The following is, ironically, adapted from a dialogue with Open AI Chat GPT, an AI-powered Chatbot. 

The integration of Artificial Intelligence (AI) in therapy services has the potential to improve the way mental health services are delivered and received. Here, we will explore the ways AI could impact mental health therapy services.

1. Improved Accessibility: Similar to Telehealth counseling, AI-powered virtual therapy services have the potential to make mental health care more accessible to individuals who live in remote or underserved areas, have mobility issues, or face other barriers to accessing in-person therapy. 
2. Increased Efficiency: AI-powered tools can streamline various aspects of therapy, such as intake assessments and data analysis, allowing therapists to spend more time providing personalized treatment and support to clients.
3. Personalized Treatment: AI algorithms can analyze a client’s data, such as their medical history and symptoms, to develop a personalized treatment plan. This can help therapists tailor their approach to better meet the unique needs of each individual.
4. More Consistent Care: AI-powered virtual therapists can provide 24/7 support and ensure that clients receive consistent care even when their regular therapist is unavailable.
5. Cost-Effective: AI-powered therapy services can be more cost-effective compared to traditional in-person therapy, as virtual therapy eliminates the need for physical office space and reduces overhead costs. 

While AI has the potential to greatly improve mental health therapy services, it is important to note that a machine cannot replace the rapport and empathy that human therapists provide. Certainly, the appropriateness of AI-virtual therapy would need to be based on proper ethics and specific population needs, risks, and responsivity. 

In conclusion, the integration of AI in mental health therapy services has the potential to greatly improve accessibility, efficiency, and personalized treatment. However, it is crucial that AI be used as a tool to support and enhance human-led therapy, rather than replace it. As AI continues to evolve, hopefully, we can look forward to mental health services being even more effective and accessible to people in need.

• Blue, yellow, and red. 3 colors, the primary ones that, when mixed, give birth to all other colors.
• Do, re, mi, fa, sol, la, si. 7 musical notes that, when combined, give birth to all the sounds and music that bring beauty and meaning to our existence.
• Fear, anger, joy, sadness, disgust, and surprise. The 6 basic emotions that give birth to the countless of feelings experienced by all human beings.

Simply put, from just 3 colors we get all colors; from just 7 notes, we get all the music; from just 6 emotions, we get all the different feelings. Isn’t interesting how a vast variety of things can result from the combinations of just a few elements? And how can this point us to the importance of working on our emotions?

As a therapist, sometimes with skepticism, I often get asked: “Why do you, or therapists in general, focus so much on emotions?” And I understand the question because, at first glance, it would seem like we all operate from reasonable and logical places. But do we really? How many times have you heard or thought to yourself things like: “it does not make sense, but…” or “in my head I know that, yet I feel…” I have come to think of emotions as the base, the foundations of our essence, that when paired with reason, give birth to the endless possibilities of human behavior. Allow me to use an illustration that explains better what I mean.

Where do builders begin the construction of a building? The foundations or the 20th floor? I think (and hope!) that any building gets built from the bottom up. There are similarities between the construction of a building and the development of our nervous systems. The earliest human beings did not think about complex philosophical questions or technological advancements, yet they already felt basic emotions such as fear, anger, or joy. This means that, evolutionarily speaking, it was the emotions that largely gave way to our ability to think and progressively get to where we are today. Thus, the evolution of brain structures and the construction of a building are similar. The most elementary and basic functions, our emotions, appeared in our species like the ground floor of a building. Only later we developed new brain structures that added more complex functions, or floors to the building.

Continuing with this metaphor, just like destroying the ground floor can demolish an entire building, emotional disturbances and inability to identify, connect, and respond well to our emotions can (and in my opinion will) destroy all rational efforts to achieve well-being.

So, bringing back the original question, namely why do I focus so much on emotions as a therapist? My answer is simply because it is not possible to be a healthy balanced adult without knowing how to interact healthily with our emotions. Does that mean that reason is unimportant? Absolutely not! If anything, I hope for growth, for taller buildings (using the illustration above), but without solid emotional foundations, it can all fall apart quickly, regardless of how intellectual and rational we strive to be.

How do you feel today? Do you feel calm, connected, curious, compassionate, clear, creative, confident, and courageous? How comfortable do you feel with sharing, sitting with, and talking about your emotions, such as your fears or joys? Do you know what angers you and what to do with it? How do you do intimacy? Do you act from a healthy balanced adult place or from a wounded part of yourself?

