Saturday, December 1, 2007

Question About Manic Depression and Medication

This week, I received this letter in the mailbox. I've underlined the key questions and terms.

I was talking to a friend recently and although I'm generally a completely manic person, (my doctor called me hypomanic) I've been going through a huge personal transition that has its stresses and I've been feeling down occasionally.

My friend then used the term "manic depressive" and said that was what I was experiencing, and though I never recognized it myself, I know she was absolutely right.

My question is, if I'm generally just hypomanic, what's the harm in me just going through life being unmedicated and an overachiever?

If I really focus, I CAN do normal things like sleep and maintain routine, I'm just channeling my inner terrier, is all. Honestly, anti-depressants saved my life a couple years ago, and I'll always keep the possibility of Lexapro in reserve as a life-preserver, but generally, is it possible it's okay for me to be hypomanic and not drive others crazy and still have a fulfilling life? I mean, could I fall in love and have a happy life and not just annoy the crap out of other people without relying on pharmaceuticals, or is this an unrealistic hope?

Well, first of all, let's make sure we're all on the same page with our terminology. Manic Depression, while a vastly more descriptive term for what's actually going on with the emotions, fell out of favor with Mental Health practitioners at the beginning of the Politically Correct movement in the late '70's and early '80's. It was replaced with the term Bi-Polar Disorder.

Personally, I prefer the term Manic Depression. I think it describes the disorder in a more understandable fashion for client, family, friends, and any interested party. Besides, I've been involved in the Mental Health field long enough to see the pendulum swing to both extremes in a lot of areas. And, besides, that what this writer calls it. A provider of advice, counsel, therapy should always be guided by the "client," so that's what I'll call it.

Now, first off, you mention stresses caused by a personal transition. Stress can often bring on what is called "cycling" in someone with Manic-Depression. Cycling is the transition between the mania and the depression. Most people with this disorder, when looking back, [and isn't hindsight a wonderful diagnostic tool?] realize their symptoms began to manifest during their teens and early '20's.

Before that time they may only have experienced depression. Therefore when the manic side of the disorder began, especially, if it was "hypomanic" as in this person's case, they may have, experienced the mania as a period of what they perceived as normalcy. And who wouldn't want to feel mania after depression. Hypomania brings energy, creativity, a feeling of being on top of the world. After the sadness, lethargy and mental sludge and memory lapses of depression, who wouldn't welcome the ability to think one great idea after another?

The problems begin to arise when those wonderfully creative thoughts begin racing through your mind and you cannot control them. The problems begin when you begin to make really BAD choices about spending too much money, drinking too much booze, taking too many drugs, having sex with too many people or in inappropriate places. These are what can happen with unmedicated Manic Depression.

What is MOST important about making the decision about whether or not to start medication is to do a realistic inventory of your life. Are your decisions being influenced by your mania? Are you making good decisions, and by that I mean are the decisions you are making impacting your life in a negative or positive way? Are you financially stable, or has your mania caused you to overspend to the point that you are in a financial bind? How about your use of alcohol or other drugs? Are you endangering your health with the use of too much booze, or too much food or too much of any substance? Do you drive when you are impaired, thus endangering yourself and others? Are you having sex with people you don't know or don't know well? Are you having sex when you're drunk or otherwise impaired? Male or Female, HIV, HepC, HepB, STDs, love is fleeting Herpes is forever.

If you answered "Yes" to one or more of these questions, you need to be on some type of medication. Being medicated doesn't mean you will give up the energy, the creativity, the ability to think. You won't lose your "inner terrier" if you start a course of mood stabilizing drugs in combination with anti-depressants.

It may take some tweaking to find the right combination of the right drugs for you. But with all the research being done by pharmaceutical companies, new drugs hit the market almost monthly. The problem with being afraid of taking medicine, is that you may not recognize a problem until you're hip deep in it. Denial is an awesome coping mechanism, but it's not always the most productive one.

So, yes, you can go on being unmedicated, IF you are self-aware enough to do an inventory on a regular basis. But, would you walk on a sprained ankle, if support in the form of a brace was available? Would you walk around with hypertension when there was medicine to control it if dietary changes alone weren't bringing it down into a safe range?

I see a lot of clients who think that once they stabilize, they don't need their medicine anymore. Not just Manic Depressives, but all across the Neurotic board, and most of the psychotics, too. They view their mental health issues as something they can control through an effort of will. What I see is someone who doesn't have an understanding that their disorder is FIRST an imbalance of neurotransmitters in their brain, and then a disorder of psychology caused by their individual circumstances. Until the brain chemistry is under control, through the use of modern chemistry, any counseling, behavior modification, therapy, or spiritual intervention is ultimately less than effective because it only treats symptoms and not the underlying biological disease. Some, the lucky or smart ones eventually "get" it, find the right combination of meds and stay on meds, making changes as necessary. And changes will be necessary. The brain is a living organ, it adapts and changes over time. Changes in medication are inevitable.

Manic Depression, left untreated, will usually get worse. Sometimes it takes years. But in most cases, it does get worse. Especially as the client ages, as stressors multiply, as women give birth, approach menopause, as men reach their mid-life crises and own hormonal changes. Doesn't it make sense to be prepared with your own arsenal of medication already in place?

Please feel free to contact me again if you have more questions.

Saturday, October 27, 2007

Grieving for a Parent

This week marked the 3rd anniversary of my Daddy's death. Because he had "beaten" cancer in 1991, and reached that all important 5 year, Cancer-free milestone, he, and we thought he was home free. When, in 2004, he began to have some back pains, he wrote it off to "old age." At 77, he had to expect some aches and pains, right? By the time he went to see the Dr. in July of 2004 because of bloody stools, the cancer had metastasized from his remaining kidney to his spine, stomach, liver,and lungs.

It was August before all the tumor typing and classing was done. That was when one resident finally gave us a prognosis, none of the Attendings would be that brutal. But this one Resident talked to one of my Stepbrothers and me. He wouldn't say anything in front of Daddy or my Stepmother, they had so much hope and faith, he just couldn't, I guess, or maybe the Attendings had told him not to say anything. But, we cornered him and just bluntly said, "Look, we're not like Mom and Daddy. WE know it's bad. Just give us a round number so we can start to prepare ourselves and the rest of the sibs, and our kids and nieces and nephews. They deserve that much. We'd like for them to be able to see him while he's still in good spirits, not when he's too weak or in too much pain to respond. " God Bless him, He took us at our word. "Well they want me to tell you a year. But I think that's way too optimistic, I don't see him lasting much past Thanksgiving, Christmas at the outside."
That knocked me for a loop. This was August. But I took a deep breath and gutted it up and thanks the Doc and shook his hand.

I went downstairs, cried for a few minutes and then I started calling. I called my kids, I called Daddy's closest out of town Cousins. I told them they didn't have to come that weekend, but they needed to come soon.

I also called members of his High School football team. The remaining members still got together for lunch once a month. I told them, honestly how serious it was. He was as close to these men and their wives as as he was to brothers. He loved them. And they came. The ones who lived close to the hospital came often and came to see him at home, too.

I am proud of that. I think it was a kindness and that it helped Daddy. I know it helped me and eased my mind to see him surrounded by all that love and affection.

As I was watching Daddy die, I was watching myself go through the classic stages of grief at the same time. Anger, Denial, Bargaining, Depression, Acceptance, yeppers, went through all of them. Though not necessarily in that order and I went through some of them more than once. It was surrealistic at times because I'd get this detached, clinical feeling of watching myself from a distance, "yes, now I'm Angry." "OK, now I'm in the Bargaining Stage." "Look, Holly you're in Denial again, and you KNOW that's not productive!"

One of the most useful tools I learned when I was in training to be a Grief Counselor was to give the client permission to be ANGRY at the person who is dying/has died. I hear what you're thinking, "WHAT?!?! How can you be mad at someone for dying?" Simple, when you think of dying as abandonment. And, if you're honest with yourself, emotionally, death feels like being abandoned now doesn't it. When a friend lost her Mother and was going through a really bad bout of depression a couple of weeks after the loss, I went to visit her. I said, "You know, it's okay to be mad at her. After all, she DID abandon you." If you want to yell at her and get it off your chest, I won't tell anybody." For a couple of seconds she just looked at me with this shocked expression on her face. Then she was crying and grinning at the same time, "I am pissed off at her. She DID go off and LEAVE me here. How dare she do that to me? I've still got a family to take care of and problems to go through, and, and and..."

See what I mean? When you're given permission to feel an emotion that is somewhat shameful, it is liberating. It allows you to own that emotion and work through it instead of keeping it bottled up and having it fester inside. Emotions WILL find a way to express themselves if you don't do it verbally,trust me. Ever had a tension headache? Known someone with an ulcer? If they'd express those nasty old emotions...

Losing a parent is one of the most stressful events that an adult experiences. We expect to loose them at some point, but we dread it, too. Unless there was a history of horrible abuse, and sometimes even then, we hope for a final showdown or resolution before our parents leave us. But for the lucky among us, our parents death symbolizes the loss of a layer of "insulation" between us and the world. NO matter that we are functional, independent adults and our parents may have been the infirm of body and mind; we may have been the caretakers with them in the dependent role. We still have the illusion of our parent as Protector, as guardian from all things dark and menacing.

Losing that illusion is a blow. One that it takes time to heal. I have been granted that time by a loving and understanding family.

I hope that those of you who have lost or face losing a parent have been or will be comforted or in some helped by reading this entry. AS always, if you have questions or comments, you may leave them anonymously in the comments section or send me an email at the addy listed to your right.

Saturday, October 20, 2007

An interesting blog someone else wrote

I got this from a Blog named: Rickety Contrivances of Doing Good. You can find it here. I have highlighted in orange the phrases and words I found most significant. I hope y'all find this useful, too. The author's name is at the bottom of the blog.
Sunday, October 14, 2007

Narrating Trauma
I've posted here before about the work I'm doing with the University of Nevada School of Medicine, helping them integrate more narrative medicine into the curriculum. Since I have a PhD in English and volunteer in an emergency department, the UNSOM folks like having me there, and I certainly like being there; it's a place where I can integrate several areas of my life that otherwise seem far-flung.In the ED itself, I think of myself as practicing a kind of narrative medicine, encouraging patients to tell stories and listening carefully to what they say. But I'm well aware that most of the medical staff has very little time to do anything similar (which is why chaplains are so important!). In the ED, narrative medicine seems like a luxury better suited to slower-paced specialties where caregivers develop relationships with their patients over time. And that's a real shame, because for patients able to speak at all, turning their fear and worry into narrative can have powerful healing effects.

A few weeks ago, I gave a very basic lecture on trauma theory to my freshman composition class. Trauma -- used here more broadly than medical caregivers define it -- is any event that overwhelms the individual's ability to cope. Trauma takes many forms, but all of them share certain characteristics:
1. Trauma is unpredictable and uncontrollable.
2. It threatens the individual with death, not-being.
3. It threatens and undermines meaning, toppling previous belief systems.
4. Because it is so overwhelming, the individual carries it inside even when it appears, to outside observers, to have ended. It is always now and always here.
5. Because it is so overwhelming, it is extremely difficult to talk about: partly because it defies language, partly because the individual fears invoking it again, and partly because often, no one wants to listen, or is able to understand.

And yet talking about the trauma, shaping it into narrative -- a story -- is essential, because narrative is the opposite of trauma:
1. Storytellers control what happens in the story, so telling a story about the trauma gives the victim control over it, the very control that was lacking in the event itself.
2. Telling a story is a way of asserting survival and existence: "This happened to me, but I'm still here to talk about it."
3. Telling stories is how we make meaning of what has happened to us, shaping chaos into coherence.
4. Telling a story about trauma externalizes the trauma, moving it from the victim's brain and body into public space. Story-telling helps survivors birth their own experience.
5. Shaping the trauma into language, taming it into a tale, helps survivors "rejoin the land of the living" by casting what has happened to them into shared language.

Stories build a bridge of words and images between the trauma and the rest of life. This is why I believe that narrative is as vitally important in the emergency department as it is anywhere else in medicine. Of course, many ED patients are unable to speak, and of those who can, some may be so overwhelmed that it will be days or weeks before they can begin processing what has happened to them.

But we've all met ED patients or visitors who compulsively narrate what has brought them there, who repeat the same tale to everyone who enters the room: even if the doctor's already heard it, even if most of the details have no possible bearing on anything medical. "I was eating a tuna-fish sandwich, and he just keeled over into his tomato soup, and then I was trying to pull his face out of the bowl and call 911 at the same time, and oh, gosh, these slacks are covered with tomato soup, aren't they?" "I was in Home Depot buying nails when I felt this crushing pain in my chest, and one of those guys pushing a huge lumber cart asked me if I was okay, and I couldn't answer! It was so scary not to be able to talk. It reminded me of that time in third grade when the other kids pushed me into the water and held me down, and the guy with the lumber was kneeling down next to me, and I didn't know how I'd wound up on the floor, and I'd dropped my nails and I wanted to pick them up, but he kept telling me just to stay there, the ambulance was coming."

Compulsive repetition of such stories isn't just a sign of shock. It's an essential coping strategy: the speaker is desperately trying to regain control by turning the event into a known, predictable narrative. If your ED has a chaplain, social worker, or someone else whose primary job is to listen, by all means try to have that person visit the room.

If you're a medical caregiver and you have two extra seconds, by all means listen, and try -- without interrupting -- to give some active sign that you've heard. Body language and facial expressions count for a lot here. But what if there's no chaplain or social worker in sight? What if the department's so busy that you don't have two extra seconds to spend listening to anyone? One easy answer is, "There will be someone to listen later, in or out of the hospital," and of course that's true. But I suspect that the earlier this process begins, the better. And so, if patients or bedside visitors are able to write, why not encourage them to start putting their stories down on paper? I've linked here before to this article about the healing effects of writing. I've often told my ED patients about this, and they're almost often intrigued. Several times, I've given a patient pen, paper, and encouragement to write the story down. It seemed to help.

If nothing else, writing is something to do, something to focus on during an overwhelming time in a chaotic environment. And paper always listens, even when people can't. The paper will contain the story until other people can make the time to listen too.

Posted by Susan Palwick at 7:06 PM

Labels: chaplaincy, hospital, medical school, narrative medicine, teaching

Sunday, September 9, 2007

Out of Town

I'm takin' a short hop down to Houston for a few days. My Bro down there hasn't been dragged into the 21st century, yet, so I won't be posting until I'm back home. I'll try to have something helpful to say when I return.

Friday, September 7, 2007

Question from the Mailbox

A Reader wrote in with a question about Worker's Compensation. Reader didn't say what state the person having a problem lives in, so my answers will be for Texas, but the basic steps for finding your own answers will be the same. And Worker's Comp rules are fairly standard from State to State.

So, let's get y'all started:
Use your Search engine of choice and enter {your State} Workers Compensation.
I got several choices, and choose the official State agency. From their home page, I clicked on the Division of Workers Compensation Home. I found a treasure trove of information and links on that page.
When you are injured at work you can choose your Doctor from the Workers Compensation Health Care Network, if your employer is a member. If your employer is NOT a member of that Network you can choose ANY Doctor from the Approved Doctor List kept by the Division of Workers Compensation. So remember, it is YOUR choice which provider you see, NOT your employer's choice. If you are unhappy with the provider, go see another one. Just remember, when you go see a new Doc, take all your employer's contact info, including their Human Resources information, or whoever the person who handles W.C. claims is. Or the name of their W.C. insurance carrier and that contact information. If you already have your claim number, that would speed things along, too.

If you are unhappy with the way your employer is treating you after you are injured; if you feel that you are being discriminated against, or if you have been demoted or fired because you filed a W.C. can contact the Office of Injured Employee Counsel at 1-866-393-6432, if you live in Texas for FREE legal advice.

The page also lists an Ombudsman for further assistance. But you can find that on your own by following the link and clicking on the Division like I did.

Of course, State provided counsel is always going to be overworked. So if changing Doctors doesn't solve your problem, as I understood it from your letter, you might have to hire your own Attorney. Since the person with the injury was terminated after filing a W.C. claim, despite being told it was for other reasons, when other, lighter duties could have been assigned while the injury healed, I would suspect that a good case could be made for a discriminatory termination. Back pay and reinstatement would be the minimum to be recovered. The employer also could be fined. Given their reprehensible behavior, I say they need to be fined and given a good swift kick in the rear! Waiting on the Injured Party, hand and foot, taking care of their house, doing the laundry and cooking for them doesn't sound bad either, but that ain't gonna happen.

I hope this info was helpful to you and others.

Now...I gotta go write three 500 word articles I'm gonna try to sell. Mama needs a laptop!

Thursday, September 6, 2007

Questions about the NEW days...

In the absence of anyone writing in with questions or problems, I'm just gonna take the bit in my teeth and address myself to the Anon. Texas P.O.

I will be completely honest [because I've never been shy about admitting my ignorance] I had to go to the TDCJ [Texas Department of Criminal Justice] website so I could look up the collection of letters you used. I have been out of the loop so long [over a decade] that it wasn't at all familiar. I better find a way to stop using all these brackets or the Grammar Police will come and slap me with a Big Ol' Fine.
Anyway, for those of you, like me, who were puzzled by the "SISP/EM/SO" in the comment the P.O. left, I will share my new found knowledge. It stands for Super-Intensive Supervision Program/Electronic Monitoring/Sex Offender.
Show of many of you had a flashback to "Animal House"; Dean Wormer, and laughed when you read "Super-Intensive Supervision Program"? I know I did.
Anon.P.O., please forgive me, I mean NO disrespect. In fact as someone who has toiled in the vineyards of the Board of P&P, I KNOW how frustrating it can be. I was reading about all these new "special programs" they have instituted in the years since I left. I was wondering about the COST of these programs. I noticed on the home page that P.O.'s got a raise in pay and a raise in "Hazardous Duty" pay.
Hazardous Duty pay was something the State Employees Union was pushing for when I left, back in the early 90's. That was when the physical assaults on officers were starting to increase. And Officers "could" carry pepper spray and stun guns but weren't required to carry them. And cell phones, in the early 90's? Forget that! No way was the Board gonna pay for THAT expense! SO tell me... did HD pay take the place of something like longevity pay? or is it truly a benefit that other State Employees, who are NOT exposed to dangerous convicted felons don't get? Because if all they did was replace one benefit with another, essentially changing the name from longevity pay to Hazardous Duty pay that's not much of a dahm benefit, but about what I came to expect from the State.

Also, about a year after I left, I heard that because most of us who were in the FIRST Batch of Sex Offender P.O.s started burning out after a year to 18 months, it was decided to rotate the P.O. off that caseload every 9 mo. or so. Did they implement that or not?
I had a caseload that was about 40 Sex Offenders with the balance of my caseload, about 80-85 parolees, being everything from burglars to murderers, male and female. But then, I had some female sex offenders, too.

Also, I'd be interested to know just how many of the folks on your caseload who have alcohol or other substance abuse problems actually benefit from the ENTIRE 4 hours of counseling they get in the SACP. The Parole Division Counselors, did they get their alcohol and substance abuse counseling training from the State, or did they go out and go through an independent course and internship?
I see the wisdom of the SACP-ISF, it keeps them from going back to TDCJ-ID. Back in the OLD Days, at least 75% of my caseload had a substance or alcohol abuse problem in their history. I have a story in my archives on Holly's Hystrionics about the Old Drunk who had about 6 pages from TCIC, going back 40 years, of DWIs. And he just kept on drinking and driving. Do you still see guys like that?

The Therapeutic Community Substance Abuse Aftercare Treatment Program is bound to be an expensive program. Has it proved cost effective yet in terms of reducing the recidivism rate, or are the figures not in,yet? Because we had a recidivism rate of close to 66% for all parolees, and closer to 80% for drug offenders and this was BEFORE the meth explosion. It was around, sure and one of our county had a bunch of labs, but it wasn't as big a prob as it is now.

Does every District have a District Resource Center? Because my District was composed of 4 counties. The District Office was in the County Seat and once a month the Officers responsible for the outlying counties would go there and take report for the Parolees who simply could NOT make into the DPO.

I'm gonna take a big leap here and guess that the Serious and Violent Offender Reentry Initiative Program is offered to guys who are gonna be released on Mandatory Supervision anyway, right? 'Cause if it's being offered to some felon so he can get PAROLE, I Thank GAWD I don't live in Bexar, Dallas, ElPaso, Harris, Nueces, Tarrant or Travis Counties. In fact, where I live is not far enough away from those counties. I am now giving serious thought to moving to Brewster County!

The Special Needs Offender Programs for the mentally ill, mentally retarded, terminally ill, physically handicapped, and medically recommended intensive supervision offenders, seems like it would take a toll on the psyche of the officer. When I got hired in the mid-80's they were hiring anyone with a degree in the Social Sciences. By the time I left, there seemed to be a preponderance of CJ degree holders. I don't mean this as a criticism of people who choose Criminal Justice as a degree field, but I fear for their mental heath working with this particular group of offenders. What do you hear about these officers and what they do to cope with the stressors of their particular offenders? Is there a time restriction placed on their tenure with this caseload?

I'm glad I went to the website to see what's going on with these new programs. I hope you have time to reply and answer my questions.
The website makes it sound like all these programs are available all over the state. But I know that all too often the good programs are only available in the big city areas. I truly hope that the Drug treatment programs are available statewide. The Parolees in the cities can always find help. It's the Parolees in the rural areas that are usually SOL. I know that about 1/3 of the parolees I handled, if they'd had access to a better treatment and aftercare system, like what the State has in place NOW, they wouldn't have re-offended. So it will be interesting to see how these programs fare. And if the Lege is willing to continue to fund them.

Also, what are caseloads like now? Because a caseload of 125+ was not at all uncommon when I left. We were just runnin' ourselves ragged trying to keep up with all the home visits, job visits, and documentation, jail visits, violation report writing, hearings, applications for warrants, and then of course there was the much loved Duty Day! If a Parolee came in on whom you had a Blue warrant, you had to stall and find a way to keep him from getting suspicious until the P.D. or the S.O. could get there to arrest him. Reading the entire Parole Certificate to the Parolee on his first visit; whether he was YOUR Parolee or he was to be assigned to someone who was out of the office that day. Yeah, my Duty Day was Friday, so lots of days, it was the Supervisor, the Secretary, and ME.

And then of course, we started doing UAs in the OFFICE! Do y'all still test the pee of Parolees there in the office? If that's one of your duties from the beginning I guess you are conditioned to be used to it. BUT, on the other hand, I spent those years getting a degree,Ididn't plan on testing somebody else's URINE at the end of a long hard duty day! If I'd wanted to handle someone bodily fluids I'd have gone into a Health Science, NOT a Social Science!

Monday, September 3, 2007

Welcome to my Office!

Sit down, make yourself comfortable, let's talk for a bit.
No, that's OK, you don't need to shut the door, let's just let the breeze blow through.

Since you're my very first client here in my new office, let me explain the office policies:
  • If you should bump into another client coming in or on the way out, just nod and give each other a polite greeting. There's no need to trade life stories in the waiting room.
  • For now, I'm letting all comments be anonymous. Whether or not Google will let you be Anonymous, is completely out of my hands. And as long as I don't get spammed, I'm not doing word verification, either. I hate that on other folk's blogs, so I'm not putting it in here.
  • I'm also not doing comment moderation, for now. If any commenter should flame, or otherwise be unkind to another commenter, I may have to start that. So please, don't be the cause of me starting comment moderation.

That's pretty simple, nu?

The purpose of this blog is to help you, the reader, with any problems of the type that my training and experience in Social Work and a variety of Social Service agencies qualifies me to help with.

Right about now, if you are not a regular reader, you might be asking, "Well, just what have you done that makes you think you can help ME, Miss Smarty Pants?" I would answer that I have done work with Alcoholics, Drug Addicts, Parolees, the newly diagnosed HIV+ and the end-stage AIDS patients and their families. I have helped retired folks, who were living on fixed incomes apply for Medicaid benefits that would pay for their Medicare premiums, deductibles and co-pays. When you're 70, trying to live on $700/month, having those medical bills off your shoulders can be a literal life saver! I have also shown the grown children of elderly folks living in nursing homes how to save Mama's house and still get Medicaid to pay for her Nursing Home care. And it was all legal, above board and I was a State employee when I did it. Did you know that if your spouse needs Nursing Home care you have one year to transfer ALL your jointly held assets into YOUR name without penalty?

How about this one? I used to give Safer Sex talks to groups of strangers. SO I can help you talk to your kids about HIV, STDs and Teen Pregnancy. I can tell you where to go to find the latest stats for your state on all three, but since most teens think they are bullet-proof and immortal they think it won't happen to them, that probably won't do you much good. But, I have some tricks up my sleeve that might work. Email or leave a comment for me and I'll be off and galloping on this subject. It's my favorite hobby horse.

The drugs and alcohol experience I have has served me well in my own fam. I can trace the addiction in my family back 3 generations. Two of my siblings are effected. I somehow managed to dodge that bullet. So far, all of our children are relatively unscathed, too. So bring on the addict and alcoholic relative problems, I've heard it ALL before.

Since some of my time with Parolees included time working with Sex Offenders...I can handle listening to your tales of sexual assault, incest, emotional abuse, psychological abuse, physical abuse. Bring it on. I can say, "there, there", but then I will tell you what you can do to start healing, and how to get OUT of that situation if you are still in it.

I've done some grief counseling. Being 52, I've suffered my own losses as well. I can honestly say I KNOW what it's like to lose someone you love. There are many strategies to deal with loss, not every one works for every person, but I can help you find the ones that will work for you.

So, what do you say? Ready to come back for another session? Hey, at least the price is right!