What Is Self-Care? An Essay

I found this and its worth preserving, so I'm posting it here:

“Self-care is often a very unbeautiful thing.

It is making a spreadsheet of your debt and enforcing a morning routine and cooking yourself healthy meals and no longer just running from your problems and calling the distraction a solution.

It is often doing the ugliest thing that you have to do, like sweat through another workout or tell a toxic friend you don’t want to see them anymore or get a second job so you can have a savings account or figure out a way to accept yourself so that you’re not constantly exhausted from trying to be everything, all the time and then needing to take deliberate, mandated breaks from living to do basic things like drop some oil into a bath and read Marie Claire and turn your phone off for the day.

A world in which self-care has to be such a trendy topic is a world that is sick. Self-care should not be something we resort to because we are so absolutely exhausted that we need some reprieve from our own relentless internal pressure.

True self-care is not salt baths and chocolate cake, it is making the choice to build a life you don’t need to regularly escape from.

And that often takes doing the thing you least want to do.

It often means looking your failures and disappointments square in the eye and re-strategizing. It is not satiating your immediate desires. It is letting go. It is choosing new. It is disappointing some people. It is making sacrifices for others. It is living a way that other people won’t, so maybe you can live in a way that other people can’t.

It is letting yourself be normal. Regular. Unexceptional. It is sometimes having a dirty kitchen and deciding your ultimate goal in life isn’t going to be having abs and keeping up with your fake friends. It is deciding how much of your anxiety comes from not actualizing your latent potential, and how much comes from the way you were being trained to think before you even knew what was happening.

If you find yourself having to regularly indulge in consumer self-care, it’s because you are disconnected from actual self-care, which has very little to do with “treating yourself” and a whole lot do with parenting yourself and making choices for your long-term wellness.

It is no longer using your hectic and unreasonable life as justification for self-sabotage in the form of liquor and procrastination. It is learning how to stop trying to “fix yourself” and start trying to take care of yourself… and maybe finding that taking care lovingly attends to a lot of the problems you were trying to fix in the first place.

It means being the hero of your life, not the victim. It means rewiring what you have until your everyday life isn’t something you need therapy to recover from. It is no longer choosing a life that looks good over a life that feels good. It is giving the hell up on some goals so you can care about others. It is being honest even if that means you aren’t universally liked. It is meeting your own needs so you aren’t anxious and dependent on other people.

It is becoming the person you know you want and are meant to be. Someone who knows that salt baths and chocolate cake are ways to enjoy life – not escape from it.”
-Brianna Wiest

x

What Causes Domestic Violence

A brief overview of how domestic violence is a choice that abusers make.

Domestic Violence: Blaming the Victim

This is a brief clip on some of the key focuses of domestic violence treatment - recognizing the role played in abuse by focusing on the language used to describe it, which shapes how we think about it.

Questions and Flaws with Red-Flag Laws

(The following piece is written about the considerations and realities of the "gun violence debate" from the perspective of a mental health practitioner specializing in forensics, evaluations, criminal behaviors and abuse - what follows is not meant to be nor can it be considered comprehensive or exhaustive in scope, but is meant to simply illustrate some of the considerations that go into forensic evaluations, highlight that more questions need to be asked on addressing the issues of mental health, violence with guns, abuse in general, evaluations, legal processes, and how they affect all concerned)

There are a lot of very concerning flaws with the so-called "red-flag laws" beginning with the the unanswered question as to whether this is a legal issue or a mental health/behavioral health issue.

We need to beware of following in the footsteps of the witch-trial era where accusations are made, fear is the motivator, ignorance is the tool, and society pays the price on a number of fronts with due process and scientific processes / knowledge being ignored, while ignoring the core issues and creating others.  

A doctor, a lawyer, a judge, an attorney, a police officer, a detective, are not specifically trained and certified in clinically or forensically evaluating risk of violence as a part of their job description - they may be mandatory reporters or charged with addressing violence, but that is far different than evaluating and assessing risk of future violent behaviors.  Even being a clinician - psychologist, psychiatrist, counselor, social worker - does not automatically grant an acumen in dealing with criminal behaviors - which is it's own specialty.