In a world where reason and logic can be the center of attention for many of us, let us remember that, as important as these are, they alone do not seem to put us in the path to well-being. Let’s continue to grow, to build ourselves up, not merely focusing on the intellectual intelligence (IQ), but the other intelligence that is at the base of how we function: our emotional intelligence (EQ). After all, look at how far we have come and how diverse we can be from just 6 basic emotions!

The hope is that we, as children, outlive our parents. That our parents live a long and rewarding life before they die. But what happens when this isn’t the case? What happens when our parents die young? What happens when we lose both of our parents and we aren’t quite ready to be the adultest adult in the room yet? This blog addresses things I wish I would have known being in the Young Adult Orphan Club along with some things that I have found to be helpful.

Both of my parents passed away in their early-mid 60s. Wham, I was suddenly very alone by the age of 40. I entered a special club that I had no idea existed nor did I want the honor of joining. My parents still had places they wanted to visit, grandchildren they wanted to watch grow up, traditions they wanted to pass on, relationships they wanted to enjoy, work that needed to be done, and quilts that needed to be created. There was a sense of being robbed, the “no fair” siren was screaming, and I was lost.

Grief. What a term, right? That thing that we all go through, multiple times in life, yet each time is unique and different in its own right. The waves carry us into a numbed daze, knock us over, and even provide a salve to our aching heart. Sometimes it was hard to breathe and in other moments, time lapsed without any sort of awareness. Each “task” that needed to be completed was painful and carried a sense of finality. It was raw and I couldn’t help wishing that I had been more prepared. Because when we know what to expect, it hurts less… right?

Here are some things that I wish I would have known…

• Holidays, birthdays, and anniversary’s = yep they suck. There is a sense of not wanting to participate or forget the day is supposed to be “special.” However, there is also a pull to ensure that family traditions and my folks legacy remains. The memories come flooding back, the pain that they aren’t here is heavy, and it’s also a time to honor what they have given me. One word comes to mind, torn. What helped me = I took a break from holidays and traditions. I started to add in somethings that felt “safe” and was able to go at my own pace. I allowed myself time to cry and take breaks from the day as needed. .
• Despising certain words and phrases. We never know what to say in times of grief, so sometimes what we think might help actually backfires. I experienced so much anger towards people who were trying to provide comfort but I felt they just didn’t get it. Hearing “with time, things will get better”, “I can’t even imagine,” “they are in your heart, keep their memory alive,” and even the Bob Marley quote that I adored “You never know how strong you are until being strong is all you have left” became massive triggers for me. I didn’t know how to respond so I isolated. What helped me = I started telling myself the things that I was needing to hear. I found phrases that worked for me. I told my support system my phrases.
• Others are grieving too, in their own way. I wasn’t prepared for being a reminder to my mom’s siblings and friends that she’s gone. People that I was hoping to find comfort with, weren’t able to give me that support. Partly because they were grieving, partly because I was grieving, and partly because it just hurts all the way around. It was easy to isolate and turn off the world. What helped me = I turned to others within this club to provide support and understanding. I tried to not take things personal. I got really good at deep breathing exercises
• Life milestones and highlights aren’t the same. The dreams of having a parent walk you down the aisle, see you walk across that graduation stage, watch your children grow up, and taking those family trips to faraway lands will not happen as we had hoped. Going to weddings, funerals, birthday parties, retirement parties, etc. can cause a windfall of emotions. Taking a trip to the restroom when the father daughter dance happens and even minimizing your accomplishments can occur. Some may see this as running away from the pain, I see it as a protective factor to help us be present when we can. It’s okay to not be okay. What helped me = I talked to my parents and envisioned them watching my accomplishments. I purchased gifts for myself in their memory. I sent cards for events when I wasn’t ready to attend yet. I told my support system and they walked beside me.
• “I wish I would have taken the time” moments will happen on a regular basis. Wishing to have conversations that we can’t have now, gain a better understanding of family history, learn how to quilt/wood work, master the family recipes, learn the adulting tricks, and take those trips we always said we would. The missed opportunities can be haunting and yet there are times I’m able to channel my folks and fix the garbage disposal or remind myself “the trick to cooking is to just let it sit.” What helped me = Every time I found myself in the ‘I wish’ loop, I would remind myself of something I had learned/experienced. Sometimes I even completed the task for added measure. I started paying more attention when family members would reminisce. I asked people to tell me about my folks as a kid. I made family dishes and started to experiment with making them my own.

There are so many more bullet points I could add to this topic and in all honestly, even in this club, we all grieve differently. I’m a firm believer that our grief doesn’t shrink over time, it’s more about how we grow around our grief. Yes, some days are much easier than others. Yes, I am thankful for the time and memories I have with my parents. Yes, my love for them has not changed. AND yes, it still hurts. Anne Lamott wrote it best, “It’s like having a broken leg that never heals perfectly that still hurts when it’s cold, but you learn to dance with a limp.”

