Shay Porter - Therapist

07/05/2022

What is confidentiality?

We hear the concept of confidentiality thrown around a lot. We know that doctor’s offices can’t go around sharing our private information. We know that if you we sign a NDA, a non-disclosure agreement, we should keep information covered by that agreement confidential.

The idea of confidentiality is present in most aspects of our lives in some way or another. But what does it mean for therapy?

You can probably guess it operates similarly for therapists as it does for doctors and you’d be right. Therapist cannot share your personal info outside of four specific situations, which are fairly common among jurisdictions: 1) you report wanting to kill yourself; 2) you report wanting to kill someone else; 3) you repost knowledge of child abuse; or 4) dependent elder abuse.

All of that makes a lot of sense, I’m sure. But it sometimes works out in different ways.

What if I’m just venting? I don’t really want to kill someone else, it was a figure of speech.

What if someone lies and says they were abused by me?

In cases such as these, therapists are bound by mandated reporting laws. If I think that my client is seriously considering killing themselves, it is my duty to ascertain if they have a plan, means and intent to do so. If I feel that there is a serious risk, I call the cops.

If abuse is reported to me I report it to CPS. It is there job to investigate not mine.

See ya!!

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07/04/2022

Hiya! Last post, I promise! I will be starting a substance use/chemical dependency groups for adolescents (12+). The group will run weekly for $25/week and membership will be capped at 8 members. We will discuss relapse planning, triggers, cravings and have time to process experiences that led clients to use or keep them using. I need four more members to begin. If you are interested email me at shay@shericobarruviaslpc.com or call/text at (830)251-2834.

07/04/2022

Hello! I am starting a trauma/grief processing group for adolescents (12+). The group will run weekly for $25/week and membership will be capped at 8 members. We will of course process experiences and I will incorporate psychoeducation and coping skills to help group members cope with the effects of their trauma and grief. I need two more members to begin! If you are interested email me at shay@shericobarruviaslpc.com or call/text at (830)251-2834.

07/04/2022

Hey guys! I am starting a neurodivergent skills group for adolescents (12+) with ASD, ADHD, sensory processing disorder, dyslexia and dyspraxia. The group will run weekly for $25/week and membership will be capped at 8 members. We will cover topics such as social skills, emotion regulation, dealing with sensory triggers, meltdowns and how to work with our brains in a world not designed for us. I need three more members to start. If you are interested email me at shay@shericobarruviaslpc.com or call/text at (830)251-2834.

07/02/2022

Let me riddle you this: is self-care a concept that only pertains to the health and care of the body?

If you’ve read any of my other self-care posts you can probably guess my answer.

No! Of course, not!

Of self-care only pertains to the body then why isn’t it called body-care or something similar. It pertains, instead, to the self.

What’s the ‘self’?

The self is you. Plain and simple. Self-care is taking care of you. This certainly, and importantly, includes taking care of what makes you, you. This means being the most genuine version of you possible. This means surrounding yourself with people who accept and love you for you. This means trying longer nails or a brave new style if you’ve always wanted to, getting into an intimidating new sport if you’ve always been curious, moving to a new place, painting your house black and moving your bedroom to the basement.

Whatever feels genuine, as long as it is not harmful or illegal, do that thing.

Take care of yourself.

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06/30/2022

Eye Movement Desensitization and Reprocessing is a trauma therapy aimed at helping clients “reprocess” traumatic memory. It is based on the theory, backed by research, that our brains act a bit like supercomputers.

(Or I guess supercomputers act a bit like brains since, you know… whatever)

What I mean by this is that our brains are organized into ‘channels’ or ‘pathways’ of information. This is why sometimes one factoid brings up another, seemingly unrelated memory, like vanilla reminding you of your grandma or My Chemical Romance reminding me of Harry Potter.

When we experience a traumatic event, AIP theory (Adaptive informative processing), the theory in which EMDR is based, postulates that those memories get “stuck” in our emotional memory. This is why we get “triggered” and often experience overwhelming emotions in response to seemingly minor events.

EMDR helps client reprocess those memories with their logical, left brain so they can build resilience to the distressing parts of the memory and shift the sometimes flawed or irrational beliefs the originally received from the trauma.

06/28/2022

What should I expect at my first therapy session?

