Author Archives: Rachel Aylward

Healing Depression: How It Begins

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A young man met with his therapist for the first time and told him: ”I am depressed.”

To his surprise the therapist asked him if he considered his depression an enemy or a friend. “Of course it is an enemy. I hate it. I do everything to get away from it. Nothing works. That is why I am here, to get rid of it.”

The therapist understood his response, with much compassion. Then the therapist asked in a tone of curiosity: “What would it be like to treat your depression as a friend rather than as an enemy?”

The young man was now so confused. This question did not make any sense to him.

The two men talked for a while about the young man’s awareness that fed his depression. At session end the therapist said to the young man that he now understood how his depression was caused by years of quiet anger.

Leaving the session the young man shook his head saying to himself: ”Yea, it is so quiet I do not even see it.”

Getting into his car and turning on the radio he heard his favorite Simon and Garfunkel song, Sound of Silence, and he was singing along with them the words: “Hello Darkness, my old friend, I have come to talk with you again.” At that moment a heartfelt understanding took place about what the therapist was inviting him to do, that is, to talk with his depression as a friend. It wanted to speak and be heard. However, it had been repressed and buried for many years. A tear came down his cheek as he connected with that buried pain. He had begun to talk, to listen, to heal, forgive and move forward.

May you all find within yourselves the grace to slow down, be gentle, and listen kindly to your own experience. You deserve compassion, just as all living beings do. Being alive can be a tall order. Let us all take comfort in the truth that we are walking this path together.

Especially during these challenging times, it is important for us all to be gentle with ourselves and with eachother. If you or a loved one needs support please reach out to a therapist today. Our counselors are trained to provide teletherapy so that you can receive support from the safety and comfort of your own home.

The Magic of Listening

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Now more than ever, most of us are spending long stretches of our days at home with loved ones. This brings with it a new possibility for intimacy, and therefore a new possibility to cultivate listening skills.

In the classic movie, “Two for the Road,” Albert Finney and Audrey Hepburn are creeping up the stairs to their room.  Looking down into the hotel’s dining room, they see a man and a woman sitting in stony silence.

“What kind of people just sit like that without a word to say to each other?” Finney asks.

“Married people?” replies Hepburn, with wide eyes and a small, ironic smile.

Much of my work at Samaritan, and earlier in a retirement community in Arizona, has been with couples.  Many of them have been married for 20, 30 or more years.  Frequently they tell me that what brings them to therapy is their trouble with communication.

Over the years, couples can become experts at pushing each other’s hot buttons and short-circuiting their lines of communication.  In the early stages of a relationship, they would talk for hours, yet they find themselves becoming more distant and, in a way, losing their good manners with each other.

While what they’re facing isn’t new, it has somehow found a way to break through the surface of their everyday life, and one or both of them feel compelled to deal with it.  Coming to therapy is an admission that they need to make some serious changes if they are going to stay married.  It’s time to develop more generous ways of talking and listening to each other.

Listening? What an idea! Most of us grew up thinking that communication is all about talking, making our point, getting our way. When couples are able to shift their attention to listening to each other, they can increase their ability to truly understand each other.  They can stop having the same old arguments over and over.  They can bring respect and warmth into their relationship.

Maintaining healthy communication isn’t rocket science, but it does require effort.  Here are some tips:

  • Be aware of the message your face, your tone of voice and your body are sending.
  • Don’t mind read.  Don’t assume.  Try not to finish each other’s sentences.
  • Be curious about each other. Bring new ideas to the conversational table.
  • Accept that you can have different opinions and still be friends.
  • Avoid the “trigger” words that you know are likely to set each other off.
  • Be direct.  Ask (nicely) for what you want. Don’t expect the other person to know.
  • When you argue, be fair. Stay on the subject. Don’t be insulting or sarcastic.
  • Most important, be willing to see try on a new perspective. How can you see your relationship with new eyes?

Many of our counselors work with couples and families as well as individuals. Reach out to a therapist today to discuss how we might support you and your partner.

“Lockdown,” a Poem by Franciscan Richard Hendrick

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Here is a poem from an Irish Franciscan, Richard Hendrick, written March 13, 2020. Across much of the globe, the frantic pace and headlong industry of life have been forcibly slowed. Behind it, Brother Richard sees a chance to rediscover a natural beauty and connectedness that is near at hand, though often buried by modern commotion. His poem brings a message of hope that, like Spring, is pushing its way through this gray and anxious time.