I have worked at a children’s hospital in their inpatient psychiatric unit for over four years now. To this day, one of the most visceral images I have from my time there is of spaghetti with spoons.

I mean it makes no sense. You give a kid that has a very small window of tolerance a plate of noodles and two spoons. The thought of navigating that as an adult makes me angry. And yet, somehow, they all find a way to manage.

Some will painstakingly cut the noodles up until they have a makeshift soup to spoon from their plates. Others use a two-spoon approach, similar to chopsticks. And then of course there are the ones that use their hands—dangling the long noodles high in the air and catching them like a fish would take bait. It’s incredible, really, to watch them make do. Against all odds, they manage to find a way to fuel their bodies and fill their stomachs. To survive.

I think many of us have been given a plate of spaghetti with two spoons. And like the kids I work with, we’ve found ways to get by.

We find ways to cope. We avoid things that make us feel uncomfortable and small. We become dependent on our loved ones or shut them out completely. To be fair, these strategies often work. They may even work for years or decades.

The thing is, it’s very easy to get stuck using these strategies. Why change it if it works? Why try something new and risk failure?

How could someone suggest that we’re eating the spaghetti wrong?

Therapy is a lot like trying to eat spaghetti with a fork for the first time. It’s new. It’s unfamiliar. It challenges so many of the things that we have known to be true.

Learning to use the fork—or beginning a therapeutic relationship—takes courage. It takes humility. It is by no means an easy thing to do. However, learning a better way to navigate our lives is a worthwhile endeavor. There may be giant plate of spaghetti in front of you, but you don’t have to suffer through it.
In fact, the best way to eat spaghetti is by taking a spoon and a fork, together, and using them in tandem.

I wish someone had told me…

1. No matter how prepared you think you are for a death, you can never be fully prepared for the loss and the grief.

2. You can plan for death, but death does not always comply with our wishes or plans.

3. “Stop avoiding and be present.”

4. “Dying is not like you see on TV or in the movies. It is not peaceful or prepared. You may not have a spiritual or meaningful moment. It’s too real.”

5. A hospital death is not always a bad death.

6. A home death/hospice death is not always a good death.

7. “There will be pressure from others to move on, even minutes or hours after a death, and this can lead to regrets”.

8. “Death is not an emergency. There is always time to step back and take a moment to say goodbye.”

9. Death and grief make people uncomfortable, so be prepared for awkward encounters.

10. You will plan the funeral while in a haze. If you aren’t happy with the funeral you had, have another memorial service later.

11. When people offer support, take them up on it.

12. People will bring you food because they don’t know what else to do. Don’t feel bad throwing it away.

13. People will say stupid, hurtful things without even realizing it.

14. People will tell you things that aren’t true about your grief.

15. Death brings out the best and the worst in families, so be prepared.

16. There is no such thing as closure.

17. There is no timeline for grieving.  You can’t rush it.  You will grieve, in some form, forever.

18. “There will always be regrets.  No matter how much time you had, you’ll always want more”.

19. Guilt is a normal part of grief.

20. Anger is normal part of grief.

21. “The pain of a loss is a reflection of love, but you never regret loving as hard as you can.”

22. Grief can make you question your faith.

23. “Grief doesn’t come in five neat stages. It’s messy and confusing.”

24. Grief makes you feel like you are going crazy.

25. Grief can make you question your life, your purpose, and your goals. And that isn’t always a bad thing.

26. We all grieve differently, which can create strain and confusion between family members and friends.

 27. “However badly you think it is going to hurt, it’s going to be a million times worse”.

 28. You may find comfort in very unexpected places.

29. “You should go somewhere to debrief after caregiving”.

 30. “The last 24 hours of their lives will replay in your mind”.

31. Trying to protect children from death and the emotions of grief isn’t helpful.

32. “It’s sometimes necessary to seek out new ways to grieve on your own, find new guidance if the people who are supposed to be supportive simply haven’t learned how.”

33. “You grieve your past, present, and future with that person”.

34. Big life events and milestones will forever be bittersweet.

35. Grief triggers are everywhere. You will see things that remind you of your loved one all over the place, and it may lead to sudden outbursts of emotion.

36. “You lose yourself, your identity, meaning, purpose, values, your trust”.

37. Holidays, anniversaries, and birthdays will be hard forever.

38. People will tell you what you should and shouldn’t feel, and how you should and shouldn’t grieve.  Ignore them.

39. “The grief process is about not only mourning the loss, but getting to know yourself as a different person.”

40. There is no normal when it comes to grieving.

41. Sometimes it gets worse before it gets better.

42. “It’s normal to feel numb after it happens. The tears will come. They come in waves.”

43. Grief can make you feel selfish and entitled, and that’s okay (at least for a while).

44. Meeting new people, who never knew the person who died, can be hard and sad. But eventually it can be nice to “introduce” them through stories and photographs.

45. The practice of sending thank you notes after a funeral is a cruel and unusual tradition.

46.“People love to judge how you are doing. Watch out for those people.”

47. You can’t compare grief or compare losses, though people will try.

48. Any loss you grieve is a valid loss, though people will sometimes make you feel otherwise.

49. “Just because you feel pretty good one day it doesn’t mean you are cured of your grief.”

50. There are many days when you will feel totally and completely alone, whether you are or not.

51. Grief can make you do stupid, crazy things. They may be what you need at the time time, but you may regret them later. Cut yourself some slack.

52. Grief can make you a stronger person than you were before.

53. Seeking grief counseling doesn’t mean you’re crazy or weak.

54. It’s okay to cry sometimes.

55. It’s okay NOT to cry sometimes.

56. “Time does NOT heal all wounds.”

57. “Grief re-writes your address book.” Sometimes the people you thought would be there for you aren’t, and the people you last expected become your biggest supporters.

58. “You don’t get over it, you just get used to it.”

59. It is okay to tell people when they are not being helpful.

60. Watch your drinking. Alcohol can quickly become an unhealthy friend.

61. You will have to face your emotions eventually. You can avoid them for a while, but they will catch up with you in the end.

62. Talking isn’t the only way to express and process emotions.

63. You will never go back to being your “old self.” Grief changes you and you are never the same.

64. Nothing you do in the future will change your love for the person who died.  Eventually, you will begin to enjoy life again, date again, have another child, seek new experiences, or whatever. None of these things will diminish your love for the person you lost.

In our PCS Intensive process, I’ve yet to work with someone suffering from an addiction who has not experienced some essence of trauma, whether that be overt, obvious traumatic experiences, or the other, the covert, one-thousand-paper-cut-style traumas. And so to unlock the door to full-course healing we, as therapists, have to help them identify and process these events, in order to understand why they adopted this maladaptive, addictive coping style in the first place. We also have to help them grieve these traumas and develop empathy for themselves and the person or child they were when these difficult events occurred. We help them understand that they can really only give empathy and intimacy to others to the degree they can give it to themselves. So often, we will ask the Adult today to imagine being there for the Child then, and fulfilling what that Child needed and did not get. There is nothing more gratifying than seeing that Adult finally grieve what was denied them, and grow as the Adult showing up as the “parent” today for that Child, in the here-and-now. Clients will often say they feel as if they have lifted a heavy weight they have carried most of life.

Then what often happens is the Client shares their trauma processing with their significant other, partner or spouse. And when the Client informs this loved one of the trauma and neglect that is most certainly behind the addictive behavior the loved one has been subjected to, often for years, and, understandably, their significant other is less than happy. It is as if we, the therapists, are hand-holding this Client and giving them a pass for their hurtful behaviors (whether that involves sexual betrayals, alcohol of drug-related incidents, gambling precious finances, etc.). They want to tell the Client to take their trauma egg and “you’ve got to be kidding me”, Build-a-Bears, and shove them…somewhere! The Client might explain that the Build-a-Bear is to remind them to show up as the “parent” today for that Child that was harmed back-then, and, again understandably, the loved one has heard enough. They respond, “It sounds like they’re helping you find your grand EXCUSE for all the harm you’ve caused!”

Makes sense. And so, clarity is necessary, as the one who has endured someone’s hurtful, addictive behavior deserves empathy and beyond. So, one thousand percent, trauma is NOT an excuse; it’s an explanation.

A Client needs to understand what happened in order to realize that back then, they most certainly had zero power and control over their life circumstances. Now they can face the explanation and grieve and process it. From there, they are encouraged to understand that today, as an Adult, they fully have power and choice, and therefore, are fully responsible for ALL of the decisions they make. They are also responsible for any harm they cause. Their childhood trauma, though at times awful and heartbreaking, is NOT an EXCUSE.

At times I have seen Clients attempt to use their traumatic childhood experiences as a “trauma shield,” in order to dodge what they perceive as shame-inducing blame and finger-pointing. It is a maladaptive way of avoiding the hurt and pain of the one they have harmed, and they cling to it like a life-line. It is at this juncture that I and their team of therapists try and help them understand that unconditional love and acceptance is the pathway to true internal freedom, and to get there and be free of shame, one has to embrace all that is wonderful about them, and all that is challenging about them as well.

When a Client can speak openly about what makes them hard to live with, shame ceases to have an leverage over that individual, and only then are they truly on the path to strength and recovery. No longer allowing the explanation to control them or their choices, and no longer needing an excuse to manage their shame and avoid responsibility.

As an EMDR and experiential therapist, the most satisfying part of my work is seeing someone genuinely experience self-love and watching them gain insight as they process traumatic events in their lives. It is beyond satisfying to hear them name their challenges and talk about how those behaviors no longer serve them. Many people shed tears and believe they look “terrible” after EMDR; however, I will ask them to look in the mirror and what they see is the opposite – they see a person free of the weight that has held them back; a person who has never looked better!

Hayes & Roadin – 2003 developed four factors as a measure to understand the aging process.  They are:

• Chronological Age – The number of years that have elapsed since birth. Time may be considered as a simple number of many events and experiences.
• Biological Age – A person’s age in terms of biological health. The younger a person’s biological health, the longer a person is expected to live regardless of chronological age.
• Psychological Age – An individual’s adaptive capacities compared with those of other individuals of the same chronological Age. Thus, older adults who continue to learn are more flexible, motivated, in control of their emotions and are able to think clearly.  They are able to utilize more adaptive behaviors than their chronological age.
• Social Age – The social roles and expectations related to a person’s age.  Older adults who continue with their social interactions and activities age longer than their chronological age.

The following information is provided by The World Health Organization (WHO) concerning ageism. 

The term “ageism” was coined by Robert Neil Butler in 1969. The definition of ageism refers to the stereotypes (how we think), prejudice (how we feel) and discrimination (how we act) towards others based on age.

There are three levels of ageism:

• Micro level – Individual
• Meso level – Social networks
• Macro level ­– Institutional and cultural

Data from the 2020 National Poll on Healthy Aging found that 82% of older Americans reported experiencing ageism regularly, 65% experienced ageist messages from the media, 45% experienced interpersonal intentional ageism and 46% had internalized ageism.

Workplace Examples of Ageism

• Using a person’s age to decide whether to hire or not
• Asking a person’s age not related to the type of work
• Company policies that negatively reflect a person’s age
• Rejecting a person by age because they are seen as out of touch, less skilled or fixed in their ways
• Taking advantage of a person by bullying, critizing or harassing because of their age

Personal Examples of Ageism

• Elder abuse, whether physical, emotional, sexual or financial
• Making jokes demeaning a person’s abilities or appearance
• Taking away a person’s independence because of their age
• Withholding medical and mental treatment due to the person’s age
• Forcing a person to undergo unnecessary procedures

Ageism has far reaching consequences and effects all age groups worldwide.  As a person ages, their physical and mental health declines requiring greater care.  With the need for greater care the cost of this care increases.  WHO reported that the United States spends billions of dollars each year to treat the elderly’s medical and mental health condition.

Ageism is associated with an earlier death; estimated to be 7.5 years on average.  They are seen as less capable and worthy of care.

How to Combat Ageism

Education – Provide a better understanding of the process and how to manage this process.

Intergenerational Intervention – Develop and encourage more cooperation, compassion and empathy between the age groups.

• Change the law and practices to reduce inequality and discrimination.
• On an individual level, become knowledgeable about the aging process
• Enable a person to become more aware of their feelings, manner of thinking and decision making
• Be able to call on life experiences to engage the aging person
• Help the aging person develop allies so they can be heard, recognized, respected and appreciated for their views, knowledge and life experiences

What Are the Positive Views of Aging?

• 88% feel more comfortable being themselves
• 80% have a strong sense of purpose
• 67% feel more positive about aging
• 65% think their life is better than they thought it would be
• (taken from Institute for Healthcare Policy and Intervention, University of Michigan)

The aging process involves many factors including heredity/genetics, cultural, nutritional, level of exercise, level of education, early child development process, plus many more.  It is a complex process which requires a good deal of patience, diligence, foresight, planning and fortitude.

I would like to conclude with a brief vignette.  My mother-in-law, who was a mother to me was diagnosed with lymphoma at age 88.  She received treatment for it successfully! She was a sage with a willingness to share her wisdom and life experiences.  I am sure that if I asked her about ageism she would respond with a twinkle in her eyes and a smile on her face.  “Those people should be forgiven for they known not what they are thinking or saying.”  She lived another 15 years and passed peacefully at 103 years old.  Her beacon of light continues to shine brightly to this day.