What we fight for, both for and against.

You are so good

Sat, 06 Aug 2022 16:53:18 GMT

Sensory differences and being an outlier

So I am this chronic outlier.

it is kind of a problem. I was just watching youtube and the video below came up. What is amazing about youtube is all the amazing information on it, I am a huge fan and love it love love it. (ask me sometime about how Wikipedia changed the world and lead to the youtube movement (yes, it is a movement). So anywho, the bad thing about youtube (and other media sites) is that it will autoplay stuff that you weren't necessarily expecting or ready for it, like this video, for example. I am going to add a trigger warning, that this woman describes her story of terrible abuse and neglect. Please don't let a trigger warning prevent you from watching/reading something, just make sure you have some skills prepared in case you get triggered. Avoiding our triggers makes them bigger and our lives smaller, giving them more control over us.

Around puberty, I realized that I had a rage problem that resulted in me losing my ever-loving mind at certain noises. I tried to explain to myself that it must have been linked to some weird gum-related trauma I must have experienced and it was my PTSD having self's hypervigilance that made it a problem. Trouble is, that didn't make it stop or lessen the stress of it, and even the most wholesome and safe feeling time part of my week, when Stepmom2 would make homemade breakfast for the family on Sunday mornings became torture because it was accompanied by the sound of everyone CHEWING. If the word CHEWING in all caps is a bit of a trigger for you, you may know where I am going with this one.

Misophonia or how I found out I am not just a rage monster.

As I became older and more and more people were telling their own stories through social media, I discovered I wasn't the only rage monster that became wanted to scream, cry, or attack when chewing sounds, ticking, clocks, and KitKat commercials came on (I hate you KitKat commercials). Turns out there are lots of us and the audiological/neurological difference we have has been called Misophonia, also called 4s (Selective Sound Sensitivity Syndrome. The video below explains some of the science. I will tell my fellow misophonics that they start to play the trigger sounds at 3:11 point. The first couple are okay but then the miso triggers start and I urge you not to listen to them. Unlike with anxiety disorders, I have not found that exposure to trigger sounds paired with skills use has been effective enough to do away with the reactions sufficiently enough to insist you not avoid your miso triggers.

I just attempted to find you a video that accurately shows what I and other misophonics experience when hearing their trigger sounds and all of them contained said trigger sounds and now I have to go run a marathon to expend the fight or flight energy in my body or I will cry in the corner of my office before my next session, either is possible. See what happens to folks with misophonia is these trigger noises aren't just annoying; it feels very much like the noises are being made AT ME and with malicious INTENT, essentially, my body responds with a fight or flight response. It can be so instantaneous that self-control feels impossible, like the few times I may have loudly cussed out the television or thrown the remote because, for some reason, sound people think that we NEED to hear the sound of liquid being poured into a glass on this show I love even though it tortures me. I have learned over the years that I have a relatively mild reaction compared to some people. I do think that over the years my DBT skills have helped greatly to reduce the level of my reaction to my triggers and I have had to withdraw from classes based on the incompatibility between myself and the voice of a professor or the amount of saliva they carry in the corners of their mouths at any given moment.

Ways to cope with Misophonia:

I have tried Calmer and although I think they may be helpful I genuinely hate having things in my ears to the point that I haven't been able to adjust properly to them. I plan to give them another try and hopefully you will too if this is an issue for you.

DBT TIPP Skills- Temperature, Intense Exercise, Paced Breathing, and Progressive muscle relaxation.- This is a set of Distress Tolerance skills in DBT used to reduce the intensity of emotions when they are at crisis levels, using your body's physiology to calm down until the ability to think comes back online.

Awareness- I tell everyone I meet about misophonia eventually. sometimes sooner rather than later. This OFTEN leads to people making exaggerated trigger noises at me because they don't understand the actual suffering it causes me. Though I've also helped people to recognize their misophonia, which is the most beautiful thing, as I love helping them realize they aren't rage monsters either. The thing about misophonia though, is that it is OUR THING, not THEIR fault, right? They (trigger noise makers) are not to blame for our reaction and we aren't making it up either. So another DBT Concept to rescue: we didn't cause our problem and it is our job to fix it anyway. Okay, that doesn't feel very rescue-y AND it can help with the whole "I want to attach that bastard with the gum" feelings of rage. We can practice becoming aware of our triggers and using skills before we are too far into distress.

By awareness I mean: TELL FOLKS IN YOUR LIFE. If that means you have to say "Hey, sorry, I have this neurological disorder that causes a fight or flight response to small sounds most people don't hear, this means I need to go to the other room for a moment". Or you can send them to this post!

If you love someone with misophonia?

Okay, you cannot prevent from making all trigger noises. it just isn't a thing you can do. You can be mindful of it though, trying to keep those noises you can to a minimum by not chewing gum or eating with misophonia friends or eating when on the phone (we can ALWAYS tell).

Remember how I started this post with the fact that I am a chronic outlier and a youtube video about auditory processing disorder? Funnily enough, I wasn't planning to write about bout misophonia when I started this post! However, we have reached the end of reasonable blog entry posts and so you will have to stay tuned for further adventures in my brain and sounds!

Keep changing, keep growing, no matter what, just keep going!

Maggie Lipham, LCSW

My Blind Spots

Mon, 25 Jul 2022 22:15:11 GMT

No one is good at EVERYTHING

For Example:Straight lines...

I am pretty terrible at straight lines. I am not kidding when I tell you that with TWO T-squares and a ruler, I managed to make several pieces of paper into rhombus shaped messes rather than half sheets of paper I was aiming for. You know most of the time I am just fine with my blind spots, as we all have them. Sometimes though, they bug the crap out of me and if push comes to shove, I have been known to cry when trying to draw or hang something in any sort of straight line.

I did not start this post to talk to you about my difficulties with straight lines though, I got started because I was noticing again how many therapist profiles list a huge variety of "specialties" and it got me thinking about the things that although I AM trained to work with and could probably do a competent version of working with a client on the topic....that I really just am not the BEST at. I thought I might take this opportunity to share with you some of my "blind spots", for the purposes of knowing what we are working with...and what I might refer you to someone else on:

Substance use disorders:

Y'all. Addiction runs deep in my DNA you will often hear me sharing phrases common to 12 step meetings and that community. I have spent time in and around it since I was a child in various versions of the 12 step model and so it isn't that the concepts allude me or make me uncomfortable. It is that I have big 'old blinders on when it comes to people being honest with me about their substance use. Tell me you are sober and unless I catch you with substance in hand, I am going to believe you. Call it a personality flaw AND it is a good one to be aware of! If we are working on other things and substance use disorder is a part of your struggle, I can help you with that. However, if substance use is the primary diagnosis, and is the problem driving you to therapy? That is a time for referring you to another provider, as there are many gifted therapists that can catch you in the lie you may be driven to tell to keep using your drug of choice.

Psychotic Disorders

I have worked with clients experiencing various degrees of psychosis, which involves a cluster of symptoms that can occur alongside all of the mood disorders (depression with psychotic features, bipolar with psychotic features…etc.) and also can be the primary presenting problem, as is the case with thought disorders such as schizophrenia. However, I do not believe my grasp on what IS or IS NOT firm enough that I can reliably spot hallucinations and/or delusions. I really REALLY love deadpan comedians, such as Steven Wright, who you can see below. A common symptom in psychotic disorders is called a blunted affect, when that type of communication is the most common type of communication from a client. Being a therapist to someone experiencing this symptom can be SUPER complicated when you are used to the blunted affect accompanying some truly funny stuff.

I think those are my two biggies, the categories that I am going to really do a lot of soul searching before accepting a client to work on those topics primarily.

OK, SO WHAT DO YOU DO?!

Excellent question! I have actually written quite a bit on my website about my ideal client and the people I could work with most successfully for convenience though, the list goes as follows: self-esteem, depression, anxiety, chronic suicidal ideation and emotional dysregulation, living with chronic illness/pain, and trauma.

I am sure somewhere I have managed to do the SEO for those heading all bass ackwards and well, one day the formatting on this post may change drastically. In the meantime, for my fellow therapists: What are some of your blind spots? Are there any areas that you just do not feel confident in, even if you are competent in them? I would love to hear your thoughts!

-Maggie Lipham, LCSW

Living the Dream, Fighting the FIght

Sat, 30 Apr 2022 22:12:44 GMT

Slowly but surely, I am building my dream....

The above is a picture of my office as it stands today. I am now offering in person sessions for those vaccinated and willing to mask in common areas of the building! I have also partnered with Headway.c o and am in-network with Aetna, Anthem Blue Cross Blue Shield of Georgia, Cigna, Oscar Health, Oxford, and United Healthcare (check your specific plan) also, I am working on another partnership that will allow me to expand to a few more of the major providers as well. I want to have the energy to write out all of the wonder plans and dreams I have for this space (virtually and physically) and as I am still living the millennial reality of Day Job + Small Business Building, I have reached the end of my working day and have given myself Sunday off to REST.

Projects I can tease: Social media! I have the accounts, soon, CONTENT!

Blogging topics: Chronic Illness and the Fucked up Ableism that exists in the world, Media as Mental Health Boon!....and other things!

You Aren't Broken, The World Is! -A Podcast about Hope and Mental Health with Maggie Lipham, LCSW

DBT SKILLS GROUPS!

Stay tuned you lovely folks, once I work out this whole "having energy to spare" thing, WATCH OUT WORLD!

-Keep Changing, Keep Growing, Just KEEP GOING-

Maggie Lipham, LCSW