Well firstly, it’s probably going to be a bit awakened. I write about first session jitters in an earlier post but the reality is that therapists aren’t alway extroverts. People people maybe… but not always social butterflies. So expect awkwardness.

Second: paperwork. One of the benefits of COVID necessitating teletherapy is the streamlining effect it has had on first session paperwork. This doesn’t mean less paperwork necessarily… unfortunately, just hopefully that it’s easier to do the paperwork. Regardless of whether you are in-person or virtual, you will have to do some paperwork.

Third, the dreaded question: what do you want to work on?

Now you don’t have to have a specific answer for this week question, but just shrugging and “idk, what do you think I should work on?” (Yes I’ve received that answer) is not enough. Give it some thought. If you could change anything, what would it be? What bothers you most in your daily life and what would improve your daily life the most?

06/28/2022

Hello! I will be starting three adolescent groups in the coming months! A neurodivergence skills group, a trauma and grief processing group and a substance use group. I will be serving adolescents in TX 12-17 years of age. We will be meeting weekly and each group will be $25/week. If you’re interested please contact me at shay@shericobarruviaslpc.com

06/26/2022

So this is a bit late but I have a pretty chill Saturday and blogging completely slipped my mind.

That being said, I want to write about something that’s been on my mind lately: finding the place where you make sense.

I am from South Texas, San Antonio more specifically. Despite the fact that I love SA, that I love the people, the culture, the food, I don’t really make sense here. I am very introverted, I am very private and honestly- a bit of self-disclosure here -I am pretty liberal. I won’t elaborate any more than to say that I am not normally politically aligned with the traditional politics of Texas.

I make sense in London. That is the context where I am most comfortable, more aligned with the morals and politics (generally speaking), and honestly more at peace. I lived in London for two years and, quite frankly, learned to love myself, learned to take pride in who I am, and started to present myself in the way that feels the most authentic to my true self.

Find that for yourself. Find a place where you feel safe and authentic. For a lot of people, that may be your hometown or your home state. That’s great! You are so fortunate.

For so many of us, it isn’t and it won’t be. Don’t be afraid to explore, to branch out until you find it. You won’t regret it.

Take care of yourself.

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06/23/2022

Feeling stuck is a fairly normal thing. Sometimes we feel stuck when we look around and don’t feel as though we have options. Sometimes we feel stuck because, even if we have options, we don’t have the strength or motivation to make change.

Sometimes we are stuck because our experiences have convinced us that we, other people and the world more broadly are incapable of change.

This is what is called a stuck point in cognitive processing therapy. When someone has experienced trauma, they often adopt beliefs about themselves, the world around them that are concrete, irrational or feel immutable or unchangeable.

These can range from “I am unable to change” or “the world is fundamentally unsafe.” These thoughts and beliefs can lead to fear, depression, anxiety, anger and anything in between which can be debilitating and paralyzing.

Next week we will discuss how to deal with stuck points.

What beliefs are you treating as gospel that are little more than a sticky note?

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06/21/2022

A lot of therapists, myself included, offer purely telehealth therapy. This is a reality of the world post-COVID and I don’t foresee it changing anytime soon.

That being said, here are dos and don’ts of telehealth.

Do pick the same spot in your house to do therapy. This helps your therapist assess for safety.

Don’t pick your bedroom. This goes to sleep hygiene. Try to keep your bedroom to just sleep when possible.

Eat before therapy. Not only will this help with emotional regulation and mood, the less distractions the better and telehealth from home is already rife with distractions.

Don’t do therapy in a public, loud or unsafe environment. Get comfortable and safe. You’re more likely to share in that environment.

Do keep comforting smells or items around especially if you are doing trauma work. If you become upset, triggered or angry, these can aid you in emotionally regulating.

Don’t use substances before or during your session. You shouldn’t do this before any kind of session but if you struggle with substance use, telehealth presents a unique temptation. Just remember you have to feel to heal and substances numb you.

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06/18/2022

Sleep hygiene… I feel like this topic is a boogeyman on level with sermons on tithing in Southern Baptist churches.

Sleep hygiene… oooohh~

You should be sleeping better…. Aaaahhh~

While this is certainly true and research certainly bears out that better sleep leads to better mental health, sometimes mental health practitioners get a bit ahead of themselves… or maybe we get in the way of ourselves.

What I mean by this is: if we can’t address sleep without skyrocketing the anxiety of already stressed out clients or plummeting depressed clients into further, deeper depression, are we really being effective therapists? Or even being honest with ourselves?

I certainly struggle with sleep hygiene. I sleep with a TV on and use my phone up and until I fall asleep. I doubt I get a solid 8 hours of sleep and am a very light sleeper.

Regardless, feeling anxious about the amount of sleep I’m getting isn’t going to help me sleep better. It’ll likely do the opposite and ruin the quality of the sleep I am getting.

My suggestion is this: try to set yourself up for success. If you notice a specific thing is ruining your sleep quality, find a way to remove that impediment. Find easy, simple ways to improve your sleep and try not to stress about doing it perfectly.

Take what you need and leave the rest.

Take care of yourself.

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06/16/2022

You’ve probably all heard of a Freudian slip, that comment or thought that slips out before you’ve even really thought about it. The reality is, as embarrassing as those thoughts are, you usually don’t have a lot of control over them. In light of this, it’s usually just best to accept them as is and find a way to laugh about them.

The same cannot be said for automatic thoughts, those knee jerk reactions you have to normal events of daily life. These differ from Freudian slips because Freudian slips are intrusive and not usually indicative of how you really think or feel. They pop in your head or out of your mouth with very little thought on your part.

On the other hand, automatic thoughts are usually your purest reaction to a situation before you have time to rationalize or moralize.

While automatic thoughts are thoughts you may not necessarily have control over but you can learn to control your emotional reaction to them. You can learn to expect them and prepare for your reaction. You can learn to analyze and challenge them, decide what might make that thought valid and what disproves it.

The creators of CBT explain the interaction between automatic thoughts and mood with the acronym: ABC. ‘A’ is for
Activating Event, the situation, the thing that happened. ‘B’ is for Belief or thought, the cognitive reaction to an event. ‘C’ is for consequence, which can be the emotional or behavioral reaction to an event. A+B=C

By learning to accept A and analyze and challenge B, you can make C more healthy and helpful. By harnessing your thoughts, you can learn to respond instead of react.

See ya later!

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06/14/2022

The first of anything- first game, first class, first child- is oftentimes alternatively excited and terrifying. We often describe this feeling as “butterflies in my stomach,” “fluttering,” but it can also be “nauseous,” and “jittery.”

This is often true of your first counseling session. You feel excited, perhaps, to start working on issues and problems that have bothered you for years. You may be looking forward to doing something for yourself “for a change.” Maybe you have a close friend or family member who’s experienced benefit from therapy and you’re eager to try it yourself.

At the same time, you may be absolutely petrified to engage in true vulnerability with someone who probably don’t know all that well yet. Maybe you feel like you have skeletons in your closet and you are terrified of the counselor’s response when you open said closet. Maybe you have social anxiety and any social interaction is a scary interaction.

The good news is this: you’re likely not the only one experiencing that flutter in you stomach. No matter how long most clinicians practice, your therapist is also probably nervous.

I don’t say this to make you feel responsible for a therapist possible emotional response but to remind you that you are human and sometimes humans feel the same stuff. It’s called universality and it’s the reason therapy works for a lot of people.

You are not alone. We (us therapists) are right there with ya.

TTYL, friends!

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06/11/2022

When we usually talk about self-care, we wax poetic about spa days and pedicures and fishing on tranquil rivers. We speak about activities that are enjoyable, activities we want to do. We talk about relaxation or luxury. This is valid and my soul feels rested just imagining it but self-care isn’t always wanted or restful even if it is always needed.

There are a number of reasons why someone may not want to take part in self-care.

Someone paralyzed by deep depression, for instance, may not have the motivation to take care of activities of daily life (ADLs) such as showering and hygiene, much less a spa day.

Someone who’s experiencing the heights of anxiety may not believe they have the time, or much less, deserve the time spent hiking in a national park or wandering through a botanical garden.

Someone who is agoraphobic or whose experiences have taught them that large groups of people are dangerous may not feel able to venture out at a park or concert.

Despite all of that being true, these hypothetical people still need self-care and sometimes need it desperately. Self-care is often not hedonistic or luxurious, it is often a necessity, an imperative for survival.

So start small. Start with those ADLs. Carve out a small chunk of time to walk around the block. Visit a quiet park or a museum or a gig night at a small coffee.

Start as small as you need to, but start all the same.

Take care of yourself.

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06/09/2022

It is what it is.

We (or maybe just I) say this phrase all the time. Usually, if I’m being honest I say this the most when something is happening that I don’t like but I have- or perceived that I have- no control over.

Oh… the weather. It is what it is.

Oh… this person ghosted me. It is what it is.

Oh… my HEB is out of my favorite snack. It is what it is.

While this phrase is actually therapeutically relevant and helpful, I often find that I fall into the pattern of using it to justify inaction.

It is what it is… what can I do? Might as well do nothing.

But that is not a faithful use of this therapeutic tool. Rather, we should use it to accept that which we cannot change but what still evokes a strong emotional reaction. It is the reaction, our reaction, that requires our action.

Oh… the weather. It is what it is, but I won’t let it ruin my day.

Oh… HEB doesn’t have my snack. It is what it is, but if I’m this disappointed about a snack maybe I should drive to another HEB.

Be mindful of your reaction to a distressing event, whether that event is an injustice or an inconvenience. It will tell you a lot about your mental and emotional health. What you can change for the better, change that. What you can’t, learn to accept.

See ya!

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06/07/2022

On this blog, Tuesdays will be dedicated to practical discussions of therapy. What, when, where, how and who.

This first Therapy Tuesday is about that last question word: Who?

How do you know who is the best therapist for you? What are qualities to look for? What should you expect?

You know that old dating adage: “a key for every lock”? That is maybe less true of the dating world than it is for therapists. There are loads of therapists and the choice may be overwhelming.

It didn’t always use to be this way, however. At one point in the history of the western psychological professions, therapists were fairly homogeneous. Largely speaking, they were white and male.

Nowadays, the psychological professions, especially therapists, are more diverse then they’ve ever been and are becoming ever more diverse. This is wonderful but potentially daunting.

So, decide what’s most important to you. Is it important that they look like you, i.e. from a similar cultural background or think like you, e.g. a similar religious or ideological background?

Are you willing to pay out of pocket or do you want to use insurance benefits? Is there a specific type of therapy you want them to be trained, or well-versed, in?

Whatever is most important, start there. Make a list of your ‘must-haves’ and a list of things you are willing to compromise on.

TTYL, friends!

06/04/2022

I am an introvert. A consummate introvert. Probably the most introverted person in my family of extroverts and ambiverts. I am also a homebody. I am that COVID meme. At first, the thought of being able to- nay- encouraged to stay home and avoid people was euphoric in effect.

Regardless, I have realized that, as introverted as I am, as content and rejuvenated by solitude as I am, I too need social self-care. The most extroverted person alive also needs some amount of solitary self-care. That’s just the reality of being a person on this green earth. You need a bit of both.

For me, when I am healthy and not attempting to burn the candle at both ends, my job, interacting with clients and coworkers, is a form of social self-care.

Social media can be a form of social self-care when approached with balance, moderation and knowledge of how SM effects you personally. Join a club, a quiz night at a bar or pub, if you’re my dad: a motorcycle club. Find people who you feel safe enough to be yourself with, find people that you can share yourself with.

Solitary self-care is even more variable. Go watch a movie at the theatre by yourself, go for a hike, take up a hobby. Find a place, an activity, a thing to do that doesn’t require anyone else to be fun and fulfilling.

For some people the thought of being alone is terrifying, for others the thought of people, even people they already know, is equally terrifying. Given the broad range of human experience, this is to be expected and shouldn’t be a thing to be ashamed of.

People aren’t one-dimensional, we are multi-faceted and complex. It’s one of the reasons I love my job. We need to be able to feel safe and fulfilled in as many aspects of our life as possible. This may necessitate stepping out and trying something new. Deb Dana describes this process as leaning into “stretching” experiences in her book ‘Anchored.’ Stretching leads to growth and healing.

The point is: find yourself ways to care for you, a list of ways. Ways that both involve other people with whom you feel safe and ways to be by yourself and still feel safe.

Take care of yourself.