 

Lockdown
by Richard Hendrick

Yes there is fear.
Yes there is isolation.
Yes there is panic buying.
Yes there is sickness.
Yes there is even death.
But,
They say that in Wuhan after so many years of noise
You can hear the birds again.
They say that after just a few weeks of quiet
The sky is no longer thick with fumes
But blue and grey and clear.
They say that in the streets of Assisi
People are singing to each other
across the empty squares,
keeping their windows open
so that those who are alone
may hear the sounds of family around them.
They say that a hotel in the West of Ireland
Is offering free meals and delivery to the housebound.
Today a young woman I know
is busy spreading fliers with her number
through the neighborhood
So that the elders may have someone to call on.
Today Churches, Synagogues, Mosques and Temples
are preparing to welcome
and shelter the homeless, the sick, the weary
All over the world people are slowing down and reflecting
All over the world people are looking at their neighbors in a new way
All over the world people are waking up to a new reality
To how big we really are.
To how little control we really have.
To what really matters.
To Love.
So we pray and we remember that
Yes there is fear.
But there does not have to be hate.
Yes there is isolation.
But there does not have to be loneliness.
Yes there is panic buying.
But there does not have to be meanness.
Yes there is sickness.
But there does not have to be disease of the soul
Yes there is even death.
But there can always be a rebirth of love.
Wake to the choices you make as to how to live now.
Today, breathe.
Listen, behind the factory noises of your panic
The birds are singing again
The sky is clearing,
Spring is coming,
And we are always encompassed by Love.
Open the windows of your soul
And though you may not be able
to touch across the empty square,
Sing.

Ongoing Care Available with Teletherapy

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Now more than ever, there is a need for ongoing support in our communities. With physical distancing in practice to help us all minimize the risk of spreading COVID-19, we still need to connect with each other. Our therapists are equipped to offer virtual counseling, or teletherapy, moving forward.

Teletherapy is a valuable solution, enabling us to continue serving clients both new and already established. Below are commonly asked questions clients might consider before starting or switching to teletherapy:

 

How is a teletherapy session different than an in-person session? 

Teletherapy sessions and in-person sessions have more similarities than differences. They are both private, secure, one-on-one conversations in the context of a therapy relationship. Most of the boundaries remain consistent between both: the scheduling of times, the length, and the content of the sessions. The major and obvious difference is that you and your therapist are using video technology to communicate instead of being in the same room. With that difference, it can for some seem very similar to in-person therapy; for others it can require more adjustment.

 

Will my insurance cover teletherapy?

In most cases, yes. Fortunately, Medicare covers teletherapy sessions and insurers (including employee health plans) must reimburse a provider for services delivered through telemedicine or store-and-forward when the service is “medically necessary” (a standard that also applies to in-person therapy services). Note that only video conferencing (and not phone calls) will be covered by insurance. To ensure coverage, please enquire directly with your insurance provider about your plan’s teletherapy (tele-mental health) benefits.

 

What will I need in order to get started with teletherapy?

You will need a computer or device with a camera and a microphone. In addition, internet access is required and we ask that, if you are using wifi, you use a secure signal. Once you have consulted with your therapist about the prospect of using teletherapy, you will be given forms to read, fill out, and sign. Then, you will meet with your therapist for an intake evaluation.

 

What measures are my therapist putting in place to protect my privacy? 

At Samaritan Center, we only use teletherapy that is secure and HIPAA compliant. All privacy laws are strictly enforced while using teletherapy, as they are when meeting face-to-face. No sessions are recorded, and we will verify with you at each session that no one else is in the room on either end. Your therapist will ensure that their workspace is free of intrusion, distraction, or interruption, and file charts will be maintained in a safe, secure manner.

 

How long are teletherapy sessions? 

Like in-person therapy, teletherapy sessions can vary in length, depending on your needs and your insurance coverage if applicable. Typically, sessions are either 45 minutes or an hour.

 

How much does teletherapy cost if I am paying out of pocket? 

When using private pay for teletherapy, the same standard fees as in-person therapy apply. Your therapist will discuss fees with you prior to starting.

 

Is a sliding scale fee available for teletherapy? 

Yes! When using private pay, you may talk with your therapist about our Adjusted Fee Schedule, which can be a useful tool in adjusting standard fees based on family income and other considerations. We want to work with you to arrive at a fee that works for you.

 

Can we do couples or family counseling over teletherapy? 

Yes. Our current setup requires all persons on your end of the video to be in the same space, using the same camera. Practical issues, such as how to capture all parties on screen, can arise when working remotely in this way, though we do not consider these to be limiting in themselves. Your therapist can help determine if your particular couple or family “setup” is right for teletherapy.

 

If I am new to therapy, can I begin with teletherapy? Or do I need to have met my therapist in person first? 

The best practice at Samaritan Center is that teletherapy relationships begin with an in-person assessment. We believe that this assessment, which can last 1-3 sessions as needed, is important for the establishment of rapport, trust, and safety. Your therapist can discuss this expectation with you prior to beginning treatment.

The initial phase of therapy is critical for you and your therapist to be evaluating your “fit” with each other, and to establish “medical necessity,” while also determining if teletherapy can be helpful in your specific situation. Additionally, it is our practice that therapists meet face-to-face with their clients periodically in order to maintain and attend to important aspects of the personal relationship.

 

How do I find a therapist? 

To find a Samaritan Center therapist who is currently offering services using teletherapy, please contact our front desk at (206) 527-2266 or visit our Find a Therapist search page. We look forward to meeting you!

 

Samaritan Center COVID-19 Response

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Please note: This policy may be updated as new information becomes available from the Center for Disease Control (CDC) and Seattle & King County’s Public Health Department.

Here at Samaritan, we are dedicated to providing ongoing support to our clients. In this spirit, we are choosing to remain open at this time and to continue serving our clients—balancing this commitment with the prevailing risks by taking aggressive steps to protect clients and staff.

As we take protective measures internally, we ask that any clients please stay home if they are showing symptoms or suspecting possible exposure to persons with COVID-19.

Should you need to cancel an appointment, you can reach out to your therapist directly to reschedule (find your therapist’s contact information here). Note that teletherapy (over video chat) or a phone session might be options to discuss with your therapist.

We care deeply about continuing to offer a safe and healthy environment to all who walk through our doors. We will continue to monitor the situation as it evolves and post updates here.

If you believe you were exposed to a confirmed case of COVID-19, contact the Seattle-King County Public Health novel coronavirus call center: 206-477-3977. For general questions and concerns about COVID-19, you may call the Washington State Novel Coronavirus Call Center: 800-525-0127. For tips on how to reduce the risk of spread, read King County’s official recommendations.

 

If you are in need of additional emotional support at this time, below are resources you can safely access from home: 

Crisis Connections (24 hours): 866-427-4747

Online 12-Step Recovery meetings: InTheRooms.org

National Domestic Violence Hotline: 1−800−799−7233

National Suicide Prevention Lifeline – For youth and adults: (800) 273-TALK (8255)

National Eating Disorders Association Helpline: (800) 931-2237

The King County Warm Line: 206-933-7001

What is Family Constellations Therapy?

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Family Constellation work in the tradition of Bert Hellinger posits the larger system, or energy field, of each person. This encompasses all the members related to and influencing the well-being of that person. The larger, whole system can be accessed in this model through a process of representation. Within a workshop setting, the client (the person presenting a problem to the facilitator) chooses representatives for significant members (mom, dad, siblings, for example) and places the reps in a contained space. Often this workspace is an open area. The reps then focus on their experience in that grouping (or constellation) and speak of the experience felt at that moment. Much information emerges from the constellation experience that relates to the client’s situation, even though the reps know little of the persons being represented.

The facilitator listens carefully and suggests options for healing the distress/discomfort felt by each. The goal is to provide a flow of Love or enlivening energy which, until this moment, has been blocked by subconscious entanglements from the past. Options for change might include moving, speaking, repositioning, testing for missing or shunned members. Often spontaneous rituals of inclusion, connection, and clarification will be created and tested for their impact on the individual or the system.  The client mostly observes until the constellation work is ready for his/her direct involvement in the dynamic of the working group.

Basic tenants of the constellation theory are called Orders of Love. These include but are not limited to:

  1.  the need to belong (bonding, similar to the focus of attachment theory by John Bowlby)
  2. the need to maintain a balance of giving and taking (in other words–equilibrium, as well as the importance of hidden bonds and loyalties described by Ivan Boszormenyi-Nagy)
  3. the need for the safety of social convention and predictability (order)

These three needs emerge differently in each person’s life and can be known through experience of guilt and/or innocence enticing and driving choices in service of, or opposition to, these needs.

In my work with clients I screen for disruptions in each of these three Orders:

For instance, each person needs a strong sense of belonging and sense of place in the system in order to thrive. Without these, anxiety takes over.

Each person needs clear permission to make personal choices in support of well-being. Often parents have been unable to generously give love and attention but have rather required the child to care for the parent’s sense of worthiness. This might emerge as guilt and confusion while making personal choices.

Too often unpredictability or disruption in the family system will reveal itself as depression in the individual. Or “too much or too little giving” indicates imbalance in the sense of order experienced by the client within the family system.

Clients can change by modifying the life circumstances experienced in any one of these orders.

A client might reconnect with those who have been separated from contact or enhance a connection that is too “thin.” In session, we might create rituals of healing that can improve the energy felt by system members either in imagination, role play, or using figurines to reimagine relationships. Sometimes just talking about experiences of belonging, giving-taking, or sense of order can initiate changes in a client’s experience.

This modality has been very useful in launching young adults from family of origin, healing wounds from early childhood, honoring lost relationships (first loves, adopted children, early deaths, injustices), managing illness, and ancestral entanglements. The introduction to Bert Hellinger’s book, Love’s Hidden Symmetry by Gunthard Weber states, “Bert Hellinger’s spirituality is close to the earth, embodied, passionate, life-affirming. It embraces the everyday lives of average people struggling with their suffering and with their greatness. It draws us into life rather than seeking to lift us above it. It celebrates the simple and ordinary, speaking to everyone who is wrestling with whatever limits the soul’s longing to reach its potential in the world. This book is about remembering how to listen to your soul and the to the Soul of the Greater Whole.”

The Nature of Unconditional Love

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We are shifting from winter’s two coldest months into February. With Valentine’s Day approaching, we are reminded to warm our hearts with love. These months likely bring more time indoors and more quiet nights, perhaps, bundled up with a blanket in the living room. These quieter times offer an opportunity for reflection on the love that exists in our lives. It is around each of us in abundance. I invite you to take an inventory of all the love present around you.

You may begin with the simple fact that you are unique, and that alone is miraculous. No thumbprint is like yours. You have been formed in a unique way from your mother’s womb. Your birth order forms you. Your urban or rural upbringing influences your worldview. All of these weave together to create your own story. A story that has purpose, meaning. You are here for a reason. Though that reason may not always be clear, your presence makes a difference in the world. Many of my clients in depressive states and those in severe health situations question what the purpose and meaning of suffering is, as well as how to live their life with purpose.

Another client cries in the darkness alone in her retirement home searching for connection with her family who have rejected her. What is the purpose and meaning?

Partners of those addicted to alcohol or drugs which wreak havoc on their finances, mental health, and behaviors begin to wonder what the purpose and meaning is in their relationship; and, without that relationship, where do they look for love?

When all else fails, remember that love is your innate state. It is available to you in all moments. Many religions and philosophies agree that the purpose of this life is to love. Jesus summarizes it all: “Love one another.” St. Augustine says, “love, and do what you want.” Buddhism encourages meditation and deep breathing to be at peace and calm which can guide each step of our journey. There is an unconditional love from a Higher Power available to each one of us. Our “job” is to receive this love and let it work on our human condition so that we can unconditionally love others. Oh, how impossibly possible this is. In a Higher Power, all things are possible. Let us all come home to our own heart and love our own self so that we can give that love to others. Let us make this a better world both inside of ourselves and in our community.

And what if love does not feel available? What if there appears to be more darkness than light? We all have those moments. I suggest a meditative technique of focusing on your breath. Each breath keeps us alive in this moment of NOW. We receive it, we hold it and we express it. A rhythm that becomes so automatic we can almost take for granted. This breathing allows us to move from the past, and holds us into the NOW until we are ready to move into the future. Then we begin the rhythm all over again. We are given this “present” to remind us to be “present.” This invisible reality is our gift, grace, spirit and life.

Go ahead. Take a very slow breath now: receive, hold, and express. Notice how your body changes into the calm energy of life. May our breathing keep us moving through dark and light moments; pain and free movement; hard and soft moments in life.