We absolutely can handle this as a legal issue, a mental health/behavioral health issue, or a combination of both.  But if we were to consider this from a mental health / behavioral health issue:

For domestic violence there are tools/instruments such as the Ontario Domestic Assault Risk Assessment and the Spousal Abuse Risk Assessment which can include, but are not restricted to violence and abuse with guns.

What assessment tool would they propose we use to predict risk of violence with guns?  Is it valid, reliable - will it actually predict what we think it is going to predict, and is it broadly applicable to both males and females of all intelligence and cultures?  Or just use the existing tools with a focus on violence with guns?

What if we address one area of concern and ignore others?  For example, someone is reported that they are at risk of committing suicide with a gun - in which case we would be assessing for suicide risk rather than violence with a gun against others. In response, let's say their guns are taken.  Who is to say they will not be afraid of losing their freedom and decide to end their life with an overdose instead?  Or let's say the individual has been reported for being at risk for violent behavior, and they decide to retaliate and find a way to carry out a crime against the reporter / intended victim regardless before they can be stopped, using another method?

What steps will we take to address these hypothetical but very real scenarios or ones like them?

What process will there be for those reported?  Will they be allowed recourse? 

And what records would we obtain for the evaluation of risk?  

If they have no criminal record, what records would we want to use? 

Would we use juvenile records?  

Traffic records?  

Gun purchase records?  

Mental health records?  

Medical records?  

Employment records?  

Who decides what's relevant to ask and what is not? 

Would the evaluators have power to request and obtain those records?  

Or would they be required to be included and simply submitted upon the order for an evaluation?  

Would we require no records and use  interviews with no collateral evidence?  

What training would evaluators have in the overview of the records used?

Would we mandate that others participate as witnesses in the evaluation and they have to be interviewed as well?  

Do we interview children?  

Coworkers?  

Family?  

What risks does this pose for the one being evaluated?  

How about for the witnesses?  

Can they opt out?  

If they decline are they now a "co conspirator" with the "accused"?  

Would there be a "cross examination" of witnesses?

For many of the red-flag laws, someone is making a report to the authorities already - do they get to be interviewed?  

Do they have to be?  

Do they do so anonymously?  

Is everyone anonymous, or do the "witnesses" have rights to be anonymous, or do they count as "accusers" in a court of law, where what they say is now public record and testimony with the reported person having the right to confront them  - thereby putting some people at risk of retaliation, and in other instances due to external pressure refusing to participate accurately, thereby skewing the record?

Is the record private? 

Public?  

Who can access it?  

Is it sealed after it's used to determine risk?

How long is it considered valid for?  

Can those evaluated as being a high risk get a second evaluation?  

Who pays for it?  

Who does the evaluator work for?  

Are they like a public defender, or an independent contractor?

Do you get a "public defender" type evaluator if you can't afford a private evaluator?  

And in which case does the quality of your evaluation - the validity and reliability - go up or go down or is it guaranteed to stay the same?  What has to go into the report?  

Are we looking at sexual abuse history?

Substance use history?  

What happens if they don't wish to participate?

Is the fact that someone accused them or reported them an instant grounds for mandatory participation in an evaluation, and like a DUI if they refuse to participate, they are cited as being "guilty" and lose their rights?

What credentials and training do the evaluators have to have, or should they have?  

What degrees?  

Who determines the standards for evaluators?

Would it be on a state-by-state basis or a national standard?  

Would the credentials fall under an organization such as the American Counseling Association, American Psychological Association or other association?  

Who would determine whether or not the standards are in need of change if they are not working? 

What consequences exist for those who report someone but do so wrongfully?  

Are they considered to have made a good-faith report?  

Or are there criminal and civil liabilities if they are found to be not-at-risk?

What constitutes a valid threshold for making a report against someone?  

Is fear alone a justifiable basis?  

Do we have to quantify fear with a numerical or a descriptive basis?  

Does there have to be evidence, or just the belief that they are dangerous?  

How would we verify the claims?  

It would be easy to deny, and then would we turn to collateral information from other reports as mentioned above? 

Would there be a "no-risk" category?  

