Talking to Loved Ones About Mental Health: The Elevator Speech

 

While not everyone in our lives has earned the right to know our story, there are probably some people in our lives who have. Partners, family, and friends (the family we choose) can provide tremendous support, but how do we even begin to explain what we’ve experiencing so that we can get their buy-in?

When I was first diagnosed with PTSD while serving in the military, I needed the support of my loved ones and didn’t know how to start the conversation. I was afraid of being judged and rejected. Later, I became a mental health provider and learned the power of role-playing and using scripts as a way to practice difficult conversations before having them. In this blog we’re going to map out exactly how to talk to the people in our lives who matter about our mental health issues and ask them for support.

To do this, we are going to create an “elevator speech.” I’ve taught this technique hundreds of times over the years and seen it work time and again.

Let’s Begin 

Awful things happen in our personal relationships when we are struggling with mental illness. Persistent negative beliefs about ourselves, other people, and the world can take a shotgun blast to our personal relationships. This is true even with the people we care about the most.

We may not know we are struggling with mental illness, but we often suspect something is off. We may feel like we’re in a funk or not feeling like ourselves, and our loved ones know something is off, too.

Our mental health issue can become “the elephant in the room.” This metaphor means that there is something in the room that is glaringly obvious to everyone, but no one talks about it because the topic is too uncomfortable. To get past this awkwardness, we are going to create an elevator speech.

The Elevator Speech

We get the term “elevator speech” from the business world. It’s brief, about 30 seconds (the time it takes to ride from the bottom to the top of a building in an elevator), and its intent is to clearly and succinctly make a pitch for support. Here are the steps we will use to make our pitch to our loved ones along with some example verbiage as a model:

1. Ask permission. Before rolling out our elevator speech, it’s important that we let our loved one know that we want to talk to them about something important, and we will need about 30 seconds of uninterrupted time to do it. Not everyone we love will be on board for this, and that’s okay.

Relationships take two people, and it is incredibly important that we choose to honor others’ boundaries. This may sound like: “There is something important I’d like to talk to you about. It’s not bad news. If it’s okay, I’d like to say it all at once and I promise it will only take about 30 seconds. Would that be okay?” Wait for a verbal yes and proceed.

Let’s say our loved one is an interrupter. That’s okay. If they interrupt, gently ask again, “Would it be okay with you if I got this all out? I promise I will answer any questions you have in about 30 seconds.”

What if they say no? This happens, and it’s okay. Let them know that if they change their mind, we are available. Reaffirm that we care about them and respect their boundaries. Then, leave it alone. They will talk to you when they are ready.

2. Introduce our elephant. I’m a believer that whenever there is an elephant in the room, we are smart to introduce it. We might feel uncomfortable, or even feel completely numb and find it hard to connect.

All of that is okay so long as we name it: “I feel really nervous talking to you right now. If I sound shaky, it’s because I am, but I’ll be okay.” Or, “I realize that I might sound like I’m not feeling anything right now. It’s hard for me to connect, but I promise that I want to.”

3. Own our past. This is an opportunity for us to own our struggles or behavior completely with no excuses. Keep it simple: “I know that things have been off. I’ve been drinking too much and spending a lot of time alone.” Or, “I’ve had a terrible couple of years, and I’ve struggled with dark thoughts.”

Nothing we say is a revelation; we are simply stating out loud what they already know.

4. The epiphany. This is when we learned something we didn’t know before or realized something we hadn’t fully grasped before. Because of this, our fundamental belief system has changed, or, for the first time, we want our fundamental belief system to change. Epiphanies come in packages large and small, but their impact is profound. This can sound like, “I realized after my last attempt to end my life that I want to live,” or, “I decided that I want to be the best Mom I can be.”

5. Ask for buy-in, manage expectations. This is when the conversation shifts to the here and now. We need support from our loved one, we know this journey will not be easy, and we state our dedication to trying: “I want to change, and I also know that this won’t be easy. I would value your support.” Our journey is not an overnight process, and we need to let our loved ones know we need them and that we are all-in.

6. Love them. Not everyone is comfortable with those three little words, but this is our chance to break ranks. Keep it simple: “the most important thing I want you to know is that I love you and I’m open to answering any questions you have.”

7. Silence. This is the hardest part of the elevator speech because every part of us wants to jump to the rescue or break the awkward silence. I implore you, friend: be quiet and listen. Our silence honors our loves ones’ experience and invites them to share with us. This is how we reconnect.

Our loved one may not be ready to talk with us at that moment, and that’s okay because we have opened a door that is not easily shut. We can let them know that if they change their mind, we are available, and reaffirm that we care. “I completely understand, and I respect your boundaries. If you change your mind, please know that I would value talking with you.” They will talk to you when they are ready. That is when the real connection or reconnection is possible.

