If You Have Begun to Drink and Use More Than You Wish

People use substances for reasons that are meaningful to them.

Researchers have found that people primarily use caffeine, nicotine, alcohol, marijuana, and other drugs for very human reasons: to feel good, to feel better, to do better, and to connect with others. Humans have done this for over 12,000 years.

If overuse has become a concern, these findings suggest logical questions to ask.

  1. For which of these reasons do I use substances?
  2. In what ways do I not feel good, have not been able to feel better, believe I’m not doing well enough, or lack sufficient connection with others?
  3. In addition to substances, what else might I discover to help myself feel good, feel better, do better, and feel connected?

To help people humanely, effectively, and efficiently answer these questions, I offer a 6-session, online counseling protocol. I am licensed to provide counseling services to residents of the Commonwealth of Virginia only.

Due to financial hardships caused by the pandemic and predictions that substance use problems will increase, I am currently accepting pay-what-you-can services. I will ask you the optimum fee for you up to the standard rate of $125 per individual session and $45 per group session.

I specialize in using research-informed methods to help people reduce or eliminate use of substances that have become problematic for them. They may have received a substance use disorder diagnosis, also termed “addiction.” I am a licensed professional counselor in the Commonwealth of Virginia, have training and expertise in addiction treatment research, track outcomes, and have personal experience in achieving remission from alcohol use disorder.

I deliberately offer self-pay counseling services to protect the immediate and long-term privacy of clients. Self-pay services are discrete, eliminate the need for notifying third parties, and prevent the presence of a permanent, stigmatizing substance use diagnosis in one’s health record. Here is more about why I do not accept health insurance.

Clients receive private, expert, in-place help. Although acute situations may require residential treatment, this protocol attempts to prevent the financial hardships of “rehab” and its sometimes-devastating 70% or higher return-to-use rates.

If you are a Virginia resident and are interested in this protocol, please feel free to contact me. If you would like to get started, please fill in our contact form. I will use your email address to send you registration information through our HIPAA-compliant electronic health record, SimplePractice.

I would welcome the opportunity to work with you. Please do email, phone, or text me with any questions you may have.

. . . . .

Here are answers to questions you may have.

How can 6 sessions possibly be sufficient to help a person with alcohol and other drug problems?

The research is clear on what helps people reduce or eliminate substance use. Medical care comes first. After receiving the stabilizing care that medical expertise can offer, individuals can efficiently learn and apply a sequenced set of specific skills to help themselves with substance use. These skills assist with symptoms of mental and physical illnesses that may also be present.

Research is clear on what can be helpful

I’ve tried everything and nothing works. What is the difference between this protocol and other substance use disorder treatment?

This protocol acknowledges that people use substances for reasons that are meaningful and important to them. People have traits, circumstances, or patterns of feeling, thinking, and behaving that cause problems. Substances can solve these problems. Why stop something that works?

With self-kindness and without self-judgment, people can meticulously identify the purposes substances and substance use serve and then find adequate – if not necessarily ideal – replacements for them. Logically, then, finding something else that works well enough helps people reduce or eliminate use.

One of the purposes served by substances is adjusting an inner state experienced as intolerable, whether it’s experienced as too intense or too empty. When substances are absent, distress rises. For some people, this distress can be experienced as depression, anxiety, or both. Other people experience distress as a loss of a sense of reality. It feels unbearable. Use of substances feels like mercy.

A specific set of skills – what I term “awareness skills” – assists people in using their own minds and hearts to adjust their inner experiences to an individually stable range.

Optimally, sessions are held once per week. Given that each week holds 168 hours, one hour of counseling per week is likely to be insufficient to sustain progress. Daily skills practice is expected.

Come on. This is just another “one-size-fits-all,” simplistic solution for a complex problem. How can this possibly work for all substances and all people?

The protocol is informed by research. The purpose of research is to determine what is helpful to most people, most of the time, better than other things, and better than nothing. The protocol has not been tested in a clinical trial. However, our outcome data indicates that the protocol – combined with medical care and/or medications, partner/family support, and a stable living situation – is helpful to many people who try it. Some individuals may not benefit.

Substance use and mental health challenges are conceptualized generally as 1) difficulty with emotion regulation, 2) belief-based thinking, and 3) insufficient empathy for self and others. This protocol consciously and specifically targets all these areas, thus increasing the likelihood that it will be helpful to many people with a variety of challenges.

Who might most readily benefit from this protocol?

I hope aspiring and current professionals, executives, and business leaders will be among the beneficiaries. As a highly-educated, highly-functional, working professional, I got the shock of my life when I attempted to stop drinking alcohol and could not. Research-backed treatment was nearly non-existent in 2012. Although I have been in remission from alcohol use disorder since 2012, I have a permanent diagnosis of alcohol “abuse” in my health record. Today, I hope people in similar circumstances will be able to help themselves directly and efficiently with this protocol.

In many business and professional networks, substance use is a social norm. Paradoxically, to meet societal norms, people may be mandated to produce urine drug screens negative for substances. Some people may wish to abstain and some people may wish to engage in skillful use. This protocol helps people individually decide on, and reach for, their personal treatment goals.

I offer the protocol freely on my site for anyone, anywhere, to self-administer. I am open to working with any Virginia resident who wants to become a client.

What happens after 6 sessions?

My hypothesis is that, in about 6 sessions – supplemented with independent daily practice and optional and recommended daily text support – a person can learn the basic awareness skills, get an idea of how to apply them, then have a sufficient ability with the skills to self-administer on-going care using the work they did in the first 6 sessions. As needed, they can refresh and deepen their understanding with the materials on the site.

Engaging concurrently in group sessions with other clients using the protocol can be helpful. If individuals already have counselors, continuing to engage concurrently in sessions with them can be helpful.

If individuals wish to continue in counseling, further sessions would support the applied use of skills acquired during the individualized one-on-one sessions. Beginning or continuing in group sessions can be helpful for consolidating and maintaining gains. (In my experience, attempting to begin to learn fundamental skills in group sessions is difficult and inefficient.)

In optional individual or group sessions with me or other providers, people can expand their understandings and start to apply skills in other areas, perhaps with family of origin issues, trauma, or problematic patterns of interacting in partner relationships or at work.

Why doesn’t your private practice take health insurance?

Substance use disorder counseling may be minimally reimbursed by health insurance companies, if at all. More importantly, given that substance use is stigmatized and criminalized, I urge anyone with a substance use concern or an addiction issue to self-pay if they can so no third parties – including health insurance companies – are notified. I explain further here.

Do you have a money-back guarantee?

I am open to sharing the responsibility and risk with you.

The cost for 6 individual, online sessions is $125 x 6 = $750. I am currently negotiating pay-what-you-can services. You are billed one session at a time. Cancellations in fewer than 24 hours and no-shows are billed at the full rate.

You, of course, can discontinue sessions at any time. At the end of the 4th session, I will ask if you would like to continue. If you decide not to continue, I will not bill you for that 4th session.

How can I increase the likelihood this protocol will be effective for me?

  1. Make a list of symptoms that cause you problems. Overuse of substances can be accompanied by trauma symptoms, neurodevelopmental disorders, and mental illnesses. Please share this list with me and disclose any diagnoses given to you, or any symptoms you have researched on your own and believe might meet criteria for a DSM-5 diagnosis. We can customize delivery of the protocol to meet your specific needs.
  2. Consult with a medical professional. Although the appointment may be via telehealth, ask a medical care professional to review your list of symptoms and this screening tool with you.
  3. Know what you want. Be clear on what you want to be able to say is true for yourself as a result of 6 weeks of counseling sessions and skills practice.
  4. Practice skills outside of sessions.

If this approach seems like a fit for you, I would welcome the opportunity to work with you. Unfortunately, I can only work directly with Virginia residents. Anyone outside of Virginia is welcome to peruse the materials listed in the dropdown menu under the Resources tab.