Or would there be a "low risk" category at the minimum?  

Does evaluating someone as "low risk" mean that there IS risk, and they receive the label simply because someone accused/reported them, and they can never receive a "no risk" label/assessment?

Will the government avoid a "no risk" category because of it's own liability if the assessment turns out wrong?  

What immunity / protections does the evaluator have?

Does the evaluator make recommendations for actions to be taken?  

Who makes the final decision about what response is to be taken and how are they supposed to use the evaluation?  

Who carries out the recommendations?  

Can the recommendations be completely disregarded?  

Would the recommendations be negotiable in  a court of law?

Who is ultimately responsible if the evaluation turns out to be faulty?  

Will the fact that someone received an evaluation / was reported ever be used in the future for other assessments should a crime occur?

If I actually believed that it was as simple as it is being presented in the media - see something, say something, the government does something, and we save something - I would be all in favor of it.

But, one of the mandates of the counseling profession is to "do no harm" and that includes to those being evaluated for risk, making sure evaluations are valid, reliable, protect their rights as well as everyone else related to the evaluations.

I'm not in favor of "doing nothing" nor am I in favor of "doing anything because we can't do nothing" - I prefer whatever is decided be done right, whatever it is. I think it needs to be handled the best way that's going to provide the least disruption that provides the most safety and privacy.   But I don't think we have figured out what that is yet.

Evaluations and government processes can be abused at the expense of the individual private citizen and we want to be aware and honest about this possibility with anything we do.  Mental and behavioral health evaluations have been rampantly abused in totalitarian states, and as mental health professionals, we have a responsibility to speak up about the processes being used and how we see them impacting the public as well as how well they do / don't protect the public.

This being said, I think the government and the public has a lot more homework to do on this subject before anything they produce is going to be able to be considered effective.  I think there are a lot more questions that need to be considered, asked and answered.

If there is anything I am in favor of it is beginning to inform the public about some of the realities we deal with in behavioral / mental health; so they can consider some of the points above as a matter of public policy, or be able to form additional relevant questions.

I also think we are ignoring the fact that in a volatile situation even if the guns are taken, that does not automatically remove the desire / ability to harm - in prison even a ball point pen is not allowed because it can be used as a lethal weapon...or anywhere else someone wants to use it as such.  Most abusers don't even need that. 

 This brings to light the issue of magazine restrictions, and firearms restrictions - banning certain capacity magazines and types of firearms.  Its worth pointing out wars were being fought and murders carried out with hundreds of millions killed over millennia without guns.  The firearms or their capacity aren't the issue - if they were, the most heavily armed country in the world would have been eliminated long before now for the massive amount of firearms in our country.  Remove a few major cities where the "gun violence" is heaviest and the firearms restrictions are also the heaviest in the country - and it becomes obvious the issue isn't the guns but a matter of local policy and conditions - most of which are claimed by their supporters to "solve" "gun violence."  And even then, again, prisons are some of the most controlled environments in the world, yet among the most dangerous because of the motives of those incarecerated there - with everyday objects being used as lethal weapons. But on the outside, we don't live in prisons, not should we make everyday life like a prison under the guise and false promise of "safety."

How we think about the problem is just as much an issue as the problem itself.  But we also need to look down the road to make sure our solutions to the problem aren't causing more problems, as well as making sure the solutions are going to do what we want them to do.  All of this requires us to be very honest with ourselves, look at the results, have more background information on the subject matter, and ask more questions.

 

What We Get Wrong About Domestic Violence: Abuse is a Pattern, Not an Incident

In preparation for a new shift to my career, I've decided to start putting down what I have learned so that others can learn from my time working with sex offenses and domestic violence - because what I'm about to share is not common knowledge, and it needs to be.  When these things become common knowledge, most of what we see will end when it comes to abuse.

The reality is, sexual abuse and domestic violence are both actual parts of our society.   They aren't some aberration that is "over there" or something that happens to "other people" that happens only sometimes and rarely.   We are literally around them every single day in one form or another.  Typically we don't even recognize when we are.  Because of this we have the opportunity to intervene much more than we think we do. 

I noticed that society and law enforcement both "get it wrong" about domestic violence - we focus on the violent act - or with sex offenses we focus on the sexual act - but we miss that the most damage actually occurs leading up to the offense.  We also tend to think as a society that "everything is fine" if justice has been served, or the abusive relationship has been left. 


Some of this is discussed in my first video here. 

I hope you will share this, feel free to comment and share, and I will be posting more of these in days and weeks to come.  

Why Domestic Violence Offenders Should Not Be Allowed to Participate in Domestic Battery Treatment Prior to Sentencing

One of the things domestic violence treatment providers need to screen for is people who have been charged but not yet sentenced for domestic violence. 

Abusers often have a history of manipulating others, both inter-personally as well as using systems such as employment, mediation services, courts, religious organizations or legal systems to do so.

When people are arrested for domestic violence, their defense attorney will often suggest they enroll in a domestic violence treatment class to make themselves look good before the judge and to show sincerity and earnestness in getting help for their problems as a means to have their sentence reduced.

If they do enroll in treatment at this point in order to manipulate the system they are actually not being treated - the therapist is tacitly endorsing the manipulation, taking money for it as well as sending messages to the victim that the abuser is once-again getting away with manipulating others - all sorts of ethical issues here on the parts of therapists and treatment providers.

The problem with power and control issues/abusive behaviors is that these are a part of a larger pattern and are ingrained behaviors.  There is a significant difference between developing accountability, insight, empathy and understanding of one's issues, and simply admitting them.

Admitting an offender "has a problem" may happen in the courtroom, or upon being confronted with evidence that they had committed a crime/were abusive or even upon being arrested.  Admittance however does not instantly give anyone the insight, skills or tools necessary to navigate life's difficulties or pursue healthy parenting or relationships. Admittance is unfortunately simply a step in the cycle of violence and abuse and often does not have a lasting impact. Abusers will say "I'm sorry" and "I messed up" and buy themselves time from the victim until they resume their abusive behaviors and the victim is hurt all over again. 

Conversely interpersonal skills, Insight and accountability, however are gained over a period of months and years, depending on the individual and the effectiveness of the treatment.

While awaiting sentencing, offenders will attend their treatment with the mentality that they only have to go through the motions for a short time to escape their consequences, so the commitment to change, developing insight and lasting behavior simply is not going to be present.  Often the judge may then assess the abuser as truly penitent, leave them to attend their treatment on their own, give them a reduced sentence and once again the abuser manages to con a system without being forced to make any lasting changes.  If the judge does require them to attend treatment, they may allow the treatment that was participated in (with a manipulative mentality) for the previous several-months/weeks to count as a part of their sentence.  At this point the treatment has lost a lot of it's edge and the therapist has lost credibility and effectiveness to help the offender make lasting changes and ultimately help protect victims.  The abuser returns eventually to their relationship or starts a new one without having made meaningful changes, and as we know the cycle of violence escalates over time, and the risk to the victim has increased. 

Admitting offenders into treatment in this manner is going to have a negative impact on the other members of the group as well.  They are now attending treatment that is supposedly about taking responsibility, gaining accountability and making personal change through insights gained; yet the therapist is taking money from people who they are now helping to escape consequences and to con the legal system, completely undermining the lessons of "treatment."

Under the current rules (as of the writing of this article) of the Idaho Council on Domestic Violence and Victim Assistance, once sentenced to treatment, abusers are not allowed to attend couples/conjoint counseling as a part of their treatment - it increases the risk to the victim because the victim will be sharing personal things that will be exploited by the abuser later, the therapist is seldom specifically trained in the treatment of power and control relationships and will often miss power and control tactics being used right in the middle of session and unwittingly endorse abusive behavior against the victim, and abusive behavior is not a shared problem as it is solely the responsibility of the abuser.

It is my opinion, that once charged with domestic violence or any abusive crime, treatment providers should not provide mandated-type treatment for that abusive behavior until after their sentence is given; or at the least, judges and juries should be prohibited from taking into consideration whether the abuser entered treatment before the sentencing in the formulation of the sentence, and any treatment received at that point should not count towards fulfilling their sentencing requirements.