Some of us struggle with verbal processing or something that makes talking to another person impossible for us. That’s okay. Write your elevator speech in a letter and hand it to a loved one. It doesn’t matter how we connect; it matters that we choose to do so in an authentic way.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

How to Reduce Dissociation (Feeling Disconnected in the Moment)

Last week on the blog, we talked about dissociation - this is a 50-cent word that means "disconnection" and PTSD can definitely make us feel disconnected from ourselves. This week, we are going to talk about ways to ground and reconnect.

We remember that many times when we dissociate we don't realize we are doing it, and it is brought to our attention by others who see us "in a trance" or "somewhere else." We also remember that dissociation is generally linked back to trauma, and it is our brain's way of trying to cope through avoidance. When we dissociate, we are not going "crazy." In fact, dissociation is an expected symptom of PTSD. 

Let's talk about how to cope with dissociative episodes. This means that we will be working to reduce "spacing out" and help ourselves be more mindful in general. We will focus on being in the present moment. 

Mindfulness Tools 

Controlled Breathing. My favorite tool is called "box breathing" and here is a 2-minute video to help. For this, we will breathe in, hold the breath, breathe out, and hold the breath again. The Navy Seals reportedly do this, and you can, too - here is an article to show you how.

Mindfulness Task. Every one of us probably has one task at work or home that we do mindlessly, like washing the dishes or preparing something. For this task, be intentional and notice how your body feels and take your time to pay close attention to physical sensations throughout your body. While doing this simple task mindfully...

Use Your Five Senses. Name 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell and 1 thing you taste. You can do this during your mindfulness task. This video is helpful to get started.

Journal. Try to recall your day in detail and make a point to notice any dissociations that may have occurred during the day. Then try to remember any thoughts or emotions you experienced before, during, or after the dissociative episode. Perhaps you experienced a trigger before the episode or you recognized you were dissociating while you were doing it. Learning to recognize these episodes is the first step

Remember, the goal is not to clear your mind or stop thinking, but it is to become more aware of our thoughts and feelings rather than getting lost in them. There is no such thing as a "drive through breakthrough" so be easy on yourself during this process. It's about progress, not perfection.

 

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Identifying Dissociation (Feeling Disconnected in the Moment)

 

Dissociation is a 50-cent word that means "disconnection," and PTSD can definitely make us feel disconnected from ourselves. Many times when we dissociate we don't realize we are doing it, and it is often brought to our attention by others who see us "in a trance" or "somewhere else." 

This disconnection can look different to everyone. Here's some common examples:

• An "out of body experience" as if we are watching ourselves from the outside
• Like we are on "autopilot" 
• Intense emotions that feel like they come out of "nowhere" 
• Feeling sad or anxious “for no reason"
• Inability to remember what we did for a period of time
• Feeling emotionally or physically numb
• Being told by others that we look like we go into a "trance" or "somewhere else"
• Disconnection from physical surroundings
• Feeling like the world does not feel "real" (or feeling like we are in a dream or in a movie)
• Unintentional dissociation while doing another task, like driving or working
• Not recognizing ourselves in the mirror
• Confusion

Let's talk about the why behind this "what." 

Dissociation is generally linked back to trauma. Dissociation can be triggered by external stressors (such as having an argument or losing your job) or internal stressors (such as pain or an intrusive memory). When our dissociation is connected to trauma memories or reminders, it is our brain's way of trying to cope through avoidance.  

Dissociation can become a challenge when there is no longer a real threat; this makes it uncertain when another dissociative episode may occur. And dissociative symptoms can make us feel like we are going legit batty. 

So first things first: we're not going "crazy." Unfortunately, dissociation is normal for PTSD. That doesn't mean that it feels good, "normal" simply means that it is an expected symptom of PTSD. The good news is that we can learn how to cope with dissociative episodes and recover from them over time. PTSD recovery is not instant, and it is 100% worth it.

Next week on the blog, we'll go over the "how to" when it comes to coping with dissociative episodes.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

I want you to know I’m cheering you on

 

Last week, I was inspired by the story of Katrina Kohel. This cheerleader competed in Nebraska's high school cheer competition solo after her team could not attend. It takes grit and determination to go it alone, especially when it feels everyone else has a team of people to support them. 

PTSD affects our physical bodies, our minds, and our souls, and so many of us have been struggling with our symptoms for years. It affects our ability to trust ourselves, other people, and the world and is a mentally exhausting journey. 

What makes PTSD especially hard is the Criterion C of PTSD: avoidance. We push away people we love (and who love us) the most and we isolate ourselves, such as through physical and emotional distance, drugs or alcohol, or staying buried in work. Because of this avoidance, a lot of the time we feel completely alone. 

