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Mental Health Meditations

Timely articles on mental health issues and spirituality

Finding a Mental Health Provider...Where to Start

3/31/2021

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Proverbs 15:22 says, “Without consultation, plans are frustrated, but with many counselors they succeed.”

It has always been important to care for our mental health. But, the impact of the pandemic has brought this issue to the forefront for many of us. Sometimes we just need more help. Perhaps you are at a point where you recognize this and would like to explore how you can support your mental health in a more formal way? Taking the step to reach out is extremely brave, but it can also be incredibly overwhelming, and even scary. This post includes some information that will hopefully guide you as you consider your next steps. 

The mental health world can be very confusing! Knowing some common terms and how to navigate things will help you feel more at ease and empowered as you consider options.

There are several different types of providers: 

  • Psychiatrists are medical doctors who specialize in treating mental health concerns. Psychiatrists can prescribe medication. Psychiatric Nurse Practitioners can also do this, as can family doctors (primary care physicians).  However, many family doctors will only prescribe certain types of medication that are more commonly used.  Most will want to refer you to a psychiatrist if things are more complicated or if it is not clear what type of medication would be most helpful to you.
  • Psychologists also diagnose and treat mental health issues, but they do not prescribe medicine. Psychologists are trained in administering a wide range of tests to help clarify diagnoses or determine the best type of treatment. Psychologists also do therapy, most often talk therapy. 
  • Therapists, or counselors--I tend to use the terms interchangeably--require masters degrees and special licensing to practice in the mental health field. Therapists provide diagnosis and treatment. Therapists can have several different degrees and credentials. Some of the most common are LCSWs (Licensed Clinical Social Workers), LMHCs (Licensed Mental Health Counselors), and LMFTs (Licensed Marriage and Family Therapists).  While some therapists treat a wide range of issues, most have some area(s) of specialization such as working with kids, couples, trauma, anxiety, behavioral problems, grief, substance abuse, etc. 

You may be asking, “So how do I know what kind of provider I need?” There isn’t any one “right” answer. The best thing to do is to start with the issue you want to address and go from there. There are several ways to research providers that can help. One of the best is word of mouth. Ask around and see who is recommended! You can also consult your primary care provider, school counselor, or pastor. There are several different websites that you can search by clinical issue. Two of these are www.psychologytoday.com and www.goodtherapy.org. Different considerations such as age and experience level of the provider, gender, location, insurance networks, and therapeutic approach are important. 

Look at profiles, check websites, and narrow it down to a few choices that appeal to you. Most providers offer a brief consultation at no cost so you can try to determine if they would be a good fit for what you are seeking. Ask questions that matter to you during this time. If you are seeking a provider who offers Christian counseling, or who can integrate your faith into the work that you are doing, this is a great time to explore what this would look like. 

At its heart, counseling is about creating a safe, trusted relationship between you (or your child) and your counselor, so the single biggest predictor of whether a therapeutic experience is going to be successful or not is the quality of the relationship between therapist and client. At the end of the day, finding the right provider for your needs may take more than one try.  While this can be frustrating, don’t give up on the process!  Your health and well being are too important.  

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Marriage in the Time of COVID - Part 2

3/18/2021

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Marriage is a big topic that deserves to get a lot of attention, and as the saga of COVID-19 plugs on marriages are still in trouble. In this article I would like to focus on a different aspect of marriage…fighting. Though this topic is unpleasant to talk about it is a normal part of every marriage. Yes, fighting is completely normal and healthy when kept within certain boundaries.  Though this part of marriage is not pleasant, it is necessary.

Fighting provides a necessary release of emotion that often gets bottled up in our society. With emotions running higher than ever due to COVID that release of emotion is even more necessary than usual. In therapy I always tell my couples that I worry more about couples that don’t fight than couples that do. This is because fighting not only releases emotion but can be a major catalyst for communication if handled properly. Also, fighting indicates that there is some baseline of caring there. After all, you don’t fight with someone that you don’t care about.

As I referenced earlier, fighting must be kept within certain boundaries in order to be healthy. There are several fair fighting rules out there that can be helpful with this. Here are some fair fighting rules from the famous marriage therapists, the Gottmans.
 No name calling
  1. No interrupting
  2. No blaming or accusations
  3. No cussing
  4. No yelling
  5. No sarcasm
  6. No Defensiveness
  7. No generalizations (you always or you never)
  8. No physical or emotional intimidating gestures/violence/threats.
  9. No walking out without naming a time for follow up

These are not hard and fast rules.  I would encourage you to change and adapt them to your unique situation.  For example, some of us use sarcasm as a second language and it is not as offensive to us, but insults are out of the question.  I encourage you to talk to your partner and figure out your own unique boundaries that will help you fight in a healthier way.  It will never be a fun or pleasant thing, but fighting leads us to stronger relationships.  

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Parenting in the Time of COVID-19

3/2/2021

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In the last post, Meagan gave us a terrific piece about the impact of the pandemic on many marriages, with some practical advice about how we can strengthen our relationships during this time. In considering the whole family, I wanted to follow up on that and talk about parenting in the time of COVID. As we know, we have been experiencing this different way of life for about a year now. While there are some encouraging signs that we may soon start getting back to a little more normalcy, it is likely that we are just scratching the surface of understanding the impact that the pandemic has had on our children.  

Predictability is a stabilizing force for kids and teens. The uncertainty of the pandemic has altered our ability as parents to provide this in many ways. Circumstances have changed over and over again, and it has been hard to settle into any kind of routine. The isolation from peers and family, uncertainty, missed milestones, loss of activities, as well as anxiety about health have taken its toll. For some young people, the pandemic may have exacerbated mental health needs that were already present. For others, especially those with social anxiety, being at home and online schooling may be a temporary relief to their anxiety, but this is not a long-term solution and may result in increased difficulty as they return to school and other aspects of life.

Here are a few ways that we can support our kids and teens as we continue to navigate the pandemic, and as we look ahead to getting back to a more familiar way of life.
  • Try to keep routines at home. We can’t control that routines outside of our homes have altered, but we can keep family life as predictable as possible. Try to keep wake, sleep and meal times consistent. Don’t make drastic changes to rules and expectations just because you are home more. Some flexibility is certainly good--just try to avoid big changes from what your “normal” would look like. Habits that may seem harmless or easier right now may prove difficult to break later.  
  • Look for little moments to connect with your kids throughout daily routines. This could mean taking 5 more minutes at bedtime to read with your child, rub their back, or just talk. Institute a family devotion or prayer time at the start or at the end of the day. Or, try to eat meals together as much as possible. This is a powerful way of connecting as a family.  Magic happens around the dinner table! 
  • Get outside as much as possible. Research has shown over and over again that time spent in nature has multiple benefits to our children’s mental health and overall development.
  • Try not to stress too much about school performance this year. Set your child up to be as successful as possible with whatever school model they are in. But if they are struggling, recognize that it is a very different year and they are likely doing the best that they can. Encourage them to do their best, stay in communication with their teachers, but try not to worry too much about the actual grades. If your child feels discouraged by lower than normal grades, encourage them to consider the other ways in which they are learning and growing as a person this year, such as developing perseverance and flexibility. Let them know how these things will serve them in their future.  
  • If your child is anxious about returning to school or other activities, it is to be somewhat expected, especially for our littlest ones, and our kids with social anxiety.  Encourage your child to talk about the specific things that are on their mind. Validate their feelings and address their worries truthfully, but support them in facing these things.  The longer that kids stay out of familiar routines, the more difficult it may be for them to re-engage. Here is a social story for our youngest ones, written by Dr. Emily King (a Raleigh child psychologist), to help support children as they return to school: https://www.parentingonyourownpath.com/product-page/free-safely-back-to-school. There are also some wonderful books for older kids that address this kind of worry.  One of my favorites is The Invisible String, by Patrice Karst.
  • Make your own self care and mental health a priority. This type of modeling is so important for your children to see! When we take care of ourselves and manage our own stressors in a healthy way, we are caring for our kids in turn.  
  • As always, don’t hesitate to reach out to a mental health professional to explore ways to support your child that are specific to your unique situation.

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Marriage in the Time of COVID-19

2/17/2021

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One disturbing trend that I have seen in my practice since the advent of the COVID-19 virus is
the explosion of the need for marriage counseling. I have had so many new clients as well as
former clients contact me for help with struggling marriages, and I know from talking to
colleagues that I am not alone. According to the New York Post, divorce rates have been spiking
since April 2020, which is just one month after many states started lockdown protocols. The
data showed that 31 percent of couples admitted that irreparable damage had been done to
their relationship during lockdowns. The combination of spending more time together,
increased anxiety, deaths of loved ones, homeschooling children, working from home,
unemployment, and financial strain along with a myriad of other things has put couples in a
very difficult position.

Though COVID may not be responsible for all the problems couples have faced, it certainly has
exacerbated things. With the added strain marriages are crumbling like never before. Previous
separate routines may have masked existing problems that forced lockdowns brought to light.
COVID may not cause breakups, but it is more of a catalyst for break ups that may have
happened anyway. Even couples who were stronger before the pandemic and did not make
major shifts in their family roles have still been susceptible because coping skills that were used
previously have been taken away such as going out with friends, playing sports, or just spending
time alone.

It is important to find ways to spend quality time together and not just a large quantity of time.
It is also important to spend time apart and engaging in self-care. You might feel comfortable
going out to restaurants for dates, but if you don’t there are still fun things that you can do at
home or at a safe distance. Here are some ways to combat the stress that the pandemic could
be placing on your marriage:
  • Go for a picnic when the weather permits (I know it has not been great lately!) Pack a picnic basket at home or pick up some food from your favorite restaurant, grab a picnic blanket and go find a pretty spot to share a nice meal together. I came across this girl and had to share her page: https://www.facebook.com/Mels-Premium-Picnics-114286277090388/. She sets up romantic picnics for people at different spots around town. It is an amazing idea!
  • Do an at home date night kit. There are many places online that you can find interesting things to do for date nights that can be delivered right to your door. Here are just a few that I have found, but a simple Google search can turn up many.
    • https://datenightinbox.com/
    • https://cratedwithlove.com/
    • https://www.huntakiller.com/
    • https://thehappily.co/
  • A more budget friendly option might be to cook a meal together, have a screen free night, read a book or devotional together and discuss it, work on a craft or household project together, or go for a walk together.
  • Find ways to spend time apart. This is equally as important as spending time together, so don’t neglect this one. You may need to call or Face Time a friend in your car, go for a hike or a walk in the park, or get involved in an online class. It may help to find your own space in your house that you can go to when things get tense. You might even personalize this space so that it feels comforting to you.

Remember to give each other grace and try to have empathy for one another.
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Destigmatizing Mental Illness in the Church

2/4/2021

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Join me in imagining for a moment if you will...

Imagine that you (or perhaps a close family member) have a health issue that could present challenges in different areas of your life. Let’s say that the issue is one that is quite common and treatable, but you may need to see a specialist periodically. You are experiencing this health issue by no fault of your own...some people just have it. Maybe it’s asthma, diabetes, or perhaps an autoimmune syndrome or an allergy? Maybe you suffered a traumatic injury of some sort? Would you share this issue with others in your circle? Would you seek treatment to improve your quality of life? I’m guessing that for most of us the answer sounds something like “Well of course I would!”

Now, consider the exact same scenario, but instead of the health concern being any of the things named above, imagine that it’s a mental health issue. Would you still share with those around you? Would you still seek treatment to improve your quality of life? 

If you answered that you would not, there are likely a number of reasons. But, I would venture to guess that some part of your hesitancy would be due to the stigma associated with mental health in our culture. The conversation about mental health is becoming more prevalent (as is evidenced by the work that Woodland is doing….Way to go, Woodland!). But overall, as a culture, and as Christians, we still have a lot of work to do. In any given year, 1 in every 5 adults, and 1 in 6 children/adolescents experience a mental health issue. In the time of COVID, these statistics are likely much higher.  

Stigma refers to stereotypes, or negative views, that are attributed to a person/group whose experiences, characteristics or behaviors are seen as different from the norm. Stigma is often rooted in misinformation and fear.  Over time, stigma is internalized and can lead to feelings of shame, guilt, or inadequacy. Those affected may feel tainted in their identity in some way. 

But we must ask ourselves...what does the Bible say about our identity? It tells us that we are created in God’s image and that we are his masterpiece. He saw our unformed body and has ordained all of our days. He knows of our challenges and suffering, and he has plans for us. His word assures us that his plans give us a future and hope!  (Genesis 1:27; Ephesians 2:10; Psalm 139:16; Jeremiah 29:11). 

So, as Christians, how can we work to destigmatize mental illness? Here are a few thoughts:

  • If you are suffering, know that you are not alone (remember..at least 1 in 5 people!). Speaking openly about your struggles opens the door not only for you to receive support, but for others to share their struggles too. Shared struggle can be an opportunity to speak truth about Christ’s love to others.
  • Offer the gift of your presence to others. It’s okay if you don’t understand exactly what they are going through.  A spirit of loving care and a listening ear goes a long way. That being said....recognize the limits of what you can do as a friend/caregiver, and encourage people to seek professional help when appropriate.
  • Avoid perpetuating messages that may unintentionally increase stigma in the church. Some of these might include the idea that mental illness is a sign of weakness, result of sin, lack of faith, or that the person just needs to surrender the issue to God. Of course we want to encourage folks to turn to God for help in their trials. And, we certainly want to love them through acts of service and prayer. But, it’s important that we also encourage them to seek professional help when needed.  
  • Avoid flippant use of mental health “labels” in seemingly innocuous ways. (“I’m so ADHD...That just gave me PTSD...This mess is bothering my OCD...Don’t have a panic attack...You’re being so bipolar”). These words may seem harmless, but such statements can minimize and invalidate the trials that folks dealing with these challenges face in their daily lives.. 
  • Similarly, remember that a person with a mental health challenge is just that...a person! Let’s not define them by their struggle. Try to use “person first language”. So, instead of calling someone an “addict” or a “schizophrenic”, consider saying that they are “a person living with an addiction” or a “person with schizophrenia”. This helps us remember that they are a whole person, created in God’s image, and their mental health struggle is just one part of their story.

We know that God provides comfort to the suffering and meets the needs of the brokenhearted (Psalm 34:18; Psalm 145:18), and we must trust him on our journey. However, this trust doesn’t always mean waiting out a situation of suffering. Rather, it may look like taking a faith-filled step to harness resources that God has placed in your path, whether that be a counselor, friend, support group, or medication. Friends, please don’t suffer alone. Reaching out does not indicate weakness or lack of faith. Rather, getting help may provide you with healing and clarity that will allow you to experience God’s presence in your life more fully.   

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Ambiguous Grief in an Uncertain Time

1/20/2021

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So many of us have experienced so much loss during this pandemic. Loss can take many forms, and along with loss comes grief. There are several different types of grief and loss, but for the purposes of this article we will focus on Pauline Boss’s concept of ambiguous grief. Though there are so many people who have experienced the death of a loved one during this pandemic, even more prevalent are those that have experienced losses of relationships, events, or even dreams of what should be. This is ambiguous loss meaning that there is not a concrete person or thing that we have lost, but something not able to be seen. Ambiguous grief happens as the result of a lost relationship with someone who is still living or the loss of something that is very important to us. Some examples of this might be when a loved one begins to slip away due to mental illness, a divorce, losing a friendship, infertility, losing a career, or the loss of opportunities.  

Most of us have experienced some kind of ambiguous grief since the pandemic. Children and teens are missing out on life experiences that they will never be able to get back like birthday parties, school events, or even just the everyday fun of getting together with their friends. Adults are missing out on in person social connections with family and friends, impromptu social connections out in the community, and even career opportunities. I have heard several stories related with deep sadness about missing out on the Christmas celebrations that are held so dear. One client told me that she so deeply misses giving people hugs and feels a profound loss in her life at the loss of this form of social connection that is so dear to her. We can even feel grief over the loss of our “normal” way of living such as being able to go out in our communities without putting our health in jeopardy. However you are experiencing it, ambiguous grief is becoming more and more of a problem as this pandemic wears on.  

When we look at the experience of grief in the Bible there is no shortage of examples. One of the most inspiring examples of grief, for me, is the story of Job. Job experiences so many losses in a short amount of time from the deaths of his children to the loss of all his material possessions. The thing I find so inspiring about Job is that he does not sugar coat his grief.  He says, “May the day of my birth perish, and the night that said, ‘A boy is conceived!’ That day may it turn to darkness; may God above not care about it; may no light shine on it.” (Job 3:3-4). He embraces it and voices it and allows it to wash over him completely. Though he tenaciously holds on to his faith in God in the face of intense struggle he does not hesitate to be angry at God, lash out at God, and even question God in his grief. I find that many people of faith today that encounter grief hesitate to really fully experience and feel it. This may be because it hurts, and we tend to avoid pain whenever we can. I think others avoid fully experiencing their grief because it is scary to question God, and we may fear that in questioning God we will lose his favor. Whatever the reason, avoiding grief can lead to many psychological and physical problems such as depression, anxiety, stress, or physical symptoms like headaches, fatigue, gastrointestinal distress, and muscle tension. We have seen an influx of grief related symptoms in the mental health field since the pandemic, and all this unexperienced grief is causing so many to experience more mental health symptoms than normal.

So, what does it look like to experience our grief? That is not really a question that has one single answer. I often encounter clients who think that they are not “doing grief right”, but there is not a right or wrong way to experience it.  The most important thing to remember when experiencing grief is to not hold it back or try to limit it. This could be allowing yourself time to cry or reflect or just feel whatever it is that you feel (sadness, anger, betrayal, hurt, fear, anything). Another way to experience grief might be spending time in prayer or meditation or even spending time in nature. Walking or sitting in nature can really allow for some deep reflection. For some of us the grief can be too much to hold on our own, so I encourage you to reach out to a trusted friend or family member, a pastor, or even a counselor to help you navigate this process. Grief is an important part of life and it should not be ignored or avoided, and like our friend Job, grief may be intense for a while but there is hope on the other side of it. Our lives will probably never be the same, but there is hope on the other side of this pandemic. For now, we can grieve our losses and wait for the day when we can be reunited in whatever way that is possible.    

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Getting Back to Basics in 2021

1/6/2021

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As I sit down to write this, the world is counting down the days (or even hours and minutes!) until we say goodbye to the year 2020. Perhaps many of us are actually saying “good riddance” to a year that has seen so many challenges? 
Wherever you find yourself, a new year typically brings about the sense of a fresh start, or perhaps renewed purpose.  But, what about the year 2021? Are things really going to feel that different once the ball in Times Square has dropped and we officially turn the page in our calendars? It’s a tricky question. There is hope and encouragement in the fight against COVID with the vaccine being approved and distribution happening. But let’s face it, we are bringing some serious baggage with us from 2020 and we may not feel “up” for setting resolutions, goals, or intentions as perhaps we normally would.  Here’s the thing....if this is you, it’s okay! And, dare I say, to be expected. We have, collectively, spent the last 10 months surviving a global pandemic after all.  

When humans experience significant stress, we go into “survival mode”. When this happens, our brain sends a signal to our body to produce stress hormones such as adrenaline, cortisol, and norepinephrine. God gifted us these stress hormones as a protection. When we encounter a danger, the release of stress hormones in our body enacts the fight or flight response, which allows us to effectively respond to the situation at hand. But what about the chronic stress we’ve experienced in a year like 2020? No...the smoke alarm hasn’t been going off for 10 straight months, but we have existed at a heightened state of awareness and arousal for an extended period of time now. We are weary. Those stress hormones aren’t going to just go away because there is a new date on the calendar.  

So, as we enter the new year and you ponder where to focus your energy, I challenge you to consider the following.  This may not be the time to set lofty expectations for yourself, or others around you. Maybe you will run a big race, make big gains in business, or finally break that habit. Maybe you will excel in school or on your sports team. And, if those things happen, that is wonderful and to be celebrated! But, if those things don’t happen, that’s okay. Just getting through the days right now in a physically and emotionally healthy place is a really big win! Perhaps the dawn of 2021 is a time to slow down, embrace the hope of a new beginning, and focus on recovering from the stress of this past year. 

Don’t go it alone in 2021. Even though we cannot be physically close to one another yet, we can still be present for one another in many other ways. One of my favorite quotes by Shannon Adler says, When “I” is replaced by “We”, Illness becomes Wellness. Reach out, connect, simplify, get outside, rest, pray, create, read, seek counsel, dig into the Word.  Remember the Sabbath. Send the note, make the call, take a walk, cook a meal, put down the phone, dial back your media exposure. Get back to basics in 2021. Connect with God, your own health, and with one another in the ways that you safely can. The rest will come with time. Right now, focus on how you can be kind to yourself and others as we move toward recovery with the hope of brighter days ahead.  

But if we hope for what we do not yet have, we wait for it patiently.   -Romans 8:25
​

Therefore we do not lose heart.  Though outwardly we are wasting away, yet inwardly we are being renewed day by day.  For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all.  So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.  -2 Corinthians 4: 16-18

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How to Survive a COVID Christmas

12/9/2020

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During the holidays, many look forward to the festivities and traditions associated with the season. But for a lot of us, it is a complicated and difficult time of the year. Stress, depression, anxiety, substance abuse, post traumatic stress, and a range of other mental health needs tend to intensify during the holiday season. There are different reasons for this: the often unrealistic expectations that we set for ourselves and others, financial strain, burdens on our time, confronting difficult relationships with family, and feelings of grief and loneliness as we feel the absence of loved ones. Let’s face it…it’s pretty rare that life actually ends up looking like it does on the Hallmark movies! This may be especially true this year as we collectively cope with the ongoing impact of the global pandemic. Wherever you find yourself this season, it is okay.  

This year has certainly been one of uncertainty. You may wonder if you are going to be able to hold traditions or see loved ones for Christmas? Perhaps a loved one is sick, or maybe you have experienced a loss this year (whether COVID related or otherwise). How have your work and finances been impacted? Is your tank empty from teaching and caring for children who are at home around the clock? Are you a teenager, sad and frustrated that your school and social life can’t be “normal”? Is your marriage under strain? Do you just simply miss your church family?

Advent is a season of waiting. But this year, the idea of waiting takes on a different meaning. Yes, we wait for the birth of the King. But, we also anxiously await a return to a more “normal” way of life. Dr. Richard A. Swenson defines margin as: the space between our load and our limits. It is the amount allowed beyond that which is needed. It is something held in reserve for contingencies or unanticipated situations. Margin is the gap between rest and exhaustion, the space between breathing freely and suffocating.

In other words, margin is knowing your limits and creating space for you. 

Here are a few thoughts about what giving yourself margin might look like this season:

  • Take time to think about and discuss with your family the things that are really special to you during this season and try to prioritize those things instead of trying to do everything.
  • Prioritize the gifts that you give. Try giving experience gifts that don’t cost much or just share a special Christmas memory in a special or creative way.
  • Set aside a few minutes each day to meditate on the wonders of the season and the wonder of God coming to earth for us.
  • At the end of each day try to do as Mary did in Luke 2:19 and reflect on your day, so that you won’t miss a memory to treasure.
  • Give yourself permission to not be okay. If you are grieving a loved one, facing a difficult milestone, or just not feeling very merry it is okay to not be okay. Allow yourself time and space to cry or be angry, speak with a friend or loved one (or therapist!), or just think and remember.
  • Though the weather may not be conducive all the time, try to spend some time outside. You may need to bundle up, but it has been proven that time spent in nature is healing.

Establishing margin in your life will help you as you try to wait well. Give this gift to yourself. Self care is not selfish. Self care is a way that you can honor God and be a witness to others by caring for the body, mind and spirit that he has given you.

Merry Christmas! We wish you peace and margin this year as we await the birth of the king and a more normal way of life.

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    Authors

    Laura Dempsey is a licensed social worker and therapist with nearly 20 years of experience counseling children and families.

    Dr. Meagan Jones is a licensed clinical mental health counselor focusing on a wide range of issues, including trauma and family counseling.

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