If I can be of any service at all, please do not hesitate to contact me.

Last updated 5/9/20

The views expressed are mine alone and do not necessarily reflect the positions of my colleagues, clients, family members, or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Optimize Within Constraints While Doing Time

In lockdown, I am finding much of what I used to turn to for solace inadequate.

  • My cohabitants are themselves first and my cohabitants second. For the sake of all of us, each of us needs to tend our own needs and wants first.
  • Others important to me are absent, stressed, and intermittently available.
  • Going places and doing things, with and without others, is off the table.
  • Conversing through videoconferencing with its amazing motion picture 2D-ness also tantalizes with its absence of 3D.
  • Exercising at home, alone, without equipment, is inherently limited. Gyms were invented for a reason.
  • Eating, while pleasurable in the moment, also invokes a sense of dread. Stress-based eating and non-eating, plus stress-based food choices, all paired with inadequate motion? I sense I’m setting my own health-related timebomb.
  • Using substances does alter my experience of lockdown. However, unskilled, repeated use and overuse can transform unconsciously into inability to limit or stop using. That form of lockdown is one I never want again in my life, however short or long. Only planned, skilled use can occur, including my use of the drug caffeine.
  • Entertaining myself with screentime has lost nearly 99% of its appeal.
  • Goal-setting and plan-making seem futile in the midst of such uncertainty, yet winging it in the short-term no longer is working.
  • Sayings like “This too shall pass” don’t account for an unprecedented “this” and are based on the unfounded belief that things will return to normal and we will get our old lives back. Social protocols have changed and so will our lives and relationships.
  • Turning to literature, whether inspirational, literary, or scientific, produces frustration. “Yes, but,” I say to all of them, “that doesn’t cover this.” Apparently the last person who really wrote about what’s going down is Samuel Pepys in 1666.

Optimizing within constraints.

If I’m going to make it through this, I’m going to have to cobble together a credo, a manifesto, and an operating manual, all in one.

I’m going to call forth wisdom from my father, my own counseling knowledge – particularly decastaphrophizing using the worst case scenario – my clients who have been incarcerated, and the founder of dialectical behavior therapy, Marsha Linehan. I’m calling forth the bravery of those who wrote for us: Anne Frank, Nina Kosterina, Elie Wiesel, Primo Levi, Viktor Frankl, and survivors of the Warsaw Ghetto.

I am going to optimize within constraints while doing time, based on my values and in line with my priorities, all the while knowing opposites may both be true.

Optimize within constraints.

When my father explained the concept of optimizing with constraints to me, he described himself in a hypothetical jail cell, raging at the bars that confined him. He then shifted his attention to the bars, noted the facts of their strength, and acknowledged his confinement. Then he looked around the cell and asked himself what he could do, based on his values, to maximize and optimize his progress towards achieving his objectives.

Acknowledge my worst case scenario.

To my father’s metaphor, I would add decreasing the size of the cell by six inches all around by one’s conception of the worst case scenario. As of this writing, the worst case scenario for me – my greatest fear – is that lockdown will occur indefinitely, that a life sentence in confinement will be my fate. Science predicts that is unlikely but I acknowledge and honor my greatest fear just the same.

Avoidance of what’s bothering me, while seemingly self-merciful, heightens distress in the long-term. Approaching what is real to me – including fears that may be unfounded – even though causing distress in the short-term, is actually an act of self-kindness that increase my endurance for the long run.

Acknowledge the extents and limits of what can be accomplished while doing time.

On behalf of clients who were about to go to jail or prison, I have asked clients who have been to jail or prison to offer their guidance.

This WikiHow guide elaborates, but this is the essence of their hard-won wisdom:

  • Do you, not others.
  • Get fit.
  • Learn something new on the way to where you want to go.

Finish unfinished business.

No matter how much I wish this were not true, I need to:

  • get my affairs in order,
  • have conversations with people important to me about the location of important documents, their wishes and mine,
  • write letters of appreciation to people important to me while there’s still time,
  • acknowledge the grief I have now, and plan to grieve the loss of people important to me, given the achingly high numbers of what’s ahead for us.

Remind myself of my values and rank order them.

This Personal Values Card Sort asks me to become aware of what values are “very important to me,” “important to me,” and “not important to me,” then to rank order the values in the “very important to me” category.

Remind myself of my priorities and rank order them.

I can write my priorities on slips of paper, then arrange them on a table in categories of “right now,” “soon,” and “later.” (“Unfinished business” may need a category as well.) I can rank order my priorities in each category. Then I can, with regret, remove the slips representing priorities that are impossible to achieve in lockdown. What remains can help me decide what to do next with the time ahead.

Bravely approach opposites that are both true.

I want parents and partners and leaders to do the job of loving me, comforting me, helping me, and immediately taking over what becomes so hard for me AND I am the only adult on this job.

In lieu of parents, partners, and leaders, I wish I could find a formula to serve in their places for doing all this AND life is dynamic and complex and so must be my strategies.

I am benefiting from what being home offers AND I am losing out on what being in the world offers.

I will make decisions now that will prove both helpful and harmful AND I am consciously making the best decisions I can with all my heart, all my mind, and all the knowledge I can bring to bear on this as often as I can.

I am intermittently made insane by my cohabitants AND I am intermittently kept sane by my cohabitants.

I have too many cats to care for during a lockdown in a pandemic AND I treasure every single moment spent with every single kitty.

I am uncertain how to help others – like the man with whom I have crossed paths in my hometown for years asking me for money to buy food in the grocery store parking lot (I am haunted by the look in his eyes) – AND I am aware that it is the wolf pack that survives, not the mythological lone wolf who dies sooner rather than later, riddled with parasites, doomed to survive on carrion because he can’t bring down fresh game on his own. I must keep aware of ways to respectfully, skillfully, and effectively assist my pack.

I am afraid of what will happen to me AND right here, right now, I am safe.

I am trapped in these four walls with issues I have avoided, I may panic, AND I am free to learn skills to finally approach what has been present with me for a long time.

I am uncertain what the future holds for me, my finances, people I care about, people I don’t even know, and our world AND I am aware that I am actually used to living with uncertainty. Certainty is always an illusion because humans – however much they wish or believe otherwise – cannot predict or control what happens next.

I treasure my ability to think, the greatest gift of being human – which includes the ability to think worried, painful thoughts about the future – AND I can shift my attention to thoughts that are helpful to me right here, right now. (As Agnes Callard writes, “There’s no reason to add an additional harm to whatever evils have already taken place.”)

I am tempted to blame myself and others for a pandemic AND biology happens, species are impacted by other species, and these are occurrences without meaning.

I have loved the beings who have been in my life, the places I have lived, the possessions I have owned AND I love best and most the presence and company of my own consciousness.

Deprivation is present now. Unknown magnitudes of illness, death, loss, and grief are ahead.  These have power over me AND I have power to intend to mitigate the effect of hardships. I can use awareness skills to help me through all feelings, all thoughts, all happenings. I may hurt at times and I may struggle at times but external conditions do not define my intentions nor control my inner state.

I love my own consciousness too much to let what’s happening happen to it, too.

I dedicate this post to Jay Wiley, a former student and current resident of New York, who invited me to sing a bit of this tune for his video. May this not be the last video footage of me but, if it is, it’s the best of me. I was laughing, singing, moving in time with someone else, all for a student. I have lived a perfect, precious life.

On a lighter note, here are the outtakes.

The views expressed are mine alone and do not necessarily reflect the positions of my colleagues, clients, family members, or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Self-Kindness Begins with a Self-Hug

Self-kindness is an open-armed embrace of who one is and what one has done and not done.

That’s a definition I find helpful. Note what is not part of the definition:

  1. Judgment of who one is.
  2. Judgment of what one should have done or not done.

The opposite of self-kindness is self-judgment.

Self-hug of self-kindness

It’s human to wish some things were not true. We may wish some things about ourselves were not true. We may wish we had done some things or not done others. We may wish profoundly that what’s happening were not true.

We naturally try to turn away from what we don’t want to be true. Unfortunately, when we cut ourselves off from any part of what is true, we cut ourselves off from the wholeness of what is real. But it’s the wholeness of reality that is our resource. Turning towards reality is like playing a gardening video game. Instead of having to earn and buy shovels one-by-one, you open the door to a shed full of shovels, rakes, and trowels, all within reach!

You might be thinking:

“Yes, but I don’t want what’s true to be true! I don’t want to need tools! It’s all so scary and sad and frustrating!”

Exactly. This is all true.

Self-kindness is grounded in the concept of “opposites can both be true.”

Here are two examples that might make sense right now:

“I wish things were different AND I will need to figure out how to handle things as they are.”

“I feel scared and sad and frustrated AND I will need to figure out how to feel these feelings and still handle what’s happening.”

To practice self-kindness, one modifies the wording of one’s thoughts.

Let’s do an example.

Please become aware of what feelings you have as you read this sentence. To keep things simple, try one of the “big four” feelings words: “mad,” “sad,” “glad,” “afraid.”

“I am really struggling with what’s happening. I should be a stronger person. I should be handling this better.”

Many people feel mad at themselves when they judge themselves as not being and doing what they believe to be “correct.” They try to scold themselves into doing better. Scolding hurts. People naturally back away from what hurts.

Please become aware of what feelings you have when you read this sentence:

“I embrace who I am and what I have done and not done AND I am really struggling with what’s going on right now.”

When they approach the reality of what they’re feeling and thinking about how things are, many people feel sad and scared. These feelings hurt in a different way. We’re tempted to back away.

Self-kindness often involves acknowledging the reality that one feels sad and scared. Many people try to avoid these feelings. But they are there. This is why the image in this post is a person giving herself a hug. When people feel sad and scared, they need comforting.

Self-kindness starts with a self-hug.

Self-kindness creates a bit of calm and stability, even in the hardest times. When eased a bit within, people can begin to take a look at their own inner resources and at the external resources available to them – the tools in their tool sheds. Then they can begin to think of ways to use what they have on hand to be helpful to themselves.

“Yes, but,” you may be thinking. “I have done terrible things. I said I would do some things and didn’t do them. I don’t deserve self-kindness.”

The first of these statements may be true. But opposites can both be true. Looky:

“I recognize I have done some things, didn’t do some other things, and have caused harm to others. I deeply regret these things AND I see that change can start with self-kindness. I might want to make some changes. Even though I might not understand exactly how this would work, self-kindness might be a place for me to start.”

Self-kindness takes practice.

Please take a moment to compose an “opposites are both true” statement of self-kindness like one of the examples I’ve given.

Self-Kindness Group members read these aloud to each other, filling our virtual Zoom room with warm kindness.

. . . . .

The Self-Kindness Group for Virginia residents meets on Thursdays from 5:30 – 6:45 PM EDT. Here’s more about this CBT-based, online counseling group. This post consists of the notes I used for the skills instruction portion of our inaugural meeting on Thursday, 3/26/20. In our 75-minute groups, skills instruction takes about 15 minutes, then group members take turns sharing, processing, and problem-solving.

Although I wish the group could be open to all, registration and Virginia residency are required to be a member of the Self-Kindness Group.

The next session on Thursday, April 2, 2020 at 5:30 PM EDT, will include a guest appearance by Wren West, L.P.C., a licensed professional counselor in Roanoke, Virginia. Sometimes “opposites can both be true” results in conflict between our feelings vs. our thoughts! We plan to hold an extemporaneous dialogue between feelings (Wren) and thoughts (Anne) to show how acknowledging the reality of both feelings and thoughts results in a remarkable synergy of inner wisdom to guide us.