And I want you to know that you're not alone - I want you to know that some weird internet person in deep South Texas is routing for you and straight-up cheering for you. As a clinician, I get to work with clients every single day who are on their own PTSD recovery journey, and it is an absolute privilege to act as a Sherpa of sorts, guiding folx from all walks of life and all manners of trauma toward their Everest of recovery. It's an inspiration to watch people I have grown to love recover and reclaim their lives. 

You absolutely can do this.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

"No problem can be solved from the same level of consciousness that created it"

 "Maybe it's time for you to get some help." Real talk: there is no phrase that packs more oof per square inch than that one. Even when it's well meaning, it can feel like a gut punch - because we already know we need help.   

PTSD is one of those secrets that does not keep well. Even when we don't have a name for it, we know that something is off. Maybe we're getting angry unexpectedly, drinking more, having nightmares, or feeling jumpy. We start to push our loved ones away or self-isolate because we don't want to worry anyone, but the truth is that everybody knows something is up and they are worried. But they don't talk about it. And we don't talk about it. And we all just pretend that it is not a thing. But, it is. 

So when our loved ones finally get up the gumption to suggest that it is time to get some help, it can sting. Especially when "getting some help" means seeing a therapist. 

A therapist. (Insert more oof * here *)

Yes, I know the stereotypes: lying on a couch talking endlessly about your mother, a bespectacled guru encouraging you to heal your inner child, or looking at ink blot after ink blot but all of them just look like your parents fighting. Friend, I hear you, and I know that you would rather go it alone than relive your trauma with a stranger who spent decades in college. So how can we get the help we need to no-shit reclaim our lives from PTSD without having to sift through this horseshit? I'm so glad you asked! 

First things first: there are a lot of therapists out there who haven't jumped head-first into the woo-woo vortex, and I'm here to help you find them. Not all therapists are touchy-feely or use crystals or give two shits about your mommy-issues, and these are usually certified trauma therapists.

Trauma therapists specialize in PTSD and use specific Evidence-Based Treatments (EBTs) to treat PTSD. As of this writing, there are three EBTs for PTSD that are approved by the VA: 

• Prolonged Exposure Therapy
• Cognitive Processing Therapy
• Eye-Movement Desensitization and Reprocessing Therapy (EMDR)

Because these EBTs are endorsed by the VA, they tend to be widely available in Military Treatment Facilities (MTFs), VA clinics, and with therapists in private practice – so I encourage you to ask for these EBTs by name and be insistent. There is no sense in working with a therapist who is not specifically trained in how to treat PTSD; it’s a waste of time and leads to even more frustration.  

Moreover, the data are clear: EBTs work most of the time for most people, and they do so in 10-15 sessions. No lying on the couch for years on end; you can knock this out in a couple months and get on with your life. Or we can continue to go it alone.

To quote Albert Einstein, "No problem can be solved from the same level of consciousness that created it." The fastest way to reclaim our lives is to reach out and get an objective, third-person perspective. Did I mention that it's only 10-15 sessions? This is not forever, friend; time to suck it up. 

To find a trauma specialist, we can get help from Military One Source, look up providers on our health insurer’s website, or use our company’s employee assistance program, or EAP. We can also find therapists on the internet by searching by the name of the evidence-based treatment and with our zip code (for example, “EMDR therapist Tampa 33607”). Psychology Today has a helpful database.

Once we find a therapist, we can call and request a phone consultation with them. Keep in mind that we may call and leave messages with several providers but only hear back from a few. (Therapists can be crappy this way.)

During the phone consult:

• Briefly explain why we are seeking therapy
• Ask what experience they have treating clients like us
• Ask if they are trained in Evidence-Based Treatments for PTSD

This may sound like, “I was in the military and experienced some bad stuff during a deployment to Afghanistan. What experience do you have helping Soldiers like me? What kind of treatment do you use for PTSD?” If the therapist does not have training in an Evidence-Based Treatment for PTSD, ask them if they can recommend someone who does. 

Therapists tend to specialize in specific treatment methods or specific client populations. For example, I focus on combat-related PTSD and Moral Injury; I’m pretty much a one-trick pony. I can do other things, but it’s not what I’m best at. I have amazing colleagues who specialize in eating disorders, adolescent-issues, depression, anxiety, and all manner of mental health issues, and if you come into my office with an experience that is better addressed with one of my colleagues, I will send you to them. 

Don't be afraid to ask about style, either. This may sound like, "I want to work with someone who is straight-forward and direct," or "I'd prefer to work with a Veteran." You may not get what you ask for, but therapists tend to hang out with other therapists and are connected into the community. Let us help you find the right person for you.

Another Einstein quote:  "Insanity is doing the same thing over and over again and expecting different results." Going it alone just doesn't work. Now I hope you have more tools than when you started.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD