh coffee and know that joy is for everyone.

Joy is for you and me 🙂

With Love,

Terra Rose

Practical Exam on Saturday

I made it to the EMR (emergency medical responder) level last April. Now, I will have the hands-on practical exam for EMT level this Saturday. I’m trying not to freak out, and its not really working. The same old routine, but always so intense. I keep picturing myself holding a splint and there’s just a gap on how to tie it.

The rest of it, I have have committed to memory. There’s an order…even to emergencies…and I’m glad I learned it. 1) BSI/scene safe 2) Number of patients 3) Assess need for additional resources 4) Assess the mechanism of injury or nature of illness 5) Consider c-spine (hold someone’s head/jaw in order to prevent spinal damage).

After you do the first 5 things above: It’s your A, B, C, D’s. A: Airway: is the airway open? B: Breathing: is the person breathing? C: Circulation: Does the person have a pulse? D: Transport Decision: Is this rapid/high priority transport or not?

If someone does not have a pulse, CPR is your next move. CPR is 30 and 2. 30 head compressions and two breaths with pocket mask or bag-valve-mask. AED will also be applied and shocks likely adminstered.

This is where it divides. Trauma Assessment or Medical Assessment. If it is a trauma, and the person is unconscious, you will start at the head and feel for broken bones and look for bleeding and hard abdomen/internal bleeding. You will look for pulses in ankles. Press on visible skill and notice if the capillary refill time is under 2 seconds (healthy) or takes longer than that (not good). With a Trauma Assessment, you will look for family members or bystanders to give you more information. When did this start? Does this person have any allergies? Is this person taking any medications? What is this person’s medical history: any history of asthma or heart issues?

Medical Assessment: AVPU: Alert (Can the person say their name, where they are, know what time of year it is?), Verbal (Can the person make sounds and some verbalizations, but doesn’t exactly know what is happening?), Pain (If you rub hard above their eye brows, will the person show some response?), Unresponsive (None of the above). OPQRST: Onset: What were you doing when this started? When was that? Provocation: Does anything make it better or worse? If you take a deep breath is that worse (lung issue, rather than heart)? Quality: Is this a dull pain? Sharp? Radiate: Does the pain radiate/spread to anywhere else? Your side? Your shoulder? Severity: Where 0 is no pain and 10 is the worst pain you’ve felt in your life, where are you now? SAMPLE: Signs and Symptoms: Observing shortness of breath or the person verbalizes they can’t breathe or they’ve been feeling progressively worse all day. Allergies: Do you have any allergies? Medications: Can you show me the medications you take? Pertinent medical history: Have anything like this ever happened before? Do you have a history of heart or breathing issues? Last oral intake: When is the last time you had anything to eat or drink? Events leading up to: Can you tell me again what was happening prior to this?

Meanwhile/during these questions: The second EMT or EMR is getting vitals. Pulse, Blood Pressure, counting Respirations, Blood sugar, shining a light in their eyes to check dilation, asking: Can you feel my hands? Can you squeeze my hands? And listening to lung sounds.

Oxygen is often given via nasal cannula at a rate of 4 to 15 ml.

A person in shock needs to be kept warm. A pregnant person shouldn’t be transported flat on their back (compresses an artery).

When you are headed to the hospital, you should give a radio report/let them know what to prepare for: “This is ——-, transporting a ——year old male with shortness of breath and blood sugar was low. Administered glucose. Blood pressure is——–. Pulse is————. Reports a history of ———–. Pulse ox showed 95%, so we are administering oxygen via nasal cannula at a rate o 4ml. Do you have any questions for us?”

That’s all I can think of for now.

Happy Tuesday!

Terra Rose

Grant us peace

“Grant us peace in our days” is part of prayer. I’ve been thinking about that a lot this week. One person, I even asked, “Are you looking for more peace in your days?”

Most people will answer yes to a question like that.

Maybe because I’ve spent a good deal of time with people who have disabilities, I’m really conscious of how much I’m able to do. I feel the ethical weight of knowing that I should do all I can possibly do. I probably go too hard sometimes, and I feel that physical and emotional exhaustion that comes from not fully understanding how to balance doing and being. But when I try to ease up, that can go sideways as well. Doing too little is worse.

I’m going to meet with a GI doctor next Friday. I think my insides aren’t well. The last time this occurred was 5 years ago, and the doctor told me stress and possibly the muscle split (diastisis recti) that happens with most pregnancies. That got better and became a problem again around December this past year. I’ve been trying my usually strategies: drinking lots of water, running at least 3 times a week, sitting up straighter at work, significantly reduced dairy intake (may need to give this up entirely), and laying on the floor at the 55 minute mark (therapy hours are 53 minutes, but it seems easier for people to wrap their heads around 55…this is time to write notes and take a bathroom break or lay on the floor look up at the ceiling as ask for God’s help).

Well, at least I’ve been able to maintain my keen sense of drama as I’ve aged 🙂

Wishing you all moments of peace in your day!

Terra Rose

You don’t know what it’s like

“You don’t know what it’s like” is a weird game we play amongst each other. A competition that nobody wins that has gone on for far too long. I’m the loneliest. I’m the one who was hurt the most. I’m the one who struggles.

Please. Do. Not. Say. This. Story. To. Yourself.

Please.

Please.

I’m not saying that I haven’t jumped down this hole and sat down there, while family and friends pointed frantically to the ladder. I have. I do. Just not as often anymore.

My prayer today is: “Please, God, help us to listen to each other for even 10 minutes.” Ten focused minutes would make a difference. Let the other person talk! Summarize what you heard them say. Ask questions/have curiosity about what it is like to be someone else. The truth is that no one us, knows what it’s like to be the other. But we can fucking try.

Try.

Love,

Terra Rose