If you’d like to look ahead, these are the handouts we’ll be using for context:

The concept of “opposites are both true” is a component of dialectical behavior therapy, a form of cognitive behavior therapy. If you would like to read an in-depth discussion of this concept, this article might be useful.

If you would like to join the Self-Kindness Group, other groups, or request other counseling services, please learn more about appointments and fees, then use our contact form to send me your email address. I will email you registration information through our client portal.

The views expressed are mine alone and do not necessarily reflect the positions of my colleagues, clients, family members, or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Self-Kindness: A CBT-Based Online Counseling Group for Virginia Residents

Addressing challenges together – whether with one’s partner, family members, co-workers, or, in unprecedented times, with a whole nation – begins with self-kindness.

The Self-Kindness Group for Virginia residents meets on Thursdays from 5:30 to 6:45 PM EDT.

  • Fees are pay-what-you-can up to the standard fee of $45 per group session.
  • I offer self-pay counseling services and do not accept health insurance.
  • Virginia residency and registration are required. Attendees must register as clients and sign consent forms to participate in online counseling.
  • Please contact me to register for the group or with any questions you may have.

Self-kindness provides an inner sense of safety and strength from which one can powerfully contribute to teamwork. The self-judgment and self-reprimand inherent in  “tough love” – widely believed to be motivating – actually can cause immobilizing despair.

Self-kindness begins with a self-hug.

Self-hug of self-kindness

The top-recommended counseling protocol for anxiety, depression, and many mental health challenges is cognitive behavior therapy (CBT). Using CBT, one becomes aware of one’s feelings and thoughts and challenges unhelpful beliefs with facts. The next step is self-support.

The Self-Kindness Group will focus on the self-support skills offered by CBT. Here’s the group’s mission: Learn and practice skills to address troubling feelings, thoughts, words, and actions that arise in troubling times. Here’s more information about this and other groups and here’s the meeting protocol we use.

I wish I could open this group to everyone. However, national licensing for counselors is not available in the United States. I am licensed to practice counseling in the Commonwealth of Virginia only.

Avoiding troubling realities is human and humane. When avoidance becomes the go-to, it becomes both a cause and symptom of many mental health challenges. We may all need extra support as staying in our homes may require us to approach what we’ve avoided for awhile.

We’ll also need a sense of humor.

If you would like to find an image on the Internet that you like, please compose an awareness-themed caption for it. (For ideas, check out the Awareness Skills and Awareness Skills Curriculum pages under the Resources menu on our site.)

Serious is good, but funny is better. Here are my examples. I invite you to best them!

Example #1: Image
Caption: “You’re a dog named Issues?! I’ve been avoiding you!”

Example #2: Image
Caption: “Volume control?! I don’t need no stinkin’ volume control!”

Please have your image’s URL and your caption ready to copy and paste into the chat at 5:30 PM!

To register for the Self-Kindness Group, other groups, or to request other counseling services, please learn more about appointments and fees, then use our contact form to send me your email address. I will email registration information through our client portal.

If you have questions, please feel free to contact me. Anyone, anywhere is welcome to use any of the materials that might be helpful to them under the Resources menu.

If you reside in Virginia and this is a fit for you, I welcome seeing you and sharing kindness with you online!

Image: iStock

This post originally announced the inaugural session of the Self-Kindness Group. Here is the introduction to self-kindness that we discussed in the first group. This post was last updated on 4/10/20.

The views expressed are mine alone and do not necessarily reflect the positions of my colleagues, clients, family members, or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

We Will Be Called to Approach What We’ve Avoided

For many people, a continuum exists of feeling free and feeling trapped, of feeling free to _____ and feeling free from _____.

Confined to their homes, people may experience shifts along the feeling free/feeling trapped continuum. They may feel relieved from burdens, free to finish what they start, and trapped by circumstance.

Gently approaching what we've avoided

When literally trapped by circumstance, people may find themselves up-close-and-personal with realities they have been able to avoid for awhile.

Note: “Avoidance” is a clinical term with judgmental overtones for the very human and humane desire to protect oneself from troubling feelings and thoughts. It’s not a moral shortcoming. It’s simply a practice that causes more problems than it solves in the long-term.

To help oneself with avoidance, one gently begins to approach uncomfortable realities with self-compassion and self-kindness.

People may feel backed into a corner in these areas:

  1. self: how they talk to themselves and treat themselves
  2. personal interaction style: the part they play in problematic patterns of interactions with others
  3. problematic interaction styles of others: what others do that cause problems in interactions and relationships
  4. mental illness symptoms: what thoughts, memories, and behaviors arise under stress
  5. avoidance methods: what they do to evade troubling feelings and thoughts when any of the above occurs

Self-concept example: People who repeatedly say to themselves, “I can’t handle this!” are going to feel terrorized by that belief because, in isolation, unless they have a 24-7 caregiver, they’re now the only person on the job.

Personal interaction style example: People who over-function in relationships and use the people they live with to reassure themselves are going to wear those people out. People who under-function and aren’t sustainably connected to the people in their worlds may find themselves losing energy and feeling disoriented from over-isolation.

Interaction style of others example: People who have tolerated disrespect, even cruelty, from their co-inhabitants, hoping things would work out or go away over time, may experience these frequently and painfully, perhaps in escalated form.

Mental illness symptom example: People who trusted they were successfully managing symptoms primarily through medications may find these symptoms “breaking through” the limits of assistance medication provides.

Avoidance method examples: Things people use and do to get away from all these challenges – alcohol, nicotine, marijuana, other drugs, overuse or underuse of food, overuse of the Internet, exercise, gambling, sex, the list goes on and on – may be in short supply, or no supply may exist, or they may be undoable because of lack of privacy.

You may be thinking: Whaaat?! I’ll have to look at all this all at once?!


People may feel panic when they believe they are trapped. However, they can help themselves with panic.

With an inner state in a more stable range, this process can be helpful:

“If I can become aware of the primary, natural feelings that arise, the thoughts I’m thinking, and the secondary feelings born of these thoughts, I can reassure myself and regain stability. I can sort facts from unhelpful beliefs, shift my attention to the facts, orient myself with my values and priorities, and help myself skillfully and effectively handle whatever is happening.”

Current crises are certainly on everyone’s minds and hearts. Whether in stable or unstable times, whatever is happening can call to us and we usually handle it as we’ve always handled it, sometimes unskillfully and ineffectually.

As never before, we are now called to be skillful and effectual.

Since addressing avoidance is a hard task, softness is needed. The task may be unwelcome and seem overwhelming. Separating the task into manageable parts may be helpful. Consider trying these questions:

What are the top two areas that may become problematic for me:

  1. in the ways I talk to myself and treat myself?
  2. in the ways I interact with others, particularly partners or my closest family member(s)?
  3. in the ways I have ended up being interacted with by others?
  4. in the ways I have managed mental illness symptoms (if I have them)?
  5. in the shortage or absence of what I often use or do to get away from what’s bothering me?

Even becoming aware of areas that may be challenging can offer strength to handle them. When problematic patterns arise, they are expected.

Simply recognizing when feelings are intense and thoughts are troubling can free people to pause and consider what to say or do next – or not say or not do – to be kind to themselves and others.

I theorize that gaining skill and power in the areas we have avoided will give us unprecedented skill and power to handle whatever happens in unprecedented times.

Wren West, L.P.C. contributed to this post.

Image: iStock

For people in the Blacksburg and Roanoke, Virginia areas who want to be able to follow up in-person after online counseling sessions, I recommend these providers of telehealth sessions: Stephanie Fearer, Ph.D., L.C.P. in Blacksburg (540-251-1567), and Wren West, L.P.C. in Roanoke (540-808-7948). I offer online counseling services to Blacksburg-area and Virginia residents as well, both individual and group sessions.

This guide to selecting an online counselor may be helpful.

The views expressed are mine alone and do not necessarily reflect the positions of my colleagues, clients, family members, or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.